RESUMEN
Background: Cervical cancer is the leading cause of cancer deaths in Botswana. More than two-thirds of cases occur in HIV-infected women, in a nation with a high HIV prevalence of 17%. Even though cancer screening is free in health facilities, cervical cancer screening is low. The objective of this study was to assess the knowledge and attitudes of University of Botswana female students on cervical cancer screening. Methods: A cross-sectional study was conducted among University of Botswana female students to elicit information about their knowledge and attitudes on cervical cancer screening. Results: A total of 335 students completed the questionnaire and all reported that they were aware of cervical cancer. The awareness was mostly through brochures, posters and other printed material. Regarding cervical cancer risk 315 (94%) attributed cervical cancer to smoking and 301 (89.9%) to early sexual debut. The majority of students 329 (98.2 %) were aware of cervical cancer screening. Papanicolaou (Pap) smear was the most popular screening test reported by 160 (47.8%) of the respondents as compared to Human Papilloma Virus testing (HPV) reported by 106 (31.6 %) of the respondents. The overall Pap smear screening rate was 92 of 335 students (27.5%). Those who perceived themselves to be at risk of contracting cervical cancer 203 (60.6%) where 1.8 times more likely to go for Pap smear than those who perceived to be safe, (Adjusted Odds Ratio [AOR] 1.834; 95% Confidence Interval [CI]; 1.094-3.067), (P = 0.02). Conclusions: Pap smear screening uptake is low amongst University of Botswana female students. The likely reason for this could be because students do not perceive themselves to be susceptible to cancer so the lesser the likelihood of engaging in preventive behaviours. There is urgent need for university based cancer education campaign on cervical cancer screening benefits and incorporating these campaigns into the existing university medical services to increase uptake of screening programs offered.