Is Pap Test Awareness Critical to Pap Test Uptake?: Findings from Vietnamese Women in Rural Vietnam

Background and Objectives: Cervical cancer is the second leading cause of death among Vietnamese females. The early detection of precancerous cells play a critical role in survival rates. While cervical cancer screenings, such as Pap tests, serve as a promising preventative measure to identify and treat cervical pre-cancers, the basic knowledge of regular Pap test screening remains low in all regions in Vietnam. This study aims to investigate health-related factors associated with receipt of Pap test among Vietnamese females living in rural Vietnam, particularly examining the correlation between awareness level of the Pap test and the receipt of the Pap test.

Data and Methods: As part of a larger research project investigating prevention behaviors of different cancers, this cross-sectional research project utilized a self-administrated questionnaire among Vietnamese women (N=193) residing in Quantri City, Vietnam. The receipt of Pap test was the dependent variable and Anderson’s Behavioral Model of Health Services Use was utilized to guide the study and to categorize the independent variables (sociodemographic characteristics, health accessibility, health history information, and health literacy information) into predisposing, enabling, and need variables to identify malleable factors for intervention. Multivariate analysis such as logistic regression was conducted to predict Pap test receipt with the predisposing, enable, and need variables.

Results: Only 15.5% (N=30) of participants in our sample received a Pap test within their lifetime. Pap test awareness (OR=18.614, p<.001, 95% CI [5.304, 62.203]) was a strong predictor of Pap test receipt. Participants who had heard about the Pap test were 17.61 times more likely to take a Pap test compared to those who had no prior knowledge. Additionally, variables including age (OR=.906, 95% CI [.821, .999]), employment (OR=.166, 95%CI [.031, .898]), and health insurance coverage (OR=9.307, 95%CI [.998, .86.747]) were significantly associated with Pap test uptake.

Conclusions and Implications: Our findings provided the first empirical evidence regarding the low level of Pap test receipt among females in rural Vietnam. Studies have shown that Pap test receipt is associated with those who have health insurance and are more aware of the Pap test, which our findings support. Additionally, Vietnamese females who are employed tend to be occupied by their work and have fewer opportunities to partake in cancer screenings than those who were unemployed. These findings indicate a need for innovative cancer prevention programs targeting employed females, effective strategies to increase health insurance coverage to promote cancer preventative behaviors, and proactive community outreach services to build awareness and improve Pap test receipt among females in Vietnam.