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      Cervical cancer knowledge and screening behaviors among female university graduates of year 2012 attending national graduate orientation program, Bhutan

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          Abstract

          Background

          Cervical cancer is the leading female cancer in Bhutan. This study describes the level of cervical cancer knowledge and screening behaviors among female university graduates attending the National Graduate Orientation Program (NGOP), 2012.

          Methods

          A cross-sectional study of female graduates attending NGOP was conducted using self-administered anonymous questionnaire developed through literature reviews and expert discussions to elicit information on demographic characteristics, knowledge, screening behaviors and determinants of cervical cancer. The association of demographic and other important study characteristics with uptake of Pap test was investigated using cross tabulation and Fischer Exact test. Frequencies and percentages were calculated for all the questions.

          Results

          The average age of the participants was 23.43 ± SD 2.73. About 92% (n = 513) of the respondents were aged 25 years or less and 7.9% (n = 44) of the respondents were aged 26 or more. The study revealed low cervical cancer knowledge and poor screening behavior among the graduates. The mean knowledge score was 3.571 (SD1.75, Range 0–8). About 6% (n=34) of the respondents reported undergoing Pap test at least once and 94% reported as never having done Pap test. The most commonly cited reasons for not doing Pap test included “never thought I needed one” (57%, n = 320), “embarrassment of being examined by male health professional” and “fear of finding out cancer”. The study revealed evidence of significant association between increasing age, those who are married, knowledge score and those recommended for screening by health professionals with the uptake of Pap test.

          Conclusion

          Our study revealed poor knowledge and screening behaviors among female university graduates in Bhutan. This may be suggestive of even poorer awareness and screening practices among young unmarried women who are less educated or with no education. Although our study group is not appropriate for measuring practice of cervical cancer screening in the country, the findings are expected to highlight the shortcomings and trigger development of comprehensive cervical cancer control programs in Bhutan.

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          Most cited references17

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          Breast and cervical cancer in 187 countries between 1980 and 2010: a systematic analysis.

          Breast and cervical cancer are important causes of mortality in women aged ≥15 years. We undertook annual age-specific assessments of breast and cervical cancer in 187 countries. We systematically collected cancer registry data on mortality and incidence, vital registration, and verbal autopsy data for the period 1980-2010. We modelled the mortality-to-incidence (MI) ratio using a hierarchical model. Vital registration and verbal autopsy were supplemented with incidence multiplied by the MI ratio to yield a comprehensive database of mortality rates. We used Gaussian process regression to develop estimates of mortality with uncertainty by age, sex, country, and year. We used out-of-sample predictive validity to select the final model. Estimates of incidence with uncertainty were also generated with mortality and MI ratios. Global breast cancer incidence increased from 641,000 (95% uncertainty intervals 610,000-750,000) cases in 1980 to 1,643,000 (1,421,000-1,782,000) cases in 2010, an annual rate of increase of 3·1%. Global cervical cancer incidence increased from 378,000 (256,000-489,000) cases per year in 1980 to 454,000 (318,000-620,000) cases per year in 2010-a 0·6% annual rate of increase. Breast cancer killed 425,000 (359,000-453,000) women in 2010, of whom 68,000 (62,000-74,000) were aged 15-49 years in developing countries. Cervical cancer death rates have been decreasing but the disease still killed 200,000 (139,000-276,000) women in 2010, of whom 46,000 (33,000-64,000) were aged 15-49 years in developing countries. We recorded pronounced variation in the trend in breast cancer mortality across regions and countries. More policy attention is needed to strengthen established health-system responses to reduce breast and cervical cancer, especially in developing countries. Susan G Komen for the Cure and the Bill & Melinda Gates Foundation. Copyright © 2011 Elsevier Ltd. All rights reserved.
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            Cervical cancer screening among college students in ghana: knowledge and health beliefs.

            Cervical cancer is the most incident cancer and the leading cause of cancer mortality in women in Ghana. Currently, little is known about Ghanaian women's knowledge and beliefs about cervical cancer screening, yet this information is essential to the success of cervical cancer screening programs. Therefore, the purpose of this study was to describe the knowledge and beliefs of female university college students in Ghana. A cross-sectional survey among college women in a university in Ghana elicited information about sociodemographics, knowledge and beliefs, and acceptability of cervical cancer screening, screening history, and sexual history. Bivariate analyses were conducted to identify factors associated with screening. One hundred forty women were recruited; the age range was 20 to 35 years. The prior Papanicolaou (Pap) screening rate was 12.0%. The women were unaware of local screening initiatives, and only 7.9% were aware of the link between human papillomavirus and cervical cancer. The most prevalent barriers were lack of awareness that the purpose of Pap screening is to diagnose cancer, concerns about what others may think, and lack of information about how to obtain screening services. Although women perceived the benefits of screening, only about half perceived themselves to be at risk. Women received few screening cues. Three barriers were negatively associated with screening in bivariate analyses: lack of belief that cancer is diagnosed by cervical screening, belief that Pap test is painful, and belief that the test will take away virginity. New screening programs in Ghana should address these barriers and increase screening cues to the public.
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              Conhecimentos, atitudes e prática do exame de Papanicolaou entre mulheres argentinas

              OBJETIVO: Avaliar os conhecimentos, atitudes e prática acerca do exame de Papanicolaou e verificar sua associação com variáveis sociodemográficas entre mulheres. MÉTODOS: Por meio de inquérito domiciliar foram entrevistadas 200 mulheres da localidade de Puerto Leoni, Misiones, Argentina, selecionadas de forma aleatória simples. As respostas foram descritas quanto ao conhecimento, atitude e prática, e suas respectivas adequações para o exame de Papanicolaou, previamente definidas. A adequação foi comparada entre as categorias das variáveis de controle pelo teste chi2, com nível de significância de 5%. RESULTADOS: O conhecimento e prática do exame de Papanicolaou foram adequados em 49,5% e 30,5% das entrevistadas, respectivamente, embora a atitude frente ao exame tenha sido considerada adequada em 80,5% das entrevistadas. A falta de solicitação pelo médico ou por outros profissionais de saúde foi referida por 58,9% das mulheres como principal motivo para não realização do exame. CONCLUSÕES: Os resultados revelaram a necessidade, sobretudo entre os profissionais de saúde, de fornecerem mais informações sobre o exame, gerando conhecimento à população sobre as vantagens e benefícios do exame Papanicolaou.
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                Author and article information

                Contributors
                Journal
                BMC Womens Health
                BMC Womens Health
                BMC Women's Health
                BioMed Central
                1472-6874
                2014
                12 March 2014
                : 14
                : 44
                Affiliations
                [1 ]Head, Health Research and Epidemiology Unit, Planning and Policy Division, Ministry of Heath, Kawangjangsa, Thimphu, Bhutan
                [2 ]Bhutan Medical and Health Council, Ministry of Health, Kawangjangsa, Thimphu, Bhutan
                Article
                1472-6874-14-44
                10.1186/1472-6874-14-44
                3975232
                24618416
                adb5b4ff-cb4c-405c-b604-52dbd1423f88
                Copyright © 2014 Dhendup and Tshering; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. 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
                : 7 November 2013
                : 4 March 2014
                Categories
                Research Article

                Obstetrics & Gynecology
                bhutan cervical cancer knowledge,screening behavior,determinants,university graduates

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