title: Factors affecting the uptake of cervical cancer screening among nurses in Singapore.
abstract: OBJECTIVE
  To identify factors other than socioeconomic status that influence participation in cervical cancer screening.
  
  
  METHODS
  A prospective, questionnaire-based, cross-sectional study was conducted among all female nurses working at Singapore General Hospital, Singapore, between November 1 and December 15, 2013. Characteristics assessed included age, knowledge score (0-10, on the basis of 10 true-or-false statements), perceived risk of cervical cancer, and health facility use.
  
  
  RESULTS
  Among 2000 nurses, 1622 (81.1%) responded. The mean knowledge score was 4.70±1.76. Among 1593 nurses who reported on self-perception of risk, 97 (6.1%) reported high risk, 675 (42.4%) reported low risk, and 821 (51.5%) reported uncertainty. Of the 815 nurses reporting on their history of screening, 344 (42.2%) were screened regularly, 103 (12.6%) underwent opportunistic screening, and 368 (45.2%) had never undergone screening. The likelihood of screening was increased among women aged 35-4years, those who had recent experience of medical screening, those who had recently had a specialist consultation, or those who had recently had a consultation with a gynecologist (P<0.001 for all). Nurses undergoing regular screening reported positive effects of a doctor's recommendation, husband's encouragement, people talking about screening, and people close to the respondent undergoing screening.
  
  
  CONCLUSIONS
  Advocacy and herd signaling positively influenced the cervical cancer screening rate.
authors.affiliation: Department of Obstetrics and Gynecology, Singapore General Hospital, Singapore.
authors.forename: Kaijun
authors.initials: K
authors.lastname: Tay
authors.affiliation: Department of Obstetrics and Gynecology, Singapore General Hospital, Singapore. Electronic address: tay.sun.kuie@sgh.com.sg.
authors.forename: Sun K
authors.initials: SK
authors.lastname: Tay
authors.affiliation: Department of Obstetrics and Gynecology, Singapore General Hospital, Singapore.
authors.forename: Katherine C
authors.initials: KC
authors.lastname: Tesalona
authors.affiliation: Department of Obstetrics and Gynecology, Singapore General Hospital, Singapore.
authors.forename: Nadia M R
authors.initials: NM
authors.lastname: Rashid
authors.affiliation: Department of Obstetrics and Gynecology, Singapore General Hospital, Singapore.
authors.forename: Esther Y S
authors.initials: EY
authors.lastname: Tai
authors.affiliation: Department of Obstetrics and Gynecology, Singapore General Hospital, Singapore.
authors.forename: Sitti J M
authors.initials: SJ
authors.lastname: Najib
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009726:Nurses / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012306:Risk; D012846:Singapore; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D055815:Young Adult
keywords: Cervical cancer; Cervical smear; HPV; Herd signaling; Physician advocacy; Risk factors; Self-perceived risk