Professional Documents
Culture Documents
Use of and attitudes and knowledge about pap smears among women
in Kuwait.
Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University,
Kuwait. lthalib@hsc.edu.kw
OBJECTIVE: To estimate the lifetime prevalence of Pap smear among women in Kuwait and to assess their
knowledge about and attitude toward Pap smears. METHODS: This was a descriptive cross-sectional study
using a multistage cluster sampling method. We interviewed 299 women attending polyclinics in Kuwait
using a self-administered questionnaire. Factors related to history of having a Pap smear, knowledge level,
and willingness to participate in a screening program were evaluated. RESULTS: The lifetime prevalence of
Pap smear was found to be 37% (95% CI 33-43). Forty-four percent of women in our study had a Pap smear
only once in their lives. History of having at least one Pap smear was significantly related to such factors as
age, total family income, marital status, history of cervical infection, and knowledge. The level of knowledge
about cervical cancer varied among the participants. Forty-six percent of women were uncertain about the
symptoms of cervical cancer. About half the women recognized cervical infection, smoking, and having
multiple sexual partners as risk factors for cervical cancer; however, only 10% recognized early sexual
intercourse as a risk factor. Willingness to participate in a future screening program varied significantly
according to educational level, employment status, and total family income. CONCLUSIONS: Although
cervical cancer incidence and mortality are relatively low in Kuwait, they may be underreported in the
absence of a screening program. Moreover, lifetime prevalence of having a Pap smear was found to be
http://www.ncbi.nlm.nih.gov/pubmed/19951218
Tung WC.
Low participation in Papanicolaou screening among Vietnamese American women remains a significant
public health problem. This study explored differences in the perceived benefits of and barriers to obtaining
Papanicolaou smears within the framework of the transtheoretical model stages of readiness. A descriptive,
cross-sectional design with snowball sampling was used to recruit 80 Vietnamese American women. The
Questionnaire, and Benefits/Barriers Scale. Results suggest that knowledge of cervical cancer, awareness
of screening programs, and availability of female physicians play important roles in the transition from
http://www.ncbi.nlm.nih.gov/pubmed/20131133
Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra
State.
BACKGROUND: Cervical cancer is a major cause of death in the developing world. This high fatality is due
to late presentation. It is believed that widespread screening of women for precursor lesion and early
detection of the invasive disease can lead to a reduction in cervical cancer and cervical cancer deaths. This
study assesses the knowledge, attitude and practice of cervical cancer among sexually active women in
Onitsha Southeast Nigeria. METHODS: Three major layouts in Onitsha were chosen as the areas of study
In these areas, 5 sites each where major economic activities take place were chosen for the distribution of
the questionnaire. A total of 400 pretested questionnaires were administered to women who gave their
verbal consent to participate in this study. The data were analyzed using SPSS package for windows
version 11.0. RESULTS: The result showed that 76 (26.85%) of the respondents were aware of cervical
cancer screening. Thirty six (47.4%) of the aware group knew that the test was a screening test for cervical
cancer There was significant association between the educational status and the knowledge of Pap test but
there was no significant association between the educational status and the utilization of the Pap test.
CONCLUSION: This study shows that there is poor awareness and utilization of cervical screening test in
our environment. There is therefore an urgent need to establish an aggressive and sustainable awareness
campaign on the preventive nature of cervical cancer and further establish an organized cancer screening
programme.
http://www.ncbi.nlm.nih.gov/pubmed/20120142
Green JS, Williams DG, Scott DB, Madison SB, Comer KD, Haynes JA.
