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Pap Testing Adherence among Vietnamese American Women

¹ Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA; Departments of ² Health Services and ³ Medicine, University of Washington, Seattle, WA; ⁴ Comprehensive Cancer Center and ⁵ Department of Medicine, University of California, San Francisco, CA; and ⁶ Harborview Medical Center, Seattle, WA

Requests for reprints: Vicky Taylor, Fred Hutchinson Cancer Research Center, PO Box 19024, Seattle, WA 98109-1024. Phone: (206) 667-5114; Fax: (206) 667-5977. Email: vtaylor{at}fhcrc.org

Objectives: Vietnamese American women are five times more likely to be diagnosed with cervical cancer than their White counterparts. Previous research has demonstrated low levels of Papanicolaou (Pap) testing among Vietnamese. Our study objective was to examine factors associated with interval Pap testing adherence. Methods: A population-based, in-person survey of Vietnamese women aged 18–64 years was conducted. Questionnaire content was guided by the Health Behavior Framework (HBF). The study sample was randomly selected from 1639 south Seattle households. Statistical methods included ² tests and logistic regression. Results: The response rate among eligible households was 82%, and the study included 352 women. Sixty-eight percent of the participants had been screened during the preceding 3 years. The following HBF factors were associated (P < 0.05) with interval Pap testing in bivariate comparisons: believing Pap tests decrease the risk of cervical cancer and believing cervical cancer is curable if detected early (perceived effectiveness); knowing testing is necessary for women who are asymptomatic, sexually inactive, or postmenopausal (knowledge); reporting concern about pain/discomfort as a barrier to screening (barriers); family member(s) and friend(s) had suggested testing (social support); doctor(s) had recommended testing; and had asked doctor(s) for testing (communication with provider). In a multivariate analysis, being married, knowing Pap testing is necessary for asymptomatic women, doctor(s) had recommended testing, and had asked doctor(s) for testing were independently associated (P < 0.05) with screening participation. Conclusion: Our results confirm low levels of Pap testing among Vietnamese women and demonstrate the importance of physician-patient communication in increasing screening adherence. Health education efforts should target unmarried women and reinforce the importance of Pap testing for all Vietnamese women.

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