Knowledge, Attitudes, and Practices Regarding Cervical Cancer Screening among Omani Women Attending Primary Healthcare Centers in Oman: A Cross-Sectional

Insights Into Cancer Awareness and Health Practices in Rural Kenya: A Cross-Sectional Study of Esophageal, Breast, Prostate, Cervical, and Colorectal Cancers

PURPOSE

In sub-Saharan Africa (SSA), there has been an epidemiologic transition from infectious diseases to noncommunicable diseases, including a projected doubling in incidence of cancer. Understanding the underlying factors driving this surge is crucial for designing effective strategies to mitigate the cancer burden. This study focuses on assessing knowledge, attitudes, screening practices, and health behaviors related to five most prevalent cancers in SSA: prostate, breast, cervical, esophageal, and colorectal-among a predominantly rural coastal population in Kenya.

MATERIALS AND METHODS

We used a cross-sectional study design targeting 1,500 adult respondents randomly selected from an existing community health and demographic surveillance system. Face-to-face interviewer-administered questionnaires were used to collect data.

RESULTS

One thousand four hundred fifty-two adults participated in the final survey. Breast cancer awareness was highest (69.1%), while awareness of colorectal cancer was lowest (34.6%). Given a list of possible risk factors and symptoms, most respondents (>50%) could only recognize one to two per cancer type. Perceptions of survival from colorectal cancer were particularly pessimistic, with <70% recognizing early detection as a means to improve survival outcomes. In terms of cancer-associated risk factors, more men engaged in tobacco and alcohol use (20.5% and 22.4%, respectively). Additionally, fewer than 10% of eligible participants had ever undergone cancer screening.

CONCLUSION

This study addresses a gap in population-level Knowledge, Attitudes, and Practices studies in rural SSA, offering insights crucial for cancer prevention, early detection, and treatment. The low awareness and knowledge levels and unhealthy behaviors emphasize a need for targeted educational campaigns at community level and enhanced understanding of barriers to uptake of screening if we are to effectively combat the growing cancer burden in this region.

Cervical cancer screening uptake in Arab countries: a systematic review with meta-analysis

BACKGROUND

Cervical cancer, though one of the most common cancers affecting women globally, holds immense potential for prevention through screening. Therefore, we conducted this meta-analysis to assess the rate of cervical cancer screening in Arab countries and identify barriers among those who did not participate.

METHODS

A comprehensive search was conducted from January 1st to June 1st,2024, including all observational studies that reported cervical cancer screening uptake in any Arab country. A meta-analysis was performed using a random-effects model to estimate the pooled prevalence, and sensitivity analyses were conducted to test the robustness of the findings. The study followed PRISMA guidelines.

RESULTS

This meta-analysis, covering 55 studies and 204,940 Arab women, found an overall cervical cancer screening uptake rate of 18.2% (95% CI: 13.9-23.6), with sensitivity analysis confirming the reliability of this estimate. Country disparities were evident, with Bahrain having the highest uptake at 44.1%, while Somalia had the lowest at 8.9%. Among women who underwent screening, the majority were ever-married (94.7%) and held positive attitudes towards screening (91.0%). Barriers to screening were common among women who did not participate, with the most frequent reasons being a lack of information (25.1%), the misconception of feeling healthy (24.5%), fear of the procedure (19.3%), and feelings of embarrassment (13.2%). Additionally, women who were screened had lower perceived barrier scores (SMD = -0.466) and higher perceived benefits scores (SMD = 0.379) than those who were not (p < 0.05).

CONCLUSION

This meta-analysis reveals a low overall cervical cancer screening uptake (18.2%) among Arab women. Key barriers such as lack of information, fear, the misconception of feeling healthy, and embarrassment hinder uptake. This alarmingly low rate underscores the urgent need for targeted interventions to address these barriers and promote awareness of early detection's life-saving potential.

Cervical cancer screening and its associated factors among women of reproductive age in Kenya: further analysis of Kenyan demographic and health survey 2022

INTRODUCTION

Although cervical cancer screening is one of the most effective strategies to reduce the incidence and mortality of cervical cancer, the percentage of cervical cancer screening in low- and middle-income counties is low. In Kenya, the current nationwide prevalence and associated factors for the detection of cervical cancer is unknown. Therefore, this study aimed to assess the prevalence and associated factors for the detection of cervical cancer screening among women of reproductive age in Kenya using the Kenyan Demographic and Health Survey 2022.

METHODS

This study used the most recent Kenyan Demographic and Health Survey data (2022) with a total weighted sample of 16,901 women. A mixed effects logistic regression analysis was performed and in the multivariable analysis, variables with a p-value below 0.05 were considered statistically significant. The strength of the association was evaluated using adjusted odds ratios along with their corresponding 95% confidence intervals.

