Background Cervical cancer is the fourth most common cancer among women worldwide. Sub- Saharan Africa has a high incidence, prevalence and mortality due to shortage and underutilization of screening facilities. This study aims to assess knowledge and attitude towards cervical cancer and its prevention, as well as practice of cervical cancer screening. Methods This cross-sectional community- based study was conducted in Butajira, Ethiopia in February 2018. Systematic cluster randomized sampling was used to select households from which women in the targeted age group of 30–49 years were invited to participate. Data was collected using a quantitative door to door approach. The questionnaire included socio-demographic data, obstetric history, general knowledge, risk factors, attitude and practice. Logistic regression was used to assess factors associated with knowledge, attitude and practice after dichotomizing the scores using the median as cut off point. Results Three hundred forty-two out of 354 women completed the interviewer administered questionnaire making the response rate 96.3%. 125 women (36%) were aware of cervical cancer and 14 (4.7%) knew symptoms. None of the women named HPV as a risk factor. 61% thought it was a deadly disease, 13.5% felt at risk of developing cervical cancer and 60.7% said cervical cancer is treatable. Eight women (2.3%) had previously been screened. 48.1% had a source of information concerning cervical cancer, of which 66.5% named nurses. Better knowledge was associated with 1–8 years of education (OR = 2.4; CI: 2.4–1.3), having a source of information (OR = 9.1, CI:4.0–20.6), use of contraceptives (OR = 2.3, CI: 1.3–4.0) and a higher income (OR = 1.009, CI: 1.00–1.01). Naming nurses (OR:5.0, CI:2.4–10.3), another source of information (OR = 3.3, CI:1.2–9.0), use of contraceptives (OR = 2.2, CI:1.2–3.8) and living in an urban area (OR = 3.3, CI:1.2–9.0) were associated with a positive attitude. Naming nurses (OR = 21,0, CI:10.4–42.3) and another source of information (OR = 5.8, CI:2.4–13.5) were associated with participating in cervical cancer screening. Conclusion Most women were unaware of cervical cancer, HPV-infection as a risk factor and did not feel susceptible to cervical cancer. As Health workers were the most commonly mentioned source of information, focus should be put on their further education.

In Ethiopia, cervical cancer is the second leading cause of morbidity and mortality from all cancers in women. Persistent infection with human papillomaviruses (HPV) plays a key role in the development of cervical intraepithelial neoplasia and invasive cervical cancer. To establish baseline data on the population‐based prevalence of HPV infection and genotype distribution, we investigated cervical HPV epidemiology among rural women. This population‐based study was conducted among rural women aged 30‐49 years in Butajira, south‐central Ethiopia. A total of 893 samples were tested from 1020 screened women. A self‐sampling device (Evalyn Brush, Rovers, Oss, The Netherlands) was used and HPV presence and genotype was determined using multiplexed genotyping (MPG) by BSGP5+/6+ PCR with Luminex read out. The HPV positivity rate was 23.2% (95% CI: 23.54‐22.86%) and 20.5% (95% CI = 20.79‐20.21) and 10.3% (95% CI = 10.52‐10.08) women were high‐risk (hr‐ and low‐risk (lr‐) HPV positive, respectively. Fifty five (7.2%) of the women showed multiple hr‐HPV infections. Age‐specific hr‐HPV infection peaked in the age‐group 30‐ to 34 years old (58.6%) and decreased in 35‐39, 40‐44 and 45‐49 years to 20.4%, 4.5% and 3.8% respectively. The top five prevalent hr‐HPV genotypes were HPV16 (57.1%), 35 (20.3%), 52 (15.8%), 31 (14.1%), and 45 (9.6%) in the Butajira district. As a first population‐based study in the country, our results can serve as valuable reference to guide nationwide cervical cancer screening and HPV vaccination programs in Ethiopia.