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      Knowledge, Attitude, and Practice on Cervical Cancer Screening and Associated Factors Among Women Aged 15–49 Years in Adigrat Town, Northern Ethiopia, 2019: A Community-Based Cross-Sectional Study

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          Abstract

          Background

          Cervical cancer, mainly attributed to persistent infection with a high-risk oncogenic human papillomavirus (HPV), is one of the most common types of women’s cancer globally, with more than 90% of new cases occurring in developing and resource-limited countries. In Ethiopia, cervical cancer ranks as the most frequent cancer among women and cause for 4732 deaths annually.

          Objective

          To assess knowledge, attitude, practice towards screening on cervical cancer and associated factors among women aged 15–49 years in Adigrat town, northern Tigray Ethiopia.

          Methods

          A community based quantitative study design was conducted among 617 samples in Adigrat town, northern Tigray Ethiopia. Data were collected using a structured, semi-structured, and pre-tested questionnaire. Associations between dependent and independent variables were tested using logistic regression with the assumptions of p-values <0.05 and confidence interval 95% and considered to be statistically significant.

          Results

          This study indicated that 46.4%, 53.3%, 38.1% of participants had knowledge, positive attitude, and screened on cervical cancer, respectively. Diploma and above [AOR=3.7, 95% CI (1.443, 9.433) were significant factors associated with knowledge of cervical cancer screening utilization. Primary school (1–8) [AOR=2.7, 95% CI (1.297, 5.699)], greater than 500 ETB household income [AOR = 4.8, 95% CI (2.783, 8.577)] were significant factors associated with attitude of cervical cancer screening utilization. Secondary school (9–12) [AOR = 3.4, 95% CI (1.565, 7.458)], not knowledgeable of cervical cancer [AOR = 1.8, 95% CI (1.156, 2.698)] were significant factors associated with practice of cervical cancer screening utilization.

          Conclusion

          Factors like age, educational status, anyone knowing with cervical cancer and ever received cancer information had a significant association with knowledge of cervical cancer screening utilization. Educational status and perceived income of the household had a significant association with an attitude of cervical cancer screening utilization. Educational status perceived income of the household, anyone knowing with cervical cancer, ever received cancer information, and knowledge of cervical cancer screening utilization were predictors of cervical cancer screening practice.

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          Most cited references42

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          Worldwide burden of cervical cancer in 2008.

          The knowledge that persistent human papillomavirus infection is the main cause of cervical cancer has resulted in the development of assays that detect nucleic acids of the virus and prophylactic vaccines. Up-to-date and reliable data are needed to assess impact of existing preventive measures and to define priorities for the future. Best estimates on cervical cancer incidence and mortality are presented using recently compiled data from cancer and mortality registries for the year 2008. There were an estimated 530,000 cases of cervical cancer and 275,000 deaths from the disease in 2008. It is the third most common female cancer ranking after breast (1.38 million cases) and colorectal cancer (0.57 million cases). The incidence of cervical cancer varies widely among countries with world age-standardised rates ranging from 50 per 100,000. Cervical cancer is the leading cause of cancer-related death among women in Eastern, Western and Middle Africa; Central America; South-Central Asia and Melanesia. The highest incidence rate is observed in Guinea, with ∼6.5% of women developing cervical cancer before the age of 75 years. India is the country with the highest disease frequency with 134,000 cases and 73 000 deaths. Cervical cancer, more than the other major cancers, affects women <45 years. In spite of effective screening methods, cervical cancer continues to be a major public health problem. New methodologies of cervical cancer prevention should be made available and accessible for women of all countries through well-organised programmes.
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            Papillomaviruses in the causation of human cancers - a brief historical account.

            Approximately 35 years ago a role of human papillomaviruses (HPV) in cervical cancer has been postulated. Today it is well established that this very heterogeneous virus family harbours important human carcinogens, causing not only the vast majority of cervical, but also a substantial proportion of other anogenital and head and neck cancers. In addition, specific types have been linked to certain cutaneous cancers. In females, HPV infections on a global scale account for more than 50% of infection-linked cancers, in males for barely 5%. Vaccines against the high risk HPV types 16 and 18 represent the first preventive vaccines directly developed to protect against a major human cancer (cervical carcinoma). This review will cover some of the historical aspects of papillomavirus research; it tries briefly to analyze the present state of linking HPV to human cancers and will discuss some emerging developments.
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              Epidemiology and prevention of human papillomavirus and cervical cancer in sub-Saharan Africa: a comprehensive review.

              To identify the gaps of knowledge and highlight the challenges and opportunities for controlling cervical cancer in sub-Saharan Africa (SSA). A comprehensive review of peer-reviewed literature to summarize the epidemiological data on human papillomavirus (HPV) and invasive cervical cancer (ICC) by HIV status, to review feasible and effective cervical screening strategies, and to identify barriers in the introduction of HPV vaccination in SSA. ICC incidence in SSA is one of the highest in the world with an age-standardized incidence rate of 31.0 per 100,000 women. The prevalence of HPV16/18, the two vaccine preventable-types, among women with ICC, does not appear to differ by HIV status on a small case series. However, there are limited data on the role of HIV in the natural history of HPV infection in SSA. Cervical screening coverage ranges from 2.0% to 20.2% in urban areas and 0.4% to 14.0% in rural areas. There are few large scale initiatives to introduce population-based screening using cytology, visual inspection or HPV testing. Only one vaccine safety and immunogenicity study is being conducted in Senegal and Tanzania. Few data are available on vaccine acceptability, health systems preparedness and vaccine cost-effectiveness and long-term impact. Additional data are needed to strengthen ICC as a public health priority to introduce, implement and sustain effective cervical cancer control in Africa.
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                Author and article information

                Journal
                Int J Womens Health
                Int J Womens Health
                ijwh
                intjwh
                International Journal of Women's Health
                Dove
                1179-1411
                05 January 2021
                2020
                : 12
                : 1283-1298
                Affiliations
                [1 ]Department of Psychiatry, College of Health Science, Mekelle University , Mekelle, Tigray, Ethiopia
                [2 ]Department of Public Health, College of Health Science, Adigrat University , Adigrat, Tigray, Ethiopia
                Author notes
                Correspondence: Abreha Tsegay Email abrehatsegay@gmail.com
                Author information
                http://orcid.org/0000-0001-7822-1821
                http://orcid.org/0000-0001-8008-1805
                Article
                261204
                10.2147/IJWH.S261204
                7801815
                33447089
                4bcce8f8-014d-4973-9f60-8b23a18e722d
                © 2020 Tsegay et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 26 May 2020
                : 29 October 2020
                Page count
                Figures: 3, Tables: 11, References: 49, Pages: 16
                Funding
                Funded by: Not applicable;
                Not applicable to this section.
                Categories
                Original Research

                Obstetrics & Gynecology
                cancer,knowledge,attitude,practice,screening,ethiopia
                Obstetrics & Gynecology
                cancer, knowledge, attitude, practice, screening, ethiopia

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