Confusion about Pap smears: lack of knowledge among high-risk women

J Womens Health (Larchmt). 2013 Jan;22(1):67-74. doi: 10.1089/jwh.2012.3667. Epub 2012 Dec 6.


Background: The impact of the Papanicolaou (Pap) smear on the prevention of cervical cancer is one of the greatest public health success stories. However, it is not clear if women understand the purpose of the Pap smear despite recent advancements and national attention over cervical cancer prevention. The purpose of this study was to examine Pap smear knowledge among three high-risk populations at different points in time.

Methods: Women from three separate human papillomavirus (HPV) psychosocial studies completed surveys assessing Pap smear knowledge: (1) HPV-positive women (prevaccine population in 2005-2006, n=154, mean age 23.5), (2) college women (postvaccine population in 2008, n=276, mean age 18.9), and (3) minority college women (postvaccine population in 2011, n=711, mean age 23.3). Frequencies and logistic regression were employed to examine associations between demographic factors and accurate knowledge of Pap smear testing within each study.

Results: Approximately one quarter of participants across all three samples did not know that the Pap smear is a test for cervical cancer. Participants also incorrectly believed that the Pap smear tests for HPV (82%-91%), vaginal infections (76%-92%), yeast infections (65%-86%), gonorrhea (55%-81%), herpes (53%-80%), HIV/AIDS (22%-59%), and pregnancy (17%-38%). Among all three studies, older age was the only factor significant with higher Pap knowledge. Higher HPV knowledge scores were significantly associated with higher Pap knowledge in studies 2 and 3 only.

Conclusions: Knowledge about the purpose of the Pap smear remains low. Findings underscore the significant need for clear and consistent messages among high-risk women regarding the prevention of cervical cancer and other reproductive health conditions.

MeSH terms

  • Adolescent
  • Adult
  • Confusion
  • Early Detection of Cancer*
  • Ethnicity
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Health Surveys
  • Humans
  • Logistic Models
  • Mass Screening
  • Papanicolaou Test*
  • Papillomavirus Infections / diagnosis
  • Papillomavirus Infections / prevention & control
  • Risk Factors
  • Socioeconomic Factors
  • Students
  • Uterine Cervical Neoplasms / prevention & control*
  • Vaginal Smears*
  • Vulnerable Populations / statistics & numerical data*
  • Young Adult