1
|
Agarwal M, Sinha S, Singh G, Singh S, Ahmad S. Attitude and Perceived Barriers Among Highly Educated Women Towards Cervical Cancer Screening by Pap Smear: An Online Survey. Cureus 2022; 14:e28641. [PMID: 36059362 PMCID: PMC9433053 DOI: 10.7759/cureus.28641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2022] [Indexed: 11/05/2022] Open
Abstract
Background Cervical cancer continues to pose a heavy burden on developing countries like India. Early detection of precancerous lesions via Pap smear screening can greatly avert cervical cancer deaths. However, the uptake of cervical cancer screening is poor, and several barriers exist to adequately utilizing screening services. Knowledge of women’s attitudes in the target community is essential for successfully implementing a cervical cancer screening program. Aim This study aimed to provide insight into the attitude and perceived barriers among highly educated women and determine the association between the sociodemographic characteristics and their attitude towards screening. Methods It was an online descriptive study using a questionnaire conducted among highly educated women. Sociodemographic details and the perceived gynecological morbidities were enquired upon. The attitude was measured on a 5-point Likert scale, while practice was assessed by response towards ever screened. Significant barriers to not undergoing cervical cancer screening and determinants of attitude towards screening were evaluated. Results A total of 150 women participated, with a mean age of 36.9+9.7 years. Most (85.33%) women were apparently asymptomatic. Overall, the majority (82.67%) of participants had a favorable attitude toward cervical cancer screening, but only 5.33% of women were ever screened in the past. A major impediment to adequate practice identified was that a Pap test is ‘not required.’ In addition, the women’s age, marital status, and education were found to be significantly associated with women’s attitudes towards screening. Conclusion The study revealed that educated women do possess a favorable attitude towards cervical cancer screening. However, a major gap is still a hindrance between women’s perception and practice. This reiterates the need for a well-designed health educational program focusing on effective information, education, and communication (IEC) strategies and strengthening the national screening program by effectively incorporating it into the health system.
Collapse
|
2
|
Burrowes S, Holcombe SJ, Leshargie CT, Hernandez A, Ho A, Galivan M, Youb F, Mahmoud E. Perceptions of cervical cancer care among Ethiopian women and their providers: a qualitative study. Reprod Health 2022; 19:2. [PMID: 34983586 PMCID: PMC8725313 DOI: 10.1186/s12978-021-01316-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 12/04/2021] [Indexed: 01/26/2023] Open
Abstract
Background Cervical cancer is the second most commonly diagnosed cancer among Ethiopian women, killing an estimated 4700 women each year. As the government rolls out the country’s first national cancer control strategy, information on patient and provider experiences in receiving and providing cervical cancer screening, diagnosis, and treatment is critical. Methods This qualitative study aimed to assess the availability of cervical cancer care; explore care barriers and sources of delay; and describe women’s and providers’ perceptions and experiences of care. We analyzed data from 45 informants collected at 16 health centers, district hospitals and referral hospitals in East Gojjam Zone and a support center in Addis Ababa. Thirty providers and ten women receiving care were interviewed, and five women in treatment or post-treatment participated in a focus group discussion. Deductive and inductive codes were used to thematically analyze data. Results Providers lacked equipment and space to screen and treat patients and only 16% had received in-service cervical cancer training. Consequently, few facilities provided screening or preventative treatment. Patients reported low perceptions of risk, high stigma, a lack of knowledge about cervical cancer, and delayed care initiation. All but one patient sought care only when she became symptomatic, and, pre-diagnosis, only half of the patients knew about cervical cancer. Even among those aware of cervical cancer, many assumed they were not at risk because they were not sexually active. Misdiagnosis was another common source of delay experienced by half of the patients. Once