An Exploration of Papanicolaou Smear History and Behavior of Patients With Newly Diagnosed Cervical Cancer in Taiwan

Background: Papanicolaou (Pap) smear is an effective preventive measure in reducing cervical cancer incidence and mortality. The national health insurance made free annual cervical screening available to all Taiwanese women 30 years or older. Objective: The objective of this study was to increase knowledge about Pap smear screening history, attitudes, and behavior in Taiwanese women with newly diagnosed cervical cancer. Methods: One hundred forty-one women with newly diagnosed cervical cancer were prospectively enrolled between January 2007 and June 2008. Data were collected via a questionnaire survey, which included (1) demographic and socioeconomic characteristics, (2) reasons for receiving or not receiving a Pap smear test, and (3) knowledge of and sources of information on Pap smears. Results: Of the 141 patients, 62 (44.0%) had never had a Pap smear before diagnosis, 10 (7.1%) did not know about the Pap smear, and only 30 (21%) reported having had more than 3 Pap smears in their lifetime. Stepwise logistic regression identified perceived potential pain, fear of embarrassment, and the number of sexual partners of the male consort as independently associated with the number of previous Pap smears (0 vs >= 1). Conclusion: Our results highlight the need for a better understanding of women's knowledge and experiences with Pap smear screening and developing more comfortable methods of cervical cancer screening. Implications for Practice: Education strategies should be focused on improving access to never-users. The need for a better understanding of women's experiences with Pap smear screening is highlighted.