Knowledge, attitude and practice about cancer of the uterine cervix among women living in Kinshasa, the Democratic Republic of Congo

Abstract

BackgroundCervical cancer is the most frequent cancer of women in the Democratic Republic of Congo (DRC). Nevertheless, the level of women’s awareness about cervical cancer is unknown. Knowledge, attitude and practice (KAP) are important elements for designing and monitoring screening programs. The study purpose was to estimate KAP on cervical cancer and to identify associated factors.MethodsA cross-sectional study was conducted in Kinshasa, DRC, including 524 women aged 16–78 years (median age 28; interquartile range 22–35). The women were interviewed at home by trained field workers using a standardized questionnaire. The women’s score on knowledge, attitude and practice were dichotomized as sufficient or insufficient. We used binary and multiple logistic regression to assess associations between obtaining sufficient scores and a series of socio-demographic factors: age, residence, marital status, education, occupation, religion, and parity.ResultsThe women’s score on knowledge was not significantly correlated with their score on practice (Spearman’s rho = 0.08; P > 0.05). Obtaining a sufficient score on knowledge was positively associated with higher education (adjusted odds ratio (OR) 7.65; 95% confidence interval (95% CI) 3.31-17.66) and formal employment (adjusted OR 3.35; 95% CI 1.85-6.09); it was negatively associated with being single (adjusted OR 0.44; 95% CI 0.24-0.81) and living in the eastern, western and northern zone of Kinshasa compared to the city centre. The attitude score was associated with place of residence (adjusted OR for east Kinshasa: 0.49; 95% CI 0.27-0.86 and for south Kinshasa: 0.48; 95% CI 0.27-0.85) and with religion (adjusted OR 0.55; 95% CI 0.35-0.86 for women with a religion other than Catholicism or Protestantism compared to Catholics). Regarding practice, there were negative associations between a sufficient score on practice and being single (adjusted OR 0.24; 95% CI 0.13-0.41) and living in the eastern zone of the city (adjusted OR 0.39; 95% CI 0.22-0.70). Although 84% of women had heard about cervical cancer, only 9% had ever had a Papanicolaou (Pap) smear test.ConclusionsThis study shows a low level of knowledge, attitude and practice on cervical cancer among women in Kinshasa. Increasing women’s awareness would be a first step in the long chain of conditions to attain a lower incidence and mortality.

Knowledge about cervical cancer and barriers toward cervical cancer screening among HIV‐positive women attending public health centers in Addis Ababa city, Ethiopia

“…This is similar to findings from a previous study in the northwest part of Ethiopia [17]. In contrast, a study conducted among Kinshasa women showed that more than half of participants knew of cervical cancer via conversation with other people, and less frequently through media [24]. Our finding of media as the major source of information for cervical cancer knowledge among HIV-positive women in Addis Ababa may in part reflect the substantial media coverage of the recent government/ civil society initiatives to expand cervical cancer screening in the city and other parts of the country.…”

“…More than half of the participants in our study had heard about cervical cancer, which is comparable with findings among HIV-positive women in Nigeria [21,22] but significantly higher compared to findings in southern Ghana [23]. In contrast, level of awareness of the disease is much higher among women in some African countries such as in Kinshasa, Republic of Congo (81.9%) and in Botswana (77%), and in female sex workers in China (70.2%) [19,24,25]. These regional differences in part reflect differences in socio demographic characteristics of study participants and setting, that is, all women versus HIV-positive women and health facility versus community-based studies.…”

Awareness of cervical cancer risk factors and symptoms: cross‐sectional community survey in post‐conflict northern Uganda

“…This is consistent with findings in Ethiopia, where more than half of participants believed that cervical cancer can be prevented (63.5%), treated (66.1%) and cured if detected early (52.8%). 44 High level of awareness about cervical cancer was also found in Democratic Republic of Congo (DRC) 45 and South Africa. 46 Limited awareness or inability to recognize cancer symptoms may lead to delay in presentations.…”

Awareness of Cancer Risk Factors and Its Signs and Symptoms in Northern Tanzania: a Cross-Sectional Survey in the General Population and in People Living with HIV

“…For each participant, written informed consent was obtained prior to conducting interviews using a pre-tested interviewer-administered questionnaire in Kiswahili. For knowledge of cancer risk factors, participants were asked whether each of a list of items is common in this setting Bincreased cancer risk,^with the answers Byes, a strong cause of cancer,B yes, a moderate cause of cancer,^Bno, not related to cancer,^and BI don't know.^Fourteen of the items were expected to be answered in either of the Byes^categories [33]: [1] tobacco use, [2] any alcohol, [3] spirits, [4] home brew, [5] EBV, [6] hepatitis B, [7] HIV/AIDS, [8] HPV, [9] indoor air pollution, [10] relative with breast cancer, [11] old age, [12] overweight or obesity, [13] moldy groundnuts as proxy for aflatoxin, and [14] processed meat. If the person identified the carcinogen, they were asked what types of cancer it could cause, with multiple types allowed.…”