Perception and use of Pap smear screening among rural and urban women in Romania.

Background: In 2012 the National Screening Program for all women between 25 and 64 years of age was launched in Romania. Public awareness is an important factor in the success of a screening program. For this reason, we intended to assess the perception and the level of awareness of Romanian women regarding the Pap test in the prevention of cervical cancer.

Methods: A cross-sectional study was conducted among 454 women from rural and urban areas. For our study, we used a questionnaire covering general characteristics, awareness, knowledge and practices regarding cervical cancer and Pap smear.

Results: 431 participants (95%) had heard of cervical cancer and Pap smear but only 71.8% knew the exact role of it. Bivariate analysis showed that knowledge about the importance of the Pap smear, early detection and treatment of early-stage cervical cancer was reduced among women with low socio-economic status, mainly living in rural area. The most frequent reasons for avoiding Pap smear screening were: lack of money, embarrassment or fear of gynaecological consultation and pain, the feeling that they don't need it, misconceptions about cervical cancer, fatalistic attitude, perceived low susceptibility to cervical cancer.

Conclusions: Because the uptake and the success of cervical cancer screening are determined by women's knowledge and awareness of Pap smear, it is critical to improve these perceptions in the near future especially in rural area characterized by a low socio-economic status.