Socio-Cultural factors and knowledge associated with cervical cancer and screening among Colombian women

BACKGROUND: In Colombia, cervical cancer (CC) is the most common cancer among women with age-standardized incidence (36.4/100,000) and mortality rates (18/100,000) much higher than for the U.S. (7.7 and 2.3 respectively).

PURPOSE: To examine knowledge and socio-cultural factors associated with CC and screening among low/medium income women through 10 focus groups.

RESULTS: The sample consisted of 81 women 18 to 65 years of age (x=41.5). In average, participants had 9.3 years of education, 88.9% had health insurance, 99% had heard about Pap smears, 59% had heard about Human Papilloma Virus (HPV), and 10% had never had a Pap smear. Early onset of sexual activity, promiscuity, lack of condom use, abortion, genetics, HPV, and lack of hygiene were identified as the most important risk factors for CC. Participants recognized that not all women with cancer have symptoms, and that Pap smears are important to prevent or detect cancer early; however, they mentioned discomfort or pain, fear of finding cancer, embarrassment, and poor services from health care providers as the main barriers to get regular screening. Women recommended educational campaigns and better customer service at clinics to motivate women to get screened.

CONCLUSIONS: Overall, Colombian women have basic knowledge about CC and screening. Indirectly, factors associated with the transmission of HPV, such as promiscuity, were mentioned as risk factors for CC. As noted by participants, training of health care providers not only on performing Pap smears, but also on client service, may help to overcome the main barriers for screening.