Factors Associated with Mammograms and Pap Smears Screening: A National Survey in Thailand

Abstract

During the COVID-19 epidemic, the accessibility of healthcare facility services was disrupted. This study examined factors associated with having mammograms and Pap smear screenings during the COVID-19 epidemic in Thailand. The study was based on the 2021 Health and Welfare Survey of the Thai National Statistical Office. Skilled interviewers systematically conducted population-based surveys. They polled 11,078,970 women aged 40 or older regarding mammographic screening for breast cancer and 13,460,390 women aged 30 or older about Pap screening for cervical cancer. The independent variables were age, religion, education, occupation, income, healthcare-cost coverage, geographic region, and domicile location. The two dependent variables were mammograms and Pap smears. Univariate and multiple binary logistic regression analyses were performed to identify the factors associated with mammograms for breast cancer and Pap smears for cervical cancer. Results found that cancer screening rates via mammograms and Pap smears decreased during COVID-19 in Thailand. The women who had mammograms and Pap smear screenings were 13.8% and 54.0%, respectively. The primary reason for not undergoing screening was the women’s belief that they did not have any abnormalities in their breasts (64.5%) or cervix (53.1%). Some women were unaware that breast cancer could be screened via mammography (19.2%), while 22.7% believed that Pap smear screening for cervical cancer was unnecessary. Binary logistic regression analyses found that the factors associated with having mammograms and Pap smears were demographic, socioeconomic, geographic, healthcare-cost coverage, and economic status. The Thai government could conduct information campaigns to educate women about the need for breast and cervical cancer screening via mammograms and Pap smears, especially among at-risk populations.