Attitudes and practice of cervical cancer screening among female university students from 25 low, middle income and emerging economy countries

Cervical cancer, the third commonest cancer in women worldwide, can be prevented through early detection by cervical screening (Pap smear). The aim of this study was to investigate the attitudes and practice of cervical cancer screening among female undergraduate university students from 25 low, middle income and emerging economy countries. Using anonymous questionnaires, data were collected from 9,194 female undergraduate university students aged 18-26 years (mean age 20.9, SD=2.0) from 26 universities in 25 countries across Asia, Africa and the Americas. Overall, 11.6% of the female students indicated that they had conducted one or more times a cervical (Pap) smear test; 8.3% among 18-20 year-olds and 15.6% among 21-26 year-old students. There was considerable country variation on having had a cervical (Pap) smear test among 21-26 year-old female university students, ranging from 59.2% in Colombia and 50.9% in Barbados to 0% in India and 1.0% in Tunisia. Logistic regression showed that cervical cancer screening importance or positive attitude were highly associated with the cervical screening practice. Moreover, risky sexual behaviour and tobacco use, two cervical cancer risk factors, were associated with screening. Cervical cancer screening practices were found to be inadequate and efforts should be made to develop programmes that can increase the uptake of cervical cancer screening.