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    • The authors would like to thank

    2019-06-25

    The authors would like to thank Ms. Fang-Ju Sun for her help with statistical analysis. This study was supported by a research grant from Mackay Memorial Hospital (MMH10466).
    Introduction Cancer of the Pyronaridine Tetraphosphate weight (CC) is the second most common cancer affecting women worldwide, and about 86% of CC cases occur in developing countries. In fact, these cases actually represent approximately 13% of female cancers overall. Statistically, CC is one of the leading causes of illness and death amongst the gynaecological cancers worldwide, especially in developing countries. The American Cancer Society estimated that of the over 12.000 cases of invasive cervical cancer diagnosed, approximately 3.000 of the women will die from the disease. Although CC is considered one of the most preventable cancers, most women who seek help for cancer-related illnesses usually do so when the disease has advanced, and is no longer treatable. The situation in Zimbabwe is largely unknown, particularly given the scarcity of epidemiological data. However, it is estimated that 2270 women are diagnosed with cancer every year in Zimbabwe, and 1451 die from the disease. Cervical cancer is the most frequently occurring cancer among women in Zimbabwe, and the 2nd most frequent cancer among women between 15 and 44 years of age. There has been an increase in cancer screening centers in Zimbabwe, but further improvements need to be made as the acceptance rate of this service remains low. Early detection is quite crucial for a country like Zimbabwe where treatment services such as surgery, chemotherapy and radiotherapy are frequently unavailable for advanced cervical cancer. At the few institutions where these services are in place and available, they are usually very expensive and cannot be afforded by many women. The Human papillomavirus (HPV) is a sexually transmitted infection, recognized as the cause of 99% of all cervical cancers worldwide. Women are primarily infected with HPV in their teens, 20s, or early 30s. Therefore, it is recommended that women should be screened three years after their first sexual intercourse. The discovery of the human papillomavirus (HPV) as a predominant cause of cervical cancer has necessitated the administration of HPV vaccines as an additional means of cervical cancer prevention. The HPV vaccination has the potential to reduce the incidence of cervical cancer worldwide by 70%; the remaining 30% of cancers can be prevented through regular cervical cancer screening. Precancerous lesions can be detectable 10 years or more before cancer develops. However, it has been noted that many women in developing countries do not obtain screening even when the facility is available. About 90% of cervical cancer could be prevented if all women were offered and complied with high quality cytological screening programs. Papanicolaou cytological testing (Pap smear) allows cervical lesions to be detected before they become cancerous, thereby effectively reducing the incidence of cervical cancer by 75–90%. Following a Pap smear there is a need for a colposcopy procedure, which is the standard follow-up for an abnormal Pap smears. The risk factors for cervical cancer include early age of first intercourse, multiple sexual partners, HPV virus and HIV infection. In general, all sexually active women are at risk for developing cervical cancer. Non-compliance with screening guidelines continues to be a major risk factor for invasive cervical cancer. Family history of cervical cancer, early sexual activity, age, lack of regular Pap smear testing, as well as number of pregnancies are also risk factors for CC. Studies have found that there was a strong interplay between the knowledge and attitudes of CC and the resultant health seeking behaviours.Women\'s attitudes towards cervical cancer screening have been found to have an impact on the adoption of cervical cancer screening in many developing countries. A study in Thailand found that female sex workers with negative attitudes about Pap smear services were less likely to have ever had a cervical smear taken than those with a positive attitude19.