Knowledge, attitude and perceived barriers to cervical cancer screening among rural women in western Nepal

Cervical cancer is a major public health problem worldwide. It is one of the leading causes of cancer among married women. Early detection and treatment significantly reduces the mortality and morbidity due to the cancer but many cases are diagnosed late due to lack of knowledge, ignorance, and unavailability of screening facilities, affordability and cultural barriers. We conducted a cross-sectional survey using direct interviews to assess knowledge and factors that may influence cervical cancer screening among rural women in western Nepal. We interviewed 150 rural women between the ages of 15 and 65. All study subjects were housewife, were pregnant within two years of marriage, had children ranging from 1 to 6 and most of them were illiterate (53%). Eighty-six percent women knew about cervical cancer but majority did not know its cause (62%), prevention (40%) and reason for receiving Pap smear test (75%). Surprisingly, we found only 16% (n=24) had undergone Pap smear in the last four years and 75% (n=113) had never heard about Pap screening test. We also found that the most common perceived barriers to cervical cancer screening were fear of test result (62%), lack of accessibility (60%), lack of privacy (55%), embarrassment (50%) and high cost (40%).Women having college level education were found to have high knowledge of cervical cancer and Pap test as compared to illiterate women. Educating rural illiterate women about cervical cancer and Pap test is very essential to reduce barriers and increase screening compliance in Nepal.