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Keywords:
Pap smear screening; non-adherence; associated factors
Abstract
Introduction: Cervical cancer ranks as the second most frequent cancer among women in Malaysia. Although a cervical screening program has been introduced since 1960s and is provided free of charge in all government health facilities, the coverage and adherence rate to recommendation among Malaysian women remains low.
Objectives: To determine the proportion of non-adherence to Pap smear screening guidelines and its associated factors among women attending a health clinic in Malaysia.
Method: A cross sectional study involving 316 women aged 20 to 65 years who had undergone a Pap smear. Universal sampling method was applied to select participants among women who attended the selected health clinic from January 2013 to May 2013. A self-administered questionnaire was used to obtain the socio-demographic characteristics, socio-health data and perceptions about cervical cancer and Pap smear screening. The data was analysed using descriptive statistics and multiple logistic regression.
Result: The proportion of non-adherence to Pap smear screening was 90.5%. Age, marital status, duration of marriage, education level, employment, household income and number of children were not significantly associated with non-adherence. Perceived severity, perceived susceptibility, perceived benefit, perceived barrier and cues to action did not show significant association with non-adherence to Pap smear screening.
Conclusion: Non-adherence to Pap smear screening was high among Malaysian women. Measures should be taken to increase Pap smear screening coverage in our country. Other factors beyond Health Belief Model that influence Pap smear screening practice among Malaysian women should be explored.
Introduction
Cervical cancer is one of the most important health issues among women. It is the fourth leading cancer in women worldwide and the second most common cancer among women in Malaysia.1,2 The number of cervical cancer patients in Malaysia in 2003 was 1557, which accounted for 12.9% of total female cancers. Moreover, the average annual hospital admission for cervical cancer was 2000 to 3000 cases per year, with the majority of them presenting with a FIGO stage II or higher 3.
Despite all these alarming facts, cervical cancer is a preventable disease when proper screening, treatment, and follow up is conducted. A Papanicolaou (Pap) smear test, which was introduced in the 1940s, has the ability to detect cervical cancer at the pre-invasive stage.4 The...