The survey of 189 Hispanic women between the ages of 18 and 25 showed that nearly one-third had never had a Pap test. Researchers found that women who were confused about where to go for testing, or who worried that it would be painful, were less likely to have been screened.

Dr. Theresa L Byrd, of the University of Texas at Houston School of Public Health, led the study. The findings are published in the journal Preventive Medicine.

Certain sexually transmitted strains of the human papillomavirus (HPV), which commonly infects young women, are the major cause of cervical cancer. Although most women who become infected with HPV never develop cancer, persistent infection with certain viral strains can cause cervical cell changes that can lead to cancer.

The Pap test, which is performed during a routine pelvic exam, can discover such precancerous cell changes, explain the authors of the article. It is credited for the 70-percent drop in cervical cancer deaths the U.S. has seen over the past 50 years.

Yet, national statistics show that Hispanic women have lower rates of Pap testing than either non-Hispanic white or African-American women, the researchers say.

The new study looked at young Hispanic women living in El Paso, along U.S.-Mexico border. At the time of the survey, public health guidelines called for all women age 18 and older to begin getting regular Pap tests; revised guidelines now advise women to begin testing three years after the first time they have sex, or at age 21, whichever comes first.

Although cervical cancer is rare in young women, the abnormal cell changes that may eventually lead to cancer can be found and, if necessary, treated at a young age.

Overall, 69 percent of the women Byrd's team surveyed said they had had a Pap test at some point. The researchers found that women who were most acculturated (based on their use of English) were nearly five times as likely to have had a Pap test as those who were least assimilated. Concern that the test would be painful also kept some women away.

The biggest obstacle, however, was that many women did not know where to go for screening, according to the report.

A number of women said they bought their birth control in Mexico, where oral contraceptives are cheap and available without a prescription — a fact, the researchers note, that could mean they had not been advised on Pap testing.

In general, the authors point out, women who get contraceptives through a doctor's office or family planning clinic receive Pap tests at those sites.

Byrd told Reuters Health that she and her colleagues have developed a video and written materials aimed at giving women a positive view of cervical cancer screening. These materials include a list of places to get screened and a list of the documents required to qualify for "sliding-scale" pricing for the test, she said.

In the study, health insurance — which one-third of all participants lacked — did play a role in screening, as uninsured women were less likely than the insured to have had a Pap test, according to Byrd. Still, health coverage did not emerge as one of the major factors.

Byrd said she hopes to do similar research on the Mexican side of the border, since that nation's cervical cancer death rate has remained unchanged for the past 30 years.