Knowledge and Attitudes towards Cervical Cancer Screening amongst University of Botswana Female Students

Background: Cervical cancer is the leading cause of cancer deaths in Botswana. More than two-thirds of cases occur in HIV-infected women, in a nation with a high HIV prevalence of 17%. Even though cancer screening is free in health facilities, cervical cancer screening is low. The objective of this study was to assess the knowledge and attitudes of University of Botswana female students on cervical cancer screening. Methods: A cross-sectional study was conducted among University of Botswana female students to elicit information about their knowledge and attitudes on cervical cancer screening. Results: A total of 335 students completed the questionnaire and all reported that they were aware of cervical cancer. The awareness was mostly through brochures, posters and other printed material. Regarding cervical cancer risk 315 (94%) attributed cervical cancer to smoking and 301 (89.9%) to early sexual debut. The majority of students 329 (98.2 %) were aware of cervical cancer screening. Papanicolaou (Pap) smear was the most popular screening test reported by 160 (47.8%) of the respondents as compared to Human Papilloma Virus testing (HPV) reported by 106 (31.6 %) of the respondents. The overall Pap smear screening rate was 92 of 335 students (27.5%). Those who perceived themselves to be at risk of contracting cervical cancer 203 (60.6%) where 1.8 times more likely to go for Pap smear than those who perceived to be safe, (Adjusted Odds Ratio [AOR] 1.834; 95% Confidence Interval [CI]; 1.094-3.067), (P = 0.02). Conclusions: Pap smear screening uptake is low amongst University of Botswana female students. The likely reason for this could be because students do not perceive themselves to be susceptible to cancer so the lesser the likelihood of engaging in preventive behaviours. There is urgent need for university based cancer education campaign on cervical cancer screening benefits and incorporating these campaigns into the existing university medical services to increase uptake of screening programs offered.     

Awareness and Practice of Cervical Cancer Screening Among Female Undergraduate Students in a Nigerian University

Cervical cancer screening enhances early detection which reduces morbidity and mortality. The objective of this study is to assess awareness and practice of cervical cancer screening amongst female students in a Nigerian university. A cross-sectional survey of 394 students was done. About 23.1% identified the Pap smear as a screening test. Only 5.2% of respondents had ever been screened and 52.8% reported willingness to be screened. The major reason for unwillingness to get a Pap smear was absence of symptoms (31.7%). There is a critical need to improve cervical cancer screening participation amongst female undergraduate students in Nigeria.     

Knowledge and Perception Towards Cervical Cancer among Female Debre Berhan University Students

Background: Cervical cancer is a global public health problem with around five hundred thirty thousand new casesand two hundred sixty five thousand deaths annually in 2015. Risky behaviors, lack of knowledge and preventativemeasures in young women, increase the risks of cervical cancer later in life. Up to date, there is scarcity of study onlevel of knowledge and perception towards cervical cancer among young women in Ethiopia. So, this study was aimed todetermine the level of knowledge and perception toward cervical cancer among female regular undergraduate DebreBerhan University students. Methods: A facility based cross-sectional study was conducted using self-administeredquestionnaire among female regular DBU students from May to June, 2015. Two stage cluster sampling technique wasused for the study. Data was entered and cleaned in Epi info and imported to SPSS for analysis. Binary logistic regressionwas carried out to determine factors of good knowledge on cervical cancer. P-value less than 0.05 was considered forstatistical significance. Results: Eighty-four (14.5%) of the study participants were sexually active. Of the participants,232(40.5%) had heard of cervical cancer but only 195 (35.6%) had good knowledge towards cervical cancer and ofthe study participants, only 185 (33.2%) perceived as they are susceptible for cervical cancer. Using radio and TV assource of information [AOR= 1.918 (95% CI: 1.223, 3.010)], having information about sexually transmitted infections(STI) [AOR =3.030 (95% CI: 1.665, 5.514)] were significantly and independently associated with good knowledge oncervical cancer. Conclusions: The level of knowledge towards cervical cancer and perception of acquiring the diseasewas poor. Health education interventions are needed to improve the awareness and health seeking behavior in youthwomen thereby preventing cervical cancer related morbidity and mortality.     

