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

Abstract

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