Cervical cytology screening - knowledge, attitudes and practice in a periurban settlement

Abstract

Aim: To determine the knowledge, attitudes and practice of women living in peri-urban settlements with regard to screening for cervical cancer. Method: A community·based questionnaire survey of 165 women living in a defined area of Khayelitsha, a periurban settlement on the outskirts of Cape Town. Results: Two hundred households were visited, with a response rate of 84%. Median age of respondents was 27.5 years. The majority of interviewees were married (53.3%), unemployed (61.5%), had an educational status of standard 4 or less (58.1 %) and had been living in Cape Town for 4 years or more (64.3%). The median parity was 2 (range 0 - 11). Most interviewees were currently using contraception (52.4%). One-third (35.4%; 95% Cl 28.1 42.7%) of interviewees had heard of the Pap smear. Of these women, most had obtained their information from the midwife obstetric unit (MOU), and this was the most commonly reported facility where Pap tests were known to be done. The majority of interviewees did not regard the test (or the prospect thereoij as embarrassing (88.4%), painful (89.1 %) or harmful (90.9%), and indicated that they would have the test done (89.1 %). The most important reason for choice of where the test should be done was proximity to place of residence (83.9%). More than onethird of interviewees reported haVing had a Pap test (37.2%; 95% Cl 29.8 - 44.8%). The most common reason for not having had a test was that the interviewee had never heard of it (81.3%). Most had undergone the test at a MOU (65.6%), where it had been part of an antenatal work-up (80.3%). Fewer than half of the interviewees who had undergone a test knew the result of their test. Conclusion: The antenatal. obstetric and family planning services in the area have been effective, to a limited extent. in providing infonnation and conducting screening. However. these services are missing many opportunmes to fulfil this function, and knowledge and practice of cervical cytology screening in this communrty are poor. With the implementation of a rational policy for screening in this area there is the potential to achieve good coverage

S Afr, Med J 1996; 86: 1185-1188