Knowledge, attitude, and practices related to cervical cancer among adult women: A hospital-based cross-sectional study

Abstract

Background:Cervical cancer is the most common cancer among Indian women of reproductive age. Unfortunately, despite the evidence of methods for prevention, most of the women remain unscreened. The reported barriers to screening include unawareness of risk factors, symptoms and prevention; stigma and misconceptions about gynecological diseases and lack of national cervical cancer screening guidelines and policies. This study attempts to assess the knowledge, attitude, and practices related to cervical cancer and its screening among women of reproductive age (15-45 years).Materials and Methods:A facility-based cross-sectional study was done on 400 females of reproductive age who presented to out-patient-department of All India Institute of Medical Sciences Bhopal. Structured questionnaire consisting 20 knowledge items and 7-items for attitude and history of pap smear for practices were administered by one of the investigators after informed consent. Data were entered and analyzed using Epi-Info version 7. Qualitative variables were summarized as counts and percentages while quantitative variables as mean and standard deviation. Predictors of better knowledge, attitude, and practices were identified by binary logistic regression analysis.Results:A total of 442 women were approached for interview of which 400 responded of which two-third (65.5%) had heard of cervical cancer. At least one symptom and one risk factor were known to 35.25% and 39.75% participants. Only 34.5% participants had heard, and 9.5% actually underwent screening test, however, 76.25% of the participants expressed a favorable attitude for screening. Binary logistic regression analysis revealed that education age and income were independent predictors of better knowledge. Education level influences attitude toward screening and actual practice depends on age, income, and marital status. This study shows that despite the fact that women had suboptimal level of knowledge regarding cervical cancer, their attitude is favorable for screening. However, uptake is low in actual practice. Strategic communication targeting eligible women may increase the uptake of screening.

A Mixed Method Research to Identify Perceived Reasons and Solutions for Low Uptake of Cervical Cancer Screening in Urban Families of Bhopal Region

“…Only 29% of women could identify at least one symptom of cervical cancer and only 24% women knew that it could be caused by sexually transmitted disease. These findings are similar to observations on a cross-sectional study [19] conducted in hospital settings in the same area. Regarding the knowledge of preventive measures and screening, the performance is dismal as shown in previous studies [18, 20, 21].…”

“…About the vaccine availability 13% of women agreed that they know about the vaccine. This percentage seems to be higher than that shown in other studies [19]. When asked about whether they would like to get vaccinated or their daughters vaccinated only 39.60% of women agreed in the same cost.…”

“…Moreover more than 53.97% of women had their knowledge score below adequate, that is, 19. This population seems to be doing better in terms of baseline knowledge as far as other studies [18, 19] are concerned which measure maximum up to 20% only having adequate knowledge. This observation can be explained by the fact that the questionnaire was designed by the author to measure the knowledge of women sufficient enough to understand the importance of screening and not to gain in-depth knowledge of cervical cancer.…”

“…Regarding the knowledge of preventive measures and screening, the performance is dismal as shown in previous studies [18, 20, 21]. Although almost half of the women think that cervical cancer is a preventable disease only 34% of women know about cervical cancer screening and only dismal 11 percent of women have ever undergone test [18, 19]. About the vaccine availability 13% of women agreed that they know about the vaccine.…”

Challenges of health promotion and education strategies to prevent cervical cancer in India: A systematic review

“…Overall, 77 papers and one dissertation were eligible for analysis and were listed in the order of publication years. [171819202122232425262728293031323334353637383940414243444546474849505152535455565758596061626364656667686970717273747576777879808182838485868788899091929394] The review process is explained in Figure 1.…”