28872699

PMC5837890

Background

Despite known prevention and screening efforts, there are higher invasive cervical cancer rates in Appalachia than in other areas of the United States and higher mortality rates in the Appalachian region of Kentucky compared to Appalachian regions of other states.

Purpose

The primary purpose of this study was to investigate the association of psychosocial factors relevant to cervical cancer and the outcome of ever having a Pap test in a rural sample of women. The secondary purpose was to determine whether any of the same psychosocial factors were also associated with ever having an abnormal Pap test result among women with a self-reported history of having one or more Pap tests in their lifetime.

Methods

Data were collected in fall of 2013 from 393 women in 8 economically distressed counties of rural Appalachian Kentucky. Women completed an interviewer-administered survey assessing sociodemographic and health information as well as beliefs about cervical cancer.

Findings

Multivariate logistic regression results indicated that low income and greater perceived local fatalism were significant predictors of never having a Pap test. Lack of personal control over prevention, and peer and family influences were significant predictors of ever having an abnormal Pap test result.

Conclusions

Educational efforts targeted in rural Appalachia would be supported by encouraging the benefits of early and consistent screening, altering the established norms of community fatalism and lack of personal control over prevention, and creating targeted messages through public campaigns that convince rural Appalachian women that cervical cancer is highly preventable and screenable.

CDC Public Access

U48 DP001932/DP/NCCDPHP CDC HHS/United States
U48 DP005014/DP/NCCDPHP CDC HHS/United States