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Background: Observed cervical cancer morbidity and mortality health disparities are sociodemographically defined, but may also be explained by levels of health literacy. Little is known about HPV and cervical cancer screening knowledge among women of color and uninsured women. Studies in these populations have asked directly about the meaning of Pap smear or HPV, but have not examined literacy as it might be expressed in the course of receiving health services. Health literacy regarding Pap testing and its relationship to cervical cancer screening were examined as part of a larger study of cervical cancer screening in an urban STD clinic.
Methods: Survey and test result consultation data were gathered from 103 women from June 2012-October 2013. HPV-related literacy indicators included congruence between reported Pap history and reported cervical cancer screening (whether participants who answered yes to the question “Have you received a Pap test?” also answered yes to the question “Have you ever been screened for cervical cancer?”), and question content during the results communication.
Results: Findings indicated limited HPV and cervical cancer literacy in this cohort of women (African American (55.3%), White (36.9%) and Hispanic (6.8%)). More than half (55.8%) did not know that Pap testing was the same as cervical cancer screening. About one-third (31%) of all women screened were confused about what HPV was, its symptoms, its connection to cervical cancer, and the HPV vaccine.
Conclusions: Despite increased dialogue surrounding HPV vaccination, Pap testing and cervical cancer, a substantial number of women still have low HPV-related literacy. This may have an impact on willingness to access screening and to follow up on high risk results, particularly in health service settings where literacy issues are likely expressed. Examining cervical cancer literacy by congruence checks between reported Pap smears and cervical cancer screening may be beneficial.