In summary, HBCUs can no longer remain reactive, but must spearhead efforts to increase both the health
of the student body, as well as the community at large. HBCUs should collaboratively initiate a "Call to
Action", whereby policies and programs could be created to aid in the prevention of HPV and other STIs. To
support this action, HBCUs could more actively pursue funding sources that support both universities and
the communities in which they exist. Student orientation could be redefined to include short courses in STI
awareness and prevention, and be communicated in a manner that is professional, yet engaging to
students. Moreover, university departments which have an interest in the health of communities should
supervise these efforts. The knowledge of university faculty members within departments of Nursing, Social
Work, Public Health, Rehabilitation Counseling and Physical Education should extend beyond the classroom
and into the community. Clark commented, "Perhaps course content across departments could be revised to
encompass an increased focus on practice skills which support awareness and prevention efforts". Through
employment, volunteerism and student internships, each of these disciplines have established relationships
with the surrounding community and understand the associated critical needs. Such relationships provide
the best environment for both the creation and implementation of services, and provide students with a
model of how to "give back" to the community by utilizing their education. Campus health centers should be
more prevention-driven beyond the distribution of condoms and pamphlets, to collaborate with local area
high schools and community-based organizations to create an information network accessible to students
and community residents. Additionally, health centers should promote the availability of HPV vaccination,
which depending on state of residence and age, may be free or available at a discounted cost. According to
Bynum, some HBCUs have already begun to promote and provide the vaccination, "South Carolina State
University is one of the HBCUs which provides the HPV vaccination and promotes HPV prevention. There
has been a great initiative by their health center to focus prevention efforts on incoming freshman". HBCU
administrations must bear in mind that beyond the campus, students will undoubtedly carry the information
learned during college into the communities in which they live after graduation and moreover, utilize this
information as a basis for educating their children and families. Community activist and Columbia resident
Linda "T'Zima" Brown, whose 16 year-old son is considering application to Delaware State University,
believes that HBCUs bear a great responsibility to the well-being of the community, "We as residents should
be able to take part in the events that our black colleges have. Black colleges used to operate from a more
inclusive, family approach, and we need to get back to that; plus, many HBCUs are supported with our state
dollars, so the community should be able to look to them for information aside from what our children relay
to us".
http://www.ncbi.nlm.nih.gov/pubmed/20108714
The demographic characteristics of nurses and knowledge on risk factors of cervical cancer, as well as
awareness of symptoms and attitudes in terms of screening programmers such as Pap smear, were
assessed in a cross-sectional survey of nurses working in public Health Cabins and Family Health Centers
in the rural area of Izmir, located in the western region of Turkey. Of the nurses who participated in the
research, 69.1% (67) said that they had talked about cancer and cancer prevention with their families or
friends; 60.8% (59) believed that their occupation was important for cancer prevention; 11.3% of the nurses
had a history of cancer in their families; and 63.9% (62) thought that their knowledge about cervical cancer
was adequate. There were no significant differences between knowledge or attitudes about cervical cancer
risk factors or symptoms and screening methods regarding age, marital status, years of experience (p>
0.05). However, there was a statistically significant relationship between having received a Pap test and
having a history of cancer in their family (p< 0.05). In conclusion, this study has shown that most nurses
knew about the Pap smear test as a cervical cancer screening methods. However, there were no significant
differences between knowledge or attitudes about cervical cancer risk factors or symptoms and screening
http://www.ncbi.nlm.nih.gov/pubmed/20104960
[Article in Polish]
OBJECTIVES: The Aim. Early diagnosis and screening are of vital importance in Poland because of high
morbidity and mortality cervical cancer statistics. Polish cervical cancer screening programme is based on
personal invitations which are sent to women aged from 25 to 59 every three years. The aim of the study
was to assess socioeconomic conditions of the women who decided to accept or refuse that invitation.
MATERIAL AND METHOD: The data was collected from questionnaires filled in by 1625 women (age: 25-
59) who sought medical help from gynecologists in Poland. The questions included: age, place of living,
education, marital status, children, reaction to the invitation acceptance and its reasons. Social profiles of
women, both participating or not in screening, were characterized. Reasons for refusing the invite were
analyzed. Data regarding the amount of PAP smear collected, number of practices cooperating with
screening programme and invitation responses were obtained from SIMP. Statistical techniques for
correspondence analyses was used in the study. RESULTS: 1261 respondents (77.5%) had PAP smear,
894 women received a personal invitation for screening and 38% of them ignored it. In Poland 55,467
women (5.5%) responded to the personal invitation (2009) and the number was independent of the number
of cooperating practices (p=0.0001). Women from rural areas do not participate in the screening programme
comparing to city dwellers (15.2% vs. 8%), single, unmarried and widows comparing with married and
divorced (25% vs. 5%), and low-educated women in comparison to high-educated (20% vs. 6%). Lack of
time (24%), dislike for seeing an unknown physician (23%) and the examination itself (15%) constitute the
main reasons for the refusal. Women from villages and low-educated ones comprise the group not
participating in screening. High-educated women undergo screening mainly in private medical institutions
(38%). CONCLUSIONS: Personal invitations for Pap smear examination constitute an ineffective method of
increasing participation. The effectiveness of cervical cancer prophylaxis depends on medical education and
at random access to medical care. Information campaign should be mainly directed at rural areas and
among less educated people. The screening programme management should make sure women have easy
http://www.ncbi.nlm.nih.gov/pubmed/20088397
J Womens Health (Larchmt). 2009 Nov;18(11):1825-32.
