Predictors of Breast and Cervical Cancer Screening in a Spanish Metropolitan Area

Background: Gynecological cancers are an important cause of morbidity and mortality. Screening with mammography and Pap smear reduces breast and cervical cancer mortality. Neverthless, high participation rates are needed to ensure their effectiveness. We sought to assess the use of mammography and Pap smear and analyzed predictors of attendance at these cancer screenings in a large metropolitan area in Spain. Methods: We included women surveyed in the Madrid City Health Survey 2005. Cancer screening included mammography in the last 2 years and Pap smear in the last 3 years. Independent variables included socio-demographics, chronic diseases, and lifestyles. Predictors of mammography or Pap smear attendance were explored using logistic regression. Results: The number of women eligible for mammography, aged >= 40 years, was 2580, and the number eligible for Pap smear, aged 18-69 years, was 3200. Overall, 60.5% and 76.6%, respectively, had received a mammography and Pap smear. Mammography uptake was positively associated with age, higher educational level, and osteomuscular disease. Obesity and unhealthy lifestyle were associated with nonattendance to mammography. Predictors of Pap smear attendance were the same as for mammography. Conclusions: Attendance at gynecological cancer screening in a large metropolitan area in Spain is acceptable in the age group for which it is recommended. An effort must be made, however, to recruit those women who are less likely to undergo screening, as they are at the highest risk of having these diseases.