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

International Medical School, Management and Science University, Shah Alam, Malaysia.
Asian Pacific journal of cancer prevention: APJCP (Impact Factor: 2.51). 01/2010; 11(4):867-73.
Source: PubMed


This study examined the level of knowledge and barriers towards cervical cancer screening of female university students.
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.
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 and 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%).
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.

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    • "Preventive medicine is a relatively new field in the medical practice in Malaysia. Research on preventive medicine in the Malaysian context has been focused on certain topics, including lifestyle practices of university students [16], breast self-examination [17], skin cancer prevention [18], colorectal cancer screening [19], lung cancer prevention [20], and cervical cancer screening [21,22]. A previous research determined that the Public Health course, which involves preventive medicine training on smoking cessation, weight management, and cardiovascular diseases, has been successfully implemented by pharmacy schools in Malaysia [23]. "
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    ABSTRACT: Preventive medicine has been incorporated in the medical school curriculum, but its effectiveness and the factors that affect it are yet to be widely looked into in the context of Malaysia. We aimed to measure the familiarity with, perception about the importance to learn, and the ability to practice preventive medicine as well as its determinants among the medical students in Malaysia. Thus, a cross sectional study was conducted through an anonymous online survey among 387 randomly selected final year medical students of four large public medical schools in Malaysia from March to September 2014. Of the total sample, 340 (response rate 87.8%) gave a written informed consent and took part in the survey. The familiarity of the sample with preventive medicine was measured in 19 preventive medicine areas, and their perception about the importance of preventive medicine and their ability to practice it were gauged on a Likert scale (low score indicates disagreement and high indicates agreement). Descriptive statistical analysis was performed, followed by logistic regression. The mean age of the respondents was 23.7 (SD 0.77) years, and 61.2% (n = 208) of them were females. Results showed that 22.9% of the sample (n = 78) had a low familiarity with preventive medicine, whereas 76.8% (n = 261) had a high familiarity. The study sample specified that among all the preventive medicine subjects, screening and control as well as smoking cessation and immunization are "extremely important to learn." In univariable analysis, being a female, medical school, family size, and perception about the importance to learn preventive medicine were associated with the ability to practice it. In multivariable analysis, the perception towards the importance to learn preventive medicine was the only significant determinant: aOR (adjusted odds ratio) for those who "agreed" 17.28 (95% CI aOR 4.44-67.26, P < 0.001) and for "strongly agreed" 35.87 (95% CI aOR 8.04-159.87, P < 0.001). Considering these findings, the familiarity of medical students with preventive medicine should be increased. The perception about the importance to learn preventive medicine is a strong determinant for the ability to practice it.
    No preview · Article · Dec 2015 · Frontiers of Medicine
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    • "About 53% (n = 353) of the participants were aware of the purpose of Pap test which is much lower than those reported from studies conducted among Taiwanese (80%) [19] and Greek (94%) [20] students. Only about 25% of our study respondents knew about the link between smoking and cervical cancer which is slightly higher than studies reported from Sri Lanka (20.8%) [21], Nepal (0.2%) [21] and Ghana (1%) [22] but much lower than that reported from studies conducted in Malaysia (61%) [23]. On the other hand, our study revealed better awareness of the link between cervical cancer and multiple sexual partners (53%) and early onset of sexual activity (50%). "
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    ABSTRACT: Cervical cancer is the leading female cancer in Bhutan. This study describes the level of cervical cancer knowledge and screening behaviors among female university graduates attending the National Graduate Orientation Program (NGOP), 2012. A cross-sectional study of female graduates attending NGOP was conducted using self-administered anonymous questionnaire developed through literature reviews and expert discussions to elicit information on demographic characteristics, knowledge, screening behaviors and determinants of cervical cancer. The association of demographic and other important study characteristics with uptake of Pap test was investigated using cross tabulation and Fischer Exact test. Frequencies and percentages were calculated for all the questions. The average age of the participants was 23.43 +/- SD 2.73. About 92% (n = 513) of the respondents were aged 25 years or less and 7.9% (n = 44) of the respondents were aged 26 or more. The study revealed low cervical cancer knowledge and poor screening behavior among the graduates. The mean knowledge score was 3.571 (SD1.75, Range 0-8). About 6% (n=34) of the respondents reported undergoing Pap test at least once in every three years and 94% reported as never having done Pap test. The most commonly cited reasons for not doing Pap test included "never thought I needed one" (57%, n = 320) and "embarrassment of being examined by male health professional" and "fear of finding out cancer". The study revealed evidence of significant association between increasing age, those who are married, knowledge score and those recommended for screening by health professionals with the uptake of Pap test. Our study revealed poor knowledge and screening behaviors among female university graduates in Bhutan. This may be suggestive of even poorer awareness and screening practices among young unmarried women who are less educated or with no education. Although our study group is not appropriate for measuring practice of cervical cancer screening in the country, the findings are expected to highlight the shortcomings and trigger development of comprehensive cervical cancer control programs in Bhutan.
    Full-text · Article · Mar 2014 · BMC Women's Health
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    • "Luque and colleagues (42) observed greater awareness of HPV and the HPV vaccine among Anglo American and Puerto Rican women than among Mexican and Honduran women. Al-Naggar and colleagues (28) examined the level of knowledge and barriers against cervical cancer screening of female university students in Selangor, Malaysia and found that age, marital status, ethnicity, and monthly family income, were significantly associated with knowledge of cervical cancer screening. Vogtmann and colleagues (29) evaluated the demographic and behavioral factors associated with HPV awareness and knowledge in a population of Mexican college students and found that characteristics associated with not having heard about HPV were being male, not having running water, not having health insurance, and not having sexual experience. "
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    ABSTRACT: Background: Screening with HPV is more effective than Pap test in preventing cervical cancer. HPV as primary test will imply longer intervals and a triage test for HPV positive women. It will also permit the development of self-sampling devices. These innovations may affect population coverage, participation, and compliance to protocols, and likely in a different way for less educated, poorer, and disadvantaged women. Aim: To describe the impact on inequalities, actual or presumed, of the introduction of HPV-based screening. Methods: The putative HPV-based screening algorithm has been analyzed to identify critical points for inequalities. A systematic review of the literature has been conducted searching PubMed on HPV screening coverage, participation, and compliance. Results were summarized in a narrative synthesis. Results: Knowledge about HPV and cervical cancer was lower in women with low socio-economic status and in disadvantaged groups. A correct communication can reduce differences. Longer intervals will make it easier to achieve high-population coverage, but higher cost of the test in private providers could reduce the use of opportunistic screening by disadvantaged women. There are some evidences that inviting for HPV test instead of Pap increases participation, but there are no data on social differences. Self-sampling devices are effective in increasing participation and coverage. Some studies showed that the acceptability of self-sampling is higher in more educated women, but there is also an effect on hard-to-reach women. Communication of HPV positivity may increase anxiety and impact on sexual behaviors, the effect is stronger in low educated and disadvantaged women. Finally, many studies found indirect evidence that unvaccinated women are or will be more probably under-screened. Conclusion: The introduction of HPV test may increase population coverage, but non-compliance to protocols and interaction with opportunistic screening can increase the existing inequalities.
    Full-text · Article · Feb 2014 · Frontiers in Oncology
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