Identifying barriers to Papanicolaou smear screening in Korean women: Korean National Health and Nutrition Examination Survey 2005

Objective: This study was conducted to provide a nationwide analysis on barriers to cervical cancer screening in Korea. Methods: Data used for this study was obtained in a survey called Korean National Health and Nutrition Examination Survey (KNHANES) 2005, which collected data from 2,590 Korean women aged older than 21 years who had not had a hysterectomy and were eligible for Papanicolaou (Pap) smears. Multivariate analysis was adopted to control each demographic factor and unhealthy behavior variable. Demographic factors included age, education, income, job and region; health-related behavior factors were defined as current smoking, obesity, hormone replacement therapy and disability. Results: The study found that cervical cancer screening rate was significantly positively associated with income (odds ratio [OR],1.002; 95% confidence interval [CI], 1.001 to 1.002), with education (OR, 1.324; 95% CI, 1.030 to 1.703), with job (OR, 1.420; 95% CI, 1.030 to 1.957), and with hormone replacement therapy (OR, 3.732; 95% CI, 2.354 to 5.916). Meanwhile, the age (OR, 0.977; 95% CI, 0.968 to 0.985), disability (OR, 0.358; 95% CI, 0.143 to 0.894) and smoking (OR, 0.447; 95% CI, 0.280 to 0.715) were significantly negatively associated with one's chances to take cervical cytology. Conclusion: In order to increase the rates of Korean women taking Pap test, cervical cancer screening programs will have to pay special attention to the elderly, low-income group, smokers, and the disabled.