diagnosed, women faced multiple-month waits for referrals, and, once in treatment, broken equipment and shortages of hospital beds resulted in additional delays. Barriers to therapeutic treatment included a lack of housing and travel funds. Patient-provider communication of cancer diagnosis was often lacking. Conclusions In-service provider training should be intensified and should include discussions of cervical cancer symptoms. Better distribution of screening and diagnostic supplies to lower-level facilities and better maintenance of treatment equipment at tertiary facilities are also a priority. Expanded cervical cancer health education should focus on stigma reduction and emphasize a broad, wide-spread risk of cervical cancer. Cervical cancer is the second most commonly diagnosed cancer among Ethiopian women, killing an estimated 4700 women each year. This study aimed to assess patient and provider experiences in receiving and providing cervical cancer screening, diagnosis, and treatment. We interviewed 30 midlevel providers and ten women receiving care and held a focus group discussion with five women who were receiving treatment or who had recently completed treatment. Patients reported bottlenecks and delays at each stage of care. Low perception of risk, high stigma, and a lack of knowledge about cervical cancer among both providers and patients, were significant sources of delay in initiating care. Few patients had been aware of cervical cancer before they were diagnosed and of those who were aware, many assumed that they were not at risk because they were not sexually active. Misdiagnosis was another common source of delay. Once diagnosed correctly, women faced multiple-month delays after referrals, and, once in treatment, broken equipment and a shortage of hospital beds resulted in additional delays. The most frequently mentioned barriers to care were a lack of housing and travel funds while receiving treatment in the capital. Patient-provider communication of cancer diagnosis was often poor. Our findings suggest the need to intensify in-service training for providers, focusing initially on alerting them to cervical cancer symptoms. Better distribution of screening and diagnostic supplies to lower-level facilities and better maintenance of treatment equipment at tertiary facilities should also be a priority.
Collapse
Affiliation(s)
| | - Sarah Jane Holcombe
- Bill & Melinda Gates Institute for Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | | | | | - Anthony Ho
- Touro University California, Vallejo, CA, USA
| | | | - Fatuma Youb
- Touro University California, Vallejo, CA, USA
| | | |
Collapse
|
3
|
Chawla B, Taneja N, Awasthi AA, Kaur KN, Janardhanan R. Knowledge, attitude, and practice on screening toward cervical cancer among health professionals in India-A review. ACTA ACUST UNITED AC 2021; 17:17455065211017066. [PMID: 34396854 PMCID: PMC8371743 DOI: 10.1177/17455065211017066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background: Globally, 570,000 cases of cervical cancer and 311,000 deaths from the
disease occurred in 2018. Cervical cancer is the fourth most common cancer
in women. About 96,922 new cervical cancer cases are diagnosed annually in
India. Objective: To summarize the knowledge, attitude, and practice toward screening of
cervical cancer among health professionals in India. Materials and methods: Health sciences electronic databases PubMed and Google Scholar were searched
for studies published between 2012 and March 2020. Keywords used for the
search were (“CERVICAL CANCER”), (“SCREENING”), (“KNOWLEDGE”), (“ATTITUDE”),
(“PRACTICE”), (“HEALTH PROFESSIONALS”), AND (“INDIA”). A total of 22
articles were included in the review based on the eligibility criteria.
Statistical software SPSS-V.23 was used for the statistical application. Results: A total of 22 studies met the inclusion criteria with total of 6811 health
professionals. The age of the study participants ranged from 18 to 60 years.
The overall knowledge of cervical cancer among health professionals was
75.15%. The knowledge toward signs and symptoms and risk factors was
adequate among health professionals. The knowledge, attitude, and practice
toward screening was 86.20%, 85.47%, and 12.70%, respectively. Conclusion: The health professionals have optimum level of knowledge of cervical cancer
and knowledge of screening of cervical cancer with appropriate attitude
toward screening with low uptake of practice toward screening.
