Gaps in Adhering to Pap Testing Recommendations and Related Barriers in a Sample of Young Adults in the US

Authors

Tanvi Sapra, Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Katelyn F. Romm, TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Daisy Le, School of Nursing, George Washington University, Washington, DC, USA.
Carla J. Berg, George Washington Cancer Center, George Washington University, 800 22nd Street NW, #7000C, Washington, DC, 20052, USA. carlaberg@gwu.edu.

Document Type

Journal Article

Publication Date

7-13-2023

Journal

Journal of cancer education : the official journal of the American Association for Cancer Education

DOI

10.1007/s13187-023-02340-6

Keywords

Cancer screening; Cervical cancer; Pap testing; Reproductive health; Women’s health; Young adults

Abstract

Given ongoing gaps in adherence to Pap testing recommendations, this study examined: 1) adherence to Pap test screening recommendations; and 2) barriers to Pap test screening among those who were nonadherent, using constructs from the Andersen model. We analyzed Spring 2022 survey data among 541 US young adults who reported having a cervix (n = 541; mean age = 27.73, 42.1% heterosexual, 57.9% sexual minority, 86.0% woman, 3.7% transgender man, 68.2% White, 31.8% racial/ethnic minority). Multivariable logistic regression examined sociodemographic correlates of nonadherence to Pap testing recommendations (i.e., no Pap testing in the past 3 years). Among those who were nonadherent, barriers to Pap testing were assessed. 68.6% (n = 371) were defined as adherent and 31.4% (n = 170) nonadherent. Multivariable regression findings indicated significant differences by race/ethnicity such that Asians (vs. Whites) were more likely to be nonadherent (OR = 2.41, CI = 1.11, 3.70, p = .021); no other differences in relation to race/ethnicity or sexual/gender identity were found. The most commonly reported barriers were: "I have not gotten around to it" (42.9%), "getting a Pap test is just not a priority for me" (30.6%), "fear/worry" (28.2%), "dislike/don't like having procedures done" (27.1%), "my healthcare provider has never mentioned it" (21.2%), "haven't had sex so I don't consider myself at high risk" (20.6%), and "COVID-19 pandemic prevented me" (15.3%). Pap testing is underutilized among young adults in the US, particularly Asians. Multilevel interventions must address barriers within the healthcare system (e.g., provider recommendation), external environment (e.g., societal factors), and individual realm (e.g., perceptions).

APA Citation

Sapra, Tanvi; Romm, Katelyn F.; Le, Daisy; and Berg, Carla J., "Gaps in Adhering to Pap Testing Recommendations and Related Barriers in a Sample of Young Adults in the US" (2023). GW Authored Works. Paper 3083.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/3083

Department

Nursing Faculty Publications