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RESEARCH COMMUNICATION
Knowledge about Cervical Cancer Risk Factors and Pap
Testing Behaviour among Turkish Women
Aynur Uysal*, Aylin Birsel
Abstract
Background: The aim of the paper was to examine knowledge about cervical cancer and in relation to
Papanicolaou (Pap) testing among Turkish women. Methods: This cross-sectional study research was carried
out at Ege University Faculty of Medicine Hospitals Obstetric and Gynecology Outpatient Clinic between
March 1st, and May 30th, 2008 with 92 volunteer women who were sexually active and aged 25 to 61. Data was
collected through survey forms by interviews conducted by researchers. The form consisted of 30 questions and
three parts. Results: Of the women who participated in the research, 33.7 % were aged 42-49 and 44.6 % were
primary school graduates. It was determined that 53.3 % of the women had long experience of living in a
province and big city and that 82.6 % had middle income. Approximately two-thirds (68.5%) had received a
Pap test. The knowledge of the women within the scope of the research concerning cervical cancer risk factors
(having a sexually transmitted disease, giving birth to many children, smoking, having sexual activity with a
man who has had partners with a cervical cancer and having sexual intercourse at an early age) was found to be
related with their condition of having pap testing. Conclusion: The womens condition of having pap testing is
influenced by their age group, having a history of cancer in their family and having knowledge of cervical
cancer in advance (p <0.01). This research once again demonstrated that having knowledge is influential on the
habit of having pap testing. Taking this conclusion into consideration, it is crucial that information services
aimed at the whole society, specifically women, should become widespread with the participation of health
workers.
Key Words: Cervical cancer - knowledge level - risk factors - Pap smear test
Asian Pacific J Cancer Prev, 10, 345-350
Introduction
Cervical cancer is a widespread and often fatal disease
affecting 1 million women globally in 2005. Not only is it
the second most common cancer in women, but also it is
the second leading cause of cancer deaths, accounting for
over 250,000 deaths in 2005 (Behtash & Mehrdad 2006;
WHO 2007). The developing world has carried a
disproportionate share of the burden and 80 % of the
250,000 cervical cancer deaths in 2005 occurred there
(WHO, 2007).
Developed countries have been successful in
controlling the incidence of cervix cancer, whereas
developing countries have failed dismally in this respect.
The success of developed countries is largely attributed
to the widespread and systematic use of the Papanicolaou
(Pap) smear (Elovainio et al., 1997; Cronje 2005). The
value of the cervical cancer screening in reducing the risk
of cervical cancer and mortality has been firmly
established, and it is estimated that regular screening
reduces the risk of cancer up to 80% (Stewart and Kleihues
2002; zgl, 2007). In Sweden, for example, the overall
incidence of cervical cancer declined by 67% over a 40-
Department of Public Health Nursing, Ege University School of Nursing, Izmir, Turkey
*For Correspondence: uysal_aynur@yahoo.com
Asian Pacific Journal of Cancer Prevention, Vol 10, 2009
345
346
Results
Study group characteristics
Of the women who took part in the research, 33.7 %
were aged 42-49 with a median age of 47. It was
Knowledge about Cervical Cancer Risk factors and Screening Behaviour in Turkey
Pap (+)
n=63 (%)
26-33
11 (73.3)
34-41
14 (66.7)
42-49
21 (67.7)
50
17 (68.0)
Marital status
Married
56 (69.1)
Widowed
7 (63.6)
Education Primary
25 (61.0)
Secondary 25 (61.0)
High school 22 (84.6)
Faculty
11 (64.7)
Place of residence
Village/town 4 (40.0)
County
20 (60.6)
Province
30 (78.9)
Large city
9 (81.8)
Income status
Low
6 (50.0)
Medium
53 (69.7)
High
4 (100)
History of cancer in the family
Yes
24 (85.7)
No
39 (60.9)
Information on Cervix Cancer
Yes
47 (85.5)
No
16 (43.2)
Pap (-)
n=29 (%)
p-value
4 (26.7) 0.206
7 (33.3)
10 (32.3)
18 (32.0)
0.977
25 (30.9) 0.136
4 (36.4)
5 (62.5) 4.450
16 (39.0)
4 (15.4)
6 (35.3)
0.713
6 (60.0) 7.541
13 (39.4)
8 (21.1)
2 (18.2)
0.056
6 (50.0) 3.795
23 (30.3)
0 (0.0)
0.150
4 (14.3) 5.540
25 (39.1)
0.019
0.217
Pap (+)
Pap (-)
n=63 (%) n=29 (%)
p-value
347
Discussion
Of the women included within the scope of the
research, 78 % were in the age group of 35-59 years which
is the first peak period for diagnosis of cervix cancer
(zgl 2007). As long as the women in this group are
more informed and sensitive about cervix cancer, early
diagnosis will be possible.
Pap smear test is one of the most crucial screening
tools for the early diagnosis of cervix cancer (Elovainio
et al., 1997; WHO, 2007; Kaya 2009). While the rate of
women having pap testing is equal to or above 80 % in
developed countries (Welensek et al., 2002; Carrasquillo
& Pati, 2004; Sirovich & Welch, 2004; Coughlin et al.
2006), this rate varies between 2.6-68 % in developing
countries (Farland, 2003; Behbackt et al. 2004; Imani et
al., 2008). In this study, the rate of women having pap
348
Knowledge about Cervical Cancer Risk factors and Screening Behaviour in Turkey
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