Collapse
Affiliation(s)
- Bhavika Chawla
- Laboratory of Disease Dynamics & Molecular Epidemiology, Amity Institute of Public Health, Amity University, Noida, India
| | - Neha Taneja
- Laboratory of Disease Dynamics & Molecular Epidemiology, Amity Institute of Public Health, Amity University, Noida, India.,Laboratory of Health Data Analytics & Visualization Environment, Amity Institute of Public Health, Amity University, Noida, India
| | - Aanchal Anant Awasthi
- Laboratory of Health Data Analytics & Visualization Environment, Amity Institute of Public Health, Amity University, Noida, India
| | - Karuna Nidhi Kaur
- Laboratory of Disease Dynamics & Molecular Epidemiology, Amity Institute of Public Health, Amity University, Noida, India
| | - Rajiv Janardhanan
- Laboratory of Disease Dynamics & Molecular Epidemiology, Amity Institute of Public Health, Amity University, Noida, India.,Laboratory of Health Data Analytics & Visualization Environment, Amity Institute of Public Health, Amity University, Noida, India
| |
Collapse
|
4
|
Awang Sayang H, Haji Abdul Mumin K, Md Sofian HN, Abdul Rahman H, Haji Hashim S. Knowledge of Cervical Cancer and Awareness of Screening Services Among Female Undergraduate Health Sciences Students in Brunei. Indian J Gynecol Oncolog 2021; 19. [DOI: 10.1007/s40944-021-00578-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
5
|
Taneja N, Chawla B, Awasthi AA, Shrivastav KD, Jaggi VK, Janardhanan R. Knowledge, Attitude, and Practice on Cervical Cancer and Screening Among Women in India: A Review. Cancer Control 2021; 28:10732748211010799. [PMID: 33926235 PMCID: PMC8204637 DOI: 10.1177/10732748211010799] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Cervical Cancer is the second most common cancer among women in the world leading to 90% deaths in low and middle income countries. About 96,922 new Cervical Cancer cases are diagnosed annually in India. Objective: To study the knowledge, attitude and practice on Cervical Cancer and screening among women in India. Materials and Methods: Health sciences electronic databases PubMed and Google Scholar were searched for studies published between 2012 to March 2020. Keywords used for the search were (“Cervical Cancer screening”), (“knowledge”),(“attitude”), (“practice”) AND (“India”). 19 articles were included in the review based on the eligibility criteria. Statistical software SPSS-V.23 was used for the statistical application. Results: 7688 women were included in the study. Age of study participants ranged from 12-65 years. Overall knowledge on Cervical Cancer among women was 40.22%. Knowledge of risk factors and signs and symptoms was fairly adequate among the women. 32.68% of women knew that early age of marriage was a risk factor for Cervical Cancer followed by 23.01% women who mentioned that early age of initiation of sexual activity was a common risk factor for Cervical Cancer. Inter menstrual bleeding and foul smelling discharge was the most common sign and symptom reported in 30.75% and 28.86% women respectively. Knowledge, attitude and practice regarding Cervical Cancer screening was seen in 20.31%, 43.64% and 13.22% of women respectively. Conclusion: Effective information, education and communication strategies are required to improve the level of awareness of women on Cervical Cancer.
Collapse
Affiliation(s)
- Neha Taneja
- Laboratory of Disease Dynamics & Molecular Epidemiology, Amity Institute of Public Health, Amity University, Noida, Uttar Pradesh, India
| | - Bhavika Chawla
- Laboratory of Disease Dynamics & Molecular Epidemiology, Amity Institute of Public Health, Amity University, Noida, Uttar Pradesh, India
| | - Aanchal Anant Awasthi
- Laboratory of Health Data Analytics & Visualization Environment, Amity Institute of Public Health, Amity University, Noida, Uttar Pradesh, India
| | - Kumar Dron Shrivastav
- Laboratory of Health Data Analytics & Visualization Environment, Amity Institute of Public Health, Amity University, Noida, Uttar Pradesh, India
| | - Vinita Kumar Jaggi
- Department of Surgical Oncology (Gynecological Oncology Division), Delhi State Cancer Institute, New Delhi, India
| | - Rajiv Janardhanan
- Laboratory of Disease Dynamics & Molecular Epidemiology, Amity Institute of Public Health, Amity University, Noida, Uttar Pradesh, India.,Laboratory of Health Data Analytics & Visualization Environment, Amity Institute of Public Health, Amity University, Noida, Uttar Pradesh, India
| |
Collapse
|
6
|
