Cervical cancer: A public health issue in Romania

Background: In Romania cervical cancer represents the most common cause of death for women at fertile age and registers the highest rate of mortality in Europe (16.93 deaths/100,000 women in 2003). Objective: We seek to evaluate the present state of cervical cancer early detection around the country. Methods: We questioned 848 women over the age of 15 (equally distributed by age groups, instruction level and residence region) about having a Pap test in the last three years (2004-2006). Data were analyzed using SPSS logistic regression and classification tree procedures. Results: Only 17.9 % of the group reported a Pap test in the last three years. The main reasons for ignoring the test are the lack of a medical recommendation (25.6%), the personal belief I do not need this test (19%) and the lack of any information regarding the test existence (13.6%). The classification tree procedure shows women in the age groups of 15-24 and over 50 have a very low probability to have a Pap test. Significant influence factors are medical information sources (p=0.012), income (p=0.01) and instruction level (p=0.034). Logistic regression model indicates the odds to have a Pap test are 1.632 (95% CI =1.134 - 2.348) for highly instructed women, respectively 0.520 (95% CI = 0,300-0.903) for the lowly instructed ones. Conclusion: The results suggest the high cervical cancer mortality is due to the women non-participation in screening programmes. The urgent necessity of their information and education in order to participate in these programmes is underlined.