Pap smear screening: Coverage and target group factors associated with coverage in the Puttalam District

Abstract

INTRODUCTION AND OBJECTIVES: Cervical cancer is the second commonest cancer among women in Sri Lanka. Pap smear screening with coverage of over 80% is an effective preventive method. This study was undertaken to determine the Pap smear screening coverage and personal factors associated with screening of women aged 35 to 37 years in the Puttalam District. METHODS: A cross sectional analytical study was conducted in five Medical Officer of Health areas of Puttalam District in 2015. Trained interviewers collected the data using a pretested questionnaire from women randomly selected by multistage sampling from the voters' list. RESULTS: Of the 500 sampled women, 394 were contacted and interviewed giving a response rate of 79%. Among the interviewed women ,194 had undergone screening giving a coverage of 49.2% (95% CI 44.3 to 54.2%). Though 74% (290 of 354) of women had heard of cervical cancer less than 40% of them knew of symptoms, risk factors or preventive methods. 59% did not perceive themselves to be at risk of developing cervical cancer. Logistic regression model showed personal invitation by PHM (OR= 3.7) and neighbour having undergone Pap smear (OR= 3.8) as significant positive factors while anticipated pain (OR= 0.41) and time pressure due to housework (OR= 0.16) were significant negative factors associated with Pap smear screening. CONCLUSION: The current cervical cancer screening coverage is unlikely to have an impact on the incidence of cervical cancer. The personal factors associated with Pap smear screening identified in this study could be used to design interventions to increase the coverage.