Use of and attitudes and knowledge about pap smears among women
in Kuwait.
Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University,
Kuwait. lthalib@hsc.edu.kw
OBJECTIVE: To estimate the lifetime prevalence of Pap smear among women in Kuwait and to assess their
knowledge about and attitude toward Pap smears. METHODS: This was a descriptive cross-sectional study
using a multistage cluster sampling method. We interviewed 299 women attending polyclinics in Kuwait
using a self-administered questionnaire. Factors related to history of having a Pap smear, knowledge level,
and willingness to participate in a screening program were evaluated. RESULTS: The lifetime prevalence of
Pap smear was found to be 37% (95% CI 33-43). Forty-four percent of women in our study had a Pap smear
only once in their lives. History of having at least one Pap smear was significantly related to such factors as
age, total family income, marital status, history of cervical infection, and knowledge. The level of knowledge
about cervical cancer varied among the participants. Forty-six percent of women were uncertain about the
symptoms of cervical cancer. About half the women recognized cervical infection, smoking, and having
multiple sexual partners as risk factors for cervical cancer; however, only 10% recognized early sexual
intercourse as a risk factor. Willingness to participate in a future screening program varied significantly
according to educational level, employment status, and total family income. CONCLUSIONS: Although
cervical cancer incidence and mortality are relatively low in Kuwait, they may be underreported in the
absence of a screening program. Moreover, lifetime prevalence of having a Pap smear was found to be
http://www.ncbi.nlm.nih.gov/pubmed/19951218
Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer
BACKGROUND: Although it is widely accepted that Papanicolaou (Pap) screening can reduce cervical
cancer mortality, many women still do not maintain regular cervical cancer screenings. OBJECTIVE: To
describe the prevalence of cervical cancer screening and the demographic, behavioral, psychological, and
cancer-related knowledge factors associated with adherence to U.S. Preventive Services Task Force
(USPSTF) cervical cancer screening guidelines among women in the United States. METHODS: Data for
women aged 25-64 were obtained from the National Cancer Institute's (NCI) 2005 Health Information
National Trends Survey (HINTS). Women were considered adherent to screening guidelines if they had two
consecutive, on-schedule screenings and planned to have another within the next 3 years. The sample
comprised 2070 women. RESULTS: Ninety-eight percent of women reported ever having a Pap smear, 90%
reported having had a recent Pap smear (within 3 years), and 84% were adherent to USPSTF screening
guidelines. Maintaining regular cervical cancer screening was significantly associated with having health
insurance, normal body mass index (BMI), smoking status (nonsmoker), mood (absence of a mood
disturbance), and being knowledgeable about cervical cancer screening and human papillomavirus (HPV)
infection. CONCLUSIONS: Based on the observation that women who were current smokers, obese, or
experiencing a substantial degree of psychological distress were significantly less likely to adhere to
recommended screening guidelines, we suggest that healthcare providers pay particular attention to the
http://www.ncbi.nlm.nih.gov/pubmed/19951209
Ben-Natan M, Adir O.
Pat Matthews Academic School of Nursing, Faculty of Nursing, Stanley Steyer School of Health Professions,
Comment in:
BACKGROUND: The proportion of lesbian women who contract the human papilloma virus may reach 13%
or even 21%; however, lesbian women were found to receive Pap smear tests less often or less regularly.
