Women’s Participation in Pap Smear Screening in a Developing Country: Evidence for Improving Health Systems
IntroductionEvery year about 83,000 women are diagnosed with cervical cancer in the Americas. Latin America and the Caribbean (LAC) has one of the highest incidence and mortality rates from cervical cancer in the world. Although incidence has decreased by half in the last 30 years, cervical cancer r...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-06-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.642841/full |
| _version_ | 1818872397122502656 |
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| author | Carolina Santamaría-Ulloa Ileana Quirós-Rojas Melina Montero-López Hazel Quesada-Leitón |
| author_facet | Carolina Santamaría-Ulloa Ileana Quirós-Rojas Melina Montero-López Hazel Quesada-Leitón |
| author_sort | Carolina Santamaría-Ulloa |
| collection | DOAJ |
| description | IntroductionEvery year about 83,000 women are diagnosed with cervical cancer in the Americas. Latin America and the Caribbean (LAC) has one of the highest incidence and mortality rates from cervical cancer in the world. Although incidence has decreased by half in the last 30 years, cervical cancer remains a public health concern. The detection of precursor lesions through Papanicolaou (Pap) smear remains a critical tool in the context of prevention in Costa Rica and many other LAC countries.ObjectiveTo determine predictors of participation in Pap smear screening among Costa Rican women, with a special focus on women who have never had a Pap smear or have had a smear 5 or more years ago.MethodsThe data source for this study is the Costa Rican Households National Survey conducted in 2014. This survey is representative at the national, urban/rural zone, and administrative region level. A subsample of women aged 20 to 69 years who responded to the survey’s Papanicolaou Module were included in this study (n = 11,709). Statistical analyses were conducted in R-Studio. Statistical significance level was set at 5%. Two multinomial regression models were estimated. The first model aimed to explain the five different categories of cytology use, which were defined according to the last time women had a Pap smear. The second model aimed to explain the five different categories of reasons why women had never had a Pap smear. Both models controlled for age, educational attainment, and marital status.ResultsYoung women with high educational attainment were more likely to have never had a cytology. Women with a lower educational attainment, married, or in domestic relationship and of older age had greater odds of having had a cytology 5 or more years ago. Each year increment in age was significantly associated with an increase in the odds of never having a Pap smear because of health care access issues or because of cultural reasons as compared to not having an active sexual life.ConclusionsFindings can inform public policy targeted to higher risk female populations where access to health services can be improved. |
| first_indexed | 2024-12-19T12:38:09Z |
| format | Article |
| id | doaj.art-69f4f905577c44868d8b2e5caa682a06 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-19T12:38:09Z |
| publishDate | 2021-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-69f4f905577c44868d8b2e5caa682a062022-12-21T20:21:04ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-06-011110.3389/fonc.2021.642841642841Women’s Participation in Pap Smear Screening in a Developing Country: Evidence for Improving Health SystemsCarolina Santamaría-Ulloa0Ileana Quirós-Rojas1Melina Montero-López2Hazel Quesada-Leitón3Instituto de Investigaciones en Salud, Universidad de Costa Rica, San Jose, Costa RicaCoordinacion Tecnica del Cancer, Caja Costarricense del Seguro Social, San Jose, Costa RicaInstituto de Investigaciones en Salud, Universidad de Costa Rica, San Jose, Costa RicaEscuela de Estadística, Universidad de Costa Rica, San Jose, Costa RicaIntroductionEvery year about 83,000 women are diagnosed with cervical cancer in the Americas. Latin America and the Caribbean (LAC) has one of the highest incidence and mortality rates from cervical cancer in the world. Although incidence has decreased by half in the last 30 years, cervical cancer remains a public health concern. The detection of precursor lesions through Papanicolaou (Pap) smear remains a critical tool in the context of prevention in Costa Rica and many other LAC countries.ObjectiveTo determine predictors of participation in Pap smear screening among Costa Rican women, with a special focus on women who have never had a Pap smear or have had a smear 5 or more years ago.MethodsThe data source for this study is the Costa Rican Households National Survey conducted in 2014. This survey is representative at the national, urban/rural zone, and administrative region level. A subsample of women aged 20 to 69 years who responded to the survey’s Papanicolaou Module were included in this study (n = 11,709). Statistical analyses were conducted in R-Studio. Statistical significance level was set at 5%. Two multinomial regression models were estimated. The first model aimed to explain the five different categories of cytology use, which were defined according to the last time women had a Pap smear. The second model aimed to explain the five different categories of reasons why women had never had a Pap smear. Both models controlled for age, educational attainment, and marital status.ResultsYoung women with high educational attainment were more likely to have never had a cytology. Women with a lower educational attainment, married, or in domestic relationship and of older age had greater odds of having had a cytology 5 or more years ago. Each year increment in age was significantly associated with an increase in the odds of never having a Pap smear because of health care access issues or because of cultural reasons as compared to not having an active sexual life.ConclusionsFindings can inform public policy targeted to higher risk female populations where access to health services can be improved.https://www.frontiersin.org/articles/10.3389/fonc.2021.642841/fullPapanicolaoupreventioncervical cancerscreeningwomen’s health |
| spellingShingle | Carolina Santamaría-Ulloa Ileana Quirós-Rojas Melina Montero-López Hazel Quesada-Leitón Women’s Participation in Pap Smear Screening in a Developing Country: Evidence for Improving Health Systems Frontiers in Oncology Papanicolaou prevention cervical cancer screening women’s health |
| title | Women’s Participation in Pap Smear Screening in a Developing Country: Evidence for Improving Health Systems |
| title_full | Women’s Participation in Pap Smear Screening in a Developing Country: Evidence for Improving Health Systems |
| title_fullStr | Women’s Participation in Pap Smear Screening in a Developing Country: Evidence for Improving Health Systems |
| title_full_unstemmed | Women’s Participation in Pap Smear Screening in a Developing Country: Evidence for Improving Health Systems |
| title_short | Women’s Participation in Pap Smear Screening in a Developing Country: Evidence for Improving Health Systems |
| title_sort | women s participation in pap smear screening in a developing country evidence for improving health systems |
| topic | Papanicolaou prevention cervical cancer screening women’s health |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2021.642841/full |
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