Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Cancer
Published in: BMC Cancer 1/2019

Open Access 01-12-2019 | Contraception | Research article

Pap tests for cervical cancer screening test and contraception: analysis of data from the CONSTANCES cohort study

Authors: Stéphanie Mignot, Virginie Ringa, Solène Vigoureux, Marie Zins, Henri Panjo, Pierre-Jean Saulnier, Xavier Fritel

Published in: BMC Cancer | Issue 1/2019

Login to get access

Abstract

Background

In France, a Pap test for cervical cancer screening is recommended every three years for all sexually active women aged 25 to 65 years. Modes of contraception (any or no contraception, with or without a visit to a physician, and with or without a gynecological examination) may influence adhesion to screening: women who use intrauterine device (IUD) should be more up to date with their cervical cancer screening more often than those using other means of contraception. Our objectives were to analyze the association between modes of contraception and Pap tests for screening.

Methods

This cross sectional study is based on the CONSTANCES cohort enabled us to include 16,764 women aged 25–50 years. The factors associated with adhesion to cervical cancer screening (defined by a report of a Pap test within the previous 3 years) was modeled by logistic regression. Missing data were imputed by using multiple imputations. The multivariate analyses were adjusted for sex life, social and demographic characteristics, and health status.

Results

Overall, 11.2% (1875) of the women reported that they were overdue for Pap test screening. In the multivariate analysis there was no significant difference between women using an IUD and those pills or implant of pap test overdue ORa:0.9 CI95% [0.8–1.1], ORa 1.3 CI95% [0.7–2.7] respectively. Women not using contraceptives and those using non-medical contraceptives (condoms, spermicides, etc.) were overdue more often ORa: 2.6 CI95% [2.2–3.0] and ORa: 1.8 CI95% [1.6–2.1] respectively than those using an IUD.

Conclusion

Women seeing medical professionals for contraception are more likely to have Pap tests.
Footnotes
1
This method is a so-called “natural” calendar-based contraceptive method, better known as the rhythm method, which involves avoiding sexual intercourse during the period when the woman can become pregnant.
 
