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Racial Disparities in Cervical Cancer Screening

Implications for Relieving Cervical Cancer Burden in Asian American Pacific Islander Women

Lee, Hee Yun, PhD, MSW; Beltran, Raiza, MPH; Kim, Nam Keol, MA; Lee, Do Kyung, BA

doi: 10.1097/NCC.0000000000000642
Article: PDF Only

Background While cervical cancer is considered preventable and the overall Papanicolaou (Pap) test utilization rate has gradually increased in the United States, certain Asian American Pacific Islander (AAPI) women consistently rate lower in Pap test receipt compared with non-Latina whites (NLWs), leading to a higher cervical cancer mortality rate for various AAPI women. Few studies, however, have focused on female AAPI college students' cervical cancer screening behavior in comparison with NLW students.

Objective This study aimed to investigate cervical cancer screening behaviors among college-aged females by (1) determining AAPIs' and NLWs' screening rates, (2) assessing their knowledge about Pap tests, and (3) discovering factors associated with Pap test receipt. Andersen's Health Behavioral Model was used as a theoretical framework.

Methods Using a simple random sampling strategy, 2270 female students (15% AAPIs, 85% NLWs) completed an online health survey.

Results Results indicate AAPI students had significantly lower Pap test knowledge and Pap test receipt rate compared with NLW students. Age, nativity, human papillomavirus vaccination completion, frequency of obstetrician/gynecologist (OB/GYN) visits, and the number of sexual partners were associated with AAPI students' lower rate of Pap test receipt, whereas the Pap test receipt rate for NLW students was influenced by the same factors with the addition of having increased prior knowledge about Pap tests.

Conclusion Results show the importance of OB/GYN visits in obtaining Pap tests for AAPI and NLW students.

Implication for Practice Health practitioners should pay attention to students' race/ethnicity in their practice and provide corresponding ethnic group–specific preventive care.

Author Affiliations: School of Social Work, University of Alabama, Tuscaloosa (Dr Lee); and School of Social Work (Ms Beltran), Department of Educational Psychology (Mr Kim), and School of Medicine (Mr Lee), University of Minnesota, Twin Cities.

This research project was funded by the Minnesota Department of Health's Eliminating Health Disparities Initiative and endowed research fund from the University of Alabama School of Social Work.

The authors have no funding or conflicts of interest to disclose.

Correspondence: Hee Yun Lee, PhD, MSW, School of Social Work, University of Alabama, 1022 Little Hall, Box 870314, Tuscaloosa, AL 35487 (

Accepted for publication June 7, 2018.

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