title: Determinants of utilization of papanicolaou smear among outpatient clinic attendees in north-eastern Nigeria.
abstract: BACKGROUND
  The utilization of cervical cancer screening services is very poor in developing countries.
  
  
  OBJECTIVE
  The study was aimed at establishing the determinants of the awareness of cervical cancer, Papanicolaou smear and its utilization among outpatient clinic attendees in north-eastern Nigeria.
  
  
  METHODS
  Cross sectional study among outpatient clinic attendees in two tertiary institutions in north-eastern Nigeria.
  
  
  RESULTS
  A total of 235 women of reproductive age were interviewed during the study period. Sixty two (62%) were aware of cervical cancer, while 44.3% were aware of screening with Pap smear. However, overall, only 11.5% had ever been screened for cervical cancer before our study. More than half (54%) of the respondents did not state any reason for not doing the test. Compared with women who were not screened, screened women were aged 30 years and above with a mean age of 29.7 +/- 7.6 years (p = 0.021), better educated (p = 0.046), multiparous and employed outside home (p = 0.000). Determinants of awareness of cervical cancer and Pap smear were higher level of education (O.R. 7.80, 95% CI: 7.2-9.4; O.R. 5.12, 95%; CI: 5.0-6.4) and being civil servants (O.R. 2.01, 95% CI: 2.5-3.0; O.R. 3.23, 95%; CI: 2.9-4.7) respectively, while utilization of Pap smear depended on the age (O.R. 3.25, 95%; CI: 2.7-4.0) and higher educational status (O.R. 2.87, 95%; CI: 2.9-3.2).
  
  
  CONCLUSIONS
  The utilization of Pap smear among women studied is very low. But the reasons advanced for poor utilization are modifiable. Efforts at addressing these reasons might improve the take up rate of cervical cancer screening in North-eastern Nigeria.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria. mbbukar07@yahoo.com
authors.forename: M
authors.initials: M
authors.lastname: Bukar
authors.forename: I U
authors.initials: IU
authors.lastname: Takai
authors.forename: B M
authors.initials: BM
authors.lastname: Audu
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000517:prevention & control*; D014626:Vaginal Smears / Q000706:statistics & numerical data*; D055815:Young Adult