Literature
1.
2.
3.
Anttila A, von Karsa L, Aasmaa A, Fender M, Patnick J, Rebolj M, et al. Cervical cancer screening policies and coverage in Europe. Eur J Cancer Oxf Engl 1990. 2009;45:2649–58.
4.
5.
6.
7.
Arbyn M, Raifu AO, Weiderpass E, Bray F, Anttila A. Trends of cervical cancer mortality in the member states of the European Union. Eur J Cancer Oxf Engl 1990. 2009;45:2640–8.
8.
Kouchner B. In: Guilbert P, Baudier F, Gautier A, editors. Baromètre santé 2000. Volume 2, Résultats. Vanves, France: Ed. CFES; 2001.
9.
Worthington C, McLeish K, Fuller-Thomson E. Adherence over time to cervical cancer screening guidelines: insights from the Canadian National Population Health Survey. J Womens Health 2002. 2012;21:199–208.CrossRef
10.
Rondet C, Lapostolle A, Soler M, Grillo F, Parizot I, Chauvin P. Are Immigrants and Nationals Born to Immigrants at Higher Risk for Delayed or No Lifetime Breast and Cervical Cancer Screening? The Results from a Population-Based Survey in Paris Metropolitan Area in 2010. PLoS ONE [Internet]. 2014 [cited 2017 Jan 5];9. Available from: http://​www.​ncbi.​nlm.​nih.​gov/​pmc/​articles/​PMC3899363/​.
11.
Coughlin SS, Breslau ES, Thompson T, Benard VB. Physician recommendation for papanicolaou testing among U.S. women, 2000. Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol. 2005;14:1143–8.CrossRef
12.
Martín-López R, Hernández-Barrera V, De Andres AL, Garrido PC, De Miguel AG, García RJ. Breast and cervical cancer screening in Spain and predictors of adherence. Eur J Cancer Prev Off J Eur Cancer Prev Organ ECP. 2010;19:239–45.CrossRef
13.
Fish J, Anthony D. UK national lesbians and health care survey. Women Health. 2005;41:27–45.CrossRef
14.
Oussaid N, Lutringer-Magnin D, Barone G, Haesebaert J, Lasset C. Factors associated with pap smear screening among French women visiting a general practitioner in the Rhône-Alpes region. Rev Dépidémiologie Santé Publique. 2013;61:437–45.CrossRef
15.
Lee DJ. Training to fit intrauterine devices/intrauterine systems for general practitioners: is there an alternative method of service delivery? J Fam Plann Reprod Health Care. 2007;33:205–7.CrossRef
16.
Buhling KJ, Hauck B, Dermout S, Ardaens K, Marions L. Understanding the barriers and myths limiting the use of intrauterine contraception in nulliparous women: results of a survey of European/Canadian healthcare providers. Eur J Obstet Gynecol Reprod Biol. 2014;183:146–54.CrossRef
17.
Goldberg M, Carton M, Descatha A, Leclerc A, Roquelaure Y, Santin G, et al. CONSTANCES: a general prospective population-based cohort for occupational and environmental epidemiology: cohort profile. Occup Environ Med. 2017;74:66–71.CrossRef
18.
Eisenberg ML, Lipshultz LI. Estimating the number of vasectomies performed annually in the United States: data from the National Survey of family growth. J Urol. 2010;184:2068–72.CrossRef
19.
20.
21.
Sterne JAC, White IR, Carlin JB, Spratt M, Royston P, Kenward MG, et al. Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ. 2009;338:b2393.CrossRef
22.
White IR, Royston P, Wood AM. Multiple imputation using chained equations: issues and guidance for practice. Stat Med. 2011;30:377–99.CrossRef
23.
Moons KGM, Donders RART, Stijnen T, Harrell FE. Using the outcome for imputation of missing predictor values was preferred. J Clin Epidemiol. 2006;59:1092–101.CrossRef
24.
Von Hippel PT. Regression with missing ys: an improved strategy for analyzing multiply imputed data 2007;37:83–117.
25.
Allen JD, Pérez JE, Pischke CR, Tom LS, Juarez A, Ospino H, et al. Dimensions of religiousness and cancer screening behaviors among church-going Latinas. J Relig Health. 2014;53:190–203.CrossRef
26.
Duport N. Characteristics of women using organized or opportunistic breast cancer screening in France. Analysis of the 2006 French health, health care and insurance survey. Rev Dépidémiologie Santé Publique. 2012;60:421–30.CrossRef
27.
Hansen BT, Hukkelberg SS, Haldorsen T, Eriksen T, Skare GB, Nygård M. Factors associated with non-attendance, opportunistic attendance and reminded attendance to cervical screening in an organized screening program: a cross-sectional study of 12,058 Norwegian women. BMC Public Health. 2011;11:264.CrossRef
28.
Grindel CG, McGehee LA, Patsdaughter CA, Roberts SJ. Cancer prevention and screening behaviors in lesbians. Women Health. 2006;44:15–39.CrossRef
29.
Smith AMA, Heywood W, Ryall R, Shelley JM, Pitts MK, Richters J, et al. Association between sexual behavior and cervical cancer screening. J Womens Health 2002. 2011;20:1091–6.CrossRef
30.
McDonagh LK, Saunders JM, Cassell J, Curtis T, Bastaki H, Hartney T, et al. Application of the COM-B model to barriers and facilitators to chlamydia testing in general practice for young people and primary care practitioners: a systematic review. Implement Sci IS. 2018;13:130.CrossRef
31.
Lubitz RM, Litzelman DK, Dittus RS, Tierney WM. Is obesity a barrier to physician screening for cervical cancer? Am J Med. 1995;98:491–6.CrossRef
32.
Monnet E, Mauny F, Marquant A, Michaud C, Ferry JP. Knowledge and participation of general practitioners in cervical cancer screening: survey in a French pilot area. Rev Dépidémiologie Santé Publique. 1998;46:108–14.
33.
Hossein AP. Knowledge about cervical Cancer and pap smear and the factors influencing the pap test screening among women. Int J Community Based Nurs Midwifery. 2017;5:188.
34.
Verdoodt F, Jentschke M, Hillemanns P, Racey CS, Snijders PJF, Arbyn M. Reaching women who do not participate in the regular cervical cancer screening programme by offering self-sampling kits: a systematic review and meta-analysis of randomised trials. Eur J Cancer Oxf Engl 1990. 2015;51:2375–85.
35.
Lim AWW, Sasieni P. Consultation rates in cervical screening non-attenders: opportunities to increase screening uptake in GP primary care. J Med Screen. 2015;22:93–9.CrossRef
36.
Arbyn M, Smith SB, Temin S, Sultana F, Castle P, Collaboration on self-sampling and HPV testing. Detecting cervical precancer and reaching underscreened women by using HPV testing on self samples: updated meta-analyses BMJ 2018;363:k4823.
37.
Arbyn M, Verdoodt F, Snijders PJF, Verhoef VMJ, Suonio E, Dillner L, et al. Accuracy of human papillomavirus testing on self-collected versus clinician-collected samples: a meta-analysis. Lancet Oncol. 2014;15:172–83.CrossRef
Metadata
Title
Pap tests for cervical cancer screening test and contraception: analysis of data from the CONSTANCES cohort study
Authors
Stéphanie Mignot
Virginie Ringa
Solène Vigoureux
Marie Zins
Henri Panjo
Pierre-Jean Saulnier
Xavier Fritel
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2019
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-019-5477-8

Other articles of this Issue 1/2019

BMC Cancer 1/2019 Go to the issue

Study protocol

SUPR-3D: A randomized phase iii trial comparing simple unplanned palliative radiotherapy versus 3d conformal radiotherapy for patients with bone metastases: study protocol

Research article

Ectopic expression of BIRC5-targeting miR-101-3p overcomes bone marrow stroma-mediated drug resistance in multiple myeloma cells

Research article

Preliminary evidence for physical activity following pelvic exenteration: a pilot longitudinal cohort study

Research article

Integrating germline and somatic variation information using genomic data for the discovery of biomarkers in prostate cancer

Research article

Long non-coding RNA HOXB-AS3 promotes myeloid cell proliferation and its higher expression is an adverse prognostic marker in patients with acute myeloid leukemia and myelodysplastic syndrome

Research article

Droplet digital PCR as an alternative to FISH for MYCN amplification detection in human neuroblastoma FFPE samples
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits