Asian Pacific Journal of Cancer Prevention, Vol 11, 2010 435 Perception and Opinion of Medical Students about Pap Smear Test: A Qualitative Study Asian Pacific J Cancer Prev, 11, 435-440 Introduction Cervical cancer (CC) is the second most common cancer among women; affecting one million women worldwide. It is also the second leading cause of cancer deaths, accounting for more than 250,000 deaths in the year 2005 (Behtash & Mehrdad 2006; WHO, 2007). As a consequence of cervical cancer, 80% of cervical cancer deaths occur in developing countries (Gamarra et al., 2005). Infection with human Papillomavirus (HPV), early age of first sexual intercourse, multiple sexual partners and smoking are the risk for developing cervical cancer (Parkin et al., 2001). Papanicolaou (Pap) smear is one of the most essential screening tools for the early diagnosis of cervical cancer and the most effective preventive measures (WHO, 2007). The goal of routine screening is to detect early cytological changes such as dysplasia and to treat the patient before cervical cancer develops. Pap smear test plays an important role in reducing the incidence and mortality rate of invasive cancer (Brink et al., 2005). It has been observed that the decrease in incidence rates is more obvious in countries with organized screening programs (Gustafsson et al., 1997). Cervical cancer can be prevented 1 International Medical School, Management and Science University, 2 Community Medicine Department, Faculty of Medicine, National University of Malaysia, Malaysia *For Correspondence : radhwan888@yahoo.com Abstract Objective: the objective of this study is to explore the perceptions of medical students regarding the Pap smear test. Methodology: Focus group discussion was held with twenty three medical students. The students were divided into three focus groups; two groups of female participants consisting of 9 and 8 students; respectively. The third group consistedof 6 male students. Questions regarding Pap smear testing included barriers that prevented women from taking the test, gender preference for the physician to conduct the cervical screening test, willingness to suggest Pap smear test to the family or friends. The data obtained were classified into various categories and analyzed manually. Results: Most of the study participants mentioned that the main barriers for women to not perform Pap smear test is lack of awareness 16 (70%), followed by shyness 12 (52%) and the cost of the test 12 (52%). Most agreed that the gender of the physician will affect the women decision to do Pap smear test. All mentioned that the advantage of a regular Pap smear test is to detect the abnormality at the early stage of cervical cancer. Some of the participants 9 (39%) mentioned that the disadvantages are expense, possible injury in the vagina due to the test procedures 8 (35%), associated infection 7(30.4%) and pain 7(30.4%) . The majority, 20 (87%) mentioned that the most effective prevention methods for cervical cancer are having sex only after getting married with the spouse only, HPV vaccination 15 (65%) and Pap smear14 (61%). Conclusion: The main barriers for women to not perform Pap smear test is lack of awareness, shyness and the cost of the test. Gender of the physician will affect the women decision to do Pap smear test. Keywords: Perception - medical students - Pap smear test by identifying pre-cancerous lesions early using repeated Pap smear screening and treating these lesions before they progress to cancer. Prevention, early diagnosis and treatment have been shown to reduce mortality rate due to cervical cancer. The value of the cervical cancer screening in reducing the risk of cervical cancer and mortality has been established, and it is estimated that regular screening reduces the risk of cancer up to 80% (Stewart and Kleihues 2002; Özgül, 2007). Many countries have significant reduction in cervical cancer morbidity and mortality through cervical cancer screening and early treatment. The success of developed countries is largely due to the widespread and systematic use of Pap smear (Cronje, 2005). In the United States, despite the introduction of the Pap smear has been responsible for a 90% decrease in deaths from cervical cancer (Eddy, 1990); half of the United States women diagnosed with invasive cervical cancer have never had a Pap smear and 10% have not had Pap smears in the last five years (National Institutes of Health, 2007). In Australia, deaths from cervical cancer have decreased at about 2.8% a year, since the introduction of the National Cervical Cancer Screening Program in 1991 (Free et al., RESEARCH COMMUNICATION Perception and Opinion of Medical Students about Pap Smear Test: A Qualitative Study Redhwan Ahmed Al-Naggar 1 , Zaleha Md Isa 2