Knowledge and Barriers Towards Cervical Cancer Screening Among Young Women in Malaysia

Objectives: This study examined the level of knowledge and barriers towards cervical cancer screening of female university students. Methodology: A cross-sectional design was used for 287 female students at a tertiary institution located in Selangor, Malaysia. A name list of all students in the all faculties were obtained from each faculty’s registrar and the ethics committee of the Faculty of Health and Life Sciences, approved the study. Respondents completed a consent form before they were given the questionnaire consisting of four sections: socio-demographic characteristics (six questions); risk factor of cervical cancer (six); knowledge about cervical cancer and the Pap smear test (ten); and finally barriers to Pap screening (eleven). Data were analyzed using SPSS version 13. Results: The prevalence of ever having had a Pap test was 6%. Majority of the participants had adequate knowledge about risk factors of cervical cancer. The highest knowledge about cervical cancer risk factor reported by the respondents was having more than one sex partner (77.5%), whereas the lowest was the relationship between HPV and cervical cancer (51.2%). Age, marital status, ethnicity, monthly family income and faculty were significantly associated with knowledge of cervical cancer screening (p=0.003; p=0.001; p=0.002; p=0.002; p=0.001 & p=0.002; respectively). The most common barriers of cervical cancer screening were the Pap smear test will make them worry (95.8%) whereas the least common barrier reported among participants was no encouragement from the partner (8.8%). Conclusion: Some misconceptions and barriers in uptaking Pap smear test are still serious problems among young women. Although knowledge about cervical cancer screening is adequate they have a very poor practice of Pap smear test. The introduction of reproductive health subjects is warranted for all university students.     

Knowledge,Attitudes and Practices of Sudanese Women Regarding the Pap Smear Test and Cervical Cancer

Background: Despite the established role of the Pap smear test (PST) in prevention and early detection of cervical cancer, it is still rarely practiced in Sudan. Many challenges hinder the establishment of an effective cervical cancer screening program, including socio-cultural factors. Therefore, this study aimed to investigate the knowledge, attitudes and practices (KAP) of Sudanese women with regard to the Pap smear test and cervical cancer. Materials and Methods: A total of 500 married women aged 14 to 58 years were recruited from obstetric clinics, hospitals and universities in Khartoum in 2014. Data were collected using a standardized, pretested questionnaire that inquired socio-demographic characteristics and their KAP about cervical cancer and the PST. Results: More than 52% of participating women were above 30 years of age, and the majority (78.8%) were university degree holders. A total of 486 (97.2 %) of participants were resident in urban areas of Khartoum State. However about 48% of the respondents had never heard about PST, and only 15.8% of the participants had undergone a Pap smear test previously; 46.6% (233/500) knew that the human papilloma virus (HPV) was the causative agent, but only 39.2% (196/500) had heard about HPV vaccination, and only 11.4% (57/500) had received the vaccine. However 68% of the respondents agreed to do Pap smear if properly informed about the test and 75.4% of the respondents agreed to participate in a cervical cancer screening program. Conclusions: Despite a high educational level, less than half of our participants had accurate knowledge about cervical cancer, HPV, and cervical cancer screening. Health education about cervical cancer, HPV and sexually transmitted infections and the role of PST in cervical cancer prevention are crucial when designing interventions aimed at improving cervical cancer screening for Sudanese women.     

Knowledge,Barriers and Attitudes Towards Breast Cancer Mammography Screening in Jordan

