Perceptions and Attitude of Women in Luderitz, Namibia on Pap Test and Cervical Cancer Prevention | BMC Women’s Health

Sociodemographic variables and participants’ perception of the Pap test.

A total of 136 female volunteers were selected to take part in the study. The majority (28.7%) of them belonged to the age group of 41 to 60, with Christianity (97.8%) being the predominant religion (Table 1). Nearly a third of the sample, n=48 (35.3%) had an upper secondary level of education, while intermediate and higher education amounted to 29.4% and 28.7% respectively . Only one individual declared having completed primary education (0.7%). Most women were single n=98 (72.1%), while n=34 (25%) are married. Of the 136 participants, 32 (23.5%) had no children, 32 (23.5%) had 1 child, 70 (51.5%) had 2 to 5 children and 2 (1.4 %) have more than 5 children. The majority of the 119 participants (87.5%) were employed while 13 (9.6%) of the participants were unemployed.

Table 1 Sociodemographic variables of participants n = 136

According to Table 2, all women between the ages of 36 and 60 have heard of cervical cancer and the Pap test. Although only 81% of women in the 31-35 age group said they had heard of cervical cancer, 84% said they had heard of the Pap test. This suggests that there are women who are aware of the Pap test but not aware of cervical cancer. Of 24 women aged ’21-25′, n=23 (96%) of them said they had heard of cervical cancer and Pap smear.

Table 2 Proportion of women in Luderitz who have heard of the Pap test by age group

Cervical cancer perception, risk factors and prevention methods

A large proportion of women reported having heard of cervical cancer (92.6%) and the Pap test (93.4%) (Table 3). However, when asked what the Pap test was used for, various answers were chosen. Most agree it is to screen for cervical cancer n=111 (87.4%). Other answers were; treatment of sexually transmitted diseases n=6 (4.7%), infertility screening n=6 (4.7%), uterine cleansing n=9 (7.1%) and bladder cancer n = 1 (0.8%) (Table 4).

Table 3 Perception of cervical cancer, Pap test, risk factors and prevention among women
Table 4 Pap test participation among participants by age group n=63

When participants were asked to indicate two factors that carry the greatest risk of developing cervical cancer. About a third gave only one answer n = 45 (35.7%). Those who gave sufficient responses (two responses) included 109 women (86.5%). Those who mentioned one of the two correct answers were 59 women (46.8%). Only n = 10 (7.9%) participants correctly identified that having a compromised immune system caused by HIV and being infected with HPV are the highest risk factors for developing cervical cancer ( table 4). Frequently cited risk factors were; having multiple sex partners n=50 (39.7%), early sexual debut n=44 (34.9%), smoking n=22 (17.5%), and long-term oral contraceptive use n=20 (15 .9%). Other risk factors included alcohol consumption (0.8%), dirty toilets (1.6%), lack of regular screening (0.8%), microwaved food (0.8 %), soap (1.6%), spicy foods (0.8%), unprotected sex (0.8%), genetics (0.8%), high blood pressure (0.8%) , lotions (0.8%), plastics (0.8%). Irregular menstruation (0.8%) has been reported as a risk factor, when in fact it is a symptom of carcinoma of the cervix.

When asked if they thought they were at risk of developing cervical cancer. More than half said they were at risk of developing cervical cancer n=72 (52.9%), while n=54 (39.7%) thought they were not. Others said they did not know if they were at risk n = 10 (7.4%) (Table 3).

About three-quarters of the n=94 sample (74.6%) reported regular screening as a preventive measure. Almost half n=61 (48.4%) said cervical cancer can be prevented by avoiding multiple sex partners, avoiding early first sex n=32 (25.4%) and quitting smoking n = 33 (26.2%). Only n = 21 (16.7%) reported having been vaccinated against HPV. A smaller proportion reported not using soap to wash the vagina (1.6%) and using clean toilets (1.6%) as cervical cancer prevention measures (Table 4). No one could name all the preventive measures for cervical cancer.

Greater proportion said cervical carcinoma can be treated n=107 (84.9%), n=14 (11.1%) said there was no treatment and n = 5 (4.0%) did not know if treatment was available (Table 3).

Table 4 indicates that of the total number of participants who took part in the study n=136, less than half were screened n=63 (46.3%), the majority of whom were women between the ages of 36 and 40 years (71%), followed by age group 41-60 years. Of the n = 24 women aged 21-25, only 6 got tested (25%).

According to Table 3 illustrated below, the reasons for their screening were mainly due to the recommendation of a doctor (29%), the desire to be informed of their state of health/well-being (24%) and knowing someone who had already been tested (21%). Others were screened as part of prenatal (2%) and postnatal (3%) procedures. Some women reported having worrying symptoms that led them to get tested (13%).

According to Table 5, most women were screened more than twice n = 28 (46.3%). When asked where they got their information about the test, the majority said they were told by their healthcare workers n=22 (36%), followed by relatives/friends n= 11 (18%). Others said Leaflets n=10 (16%), Posters n=6 (10%). Only n=1 (2%) said school was their source of information.

Table 5 Motivation, frequency of screening among women n = 63

Attitudes of participating women on cervical cancer and the Pap test

According to Table 6, the majority n = 84 (67%) of respondents strongly agree that if testing is free, they will do it. Again, the majority strongly agreed that cervical cancer is a serious disease n=95 (76%). And finally, a larger portion strongly agreed that they would be screening in the near future. Conversely, n = 6 (5%) neither agree nor disagree when asked about screening in the future.

Table 6 Attitudes toward cervical cancer and screening among participants aware of cervical cancer n=125

Factors associated with Pap smear use

Sociodemographic variables associated with the use of screening

From Table 7 above (using Pearson’s chi-square test), one can observe the presence of relationships between age and Pap smear screening as well as between participants’ residency eras and Pap smear screening. .

Table 7 Relationship between categorical variables

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