Evaluation of cervical cancer screening program at a rural community of South Africa.

OBJECTIVE: Cervical cancer is a leading cause of deaths among women worldwide. But the condition is preventable through regular screening of women those are 'at risk' for abnormal changes in the cervix and treating them who have positive results. Although screening facilities are available in South Africa, the incidence and mortality from cervical cancer remains very high and many women present health facilities with late stage diseases. Purpose of the study is to determine the baseline information on knowledge and practices on risk factors for cervical cancer and Pap smear and to design an intervention to improve Pap smear uptake.

METHODS: A cross-sectional population based descriptive study was undertaken at a rural community of South Africa targeting women 30 years and over. The assessment was performed by means of a questionnaire survey. Outcome measures were percentage of women with the knowledge on risk factors for cervical cancer and use of Pap smear test and had undertaken Pap smear test. Binary logistic regression analysis was carried out to identify possible predictors of Pap smear test undertaken. A total of 611 women (random samples) were recruited from the selected households.

RESULTS: The mean age of the sample was 43 years and 54% of them had no education. Only 6% knew all and 65% knew any one of the risk factors of cervical cancer whereas less than half (49%) of them knew that Pap smear is used for prevention of cervical cancer. Only 43% respondents received information on Pap smear from health care workers. Among all the respondents only 18% (95% CI, 15-21) had ever done Pap smear test.

CONCLUSIONS: This study showed low uptake of Pap smear test and low level of knowledge on prevention of cervical cancer and risk factors thus warrants urgent extensive health education program for this rural communities.