health belief model for doing pap test
After breast cancer and colorectal cancer, cervical cancer is the third prevalent cancer in women [1, 2]. Every year, 300 to 400 thousand women are diagnosed with cervical cancer and 200 thousand women dye because of the disease in the world. The prevalence of the disease is highest in the developing countries so that about 80% of the new cases of the disease are diagnosed in these countries. About 15% of malignancies of women in the developing countries is caused by cervical cancer; this figure in the developed countries is 1%. The prevalence of the cancer in Iran is 3.73 cases in every 100 thousand women [3]. Experts believe that geographical differences mostly depend on the availability of effective screening and therapeutic programs [2] and also access to pap test as an early diagnostic tool of cervical cancer [4]. Mortality rate of cervical cancer in the developed countries has declined notably thanks to routine pap tests and human papilloma virus (HPV) screening in the recent years [5].
The main risk factors of cervical cancer are pregnancy in young ages, several sex partners, human immune deficiency virus (HIV), herpes simplex virus (HSC), cytomegalo virus (CMV), HPC, exposure to DES during embryonic period, sexual infection, frequent infections, the immune system weakness, contraceptive medicines, diet (shortage of folate serum, vitamins C and A, and beta carotene), genetical factors, and exposure to chemical material (for the women working in chemical plants or farms) [6-8].
cervical cancer is conserved as a preventable cancer taking into account the long precancer period, availability of reliable screening plans, and efficient treatment of the early lesions. In general, preventive healthy behaviors can lead to satisfactory health results. The preventive behavior for this disease is pap test, which is a fast way to diagnose the cancer and attenuate the effects of the disease to a great extent []. As a healthy behavior and a way to improve health condition, pap test is a screening test for cervical cancer in women who demonstrate no symptoms. The test should be conducted every three years in sexually active women.
Pap test is the most efficient and economic way for screening cancer and a simple, economic, and with no side-effect way for screening cervical cancer [9]. If performed properly using proper sampling tools, pap test can diagnose cervical cancer with 70-95% accuracy [8]. Lack of routine pap test screening leads to 2-6times increase in the risk of cervical cancer [7]. About 70% of women who dye due to cervical cancer did not take pap test [8].
The first step in the process of programming health education is to use models and theories. Health belief model (HBM) has been recommended by many studies as an educational model. It is a comprehensive model that, rather than controlling the disease, is mostly used for preventing diseases. The model emphasizes on how one’s perception leads to motivation, movement, and behavior in return [11].