Abstract

To assess knowledge, attitudes and cervical cancer screening behavior of Bangkok Metropolitan women. Thai women, aged 25-to-65 years old, having lived in Bangkok for 5 years or more were invited to participate in the study. After signing informed consent, all women were asked to complete a self-questionnaire (Thai language) with literate assistance if needed. The questionnaire was divided into 3 parts: (I) demographic data; (II) knowledge about cervical cancer screening; and (III) behavior and attitudes, towards cervical cancer screening. Adequate screening was defined as women who had ≥two cervical cancer screening tests except women aged 25-30 years who may have only one screening, and the last screen was within 5 year or had had regular screening. Of 4,339 women, there were 1,857 (42.8%) with adequate screening and 2,482 (57.2%) with inadequate screening. Significant factors associated with inadequate screening included age < 45 years, pre-menopausal status, family monthly income <625 USD, no reported sexual intercourse, nulliparous, no knowledge, lack of awareness and poor attitudes. Three major reasons provided by women for inadequate screening were no symptoms (54.4%), fear of pain (33.2%), and embarrassment (34.6%). Personal features, knowledge, and attitudes influence screening behavior of Bangkok Metropolitan women. The three most common reasons of women for not undergoinging screening are no symptoms, fear of pain, and embarrassment. These factors should be the focus of attention to improve coverage of cervical cancer screening in Bangkok.

Highlights

  • Cervical cancer is the fourth most common cancer in women worldwide with an estimated 528,000 new cases and 266,000 deaths in 2012 (Ferlay et al, 2015)

  • The questionnaire was divided into 3 parts: (I) demographic data; (II) knowledge about cervical cancer screening; and (III) behavior and attitudes, towards cervical cancer screening

  • As mentioned earlier that this study was a parallel project with the co-test screening of cytology and human papilloma virus (HPV) DNA test in Bangkok women

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Summary

Introduction

Cervical cancer is the fourth most common cancer in women worldwide with an estimated 528,000 new cases and 266,000 deaths in 2012 (Ferlay et al, 2015). After a discovery of human papilloma virus (HPV) as the cause of cervical cancer (zurHausen, 1977), HPV DNA testing has become an effective means of screening (Saslow et al, 2012). Another practical test in low resources setting, where cervical cytology of HPV test are inadequate or unavailable, is visual inspection with acetic acid (VIA) (Sankaranarayanan et al, 2003; Gaffikin et al, 2003; Sanghvi et al, 2008; Paul et al, 2013; Bradford and Goodman, 2013). In Thailand, the Ministry of Public Health (MOPH) solicited a cervical cancer screening program for women aged 30-60 years by Pap test every 5 years to

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