AIM: To explore factors influencing lesbian women to undergo Pap smear tests and to determine whether
the Health Belief Model (HBM) is able to predict whether lesbian women would be willing to undergo the
test. METHOD: This is a correlational quantitative study guided by the HBM. A convenience sample of 108
Israeli lesbian women was recruited from local events in the lesbian community in the city of Tel Aviv, Israel.
Data were collected using a self-administered questionnaire. FINDINGS: Findings indicate that only 22.2%
of the women had undergone Pap smear tests in the past, but a slightly higher proportion, 30.8%, intended
to be tested during the next year. Older women were found to be more compliant with the test. Model-based
factors affecting actual testing were perceived benefits and barriers. Factors affecting women's intention to
be tested were perceived susceptibility, perceived benefits and general health motivation. CONCLUSIONS:
Effective strategies for nurses promoting cervical cancer screening among lesbians should address ways to
improve familiarity with Pap smear tests, raise physicians' awareness of offering the test to lesbians and
http://www.ncbi.nlm.nih.gov/pubmed/19930071
Department of Public Health, Camden Primary Care Trust, St Pancras Hospital, London NW1 0PE, UK.
OBJECTIVES: To explore barriers to, and ways to improve, uptake of cervical screening among Somali
women in Camden, London. STUDY DESIGN: A qualitative research study using focus group discussions
and in-depth interviews. METHODS: A qualitative study (comprising seven focus groups and eight in-depth
interviews) was conducted with 50 first-generation Somali women aged 25-64 years. Both the groups and
the interviews explored participants' understanding of the purpose of cervical screening, and the various risk
factors for cervical cancer, as well as their opinions on barriers to screening and suggestions for overcoming
those barriers. RESULTS: Knowledge about the purpose of cervical screening was limited among Somali
women. There was also a lack of understanding of risk factors for cervical cancer, and many of the women
held fatalistic attitudes, associated with the idea of 'God's will', about this cancer and other aspects of health.
Another culturally specific barrier was embarrassment associated with female circumcision, i.e. female
genital mutilation. Other barriers suggested by the participants were: lack of knowledge about the need for
cervical screening, practical problems such as appointment times and childcare needs, language difficulties,
fear of the test and negative past experiences. Possible solutions suggested by the participants included the
provision of education and information about cervical screening in the Somali language by Somali
community workers. They also suggested that healthcare staff should be trained about Somali culture,
particularly regarding female circumcision, and that general practitioners should more proactively encourage
Somali women to attend screening. CONCLUSIONS: Language difficulties and specific cultural issues are
key barriers to first-generation Somali women attending cervical screening. Providing education and
information orally, as well as improving access to a more culturally appropriate screening service, could lead
http://www.ncbi.nlm.nih.gov/pubmed/19863980
Asian Pac J Cancer Prev. 2009 Oct-Dec;10(4):569-74.
We studied women with cervical cancer to determine whether they had had a Pap smear within the 3 years
preceding 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
were retrieved 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
administered structured questionnaires to determine their awareness about screening. The results showed
1431 cases of cervical cancer in women aged 25-85 were diagnosed in these hospitals. Most had not had a
Pap smear within 3 years before cancer development. The percentages 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 a household income of RM 1,000 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 smear were "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 the optimal interval. In conclusion, a large number of cervical
cancer patients had not had a Pap smear within 3 years preceding cancer development and most had
http://www.ncbi.nlm.nih.gov/pubmed/19827871
Department of Obstetrics and Gynaecology, Jordan University of Science and Technology, Irbid, Jordan.
isam_l@yahoo.com
The objective of the survey was to investigate the knowledge and attitudes of Jordanian gynaecologists
toward screening for cervical cancer. A pre-tested postal questionnaire was mailed to all 462 licensed
gynaecologists in Jordan. Three questions were designed to assess knowledge and two questions to assess
attitudes to screening for cervical cancer. A total of 392 obstetricians and gynaecologists completed the
survey with a response rate of 84.4%. Although the majority of Jordanian obstetricians and gynaecologists
were able to correctly identify all the important aetiological factors associated with cervical cancer and
recognised the importance of cervical cancer screening, many of them were not confident that the Pap
smear was the most cost-effective screening test, or that human papillomavirus testing improved the
http://www.ncbi.nlm.nih.gov/pubmed/19821673
Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, Nigeria.
dyme72@yahoo.com
Although cervical cancer is the commonest cause of cancer death in Nigeria, the use of cervical cancer
screening is poor. This study aimed at determining the awareness and use of the available cervical cancer
screening method (Pap smear) by women attending the outpatient clinics of a tertiary institution in Enugu,
South-eastern Nigeria. Questionnaires were administered to 912 women from November 2005 to May 2006.
