Who has Pap tests? Variables associated with the use of Pap tests in absence of screening programmes.

Characteristics associated with the use of Pap tests were studied in a random sample of 581 women 18-69 years old; residents of Turin, Italy. There has been no organized screening programme in the area. (Tests possibly related to symptoms were not considered). Data were analysed by multiple logistic regression. Some 48% of women had never had a smear. The prevalence of women ever undergoing a Pap test was higher in middle-aged, married and more educated women (p less than 0.001 in all these cases). We found a linear trend (p less than 0.05) related to time since last visit to the family physician. A number of 'preventive' behavioural practices (physical exercise, no alcohol consumption) and experience of early diagnostic procedures for cancer e.g. BSE and mammography, were also associated with ever having had a Pap smear. The prevalence of ever-tested women was significantly lower among lifetime non-smokers than among ex-smokers and current smokers who planned to stop smoking but not lower than in current smokers who did not plan to stop. Results were similar when having had a test within the last three years was taken as the outcome. These results may be useful in planning screening strategies and educational programmes designed to improve attendance in an organized screening programme.