Abstract
Coverage of cervical pap smear test in Nepal is below general global values. One of the reasons may be that cervical cancer prevention policy of Nepal has 'Visual Inspection of Cervix with Acetic Acid' as the only screening tool. The focus of present study was to find out association of demographic factors, knowledge and attitude regarding cervical Pap smear test with its practice by women in Nepal. This cross sectional analytical observational study was conducted between February 1, 2013 and April 30, 2013. Participants were interviewed with the help of a structured questionnaire. Chi square and multivariate logistic regression tests were used to detect associations of variables with pap smear practice. Chi square test showed that practice was significantly associated with knowledge about pap smear test and cervical cancer, having favourable attitude towards the test, urban residency and 36-50 years age-group. Pap smear utilization was not associated with age-at-marriage, parity and age-at-first-child-birth. Multivariate logistic regression showed favorable attitude towards pap smear test as the only variable which significantly influenced pap smear practice (p=0.006, OR: 2.4). Pap smear coverage has been found to be 15.7% which is lower than global average and that for developing countries. Health education programs which are effective not only in increasing knowledge about cervical cancer and pap smear test but also effective in positively changing attitude towards the test should be organized to increase pap smear coverage.
Highlights
Cervical cancer is the most common malignancy among women in Nepal (Family Health Division [FHD], 2011). 9.65 million women, the population of more than 15 years of age in Nepal, are at risk of developing cervical cancer
Shrestha et al, (2013) found pap smear coverage to be 10.5% in a research done in Kathmandu, Nepal
We studied intrinsic barriers of pap smear utilization among women in Chitwan district of Nepal to find out their impact on pap smear practice in Nepal
Summary
Cervical cancer is the most common malignancy among women in Nepal (Family Health Division [FHD], 2011). 9.65 million women, the population of more than 15 years of age in Nepal, are at risk of developing cervical cancer. There has been significant decline in incidence and mortality rates of the disease in developed countries in the last fifty years due to both organized and opportunistic screening with Pap smear cytology test. Coverage of cervical pap smear test in Nepal is below general global values. The focus of present study was to find out association of demographic factors, knowledge and attitude regarding cervical Pap smear test with its practice by women in Nepal. Chi square and multivariate logistic regression tests were used to detect associations of variables with pap smear practice. Results: Chi square test showed that practice was significantly associated with knowledge about pap smear test and cervical cancer, having favourable attitude towards the test, urban residency and 36-50 years age-group. Health education programs which are effective in increasing knowledge about cervical cancer and pap smear test and effective in positively changing attitude towards the test should be organized to increase pap smear coverage
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