A total of 550 (60.3%) respondents knew about cervical cancer but only 41.2% of them were aware of the
Pap smear. Only 89 (9.0%) respondents had used the Pap smear. The majority (61.9%) of those who had
not been screened despite knowledge of the Pap smear had no reason, while the remaining 112 (38.1%) felt
they were not susceptible to cervical cancer. The use of the Pap smear among women attending the
outpatient clinics in Enugu, Nigeria is very low. Routine cervical cancer counselling and screening with opt-
out option should be offered to every eligible woman attending the outpatient clinics.
http://www.ncbi.nlm.nih.gov/pubmed/19821672
Mauad EC, Nicolau SM, Moreira LF, Haikel RL Jr, Longatto-Filho A, Baracat EC.
prevencao@hcancerbarretos.com.br.
INTRODUCTION: Cervical and breast cancer are the most common malignancies among women
worldwide. Effective screening can facilitate early detection and dramatically reduce mortality rates. The
interface between those screening patients and patients most needing screening is complex, and women in
remote areas of rural counties face additional barriers that limit the effectiveness of cancer prevention
programs. This study compared various methods to improve compliance with mass screening for breast and
cervical cancer among women in a remote, rural region of Brazil. METHODS: In 2003, a mobile unit was
used to perform 10,156 mammograms and Papanicolaou smear tests for women living in the Barretos
County region of São Paulo state, Brazil (consisting of 19 neighbouring cities). To reach the women, the
following community outreach strategies were used: distribution of flyers and pamphlets; media broadcasts
(via radio and car loudspeakers); and community healthcare agents (CHCAs) making home visits.
RESULTS: The most useful intervention appeared to be the home visits by healthcare agents or CHCAs.
These agents of the Family Health Programme of the Brazilian Ministry of Health reached an average of
45.6% of those screened, with radio advertisements reaching a further 11.9%. The great majority of the
screened women were illiterate or had elementary level schooling (80.9%) and were of 'poor' or 'very poor'
socioeconomic class (67.2%). CONCLUSIONS: Use of a mobile screening unit is a useful strategy in
developing countries where local health systems have inadequate facilities for cancer screening in
underserved populations. A multimodal approach to community outreach strategies, especially using CHCAs
and radio advertisements, can improve the uptake of mass screening in low-income, low-educational
http://www.ncbi.nlm.nih.gov/pubmed/19778158
Fernandes JV, Rodrigues SH, Costa YG, Silva LC, Brito AM, Azevedo JW, Nascimento ED, Azevedo PR,
Fernandes TA.
OBJECTIVE: To assess the knowledge, attitudes and practices of women related to the Pap test and the
selected in a stratified manner, living in the city of São José de Mipibu, Northeastern Brazil, were
interviewed in 2007. A questionnaire consisting of pre-coded open questions was administered and answers
were described and analyzed, as for adequacy of knowledge, attitudes, and practices of women regarding
the Pap test. Tests of association were carried out between sociodemographic characteristics and behaviors
studied at a 5% significance level. RESULTS: Although 46.1% of the women interviewed showed adequate
knowledge about the Pap test, a significantly higher proportion of adequacy was seen regarding attitudes
and practices, 63.3% and 64.4%, respectively. Higher schooling was associated with adequacy of
knowledge, attitudes, and practices. The main barriers to the Pap test were negligence, non-requesting by
their physicians, and shame. CONCLUSIONS: The physician is the main source of information about the
Pap test. However, women who more often attend medical visits, despite their good practice, show low
adequacy of knowledge and attitudes related to the Pap test, which indicates that they are not receiving
appropriate information on the test's purpose, advantages and benefits to women's health.
http://www.ncbi.nlm.nih.gov/pubmed/19768236
Sait KH.
