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March 22, 2010

J Womens Health (Larchmt). 2009 Nov;18(11):1825-32.

Use of and attitudes and knowledge about pap smears among women
in Kuwait.

El-Hammasi K, Samir O, Kettaneh S, Al-Fadli A, Thalib L.

Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University,

Kuwait. lthalib@hsc.edu.kw

OBJECTIVE: To estimate the lifetime prevalence of Pap smear among women in Kuwait and to assess their

knowledge about and attitude toward Pap smears. METHODS: This was a descriptive cross-sectional study

using a multistage cluster sampling method. We interviewed 299 women attending polyclinics in Kuwait

using a self-administered questionnaire. Factors related to history of having a Pap smear, knowledge level,

and willingness to participate in a screening program were evaluated. RESULTS: The lifetime prevalence of

Pap smear was found to be 37% (95% CI 33-43). Forty-four percent of women in our study had a Pap smear

only once in their lives. History of having at least one Pap smear was significantly related to such factors as

age, total family income, marital status, history of cervical infection, and knowledge. The level of knowledge

about cervical cancer varied among the participants. Forty-six percent of women were uncertain about the

symptoms of cervical cancer. About half the women recognized cervical infection, smoking, and having

multiple sexual partners as risk factors for cervical cancer; however, only 10% recognized early sexual

intercourse as a risk factor. Willingness to participate in a future screening program varied significantly

according to educational level, employment status, and total family income. CONCLUSIONS: Although

cervical cancer incidence and mortality are relatively low in Kuwait, they may be underreported in the

absence of a screening program. Moreover, lifetime prevalence of having a Pap smear was found to be

considerably lower in Kuwait compared with developed countries.

http://www.ncbi.nlm.nih.gov/pubmed/19951218

J Community Health Nurs. 2010 Jan;27(1):12-22.


Benefits and barriers of pap smear screening: differences in perceptions
of Vietnamese American women by stage.

Tung WC.

Orivis School of Nursing, University of Nevada, Reno, Nevada.

Low participation in Papanicolaou screening among Vietnamese American women remains a significant

public health problem. This study explored differences in the perceived benefits of and barriers to obtaining

Papanicolaou smears within the framework of the transtheoretical model stages of readiness. A descriptive,

cross-sectional design with snowball sampling was used to recruit 80 Vietnamese American women. The

self-administered questionnaire included a Demographic Questionnaire, Cervical Cancer Screening Stage

Questionnaire, and Benefits/Barriers Scale. Results suggest that knowledge of cervical cancer, awareness

of screening programs, and availability of female physicians play important roles in the transition from

precontemplation to maintenance within the transtheoretical model framework.

PMID: 20131133 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/20131133

Niger J Med. 2009 Oct-Dec;18(4):384-7.

Knowledge attitude and practice of cervical cancer screening among


sexually active women in Onitsha, southeast Nigeria.

Obiechina NJ, Mbamara SU.

Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra

State.

BACKGROUND: Cervical cancer is a major cause of death in the developing world. This high fatality is due

to late presentation. It is believed that widespread screening of women for precursor lesion and early

detection of the invasive disease can lead to a reduction in cervical cancer and cervical cancer deaths. This

study assesses the knowledge, attitude and practice of cervical cancer among sexually active women in
Onitsha Southeast Nigeria. METHODS: Three major layouts in Onitsha were chosen as the areas of study

In these areas, 5 sites each where major economic activities take place were chosen for the distribution of

the questionnaire. A total of 400 pretested questionnaires were administered to women who gave their

verbal consent to participate in this study. The data were analyzed using SPSS package for windows

version 11.0. RESULTS: The result showed that 76 (26.85%) of the respondents were aware of cervical

cancer screening. Thirty six (47.4%) of the aware group knew that the test was a screening test for cervical

cancer There was significant association between the educational status and the knowledge of Pap test but

there was no significant association between the educational status and the utilization of the Pap test.

CONCLUSION: This study shows that there is poor awareness and utilization of cervical screening test in

our environment. There is therefore an urgent need to establish an aggressive and sustainable awareness

campaign on the preventive nature of cervical cancer and further establish an organized cancer screening

programme.

PMID: 20120142 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/20120142

J S C Med Assoc. 2009 Dec;105(7):260-2.

HBCUs inform students and the community about cervical cancer.

Green JS, Williams DG, Scott DB, Madison SB, Comer KD, Haynes JA.