Background: Breast cancer is the most common type of cancer in Jordan. Current efforts are focused onannual campaigns aimed at increasing awareness about breast cancer and encouraging women to conductmammogram screening. In the absence of regular systematic screening for breast cancer in Jordan, there is aneed to evaluate current mammography screening uptake and its predictors, assess women’s knowledge andattitudes towards breast cancer and screening mammograms and to identify barriers to this preventive service.Materials and Methods: This cross-sectional study was conducted in six governorates in Jordan through faceto-face interviews on a random sample of women aged 40 to 69 years. Results: A total of 507 participants withmean age of 46.8±7.8 years were interviewed. There was low participation rate in early detection of breastcancer practices. Breast self-examination, doctor examination and periodic mammography screening werereported by 34.9%, 16.8% and 8.6% of study participants, respectively. Additionally 3.8% underwent breastcancer screening at least once but not periodically, while 87.6% had never undergone mammography screening.Reported reasons for conducting the screening were: perceived benefit (50%); family history of breast cancer(23.1%); perceived severity (21.2%); and advice from friend or family member (5.8%). City residents haveshown higher probability of undergoing mammogram than those who live in towns or villages. Results revealednegative perceptions and limited knowledge of study participants on breast cancer and breast cancer screening.The most commonly reported barriers for women who never underwent screening were: fear of results (63.8%);no support from surrounding environment (59.7); cost of the test (53.4%); and religious belief, i.e. Qadaa WaQadar (51.1%). Conclusions: In the absence of regular systematic screening for breast cancer in Jordan, theuptake of this preventive service is very low. It is essential for the country of Jordan to work on applying regularsystematic mammography screening for breast cancer. Additionally, there is a need for improvement in thecurrent health promotion programmes targeting breast cancer screening. Other areas that could be targeted infuture initiatives in this field include access to screening in rural areas and removal of current barriers.     

Beliefs About Cervical Cancer Screening Among Turkish Married Women

Cervical cancer can be prevented by having a Pap test aiming for early screening. This study was planned to determine the beliefs of women about cervical cancer and the influencing factors. The cross-sectional study was conducted in Sarıyer, one of the most densely populated districts of Istanbul, which is the most crowded city in Turkey. This study sample included 300 women receiving training at public education centers. The data for the study were collected with “HBM-based scale” developed by Bryd et al. upon the basis of health belief model. The mean of the women’s ages was determined as 33.9 ± 10.6. Considering the beliefs of the women who haven’t had a Pap test about cervical cancer, it was determined that 75.7% of the women participating in the survey thought “I am not at risk for cervical cancer”. Logistic regression analysis was carried out in order to find out the most decisive variable among the reasons for not having a Pap test, and it was determined that the factors stated as “I don’t know where I could go if I wanted a Pap test” was a four times factor. This study demonstrated that the main determinant factor affecting CCS behaviors of married women is beliefs. It is considered that the results from this study could be basic data for cervical cancer early screening and educational programs.     

Knowledge about Cervical Cancer Risk Factors and Pap Testing Behaviour among Turkish Women

Background: The aim of the paper was to examine knowledge about cervical cancer and in relation toPapanicolaou (Pap) testing among Turkish women. Methods: This cross-sectional study research was carriedout at Ege University Faculty of Medicine Hospital’s Obstetric and Gynecology Outpatient Clinic betweenMarch 1st, and May 30th, 2008 with 92 volunteer women who were sexually active and aged 25 to 61. Data wascollected through survey forms by interviews conducted by researchers. The form consisted of 30 questions andthree parts. Results: Of the women who participated in the research, 33.7 % were aged 42-49 and 44.6 % wereprimary school graduates. It was determined that 53.3 % of the women had long experience of living in aprovince and big city and that 82.6 % had middle income. Approximately two-thirds (68.5%) had received aPap test. The knowledge of the women within the scope of the research concerning cervical cancer risk factors(having a sexually transmitted disease, giving birth to many children, smoking, having sexual activity with aman who has had partners with a cervical cancer and having sexual intercourse at an early age) was found to berelated with their condition of having pap testing. Conclusion: The women’s condition of having pap testing isinfluenced by their age group, having a history of cancer in their family and having knowledge of cervicalcancer in advance (p <0.01). This research once again demonstrated that having knowledge is influential on thehabit of having pap testing. Taking this conclusion into consideration, it is crucial that information servicesaimed at the whole society, specifically women, should become widespread with the participation of healthworkers.     

Knowledge,Attitudes and Practices of Women in the Southern Region of Saudi Arabia Regarding Cervical Cancer and the Pap Smear Test

Background: The main barrier for women to receive Papanicolaou (Pap) smear tests and immunization is lack ofknowledge about the disease’s signs and symptoms, women’s attitudes toward prevention programs and cultural mythsand beliefs. Therefore, the main objective of this study is to measure women’s knowledge, attitudes and practices aboutcervical cancer and the Pap smear test in the southern region of Saudi Arabia and to assess the findings in relation withwomen’s demographics. Methods: A cross sectional survey was conducted at the Armed Forces Hospital SouthernRegion Obstetrics and Gynecology Clinic using a self-administered questionnaire with a sample size of 255 womenbetween the ages of 15 and 65 years. Results: Forty-three percent of the women in this region are aware of cervicalcancer, but do not recognize its risk factors, implications, timing or main cause, which is Human papillomavirus (HPV).In fact, the primary source of information was obtained through social media. Only two women conducted Pap smeartest and that was based on doctor’s referral, where women’s main reason from not conducting the test was feeling goodand no need. Conclusions: There is a need, therefore, to create awareness programs for cervical cancer, its causes andrisk factors, as well as its preventive measures for women in the southern region of Saudi Arabia.     

