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      Knowledge, attitudes, and practices regarding cervical cancer and screening among women visiting primary health care Centres in Bahrain

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          Abstract

          Background

          Cervical cancer is one of the most common cancers among women, with 80% of the cases occurring in developing countries. Cervical cancer is largely preventable by effective screening programs. This has not been possible with opportunistic screening and its low use in the Kingdom of Bahrain. The objective of this study was to explore the knowledge, attitudes, and practices of women attending primary care health centres for cervical cancer screening.

          Methods

          This was a cross-sectional study of 300 women attending primary health care centres in Bahrain. We used a validated tool comprised of 45 items to collect data through face-to-face interviews between December 2015 and February 2016. Descriptive data are presented for demographic data, and frequency distributions with percentages are presented for each item of the knowledge and attitude questionnaire.

          Results

          The mean age ± SD of the participants was 37.24 ± 11.89 years, they were mostly married (221; 73.7%), and had a high school or higher education (261; 87%). Over 64% (194 participants) had never heard of a Pap smear procedure and only 3.7% (11 participants) had heard about the human papillomavirus (HPV) vaccine. Nearly 64% (192 participants) believed that a Pap smear was helpful in detecting pre-cancer and cancer of the cervix, and 44.3% (133 participants) believed that they should have a Pap smear at least every 3 years. Regarding the practice, only 40.7% (122 participants) had a Pap smear in their lifetime. The majority of participants felt embarrassed when examined by a male doctor (250, 83.3%) and few underwent a Pap smear screening if they were never married (69, 23.0%).

          Conclusions

          The participants demonstrated a wide range of knowledge and attitudes towards cervical cancer screening. However, the majority demonstrated positive attitudes towards the HPV vaccine.

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          Most cited references9

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          Screening for cancer in low- and middle-income countries.

          Screening programs involve testing asymptomatic individuals with an accurate screening test to identify those likely to have the disease of interest and to further investigate them to confirm or exclude the disease. The aim of cancer screening is to prevent cancer deaths and improve quality of life by finding cancers early and by effectively treating them. A decision to introduce a screening program in public health services depends on the evidence that the benefits outweigh the harms of screening, disease burden, availability of suitable screening test, effective treatment, adequate resources, and efficient health services. Screening programs should achieve high participation for testing, diagnosis, and treatment to be effective and efficient.
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            Knowledge, attitude, and practices related to cervical cancer among adult women: A hospital-based cross-sectional study

            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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              Human papillomavirus vaccine acceptability among parents of 10- to 15-year-old adolescents.

              To determine human papillomavirus (HPV) vaccine acceptance among parents of 10- to 15-year-old adolescents. Five hundred seventy-five parents or guardians completed a 30-question survey regarding their knowledge of HPV and acceptance of an HPV vaccine. Afterward, subjects read an HPV educational fact sheet and completed a 26-question survey. Results were compared using the chi test, analysis of variance, and McNemar's test. More than 60% of subjects had a general understanding of HPV. Parents opposed to the HPV vaccine were more likely to believe it would promote earlier initiation of coitus compared with parents supportive or undecided about vaccination (24%, 9%, and 6%, respectively; p = .003). Of the subjects initially opposed to or undecided about the HPV vaccine, 37% and 65%, respectively, supported HPV vaccination after an educational intervention. A brief educational intervention significantly improved parent's acceptance of the HPV vaccine. The negative impact of an HPV vaccine perceived as condoning early initiation of sexual intercourse seems to be minimal.
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                Author and article information

                Contributors
                +97317351450 , gjassim@rcsi-mub.com
                Aladdin.obeid@gmail.com
                haa10537@rcsi-mub.com
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                11 January 2018
                11 January 2018
                2018
                : 18
                : 128
                Affiliations
                ISNI 0000 0004 0398 3129, GRID grid.459866.0, Family Medicine Department, , Royal College of Surgeons in Ireland –Medical University of Bahrain, ; Busaiteen Bahrain, Box 15503, Adliya, PO Bahrain
                Article
                5023
                10.1186/s12889-018-5023-7
                5765703
                29325528
                7390075f-2d25-49fb-bd41-f3a137bad636
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 1 June 2017
                : 2 January 2018
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Public health
                cervical cancer,women,screening,human papillomavirus (hpv) vaccine
                Public health
                cervical cancer, women, screening, human papillomavirus (hpv) vaccine

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