Dsouza JP, Van Den Broucke S, Pattanshetty S, Dhoore W. Exploring the Barriers to Cervical Cancer Screening through the Lens of Implementers and Beneficiaries of the National Screening Program: A Multi-Contextual Study. Asian Pac J Cancer Prev 2020; 21:2209-2215. [PMID: 32856846 PMCID: PMC7771922 DOI: 10.31557/apjcp.2020.21.8.2209] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Cervical cancer is a major reason for morbidity and mortality in Low and Middle income countries. The National Programme for Prevention and Control of Cancers, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) sets out broad national guideline to implement Cervical cancer screening. However, an implementation strategy for cervical cancer screening is not in place for districts. Although opportunistic screening takes place, implementation is hindered by psychological and physical barriers for women, as well as insufficient capacity on the part of implementers. This qualitative study aims to identify the specific barriers that prevent the uptake of cervical cancer screening. METHODS Women who could benefit from cervical cancer program were interviewed to explore the factors that influenced their uptake of the cervical screening offered. Key informant interviews were conducted with implementers of the NPCDCS and with public health staff of three States (Himachal Pradesh, Meghalaya and Karnataka), to understand their perception of determinants of the utilization of screening services. RESULTS The general health concern among the participants was low, and routine check-ups were considered unimportant. Poor knowledge about cervical cancer, benefits of screening service availability, as well as a general sense of well-being, embarrassment or anxiety related to the screening procedure, fear of being judged for lack of modesty, and stigma were common barriers to screening uptake. In addition to a general unawareness of cervical cancer geographical inaccessibility of screening as a barrier to participate in cervical cancer screening, in certain regions. CONCLUSION It is essential to increase the knowledge on cervical cancer and on the benefits of screening among Indian women. Providing information and cues to action by health workers and professionals can facilitate the decision to participate. Implementers need to be involved to ensure context specific implementation of the National programme to overcome these barriers.
Collapse
Affiliation(s)
- Jyoshma Preema Dsouza
- School of Public Health, Psychological Research Institute, UCLouvain University of Belgium, Louvain-la-neuve, Belgium
| | - Stephan Van Den Broucke
- School of Public Health, Psychological Research Institute, UCLouvain University of Belgium, Louvain-la-neuve, Belgium
| | - Sanjay Pattanshetty
- Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - William Dhoore
- School of Public Health, Psychological Research Institute, UCLouvain University of Belgium, Louvain-la-neuve, Belgium
| |
Collapse
|
7
|
Thulaseedharan JV, Frie KG, Sankaranarayanan R. Challenges of health promotion and education strategies to prevent cervical cancer in India: A systematic review. J Educ Health Promot 2019; 8:216. [PMID: 31867380 PMCID: PMC6905291 DOI: 10.4103/jehp.jehp_156_19] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 07/13/2019] [Indexed: 05/30/2023]
Abstract
BACKGROUND Although there is a reduction in cervical cancer incidence over the years, it keeps the second position of the most common cancers among females in India. The aim of this review is to understand the challenges of health promotion and education strategies to prevent cervical cancer in India. MATERIALS AND METHODS This review is based on 78 studies published during 1993-2017 on the topics of awareness, attitude, and acceptance toward cervical cancer, screening, and human papilloma virus vaccination among Indians. The extracted information was summarized according to different populations such as people from different social and community groups, women and men attended clinics, students (nursing/medical/nonmedical), health-care providers (doctors, nurses, and other health workers), migrated Indians, and cervical cancer patients. RESULTS The awareness about cervical cancer and its prevention was very poor among women from different communities and the majority had a negative attitude toward screening and vaccination in general. The health professionals and medical students were more aware of cervical cancer and its prevention compared to the general population. Majority of students irrespective of medical or nonmedical background had a positive attitude toward vaccination. Only a small proportion of women in the general population were ever screened. CONCLUSIONS Observations from this review indicate immediate attention of the public health authority to take appropriate actions to educate and motivate general population toward cervical cancer prevention and to improve the facilities to incorporate the much needed preventive and early detection interventions in India.
