Uncorrected Proof Health Scope. 2021 November; 10(4):e119411. Published online 2021 November 12. doi: 10.5812/jhealthscope.119411. Research Article Knowledge and Practice of Pap Smear and Vaccination Regarding Human Papillomavirus Among Female Medical Students in Karachi, Pakistan Tafazzul Hyder Zaidi 1 , Mubashir Zafar 2, * , Sobia Memon 1 , Mehrunnisa Tufail 1 , Aqsa Sattar 1 , Parshant Bajaj 1 , Shahreen Mukhtar 1 , Muhammad Sufiyan Sufiyan 1 and Ahmad Masood 1 1 Jinnah Sindh Medical University, Karachi City, Pakistan 2 University of Hail, Hail, Saudi Arabia * Corresponding author: University of Hail, Hail, Saudi Arabia. Email: researchmubshir@outlook.com Received 2021 September 10; Revised 2021 October 13; Accepted 2021 October 15. Abstract Background: Cervical cancer is the leading cause of women’s death in developing countries. The change in the epidemiological trends has been attributed to mass screening with the help of a Pap smear. Objectives: This study aimed to determine the knowledge level and practice regarding a Pap smear and human papillomavirus (HPV) vaccination among female medical students in Karachi, Pakistan. Methods: In this cross-sectional study, 147 participants were selected through multistage stratified random sampling. The knowl- edge level was categorized as adequate if the participants answered 60% of the items. Questionnaire validity was determined through Cronbach’s alpha value (α = 0.69). Binary logistic regression was applied to determine the factors associated with the knowledge level among the students. A confidence interval (CI) of 95% was considered with a margin of error of 5% and a P-value of 0.05 as statistically significant. Results: Most students (60.5%) had adequate knowledge regarding a Pap smear and HPV vaccination. Only 3.4% of the students underwent a Pap smear test. The most common factors contributing to the knowledge level were marriage (OR = 2.98; 95% CI: 1.23 - 11.09; P = 0.003), first academic year of students (OR = 10.78; 95% CI: 1.03 - 12.01; P = 0.046), family history of cancer (OR = 2.76; 95% CI: 1.34 - 7.90; P = 0.004), and family income less than < 100000 Pakistani Rupee (OR = 5.45; 95% CI: 2.09 - 9.06; P = 0.005). Conclusions: Being medical students studying in the first academic year, family history of cancer, and family income less than 100000 Pakistani Rupee had significant effect on knowledge gap about a Pap smear and HPV vaccination. There is a need for an increased level of knowledge in this regard by addressing the risk factors contributing to the knowledge level. Keywords: Cervical Cancer, Knowledge, Pap Smear, Students, Vaccination 1. Background Cervical cancer is the leading cause of women’s death in developing countries (1). Cervical cancer is caused by human papillomavirus (HPV), and the important determi- nant of this cancer was a low level of awareness among females regarding this cancer (2). The most important factor which early detects cervical cancer is the screening method, such as a Pap smear, which helps manage the can- cer at an early stage (3). The HPV is sexually transmitted and causes all cervical cancers. The adult females’ knowledge level is the key to the prevention of this type of cancer (4). Previous studies regarding the knowledge level of HPV vaccination and a Pap smear obtained different results (4, 5). A study demonstrated that females with more knowl- edge regarding cervical cancer had a high level of HPV vaccination coverage (6). The aforementioned study also showed that the cost of HPV vaccination is the main barrier among females. A high level of awareness regarding cervi- cal cancer correlated with the high vaccination coverage of HPV (6). Cervical cancer screening is reported with a poor level of practice among females in society (7). The most effective screening method for cervical cancer is a Pap smear test which is cost-effective and easy to access in every health center (8, 9). In Pakistan, cervical cancer screening practice at governmental and private health centers is very poor (10). Surveys from different areas of Pakistan showed that cervical cancer is the third most malignant tumor (10, 11). Copyright © 2021, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.