Knowledge of Cervical Cancer and Adherence to Pap Smear Screening Test Among Female University Students in a Multiethnic Institution, USA

Background/Purpose: This study assessed cervical cancer knowledge and examined its correlation with adherence to Pap smear guidelines. Methods: We carried out a cross-sectional survey in 141 undergraduate female college students. The response rate of the survey was 91.5%. Knowledge scores (0 - 4) were calculated based on students' answers to four items. Results: About 61.7% of the participants did not have annual checkups within a year, and 69% have never received Pap-test. Students who never received Pap-test mentioned procrastination (82%), lack of interest and fear as reasons for not practicing the behavior. About 92.9% of the students were not aware that the university student health service provides free Pap tests. More than double of annual checkup recipients undergone Pap test (33%) compared with those who did not have annual checkups (14.3%). Students who knew multi-partners sexual activity as a risk factor for cervical cancer had higher odds of receiving Pap test than those who didn't know the correlation between the number of sexual partner and the risk of cervical cancer [aOR= 2.87; 95% CI 1.07- 8.90]. Students with knowledge scores about cervical cancer risk factors and prevention methods at least a median had higher odds of receiving Pap test than those with knowledge scores lower than the median (aOR-6.49; 95% CI 2.8 - 14.7]. The increase in receipt of Pap test was associated with an increase in the level of knowledge about risk factors of cervical cancer. Conclusions: This study confirmed a correlation of the receipt of Pap test with knowing the causes and prevention mechanisms of cervical cancer. Adequate knowledge about cervical cancer causes, and prevention/control strategies may help to improve adherence to Pap smear testing in college students.