Cervical smear screening in a tertiary care gynaecological clinic in Sri Lanka: A survey from a middle income country

Introduction: Awareness and knowledge about cervical smear are lacking among the women in the developing world. The aim of the study was to study the awareness and knowledge regarding cervical smear screening among a cohort of Sri Lankan women. Methods: A cross-sectional study was conducted at a gynaecology clinic in a tertiary care hospital, Sri Lanka from January to August 2018. A consecutively recruited clinic attendees who attended the clinic for the first-time; aged over 35 years were interviewed using a previously piloted questionnaire. Outcome measures were socio-demographic and clinical characteristics, knowledge about cervical smear screening and uptake of Pap smear testing. Results: Among the 165 women interviewed, 146 (88.5%) had heard about cervical carcinoma. Median (IQR) age was 46.0 (39.0-54.0) years. Only 75.2% had heard about cervical screening. Knowledge about cervical smear screening was low and 60% of women were not worried about themselves getting cervical carcinoma. Awareness about cervical smear screening was 58.8% and only 78/165 (47.3%) had ever undergone screening. Fear of vaginal examination and lack of awareness was noted in 6.7% and 29.7% of them respectively. Public health midwives were the commonest source of information to them regarding cervical smear. Conclusion: Awareness and knowledge regarding cervical carcinoma is poor in the study sample.