Collapse
Affiliation(s)
- Jissa Vinoda Thulaseedharan
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Kirstin Grosse Frie
- Institute for Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Rengaswamy Sankaranarayanan
- Research Triangle Institute Global India Private Limited (RTI International), New Delhi, 100 037, India
- International Agency for Research on Cancer (IARC/WHO), Lyon CEDEX 08, France
| |
Collapse
|
8
|
Getahun F, Addissie A, Negash S, Gebremichael G. Assessment of cervical cancer services and cervical cancer related knowledge of health service providers in public health facilities in Addis Ababa, Ethiopia. BMC Res Notes 2019; 12:675. [PMID: 31639068 DOI: 10.1186/s13104-019-4701-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 10/03/2019] [Indexed: 11/20/2022] Open
Abstract
Objective To assess cervical cancer services and knowledge of health service providers in public health facilities. Result Two of the three hospitals had cervical cancer screening services. One-third of the hospital had cervical cancer diagnosis service punch biopsy and cervical cancer treatment. Majority, 289 (93.5%) of study participants said cervical cancer was a preventable disease. Having multiple sexual partners 257 (83.2%) and post coital bleeding 251 (81.2%), were the most mentioned risk factor and clinical manifestation of cervical cancer respectively. Majority of the participants were aware of the correct time to start screening 291 (70.5%), and only 95 (25.9%) knew the screening intervals. Overall, 165 (53.4%) of health providers scored below the mean knowledge level score. Females had better knowledge about cervical cancer than males (X2 = 8.4, P = 0.003).
Collapse
|
9
|
Sreeja SR, Lee HY, Kwon M, Shivappa N, Hebert JR, Kim MK. Dietary Inflammatory Index and Its Relationship with Cervical Carcinogenesis Risk in Korean Women: A Case-Control Study. Cancers (Basel) 2019; 11:cancers11081108. [PMID: 31382563 PMCID: PMC6721526 DOI: 10.3390/cancers11081108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/26/2019] [Accepted: 07/31/2019] [Indexed: 12/14/2022] Open
Abstract
Several studies have reported that diet’s inflammatory potential is related to chronic diseases such as cancer, but its relationship with cervical cancer risk has not been studied yet. The aim of this study was to investigate the association between Dietary Inflammatory Index (DII®) and cervical cancer risk among Korean women. This study consisted of 764 cases with cervical intraepithelial neoplasia (CIN)1, 2, 3, or cervical cancer, and 729 controls from six gynecologic oncology clinics in South Korea. The DII was computed using a validated semiquantitative Food Frequency Questionnaire (FFQ). Odds ratios and 95% CI were calculated using multinomial logistic regression. Higher DII scores were associated with higher cervical carcinogenesis risk. A significant association was observed between the DII and risk among CIN2/3 [Odds Ratio (OR) = 3.14; 95% Confidence Intervals (CI) = 1.57–6.29] and cervical cancer patients (OR = 1.98; 95% CI = 1.01–3.88). Among Human Papilloma Virus (HPV)-positive women, a significant association was found between DII and cervical carcinoma risk with CIN2/3 (OR = 5.65; 95% CI = 1.38–23.2). Moreover, women with CIN2/3 and cervical cancer showed a significant association with proinflammatory diet in people without of physical activity (OR = 3.79; 95% CI = 1.81–7.93). These findings suggest that high intake of proinflammatory diets is associated with increased risk of cervical carcinogenesis among women with CIN2/3. Further evaluation in future studies to confirm this association is warranted.
Collapse
Affiliation(s)
- Sundara Raj Sreeja
- Cancer Epidemiology Branch, Division of Cancer Epidemiology and Prevention, National Cancer Center, Madu-dong, Ilsan-dong-gu, Goyang-si, Gyeonggi-do 10408, Korea
| | - Hyun Yi Lee
- Cancer Epidemiology Branch, Division of Cancer Epidemiology and Prevention, National Cancer Center, Madu-dong, Ilsan-dong-gu, Goyang-si, Gyeonggi-do 10408, Korea
| | - Minji Kwon
- Cancer Epidemiology Branch, Division of Cancer Epidemiology and Prevention, National Cancer Center, Madu-dong, Ilsan-dong-gu, Goyang-si, Gyeonggi-do 10408, Korea
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Connecting Health Innovations Columbia, Columbia, SC 29201, USA
| | - James R Hebert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Connecting Health Innovations Columbia, Columbia, SC 29201, USA
| | - Mi Kyung Kim
- Cancer Epidemiology Branch, Division of Cancer Epidemiology and Prevention, National Cancer Center, Madu-dong, Ilsan-dong-gu, Goyang-si, Gyeonggi-do 10408, Korea.
