American Journal of Obstetrics & Gynecology
Volume 200, Issue 1 , Pages 40.e1-40.e7 , January 2009

Ending cervical cancer screening: attitudes and beliefs from ethnically diverse older women

  • George F. Sawaya, MD

      Affiliations

    • Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, School of Medicine, San Francisco, CA
    • Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, CA
    • Medical Effectiveness Research Center for Diverse Populations, University of California, San Francisco, School of Medicine, San Francisco, CA
    • ,
  • A. Yuri Iwaoka-Scott, MA

      Affiliations

    • Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, School of Medicine, San Francisco, CA
    • ,
  • Sue Kim, PhD, MPH

      Affiliations

    • Medical Effectiveness Research Center for Diverse Populations, University of California, San Francisco, School of Medicine, San Francisco, CA
    • Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, CA
    • ,
  • Sabrina T. Wong, PhD, RN

      Affiliations

    • Medical Effectiveness Research Center for Diverse Populations, University of California, San Francisco, School of Medicine, San Francisco, CA
    • University of British Columbia School of Nursing and Centre for Health Services and Policy Research, Vancouver, BC, Canada
    • ,
  • Alison J. Huang, MD, MPhil

      Affiliations

    • Medical Effectiveness Research Center for Diverse Populations, University of California, San Francisco, School of Medicine, San Francisco, CA
    • Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, CA
    • ,
  • A. Eugene Washington, MD, MSc

      Affiliations

    • Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, School of Medicine, San Francisco, CA
    • Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, CA
    • Medical Effectiveness Research Center for Diverse Populations, University of California, San Francisco, School of Medicine, San Francisco, CA
    • ,
  • Eliseo J. Pérez-Stable, MD

      Affiliations

    • Medical Effectiveness Research Center for Diverse Populations, University of California, San Francisco, School of Medicine, San Francisco, CA
    • Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, CA
    • Corresponding Author InformationReprints: Eliseo J. Pérez-Stable, MD, 3333 California St, Suite 335, San Francisco, CA 94134-0856

Received 5 December 2007 ,Revised 28 April 2008 ,Accepted 7 July 2008.

References 

  1. Ries LAG, Eisner MP, Kosary CL, et al. SEER Cancer Statistics Review, 1975-2002. Bethesda, MD: National Cancer Institute; 2003;
  2. Sawaya GF, Grady D, Kerlikowske K, et al. The positive predictive value of cervical smears in previously screened postmenopausal women: the Heart and Estrogen/progestin Replacement Study (HERS). Ann Intern Med. 2000;133:942–950
  3. Sawaya GF, McConnell KJ, Kulasingam SL, et al. Risk of cervical cancer associated with extending the interval between cervical-cancer screenings. N Engl J Med. 2003;349:1501–1509
  4. ACOG practice bulletin. Cervical cytology screening (Number 45, August 2003). Int J Gynaecol Obstet. 2003;83:237–247
  5. Saslow D, Runowicz CD, Solomon D, et al. American Cancer Society guideline for the early detection of cervical neoplasia and cancer. CA Cancer J Clin. 2002;52:342–362
  6. US Preventive Services Task Force. Cervical cancer screening. http://www.ahrq.gov/clinic/uspstf/uspscerv.htm2007;Accessed September 5
  7. Saint M, Gildengorin G, Sawaya GF. Current cervical neoplasia screening practices of obstetrician/gynecologists in the US. Am J Obstet Gynecol. 2005;192:414–421
  8. Sirovich BE, Woloshin S, Schwartz LM. Screening for cervical cancer: will women accept less?. Am J Med. 2005;118:151–158
  9. Kim SE, Perez-Stable EJ, Wong S, et al. Association between cancer risk perception and screening behavior among diverse women. Arch Intern Med. 2008;168:728–734
  10. Weinstein ND. What does it mean to understand a risk? (Evaluating risk comprehension). J Natl Cancer Inst Monogr. 1999;15–20
  11. Lewis CL, Kistler CE, Amick HR, et al. Older adults' attitudes about continuing cancer screening later in life: a pilot study interviewing residents of two continuing care communities. BMC Geriatr. 2006;6:10
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  13. Rolnick SJ, LaFerla JJ, Jackson J, Akkerman D, Compo R. Impact of a new cervical Pap smear screening guideline on member perceptions and comfort levels. Prev Med. 1999;28:530–534
  14. Smith M, French L, Barry HC. Periodic abstinence from Pap (PAP) smear study: women's perceptions of Pap smear screening. Ann Fam Med. 2003;1:203–208
  15. Becker HI, Longacre MR, Harper DM. Beyond the Pap: assessing patients' priorities for the annual examination. J Womens Health (Larchmt). 2004;13:791–798
  16. Ostbye T, Greenberg GN, Taylor DH, Lee AM. Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD). Ann Fam Med. 2003;1:209–217
  17. Walter LC, Covinsky KE. Cancer screening in elderly patients: a framework for individualized decision making. JAMA. 2001;285:2750–2756
  18. Kulasingam SL, Myers ER, Lawson HW, et al. Cost-effectiveness of extending cervical cancer screening intervals among women with prior normal pap tests. Obstet Gynecol. 2006;107:321–328

 Cite this article as: Sawaya GF, Yuri Iwaoka-Scott A, Kim S, et al. Ending cervical cancer screening: attitudes and beliefs from ethnically diverse older women. Am J Obstet Gynecol 2009;200:40.e1-40.e7.

 This study was supported by the Agency for Healthcare Research and Quality (5P01 HS10856) for an Excellence Center to Eliminate Ethnic/Racial Disparities (EXCEED); by Grant P30-AG15272 under the Resource Centers for Minority Aging Research program by the National Institute on Aging, the National Institute of Nursing Research, and the National Center on Minority Health and Health Disparities, National Institutes of Health; and by Redes En Acción: The National Latino Cancer Network Grant U01-CA86117 from the National Cancer Institute. Dr Wong was supported by a NIA Diversity Supplement (PA-01-079), a Michael Smith Scholar Award (CI-SCH-051), and a CIHR New Investigator award. Dr Huang's research efforts were further supported by Grant KL2RR024130 from the National Center for Research Resources, a component of the Clinical and Translational Science Awards for Medical Research, National Institutes of Health.

PII: S0002-9378(08)00798-9

doi: 10.1016/j.ajog.2008.07.015

American Journal of Obstetrics & Gynecology
Volume 200, Issue 1 , Pages 40.e1-40.e7 , January 2009

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