RESULTS

The prevalence of cervical cancer screening in Kenya was 16.81%(95% CI: 16.24, 17.38%). Having a history of abortion (AOR = 1.33, 95% CI: 1.171.50, 1.43), using modern contraceptive methods (AOR = 1.57, 95% CI: 1.25, 1.95), media exposure (AOR = 1.31, 95%CI: 1.03, 1.65), primary education (AOR = 1.56, 95%CI: 1.09, 2.22), secondary education (AOR = 21.99, 95% CI: 1.1.38, 2.87), higher education (AOR = 2..50, 95% CI: 1.71, 3.65), visiting health facility within the past 12 months (AOR = 1.61, 95%CI: 1.46, 1.79), positive HIV status (AOR: 3.50, 95% CI: 2.69, 4.57), being from a community with a higher proportion of educated individuals (AOR = 1.37, 95%CI: 1.13, 1.65) and being from a community with high proportion of poor individuals (AOR = 0.72, 9 5%CI: 0.60-0.87)) were significantly associated with cervical cancer screening.

CONCLUSION

In Kenya, the prevalence of cervical cancer screening was found to be low. A history of abortion, use of modern contraceptives, exposure to the media, visits to health facilities in the past 12 months, HIV status, level of education, community educational level, and community wealth were identified as significant associated factors for cervical cancer screening. Therefore, it is recommended to implement targeted public health interventions that focus on these identified factors to improve the adoption of cervical cancer screening in Kenya.

Knowledge of cervical cancer screening among Omani women attending a university teaching hospital: a cross-sectional study

OBJECTIVES

To assess knowledge, attitudes, and practices regarding cervical cancer and Pap smear screening among Omani women attending a tertiary clinic in Muscat, Oman, and to establish correlations with selected sociodemographic factors.

METHODS

An observational, cross-sectional study was carried out among Omani women aged 18-50 years old attending the outpatient clinic of the Department of Obstetrics and Gynecology, Sultan Qaboos University Hospital, from October 2019 to February 2020. A validated Arabic-language questionnaire was utilized to collect data regarding the participants' sociodemographic characteristics, their knowledge of cervical cancer and related risk factors, and their knowledge, attitudes, and practices related to cervical cancer screening and Pap smear testing.

RESULTS

Of the 380 respondents, 86 and 55% had previously heard of cervical cancer and Pap smear testing, respectively; however, only 26% were knowledgeable concerning these topics. Knowledge scores were significantly associated with various sociodemographic factors, including marital status and a previous awareness of cervical cancer (odds ratio: > 1, p < 0.05). Only 21% had themselves previously undergone Pap smear testing; however, 75% reported being willing to undergo such screening in future.

CONCLUSIONS

Knowledge regarding cervical cancer-related risk factors and Pap smear screening was poor among a cohort of Omani women attending a tertiary clinic in Muscat, Oman. This may play a role in the increased frequency of cervical cancer cases observed in Oman over recent years. As such, a well-structured public education program is recommended to raise awareness of this issue.

An exploratory study of knowledge, attitudes, and practices toward HPV associated anal cancer among Pakistani population

Background

Anal cancer, mainly attributed to human papillomavirus (HPV) infection, is rising in prevalence among the general population in Pakistan. This study aimed to examine the knowledge, attitudes, and practices (KAP) towards anal cancer screening and HPV of the general population in Pakistan.

Method

We surveyed anal cancer KAP using social media and snowball sampling from December 2022 to May 2023. The questionnaire had 16 knowledge, 12 attitudes, 6 practice questions, and socio-demographic variables. We applied validity criteria for inclusion and exclusion and used cutoffs ≥50% for each KAP category. We analyzed data in R with Guttman's λ2 for reliability, did univariate and bivariate analysis, and reported frequencies, percentages, p-values, coefficients, odds ratios, and 95% confidence intervals.

Results

We surveyed 1620 people and discovered low awareness of HPV and anal cancer causes prevention, and screening (11%-24%), high stigma and embarrassment for screening (54%-70%), strong moral beliefs (89%), condom nonuse (91%), and low engagement in health services and programs (9.1%-14%). Knowledge (75.23%, OR = 1.0984, p = 0.05) was shaped by socio-demographic factors, attitude, and practice, with higher education enhancing knowledge (OR = 1.0984, p = 0.05). Attitude (78.45%, OR = 6.6052, p< 0.001) was influenced by socio-demographic factors, practice, and knowledge as well. Younger females, single, unemployed, students, living with more family members, earning more income, and residing in Islamabad had a more positive attitude (ORs from 1.0115 to 6.6052, p< 0.05), while religion did not affect attitude (p = 0.51). Practice (9.16%, OR = 0.1820, p< 0.001) was determined by socio-demographic factors, knowledge, and attitude. Older males, employed teachers, living with more family members, earning less income, and residing in Islamabad had better practice (ORs from 0.1323 to 3.8431, p< 0.05), but marital status and religion did not influence practice (p > 0.05).