深圳市低收入妇女人群宫颈癌防治知识知晓

[目的]了解深圳市低收入妇女人群宫颈癌防治知识知晓及筛查参与情况,为制定宫颈癌防治策略提供参考依据.[方法]用多层次整群随机抽样的方法选择深圳市8个行政区30～59岁低收入妇女1 892例为研究对象,采用统一设计的问卷表进行宫颈癌防治知识和筛查参与情况调查.[结果] HPV病毒感染是宫颈癌发生的必要病因知晓率为32.05％、性行为紊乱增加宫颈癌发生危险性知晓率为49.63％、良好的性生活卫生习惯可以预防宫颈癌知晓率66.84％、已经有早期发现宫颈癌及癌前病变的检查方法的知晓率为51.67％、不同文化程度人群既往参加宫颈癌筛查率差异有统计学意义(x2=68.616,P＜0.001),筛查费用贵或经济困难是影响低收入人群参与筛查的主要原因.[结论]低收入人群宫颈癌防治相关知识知晓率普遍较低,对该类人群采取多种形式的健康教育及政府提供一定的资助有利于提高宫颈癌筛查参与率.     

Barriers to Cervical Cancer Screening Among Haitian Immigrant Women in Little Haiti, Miami

Previous research has not examined barriers to Pap test screening among Haitian immigrant women through their own discourse. Community Health Workers conducted in-depth interviews with Haitian women in Little Haiti, Miami. We used a grounded theory approach to analyze data from the in-depth interviews. Emergent themes coalesced into three core categories of screening barriers: structural, psychosocial, and sociocultural. We developed a model of screening barriers to depict the themes within each core category. Screening barriers must be examined and understood from the social contexts in which they are produced in order to create meaningful interventions.     

Knowledge,Attitudes and Behavior of Bangkok Metropolitan Women Regarding Cervical Cancer Screening

Purpose: To assess knowledge, attitudes and cervical cancer screening behavior of Bangkok Metropolitan women. Materials and Methods: 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. Results: 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 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%). Conclusions: 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.     

Perceived Susceptibility,and Cervical Cancer Screening Benefits and Barriers in Malaysian Women Visiting Outpatient Clinics

Aims: A main reason for increasing incidence of cervical cancer worldwide is the lack of regular cervicalcancer screening. Coverage and uptake remain major challenges and it is crucial to determine the perceivedsusceptibility to cervical cancer, as well as the benefits of, and barriers to, cervical cancer screening among women.Materials and Methods: A cross-sectional survey was conducted among 369 women attending an outpatient centrein Malaysia and data were collected by administering a self-report questionnaire. Results: The majority of theparticipants (265, 71.8%) showed good level of perception of their susceptibility to cervical cancer. Almost allresponded positively to four statements about the perceived benefits of cervical cancer screening (agree, 23.1% orstrongly agree, 52.5%), whereas negative responses were received from most of the participants (agree, 29.9%orstrongly agree, 14.6 %) about the eleven statements on perceived barriers. Significant associations were observedbetween age and perceived susceptibility(x2=9.030, p=0.029); between employment status (p<0.001) as well asethnicity and perceived benefits (p<0.05 [P=0.003]); and between education and perceived barriers to cervicalcancer screening (p<0.001). Conclusions: Perceived susceptibility, including knowledge levels and personal riskassessment, should be emphasized through education and awareness campaigns to improve uptake of cervicalcancer screening in Malaysia.     

