Skip Navigation LinksHome > April 2012 - Volume 16 - Issue 2 > Correlating Knowledge of Cervical Cancer Prevention and Huma...
Journal of Lower Genital Tract Disease:
doi: 10.1097/LGT.0b013e318238e83d
Original Articles

Correlating Knowledge of Cervical Cancer Prevention and Human Papillomavirus With Compliance After Colposcopy Referral

Massad, L. Stewart MD1; Weber, Kathleen M. RN, BSN2; Wilson, Tracey E. PhD3; Goderre, Johanna L. BA4; Hessol, Nancy A. MSPH5; Henry, Donna MD, MPH6; Colie, Christine MD7; Strickler, Howard D. MD, MPH8; Levine, Alexandra M. MD9,10; Watts, D. Heather MD11; Evans, Charlesnika T. MPH, PhD12

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Objective: This study aimed to assess the impact of knowledge of cervical cancer biology and prevention as well as noncognitive measures on compliance with colposcopy referral in a high-risk population.

Methods: Participants in a US cohort of women with human immunodeficiency virus (HIV) infection and at-risk comparison women completed behavior questionnaires and instruments measuring knowledge of cervical cancer prevention, depressive symptoms, trust in physicians, and perceived stress. Examinations including Pap tests also were conducted. Associations with compliance with resulting indicated colposcopy were assessed in multivariable models.

Results: Of 326 women with indicated colposcopy, 222 (68%) were compliant with colposcopy referral and 104 (32%) were noncompliant. In multivariable analysis, better colposcopy compliance was associated with less education (odds ratio [OR] for compliance = 2.24, 95% confidence interval = 1.12–4.51 vs more than high school), previous abnormal Pap result (OR per previous abnormal Pap result = 1.08, 95% CI = 1.01–1.15), study site (OR for site with best vs worst compliance = 16.1, 95% CI = 2.91–88.6), and higher stress (OR for perceived stress scale 10 score >16 vs lower 3.25, 95% CI = 1.45–7.26).

Conclusions: Noncognitive factors and how sites manage abnormal Pap testing affect colposcopy compliance. Educational interventions alone are unlikely to improve colposcopy compliance in similar high-risk populations.

©2012The American Society for Colposcopy and Cervical Pathology


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