Awareness and use of cervical cancer tests in a southern Appalachian community

The knowledge and use of cervical cancer screening (Papanicolaou smear test) by female members of a prepaid health plan (Health Maintenance Organization--foundation-type) based in souther Appalachia were surveyed. Of the 105 members of the plan interviewed, 81 indicated that they had experienced one or more Papanicolaou tests. This percentage (77.1%) was greater than might have been expected on the basis of a review of previous research. Factors contributing to this higher percentage were the subjects' membership in the prepaid health care plan and the increasing tendency of physicians to perform cervical cancer screening tests on patients who visit them for reasons unrelated to cancer detection. The latter phenomenon, coupled with inadequate patient education at the time of the service, is viewed as a major cause of the discrepancy found between the women's Papanicolaou test experience and their Papanicolaou test awareness. Of the 81 women in the study reporting one or more previous cervical cancer screening tests, only 49 were able to identify a specific test for detecting cervical cancer. Most of the results of previous research concerning the relationship of Papanicolaou test experience to age, to education, to economic, employment, and marital status, or to number of children were supported by the current study. The results of this study, conducted in a relatively isolated American community, suggest that the nationwide cervical cancer educational efforts of a multitude of agencies and individuals have met with considerable success.