Cervical screening uptake and its predictors among rural women in Malaysia

Abstract

INTRODUCTIONCervical cancer is the third most common cancer among Malaysian women. However, the uptake of cervical cancer screening -Pap smear -by women in Malaysia has been low and remains a challenge. This study was conducted to assess the cervical screening practices of rural women in Malaysia and to examine the factors associated with such practices.METHODS A cross-sectional survey was conducted in five rural districts in Perak, Malaysia. 1,000 households were selected through multistage random sampling. Women aged 20-64 years were interviewed by trained enumerators using structured questionnaires. Binomial logistic regression was used to identify predictors of cervical screening through univariate and multivariate analyses.RESUlTS Among the 959 respondents, only 48.9% had undergone Pap smear at least once in the past three years.Women in the age group 40-49 years (odds ratio 3.027, 95% confidence interval 1.546-5.925; p < 0.005) were found to be significantly more likely to attend cervical cancer screening as compared to those in the age group 20-29 years. Other significant predictors were being married with children, having knowledge of cervical cancer symptoms, receiving relevant information regarding cervical cancer from health personnel or campaigns, being engaged in family planning and receiving encouragement from husbands. CONClUSIONEfforts to boost the uptake of Pap smear screening among the rural population should be targeted toward the predictors of positive uptake.

Lack of Understanding of Cervical Cancer and Screening Is the Leading Barrier to Screening Uptake in Women at Midlife in Bangladesh: Population-Based Cross-Sectional Survey

“…The variables positively associated with CCa screening in our study-namely, level of education, urban living, employment outside the home, and age-are all indices of opportunity for knowledge acquisition. The impact of age is in agreement with studies undertaken in rural Malaysia, Tanzania, and New Zealand [24][25][26].…”

Factors Affecting Cervical Cancer Screening Uptake by Hmong Hilltribe Women in Thailand

“…Failures to attend screening have been positively associated with low levels of literacy or education (Chan et al, 2002;Nene et al, 2007;Lyimo and Beran, 2012;Gan and Dahlui, 2013;Gyenwali et al, 2013;Wong et al, 2013), lack of knowledge about cervical cancer and/or its prevention (Lyimo and Beran, 2012;Gan and Dahlui, 2013;Shekhar et al, 2013), and no children or nulligravidity (Nene et al, 2007;Gan and Dahlui, 2013). The reasons given for not attending screening are also consistent with the findings of these studies.…”

Knowledge, Attitudes and Behaviors of Women Over 20 Years Old on Cervix Cancer in Istanbul, Turkey

“…In the literature, pap smear and HPV knowledge levels, cervical cancer story in family, smoking, suggestion of healthcare workers, sociodemographic factors like especially age, ethnicity, education level, income level, employment status, marital status, use of contraception, number of children, health insurance status, religious and cultural factors were identified as factors affecting having a pap smear test. Again analogously to the results of research, increase in level of knowledge of cervical cancer was noted as one of the factors influencing having pap smear test (Uysal and Birsel, 2009;Erbil et al, 2011;Gulten et al, 2012;Reis et al, 2012;Thulaseedharan et al, 2012;Baskaran et al, 2013;Demirtas and Acikgoz, 2013;Ersin and Bahar, 2013;Gan and Dahlui, 2013;Gyenwali et al, 2013;Karabulutlu, 2013;Shekhar et al, 2013;Budkaew and Chumworathayi, 2014;Sahin et al, 2014;Wongwatcharanukul et al, 2014). Research results and the results expressed in the literature were similar.…”

“…Also most of women who stated they had Pap smear test, had it irregularly. While studies conducted in developed countries, pap smear screening rates over 70% (Gonzalez et al, 2012;Shekhar et al, 2013;Suh et al, 2013), in developing countries, this ratio was below 70% (Imam et al, 2008;Gan and Dahlui, 2013;Wongwatcharanukul et al, 2014). In Turkey studies, ratios ranged between 9.4%-68.5% (Uysal and Birsel, 2009;Erbil et al, 2011;Demirhindi et al, 2012;Bekar et al, 2013;Coskun et al, 2013;Demirtas and Acikgoz, 2013;Dinc, 2013;Karabulutlu, 2013;Karadag et al, 2014;Sahin et al, 2014).…”

“…In a study of cervical cancer, doctors were noted as the most important source of information (Tran et al, 2011). Also studies for Pap smear test, the most important source of information have been noted as health care workers (Gan and Dahlui, 2013;Karabulutlu, 2013;Sahin et al, 2014). Research results are similar to other studies.…”