Introduction Cervical cancer screening has resulted in a decrease in the occurrence of and death from cervical cancer. The Canadian Longitudinal Study on Aging (CLSA) prospectively collected health outcomes on >50,000 individuals. We sought to identify the prevalence of Canadian female participants having never undergone cervical cancer screening and the association with social determinants of health.

Methods We performed a cross-sectional analysis from CLSA data. The main outcome was self-report of ever having undergone a pap test. Regression analyses, controlling for the complexity of the design and covariates, evaluated the association between self-reported lifetime cervical cancer screening and social determinants of health.

Results The population-based sample comprised 22,910 participants aged 45–85, of whom 99.8% had available information on cervical cancer screening (n=22,720). The prevalence of never having undergone a pap was 14.1%; weighted prevalence, 11.8% (95%CI 11.0–12.6). Older age_(10-year) (OR 1.5, 95%CI 1.4–1.6), lower education_{(low vs. high)} (OR 1.5, 95%CI 1.2–1.9) and low household income_{(low vs. high)} (OR 1.7, 95%CI 1.3–2.3) were associated with absence of lifetime screening. Having a religious affiliation (OR 1.3, 95%CI 1.1–1.5) and never being married/lived in common-law (OR 1.5, 95%CI 1.2–1.9) were also associated with never having undergone screening. Notably, not having a family physician was an important contributing factor (OR 2.3, 95%CI 1.6–3.3). However, of participants who never underwent a pap test, 97% reported having a family physician.

Conclusion/Implications Our analysis highlights inequities in access to cervical cancer screening in the Canadian context. This data can help inform targeted education and empowerment strategies to increase cancer screening uptake.