Attitudes and practice of cervical cancer screening among female university students from 25 low, middle income and emerging economy countries.

Karl Peltzer,Supa Pengpid

doi:10.7314/apjcp.2014.15.17.7235

Abstract

Cervical cancer, the third commonest cancer in women worldwide, can be prevented through early detection by cervical screening (Pap smear). The aim of this study was to investigate the attitudes and practice of cervical cancer screening among female undergraduate university students from 25 low, middle income and emerging economy countries. Using anonymous questionnaires, data were collected from 9,194 female undergraduate university students aged 18-26 years (mean age 20.9, SD=2.0) from 26 universities in 25 countries across Asia, Africa and the Americas. Overall, 11.6% of the female students indicated that they had conducted one or more times a cervical (Pap) smear test; 8.3% among 18-20 year-olds and 15.6% among 21-26 year-old students. There was considerable country variation on having had a cervical (Pap) smear test among 21-26 year-old female university students, ranging from 59.2% in Colombia and 50.9% in Barbados to 0% in India and 1.0% in Tunesia. Logistic regression showed that cervical cancer screening importance or positive attitude were highly associated with the cervical screening practice. Moreover, risky sexual behaviour and tobacco use, two cervical cancer risk factors, were associated with screening. Cervical cancer screening practices were found to be inadequate and efforts should be made to develop programmes that can increase the uptake of cervical cancer screening.

Highlights

Cervical cancer is the third most common cancer in women, accounting for 9% of all female cancers
Logistic regression showed that cervical cancer screening importance or positive attitude were highly associated with the cervical screening practice
The study found, among a large sample of female university students across 25 low and middle and emerging economy countries, an overall low participation rate in cervical cancer screening, which is comparable to previous studies in low and middle income countries (Ayinde et al, 2004; Akujobi et al, 2008; Oladepo et al, 2008; 2009; Abotchie and Shokar, 2009; Al-Naggar et al, 2010; Aniebue and Aniebue, 2010; Hoque, 2013; Dhendup and Tshering, 2014)

Summary

Introduction

Cervical cancer is the third most common cancer in women, accounting for 9% of all female cancers. The United States Preventive Services Task Force (USPSTF, 2012) and the American Cancer Society (ACS) recommend that all women should begin cervical cancer screening at age 21, every three years for women ages 21-65. Several other countries such as Barbados (Pan American Health Organization, 2013) and South Africa (Botha et al, 2010) recommend to begin cervical cancer screen at the age of 21, while other countries such as Singapore, Jamaica, Colombia and Venezuela follow the recommendations of the World Health Organization (2013), namely to begin cervical cancer screening with the age of 25 years While studies among female university students in high income countries found a higher participation rate in screening for cervical cancer, e.g. 44.8% in Greece (Bakogianni et al, 2012) and 41% in USA (Durvasula et al, 2006)

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