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Cervical cancer and Pap smear screening in Botswana: knowledge and perceptions.

BACKGROUND: Cervical cancer is the most common cancer in Botswana. Little is known about women's use of Papanicolaou (Pap) cervical smear tests.

AIM: The study is to explore knowledge and beliefs of 30 women about cervical cancer and Pap smear tests using the Health Belief Model.

METHOD: Women were recruited from all income levels using network sampling. Data were collected using a demographic questionnaire and semi-structured interview guide. Data analysis included descriptive statistics for demographic data and content analysis for interview data.

FINDINGS: Knowledge of cervical cancer and the Pap smear test was inadequate among women with low incomes. Pap smear utilization was also limited among low-income women. Of the 18 women who had at least one Pap smear test in their lifetime, eight (44%) had opportunistic testing as a result of having gynaecological symptoms. Twelve women (40%) had never had Pap smear tests. Major barriers to Pap smear screening included inadequate knowledge about Pap smear testing, providers' negative attitudes, and limited access to doctors.

CONCLUSION: The study has implications for health education and health policy and for nurses' involvement in both.

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