Although age is a major risk factor for cervical cancer — especially between the late teens and mid-30s — a new study shows that Chinese women age 50 and older in Hong Kong do not undergo sufficient screening for this disease.
The research aims to unravel the factors affecting cervical cancer screening in Chinese women, showing that most women believe that cervical screening is no longer needed after menopause, and that those who are older, single, or have a lower educational level are less likely to undergo screening throughout their lifetime.
The Hong Kong-based study, “Examining the Cervical Screening Behavior of Women Aged 50 or above and Its Predicting Factors: A Population-Based Survey,” was published in the International Journal of Environmental Research and Public Health.
Cervical cancer screening rates seen, for example, in North America or Europe can be attributed to a woman’s increased knowledge and perceptions of personal risk of developing cervical cancer. Hong Kong, however, is unique — a melting pot of contemporary Western values combined with traditional Chinese culture, suggesting the factors motivating women to undergo cervical cancer screening are more complex.
To understand the reasons why Chinese women decide to get screened (or not) for cervical cancer, the research team conducted a telephone survey of 959 women age 50 and older in Hong Kong who had no history of cervical cancer.
The survey included a structured questionnaire with questions regarding sociodemographics, past health issues, perceptions of that individual’s health, use of traditional Chinese medical practices, use of available cervical screening tests, and reasons behind undergoing cervical screening tests or not.
Results showed that nearly half of the surveyed women had never had a cervical smear test. The most common reason given (66 percent) when asked why was that they believed the test was not necessary after menopause. Of the women who had been screened for cervical cancer, only 5 percent said their reasons were based on a physician’s recommendation.
Several factors were shown to significantly influence a woman’s choice to undergo cervical screening. These included age, educational level, marital status, family history of cancer, smoking status, use of complementary Chinese therapy, recommendation from a health professional, and believing that visiting a doctor or a Chinese herbalist regularly was good for her health.
The authors suggest that older women were less likely to undergo cervical cancer screening because of their misconception of cancer risk after menopause. Additionally, participants with a family history of cancer or with higher education status were more likely to be screened for cervical cancer, suggesting that this population is more aware of their health status.
Participants who were married were also more likely to be screened, which may relate to the influence of their partner.
“Misconceptions concerned with older age and menopause may reduce women’s perceived susceptibility to cervical cancer and exert a negative effect on their screening behavior,” the researchers wrote. “Healthcare professionals such as nurses and other primary care providers need to make active approaches to these high-risk groups — older unmarried women, smokers, the less educated and those with generally low health consciousness.”
The actions suggested by the authors may lessen the burden of cervical cancer in China.