Women's knowledge of cervical cancer and uptake of Pap smear testing and the factors influencing it in a Nigerian tertiary hospital

Abstract

Background: Both the incidence and burden of cervical cancer have been drastically reduced in the developed world, due to the practice of regular cervical cancer screening with Pap smear. Unfortunately, the disease is still the most common gynaecological cancer, and the second leading cause of female cancer mortality in Nigeria, with up to 80% of women with cervical cancer ultimately succumbing to the disease. Objective: We examined the knowledge of cervical cancer and uptake of Pap smear screening among women attending obstetric and gynaecological outpatient clinics at the Lagos University Teaching Hospital in Lagos, Nigeria, and the factors that affect it. Methods: The study was a descriptive cross-sectional study derived from a cohort of 225 pregnant and non-pregnant women using a structured questionnaire to assess their knowledge of cervical cancer, uptake of Pap smear and factors that affect them. Data was analyzed using the Statistical Package for Social Sciences (SPSS) version 20.0. Results: The knowledge of women in this study regarding symptoms and risk factors of cervical cancer was very poor (40.0% and 15.6%, respectively), despite a 78.5% awareness rate. Likewise, the uptake of Pap smear was very low (22.9%), with an awareness rate of 55.1%. The major reasons for having a Pap smear were recommendation from doctors/nurses (89.4%) and fear of developing cervical cancer (23.4%), while the reasons for not having a Pap smear were lack of awareness (53.8%) and non-recommendation of the test by doctors/nurses (31.0%). Prior counseling by doctors/nurses and knowing someone with cervical cancer significantly increased the knowledge of cervical cancer and the uptake of Pap smear, while high level of education was significantly associated only with increased knowledge of cervical cancer and awareness of Pap smear, but not its uptake. Conclusion: Our study indicates that when healthcare providers supply regular health education and recommendation of Pap smear test, this will increase the knowledge of cervical cancer and its screening, and reduce the burden of the disease. Keywords: Knowledge of cervical cancer, Risk factors for cervical cancer, Symptoms of cervical cancer, Uptake of pap smear, Nigeria