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Prev Med. 2013 Nov;57(5):641-5. doi: 10.1016/j.ypmed.2013.08.021. Epub 2013 Sep 5.

Patient knowledge and beliefs as barriers to extending cervical cancer screening intervals in Federally Qualified Health Centers.

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CDC, Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch, Atlanta, GA, USA. Electronic address:



Despite guidelines recommending cervical cancer screening intervals be extended beyond one year, clinical practice has been slow to change. Patient preferences are a potential barrier. In the Centers for Disease Control's Cervical Cancer (Cx3) Study at Federally Qualified Health Centers (FQHCs) across Illinois, we surveyed patients about screening practices, and assessed beliefs regarding lengthening screening intervals.


We analyzed data from 984 low income women in the Cx3 Study (2009-2011). Participants completed a survey assessing health history, knowledge about Pap testing, beliefs and intentions about extending screening intervals, and demographics.


The majority reported annual Pap testing (61%), while only 24% reported a 2-3 year screening interval (recommendation at time of survey). Misunderstandings about the Pap test were prevalent, with over half believing it screened for vaginal, yeast, and sexually transmitted infections (58%-72%). Unfavorable beliefs about extending screening intervals were common. The majority (57%) indicated that they would not wait 3 years to be screened if their physician recommended it, and intentions were associated with knowledge about Pap testing.


Most women reported annual cervical cancer screening, and intended to resist longer screening intervals. Patients' lack of knowledge and unfavorable beliefs may serve as barriers to extending screening intervals.


Cervical cancer screening; Early detection of cancer; Healthcare disparities; Patient acceptance of health care; Patient compliance

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