超薄细胞检测及TBS分类法在宫颈癌筛查中的应用

[目的]对超薄细胞检测系统(thinprep pap test,TPTP)及Bethesda(TBS)细胞学分类法在宫颈癌筛查中的应用价值进行综合评价。[方法]对进行TPT检查及TBS细胞学分类的1209例临床资料进行回顾性分析。[结果]标本满意率93．38％；鳞状上皮异常96例中，未明确诊断意义的鳞状细胞(ASCUS)14例；低度鳞状上皮内瘤变(LSIL)55例，活检证实CINⅠ-Ⅱ级46例(83．64％)，CINⅢ级2例(3．64％)；高度鳞状上皮内瘤变(HSIL)10例，活检证实CINⅢ级及原位癌8例(80％)，CINⅠ-Ⅱ级1例(10％)，鳞癌早浸1例(10％)；TBs诊断为鳞癌者17例，均经病理证实，准确率100％。超薄涂片找到腺癌4例，经活检证实宫颈腺癌2例，子宫内膜癌1例．卵巢癌宫颈转移1例，未明确诊断意义的腺细胞(AGCUS)2例病理均阴性；不典型腺上皮3例，活检及诊刮结果为子宫内膜癌1例，宫颈腺癌1例，阴性1例。[结论]TPT技术应用于宫颈癌筛查能明显提高涂片满意率及宫颈异常细胞检出率。TBS报告方法内容直观、易懂、具体，便于细胞学医生与临床医生之间的沟通．增加了标本的可信度。     

Factors Influencing Knowledge and Practice Regarding Cervical Cancer and Pap smear Testing among Omani Women

Background: Knowledge of cervical cancer and performance of Pap smear testing are influenced by severalsociodemographic factors. This study aimed to describe the effect of relevant variables on knowledge and compliancewith guidelines in Oman. Methods: In this cross-sectional survey, participants were divided into three groups: patientswho attended Outpatient Gynecology Department, female medical staff and university graduate students. Results: Therewere 204 outpatients, 133 staff, and 157 students. Adequate knowledge among was seen in 38.7%, 35.3%, and 7.6%,respectively. Knowledge of cervical cancer and Pap smear was significantly lower among outpatients with secondaryeducation, while those with high level of income were more likely to have adequate cancer knowledge. Uptake of Papsmear was significantly greater among outpatients aged ≥ 30 years, with high income and a positive history of cancer.Conclusion: Culturally tailored interventions that focus on improving cancer risk knowledge are needed to maximizescreening uptake for cervical cancer.     

Health Literacy,Knowledge on Cervical Cancer and Pap Smear and Its Influence on Pre-Marital Malay Muslim Women Attitude towards Pap Smear

Background: Cervical cancer is preventable. In Malaysia, women are found to have good awareness of the disease and yet, the Pap smear uptake is still poor. Measuring health literacy level could explain this discrepancy. This study aims to determine the relationship between health literacy, level of knowledge of cervical cancer and Pap smear with attitude towards Pap smear among women attending pre-marital course. Methods: A cross sectional study was performed in three randomly selected centres that organised pre-marital courses. All Malay Muslim women participants aged 18 to 40 years old were recruited while non-Malaysian, illiterate, and had hysterectomy were excluded. Validated self-administered questionnaires used were European Health Literacy Questionnaire (HLS-EU-Q16 Malay) and Knowledge and attitude towards Cervical Cancer and Pap Smear Questionnaire. The mean percentage score (mean± SD) was calculated, with higher scores showed better outcomes. Multiple linear regression was used to measure the relationship of independent variables with attitude towards Pap smear. Results: A total of 417 participants were recruited with a mean age of 24.9 ± 3.56 years old. Prevalence of awareness of cervical cancer was 91.6% (n=382, 95% CI: 89.0%, 94.2%) and mean percentage score was 74.7%±7.6. Prevalence of awareness of Pap smear was 59.0% (n=246, 95% CI: 54.2%, 63.8%) and mean percentage score was 80.2% ± 6.5. The health literacy mean score was 13.3±3.6, with minimum score 0 and maximum score 16. The mean percentage score of attitudes towards Pap smear was 64.8%±9.3. Multiple linear regression analysis demonstrated significant relationship between health literacy (p=0.047) and knowledge of Pap smear (p<0.001) with attitude towards Pap smear. Conclusion: A higher health literacy with high knowledge of Pap smear improves the attitude towards Pap smear. Pre-marital course is an opportunistic platform to disseminate information to improve health literacy and knowledge of cervical cancer and Pap smear screening.     

