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The reasons for refusing a pap smear include that
the women who believe it might be painful (representing 42% of the studied
population), followed by embarrassment which represents 36.1%, then the
belief they are healthy (17%), and the last reason that their husband
refuses (representing 5.5% of the studied population).
Discussion
The percentage of school teachers who have a good knowledge about cervical cancer and papanicolaou smear test as a screening test is (84%) compared to those who have average to bad knowledge (15.6%).
With closer analysis of the results between decade age groups, there was no difference in the knowledge between the (20-39) year old group and older age group. This is expected because they are both elite groups (highly educated groups).
So the relationship between knowledge on one hand and practice of papanicolaou smear screening on the other hand has not confirmed the second hypothesis (The greater the knowledge about cervical cancer and pap smear tests the more papanicolaou smear screening is practiced).
The result of the study supported the first hypothesis in terms of the relationship between educational level and knowledge about papanicolaou smear and cervical cancer. Similar results were found in Arevian and Noreddine who report that education is the most important predictor of knowledge about papanicolaou smear test. But surprisingly, majority of that knowledgeable group did not have a papanicolaou smear test even once in their life (Table 1-5).
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Women in general throughout their lives have more frequent contact with health care services particularly at the level of primary care. The high prevalence, long mean duration of a symptomatic detectable disease, and availability of a high specific screening test make cervical cancer screening an important task for all primary care providers.
In this survey the majority of women (91.11%) want the screening of cervical cancer to be carried out by the Gynecological Doctor in Hospitals (Gynecological Clinic); which will contribute unnecessary increase the load in the Hospitals. Where as only 3% of women who participated in the study would prefer the screening of cervical cancer to be performed by a primary care physician.
The major source of information about papanicolaou smear test have been delivered through the gynecological doctor which indicate that the primary care physician has no role in providing the information about cervical cancer and its detection by the papanicolaou smear screening. This may be attributable to a lack in the screening programme in
U.A.E. So programmes are required to train primary care physicians about the technique of taking a sample to avoid any sampling error and comprehensive educational programmes about cervical cancer and papanicolaou test screening should be implemented through the mass media and primary health doctors.
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