Adherence to recommended health checks by women in mid-life: data from a prospective study of women across Australia

Objective: To examine the factors related to Papanicolaou (Pap) tests, mammography and cholesterol testing in mid-aged Australian women as they age. Methods: Data were obtained from the 1946–51 cohort of the Australian Longitudinal Study on Women's Health, a prospective study of the health and lifestyle of Australian women. Data were collected via self-report mailed surveys on a three-yearly basis since 1996, when participants were aged 45–50. Demographic factors, health service use and health-related factors were examined in relation to screening practices in a lagged analysis. Results: As women aged, they were less likely to have a Pap test and more likely to report having a mammogram and a cholesterol test. Smokers were less likely to have all screening tests, and HRT use and more general practitioner (GP) visits were associated with increased odds of having health checks. Compared to healthy weight, higher BMI was associated with increased odds of cholesterol testing but decreased odds for Pap testing; obese women had lower odds for mammography. Underweight women had lower odds for mammography and Pap testing. Worse self-rated health and self-report of a chronic condition were significantly related to increased likelihood of cholesterol testing. While some demographic and area of residence factors were also significantly associated with screening, large inequities based on socioeconomic status were not evident. Conclusions: Health and healthcare use are important determinants of screening. Implications: Greater advantage needs to be taken of opportunities to encourage women with more health risk behaviours and health problems to engage in screening