Association of knowledge, attitude and demographic variables with cervical Pap smear practice in Nepal.
BACKGROUND
Coverage of cervical pap smear test in Nepal is below general global values. One of the reasons may be that cervical cancer prevention policy of Nepal has 'Visual Inspection of Cervix with Acetic Acid' as the only screening tool. The focus of present study was to find out association of demographic factors, knowledge and attitude regarding cervical Pap smear test with its practice by women in Nepal.


METHODS
This cross sectional analytical observational study was conducted between February 1, 2013 and April 30, 2013. Participants were interviewed with the help of a structured questionnaire. Chi square and multivariate logistic regression tests were used to detect associations of variables with pap smear practice.


RESULTS
Chi square test showed that practice was significantly associated with knowledge about pap smear test and cervical cancer, having favourable attitude towards the test, urban residency and 36-50 years age-group. Pap smear utilization was not associated with age-at-marriage, parity and age-at-first-child-birth. Multivariate logistic regression showed favorable attitude towards pap smear test as the only variable which significantly influenced pap smear practice (p=0.006, OR: 2.4).


CONCLUSIONS
Pap smear coverage has been found to be 15.7% which is lower than global average and that for developing countries. Health education programs which are effective not only in increasing knowledge about cervical cancer and pap smear test but also effective in positively changing attitude towards the test should be organized to increase pap smear coverage.
Department of Pathology, Chitwan Medical College, Bharatpur, Nepal E-mail : rbhatsabin@gmail.com.
Sabin
S
Ranabhat
Mamta
M
Tiwari
Govinda
G
Dhungana
Reshmi
R
Shrestha
D000328:Adult; D003430:Cross-Sectional Studies; D003710:Demography; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009390:Nepal / Q000453:epidemiology; D065006:Papanicolaou Test / Q000706:statistics & numerical data*; D010349:Patient Compliance; D011379:Prognosis; D012307:Risk Factors; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D014626:Vaginal Smears