title: Awareness and prevalence of cervical cancer screening among women in Nepal.
abstract: OBJECTIVE
  To estimate awareness and prevalence of cervical smear testing among women in Nepal.
  
  
  METHODS
  A secondary analysis of data obtained as part of a nationwide household survey between May 25 and June 14, 2015, was undertaken. Information obtained from women aged 21-65years was included. Multiple regression analyses were performed to identify factors associated with having undergone cervical smear testing.
  
  
  RESULTS
  A total of 829 women were included. Among 816 women who answered the relevant survey question, 710 (87.0%) had no knowledge of cervical smear tests. Only 39 (4.7%) of the 829 women had ever undergone a cervical smear. In multivariate analysis, having undergone a cervical smear was associated with literacy (adjusted odds ratio [aOR] 3.26, 95% confidence interval [CI] 1.25-8.51; P=0.016) and living in rural areas (aOR 0.48, 95% CI 0.24-0.96; P=0.038).
  
  
  CONCLUSIONS
  Nepali women rarely undergo cervical smear screening, with the lowest prevalence recorded among the illiterate and those living in rural areas. To boost screening rates, educational campaigns and rural outreach are needed.
authors.affiliation: Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Harvard School of Public Health, Boston, MA, USA. Electronic address: aranjit@bwh.harvard.edu.
authors.forename: Anju
authors.initials: A
authors.lastname: Ranjit
authors.affiliation: Surgeons OverSeas, New York, NY, USA; Department of Surgery, University of California, San Francisco, East Bay, CA, USA.
authors.forename: Shailvi
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Department of Surgery, Nepal Medical College Teaching Hospital, Kathmandu, Nepal.
authors.forename: Ritesh
authors.initials: R
authors.lastname: Shrestha
authors.affiliation: Surgeons OverSeas, New York, NY, USA; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Surgery, Columbia University, New York, NY, USA.
authors.forename: Adam L
authors.initials: AL
authors.lastname: Kushner
authors.affiliation: Surgeons OverSeas, New York, NY, USA; Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Benedict C
authors.initials: BC
authors.lastname: Nwomeh
authors.affiliation: Surgeons OverSeas, New York, NY, USA; Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Reinou S
authors.initials: RS
authors.lastname: Groen
mesh_terms: D000328:Adult; D000368:Aged; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D000067010:Literacy; D016015:Logistic Models; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015999:Multivariate Analysis; D009390:Nepal; D015995:Prevalence; D012424:Rural Population; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Cervical cancer; Cervical smear; Nepal