Differential Impact of Education Level, Occupation and Marital Status on Performance of the Papanicolaou Test among Women from Various Regions in Brazil

Document Type: Research Articles

Authors

1 Postgraduate Program in Public Health, State University of Paraíba (UEPB), Campina Grande, Paraíba, Brazil.

2 Institute of Biosciences, Federal University of Mato Grosso do Sul (UFMS), Campo Grande- Mato Grosso do Sul, Brazil.

3 Instituto Integrado de Saúde, Federal University of Mato Grosso do Sul (UFMS), Campo Grande- Mato Grosso do Sul, Brazil.

Abstract

Background: In Brazil, little is known regarding the underlying causes of differences among populations regarding
socio-economic variables that affect women’s cervical cancer screening behavior. The present study focused on
socio-economic variables that affect women’s performance of the Papanicolaou test, comparing two distinct Brazilian
populations. Methods: We collected data regarding performance of the Papanicolaou test and socio-economic variables
from 559 women in Mato Grosso do Sul (MS), in the Central East region, and 338 women in Paraíba (PB), in the
Northeast region of Brazil. Nominal logistic regression modeling was performed to identify independent variables for
both groups of data. Results: Of the women interviewed from MS and PB, 116 out of 599 (19.37%) and 94 out of 338
(27.81%), respectively, had not performed the Papanicolaou test within the last three years (p = 0.025). Low educational
level characterized 570 (95.16%) and 203 (60.06%) of women from MS and PB, respectively (p = 0.000). Women in
PB who had a low educational level and were unemployed had a 2.96-fold (OR = 0.338; 95% CI: 0.121 - 0.939) and
2.40-fold (OR = 0.416; 95% CI: 0.199 - 0.869) lower chance, respectively, to have performed the Papanicolaou test ≥
three times, or once within the last three years (p = 0.029; p = 0.014). The chance of women in MS who did not live in
a stable relationship to have performed the test ≥ three times was 1.79-fold (OR = 0.560; 95% CI: 0.348 – 0.901) lower
compared to women who reported a stable relationship (p = 0.039). Conclusions: High educational level, employment,
and having a stable interpersonal relationship positively associated with performance of the Papanicolaou test among
women in PB and MS. Despite having predominantly a low educational level, women in MS performed the Papanicolaou
test more frequently than those in PB.

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