title: Knowledge, attitude and practice (KAP) concerning cervical cancer and screening among rural and urban female healthcare practitioners in the Democratic People's Republic of Korea.
abstract: OBJECTIVE
  Little is known about cervical cancer (CC) in the Democratic People's Republic of Korea (DPRK). This study examines the knowledge, attitudes and practices (KAP) concerning CC and screening among female health care practitioners (HCPs), and whether differences exist between rural and urban HCPs.
  
  
  METHODS
  In a descriptive cross-sectional study, a purposive sample of 200 women HCPs from 128 health care centers in 6 provinces of DPRK was interviewed using a standardized questionnaire.
  
  
  RESULTS
  98% of HCPs were aware of CC. Awareness of the national CC policy was significantly lower in rural (44%) than urban (62%) respondents (p<0.05). Fewer rural (71%) than urban (89%) HCPs knew of cervical cytology (p<0.05). Around 30% of HCPs were aware of the association between CC and human papillomavirus infection. Only 13% of HCPs had ever had a cervical cytology smear. Only 4% of rural and 21% of urban practitioners (p<0.05) provided cytology; all used unaided visual inspection of the cervix without staining to determine whether cytology testing was indicated. For all, screening intervals depended on presence of symptoms.
  
  
  CONCLUSIONS
  Misconceptions and ineffective clinical practices regarding screening need to be urgently addressed among both rural and urban HCPs. There are no major differences between rural and urban HCPs regarding their KAP.
authors.affiliation: International Planned Parenthood Association, East Southeast Asia and Oceania Regional Office (IPPF ESEAOR), Kuala Lumpur, Malaysia. ttran@ippf.org
authors.forename: Nguyen Toan
authors.initials: NT
authors.lastname: Tran
authors.forename: Richard
authors.initials: R
authors.lastname: Taylor
authors.forename: Song Il
authors.initials: SI
authors.lastname: Choe
authors.forename: Hae Suk
authors.initials: HS
authors.lastname: Pyo
authors.forename: Ok Suk
authors.initials: OS
authors.lastname: Kim
authors.forename: Hyon Chol
authors.initials: HC
authors.lastname: So
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D056911:Democratic People's Republic of Korea; D055088:Early Detection of Cancer; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000175:diagnosis; D012423:Rural Health; D011795:Surveys and Questionnaires; D014504:Urban Health; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000517:prevention & control*; D055815:Young Adult