title: Knowledge of the cervical cancer screening process among rural and urban illinois women undergoing colposcopy.
abstract: OBJECTIVE
  To describe knowledge of the cervical cancer prevention process among rural and urban women referred for evaluation of abnormal cytology.
  
  
  METHODS
  Women with abnormal screening cervical cytology attending university colposcopy clinics (n = 178) were asked about demographic factors and knowledge of Pap testing, human papillomavirus (HPV) infection, and risk factors for cervical cancer. Responses were tabulated, and correlations assessed.
  
  
  RESULTS
  Only 131 (74%) of 176 responding women understood that Pap tests evaluate the cervix, whereas 137 (78%) understood that Pap tests should be repeated at intervals of 1-3 years. The cancer screening function of a Pap test was identified by 122/177 (69%), but only 99 (56%) knew HPV is sexually transmitted and causes warts and premalignant changes. Rural residence was not associated with knowledge, but older women were more likely to know the nature of the Pap test (p =.005) and the meaning of an abnormal Pap test (p = .04). Women in higher income strata were more likely to understand the meaning of an abnormal Pap test (p = .03), the nature of HPV (p = .005), and risk factors for cervical cancer (p = .03). College graduates were better (p = .0005), and women of greater parity were less (p = .02) able than others to identify the nature of HPV, although neither differed from others in ability to answer other questions correctly (p > .1).
  
  
  CONCLUSIONS
  Income and education are better predictors of knowledge of the cervical cancer prevention process than rural residence. Higher rates of cervical cancer in rural areas may reflect lower educational attainment and lower income.
authors.affiliation: Department of Obstetrics and Gynecology, Southern Illinois University School of Medicine, Springfield, IL 62794-9640, USA. LSMASSAD@ameritech.net
authors.forename: L Stewart
authors.initials: LS
authors.lastname: Massad
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Verhulst
authors.forename: Matthew
authors.initials: M
authors.lastname: Hagemeyer
authors.forename: Patricia
authors.initials: P
authors.lastname: Brady
mesh_terms: D000328:Adult; D000368:Aged; D003127:Colposcopy; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D015994:Incidence; D008875:Middle Aged; D010353:Patient Education as Topic; D012424:Rural Population / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control