title: Knowledge, practice, and barriers toward cervical cancer screening in Elmina, Southern Ghana.
abstract: OBJECTIVE
  The aims of this study were: 1) to assess the level of knowledge of women about Pap smear tests, 2) to determine the practices of women regarding Pap smear tests, and 3) to determine the barriers to Pap smear tests in Elmina, Ghana.
  
  
  METHODS
  A cross-sectional study was conducted with 392 randomly selected sexually active females aged 10-74 years using structured interview questions. The Institutional Review Board of the University of Cape Coast gave ethical approval for the study and informed consent was obtained from participants. Data were analyzed with SPSS software (v19.0) using frequencies, chi-square test, and exploratory factor analysis.
  
  
  RESULTS
  The results revealed that 68.4% had never heard about cervical cancer, 93.6% had no knowledge on the risk factors, nine (2.3%) reported multiple sexual partners and being sexually active as risk factors, and 92% did not know about the prevention and treatment of cervical cancer. The majority (97.7%) had never heard of the Pap smear test. Only three (0.8%) women out of 392 had had a Pap smear test. Reasons for seeking a Pap smear test included referral, fear of cervical cancer, and radio campaigns. A significant association was found between institutional and personal barriers and having a Pap smear test.
  
  
  CONCLUSIONS
  Comprehensive education on cervical cancer screening and removal of access barriers are critical in reducing risk associated with the disease and promoting women's health.
authors.affiliation: University of Cape Coast, School of Nursing, Cape Coast, Ghana.
authors.forename: Nancy Innocentia
authors.initials: NI
authors.lastname: Ebu
authors.affiliation: Kirkhof College of Nursing, Grand Valley Sta University, Grand Rapids, MI, USA.
authors.forename: Sylvia C
authors.initials: SC
authors.lastname: Mupepi
authors.affiliation: University of Cape Coast, School of Nursing, Cape Coast, Ghana.
authors.forename: Mate Peter
authors.initials: MP
authors.lastname: Siakwa
authors.affiliation: School of Nursing, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Sampselle
keywords: awareness; cervical screening; community; developing countries; factors; women