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South Asian women living in the United States should be targeted to receive Pap smears for cervical cancer screening

Cervical cancer is the second most common cancer among Indian women. Yet, despite the high socioeconomic status of Indian and other South Asian women living in the United States (from Pakistan, India, Bangladesh, and Sri Lanka), a recent survey revealed that one-fourth of them had not received a Pap smear to detect cervical cancer in the past 3 years. This research was supported in part by the Agency for Healthcare Research and Quality (HS10597).

Researchers from the University of Chicago, RAND, and the University of California, Los Angeles, mailed a survey to a random sample of 1,913 South Asian women nationwide over a 3-month period. The survey asked about receipt of Pap smears, sociodemographic characteristics, and measures of acculturation (for example, language spoken at home and time lived in the United States).

Of the 42 percent of South Asian women who responded, 45 percent had a household income of more than $80,000, and 42 percent had a master's degree. Three-quarters of the women (73 percent) said they had received a Pap smear in the last 3 years. The probability of Pap smear receipt was 92 percent for a 38-year-old married female who had spent at least 25 percent of her life in the United States, had a usual source of care, and had a bachelor's degree.

The probability decreased to 71 percent if the woman was unmarried, 80 percent if she had less than a bachelor's degree or did not have a usual source of care, and 79 percent if she had lived less than 25 percent of her life in the United States. Locales with large South Asian populations should be targeted for cervical cancer screening, for example, with community health fairs and awareness campaigns via ethnic newspapers and television programs. The message should be aimed particularly at unmarried South Asian women of lower socioeconomic status who have spent little time in the United States, suggest the researchers.

More details are in "Utilization of Papanicolaou smears by South Asian women living in the United States," by Saima Chaudhry, M.D., M.S.H.S., Arlene Fink, Ph.D., Lillian Gelberg, M.D., M.S.P.H., and Robert Brook, M.D., Sc.D., in the May 2003 Journal of General Internal Medicine 18, pp. 377-384.

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