Prevalence and risk factors for lifetime exposure to Pap smear abnormalities in the Australian community

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.