HPV,Cervical Cancer and Pap Test Related Knowledge Among a Sample of Female Dental Students in India

Background: The present study was designed to ascertain knowledge about HPV, cervical cancer (CC) andthe Pap test among female dental students of Panineeya Institute of Dental Sciences and Hospital, Hyderabad,India. Materials and Methods: A self-administered questionnaire covering demographic details, knowledgerelating to human papilloma virus (HPV) (8 items), cervical cancer (4 items) and the Pap smear (6 items) wasemployed. Responses were coded as “True, False and Don’t Know”. Mean and standard deviation (SD) for correctanswers and levels of knowledge were determined. Results: Based on the year of study, significant differences inknowledge of HPV werenoted for questions on symptoms (p=0.01); transmission from asymptomatic partners(p=0.002); treatment with antibiotics (p=0.002); start of sexual activity (p=0.004); and recommended age for HPVvaccination (p=0.01). For knowledge regarding CC, significance was observed for the age group being affected(p=0.008) and symptoms of the disease in early stages (p=0.001). Indications for Pap smear tests like symptoms’ ofvaginal discharge (p=0.002), marital status (p=0.01) and women with children (p=0.02) had significant differencebased on the year of study. Based on religion, transmission of HPV via pregnancy, HPV related diseases exceptCC and preventive measures except condom use and oral contraceptives showed significant differences. However,significant variation with religion was observed only for two preventive measures of CC (Pap test; p=0.004) andHPV vaccination (p=0.003). Likewise, only the frequency of Pap test showed a significant difference for religion(p=0.001). Conclusions: This study emphasizes the lack of awareness with regard to HPV, CC and screeningwith pap smear even among health professionals. Hence, regular health campaigns are essential to reduce thedisease burden     

Awareness of Cervical Cancer and Pap Smear Testing Among Omani Women

Background: In developed countries, awareness of cervical cancer screening is well documented. In contrast, in Oman as a developing country, public responses regarding cervical screening are unclear. This study aimed to assess the level of awareness about cervical cancer and Papanicolau (Pap) smear testing and to establish any correlations between knowledge and demographic factors among Omani women. Methods: In this cross-sectional survey, participants were divided into three groups: patients who attended the Outpatient Gynecology Department in Sultan Qaboos University Hospital (SQUH), Oman, female staff from SQUH, College of Medicine and College of Nursing at Sultan Qaboos University (SQU) and graduating female students at SQU. Data collection was through interview-based and online self-administered questionnaires. Cumulative scoring was used for data analysis. Results: There were 204 outpatients, 133 staff and 157 students. Outpatients (79.4%), staff (97.7%) and students (75.2%) had heard of cervical cancer. Nevertheless, their specific knowledge, regarding signs and symptoms, risk factors and Pap smear, was low at 38.7%, 35.3% and 7.6% among outpatients, staff and students, respectively. Some 39.9% of the married outpatients had adequate overall knowledge as compared to none of the single women. Educational level was found to be significantly associated with outpatient knowledge with the highest awareness levels among postgraduates and medical university graduates (61.5%). Conclusion: Specific knowledge of cervical cancer, its risk factors and cervical Pap smear is generally poor among Omani women. This lack of knowledge may be one of the contributing factors for the high incidence of cervical cancer in Oman relative to that in developed countries.     

Limited Understanding of Pap Smear Testing among Women,a Barrier to Cervical Cancer Screening in the United Arab Emirates

Global data indicate that cervical cancer is the fourth most common cancer among women worldwide. Important factors that affect interventions for early diagnosis of cervical cancer include social beliefs and values and poor knowledge. These may contribute to women’s participation in screening for cervical cancer and have a significant impact on decisions to take preventive action. The present study was conducted with 599 women in the UAE between September 2016 and March 2017. A cross-sectional survey was conducted to determine knowledge about cervical cancer and screening, demographic characteristics and perceived barriers. Knowledge about the Pap smear test was limited, and awareness that they should undergo the Pap smear test every three years even with an initial negative/normal Pap smear result was abysmal. In spite of the positive attitude of the women towards the Pap smear test, almost 80% of the women surveyed had no knowledge of precancerous lesions. Having higher income (21/29, 72%, p=0.027) and more miscarriages were associated with better practice of Pap smears (19/26, 73%, p=0.010). Knowledge levels were significantly higher (66.3±22.2,) that values for attitude (60.5±20.9, p= 0.03, 95% CI {0.22-11.3}, Chi-square 4.38) and practice (53.7 24.1, p= 0.001, 95% CI {6.9-18.1}, Chi-square 19.7). A well-designed health education programme on cervical cancer and benefits of screening should increase the awareness among women in UAE. One point to stress is that better communication with health professionals and improvement of access to health care services should increase the rate of cervical cancer screening.     

