Levels and Correlates of Functional Cervical Cancer Literacy among Lebanese Women: A Cross-sectional Study

Abstract

Introduction: Cervical cancer can be prevented through vaccination against HPV and routine screening through HPV DNA testing or Pap smear. This cross-sectional study aimed to assess functional cervical cancer literacy (FCCL) levels and correlates among women of reproductive age in Lebanon.

Methods: The Arabic self-administered questionnaire consisted of the Cervical Cancer Literacy Assessment Tool, socio-demographic characteristics (age, education, employment status, religiosity, ability to pay), and health-related factors (smoking, parity, chronic diseases, self-perceived health, history of uterine or cervix surgeries, health insurance, visits to physician in the past three months, and regular Pap smear and HPV DNA testing).

Results: Of 619 women mean age of 33.9 years (±12.0), 51.7% had insufficient FCCL. Lower educational level, difficulty in covering medical expenses, lack of health insurance and poor self-perceived health were significantly associated with insufficient FCCL. Multiple logistic regression analysis showed that monthly income (OR: 1.74 [95% CI: 1.12 – 2.72]), ability to pay for medical expenses (OR: 1.81 [1.05 – 3.14]), and visits to the doctor in the last three months (OR: 1.51 [1.07 – 2.12]) were predictive of FCCL level.

Conclusion: In addition to a national vaccination program against HPV combined with cervical cancer screening, we recommend the inclusion of cervical cancer as a topic within sexuality education programs. Special attention should be given to women with limited FCCL and uninsured women of low socioeconomic status. To enhance cervical cancer literacy, and promote vaccination and screening, efforts should extend beyond health care settings and leverage various media channels, including social media.