Behavior and related factors for early diagnosis of cervical cancer in women aged 30-65 years living in Konyaalti, Antalya

In our country, every woman in the 30-65 age group should undergo HPV or Pap-smear test at least once every 5 years. The aim of this study was to determine the compliance of women with cervical cancer screening standards and related factors. The population of the cross-sectional study performed during October 2018 was 44,504 women with age range 30-65 living in Konyaaltı. The sample size was determined as 726 with a prevalence of 39%, a pattern effect of 2, a deviation of 5%, and a confidence level of 95%. Cluster sampling method was used. Research was conducted in 730 women in 73 clusters, 10 of them were in one cluster. The dependent variable was compliance with the national cervical cancer screening program and those who had a screening test in the last five years were accepted as compatible. Independent variables were sociodemographic characteristics, reproductive health characteristics, knowledge test scores, risk factors, health beliefs. In order to measure the level of knowledge of the participants, 20 questions were collected from the literature. Each correct answer was given 1 point. The risk of cervical cancer was examined with the variables in Siteman Cancer Center's risk level determination program. Cervical Cancer and Pap-smear Test Health Belief Model Scale, which consists of five subdimensions, 35 items, which was developed, and the validity and reliability was confirmed by Guvenc, Akyuz and Acikel were used. After obtaining the consents of the participants, the questionnaire was applied by face-to-face interview and closed envelope method. The mean±standard deviation (SD) age of the participants was 44.61±9.59 and 61.8% of them were educated from high school and above. The city where the 84.8% of the participants the longest live is the metropolitan / provincial center, the income of 57.5% is equal to the expenses and 42.3% of them work in a business generating income. The mean±SD score obtained from the knowledge test was 13.4±4.1 (0- 20). It was found that 30.7% of the participants smoked at least one cigarette every day, 15.2% had 2 or more sexual partner, and the first sexual experience age was under 16 years in 7.3% of the participants. The rate of women who used mostly condoms during their lifetime was 29.0%. Benefit/motivation subscale of Health Belief Scale was 32.2±4.5 (8-40), disability perception was 31.4±8.6 (14- 70), and severity perception subscale was 22.0±5.7 ( 7-35), 7.2±2.3 (3-15) points from sensitivity perception sub-dimension and 9.9±2.5 (3-15) points from health motivation sub-dimension. A cervical cancer screening test at least once in a lifetime was 73.2%, while compliance with national screening standards was 65.3%. As a result of logistic regression analysis, between the age of 40-49 years the compliance with national screening standards was found 2.89 times higher than those of 60-65 years. Also, the compliance 2.67 times higher between the ages 50-59 years than those of 60-65 years. The compliance was found 3.90 times more in the participants attended regular gynecological examinations comparing to those who did not. One unit increase in the knowledge test score increased the compliance to the screening by 1.11 times. When the obstacle perception score increased by one unit, the compliance to the screening decreased by 0.89 times. Lack of habit of going to regular gynecological examination, the age between 60 and 65, low level of knowledge and high perception of disability affect negatively the participation in screening test. Considering these risk groups, it is recommended to providing services and trainings. Key Words: Cervical Cancer, Screening Compliance, Related Factors