# Psychometric Evidence of the Pap Smear Test and Cervical Cancer Beliefs Scale (CPC-28) in Aymara Women from Chile

## TL;DR

This study evaluates a tool to measure cervical cancer and Pap test beliefs among Aymara women in Chile, finding it valid but highlighting cultural and structural barriers to screening.

## Contribution

The study provides psychometric validation of the CPC-28 scale for Aymara women, a previously under-represented population in cervical cancer research.

## Key findings

- The CPC-28 demonstrated strong psychometric properties with a six-factor structure among Aymara women.
- Cultural and structural barriers, such as language and healthcare inaccessibility, influence screening behaviors.
- CPC-28 results did not predict Pap test adherence, suggesting the need for mixed-method approaches to understand barriers.

## Abstract

Cervical cancer (CC) remains a critical global health issue which disproportionately affects low- and middle-income countries. In Chile, the Arica and Parinacota region experiences high CC mortality and low Papanicolaou (Pap) test coverage, with indigenous Aymara women facing significant screening barriers. Understanding health beliefs surrounding CC prevention is essential for improving adherence, particularly in under-represented populations. This study assesses the psychometric properties of the CPC-28, an instrument measuring beliefs about CC and Pap testing, among Aymara women in Chile. A cross-sectional survey of 299 Aymara women (25–64) was conducted using stratified probabilistic sampling. Confirmatory factor analysis (CFA) confirmed the CPC-28’s six-factor latent structure, demonstrating strong model fit (CFI = 0.969, TLI = 0.965, RMSEA = 0.058). Reliability indices ranged from acceptable to excellent (α = 0.585–0.921; ω = 0.660–0.923). Moderate correlations emerged between severity, susceptibility, and perceived benefits of Pap testing, although CPC-28 results did not predict adherence. These findings support CPC-28’s validity evidence for Aymara women but highlight cultural influences on screening behaviors. Structural barriers, including language and healthcare inaccessibility, are likely to affect perceived susceptibility. Future research should explore indigenous perspectives and socio-cultural determinants of Pap testing, incorporating mixed-method approaches to identify culturally relevant interventions and improve screening adherence.