Preliminary examination of cervical health practices and knowledge among university-aged females

College Student Journal, Sept, 2005 by Paula C. Fletcher, Pamela J. Bryden

Cervical cancer is relatively preventable through regular cervical examinations and by engaging in healthy practices concerning lifestyle behaviors, like safe sexual intercourse. Despite the benefits that regular pap tests provide, screening tests continue to be under used by women, with younger women being one of the most negligent groups. Since knowledge levels are one of the most significant barriers in non-compliance, investigating the knowledge of younger women would seem essential. A questionnaire was distributed to female university students in Southwestern Ontario, Canada and examined: (1) socio-demographic information, (2) health information and health practices, and (3) knowledge of cervical health.

Preliminary analysis revealed that women that had received a Pap test were more knowledgeable about cervical health than those that had not; however, overall knowledge among all women was inadequate. Although cervical screening affords women with the opportunity to take control of their cervical health, they may not be cognizant of issues surrounding cervical cancer to understand and engage in the appropriate cervical screening practices.

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Cancer of the cervix is the second most frequent type of cancer for women between 20 to 44 years of age. (1) In Ontario alone 11 women develop and 3 die each week from cervical cancer. (2) What is most troubling about such statistics is the fact that cervical cancer is relatively preventable through regular Pap tests/cervical smear examinations (3) and practicing certain health behaviors. Many of the risk factors associated with the development of cervical cancer, such as multiple sexual partners, smoking, engaging in sexual intercourse at an early age, and absence of barrier contraception (4,5,6) are behaviors that, for the most part, are under the individual's control. As such, refraining from these unhealthy practices should decrease one's risk of disease development. In terms of screening, unfortunately, women have inadequate screening histories as demonstrated by surveys such as the 1994-1995 and 1996-1997 National Population Health Survey conducted in Canada. (3,7) Specifically, both younger and older women were most likely to have had a Pap test three or more years prior or to have never had a Pap test. (3,7) The fact that the Pap test has been associated with decreases in cervical cancer mortalities (8) is significant for women's health; however, these reductions are largely dependent upon the acceptance, and proper utilization practices and patterns of women. (9)

Research has identified several barriers to non-compliance, such as lack of knowledge (10,11,12,13,14,15,16,17) lack of financial resources, (10,13) fear surrounding the procedure or the disease and/or feelings of discomfort or embarrassment, (10,11,13,14) misinformation about screening recommendations, (10,11,14) and barriers to accessing health care and/or access to physicians. (11,14) Some women also considered the gender of the physician to be a determinant to having a pap test. (14,18) With adolescent women, fear of their parents finding out that they were sexually active was also a notable issue. (13)

Despite the benefits that regular Pap tests provide women in detecting and preventing cervical cancer, screening tests continue to be under used by many women, (7,11) with younger women being one of the most noncompliant groups. (3,7) More importantly, 90% of cervical cancer cases are preventable with regular Pap tests. (2) Further, limited research efforts have focused on the cervical knowledge of younger women, particularly women in university/college. (19) Since knowledge levels are one of the most substantial barriers in noncompliance, completing research on the knowledge of younger women would seem essential in facilitating health care professionals with information concerning women and their cervical health practices.

METHODS

Questionnaire

A questionnaire developed by the research team was distributed to female undergraduate students at a university in Southwestern Ontario. The questionnaire included the following sections: (1) socio-demographic information (i.e., age, level of education attained); (2) health information and health practices (i.e., perceived health; screening practices with respect to the breast and cervix); and (3) knowledge of cervical health (i.e., questions concerning: purpose of Pap; Pap procedure; risk factors for cervical cancer; factors that would negatively affect Pap smear results; cause of cervical cancer).

Participants

The participants were female undergraduate university students enrolled in the Kinesiology and Physical Education Department. All of the recruited participants were 18 to 24 years of age. Prospective participants were approached at the onset of their classes in Kinesiology and Physical Education. Students did not receive "bonus" marks for their participation and were not penalized for lack of participation. The response rate was approximately 95%.

Procedure