Knowledge,Belief and Practice of Cervical Cancer Screening and Prevention among Women of Taraba,North-East Nigeria

Objective: The rising prevalence of cancer of the cervix especially in developing countries gives cause for concern. Fortunately, it can be prevented especially when the women at risk possess correct knowledge, have the right belief and access to screening and prevention services. Previous studies have reported poor knowledge and screening practices among women in developing countries raising the fear of continued spread. The aim of the study was to establish the cervical cancer knowledge, belief and prevention/screening practices among women in Taraba, North-East Nigeria. Methods: The study adopted a cross sectional survey design. A self-designed structured and validated questionnaire with a reliability index of .82 was employed to elicit information from 978 women of child bearing age. Data collected were analysed using percentage, mean, Chi-Square and ANOVA statistics. Result: The findings of the study revealed that the women of Taraba had appropriate knowledge about the nature of cervical cancer (73. 2%) signs and symptoms of cervical cancer (76.5%) risk factors of cervical cancer (88.0%), and prevention of cervical cancer (90.3%). The women did not have the right beliefs about the concept of cervical cancer and its preventive measures. They believed that the screening procedure is painful; they were too young to contract the disease and risk stigmatization if they went for screening. Only 45.2% of the women regularly engaged in screening and other prevention practices. Location of residence, and religion significantly determined knowledge and screening/prevention practices (P<0.05) while marital status and age (P<0.05) significantly affected the respondents’ beliefs about cervical cancer and prevention practices. Location of residence, and religion significantly determined knowledge and screening/prevention practices (P<0.05) while marital status and age (P<0.05) significantly affected the respondents’ beliefs about cervical cancer and prevention practices. Conclusion: It was concluded that knowledge about cervical cancer did not translate to right belief and good practice, and that belief and practice were affected by demographic variables of location of residence, religion, marital status and age.     

Cervical Cancer Screening Among Adult Women in China, 2010

Introduction.

Cervical cancer is one of the most commonly diagnosed cancers among women in China. The World Health Organization (WHO) recommends routine screening for cervical cancer, and the WHO Global Monitoring Framework suggests that every nation monitors cervical cancer screening. However, little information is available on cervical cancer screening behavior among women in China.

Methods.

We used data from the 2010 China Chronic Disease and Risk Factor Surveillance System that included 51,989 women aged 18 years and older. We report the proportion of women who reported ever having had a Papanicolaou (Pap) test, stratified by sociodemographic characteristics and geographic region. Multivariable logistic regression modeling was performed to adjust for potential confounders.

Results.

Overall, 21% of 51,989 women reported having ever had a Pap test. The highest proportion was reported among women aged 30–39 years (30.1%, 95% confidence interval, 26.8%–33.4%). In all geographic regions, women in rural areas were consistently less likely than women in urban areas to report having had a Pap test. Among women who reported ever having a Pap test, 82% reported having the most recent test in the past 3 years. Factors associated with reporting ever having a test were being aged 30–49 years, higher education, being married, and having urban health insurance.

Conclusion.

Our results indicate that screening programs need to be strengthened along with a more intense focus on specific demographic groups. National cervical cancer screening guidelines and comprehensive implementation strategies are needed to make screening services available and accessible to all women.

Implications for Practice:

This study is the largest nationwide and population-based assessment of self-reported history of Pap test for cervical cancer screening in China. This article describes cervical cancer screening behavior among women and examines key demographic and geographic factors. Only one fifth of Chinese women reported having ever had a Pap test for cervical cancer screening. The results highlight the urgent need to develop national cervical cancer screening guidelines and strategies that make screening services widely available, accessible, and acceptable to all women, especially to those who reside in rural areas and those with no health insurance.