Cervical Cancer Screening: Patients Understanding in Major Hospitals in Malaysia

We studied women with cervical cancer to determine whether they had had a Pap smear within the 3 yearspreceding cancer development and their understanding of screening for this cancer. The study had 2 parts;Pathology Data and Survey Data. For pathology data, all cases of cervical cancer diagnosed in 2000-2006 wereretrieved from eight hospitals and Pap smear history was obtained from clinical records. For the Survey data;patients who were still undergoing treatment in some of these hospitals and three others were administeredstructured questionnaires to determine their awareness about screening. The results showed 1431 cases ofcervical cancer in women aged 25-85 were diagnosed in these hopsitals. Most had not had a Pap smear within 3years before cancer development. The percentage of patients who had had Pap smear ranged from 0-12%.Questionnaires were returned by 221 patients; 56.3% had none or only primary education and 61.1% had ahousehold income of RM1000 or less. Level of education and the household income were strongly associated(p<0.05) with knowledge and having had a Pap test. The main reasons cited for not having had a Pap smearwere “Never heard about it” (36.2%), “Shy” (10.4%), “Afraid to do it” (13.1%), “Think the test is not important”(8.1%) and “No encouragement from family” (4.5%). A large majority (95.9%) of the patients did not know theoptimal interval. In conclusion, a large number of cervical cancer patients had not had a Pap smear within 3years preceding cancer development and most had inadequate knowledge about this screening test.