Women's Knowledge and Behavior on Cervical Cancer, in Kayseri, Turkey

Objective: Cervical cancer, the second leading cause of death in women worldwide, can be prevented by education, routine screening and HPV immunization. This study was aimed to determine the level of knowledge and behavior of married women over 18 years regarding cervical cancer in the city of Kayseri, Turkey. Material and Methods: In this cross-sectional study performed in 2009 in the province of Kayseri, a questionnaire was filled out for 1000 married women over 18 with face-to-face interview. Women were asked a series of questions that evaluated their knowledge about cervical cancer, its risk factors, early signs and symptoms and whether they had undergone a Pap smear test within the last three years. Questions and correct answers were developed in accordance with the relevant literature. Results: The mean age, age at first marriage, and parity were 35.40 +/- 12.77, 19.15 +/- 3.41, 2.57 +/- 1.86, respectively. The age of first sexual experience was the same as the age at first marriage and the rate of marriage before 20 years of age was 61%. The most prominent source of information was the media (63.4%). Smoking (13.3%) and having multiple sexual partners (13.0%) were the most well-known risk factors. Fifteen point four percent of women stated that early detection of cervical cancer was possible, and 15.0% stated that women at risk should have a Pap smear test at least once a year. Although 12.3% indicated that the Pap smear was the best diagnostic method, only 7.2% thought that this should be repeated every year. Eleven percent knew there was a vaccine for cervical cancer and 9.0% indicated that condom use was a protective measure. Only 16.1% of women stated that their knowledge about cervical cancer was sufficient, and the rate of women who underwent a Pap smear test within the last three years was 23.0%. While the level of knowledge was closely associated with age, occupational status, family income and educational background, having a Pap smear within the last three years was only associated with age and family income. Conclusion: There is a serious lack of knowledge and behaviour among married women regarding cervical cancer, risk factors and protective measures. Therefore, there is an urgent need for educational programs to enhance the level of awareness and motivation, and to enable routine screenings.