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Maria Hewitt, DrPH, Susan Devesa, PhD and Nancy Breen, PhD

Maria Hewitt is with the Institute of Medicine, National Cancer Policy Board, Washington, DC. Susan Devesa is with the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Md. Nancy Breen is with the Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Md.

Correspondence: Inquires should be directed to Maria Hewitt, DrPH, Institute of Medicine, National Cancer Policy Board, 2101 Constitution Ave, NW, Washington, DC 20418 (e-mail: mhewitt{at}nas.edu).

Objectives. This study assessed the relationship between risk factors for cervical cancer and Papanicolaou (Pap) test use within the past year among reproductive-age women.

Methods. The 1995 National Survey of Family Growth, a demographic and reproductive health survey of 10 847 women aged 15 to 44, was analyzed with multiple logistic regression.

Results. Of the women, 62% reported having had a Pap test within the past year. Use was significantly higher among women with risk factors and among African American women. Use was significantly lower among uninsured, poor, and foreign-born women and among women with lower educational attainment and of "other" race/ethnicity.

Conclusions. Strategies to improve Pap test use include (1) educational campaigns that inform women of cervical cancer risk factors and encourage screening and (2) increased support for programs that expand access to Pap tests.

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