In summary, HBCUs can no longer remain reactive, but must spearhead efforts to increase both the health

of the student body, as well as the community at large. HBCUs should collaboratively initiate a "Call to

Action", whereby policies and programs could be created to aid in the prevention of HPV and other STIs. To

support this action, HBCUs could more actively pursue funding sources that support both universities and

the communities in which they exist. Student orientation could be redefined to include short courses in STI

awareness and prevention, and be communicated in a manner that is professional, yet engaging to

students. Moreover, university departments which have an interest in the health of communities should

supervise these efforts. The knowledge of university faculty members within departments of Nursing, Social

Work, Public Health, Rehabilitation Counseling and Physical Education should extend beyond the classroom
and into the community. Clark commented, "Perhaps course content across departments could be revised to

encompass an increased focus on practice skills which support awareness and prevention efforts". Through

employment, volunteerism and student internships, each of these disciplines have established relationships

with the surrounding community and understand the associated critical needs. Such relationships provide

the best environment for both the creation and implementation of services, and provide students with a

model of how to "give back" to the community by utilizing their education. Campus health centers should be

more prevention-driven beyond the distribution of condoms and pamphlets, to collaborate with local area

high schools and community-based organizations to create an information network accessible to students

and community residents. Additionally, health centers should promote the availability of HPV vaccination,

which depending on state of residence and age, may be free or available at a discounted cost. According to

Bynum, some HBCUs have already begun to promote and provide the vaccination, "South Carolina State

University is one of the HBCUs which provides the HPV vaccination and promotes HPV prevention. There

has been a great initiative by their health center to focus prevention efforts on incoming freshman". HBCU

administrations must bear in mind that beyond the campus, students will undoubtedly carry the information

learned during college into the communities in which they live after graduation and moreover, utilize this

information as a basis for educating their children and families. Community activist and Columbia resident

Linda "T'Zima" Brown, whose 16 year-old son is considering application to Delaware State University,

believes that HBCUs bear a great responsibility to the well-being of the community, "We as residents should

be able to take part in the events that our black colleges have. Black colleges used to operate from a more

inclusive, family approach, and we need to get back to that; plus, many HBCUs are supported with our state

dollars, so the community should be able to look to them for information aside from what our children relay

to us".

PMID: 20108714 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/20108714

Asian Pac J Cancer Prev. 2009;10(5):735-8.

Awareness of cervical cancer risk factors and screening behaviour


among nurses in a rural region of Turkey.
Ertem G.

Ege University School of Health, Odemis-Izmir/Turkey. gul.ertem@ege.edu.tr

The demographic characteristics of nurses and knowledge on risk factors of cervical cancer, as well as

awareness of symptoms and attitudes in terms of screening programmers such as Pap smear, were

assessed in a cross-sectional survey of nurses working in public Health Cabins and Family Health Centers

in the rural area of Izmir, located in the western region of Turkey. Of the nurses who participated in the

research, 69.1% (67) said that they had talked about cancer and cancer prevention with their families or

friends; 60.8% (59) believed that their occupation was important for cancer prevention; 11.3% of the nurses

had a history of cancer in their families; and 63.9% (62) thought that their knowledge about cervical cancer

was adequate. There were no significant differences between knowledge or attitudes about cervical cancer

risk factors or symptoms and screening methods regarding age, marital status, years of experience (p>

0.05). However, there was a statistically significant relationship between having received a Pap test and

having a history of cancer in their family (p< 0.05). In conclusion, this study has shown that most nurses

knew about the Pap smear test as a cervical cancer screening methods. However, there were no significant

differences between knowledge or attitudes about cervical cancer risk factors or symptoms and screening

methods regarding age, marital status, years of experience.

PMID: 20104960 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/20104960

Ginekol Pol. 2009 Nov;80(11):833-8.

[Women's social conditions and their participation in Cervical Cancer


Population Screening Program in Poland]

[Article in Polish]

Spaczyński M, Nowak-Markwitz E, Januszek-Michalecka L, Karowicz-Bilińska A.


Klinka Onkologii Ginekologicznej Katedry Ginekologii, Połoznictwa i ginekologii Onkologicznej, Uniwersytet

Medyczny, Poznań. onko@gpsk.am.poznan.pl

OBJECTIVES: The Aim. Early diagnosis and screening are of vital importance in Poland because of high

morbidity and mortality cervical cancer statistics. Polish cervical cancer screening programme is based on

personal invitations which are sent to women aged from 25 to 59 every three years. The aim of the study

was to assess socioeconomic conditions of the women who decided to accept or refuse that invitation.

