Knowledge and Practice of Pap Smear and Vaccination Regarding Human Papillomavirus Among Female Medical Students in Karachi, Pakistan

Background: Cervical cancer is the leading cause of women's death in developing countries. The change in the epidemiological trends has been attributed to mass screening with the help of a Pap smear. Objectives: This study aimed to determine the knowledge level and practice regarding a Pap smear and human papillomavirus (HPV) vaccination among female medical students in Karachi, Pakistan. Methods: In this cross-sectional study, 147 participants were selected through multistage stratified random sampling. The knowledge level was categorized as adequate if the participants answered 60% of the items. Questionnaire validity was determined through Cronbach's alpha value (alpha = 0.69). Binary logistic regression was applied to determine the factors associated with the knowledge level among the students. A confidence interval (CI) of 95% was considered with a margin of error of 5% and a P-value of 0.05 as statistically significant. Results: Most students (60.5%) had adequate knowledge regarding a Pap smear and HPV vaccination. Only 3.4% of the students underwent a Pap smear test. The most common factors contributing to the knowledge level were marriage (OR = 2.98; 95% CI: 1.23 11.09; P = 0.003), first academic year of students (OR = 10.78; 95% CI: 1.03-12.01; P = 0.046), family history of cancer (OR = 2.76; 95% CI: 1.34 7.90; P = 0.004), and family income less than < 100000 Pakistani Rupee (OR = 5.45; 95% CI: 2.09 9.06; P = 0.005). Conclusions: Being medical students studying in the first academic year, family history of cancer, and family income less than 100000 Pakistani Rupee had significant effect on knowledge gap about a Pap smear and HPV vaccination. There is a need for an increased level of knowledge in this regard by addressing the risk factors contributing to the knowledge level.