Journal of Community Health, Vol. 27, No. 5, October 2002 ( 2002) A SOURCE OF ERROR IN SELF-REPORTS OF PAP TEST UTILIZATION Judith Pizarro, MA; Tamera R. Schneider, PhD; Peter Salovey, PhD ABSTRACT: The prevention and early detection of cervical cancer is achieved through women’s regular use of Pap tests. Ascertaining adher- ence to Pap screening guidelines is often based on self-report, which may be unreliable. This study examined the reliability of Pap test self-reports and one potential source of error in them. We predicted that women having any gynecological examination (other than Pap tests) would falsely report having had a Pap test more often than women who had not experienced gynecological procedures. We compared self-reported Pap test utilization with medical records among 161 low-income women. Women with no Pap test in their medical record but who had experi- enced other gynecological procedures falsely reported a Pap test signifi- cantly more often than those women who actually received a Pap test or who had not received any gynecological procedure. Confusion over what type of gynecological procedures these women received could result in their under-utilization of Pap tests. Further, these findings question the validity of study findings based only on self-reported outcomes. KEY WORDS: cervical smears; Papanicolaou test; low-income population; self- disclosure. INTRODUCTION The development of cervical cancer can be prevented by the early detection and treatment of abnormal cervical cell changes. 1,2 Currently, the best method for detecting these abnormalities is the Papanicolaou (Pap) test. The Pap test reliably can detect pre-cancerous conditions that are nearly 100 percent curable. 3 The availability of such an effective screen- Judith Pizarro, MA, Research Associate, Peter Salovey, PhD, Professor of Psychology at Yale University, Connecticut, USA; Tamera R. Schneider, PhD, Assistant Professor of Psychology at Wright State University, Ohio, USA. Requests for reprints should be addressed to Peter Salovey, Ph.D., Department of Psychol- ogy, Yale University, 2 Hillhouse Ave., PO Box 208205, New Haven, CT 06520-8205; e-mail: peter. salovey@yale.edu. This research was supported by a grant from the National Cancer Institute (R01-CA68427). Manuscript preparation also was facilitated by P01-MH/DA56826 and by funding from the Ethel Donaghue Women’s Health Investigator Program at Yale. The authors wish to thank the graduate students and staff members of the Health, Emotion, and Behavior Laboratory at Yale University, and Stephen C. Updegrove MD, Deborah Russell, MHSM, RHIA, Director of Health Information, and other staff members of the Hill Health Center. 351 0094-5145/02/1000-0351/0  2002 Human Sciences Press, Inc.