MATERIAL AND METHOD: The data was collected from questionnaires filled in by 1625 women (age: 25-

59) who sought medical help from gynecologists in Poland. The questions included: age, place of living,

education, marital status, children, reaction to the invitation acceptance and its reasons. Social profiles of

women, both participating or not in screening, were characterized. Reasons for refusing the invite were

analyzed. Data regarding the amount of PAP smear collected, number of practices cooperating with

screening programme and invitation responses were obtained from SIMP. Statistical techniques for

correspondence analyses was used in the study. RESULTS: 1261 respondents (77.5%) had PAP smear,

894 women received a personal invitation for screening and 38% of them ignored it. In Poland 55,467

women (5.5%) responded to the personal invitation (2009) and the number was independent of the number

of cooperating practices (p=0.0001). Women from rural areas do not participate in the screening programme

comparing to city dwellers (15.2% vs. 8%), single, unmarried and widows comparing with married and

divorced (25% vs. 5%), and low-educated women in comparison to high-educated (20% vs. 6%). Lack of

time (24%), dislike for seeing an unknown physician (23%) and the examination itself (15%) constitute the

main reasons for the refusal. Women from villages and low-educated ones comprise the group not

participating in screening. High-educated women undergo screening mainly in private medical institutions

(38%). CONCLUSIONS: Personal invitations for Pap smear examination constitute an ineffective method of

increasing participation. The effectiveness of cervical cancer prophylaxis depends on medical education and

at random access to medical care. Information campaign should be mainly directed at rural areas and

among less educated people. The screening programme management should make sure women have easy

access to a gynecologist by steadily increasing the number of cooperating medical practices.

PMID: 20088397 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/20088397
J Womens Health (Larchmt). 2009 Nov;18(11):1825-32.

Use of and attitudes and knowledge about pap smears among women
in Kuwait.

El-Hammasi K, Samir O, Kettaneh S, Al-Fadli A, Thalib L.

Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University,

Kuwait. lthalib@hsc.edu.kw

OBJECTIVE: To estimate the lifetime prevalence of Pap smear among women in Kuwait and to assess their

knowledge about and attitude toward Pap smears. METHODS: This was a descriptive cross-sectional study

using a multistage cluster sampling method. We interviewed 299 women attending polyclinics in Kuwait

using a self-administered questionnaire. Factors related to history of having a Pap smear, knowledge level,

and willingness to participate in a screening program were evaluated. RESULTS: The lifetime prevalence of

Pap smear was found to be 37% (95% CI 33-43). Forty-four percent of women in our study had a Pap smear

only once in their lives. History of having at least one Pap smear was significantly related to such factors as

age, total family income, marital status, history of cervical infection, and knowledge. The level of knowledge

about cervical cancer varied among the participants. Forty-six percent of women were uncertain about the

symptoms of cervical cancer. About half the women recognized cervical infection, smoking, and having

multiple sexual partners as risk factors for cervical cancer; however, only 10% recognized early sexual

intercourse as a risk factor. Willingness to participate in a future screening program varied significantly

according to educational level, employment status, and total family income. CONCLUSIONS: Although

cervical cancer incidence and mortality are relatively low in Kuwait, they may be underreported in the

absence of a screening program. Moreover, lifetime prevalence of having a Pap smear was found to be

considerably lower in Kuwait compared with developed countries.

PMID: 19951218 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/19951218

J Womens Health (Larchmt). 2009 Nov;18(11):1759-68.


Adherence to cervical cancer screening guidelines for U.S. women aged
25-64: data from the 2005 Health Information National Trends
Survey (HINTS).

Nelson W, Moser RP, Gaffey A, Waldron W.

Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer

Institute, Bethesda, Maryland. 20892, USA. nelsonw@mail.nih.gov

BACKGROUND: Although it is widely accepted that Papanicolaou (Pap) screening can reduce cervical

cancer mortality, many women still do not maintain regular cervical cancer screenings. OBJECTIVE: To

describe the prevalence of cervical cancer screening and the demographic, behavioral, psychological, and

cancer-related knowledge factors associated with adherence to U.S. Preventive Services Task Force

(USPSTF) cervical cancer screening guidelines among women in the United States. METHODS: Data for

women aged 25-64 were obtained from the National Cancer Institute's (NCI) 2005 Health Information

National Trends Survey (HINTS). Women were considered adherent to screening guidelines if they had two

consecutive, on-schedule screenings and planned to have another within the next 3 years. The sample

comprised 2070 women. RESULTS: Ninety-eight percent of women reported ever having a Pap smear, 90%

reported having had a recent Pap smear (within 3 years), and 84% were adherent to USPSTF screening

guidelines. Maintaining regular cervical cancer screening was significantly associated with having health

insurance, normal body mass index (BMI), smoking status (nonsmoker), mood (absence of a mood

disturbance), and being knowledgeable about cervical cancer screening and human papillomavirus (HPV)

infection. CONCLUSIONS: Based on the observation that women who were current smokers, obese, or

experiencing a substantial degree of psychological distress were significantly less likely to adhere to

recommended screening guidelines, we suggest that healthcare providers pay particular attention to the

screening needs of these more vulnerable women.

PMID: 19951209 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/19951209

Int Nurs Rev. 2009 Dec;56(4):433-41.


Screening for cervical cancer among Israeli lesbian women.

Ben-Natan M, Adir O.

Pat Matthews Academic School of Nursing, Faculty of Nursing, Stanley Steyer School of Health Professions,

Tel Aviv University, Hadera, Israel. meraav@hy.health.gov.il

Comment in:

• Int Nurs Rev. 2009 Dec;56(4):403.

BACKGROUND: The proportion of lesbian women who contract the human papilloma virus may reach 13%

or even 21%; however, lesbian women were found to receive Pap smear tests less often or less regularly.

AIM: To explore factors influencing lesbian women to undergo Pap smear tests and to determine whether

the Health Belief Model (HBM) is able to predict whether lesbian women would be willing to undergo the

test. METHOD: This is a correlational quantitative study guided by the HBM. A convenience sample of 108

Israeli lesbian women was recruited from local events in the lesbian community in the city of Tel Aviv, Israel.

Data were collected using a self-administered questionnaire. FINDINGS: Findings indicate that only 22.2%

of the women had undergone Pap smear tests in the past, but a slightly higher proportion, 30.8%, intended

to be tested during the next year. Older women were found to be more compliant with the test. Model-based

factors affecting actual testing were perceived benefits and barriers. Factors affecting women's intention to

be tested were perceived susceptibility, perceived benefits and general health motivation. CONCLUSIONS:

Effective strategies for nurses promoting cervical cancer screening among lesbians should address ways to

improve familiarity with Pap smear tests, raise physicians' awareness of offering the test to lesbians and

emphasize the importance of women-based medical teams.

PMID: 19930071 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/19930071

Public Health. 2009 Oct;123(10):680-5. Epub 2009 Oct 27.


Cervical screening: Perceptions and barriers to uptake among Somali
women in Camden.

Abdullahi A, Copping J, Kessel A, Luck M, Bonell C.

Department of Public Health, Camden Primary Care Trust, St Pancras Hospital, London NW1 0PE, UK.

OBJECTIVES: To explore barriers to, and ways to improve, uptake of cervical screening among Somali

women in Camden, London. STUDY DESIGN: A qualitative research study using focus group discussions

and in-depth interviews. METHODS: A qualitative study (comprising seven focus groups and eight in-depth

interviews) was conducted with 50 first-generation Somali women aged 25-64 years. Both the groups and

the interviews explored participants' understanding of the purpose of cervical screening, and the various risk

factors for cervical cancer, as well as their opinions on barriers to screening and suggestions for overcoming

those barriers. RESULTS: Knowledge about the purpose of cervical screening was limited among Somali

women. There was also a lack of understanding of risk factors for cervical cancer, and many of the women

held fatalistic attitudes, associated with the idea of 'God's will', about this cancer and other aspects of health.

Another culturally specific barrier was embarrassment associated with female circumcision, i.e. female

genital mutilation. Other barriers suggested by the participants were: lack of knowledge about the need for

cervical screening, practical problems such as appointment times and childcare needs, language difficulties,

fear of the test and negative past experiences. Possible solutions suggested by the participants included the

provision of education and information about cervical screening in the Somali language by Somali

community workers. They also suggested that healthcare staff should be trained about Somali culture,

particularly regarding female circumcision, and that general practitioners should more proactively encourage

Somali women to attend screening. CONCLUSIONS: Language difficulties and specific cultural issues are

key barriers to first-generation Somali women attending cervical screening. Providing education and

information orally, as well as improving access to a more culturally appropriate screening service, could lead

to improved uptake among this group.

