Cervical cancer awareness and screening in Botswana

Int J Gynecol Cancer. 2012 May;22(4):638-44. doi: 10.1097/IGC.0b013e318249470a.


Objective: Cervical cancer remains a leading cause of death in many developing countries because limited screening by Papanicolaou (Pap) smear. We sought to better understand women's beliefs about cervical cancer and screening in Botswana, a middle-income African country with high rates of cervical cancer.

Methods: We interviewed 289 women attending general medicine or human immunodeficiency virus (HIV) clinics, where Pap testing was available, in Gaborone, Botswana, in January 2009.

Results: About three fourths (72%) of the respondents reported having ever had a Pap smear; HIV-positive women were more likely to have had a Pap smear than HIV-negative women (80% vs 64%; odds ratio, 1.97; 95% confidence interval, 1.10-3.55). Screening was also more common among women who were older, had higher incomes, or had heard of cervical cancer. Almost all participants reported a desire to have a Pap smear. Reasons included to determine cervical health (56%), to improve overall health (33%), and to obtain early treatment (34%). About half (54%) of the respondents said they did not know what causes cervical cancer, and almost none attributed the disease to human papillomavirus infection.

Conclusions: Study findings can inform interventions that seek to increase cervical cancer awareness and uptake of screening as it becomes more widely available.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Botswana
  • Culture
  • Female
  • Follow-Up Studies
  • HIV / pathogenicity
  • HIV Infections / diagnosis*
  • HIV Infections / prevention & control*
  • HIV Infections / virology
  • Health Education
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Mass Screening*
  • Middle Aged
  • Papanicolaou Test
  • Prognosis
  • Surveys and Questionnaires
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / prevention & control*
  • Uterine Cervical Neoplasms / virology
  • Vaginal Smears
  • Young Adult