Prevalence and Determinants of Knowledge and Attitudes Toward Cervical Cancer Prevention, Pap Smear Uptake, and Human Papilloma Virus Vaccination Among Lebanese Women.

Introduction: Cervical cancer is expected to become the second leading cause of female cancer mortality in low- and middle-income countries, with the majority of critical cases projected to occur in these regions by 2050. This study aimed to identify the prevalence and determinants of knowledge and attitudes toward cervical cancer prevention, including Pap smear uptake and human papillomavirus (HPV) vaccination, while highlighting actionable gaps for intervention. Methods: A cross-sectional study was conducted using an online structured questionnaire, administered to Lebanese women aged 18-50 years. A knowledge score (KS) was calculated from true-or-false questions on risk factors, symptoms, and prevention. An attitude score (AS) assessed the proportion of women with a positive attitude toward cervical cancer prevention. Results: Participants had a mean age of 28.5 years. The prevalence of women who had ever had a Pap smear was 18.6%, and HPV vaccination coverage was 17.9%. Bivariate analysis showed that HPV vaccination was significantly associated with younger age, being single, having a graduate degree, being a health care student/professional, perceiving income as sufficient, and never smoking. Binary logistic regression analysis indicated that only a KS above the mean and an AS above the mean remained significant predictors after adjustment. Physicians were the most influential incentive for vaccination, while lack of knowledge was the primary barrier. Conclusion: To improve HPV vaccination rates and reduce cervical cancer incidence in developing countries, strategies should focus on enhancing health care access and physician-patient communication. Targeted awareness campaigns addressing misconceptions and negative attitudes toward HPV vaccination are warranted to improve preventive practices and reduce disease burden.