Cervical Cancer Screening, Pelvic Examinations, and Contraceptive Use Among Adolescent and Young Adult Females

PURPOSE:The purpose of this study was to characterize the association between pelvic examination and adolescent contraceptive method use in two time periods in the 2006-2010 National Survey of Family Growth (NSFG). METHODS:Using data from the 2006-2010 NSFG, we used descriptive statistics and multivariable regression models to examine the association between pelvic examination and/or Pap smear and use of effective or highly effective contraceptive methods during two time periods (2006-2008 and 2008-2010). We used the design characteristics of the NSFG to produce population estimates. RESULTS:More than half (57.3%) of our target population reported that they had a pelvic examination and/or Pap smear in the preceding 12 months. After considering health service use, pregnancy history, and demographic characteristics, receipt of pelvic/Pap remained significantly associated with use of effective or highly effective methods of contraception. Adjusted odds ratio = 1.86; 95% confidence interval (CI), 1.17-2.97. When we examined the relationship between pelvic/Pap and use of effective or highly effective methods within time periods, we found that the odds of effective contraception use were higher among adolescents who had received a Pap/pelvic examination in Period 1 (June 2006-May 2008) but not in Period 2 (June 2008-May 2010). Odds ratio = 3.05; 95% CI, 1.53-6.03 and odds ratio = 1.52; 95% CI, .88-2.62, Periods 1 and 2 respectively. CONCLUSIONS:This finding provides some reassurance that although indications for pelvic examination and Pap smear among adolescents have decreased, the previously documented association between pelvic examination and effective or highly effective contraception appears to have decreased.