Abstract 4960: Knowledge, attitudes, and practice patterns of primary care physicians towards cervical cancer screening in Yerevan, Armenia
Authors: Nathan Chu, Romina Shahhosseini, Marine Hovhannisyan, Shant Shekherdimian
Journal: Cancer Research (2025)

Abstract Background: In Armenia, over 60% of cervical cancer is diagnosed at stages 3 or 4. Cervical cancer screening significantly reduces mortality and has been covered by Armenia’s national cervical cancer screening program since 2015. As of 2020, only 41% of women aged 30 to 60 have been screened by Papanicolaou test (Pap smear) in the past three years, which is below the screening rate of similarly resourced countries. This study aimed to understand the knowledge and practices of primary care physicians (PCPs) in Yerevan, Armenia towards cervical cancer screening. Methods: Following institutional review board exemption from University of California, Los Angeles and Yerevan State Medical University, a survey of PCPs was administered in Yerevan, Armenia. Yerevan is the capital and largest city in Armenia. Population proportional sampling throughout all 12 administrative districts to include all 31 adult policlinics was utilized. Consenting physicians who worked as family physicians and “therapists” (internists) and practiced at least half time were included. Pediatricians, gynecologists, and specialists were excluded. A previously developed survey to assess provider knowledge and attitudes regarding cervical cancer screening was utilized and edited for local relevancy. The survey was translated to Eastern Armenian and back translated to English to assure accuracy. Results: 140 PCPs completed the survey, of which 98% were female and 89% were internists. 91% of respondents were over the age of 40 and 86% had practiced for over 10 years. 98% of PCPs recognized human papillomavirus as a risk factor for cervical cancer. Over 85% of PCPs correctly identified foul-smelling discharge and heavy bleeding as common symptoms for cervical cancer. Almost all PCPs (99%) believed that cervical cancer screening is effective in early detection of cervical cancer. However, most PCPs (98%) disagreed that cervical cancer screening is harmless. Less than half (49%) of PCPs surveyed were trained in performing a Pap smear and only two (1%) performed the procedure. Of those PCPs who did not perform Pap smears, most (97%) believed that it was the role of the gynecologist. A majority (73%) also believed that there was no benefit for PCPs to perform Pap smears. Most respondents (65%) did not believe that patients would have Pap smears if performed by PCPs. Conclusions: Knowledge regarding risk factors for cervical cancer and benefits of screening is high among PCPs in Yerevan. However, lack of training and hesitancy to perform Pap smears are key barriers to cervical cancer screening delivery and uptake. Inclusion of Pap smears in primary care medical curriculum and redefining the role of PCPs in providing cervical cancer screening may be useful in improving screening access. Furthermore, developing greater trust within the physician-patient relationship may encourage patients to receive Pap smears from their PCPs. Citation Format: Nathan Chu, Romina Shahhosseini, Marine Hovhannisyan, Shant Shekherdimian. Knowledge, attitudes, and practice patterns of primary care physicians towards cervical cancer screening in Yerevan, Armenia [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4960.