HPV,Cervical Cancer and Pap Test Related Knowledge Among a Sample of Female Dental Students in India

Background: The present study was designed to ascertain knowledge about HPV, cervical cancer (CC) andthe Pap test among female dental students of Panineeya Institute of Dental Sciences and Hospital, Hyderabad,India. Materials and Methods: A self-administered questionnaire covering demographic details, knowledgerelating to human papilloma virus (HPV) (8 items), cervical cancer (4 items) and the Pap smear (6 items) wasemployed. Responses were coded as “True, False and Don’t Know”. Mean and standard deviation (SD) for correctanswers and levels of knowledge were determined. Results: Based on the year of study, significant differences inknowledge of HPV werenoted for questions on symptoms (p=0.01); transmission from asymptomatic partners(p=0.002); treatment with antibiotics (p=0.002); start of sexual activity (p=0.004); and recommended age for HPVvaccination (p=0.01). For knowledge regarding CC, significance was observed for the age group being affected(p=0.008) and symptoms of the disease in early stages (p=0.001). Indications for Pap smear tests like symptoms’ ofvaginal discharge (p=0.002), marital status (p=0.01) and women with children (p=0.02) had significant differencebased on the year of study. Based on religion, transmission of HPV via pregnancy, HPV related diseases exceptCC and preventive measures except condom use and oral contraceptives showed significant differences. However,significant variation with religion was observed only for two preventive measures of CC (Pap test; p=0.004) andHPV vaccination (p=0.003). Likewise, only the frequency of Pap test showed a significant difference for religion(p=0.001). Conclusions: This study emphasizes the lack of awareness with regard to HPV, CC and screeningwith pap smear even among health professionals. Hence, regular health campaigns are essential to reduce thedisease burden     

Knowledge,Attitudes and Practices Regarding Cervical Cancer Screening Among Village Health Volunteers

Background: In the years 2014, coverage rates of cervical cancer screening in Nakornnayok province accountedto 76.5%. This was lower than the government’s specified goal of 80%. Community health volunteers are membersof a Thai healthcare alliance established to help promoting healthcare service communication and collaborationat the primary level. Such village health volunteers (VHVs) are established in most villages. Objective: To assessthe knowledge and attitudes of cervical cancer screening among VHVs. Materials and Methods: The subjectswere 128 VHVs from four Nakornnayok sub-districts; namely KlongYai, Chomphol, Buangsan and Suksara,Thailand. The study was conducted from December 2014 to January 2015. The questionnaire was designed toassess the knowledge and attitude of cervical cancer screening provided by the VHVs. In addition, cervical cancerscreening coverage rates of each area were collected. The demographic data, scores of knowledge, attitudes,practices and the cervical cancer screening coverage rates were analyzed by one-way ANOVA. Results: Thequestionnaire reliability was assessed as 0.81. The total knowledge and attitude scores were 10 and 15 points.The mean knowledge scores of KlongYai, Chomphol, Buangsan and Suksara were 6.8, 7.0, 6.5 and 9.0 points,respectively. The VHVs had a high level of overall knowledge about cervical cancer screening. The mean attitudescores were 12.4, 13.2, 13.4 and 13.1 points. VHVs had a positive attitude to the promotion of cervical cancerscreening at the overall level. The percentages of VHVs promoting cervical cancer information in respectivedistricts were 72.2, 94.3, 94.9 and 50.0. However, the cervical cancer screening coverage rates were 62.4%,34.7%, 80.3% and 47.3% respectively. Conclusions: The knowledge, attitudes and percentages of promotinginformation of cervical cancer screening among VHVs in the four sub-districts were high but did not correlatewith the cervical screening coverage rates for each area. VHVs needed to understand socio-cultural beliefs of thewomen in the target population and design suitable strategies to encourage higher cervical screening coverage.     

Knowledge and Barriers Towards Cervical Cancer Screening Among Young Women in Malaysia

