Changes in cervical cancer screening behavior for women attending Pap Test Week clinics

Figures & data

Table 1 Summary of information acquired through the questionnaire completed by women attending 2006 Manitoba Pap Test Week clinics

Demographic questions and information	Reasons for attending a Pap Test Week Clinic (participant could check all that applied)
Can you speak English with your doctor or nurse?	I have no doctor or nurse
If not, what language do you prefer?	My doctor or nurse doesn’t do Pap tests
What is your racial/ethnic background?	Family or friends were coming to this clinic
In what country were you born?	I heard or saw an ad
If you were not born in Canada, how long have you lived in Canada?	No appointment was needed
What are the first 3 digits of your postal code?	I was able to get child care
	I prefer to have a woman do my Pap test
	Family or friends told me to come to this clinic
	I went to a talk about Pap test
	With clinic hours, I didn’t have to miss work
	It’s time for my Pap test
	It was easy to get here

Table 2 Recommended follow-up actions for Pap test results according to the CervixCheck Manitoba guidelines at the time of the study¹⁴

Pap result	CervixCheck Manitoba screening recommendation	Reasonable time frame to qualify for adequate screening/follow-upa
Normal	Pap test every 2 years	Pap test within 2.5 years
Unsatisfactory	Repeat Pap test in 3 months	Pap test within 5 months
ASCUS or LSIL	Repeat Pap test in 6 months	Pap test within 9 months
HSIL, ASC-H, AGC, AIS, malignant neoplasm	Colposcopy	Colposcopy within 3 months

Note:

a Defined by study investigators and applied consistently throughout the study.

Abbreviations: AGC, atypical glandular cells; AIS, adenocarcinoma in situ; ASC-H, high grade atypical squamous cells; ASCUS, atypical squamous cells of undetermined significance; HSIL, high-grade squamous intraepithelial lesion; LSIL, low-grade squamous intraepithelial lesion.

Table 3 Ethnicity of Pap Test Week participants compared to the Manitoba population

Self-reported ethnicity	Study population % (n)	Population in Manitoba %a
Caucasian	59.6 (610)	79.3
Aboriginal	14.6 (149)	8.7
Métis	6.6 (67)	6.3
Black	3.4 (35)	1.4
Asian	14.0 (140)	5.4
Arabic	0.6 (6)	0.4
Hispanic	1.0 (10)	0.6
East Indian	0.6 (6)	1.5

Note:

a According to 2006 Canadian census data (Statistics Canada, 2009).²⁰

Table 4 Factors associated with a woman being under-screened prior to the 2006 Pap Test Week clinics

Factor	P-value
Factors significantly associated with being under-screened prior to 2006 Pap Test Week
Older agea	0.02
English competency	<0.01
Ethnicity	0.01
Originating outside of Canada	0.01
Years residing in Canadaa	<0.01
No doctor or nursea	0.03
Able to get child care to attend Pap Test Week clinic	0.03
Factors not associated with being under screened prior to 2006 Pap Test Week
Urban or rural living	0.51
No fixed address	0.35
Prefers a woman practitioner	0.50
Not having to miss work to attend Pap Test Week clinic	1.00
Usual doctor or nurse does not do Pap tests	0.58
Ease of access (geographically or logistically) to Pap Week clinic	0.12

Note:

a Factors that remained significantly associated with being under-screened prior to 2006 Pap Test Week after integration into a multivariable logistic regression model.

Table 5 Results of the multivariable logistic model testing for the likelihood of being under-screened prior to the 2006 Pap Test Week clinics

Factor	Odds ratio (95% confidence interval)
Older age	1.02 (1.01–1.03)
No family doctor or nurse	1.34 (1.05–1.54)
Living in Canada < 1 year	5.51 (2.73–11.12)

Table 6 Results from the Pap tests performed at the 2006 Pap Test Week clinics

Cytology result	Percent frequency % (n)	2006 provincial frequency %
Negative	92.8 (1039)	92.1
Unsatisfactory	2.9 (32)	2.0
ASCUS	1.7 (19)	3.7
LSIL	1.1 (12)	2.6
Organisms	0.6 (7)	n/a
HSIL	0.5 (6)	1.36
ASC-H	(s)a	n/a
AGC	(s)a	0.15

Note:

a Cells that were suppressed because n < 6 as per Manitoba Health recommendations.

Abbreviations: AGC, atypical glandular cells; AIS, adenocarcinoma in situ; ASC-H, high grade atypical squamous cells; ASCUS, atypical squamous cells of undetermined significance; HSIL, high-grade squamous intraepithelial lesion; LSIL, low-grade squamous intraepithelial lesion.

Figure 1 Screening status subsequent to attending the 2006 Pap Test Week clinics as a function of type of follow-up required.

Abbreviation: Rpt, repeat.

Table 7 Factors associated with a previously under-screened woman becoming adequately-screened subsequent to attending a 2006 Pap Test Week clinic

Factor	P-value
Factors associated with improved screening status subsequent to 2006 Pap Test Week
Younger agea	<0.01
Country of origin	0.01
Years in Canada	0.01
2006 Pap result	<0.01
Action required for the 2006 Pap testa	<0.01
Urban vs rural	<0.01
Factors not associated with improved screening status subsequent to 2006 Pap Test Week
English competency	0.07
Ethnicity	0.09
No fixed address	0.19
No doctor or nurse	0.76
Prefers a female practitioner	0.36
Did not have to miss work	0.33
Usual doctor or nurse does not do Pap test	0.98
Ease of access	0.48
Able to get child care	0.29

Note:

a Factors found to be significant in the logistic model.

Figure S1 Questionnaire.

CancerCare ManitobaGuidelines for Breast, Cervical and Colorectal Cancer ScreeningWinnipegCancerCare Manitoba2012 Available from: http://www.cancercare.mb.ca/resource/File/Screening/CCMB_Screening_Guidelines_Jul12.pdfAccessed February 4, 2013

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Statistics Canada [database on the Internet]. Available from: http://www.statcan.gc.ca/tables-tableaux/sum-som/l01/cst01/demo26h-eng.htmAccessed June 8, 2012

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