Abstract
OBJECTIVE: To determine the percentage of women aged 40 to 70 years who had had at least one preventive Pap test (cytological examination) during the preceding 5 years, and the factors associated with use of the test. DESIGN: Population survey.Setting. Home interviews during October 2000. PARTICIPANTS: 2409 women aged 40 to 70 years residing in Spain. The nonresponse rate was 20.3%. MAIN MEASURES: The dependent variable was use of the Pap test, and independent factors examined were sociodemographic, social and health-related factors, information and attitude. Use of Pap tests was estimated with a 95% confidence interval (CI), and univariate and multivariate analysis were used to identify factors related with use of the test. RESULTS: Almost half (49.6%; 95% CI, 47.6%-51.6%) of the women had had a Pap test. The factors associated most strongly with use of the test were intention to have the test done (odds ratio [OR], 4.76; 95% CI, 3.40-6.65), not having the test done because of fear of the diagnosis (OR, 3.22; 95% CI, 1.77-5.85), earlier testing (OR, 2.59; 95% CI, 2.06-3.27), and doctor's advice (OR, 2.44; 95% CI, 1.93-3.09). Other associated factors were considering the text necessary, upper or middle-upper socioeconomic status, access to private or combined private-public health care, age 40 to 50 years, and residing in a city with a population greater than 100000. CONCLUSIONS: Half of all Spanish women aged 40 to 70 years had had a Pap test. Use of the test was related most clearly with the woman's attitude toward the test. Health care professionals should be aware of the importance of their role in encouraging Pap tests for screening.