Knowlegde and utilization of PAP smear among women attending the antenatal and gynaecological clinic at the University teaching hospital in lusaka

Abstract

Background: Pap smear is a screening test used to examine cells from cervix and vagina to determine whether there is evidence of precancerous changes or cancer. Cervical cancer is a major public health problem in the world, and it is a leading cause of cancer deaths in the third world. Cervical cancer is a preventable disease. The estimated global number of deaths from cervical cancer in the year 2000 was 233,372 with 470, 606 reported new cases. The majority of women who suffer from cancer of the cervix are diagnosed to have advanced stage of the disease without having obtained a Pap smear before. The death toll from cervical cancer at the University Teaching Hospital in Lusaka is on the increase, with records showing 160 and 251 women dying from cervical cancer for the periods 1994 to 1998 and 1999 to 2003, respectively. There is an increase in the number of Pap smears being done, 367 and 842 for the years 1997 and 2003, respectively.

Aims: The aims of this project were to determine the level of knowledge about Pap smear and cervical cancer, assess the level of Pap smear use and identify factors that may be associated with low uptake of Pap smear at the University Teaching Hospital.

Methods: A structured questionnaire was used to obtain information from 1069 women aged 18 years and above, who attended the antenatal and gynaecological clinics over a period of six months, hiformation collected from women included questions on demographic data, knowledge about cancer of the cervix, knowledge about Pap smear, and utilization of Pap smear.

Results: Using SPSS for data analysis, we have established that the level of knowledge about cancer of the cervix is low among the women who were interviewed, with the majority of women (80.3%) scoring less than 50%) of the total score. The level of knowledge about Pap smear is equally low, only 9.6% of women scored more than 50% of the total score. 320 (30.4%) women had heard about Pap smear, and of these 151 (47.2%)) agreed that the Pap smear is important. 148 (14.0%) respondents knew what a Pap smear is. We have also established that marital status can be an important factor in awareness of cervical cancer and Pap smear, as evidenced by significantly different mean scores on overall knowledge score among classes of marital status (p = 0.003). Educational background was found to be an important factor in awareness of cervical cancer and Pap smear, as means of the overall knowledge score differed significantly among educational levels (p < 0.001). This study has also shown that most women are not aware of the existence of Pap smear screening facilities at UTH, only 86 (8.1%)) out of 1059 knew about its existence.

Conclusion: The study has shown that there is need to focus on health education about cancer of the cervix and Pap smear. Women from rural areas need to be empowered with basic knowledge about cervical cancer risks, symptoms, screening and treatment options. There is also need to sensitise medical personnel on the importance of disseminating health information and promotion of Pap smears.