Knowledge, Attitude, Practice and Barriers regarding cervical cancer and its screening using Pap smear, in rural women of Ba, Lautoka and Nadi, Fiji

Background: Fiji has a high rate of cervical cancer, which is the second most common cause of cancer deaths in women in the country. Less than 10% of women are screened for cervical cancer in Fiji. In this paper we report the result of a study on Knowledge, Attitude, Practice and Barriers (KAPB) to cervical cancer and its screening with Pap smears, conducted on 1494 rural women in Fiji. Objectives: To assess the knowledge, attitudes, practice and barriers to cervical cancer and it's screening with Pap smears in rural women of Ba, Lautoka and Nadi, in Fiji. Methods: Structured questionnaires were administered to women presenting to a rural outreach Reproductive Health education and clinics, by trained health educators to ascertain their Knowledge, Attitudes, Practice and Barriers to cervical cancer and its screening with Pap smears. Results: Seventy two percent of rural women had no knowledge of cervical cancer and 80% had no knowledge of the risk factors of cervical cancer. Lack of knowledge was significantly different for age groups (p=0.006), education levels and employment status(p<0.001) and ethnicity (p=0.022). Those groups with lowest knowledge were teenagers (18 to 19 years), those with less education and iTaukei respondents. Of the respondents who had at least some knowledge of the Pap smear, 75% had had a Pap test. Of those who had no knowledge of the Pap smear, only 45% had had the test (p<0.001). Of those who did not have a Pap smear the commonest barrier was lack of knowledge at 46.3% and fear of procedure was 29.4%. Conclusion: More education is required to acquaint women in rural Fiji about cervical cancer, its associated risk factors as well as the benefits of cervical cancer screening programs and other prevention strategies.