Epidemiology of pap smear utilization among Canadian women, 2005

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Objectives: To determine the prevalence and predictors of Pap smear utilization among women in the Canadian provinces and to evaluate the association between health care satisfaction and Pap smear utilization in the context of a universal health care system. Design: The sub-sample 3 module of the Canadian Community Health Survey cycle 3.1 (2005) was used. Setting: All Canadian provinces. Participants: Women aged 18-69 years without a hysterectomy. Measurements: Pap smear utilization was defined as having had a Pap smear in the 3 years prior to the survey. A Stepwise logistic regression model was performed using all of the relevant sociodemographic, health, lifestyle, and health care satisfaction variables. Results: The prevalence of Pap smear utilization was 78.1%. Estimates of Pap smear utilization varied significantly (P < 0.001, 2-sided) across provinces, from 71.9 % in Quebec to 82.9% in the Atlantic provinces. Multivariate analysis revealed that women who had a Pap smear were more likely to be married or living common law, be widowed or divorced or separated, be between the ages of 25-54, have higher level of education, be employed and white. Women who had a regular doctor, a chronic condition, or who perceived themselves to be in excellent health, were also at increased odds of having a Pap smear. On the other hand, health care satisfaction was not significantly associated with Pap smear utilization. Conclusions: An intervention directed at underprivileged women particularly single, older women who are visible minorities and who are not regular health care users should be implemented.