Objectives: This study examined the level of knowledge and barriers towards cervical cancer screening of female university students. Methodology: A cross-sectional design was used for 287 female students at a tertiary institution located in Selangor, Malaysia. A name list of all students in the all faculties were obtained from each faculty’s registrar and the ethics committee of the Faculty of Health and Life Sciences, approved the study. Respondents completed a consent form before they were given the questionnaire consisting of four sections: socio-demographic characteristics (six questions); risk factor of cervical cancer (six); knowledge about cervical cancer and the Pap smear test (ten); and finally barriers to Pap screening (eleven). Data were analyzed using SPSS version 13. Results: The prevalence of ever having had a Pap test was 6%. Majority of the participants had adequate knowledge about risk factors of cervical cancer. The highest knowledge about cervical cancer risk factor reported by the respondents was having more than one sex partner (77.5%), whereas the lowest was the relationship between HPV and cervical cancer (51.2%). Age, marital status, ethnicity, monthly family income and faculty were significantly associated with knowledge of cervical cancer screening (p=0.003; p=0.001; p=0.002; p=0.002; p=0.001 & p=0.002; respectively). The most common barriers of cervical cancer screening were the Pap smear test will make them worry (95.8%) whereas the least common barrier reported among participants was no encouragement from the partner (8.8%). Conclusion: Some misconceptions and barriers in uptaking Pap smear test are still serious problems among young women. Although knowledge about cervical cancer screening is adequate they have a very poor practice of Pap smear test. The introduction of reproductive health subjects is warranted for all university students.     

Awareness of Cervical Cancer Among Female Students of Premier Colleges in Kolkata,India

In the absence of any nationwide cervical screening program, cancer of cervix remains a major public health problem for India. We here assessed knowledge levels of female college students about cervical cancer, its risk factors, the human papillomavirus (HPV) etiologic agent and Pap (Papanicolaou) smear testing for screening. We conducted a questionnaire survey of the students (N=630), aged 17 to 24 years, in Kolkata, India. Only 20% correctly identified cervix cancer as the most prevalent female cancer in India, while 43% were aware of the ages of occurrence. Though 41% thought sexual activity to be associated with cervical cancer, its risk factors, like, ‘smoking’, ‘having multiple sex partners’, ‘cervical infections’, ‘early onset of sexual intercourse’, ‘multiple parity’ were recognized by 29%, 3%, 4%, 13% and 15%, respectively. The terms ‘Pap test’ and HPV had been heard by 11% and 15 % of the students, respectively, and 75% of the students desired to have protective vaccination. Bivariate analysis revealed that educational stream, standard of the college and family size were significantly associated with knowledge levels. Additionally, multivariate regression analysis indicated city students were more knowledgeable than those from outside the city. It is imperative that women gather adequate knowledge on cervical cancer for the success of any program to control the disease. Wide and effective spreading of awareness about the disease among women must form an integral part of public health policy of government.     

Attitudes and Practice of Cervical Cancer Screening among Female University Students from 25 Low,Middle Income and Emerging Economy Countries

Cervical cancer, the third commonest cancer in women worldwide, can be prevented through early detection by cervical screening (Pap smear). The aim of this study was to investigate the attitudes and practice of cervical cancer screening among female undergraduate university students from 25 low, middle income and emerging economy countries. Using anonymous questionnaires, data were collected from 9,194 female undergraduate university students aged 18-26 years (mean age 20.9, SD=2.0) from 26 universities in 25 countries across Asia,Africa and the Americas. Overall, 11.6% of the female students indicated that they had conducted one or more times a cervical (Pap) smear test; 8.3% among 18-20 year-olds and 15.6% among 21-26 year-old students. There was considerable country variation on having had a cervical (Pap) smear test among 21-26 year-old female university students, ranging from 59.2% in Colombia and 50.9% in Barbados to 0% in India and 1.0% in Tunesia. Logistic regression showed that cervical cancer screening importance or positive attitude were highly associatedwith the cervical screening practice. Moreover, risky sexual behaviour and tobacco use, two cervical cancer risk factors, were associated with screening. Cervical cancer screening practices were found to be inadequate and efforts should be made to develop programmes that can increase the uptake of cervical cancer screening.     

Cervical Cancer Screening Among Adult Women in China, 2010

Introduction.

Cervical cancer is one of the most commonly diagnosed cancers among women in China. The World Health Organization (WHO) recommends routine screening for cervical cancer, and the WHO Global Monitoring Framework suggests that every nation monitors cervical cancer screening. However, little information is available on cervical cancer screening behavior among women in China.

Methods.

We used data from the 2010 China Chronic Disease and Risk Factor Surveillance System that included 51,989 women aged 18 years and older. We report the proportion of women who reported ever having had a Papanicolaou (Pap) test, stratified by sociodemographic characteristics and geographic region. Multivariable logistic regression modeling was performed to adjust for potential confounders.

Results.