| |
Collapse
|
10
|
Tapera O, Dreyer G, Kadzatsa W, Nyakabau AM, Stray-Pedersen B, Sjh H. Cervical cancer knowledge, attitudes, beliefs and practices of women aged at least 25 years in Harare, Zimbabwe. BMC Womens Health 2019; 19:91. [PMID: 31286937 PMCID: PMC6615311 DOI: 10.1186/s12905-019-0790-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 06/26/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Cervical cancer is the most common cancer and a major cause of morbidity and mortality among women in Zimbabwe yet it is preventable, early detectable and highly curable. The objective of this study was to investigate knowledge, attitudes, beliefs and practices towards cervical cancer, its prevention and treatment in Harare, Zimbabwe. METHODS Sequential explanatory mixed methods approach consisting of analytical cross sectional survey and a qualitative inquiry was used. Study population consisted of women with cervical cancer, health workers and other stakeholders who are involved in cancer control programmes. Patient survey data were collected using validated structured questionnaire in Surveytogo software in an android tablet. Qualitative study used key informant interviews to understand survey findings better. Data analyses for the survey involved univariate and multivariate analyses using STATA version 14. For qualitative study, themes in transcripts were coded and analyzed using Dedoose software to generate evidence for the study. RESULTS Participants reported different levels of knowledge of causes (23%), risk factors (71%), prevention (72%), screening (73%) and treatment (80%) of cervical cancer. Knowledge of causes of cervical cancer were negatively associated with: being aged 45 or more years (OR = 0.02; p = 0.004), having no household income (OR = 0.02;p = 0.007), household income <US$600 per month (OR = 0.02; p = 0.015), middle class wealth (OR = 0.01;p = 0.032), watching TV daily (OR = 0.01;p = 0.007) and 1-6 times per week (OR = 0.02; p = 0.045). Knowledge of causes of cervical cancer were also positively associated with listening to radio daily (OR = 394, CI: 11.02-1406) (p = 0.001) and 1-6 times a week (OR = 100, CI: 2.95-3364) (p = 0.010). Knowledge of prevention was only positively associated with listening to the radio daily (OR = 77, CI: 1.89-3114) (p = 0.022) and 1-6 times a week (OR = 174, CI: 2.42-1255) (p = 0.018). Major drivers of lack of knowledge for cervical cancer were: limited awareness programmes, lack of knowledge among health workers, donor prioritization of infectious diseases, infancy of cervical cancer interventions, negative attitudes towards cervical cancer and misconceptions. CONCLUSIONS This study revealed that knowledge of causes and prevention of cervical cancer was associated with frequent radio listenership. Strengthening of health education through the packaging of messages targeting the wider society using different delivery channels is thus recommended.
Collapse
Affiliation(s)
- O Tapera
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa.
