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JPMPH : Journal of Preventive Medicine and Public Health

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2 "Pap smear"
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Original Articles
Analysis of Pap Smear Results over Twenty Year Period, 1979-1998.
Ji Won Han, Jin Ho Chun, Dae Hoon Jeong, Ki Tae Kim, Hye Kyoung Yoon
Korean J Prev Med. 2000;33(4):505-512.
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OBJECTIVE
To estimate the significance of the Pap smear as a screening tool for cervical cancer. METHODS: A total of 79,840 Pap smear results performed at Pusan Paik Hospital over the 20 year period from 1979 to 1998 were collected and analyzed. RESULTS: The number of Pap smear cases increased markedly during this period, and the results as a whole were classified as consisting of 96.4% normal and benign cytology, 2.2% pre-cancerous cytology, and 1.4% cervical cancer. The relative frequency of cervical cancer decreased from 1.6% in 1979 to 0.7% in 1998. About 64% of the Pap smears were distributed within the age range of 30 to 49 years, and the rate of cervical cancer increased with age, age of marriage and experience of childbirth (p<0.01). The overall agreement of Pap smear results with histologic diagnosis by one histologic degree was 92.7%(1,128/1,217) with 73 overestimated cases and 16 underestimated cases of Pap smear compared to histologic diagnosis. CONCLUSION: This result implies that the Pap smear is an excellent screening tool for cervical cancer with respect to both its scale and validity. Periodic and active Pap smear testing would be helpful for the secondary prevention of cervical cancer.
Summary
Factors Associated with Cervical Cancer Screening in Busan, Korea.
Kui Son Choi, Duk Hee Lee, Kap Yeol Jung, Jieun Son, Tae Won Jang, Yoon Kyu Kim, Hai Rim Shin
J Prev Med Public Health. 2004;37(2):166-173.
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OBJECTIONS: Cervical cancer is the second most frequent cancer among women in Busan. The Pap smear test could have a significant effect on detecting cervical cancer, and enhancing their rate of use is an important strategy for reducing the incidence and mortality of cervical cancer. This study aimed to evaluate the factors associated with the past use of the Pap smear test in Korean women. METHODS: A population-based survey was carried out in Busan between November 1999 and March 2000. 1, 673 participants were randomly selected from 2, 684 women in Busan, using a 2-stage cluster sampling method, and interviewed in their homes. Their socio-demographic characteristics, smoking, drinking, familial cancer history, Pap smear screening history, reproductive and menstrual factors, sexual habits and use of contraceptive methods data were collected by a trained interviewer using a questionnaire. The use of the screening test was defined by a self-report from the participants on how many times they had had a Pap smear test in their lifetime, and when they had received their latest examination. RESULTS: Of the 1, 673 respondents (62.3% response rate), 57.6% had had a Pap smear test during her life (mean number, 2.3). Among the health examination participants (1, 064), 961 (90.3%) reported having sexual experience and 70.9% of these had had a Pap smear test. In a multiple logistic regression analysis, statistically significant relationships were observed for age groups and the Pap smear test rate (odds ratio, OR for 35-44 years=2.45; OR for 45-54 years=3.41; OR for 55 years=2.60; reference, under 34 years). The married or cohabiting women were more likely to have used the Pap smear test than those separated or widowed (OR=1.73). Among the reproductive behavioral measures, the number of births (OR for 3 births=4.22; OR for 2 births=3.95; OR for 1 births=3.38; reference, 0 births) and husband's extra-marital affairs (OR=1.50) were associated with the rates of use of Pap smear tests. CONCLUSION: It appears that the most important contributing factors to cervical cancer screening were age, marital status and number of births. A positive association was also observed for the husband's extra-marital affairs. This study enabled us to systematically assess the relationship between Pap smear rates and risk factors for cervical cancer. It is hoped that this study will make a significant contribution to the accumulating scientific evidence on the identification of factors associated with cervical cancer screening in Korea.
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JPMPH : Journal of Preventive Medicine and Public Health