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

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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).

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Acknowledgements

This study was approved by the Emory University Institutional Review Board (IRB00097895).

Funding

This work was supported by the US National Cancer Institute (R01CA215155, PI: Berg; R01CA215155-S1, PI: Le). Dr. Romm is supported by the American Cancer Society (134128-IRG-19–142; PI: Romm), Oklahoma Tobacco Settlement Endowment Trust (TSET) contract #R22-03, the National Cancer Institute grant awarded to the Stephenson Cancer Center (P30CA225520), and the National Institute on Drug Abuse (R25DA054015, MPIs: Obasi, Reitzel). Dr. Berg is also supported by other US National Institutes of Health funding, including the National Cancer Institute (R01CA239178, MPIs: Berg, Levine; R01CA278229, MPIs: Berg, Kegler; R01CA275066, MPIs: Yang, Berg; R21CA261884, MPIs: Berg, Arem), the Fogarty International Center (R01TW010664, MPIs: Berg, Kegler; D43TW012456, MPIs: Berg, Paichadze, Petrosyan), the National Institute of Environmental Health Sciences/Fogarty (D43ES030927, MPIs: Berg, Caudle, Sturua), and the National Institute on Drug Abuse (R01DA054751, MPIs: Berg, Cavazos-Rehg).

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Authors and Affiliations

  1. Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, USA

    Tanvi Sapra

  2. TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA

    Katelyn F. Romm

  3. Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA

    Katelyn F. Romm

  4. School of Nursing, George Washington University, Washington, DC, USA

    Daisy Le

  5. George Washington Cancer Center, George Washington University, 800 22nd Street NW, #7000C, Washington, DC, 20052, USA

    Daisy Le & Carla J. Berg

  6. Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA

    Carla J. Berg

Authors
  1. Tanvi Sapra
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  2. Katelyn F. Romm
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  3. Daisy Le
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  4. Carla J. Berg
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Correspondence to Carla J. Berg.

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Sapra, T., Romm, K.F., Le, D. et al. Gaps in Adhering to Pap Testing Recommendations and Related Barriers in a Sample of Young Adults in the US. J Canc Educ 38, 1845–1852 (2023). https://doi.org/10.1007/s13187-023-02340-6

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