ASSESSMENT OF KNOWLEDGE AND ATTITUDE TO CERVICAL CANCER AND PAP TEST AFFECTING ACCEPTANCE OF PAP SMEAR SERVICE AMONG WOMEN IN HAA DISTRICT, BHUTAN (AUGUST – NOVEMBER 2020)

Abstract

In Bhutan, cervical cancer is the most common cancer in women. Although Papanicolaou test (Pap test) is effective in detecting cervical cancer, a freely available service has not been optimally utilized in most parts of the country, including the Haa District of Bhutan, due to reasons not well studied or understood. Attitudes towards Pap smear screening among women 25-65 years of age, including factors influencing decision to obtain a Pap test and knowledge of cervical cancer were conducted in Haa District from August to November 2020. Proportion of women who received Pap test was higher among those presented with evidence regarding cervical cancer and importance of the test compared to those who did not. Nonetheless, number receiving a Pap test was quite low in the former group. Presence of female health workers in health centers increased likelihood of accepting the available Pap smear services. Individuals residing in areas more than one-day travel from a health facility were less likely to have received Pap smears compared to those who lived less than a 2-hour travel. In conclusion, knowledge of importance of Pap test in detecting cervical cancer and freely availability of Pap smear services are insufficient by themselves to induce receipt of a Pap test, being counteracted by other deterring factors. Thus, adopting a holistic approach is essential to improve utilization of Pap test facilities in Haa District and other regions of Bhutan.