Department of Obstetrics & Gynecology, King Abdul-Aziz University Hospital, Jeddah 21589, PO Box
OBJECTIVE: To assess the knowledge, attitude, and practices related to cervical cancer screening, and its
underlying etiology and preventive measures among women living in the Kingdom of Saudi Arabia.
METHODS: Six hundred self-administered questionnaires were distributed to randomly selected women
from different groups in the general population of Jeddah, Kingdom of Saudi Arabia. These questionnaires
were sent out to school teachers, relative, friends, as well as, through direct interview of patients visiting the
outpatient clinic while awaiting for their appointments at the King Abdul-Aziz University Hospital from
January to March 2008. There were 500 respondents (83.3%). RESULTS: The knowledge of the human
papilloma virus (HPV) as an etiological agent for cervical cancer was expressed by 72 (14.4%), and the HPV
vaccine by 49 (9.8%) of the respondents. Whereas, 338 (67.6%) of the respondents were aware of the Pap
smear, however, only 84 (16.8%) had undergone the test. The main reason for not having a Pap smear was
the lack of awareness. CONCLUSION: The awareness on cervical cancer among women in Saudi Arabia is
far behind that in the developed countries. There is a need to educate and promote awareness of cervical
http://www.ncbi.nlm.nih.gov/pubmed/19750269
Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai,
Thailand. kiet_ji@hotmail.com
OBJECTIVE: To determine the knowledge, attitudes, and awareness of female sex workers (FSWs)
regarding cervical cancer and its prevention in Thailand. METHOD: From August through November 2008,
402 consecutive FSWs were recruited for interviews. RESULTS: The mean knowledge score was 4.9
(maximum possible, 15; range, 0-14). Approximately 60% of the FSWs had knowledge scores less than 5.
Low education and a lack of health insurance were significant independent predictors of low knowledge
scores (adjusted odds ratios, 3.17 and 1.97, respectively). More than half of the FSWs were unaware of
being at higher risk for HPV infection or of the possible consequences of HPV infection. The negative
attitude regarding cervical screening was caused by the fear of abnormal results (27.9%), experiencing pain
(18.4%), and embarrassment (14.7%). CONCLUSION: The knowledge and awareness of HPV infection,
cervical cancer, and utility of cervical smears is low among FSWs in Thailand. Designing and implementing
http://www.ncbi.nlm.nih.gov/pubmed/19716556
Department of Midwifery, Ege University Izmir Atatürk School of Health, Izmir, Turkey.
BACKGROUND: Cervical cancer is the second most common cancer type seen among women in most
countries and an important cause of mortality. Although it is a preventable disease, most women living in
developing countries cannot reach effective screening programs. It is essential that appropriate education
about cervical cancer is provided. OBJECTIVE: This experimental field study was performed with the aim of
evaluating the efficacy of training given to women about cervical cancer risk factors and primary and
secondary prevention precautions. METHODS: The research focused on women between 25 and 29 years
of age, literate, married and having social security. The study was conducted in the district of Evka 4 Health
Care Center between the dates of April to August 2005. The women were given survey forms and
questionnaires in order to determine their socio-demographic features and knowledge level about cervical
cancer in the course of home visits. They were trained and given a manual at the data collection stage. At a
second visit, carried out three months later, the trained women were again evaluated for their knowledge
level about cervical cancer, risk factors and whether they had undergone a Pap smear test. RESULTS:
Together with the difference between pre-/post-training mean information scores related to women's cervical
cancer risk factors, the difference between the women's having a Pap smear test in the pre-/post-training
period was found statistically significant. Only 16.3% of the women stated that they had a Pap smear test in
the post-training period. Conclusions: It was determined that the women were in need of knowledge about
risk factors related to cervical cancer, prevention from and early diagnosis of cervical cancer, but there was
no significant increase in the rate of having a Pap smear test despite the increase in the knowledge level
http://www.ncbi.nlm.nih.gov/pubmed/19640187