PMID: 19863980 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/19863980
Asian Pac J Cancer Prev. 2009 Oct-Dec;10(4):569-74.

Cervical cancer screening: patients understanding in major hospitals in


Malaysia.

Othman NH, Devi BC, Halimah Y.

Hospital Universiti Sains Malaysia, Kelantan, Malaysia. hayati@kb.usm.my

We studied women with cervical cancer to determine whether they had had a Pap smear within the 3 years

preceding cancer development and their understanding of screening for this cancer. The study had 2 parts;

Pathology Data and Survey Data. For pathology data, all cases of cervical cancer diagnosed in 2000-2006

were retrieved from eight hospitals and Pap smear history was obtained from clinical records. For the

Survey data; patients who were still undergoing treatment in some of these hospitals and three others were

administered structured questionnaires to determine their awareness about screening. The results showed

1431 cases of cervical cancer in women aged 25-85 were diagnosed in these hospitals. Most had not had a

Pap smear within 3 years before cancer development. The percentages of patients who had had Pap smear

ranged from 0-12%. Questionnaires were returned by 221 patients; 56.3% had none or only primary

education and 61.1% had a household income of RM 1,000 or less. Level of education and the household

income were strongly associated (p<0.05) with knowledge and having had a Pap test. The main reasons

cited for not having had a Pap smear were "Never heard about it" (36.2%), "Shy" (10.4%), "Afraid to do it"

(13.1%), "Think the test is not important" (8.1%) and "No encouragement from family" (4.5%). A large

majority (95.9%) of the patients did not know the optimal interval. In conclusion, a large number of cervical

cancer patients had not had a Pap smear within 3 years preceding cancer development and most had

inadequate knowledge about this screening test.

PMID: 19827871 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/19827871

J Obstet Gynaecol. 2009 Nov;29(8):757-60.


A survey of the knowledge and attitude of Jordanian obstetricians and
gynaecologists to cervical cancer screening.

Lataifeh I, Amarin Z, Khader Y.

Department of Obstetrics and Gynaecology, Jordan University of Science and Technology, Irbid, Jordan.

isam_l@yahoo.com

The objective of the survey was to investigate the knowledge and attitudes of Jordanian gynaecologists

toward screening for cervical cancer. A pre-tested postal questionnaire was mailed to all 462 licensed

gynaecologists in Jordan. Three questions were designed to assess knowledge and two questions to assess

attitudes to screening for cervical cancer. A total of 392 obstetricians and gynaecologists completed the

survey with a response rate of 84.4%. Although the majority of Jordanian obstetricians and gynaecologists

were able to correctly identify all the important aetiological factors associated with cervical cancer and

recognised the importance of cervical cancer screening, many of them were not confident that the Pap

smear was the most cost-effective screening test, or that human papillomavirus testing improved the

sensitivity of detection of pre-invasive and invasive cervical disease.

PMID: 19821673 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/19821673

J Obstet Gynaecol. 2009 Nov;29(8):754-6.

The need to incorporate routine cervical cancer counselling and


screening in the management of women at the outpatient clinics in
Nigeria.

Dim CC, Nwagha UI, Ezegwui HU, Dim NR.

Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, Nigeria.

dyme72@yahoo.com
Although cervical cancer is the commonest cause of cancer death in Nigeria, the use of cervical cancer

screening is poor. This study aimed at determining the awareness and use of the available cervical cancer

screening method (Pap smear) by women attending the outpatient clinics of a tertiary institution in Enugu,

South-eastern Nigeria. Questionnaires were administered to 912 women from November 2005 to May 2006.

A total of 550 (60.3%) respondents knew about cervical cancer but only 41.2% of them were aware of the

Pap smear. Only 89 (9.0%) respondents had used the Pap smear. The majority (61.9%) of those who had

not been screened despite knowledge of the Pap smear had no reason, while the remaining 112 (38.1%) felt

they were not susceptible to cervical cancer. The use of the Pap smear among women attending the

outpatient clinics in Enugu, Nigeria is very low. Routine cervical cancer counselling and screening with opt-

out option should be offered to every eligible woman attending the outpatient clinics.