| | - G Dreyer
- Gynaecologic Oncology, Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria, South Africa
| | - W Kadzatsa
- Radiotherapy Centre, Parirenyatwa Group of Hospitals, Harare, Zimbabwe
| | - A M Nyakabau
- Radiotherapy Centre, Parirenyatwa Group of Hospitals, Harare, Zimbabwe
| | - B Stray-Pedersen
- Institute of Clinical Medicine, University in Oslo and Womens' Clinic, Oslo University, Oslo, Norway
| | - Hendricks Sjh
- Faculty of Dentistry and Oral Health Hospital, Sefako Makgatho Health Sciences University, Pretoria, South Africa.,Faculty of Health Sciences, University of Fort Hare, East London, South Africa
| |
Collapse
|
11
|
Sathian B, Babu MGR, van Teijlingen ER, Banerjee I, Roy B, Subramanya SH, Rajesh E, Devkota S. Ethnic Variations in Perception of Human Papillomavirus and its Vaccination among Young Women in Nepal . Nepal J Epidemiol 2017; 7:647-658. [PMID: 28970947 PMCID: PMC5607446 DOI: 10.3126/nje.v7i1.17757] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 01/08/2017] [Accepted: 01/10/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The Human Papillomavirus (HPV) is strongly associated with cervical and other cancers. In women, cervical cancer is the third most common cancer. HPV infection can be largely prevented through vaccination of (adolescent) girls. At the same time, Nepal is a low-income country experiencing a cultural change in attitudes towards sex and sexual behaviour. However, in the adolescent population knowledge about HPV, factors associated with an increased risk of HPV and the existence of the vaccination is often low. MATERIALS AND METHODS This was a cross-sectional study with female students enrolled in health and non-health science courses in Pokhara, Nepal. The questionnaire included demographic details, knowledge and attitude questions related to HPV, associated risk behaviour and its vaccination. Descriptive statistics, including Chi-Square test, were used to identify statistically significant relationships. Ethical approval was granted by the relevant authority in Nepal. RESULTS Hindu religion (75.0 %; 95% CI: 70.9, 78.6) and Newari caste (75.5%; CI: 61.1, 86.7) were more aware about HPV, HPV vaccination. Hindus religion (55.6%; 95% CI: 51.2, 60.0) and Dalit caste (61.6%, 95% CI: 53.3, 69.4) more willing to be vaccinated than other religions and other castes, respectively. Not unsurprisingly, students on health-related courses had a greater awareness of HPV, HPV vaccination and were more willing to be vaccinated than students on other courses. Similar patterns of association arose for knowledge related to those sexually active at an early age; HPV risk and multiple sex partners; and fact that condoms cannot fully prevent the transmission of HPV. CONCLUSION Knowledge about the link between HPV and (a) early sexual initiation, (b) having multiple sexual partners, and (c) the limited protection of condoms and other birth control measures was poor in our study compared to similar research conducted in other parts of the world. One key implication is the need for education campaigns in Nepal to educate young women and their parents about HPV, its risk factors and the benefits of vaccination. .
Collapse
Affiliation(s)
- Brijesh Sathian
- Assistant Professor, Department of Community Medicine, Manipal College of Medical Sciences Pokhara, Nepal
| | - M G Ramesh Babu
- Senior Lecturer, Department of Physiology, Melaka Manipal Medical College Manipal University, India
| | | | - Indrajit Banerjee
- Associate Professor, Department of Pharmacology, Chitwan Medical College and Teaching Hospital Chitwan, Nepal
| | - Bedanta Roy
- Assistant Professor, Department of Physiology, Manipal College of Medical Sciences Pokhara, Nepal
| | - Supram Hosuru Subramanya
- Assistant Professor, Department of Microbiology, Manipal College of Medical Sciences Pokhara, Nepal
| | - Elayedath Rajesh
- Assistant Professor, School of Behavioural Sciences, Mahatma Gandhi University India
| | - Suresh Devkota
- Lecturer, Department of Community Medicine, Manipal College of Medical Sciences Pokhara, Nepal
| |
Collapse
|
12
|
Asgarlou Z, Tehrani S, Asghari E, Arzanlou M, Naghavi-Behzad M, Piri R, Gareh Sheyklo S, Moosavi A. Cervical Cancer Prevention Knowledge and Attitudes among Female University Students and Hospital Staff in Iran. Asian Pac J Cancer Prev 2016; 17:4921-4927. [PMID: 28032497 PMCID: PMC5454697 DOI: 10.22034/apjcp.2016.17.11.4921] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Cervical cancer is a major preventable cancers. The, current study aimed to assess relevant knowledge and attitude of female students and hospital staff in Iran. Method: This cross-sectional study was conducted in Medical and Nursing faculties and hospitals of East-Azerbaijan Province of Iran. Participants were medical and paramedical female students and female staff in hospitals selected by stratified random sampling techniques. Tools for data collection were questionnaires for which validity and reliability had been verified (α=0.8). Descriptive and inferential statistics were used to analyze data with SPSS.16. Result: Response rates were 71 % (426 from 600) and 63.5% (254 from 400) for students and staff, respectively. Some 29.1% admitted that they had no information about cervical cancer, only 70 (10.3%) thinking their knowledge as high, 360 (52.9%) as intermediate, and 237 (34.9%) as low. While 93% of participants considered cervical cancer as a severe health problem, the only statistically significant relationships with knowledge were for education (p<.001) and occupation (p<.001) variables. Conclusion: Given the importance of the roles of medical students and personnel as information sources and leaders in health and preventive behavior, increasing and improving their scientific understanding seems vital. Comprehensive and appropriate education of all people and especially students and personnel of medical sciences and improving attitudes towards cervical cancer and its monitoring are to be recommended.
