Jordanian women’s attitudes towards cervical cancer screening: has the pattern changed?

Abstract

The objective of this study was to report the current Jordanian rate of cervical smear test uptake, and study changes in women’s attitude to the smear test since the last published report in 2002. A prospective cross-sectional study of Jordanian women who at the time of the study were living in Jordan. The study period was from December 1 2018 to December 31 2018. Six hundred and twelve women were recruited, and the mean age was 36 years. Thirty-eight percent of the women in the study said they had had a smear test before. Of those who had ever had a test, 88% did so as a routine test. Of women who had never had a smear test, 61% said they had heard about the test, 50% of them did not give a ‘logical’ reason for not having a test. While the current rate is less than in 2002, more women recognised the test as being important. While the rate of cervical smear test uptake in Jordan remained low (38%), it is better than the rate in 2002 of 25.5%. Severe deficiencies in the knowledge of the test exist. Implementing a national cervical screening programme supported by media-led health education and promotion is likely to increase the test uptake and reduce incidence of cervical cancer.

Impact statement

• What is already known on this subject? The incidence of cervical cancer (CC) in high income countries has reduced through the implementation of cervical screening programmes, with subsequent early detection and treatment of precancerous lesions. Globally, 85% of the CC burden is in low income countries. Furthermore, the implementation of screening programmes has not been successful due to limited resources and a lack of infrastructure. The rates of cervical screening test uptake vary widely among different countries. Jordan’s smear test uptake was 25% in 2002.

• What the results of this study add? The rate of cervical smear test uptake in Jordan has remained low (38%) compared to the rates in the developed countries. In addition, 12% of the cervical smears in our study were opportunistic. Our study recognised deficiencies in relation to public awareness of the importance and the details of the test.

• What the implications are of these findings for clinical practice and/or further research? In clinical practice and in the absence of national screening programme, health care workers are encouraged to perform more opportunistic smears. This study provides education on the test. Researchers may consider investigating the barriers to cervical screening and therefore increase cervical screening uptake.

Keywords:

• Pap smear
• cervical cancer
• women’s cancer

Acknowledgements

The authors would like to acknowledge Dr Ahmad Al Nabih for his contributions in preparing the manuscript.

Disclosure statement

The authors declare no conflict of interest.