Knowledge, attitude, and practice towards uterine cervical cancer screening in Egyptian females: a nationwide cross-sectional study

Background Cervical cancer is a major cause of morbidity and mortality among women worldwide; it is ranked the 4th most common cancer among women globally. The current recommendation for cervical cancer (CC) screening involves the use of cytology examination methods like Pap smear. However, there is a lack of data on the practice of Pap smear screening in Egypt. Furthermore, understanding the knowledge, attitudes, and barriers related to cervical cancer screening among potential participants is crucial. Methods In this cross-sectional study, we conducted interviews with female patients aged 21 years or more who visited outpatient clinics in six university hospitals across Egypt. The survey aimed to assess participants' compliance with CC screening guidelines, their knowledge of and attitude toward CC screening, and their perception of potential barriers. Results A total of 897 participants from the six study centers completed the survey. Only a small percentage (1.1%) of participants had undergone CC screening, although only (0.8%) of the participants were referred to do CC screening. The referral rate was more likely to be higher in participants who had one of their first-degree relatives or the surrounding people with a history of CC compared to those who have no one with CC (37.5% vs. 0.4%, P < 0.001; 5% vs. 0.6%, P = 0.035 respectively). Moreover, the referral rate was higher among participants who discussed CC and CC screening with their physicians (15.8% vs. 0.5%, P < 0.001; 23.5% vs. 0.3%, P < 0.001 respectively). Knowledge of CC screening was limited, with only 2.7% of respondents demonstrating good actual knowledge. However, after introducing the concept of CC screening to all participants, the majority (74.6%) showed a positive attitude towards undergoing the procedure. Lack of knowledge about the procedure, its tool, the place to do it, and financial burden were cited as the most common barriers to CC screening (79.8%, 65.9%, 64.2%, and 53.2%, respectively). Conclusion Despite inadequate knowledge about CC screening, there is a positive attitude toward it among eligible participants in Egypt. This lack of knowledge likely contributes to low compliance with current CC screening guidelines and calls for national-level efforts to address this issue.