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 reasonsmay be that cervical cancer prevention policy of Nepal has ‘Visual Inspection of Cervix with Acetic Acid’ as theonly screening tool. The focus of present study was to find out association of demographic factors, knowledgeand attitude regarding cervical Pap smear test with its practice by women in Nepal. Materials and
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 logisticregression tests were used to detect associations of variables with pap smear practice.
Results: Chi square testshowed 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 utilizationwas not associated with age-at-marriage, parity and age-at-first-child-birth. Multivariate logistic regressionshowed favorable attitude towards pap smear test as the only variable which significantly influenced pap smearpractice (p= 0.006, OR: 2.4).
Conclusions: Pap smear coverage has been found to be 15.7% which is lower thanglobal average and that for developing countries. Health education programs which are effective not only inincreasing knowledge about cervical cancer and pap smear test but also effective in positively changing attitudetowards the test should be organized to increase pap smear coverage.