Barriers to Cervical Cancer Screening through Pap Smear Examination among Women Attending the Gynecology Polyclinic at Dr. Zainoel Abidin General Hospital in 2024: A Cross-Sectional Study

Articles in Press

Document Type : Research Articles

Authors

1 Department of Obstetrics and Gynaecology, Faculty of Medicine, Syiah Kuala University, Banda Aceh, Indonesia.

2 General Practitioner, Cut Nyak Dhien General Hospital, West Aceh, Aceh, Indonesia.

Abstract

Background: Cervical cancer remains the fourth most common cancer among women globally and a leading cause of cancer-related mortality in low- and middle-income countries (LMICs). Despite the availability of effective screening methods such as the Pap smear, screening uptake remains suboptimal. Barriers such as limited awareness, socioeconomic challenges, cultural beliefs, and inadequate access to healthcare services contribute to this gap. Identifying these factors is essential to inform effective interventions and reduce cervical cancer mortality. Objective: This study aimed to identify the barriers and facilitators associated with Pap smear screening uptake among women attending the Gynecology Clinic at Dr. Zainoel Abidin General Hospital, Banda Aceh. Methods: A cross-sectional study was conducted in 2024 involving 200 female outpatients. Data were collected using structured questionnaires based on the Health Belief Model to evaluate personal, cultural, and social factors influencing screening behavior. Descriptive statistics, chi-square tests, and binary logistic regression analyses were performed to determine significant predictors of Pap smear uptake. Results: Although 49.5% of participants were aware of Pap smear screening, only 11.5% had undergone the procedure. Barriers identified included low educational attainment, limited monthly income, cultural misconceptions, and lack of spousal support. Logistic regression analysis revealed that perceived benefits (OR = 1.937; 95% CI: 1.011–3.711), self-efficacy (OR = 2.143; 95% CI: 1.088–4.222), positive attitudes toward screening (OR = 2.637; 95% CI: 1.386–5.017), and spousal support (OR = 2.084; 95% CI: 1.074–4.043) were significant predictors of Pap smear utilization.Conclusion: Socioeconomic barriers, negative attitudes, low self-efficacy, and insufficient spousal support substantially hinder Pap smear screening among women in this setting. Comprehensive interventions that incorporate community education, culturally sensitive approaches, and family engagement strategies are urgently needed to improve screening uptake and support cervical cancer prevention efforts in resource-limited areas.

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Asian Pacific Journal of Cancer Prevention

Articles in Press, Accepted Manuscript
Available Online from 13 September 2025

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History

  • Receive Date: 11 February 2025
  • Revise Date: 08 June 2025
  • Accept Date: 30 August 2025

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