Cervical Cancer Risk Levels in Turkey and Compliance to the National Cervical Cancer Screening Standard

Abstract

Cervical cancer screening with Pap smear test is a cost-effective method. The Ministry of Health in Turkeyrecommends that it be performed once every five years after age 35. The purpose of this study was to determinethe cervical cancer risk levels of women between 35 and 69, and the intervals they have the Pap smear test,and to investigate the relation between the two. This study was performed on 227 women aged between 35and 69 living in Balcova District of İzmir province. Using the cervical cancer risk index program of HarvardSchool of Public Health, the cervical cancer risk level of 70% of the women was found below average, 22.1%average, and 7.9% above average. Only 52% of the women have had Pap smear test at least once in their lives.The percentage screening regularly in conformity with the national screening standard was 39.2%. Women inthe 40-49 age group, were married, conformed significantly more (p<0.05) to the national screening standard.Compliance also increased with the level of education and decreased with the cervical cancer risk level (p<0.05).A logistic regression model was constructed including age, education level, menstruation state of the women andthe economic level of the family. Not having the Pap smear test in conformity with the national cervical cancerscreening standard in 35-39 age group was 2.52 times more than 40-49 age group, while it was 3.26 times morein 60-69 age group (p<0.05). Not having Pap smear test in 35-39 age group more than other groups might resultfrom lack of information on the cervical cancer national screening standard and the necessity of having Papsmear test. As for 60-69 age group, the low education level might cause not having Pap smear test. Under thesecircumstances, the cervical cancer risk levels should be determined and the individuals should be informed.Providing Pap smear test screening service to individuals in the target group of national screening standard, asa public service may resolve the inequalities due to age and educational differences.