A comparison of the knowledge and practices of cervical cancer prevention between United States and international female college students

Background: Most cervical cancer is preventable, with approximately 90–95% of cases caused by persistent high-risk human papillomavirus (HPV) infection. International women may encounter barriers to cervical cancer prevention due to limited access to education and screening in their home countries. The local problem is that female international students studying in the United States may lack knowledge about HPV and cervical cancer prevention practices available through university health clinics. Methods: This quality-improvement project surveyed 355 female students (298 United States, 57 international) at a northeastern US university between October and December 2024 using validated tools that asked questions about knowledge and practices of cervical cancer prevention. Results: Significant knowledge gaps were identified in both groups. Among students 21+ years meeting Pap smear screening criteria, 60.4% of US versus 35.5% of international students reported having had a Pap smear ( p = .0219). The primary barrier for US students was fear of pain (45.3%), whereas for international students, it was lack of understanding of the examination (60%). International students demonstrated lower knowledge across multiple areas, including HPV testing (32% of international vs 54.7% of US students knew that positive HPV did not mean cancer, p = .00256) and screening guidelines (10.4% of international vs 89.6% of US students knew that screening begins at age 21 years, p = .001). Conclusions: Both US and international students rely heavily on social media for their health care information, raising concerns about misinformation. Targeted educational interventions are needed, particularly for international students who may have unique barriers to cervical cancer prevention services.