# Factors associated with mammogram and Papanicolaou testing among Mexican American older women

## TL;DR

This study finds that education, health conditions, and financial strain influence cancer screening rates in older Mexican American women.

## Contribution

The study identifies specific factors affecting mammogram and Pap test use in Mexican American women over time.

## Key findings

- Higher education and physician visits increase odds of receiving both mammogram and Pap test.
- Financial strain and Spanish interviews are linked to lower screening rates.
- Bilingual care and mobile screening could improve access for this population.

## Abstract

Mammogram and Papanicolaou (Pap) smear tests are essential screening to detect breast and cancer cervical, respectively.

Identify predisposing, enabling, and need factors associated with mammography and Paptest screenings among older Mexican American women over time.

Longitudinal study of 912 Mexican American women aged ⩾ 67 years.

Participants were assessed five times (1995/1996–2007/2008). Independent variables were based on the Andersen’s Behavioral Model of Health Services, including predisposing factors (e.g., age of menopause), enabling factors (e.g., financial strain), and need factors (e.g., medical conditions). Outcomes included having a mammogram in the past 2 years and a Pap test in the past three. Generalized Estimation Equation models estimated the odds ratio (OR) and 95% confidence interval (CI) for receiving a mammogram, Pap test, or both based on these factors.

Higher education (OR = 1.04, 95% CI = 1.01–1.07), physician visits (OR = 1.85, 95% CI = 1.33–2.56), hypertension (OR = 1.26, 95% CI = 1.04–1.51), arthritis (OR = 1.31, 95% CI = 1.07–1.60), and greater handgrip strength (OR = 1.02, 95% CI = 1.01–1.04) were associated with greater odds of receiving both a mammogram and Pap. Older age and early menopause (OR = 0.96, 95% CI = 0.94–0.98 and OR = 0.71, 95% CI = 0.58–0.89, respectively) were associated with lower odds of receiving both tests. Spanish interview (OR = 0.71, 95% CI = 0.56–0.91) and financial strain (OR = 0.83, 95% CI = 0.70–0.99) were associated with lower odds of receiving a Pap test and mammogram test, respectively over time.

Language barriers and financial constraints reduce cancer screening rates among Mexican American women. Cultural tailored care and improved access, such as bilingual clinics and mobile screening are needed to address these gaps.