Overall, 21% of 51,989 women reported having ever had a Pap test. The highest proportion was reported among women aged 30–39 years (30.1%, 95% confidence interval, 26.8%–33.4%). In all geographic regions, women in rural areas were consistently less likely than women in urban areas to report having had a Pap test. Among women who reported ever having a Pap test, 82% reported having the most recent test in the past 3 years. Factors associated with reporting ever having a test were being aged 30–49 years, higher education, being married, and having urban health insurance.

Conclusion.

Our results indicate that screening programs need to be strengthened along with a more intense focus on specific demographic groups. National cervical cancer screening guidelines and comprehensive implementation strategies are needed to make screening services available and accessible to all women.

Implications for Practice:

This study is the largest nationwide and population-based assessment of self-reported history of Pap test for cervical cancer screening in China. This article describes cervical cancer screening behavior among women and examines key demographic and geographic factors. Only one fifth of Chinese women reported having ever had a Pap test for cervical cancer screening. The results highlight the urgent need to develop national cervical cancer screening guidelines and strategies that make screening services widely available, accessible, and acceptable to all women, especially to those who reside in rural areas and those with no health insurance.     

Knowledge and Perspectives of Breast and Cervical Cancer Screening Among Female African Immigrants in the Washington D.C. Metropolitan Area

Black women in the USA have both a higher percentage of late-stage diagnoses as well as the highest rates of mortality from breast cancer when compared to women of other ethnic subgroups. Additionally, Black women have the second highest prevalence of cervical cancer. Many reports evaluating the cancer outcomes of Black women combine data on African-born immigrants and US-born Blacks. This categorization ignores subtle yet important cultural differences between the two groups, which may ultimately affect breast and cervical cancer screening practices. Therefore, this study investigated knowledge and awareness levels of breast and cervical cancer screening practices among female African-born immigrants to the USA residing in the Washington D.C. metropolitan area. Data were collected from 38 participants through key informant interviews, focus group sessions, and a sociodemographic questionnaire over a 3-month study period. Results suggest that fatalism, stigma, and privacy are among the major factors that affect the decision to seek preventative screening measures for breast and cervical cancer among this population. Additionally, the study implies that cervical cancer awareness is significantly lower among this population when compared to breast cancer. This study highlights differences between women of African descent residing in the USA and the need for continued research to increase understanding of the manner in which immigrant status affects health-seeking behavior. This information is critical for researchers, physicians, and public health educators aiming to design culturally appropriate interventions to effectively reduce the prevalence of breast and cervical cancer among female African immigrants living in the USA.     

Human Papillomavirus and Cervical Cancer Knowledge,Perceptions, and Screening Behavior: A Cross-Sectional Community-Based Survey in Rural Philippines

Background: Cervical cancer is the second most common cancer among women in the Philippines. Cervical cancer screening is an effective method to reduce incidence. However, screening utilization is limited. This study aims to assess human papillomavirus (HPV) and cervical cancer knowledge, perceptions, and screening utilization, and to investigate factors influencing screening utilization among rural women in the Philippines. Methods: This cross-sectional community-based study was conducted among 338 rural women aged 20–50 years, with a child under 5 years old registered in one of four public rural health centers in Tacao Island, Masbate Province in October 2017. A questionnaire administered via face-to-face interviews elicited information about demographic characteristics, knowledge, perceived susceptibility and perceived severity of HPV and cervical cancer, and cervical cancer screening utilization. Results: Mean age of participants was 32.5 years. Only 13.9% of participants had ever had cervical cancer screening. Although most women had heard of cervical cancer screening, their knowledge about the cause, risk factors, and preventive measures of HPV and cervical cancer was limited. Older age and higher education status were significantly associated with screening utilization. However, knowledge and perceived susceptibility and severity showed no association. The main reason for having screening was due to a health professional’s request or recommendation, and the reasons for not having screening were cost, not having symptoms, and fear of pain or discomfort and/or embarrassment during the procedure.  Conclusions: Health education must increase knowledge about HPV and cervical cancer and screening among women, including the nature and progression of cervical cancer, benefits of screening, screening cost, and screening procedure. Health care providers have an important role in educating and motivating women to undergo screening.     

