Lower utilization of cervical cancer screening by nurses in Taiwan: A nationwide population-based study

Objective: Using a nationwide population-based database in Taiwan, this study compares use of Pap smear testing by nurses and the general population. Method: We compared 1093 practicing female nurses and 5465 randomly selected female patients from the 2006 National Health Insurance (NHI) database to evaluate the likelihood of receiving at least one Pap smear during a three-year period. Results: We found that 48.9% of the nurses and 56.2% of comparison subjects received a Pap test from 2004 to 2006 in Taiwan. Regression analysis showed that practicing female nurses were less likely to receive a Pap smear compared with the general population (OR = 0.42, 95% CI = 0.35-0.50, p< 0.001), after adjusting for monthly incomes, number of ob/gyn ambulatory care visits, urbanization level and the geographic location of the communities where subjects resided. Conclusion: Nurses were less likely to undergo cervical screening than the general population, despite ease of access and a national health insurance system providing universal coverage to residents of Taiwan. Efforts to raise the Pap screening rate among nurses may require addressing unique cultural and occupational concerns.