Knowledge of cervical cancer screening among women attending urban colposcopy clinics

To determine knowledge about cervical cancer screening among women referred to urban colposcopy clinics and to assess effects of colposcopy and directed teaching on knowledge deficits, a closed-ended questionnaire was distributed to 144 women at a university resident clinic before and after initial colposcopy. Results were compared with those of 42 patients attending a health maintenance organization (HMO) for the same procedure. Fewer than half of clinic patients correctly identified the nature of a Pap smear or the reason for their referral, but 84% knew that Pap smears were indicated annually. Fewer than 60% knew the nature of colposcopy or the organ that it evaluated, but 74% could identify its indication. Clinic patients' knowledge of colposcopy but not of Pap smears improved after colposcopy and teaching. While HMO patients had better overall understanding of Pap smears and colposcopy, a multivariate analysis found educational level to be the only significant predictor of this knowledge. Efforts to boost cervical cancer screening through improved understanding should be directed toward women with the least schooling without regard to other demographic factors.