Knowledge About Cancer Screening Among Medical Students and Internal Medicine Residents in Mexico City

It is extremely important that physicians are aware of cancer screening precise indications. We sought to explore its knowledge among Mexican medical students and internal medicine residents. Students and residents completed a questionnaire-based survey about breast, cervical, colon, and prostate cancer screening. Four hundred fifty-one individuals answered the survey: 64.52% students and 35.48% residents. Mean knowledge score was 63.97 ± 14.97. Residents scored higher than students (p = 0.0001). No difference in the education concerning cervical and colon cancer screening was found. Knowledge of screening guidelines is suboptimal among medical students and residents. Further efforts should be targeted to educational and training programs in this country.     

深圳市妇女宫颈癌防治知识知晓情况及筛查意愿调查分析

摘 要：［目的］了解深圳市社区女性宫颈癌防治知识知晓情况及宫颈癌筛查意愿,为针对性地提高社区人群参与防癌筛查依从性,制定相关措施提供依据。［方法］ 查阅相关文献,自行设计问卷,以社康中心为抽样单位,利用分层整群抽样的方法获得调查对象。［结果］ 调查样本4821例,被调查者中“多个性伴侣会增加宫颈癌发生的危险性”知晓率为62.1%,“早期宫颈癌能够治好”知晓率为60.2%,“目前已经有早期发现宫颈癌及癌前病变的检查方法”、“宫颈癌的发生与HPV有关”与“宫颈癌发生有较长时间的癌前病变阶段”的知晓率分别为57.8%、43.0%和47.8%。83.3%的人愿意参加针对健康人群的防癌筛查,5.6%的人不愿意参加,不愿意参加筛查的原因主要是“太贵了”（33.3%）,“没时间”（31.7%）,“没钱”（13.7%）。26～55岁年龄组女性更愿意接受筛查（P<0.001）。深圳户籍和暂住人口比流动人口更愿意接受筛查（P<0.05）。文化程度越高,筛查意愿增强（P<0.001）。［结论］ 宫颈癌防治知识知晓率相对较低,文化程度低的人群和外来流动人群是防癌知识健康教育的重点对象。大多数人愿意参加防癌筛查,不愿意参加筛查的主要原因是筛查费用问题。     

深圳市低收入妇女人群宫颈癌防治知识知晓

[目的]了解深圳市低收入妇女人群宫颈癌防治知识知晓及筛查参与情况,为制定宫颈癌防治策略提供参考依据.[方法]用多层次整群随机抽样的方法选择深圳市8个行政区30～59岁低收入妇女1 892例为研究对象,采用统一设计的问卷表进行宫颈癌防治知识和筛查参与情况调查.[结果] HPV病毒感染是宫颈癌发生的必要病因知晓率为32.05％、性行为紊乱增加宫颈癌发生危险性知晓率为49.63％、良好的性生活卫生习惯可以预防宫颈癌知晓率66.84％、已经有早期发现宫颈癌及癌前病变的检查方法的知晓率为51.67％、不同文化程度人群既往参加宫颈癌筛查率差异有统计学意义(x2=68.616,P＜0.001),筛查费用贵或经济困难是影响低收入人群参与筛查的主要原因.[结论]低收入人群宫颈癌防治相关知识知晓率普遍较低,对该类人群采取多种形式的健康教育及政府提供一定的资助有利于提高宫颈癌筛查参与率.     

Cervical Cancer Screening in Iranian Women: Healthcare Practitioner Perceptions and Views

Background: Although regular screening for cervical cancer with the Papanicolaou test is an important element for reducing the incidence and mortality of cervical cancer, the actual screening program in Iranian women is not sufficiently comprehensive at present. The purpose of this study was to explore healthcare provider perceptions of factors affecting cervical cancer screening in Iranian women. Methods: In this qualitative study performed from September 2015 to August 2016 in Hamadan, Iran, we conducted semi-structured in depth interviews with 14 healthcare providers selected purposefully. All interviews were recorded, transcribed and analyzed according to a conventional thematic analysis approach. MAXQDA10 software was employed for data analysis. Results: Four themes were extracted from data: "Inefficient management of cervical cancer screening process, Personal and professional characteristics of health care providers, Individual barriers and facilitators, Need for health system authorities to pay attention". Conclusion: Increased official attention to screening, and identifying challenges and providing strategies based on these challenges will help in achieving a successful screening program. It is necessary to attend to professional features of medical science students and increase the skills of interaction with clients in addition to academic training. Efforts should be made to increase trust in healthcare providers regarding the Pap test and receptiveness of society to this screening modality through informing the public, with encouragement through the media.