Prevalence and risk factors for lifetime exposure to Pap smear abnormalities in the Australian community
T. Natasha Posner A F , Frances M. Boyle B , David M. Purdie C , Michael P. Dunne D and Jake M. Najman EA Department of Primary Care and General Practice, Clinical Sciences Building, University of Birmingham, Edgbaston B15 2TT, UK.
B School of Population Health, The University of Queensland, Level 3 Edith Cavell Building, Herston Road, Herston, Qld 4029, Australia.
C Population and Clinical Sciences Division, Queensland Institute of Medical Research, Herston, Qld 4006, Australia.
D School of Public Health, Queensland University of Technology, Kelvin Grove Campus, Victoria Park Road, Kelvin Grove, Qld 4059, Australia.
E Schools of Population Health and Social Science, The University of Queensland, Herston, Qld 4006, Australia.
F Corresponding author. Email: posnertr@adf.bham.ac.uk
Sexual Health 3(4) 275-279 https://doi.org/10.1071/SH05044
Submitted: 26 August 2005 Accepted: 8 June 2006 Published: 17 November 2006
Abstract
Background: This study examined the prevalence, correlates and consequences of abnormal Pap smears in a population-based survey of sexuality and health in the Australian community. Methods: Cross-sectional telephone survey of 908 women aged 18–59 years randomly selected from the Commonwealth electoral roll. Results: Most women (91%) reported having had at least one Pap smear test, a figure directly comparable with national estimates. Being single (prevalence ratio (PR) 4.61; 95% CI 2.09–10.17) and not having had sexual intercourse (PR 5.31, 95% CI 3.11–9.07) were strong predictors of never having been tested. One in four women (26%) who reported being screened also reported having had an abnormal Pap smear result, of whom 66% said they had further testing and 52% some form of treatment. A minority (19%) reported negative effects of treatment on their sex lives. Having been diagnosed with human papillomavirus (HPV) (PR 2.87, 95% CI 1.84–4.48), and to a lesser degree, having had a greater number of male sexual partners (PR 1.38, 95% CI 1.01–1.89), and experiencing sexual problems in the last year (PR 0.99, 95% CI 0.99–1.88) were independently associated with reporting of abnormal Pap smear results. Conclusions: Approximately one in four women self report lifetime exposure to Pap smear abnormalities. It is important that women are well prepared for this common experience. A causal association between multiple sexual partners and risk of acquiring HPV infection is supported by these data.
Additional keywords: abnormal results, cervical screening, HPV, population-based survey.
Acknowledgements
This research was funded by the NHMRC. We thank the participants and interviewers, and especially Michelle Cook and Andrea Lanyon for supervising the data collection process. Dr Margot Legosz and Dixie Statham provided valuable advice in the early stages. We also thank the reviewers for their helpful comments and suggestions.
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