Modifiable barriers to cervical cancer screening adherence among working women in Mexico.

AIMS: To determine predictors of adherence to cervical cancer screening guidelines among women working in Monterrey, Mexico. Cases (n = 94) were sexually active female store clerks working in Monterrey, Mexico, aged 18-64, who were not adherent to Official Mexican Standard cervical cancer screening guidelines; controls (n = 135) were adherent to guidelines. The outcome of interest was adherence to cervical cancer screening services according to national screening guidelines. METHODS: Multivariate logistic regression analyzed knowledge factors and perceptions associated with adherence. RESULTS: Having no or inaccurate knowledge of screening guidelines (odds ratio [OR] 11.1, 95% confidence interval [95% CI] 4.3-28.5) and no knowledge of Pap examination utility (OR 6.8, 95% CI 1.0-46.4) were associated with screening guideline nonadherence. Perceptions of fear/embarrassment (OR 16.2, 95% CI 5.1-51.5) and lower levels of spousal/partner acceptance (OR 5.8, 95% CI 1.3-25.3) of the Pap examination were associated with screening guideline nonadherence. Results were adjusted for age at initiation of sexual activity, civil status, level of education, use of family planning/birth control, and income. CONCLUSIONS: Identification of knowledge factors and perceptions that predict screening guideline adherence can inform population-specific recommendations to increase screening and reduce cervical cancer morbidity and mortality among employed Mexican women.