PMID: 19821672 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/19821672

Rural Remote Health. 2009 Jul-Sep;9(3):1241. Epub 2009 Sep 22.

Adherence to cervical and breast cancer programs is crucial to


improving screening performance.

Mauad EC, Nicolau SM, Moreira LF, Haikel RL Jr, Longatto-Filho A, Baracat EC.

Barretos Cancer Hospital - Department of Cancer Screening, São Paulo, Brazil.

prevencao@hcancerbarretos.com.br.

INTRODUCTION: Cervical and breast cancer are the most common malignancies among women

worldwide. Effective screening can facilitate early detection and dramatically reduce mortality rates. The

interface between those screening patients and patients most needing screening is complex, and women in

remote areas of rural counties face additional barriers that limit the effectiveness of cancer prevention

programs. This study compared various methods to improve compliance with mass screening for breast and

cervical cancer among women in a remote, rural region of Brazil. METHODS: In 2003, a mobile unit was

used to perform 10,156 mammograms and Papanicolaou smear tests for women living in the Barretos
County region of São Paulo state, Brazil (consisting of 19 neighbouring cities). To reach the women, the

following community outreach strategies were used: distribution of flyers and pamphlets; media broadcasts

(via radio and car loudspeakers); and community healthcare agents (CHCAs) making home visits.

RESULTS: The most useful intervention appeared to be the home visits by healthcare agents or CHCAs.

These agents of the Family Health Programme of the Brazilian Ministry of Health reached an average of

45.6% of those screened, with radio advertisements reaching a further 11.9%. The great majority of the

screened women were illiterate or had elementary level schooling (80.9%) and were of 'poor' or 'very poor'

socioeconomic class (67.2%). CONCLUSIONS: Use of a mobile screening unit is a useful strategy in

developing countries where local health systems have inadequate facilities for cancer screening in

underserved populations. A multimodal approach to community outreach strategies, especially using CHCAs

and radio advertisements, can improve the uptake of mass screening in low-income, low-educational

background female populations.

PMID: 19778158 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/19778158

Rev Saude Publica. 2009 Oct;43(5):851-8. Epub 2009 Sep 18.

Knowledge, attitudes, and practices related to Pap test by women,


Northeastern Brazil.

[Article in English, Portuguese]

Fernandes JV, Rodrigues SH, Costa YG, Silva LC, Brito AM, Azevedo JW, Nascimento ED, Azevedo PR,

Fernandes TA.

Departamento de Microbiologia e Parasitologia, Centro de Biociências, Universidade Federal do Rio Grande

do Norte, Natal, RN, Brasil. veris@cb.ufrn.br

OBJECTIVE: To assess the knowledge, attitudes and practices of women related to the Pap test and the

association between these behaviors and sociodemographic characteristics. METHODS: A household


survey with quantitative approach was conducted. A total of 267 women aged 15 to 69 years, randomly

selected in a stratified manner, living in the city of São José de Mipibu, Northeastern Brazil, were

interviewed in 2007. A questionnaire consisting of pre-coded open questions was administered and answers

were described and analyzed, as for adequacy of knowledge, attitudes, and practices of women regarding

the Pap test. Tests of association were carried out between sociodemographic characteristics and behaviors

studied at a 5% significance level. RESULTS: Although 46.1% of the women interviewed showed adequate

knowledge about the Pap test, a significantly higher proportion of adequacy was seen regarding attitudes

and practices, 63.3% and 64.4%, respectively. Higher schooling was associated with adequacy of

knowledge, attitudes, and practices. The main barriers to the Pap test were negligence, non-requesting by

their physicians, and shame. CONCLUSIONS: The physician is the main source of information about the

Pap test. However, women who more often attend medical visits, despite their good practice, show low

adequacy of knowledge and attitudes related to the Pap test, which indicates that they are not receiving

appropriate information on the test's purpose, advantages and benefits to women's health.

PMID: 19768236 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/19768236

Saudi Med J. 2009 Sep;30(9):1208-12.

Attitudes, knowledge, and practices in relation to cervical cancer and its


screening among women in Saudi Arabia.

Sait KH.

Department of Obstetrics & Gynecology, King Abdul-Aziz University Hospital, Jeddah 21589, PO Box

80215, Kingdom of Saudi Arabia. khalidsait@yahoo.com

OBJECTIVE: To assess the knowledge, attitude, and practices related to cervical cancer screening, and its

underlying etiology and preventive measures among women living in the Kingdom of Saudi Arabia.

