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

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          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.

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          Most cited references22

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          Cervical cancer screening: Current knowledge & practice among women in a rural population of Kerala, India

          Background & objectives: Cervical cancer has a major impact on woman's lives worldwide and one in every five women suffering from cervical cancer belongs to India. Hence the objectives of this study were to find the knowledge of women regarding cervical cancer, to determine screening practices and determinants, and to identify factors for non screening. Methods: A cross-sectional study was conducted in Vypin Block of Ernakulam District, Kerala, India where four of the seven Panchayats were randomly chosen. Households were selected by systematic random sampling taking every second house in the tenth ward of the Panchayat till at least 200 women were interviewed. Thus, 809 women were interviewed from four Panchayats. Results: Mean age of the study population was 34.5 + 9.23 yr. Three fourths of the population (74.2%) knew that cervical cancer could be detected early by a screening test. Majority of respondents (89.2%) did not know any risk factor for cervical cancer. Of the 809 women studied, only 6.9 per cent had undergone screening. One third of the population were desirous of undergoing screening test but had not done it due to various factors. These factors related to knowledge (51.4%) such as no symptoms, not being aware of Pap test, not necessary, etc. This was followed by resource factors (15.1%) like no time, no money, etc. and psychosocial factors (10.2%) included lack of interest, fear of procedure, etc. Independent predictors for doing Pap test included age >35, having knowledge of screening for cervical cancer and Pap test (P<0.05). Interpretation & conclusions: Specific knowledge on cervical cancer screening is a critical element in determining whether a woman will undergo Pap test in addition to making cancer screening facilities available in the primary health centre.
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            Screening for cervical cancer: a review of women's attitudes, knowledge, and behaviour.

            F Fylan (1998)
            The United Kingdom (UK) cervical screening programme has been successful in securing participation of a high proportion of targeted women, and has seen a fall in mortality rates of those suffering from cervical cancer. There remains, however, a significant proportion of unscreened women and, of women in whom an abnormality is detected, many will not attend for colposcopy. The present work reviews the psychological consequences of receiving an abnormal cervical smear result and of secondary screening and treatment, and examines reasons for women's non-participation in the screening programme. Psychological theories of screening behavior are used to elucidate women's reactions and to suggest methods of increasing participation, of improving the quality of the service, and of reducing women's anxiety. A literature search identified studies that examine factors influencing women's participation in the screening programme, their psychological reaction to the receipt of an abnormal cervical smear result, and experiences of colposcopy. Reasons for non-participation include administrative failures, unavailability of a female screener, inconvenient clinic times, lack of awareness of the test's indications and benefits, considering oneself not to be at risk of developing cervical cancer, and fear of embarrassment, pain, or the detection of cancer. The receipt of an abnormal result and referral for colposcopy cause high levels of distress owing to limited understanding of the meaning of the smear test; many women believe the test aims to detect existing cervical cancer. The quality of the cervical screening service can be enhanced by the provision of additional information, by improved quality of communication, and by consideration of women's health beliefs. This may result in increased participation in, and satisfaction with, the service.
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              Knowledge, attitudes, and practice related to cervical cancer screening among Kuwaiti women.

              To assess the knowledge, attitude, and practice regarding cervical cancer screening among Kuwaiti women. A total of 300 married Kuwaiti women were randomly selected from those who visited the clinics irrespective of reason(s) for the visit. A structured questionnaire covering sociodemographic characteristics, knowledge, attitude, and practice related to cervical cancer screening was administered. Of the 300 women, complete information was collected from 281 (93.7%), the knowledge about the test was adequate in 147 (52.3%) women, while 86 (30.6%) had adequate attitude towards the test and only 67 (23.8%) had an adequate practice. The main reason given for not having had a Papanicolaou smear was that it was not suggested by the doctor. Among all the respondents 220 (78.7%) would prefer a female doctor to conduct the test. The level of education was the only significant factor independently associated with inadequate knowledge and attitude towards Papanicolaou smear test (p = 0.006 and p = 0.001, respectively) when adjusted for the effect of other factors in multivariate logistic regression analysis. However, age (p < 0.001), level of education (p = 0.028), and number of years since last visit with a gynaecologist (p = 0.005) were significant factors independently associated with inadequate practice of the test. Our findings showed that a well-designed health education programme on cervical cancer and benefits of screening would increase the awareness among Kuwaiti women. Copyright 2008 S. Karger AG, Basel.
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                Author and article information

                Journal
                J Nat Sci Biol Med
                J Nat Sci Biol Med
                JNSBM
                Journal of Natural Science, Biology, and Medicine
                Medknow Publications & Media Pvt Ltd (India )
                0976-9668
                2229-7707
                Jul-Dec 2015
                : 6
                : 2
                : 324-328
                Affiliations
                [1] Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal University, Bhopal, Madhya Pradesh, India
                [1 ] Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bhopal University, Bhopal, Madhya Pradesh, India
                [2 ] Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bhopal University, Bhopal, Madhya Pradesh, India
                Author notes
                Address for correspondence: Dr. Arun Mahadeo Kokane, Department of Community and Family Medicine, All India Institute of Medical Sciences Bhopal University, Bhopal - 462 020, Madhya Pradesh, India. E-mail: arun_kokane.cfm@ 123456aiimsbhopal.edu.in
                Article
                JNSBM-6-324
                10.4103/0976-9668.159993
                4518402
                26283822
                37a89c3a-fdaa-40f7-b63f-0c18a964b545
                Copyright: © Journal of Natural Science, Biology and Medicine

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                Categories
                Original Article

                Life sciences
                awareness,cervical cancer,pap smear,screening
                Life sciences
                awareness, cervical cancer, pap smear, screening

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