IntroductionThe concept of an abnormal pap smear test involves the ideology that the cells that are found on the cervix may not appear to be normal. There may be an indication of an infection or inflammation. Furthermore, the results may be able to determine if a woman has had recent sexual activity and if there is a possibility for trichomoniasis (Yang, 2012). Finally, the abnormal test may also indicate that there is dysplasia which refers to cells that can actually be cancerous or there may be an indication of human papilloma virus (HPV) which is a type of genital wart (Yang, 2012). Specifically, there is a growing body of literature that identifies abnormal pap smear tests among Latina women, however there are limited cases of applicable follow up (Flores & Bencomo, 2011; Mann, 2015). The purpose of this paper is to develop a literature review which assesses the trends/patterns, the possible gaps, the relationship among studies and the identification of literature in terms of how it was searched for.

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Trends/Patterns
According to Lima et al (2013), there is a disproportionate amount of women who have been impacted by abnormal Pap smear tests. Even though the rates of cervical cancer have decreased among the United States since 1941, there are still high rates throughout the Latina population. Lima et al (2013) also states that the incidence of mortality regarding cervical cancer is approximately twice as high compared to women who are Caucasian. The burden of the abnormal test and the lack of follow up may be due to an array of different factors. As per the landmark study developed by Engelstad (2001), there is a trend of Latina women who have abnormal Pap smear tests because there may be limited implications regarding prevention mechanisms and even awareness. In many instances, there are language barriers that should be taken into consideration as well. There are also Latina women within the United States who do not have proper access to health care, therefore if there are negative health issues that they should be concerned about, the factors do not often get treated. This may lead to a process which can impact whether the woman’s Pap smear is normal or not.

Lima et al (2013) also states that Hispanic individuals among the United States are more likely to live in poverty compared to Caucasian individuals who are non-Hispanic. Unfortunately, it should be known that approximately 50% of the Latina women who live in poverty do not facilitate the recommended follow up appointments after a Pap smear has been derived as abnormal (Lima et al 2013). The delays in care are very concerning because the mortality rate for cervical cancer may increase among Latina women. In a qualitative study that was developed by Nonzee (2015), the researcher found that one of the main reasons of why women did not follow up with an abnormal Pap smear test is due to embarrassment. In the study of 138 participants, more than half of the women did not feel comfortable speaking about symptoms or discussing factors with a male doctor. Moreover, while many of the women knew that they should continue with proper screening measures, the decided not to even though they had motivation from the health care providers involved (Nonzee, 2015).

Gaps
Currently, there seems to be a gap in the literature regarding narrowing down the disparities and follow up care among Latina women. Although there have been valid reasons of why adherence is not typically done after an abnormal Pap smear test, there is no full indication of the results that are derived from those parameters.

Relationship among Studies
Among the studies that have been identified above, they each discuss the different parameters regarding the reasons why many Latina women do not facilitate follow up and promote adherence after an abnormal Pap smear test. Even in the landmark study from Englestad(2001), similar implications were presented. Factors such as limited access to health care and even embarrassment were common topics that were seen after the impacted women were assessed in the studies. It should also be known that each of the studies allowed for an in-depth exploration of the impact of an abnormal Pap smear and the possibilities of contracting cervical cancer. While most of the literature focused on qualitative measures, Lima (2013) used a mixed methods approach in order to provide adequate statistical analysis.

Identification of Literature
The literature was searched through the database known as PubMed. Since journals were the main source of information, there was an allowance to review existing theories, methodologies, models, etc. Since the topic is very specific, there was somewhat of a gap in the literature, however, applicable terms were searched for based on the subsection of the studies that were desired. At the end of the literature search, there were articles that were found which were heavily related to follow up regarding abnormal Pap smear tests among Latina women.

    References
  • Englestad, L. (2001). Abnormal Pap smear follow up in a high risk population. Cancer Epidemiolgoy, Biomarkers and Prevention, 23(3), 150-167.
  • Flores, K. & Bencomo, C. (2011). Preventing cervical cancer in the Latina population. Journal of Women’s Health, 18(12), 1935- 1943.
  • Lima, S., Benner, C. S., Lui, R., Aldrich, L. S., Oo, S. A., Regan, N., & Chabner, B. A. (2013). The Impact of a Culturally Tailored Patient Navigator Program on Cervical Cancer Prevention in Latina Women. Journal of Women’s Health, 22(5), 426–431.
  • Mann, L. (2015). Increasing cervical cancer screening among US Hispanics/Latinas: A Qualitative Systematic Review, Journal of Cancer Education, 30(2), 374- 387.
  • Nonzee, N. (2015). Delays in cancer care among low income minorities despite access. Journal of Women’s Health, 24(6), 506-514.
  • Yang, K. (2012). Abnormal pap smear and cervical cancer in pregnancy. Clinical Obstetrics Gynecology, 55(3), 838- 848.