METHODS: Six hundred self-administered questionnaires were distributed to randomly selected women

from different groups in the general population of Jeddah, Kingdom of Saudi Arabia. These questionnaires
were sent out to school teachers, relative, friends, as well as, through direct interview of patients visiting the

outpatient clinic while awaiting for their appointments at the King Abdul-Aziz University Hospital from

January to March 2008. There were 500 respondents (83.3%). RESULTS: The knowledge of the human

papilloma virus (HPV) as an etiological agent for cervical cancer was expressed by 72 (14.4%), and the HPV

vaccine by 49 (9.8%) of the respondents. Whereas, 338 (67.6%) of the respondents were aware of the Pap

smear, however, only 84 (16.8%) had undergone the test. The main reason for not having a Pap smear was

the lack of awareness. CONCLUSION: The awareness on cervical cancer among women in Saudi Arabia is

far behind that in the developed countries. There is a need to educate and promote awareness of cervical

cancer in this population.

PMID: 19750269 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/19750269

Int J Gynaecol Obstet. 2009 Dec;107(3):216-9. Epub 2009 Aug 28.

Knowledge, awareness, and attitudes of female sex workers toward


HPV infection, cervical cancer, and cervical smears in Thailand.

Kietpeerakool C, Phianmongkhol Y, Jitvatcharanun K, Siriratwatakul U, Srisomboon J.

Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai,

Thailand. kiet_ji@hotmail.com

OBJECTIVE: To determine the knowledge, attitudes, and awareness of female sex workers (FSWs)

regarding cervical cancer and its prevention in Thailand. METHOD: From August through November 2008,

402 consecutive FSWs were recruited for interviews. RESULTS: The mean knowledge score was 4.9

(maximum possible, 15; range, 0-14). Approximately 60% of the FSWs had knowledge scores less than 5.

Low education and a lack of health insurance were significant independent predictors of low knowledge

scores (adjusted odds ratios, 3.17 and 1.97, respectively). More than half of the FSWs were unaware of

being at higher risk for HPV infection or of the possible consequences of HPV infection. The negative

attitude regarding cervical screening was caused by the fear of abnormal results (27.9%), experiencing pain
(18.4%), and embarrassment (14.7%). CONCLUSION: The knowledge and awareness of HPV infection,

cervical cancer, and utility of cervical smears is low among FSWs in Thailand. Designing and implementing

effective interventions is crucial and merits attention in future research.

PMID: 19716556 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/19716556

Asian Pac J Cancer Prev. 2009 Jul-Sep;10(3):437-42.

Efficacy of a training course given by midwives concerning cervical


cancer risk factors and prevention.

Yücel U, Ceber E, Ozentürk G.

Department of Midwifery, Ege University Izmir Atatürk School of Health, Izmir, Turkey.

BACKGROUND: Cervical cancer is the second most common cancer type seen among women in most

countries and an important cause of mortality. Although it is a preventable disease, most women living in

developing countries cannot reach effective screening programs. It is essential that appropriate education

about cervical cancer is provided. OBJECTIVE: This experimental field study was performed with the aim of

evaluating the efficacy of training given to women about cervical cancer risk factors and primary and

secondary prevention precautions. METHODS: The research focused on women between 25 and 29 years

of age, literate, married and having social security. The study was conducted in the district of Evka 4 Health

Care Center between the dates of April to August 2005. The women were given survey forms and

questionnaires in order to determine their socio-demographic features and knowledge level about cervical

cancer in the course of home visits. They were trained and given a manual at the data collection stage. At a

second visit, carried out three months later, the trained women were again evaluated for their knowledge

level about cervical cancer, risk factors and whether they had undergone a Pap smear test. RESULTS:

Together with the difference between pre-/post-training mean information scores related to women's cervical

cancer risk factors, the difference between the women's having a Pap smear test in the pre-/post-training

period was found statistically significant. Only 16.3% of the women stated that they had a Pap smear test in
the post-training period. Conclusions: It was determined that the women were in need of knowledge about

risk factors related to cervical cancer, prevention from and early diagnosis of cervical cancer, but there was

no significant increase in the rate of having a Pap smear test despite the increase in the knowledge level

with the training given.

PMID: 19640187 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/19640187