Barriers and facilitators to cervical cancer screening uptake among women in Nepal – a qualitative study

Andersen, Johanne Greibe; Shrestha, Aamod Dhoj; Gyawali, Bishal; Neupane, Dinesh; Kallestrup, Per

doi:10.1080/03630242.2020.1781742

Cited by 20 publications

(34 citation statements)

References 33 publications

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“…When the factors related to cervical cancer knowledge and screening were further explored through open-ended questions, four qualitative themes emerged. These aligned closely with those identified by Greibe Andersen et al 32 and included health and fertility concerns, support structures, the lack of public awareness and factors related to health care provision (access to screening sites and role of health care professionals).…”

Section: Resultssupporting

confidence: 79%

Cervical cancer knowledge and screening uptake by marginalized population of women in inner-city Durban, South Africa: Insights into the need for increased health literacy

Ducray

Kell

Basdav

et al. 2021

Womens Health (Lond Engl)

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Background: Cervical cancer in South Africa accounts for 15.85% of all female cancers and 30.29% of African female cancers, resulting in over 5000 deaths annually. South Africa’s proposed move towards universal healthcare places emphasis on health promotion through education and screening, but there is little data on the baseline levels of knowledge and screening uptake regarding cervical cancer. This study explored the levels of knowledge and screening rates of cervical cancer among vulnerable women living in the inner-city of Durban, South Africa. Methods: A mixed-method study was conducted within the context of a Women’s Health outreach initiative. Data were collected from women attending the outreach ( n = 109), many of whom were from marginalized communities. A pre-intervention survey was used to collect the data. This was followed by cervical cancer education sessions and the opportunity for a free Pap smear. Results: Knowledge of cervical cancer was low (<25%) and only a third of the women had previously been screened. After the educational sessions, 64% of women ( n = 70) took advantage of the opportunity for Pap smears, with many expressing the need for wider cervical cancer education, screening centres and support groups. Only 20% of the Pap smears were normal ( n = 14). Half of the women tested positive for infections ( n = 36; 51.4%), and a small proportion ( n = 8; 11.4%) tested positive for human papilloma virus. Abnormal cervical intra-epithelial neoplasia (CIN1 and CIN 2) were also detected in this population ( n = 12; 17.1%). Conclusion: Cervical cancer knowledge and screening among vulnerable women in Durban, South Africa, is inadequate, especially considering the high levels of abnormality found in the Pap smears. Education drives, accompanied with the provision of free testing, are required. Community health outreach initiatives in collaboration with non-government organizations set in accessible locations could be a possible course of action.

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Section: Resultssupporting

confidence: 79%

Cervical cancer knowledge and screening uptake by marginalized population of women in inner-city Durban, South Africa: Insights into the need for increased health literacy

Ducray

Kell

Basdav

et al. 2021

Womens Health (Lond Engl)

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“…All studies were published between 2001 and 2021, and nearly half (45%) within the last 5 years. Twenty-seven (71%) studies focused on CC (Baral et al 2020;Bhatta et al 2020;Darj et al 2019;Ghimire and Pathak 2020;Andersen et al 2020;Gyenwali et al 2013;Johnson et al 2014;Joy et al 2011;Khadka et al 2017;Maharjan et al 2020;Pandey and Karmacharya 2017;Poudel and Sumi 2019;Rachana and Giri 2019;Ranabhat et al 2014;Ranjit et al 2016;Satyal 2013;Shakya et al 2016;Sherpa 2007;Sherpa et al 2020;Shrestha et al 2013;Shrestha 2014;Shrestha and Dhakal 2017;Shrestha et al 2020;Shrestha et al 2021a;Thapa 2018;Thapa et al 2018;). Ten studies (26%) concerned BC (Bhandari et al 2016;Bhandari et al 2021;Bhatt et al 2011;Braun and Itano 2011;Gupta et al 2015;Narasingrao et al 2013;Parajuli and Mandal 2010;Sathian et al 2014;Shrestha 2012;).…”

Section: Search Resultsmentioning

confidence: 99%

“…Most studies had a cross-sectional quantitative design; three studies were qualitative and used focus groups or indepth interviews (Darj et al 2019;Andersen et al 2020;Shrestha et al 2020). One case report (Braun and Itano 2011) and one conference abstract were included in the review.…”

Section: Search Resultsmentioning

confidence: 99%

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Knowledge, awareness, attitudes and screening practices towards breast and cervical cancer among women in Nepal: a scoping review

Rademaker

Bhandary

Harder

2021

J Public Health (Berl.)

