Women’s knowledge and attitudes toward cervical cancer and cervical cancer screening in Zanzibar, Tanzania: a cross- sectional study

Abstract

Background: Cervical cancer is the most common cancer and the leading cause of cancer death among women in Tanzania. Knowledge and willingness of cervical cancer screening are important determinants of prevention services. This study aimed to describe women's awareness about cervical cancer and to explore the attitudes, acceptability and barriers toward cervical cancer screening in Zanzibar, Tanzania, in order to help organizing the forthcoming China-Zanzibar cervical cancer screening program. Methods: A cross-sectional study was conducted from March to June 2018, involving 1483 women who responded to questionnaires concerning general demographic characteristics, screening willingness and awareness of cervical cancer from 10 districts in Zanzibar. Chi-square tests, analysis of variance, rank sum tests and stepwise multiple regression were conducted using STATA 15.0 software. Results : The average Total Knowledge Scores(TKS) was 7.83±5.32 on a 23 scale. Education level and family income were positively correlated with TKS (Coef=1.075, 95% CI=0.687-1.462 and Coef=0.810, 95% CI=0.262-1.358 respectively). Previous schistosomiasis history (OR = 24.140, 95% CI= 3.306-176.266) and family genetic disease history (OR = 3.140, 95% CI= 1.644-5.997) were strong predictors of free screening. Women were less likely to be screened freely if they had 7 or more deliveries (OR = 0.300, 95% CI= 0.150-0.598) and were unknown about previous family tumor history (OR = 0.381, 95% CI= 0.218-0.665). As for non-free screening, age and education level were negatively associated while family income was positively associated with willingness to uptake non-free screening; divorced or widowed marriage and unawareness about previous family tumor history were predictors of reluctance to screening while previous disease history was the strong predictor of non-free screening uptake. Among 129 women who were reluctant and 50 who were uncertain to participate in the free screening, 51.4% thought it was unnecessary, 18.44% showed obvious fear and 20.67% were worrying about extra infection. Conclusions: The findings revealed that the knowledge of cervical cancer was poor. Education level, family income and awareness of previous disease history were the significant influencing factors of screening uptake. Specific awareness programs to increase knowledge and willingness to uptake screening should be designed and implemented in the public without delay.

Tanzanian women´s knowledge about Cervical Cancer and HPV and their prevalence of positive VIA cervical screening results. Data from a Prevention and Awareness Campaign in Northern Tanzania, 2017 – 2019

“…Education level and employment appear to play no role in the knowledge about cervical cancer in our study. These results are not consistent with other studies in SSA [ 7 , 22 , 30 , 31 ]. Also, no correlation was found between multiparous and cervical cancer knowledge, as has been reported in previous studies from Tanzania [ 22 , 32 ].…”

“…This is possible because women who have health insurance may have better health-seeking behavior and have had more interaction with health facilities. These findings are in tandem with results from a study from Zanzibar [ 30 ]. Another study from Zimbabwe found that women with a higher income, and who had more contact with the health care system had better cervical cancer knowledge [ 29 ].…”

Factors associated with cervical cancer screening behaviour of women attending gynaecological clinics in Kazakhstan: A cross-sectional study

“…Although attending college or university showed a higher likelihood of undergoing screening in other studies, 24,25 our study showed no association between education and the likelihood of a woman to undergo screening. This trend can be attributed to the fact that there is easy access to education in Kazakhstan.…”

Influence of Emo-Demo for Woman of Childbearing Age to Perform Cervical Cancer Screening

“…The data shows that public awareness especially women of childbearing age to perform VIA is still low, whereas the Government has encouraged healthy lifestyle and early detection. This problem occurs because their knowledge of cervical cancer is lacking, felt ashamed, felt no symptoms of cervical cancer, and felt no need to be checked (Weng, Jiang, Haji, Nondo, & Zhou, 2020). Educational influence is inevitable for such case, intended to woman of childbearing age on VIA test with Emo Demo (Emotional Demonstration) method.…”