Résumé
There are conflicting reports about the effect of wiping cervix with cotton on Pap-smear results. Therefore, we aimed to do a research about this subject. 234 eligible women attended to have Pap-smear at an educational hospital in Rasht, Iran, from July to September 2011, were allocated by block randomization into two groups. In the intervention group, we cleaned cervix with a sterile cotton rotating 360 degrees and obtained samples using spatula for exocervix and cytobrush for endocervix. This method was performed without cleaning the cervix on the control group. Data collection, vulvovaginal examination, laboratory assay were done by investigators masked to the group allocation. Participants were also blind. The data were analyzed using logistic regression in SPSS-13. Rate of sufficient endocervical cell of the slides in the intervention group was significantly higher than in the control group [70.3% vs. 57.8%, p=0.03]. In the intervention group 42.4% of the slides were satisfactory and 57.6% had limited quality for interpretation. These figures in the control group were 37.1% and 62.9%, respectively. This difference was not statistically significant. Also, there was no significant difference between the groups on rate of slides with inadequacy of squamous cells and obscuring 75% or more of the slides with inflammatory exudate or blood [p>0.05]. There were no significant differences between the groups on some quality indicators of the smears. However, frequency of smears with sufficient endocervical cells was higher in the group with cervical wipping. Therefore, it is recommended to clean cervix before obtaining the smears
Résumé
The Pap smear is a reliable, inexpensive and effective screening test for cervical cancer; the second most common cancer among women worldwide. We aimed to determine women's knowledge, attitudes and practice towards Pap smear and barriers for the screening in a public hospital. This study, was carried out on 350 outpatient married women reffering for a visit at the clinics of the Alzahra educational hospital, Rasht- Iran, 2011. A questionnaire including demographic characteristics [24 questions], knowledge [14 questions], attitudes [11 statments] and practice [10 questions] towards Pap smear was completed by interview with the women. The data were analyzed using SPSS ver.13. Mean age of participants was 32 [SD 12] years. Of the respondents, only 44.3% were aware of the Pap smear and 27.1% had had it at least once in their life. The most common reason for having the test was physicians' or other health workers' advise and for not having the test was no recommendation by health providers and lack of knowledge about Pap smear. Embarrassing, fear of the test result or economic problems mentioned by only 12 [4.2%] as the main barrier. Mean [+/- SD] knowledge score of the women who had heard about the Pap smear was 59.4 [24.3] and attitudes score of all participants was 48.5 [11.6] from possible range score of 0-100. Women with a history of Pap smear had had higher awareness and attitudes score. The knowledge and practice of the women was inadequate and need to be promoted. Considering the main reason mentioned by the participants for not having the test, all health providers should educate and encourage women to do regular Pap smear