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Open AccessArticle

Pap Testing in a High-Income Country with Suboptimal Compliance Levels: A Survey on Acceptance Factors among Sicilian Women

1
Department of Science for Health Promotion and Mother-Child Care “G. D’Alessandro”, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
2
Department of Health Services and Epidemiological Observatory, Regional Health Authority, Sicilian Region, Via Mario Vaccaro 5, 90145 Palermo, Italy
3
Regional Center for Paediatric Diabetes and Obesity, Azienda Sanitaria Provinciale Caltanissetta, Via Malta 71, 93100 Caltanissetta, Italy
4
Preventive Health Department, Cancer Registry, ASP Trapani, Via Ammiraglio Staiti 95, 91100 Trapani, Italy
5
National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health, Viale Regina Elena 299, 00161 Rome, Italy
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(9), 1804; https://doi.org/10.3390/ijerph15091804
Received: 21 July 2018 / Revised: 14 August 2018 / Accepted: 20 August 2018 / Published: 22 August 2018
(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)
Cervical cancer screening is uncommon, especially in low-income countries and among lower socioeconomic status people in high-income countries. The aims of this study were to examine the adherence of Sicilian women to Pap testing and to identify the determinants of this in a population with a secondary prevention attitude lower than high-income countries and the national average. A cross-sectional study called “Save Eva in Sicily” was conducted among all women aged 25–64 years, with a sample drawn by the list of general practitioners (GPs), using a proportional sampling scheme, stratified by age and resident population. The study outcome was performing a Pap test within the past three years. The association between the outcome and Pap test determinants was analyzed through a multivariable logistic regression. Among the 365 interviewed women, 66% (n = 243) had a Pap test during the last 3 years. On the other hand, 18% of the other women (n = 66) had performed at least one Pap test previously and 16% (n = 56) had never had a Pap test. In a multivariable model, GPs’ advice (adjusted OR 2.55; 95% CI 1.57–4.14) and perceived susceptibility (adjusted OR 3.24; 95% CI 1.92–5.48) increased the likelihood of the execution of a Pap test. The “Save Eva in Sicily” study identified GP advice and perceived cancer severity as the main correlates of Pap testing among Sicilian women, producing evidence regarding how policy makers can increase compliance. Interventions to increase Pap test adhesion should focus on stimulating GPs to identify patients who regularly do not undergo it and to recommend testing on a regular basis to their patients. View Full-Text
Keywords: Pap test; screening; prevention; general practitioner; health belief model; cervical cancer; refusal; susceptibility Pap test; screening; prevention; general practitioner; health belief model; cervical cancer; refusal; susceptibility
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Restivo, V.; Costantino, C.; Marras, A.; Napoli, G.; Scelfo, S.; Scuderi, T.; Casuccio, A.; Cernigliaro, A.; Giusti, A.; Spila Alegiani, S. Pap Testing in a High-Income Country with Suboptimal Compliance Levels: A Survey on Acceptance Factors among Sicilian Women. Int. J. Environ. Res. Public Health 2018, 15, 1804.

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