Collapse
Affiliation(s)
- Zoleykha Asgarlou
- Students’ Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
| | | | | | | | | | | | | | | |
Collapse
|
13
|
Abudukadeer A, Azam S, Mutailipu AZ, Qun L, Guilin G, Mijiti S. Knowledge and attitude of Uyghur women in Xinjiang province of China related to the prevention and early detection of cervical cancer. World J Surg Oncol. 2015;13:110. [PMID: 25885660 PMCID: PMC4371720 DOI: 10.1186/s12957-015-0531-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 02/28/2015] [Indexed: 02/08/2023] Open
Abstract
Background Cervical cancer is one of the commonest causes of cancer-related deaths worldwide. The prevalence rate of cervical cancer in Uyghur women in Xinjiang Autonomous Region of China has been remarkably higher than the ethnic groups living in the same region. This study aimed to assess the knowledge level and attitude of cervical cancer and its issues among the Uyghur women in Xinjiang province of China. Methods A cross-sectional interview-based survey of 5,000 Uyghur women was developed from 2013 to 2014 in Xinjiang autonomous region, to assess their knowledge and perception of cervical cancer and its issues. The collection of data was based on the questionnaire items. Results According to the questionnaire items, we collected a data for 5,000 participants. A very small proportion of participants had heard of the cervical cancer, human papillomavirus (HPV), and HPV vaccine, that is, 27.0%, 13.0% and, 6.0%, respectively. According to the demographic characteristics, women aged 31 to 40 years were more aware of the knowledge of cervical cancer (32.9%), HPV (17.8%), and HPV vaccine (9.1%), and women with undergraduate or higher educational level had more knowledge of cervical cancer (30.0%), HPV (21.0%), and HPV vaccine (9.7%). Conclusions From our study, we concluded that Uyghur women need more information about cervical cancer and its risk factors. Lack of the related knowledge about cervical cancer may be one of the important factors for high incidence rate of cervical cancer in Uyghur population. In order to reduce the incidence rate and mortality of cervical cancer in Uyghur women and to make extensive health education to raise awareness of cervical cancer and HPV is strongly needed than prophylactic vaccination.
Collapse
|
14
|
Abstract
Background: Most of the cervical cancer cases are diagnosed late leading to poor outcomes. Very few studies have explored the role of doctor and source of information for awareness of women about cervical cancer in India. Aim: Hence, this study was conducted with the objective of knowing the knowledge of women about cervical cancer, its screening, role of doctor, source of information, and reasons for not undergoing screening if the women had not undergone testing for cervical cancer. Subjects and Methods: This was a questionnaire based cross-sectional study conducted among the women attending the outpatient departments of teaching hospitals attached to Kasturba Medical College. A sample size of 83 was calculated. A semi-structured questionnaire was developed. After obtaining permission from Institutional Ethics Committee, the questionnaire was administered to the women in the language of their preference. Women were educated after the data collection and a hand-out was provided. Data was analyzed using SPSS Version 10. Student's independent ‘t’ test was used to compare mean knowledge scores across sociodemographic groups. Results: Majority of the women have poor knowledge about cervical cancer (81.9% [68/83]) and it's screening (85.5% [71/83]). Only 6 out of 83 women had undergone screening. Though women had come into contact with doctors earlier, they were neither educated about cervical cancer nor were they told about the screening. Whatever little knowledge the women had was obtained from mass media. Conclusions: Majority of women had poor knowledge. Mass media could be used to educate the women. There is a need to conduct community based study to know the practices of doctors and assess if they are educating and offering suggestions for screening.
Collapse
Affiliation(s)
- Hn Harsha Kumar
- Department of Community Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
| | - Shubham Tanya
- Department of Community Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
| |
Collapse
|