Conclusion

Pakistani young adults need more education, awareness, health services, and programs on HPV and anal cancer, as they have low awareness, high stigma, and socio-cultural challenges. In addition, it is recommended for more research and policy initiatives are needed to address socio-cultural factors and increase anal Pap to overcome anal cancer.

Knowledge, attitudes and acceptance toward Human papillomavirus (HPV) vaccination: Perspectives of Muslim women and men

OBJECTIVES

Human papillomavirus (HPV) infection is the leading risk factor for the development of anogenital cancers. Most Arab countries lack both HPV education and national HPV vaccination programs. The objective of this study was to assess knowledge, attitudes, and acceptance toward HPV vaccination in men and women from Oman, a country in the Middle Eastern North Africa region.

METHODS

This cross-sectional quantitative study used convenience sampling to recruit male and female participants, aged 18 years and above from all 11 governorates of Oman to complete a validated self-administered questionnaire online in the Arabic language. The questionnaire comprised five sections, with a total of 32 questions. The questionnaire, including Arabic and English versions, was content validated and piloted.

RESULTS

A total of 1403 participants, including 952 parents and 369 healthcare providers, completed the survey. The results showed a lack of knowledge regarding HPV infection and vaccines, including among healthcare providers. Less than a quarter of the participants had heard of HPV infection, with digital sources of information being the most common. Factors such as being a woman or a healthcare provider or completing higher levels of education were independently and significantly positively association with HPV awareness (p < 0.001). The majority of the participants lacked vaccine safety knowledge, had concerns about the vaccine's side effects, and sought reassurance of its protection against HPV infection (62%, 71.5%, and 84.6%, respectively). Nevertheless, nearly two-thirds of the participants agreed to take the HPV vaccine, with support for both boys and girls being vaccinated. There was almost universal agreement among the participants regarding the need for parental and adolescent HPV educational programs.

CONCLUSION

Omani women and men showed a high level of acceptance and favorable attitude toward HPV vaccination. The study findings support future efforts to implement school and public-level HPV education and a national HPV vaccination program in Oman.

Cervical Cancer-related Knowledge and Practice among Omani Women Attending a Family Medicine and Public Health Clinic

Objectives

This study aimed to assess knowledge, attitudes, and screening practices related to cervical cancer and Papanicolaou (Pap) smear testing among Omani women who were visitors to a family medicine and public health (FMPH) clinic. A secondary aim was to correlate the above with the subjects' sociodemographic characteristics.

Methods

This cross-sectional study was carried out from February 2020 to April 2021 at the FMPH Clinic of Sultan Qaboos University Hospital, Muscat. A self-administered questionnaire assessed the participants' sociodemographic characteristics, cervical cancer-related risk factors, and their knowledge, attitudes, and practices related to cervical cancer, cervical cancer screening, and Pap smear testing.

Results

The participants were 285 Omani women. The vast majority (256/285; 89.8%) had heard about cervical cancer and 208/285 (73.0%) about Pap smear testing. Only 32/285 (11.2%) and 179/285 (62.8%) demonstrated high levels of knowledge in the respective topics. Cervical cancer knowledge scores were associated with education level (p =0.039), whether the qualification was related to healthcare (p < 0.001), and the nature of employment (p =0.033). Pap smear knowledge scores were also associated with age (p =0.001), education level (p < 0.001), whether the qualification was related to healthcare (p < 0.001), the nature of employment (p =0.001), and number of children (p =0.001). Most women were aware of the availability of Pap smear testing in Oman (206/285; 72.3%) and 114/285 (40.0%) had previously undergone this test. Among those who had never undertaken Pap smear testing (171/285; 60.0%), many were willing to do so in the future (103/171; 60.2%).

Conclusions

Our results provide an increased understanding of Omani women's level of perceptions, attitudes, and screening practices related to cervical cancer. These findings will help develop strategies to improve Omani women's knowledge of cervical cancer symptoms and screening facilities and promote optimum utilization of the available screening services.

Keywords

Cervical Cancer; Papanicolaou Test; Cancer Screening; Health Knowledge, Attitudes, Practice; Human Papilloma Virus; Oman.