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Aim Breast and cervical cancers have emerged as major global health challenges and disproportionately affect women in low- and middle-income countries, including Nepal. This scoping review aimed to map the knowledge, attitudes and screening practices for these cancers among Nepali women to improve cancer outcomes and reduce inequality. Methods Five electronic databases (CINAHL, Embase, Global Health, PsycINFO and PubMed), grey literature, and reference and citation lists were searched for articles published in English up to June 2021. Articles were screened against inclusion/exclusion criteria, and data from eligible studies were extracted. Results were summarised narratively. Results The search yielded 615 articles, 38 of which were included in this scoping review (27 cervical cancer, 10 breast cancer, 1 both cancers). Levels of knowledge regarding breast and cervical varied widely. The main knowledge gaps were misconceptions about symptoms and risk factors, and poor understanding of screening behaviours. Screening practices were mostly inadequate due to socio-cultural, geographical or financial barriers. Positive attitudes towards cervical screening were associated with higher education and increased knowledge of screening modalities. Higher levels of knowledge, (health) literacy and participation in awareness campaigns facilitated breast cancer screening. Conclusion Knowledge and screening practices for breast and cervical cancer among Nepali women were poor and highlight the need for awareness and education programmes. Future research should explore community health worker-led awareness and screening interventions for cervical cancer, and programmes to increase the practice of breast self-examination and clinical breast examinations to support early diagnosis of breast cancer.

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“…In conducting a qualitative study preventive cervical screening among women in Nepal, Andersen et al, (2020) noted that a common opinion among participants was that cervical cancer is "dangerous, uncommon and requires surgery". However, it was evident that some participants had never heard of it, and lack of awareness of symptoms meant that women sought medical care only when physical symptoms arose that prevented them from early attending clinics for regular checkups.…”

Section: Resultsmentioning

confidence: 99%

Knowledge, Attitude and Practice of Quilombola Women

Miranda

Silva

Prudêncio

et al. 2021

Int J Innov Educ Res

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O Cervical cancer is considered a persistent public health problem, the access to health services, as well as women's adherence to the Pap smear, is one of the main tools to change this scenario, favoring the early detection of the disease. When considering the morbidity and mortality rates, taking into account the color, it is evident that black women need a different look. Given the above, the objective of this work is to analyze the knowledge, attitude and practice of quilombola women in Amapá about the preventive examination for cervical cancer. The study has a quantitative approach, of an applied nature, of the Survey type, having as reference the Knowledge, Attitude and Practice Survey (KAP) on the PCCU exam. The field research was carried out in the Quilombo do Curiaú in the state of Amapá. The data were submitted to the SPSS version 25.0 program, for the description of the statistical results, being considered relevant the results with p<0.05, which made it possible to trace the following socioeconomic and anthropometric profile: age from 18 to 33 years old (43.75 %), Catholic (92.50%), single (52.50%), complete high school (31.35%), without paid activity (41.25%), month family income from 1 to 2 minimum wages (37 .50%) and an average of five family members (36.25%). They present weight 69.34 (Me), height 161.06 (Me), Body Mass Index (BMI) 26.685 (Me), waist circumference (WC) 86.97 (Me), hip circumference (HC) 106 .77 (Me) and CC/HC ratio index 0.8172 (Me). Thus, the study revealed that 42.50% meet the parameter considered normal for BMI and 68.75% have a low risk for the development of Chronic Non-Transmissible Neoplastic Diseases, according to CC/HC. Using the criteria proposed by the KAP survey as a reference, 26.25% had adequate knowledge, 30% had adequate attitude and 37.5% had adequate practice, demonstrating a negative proportional assessment in relation to the PCCU exam. The KAP survey was carried out, which showed that only 36.27% of the women were characterized with Adequate Knowledge, 30.00% with Adequate Attitude and 37.5% with Adequate Practice, highlighting the need for educational actions at this topic with the female quilombola population, with a view to increasing the adherence to the uterine cytopathological examination within these communities.

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Barriers and facilitators to cervical cancer screening uptake among women in Nepal – a qualitative study

Cited by 20 publications

References 33 publications

Cervical cancer knowledge and screening uptake by marginalized population of women in inner-city Durban, South Africa: Insights into the need for increased health literacy

Cervical cancer knowledge and screening uptake by marginalized population of women in inner-city Durban, South Africa: Insights into the need for increased health literacy

Knowledge, awareness, attitudes and screening practices towards breast and cervical cancer among women in Nepal: a scoping review

Knowledge, Attitude and Practice of Quilombola Women

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