Uptake and determinants of cervical cancer prevention services among female college students in Kenya: A cross-sectional survey

Abstract

IntroductionCervical cancer is the leading cause of cancer death in women in low-and middle-income countries. In Kenya, cervical cancer incidence and prevalence have been increasing and in 2018 alone, there were 3286 deaths from cervical cancer. Previously, studies on cervical cancer prevention strategies have focused on women above 30 years old. However, as the risk factors for cervical cancer are acquired as early as in the teen years, an understanding of the awareness, uptake and determinants of screening services among college female students will help inform prevention strategies. This study sought to determine the awareness, uptake, determinants and barriers to cervical cancer screening services among colleges students in Kenya. MethodsThis was a multicenter cross-sectional study conducted in eight universities spread all over Kenya. Participants were interviewed using a self-administered structured questionnaire on sociodemographics, reproductive history, awareness on cervical cancer including screening practices, and attitude towards cervical cancer prevention services. Descriptive statistics were summarized using means and standard deviation (SD) for parametric data and median and interquartile range (IQR) for non-parametric data. Univariable and multivariable logistic regression analyses were done to determine odds ratios of factors associated with uptake of cervical cancer screening services. P-value of <0.05 was considered statistically significant. ResultsBetween January 2017 and Sept 2017, we screened 800 and enrolled 600 female colleges students from eight universities in Kenya. In total, 549 of the 600 (92%) participants completed the questionnaire. The median age (IQR) was 21(20,22) years. Nearly two-thirds 338(62.7%) were sexually active, while 54(16%) had concurrent sexual partners. The main form of contraception was oral postcoital emergency pills 123(64.7%). Only 76(14.4%) had screened for cervical cancer, and the commonest approach was a Pap smear 47(61.8%).About one half 40(54.1%) did not like their experience due to pain, discomfort and bleeding.Four out of five participants (439, 80.7%) had poor knowledge on cervical cancer screening. On bivariate analysis, increased level of awareness (odds ratio [OR] 1.08 95% ConfidenceInterval [CI] 1.03,1.18, p = 0.004), knowledge of someone with cervical cancer(OR 0.43 CI 0.23,0.78 p=0.006) and a perception of self-risk (OR2.6 CI 1.38,4.98 p=0.003) were associated with increased odds of uptake of cervical cancer screening . In the multivariate analysis, high awareness was significantly associated with increased odds of cervical cancer screening (OR 1.12 CI 1.04, 1.20 p=0.002). ConclusionsFemale college students in Kenya had low levels of awareness on cervical cancer and had very low uptake of cervical cancer screening. However, high perception of self-risk and perceived benefit was associated with increased odds of cervical cancer screening. Recommendations:Since female colleges students are generally thought to be more knowledgeable and have better a...

Knowledge and Use of Cervical Cancer Prevention Services among Social Work and Nursing University Students

“…Among the main reasons cited that prevented the participants from adhering to the cervical cancer prevention test were ‘fear and shame’. This finding corroborates the results of previous studies [ 49 ]. The embarrassment associated with the visualization of the body throughout the procedure can be the cause for some women of non-attendance to the test.…”

“…A secondary aim was to explore the influence of social capital and its parameters. The study focused on nursing and social work students as the knowledge and attitudes of future health professionals is pivotal in creating a culture of prevention for the women of the general population [ 49 ].…”

“…Similarly, high scores of knowledge and positive attitudes towards the cervical cancer preventive test were found in a study among female university healthcare students in Malaysia [ 25 ]. Moreover, in other studies comparing the knowledge of health science students to students from other fields, the former were more aware of these issues [ 49 , 52 ].…”

“…Thus, it was expected that being a university student in general and of health sciences in particular would positively affect the levels of adherence, as health and social care academic curricula reinforce health education and promote healthy attitudes and behaviors [ 49 ]. Our results confirm those of previous studies as they showed high information levels regarding gynecological preventive tests and knowledge about the existence of gynecological services or the way a PAP test is performed for both groups.…”