ABSTRACT
The study reported here sought to assess Pap test coverage of a group of asymptomatic Argentine women from the poor urban district of La Matanza in the Buenos Aires metropolitan area Initially, all 2495 women who voluntarily enrolled in a program for early detection of breast cancer between January 1991 and June 1993 were included. After removing those who did not meet various study criteria, there remained 779 study subjects with no gynecologic or mammary symptomatology. Two subgroups of these 779 were established-women who had received a Pap test at any time and those who had received such a test within the previous three years. Using these subgroups, the influence of certain sociodemographic and other variables upon the likelihood of Pap testing was assessed. The results indicated significant associations between past Pap testing and age, formal education, parity, and a family history of cancer Likewise, significant associations were found between Pap testing within the preceding three years and age, formal education, and parity. The study findings affirm the idea that it would be advisable to seek Pap testing for all study population women once every three years instead of every year. Since the study population was not necessarily representative of Buenos Aires population, however, and the findings could have been affected by self-selection and other biases, additional studies are needed to determine actual Pap test coverage among women of the metropolitan area.
PIP: The incidence of Pap test coverage was assessed in 779 asymptomatic women from a low-income district (La Matanza) of Buenos Aires, Argentina, who had enrolled voluntarily in a breast cancer screening program. Overall, 66% of respondents were 30-49 years old, 71% had no secondary education, and 67% lacked social security coverage. A total of 262 women (33.6%) had undergone Pap testing during the year preceding the survey, 279 (35.8%) had received such testing during the preceding 2 years, and 135 (17.4%) had had the test 3 or more years earlier, the remaining 103 (13.2%) had never been tested. Univariate analysis indicated that age, education, parity, and a family history of cancer other than breast cancer were significantly associated with having had a Pap test. Pap testing in the preceding 3 years was significantly associated with age, education, and parity. In the multivariate analysis, age, education, parity, and family history of cancer retained significance for testing at any time. Although the likelihood of testing increased with age, women in the oldest age group (50-69 years) were less likely to have been tested within the past 3 years than women 30-49 years. Parous women were 3-4 times more likely to have been tested than nulliparous women. These findings provide support for the recommendation that Pap testing should be scheduled every 3 years rather than every year to maximize coverage and make effective use of the health system's limited resources. The relatively high coverage rate identified in this study may not be representative of the Buenos Aires population, however, given the possibility of a self-selection bias of women concerned enough with their health to enroll in a cancer prevention program.