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Cervical Cancer Awareness and Screening in Botswana
  1. Alicea M. Mingo, MD*,,
  2. Catherine A. Panozzo, MPH*,
  3. Yumi Taylor DiAngi, MD,§,
  4. Jennifer S. Smith, PhD*,
  5. Andrew P. Steenhoff, MD§,,
  6. Doreen Ramogola-Masire, MD,§,#,** and
  7. Noel T. Brewer, PhD††,‡‡
  1. *Department of Epidemiology,
  2. ††Department of Health Behavior and Health Education, Gillings School of Global Public Health;
  3. ‡‡Lineberger Comprehensive Cancer Center, University of North Carolina Chapel Hill, NC;
  4. US Navy, Medical Corps, Bethesda, MD;
  5. Department of Internal Medicine,
  6. Department of Pediatrics,
  7. #Department of Obstetrics and Gynecology, University of Pennsylvania;
  8. Department of Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA;
  9. §Botswana-University of Pennsylvania Partnership;
  10. **Departments of Internal Medicine and Obstetrics and Gynecology, University of Botswana, Gaborone, Botswana.
  1. Address correspondence and reprint requests to Alicea M. Mingo, MD, UNC Gillings School of Global Public Health, 121B MacNider Hall CB7240, Chapel Hill, NC 27599. E-mail:


Objective Cervical cancer remains a leading cause of death in many developing countries because limited screening by Papanicolaou (Pap) smear. We sought to better understand women’s beliefs about cervical cancer and screening in Botswana, a middle-income African country with high rates of cervical cancer.

Methods We interviewed 289 women attending general medicine or human immunodeficiency virus (HIV) clinics, where Pap testing was available, in Gaborone, Botswana, in January 2009.

Results About three fourths (72%) of the respondents reported having ever had a Pap smear; HIV-positive women were more likely to have had a Pap smear than HIV-negative women (80% vs 64%; odds ratio, 1.97; 95% confidence interval, 1.10–3.55). Screening was also more common among women who were older, had higher incomes, or had heard of cervical cancer. Almost all participants reported a desire to have a Pap smear. Reasons included to determine cervical health (56%), to improve overall health (33%), and to obtain early treatment (34%). About half (54%) of the respondents said they did not know what causes cervical cancer, and almost none attributed the disease to human papillomavirus infection.

Conclusions Study findings can inform interventions that seek to increase cervical cancer awareness and uptake of screening as it becomes more widely available.

  • Cervical cancer
  • Pap smear
  • Screening
  • Africa
  • Prevention

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  • The views expressed in this presentation are those of the author and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the US Government.

  • This study was supported by a grant from the American Cancer Society (MSRG-06-259-01-CPPB) and was made possible through core services and support from the Penn Center for AIDS Research, a National Institutes of Health–funded program (P30 AI 045008).