Knowledge, Attitude, and Practice Toward Cervical Cancer Screening Among Women Attending Health Facilities in Central Ethiopia

Knowledge, attitudes and practices toward cervical cancer screening among ethnic minorities in inner Mongolia, China

AIMS

This study aimed to assess the knowledge, attitudes and practices (KAP) towards cervical cancer screening among ethnic minorities in Inner Mongolia, China.

METHODS

A cross-sectional study was conducted in Inner Mongolia between May and September, 2023, and recruiting participants undergoing dual-cancer screening. Demographic characteristics and KAP status were assessed using a self-administered questionnaire.

RESULTS

A total of 533 valid questionnaires were collected, with 53.66% aged 40 years or younger. Mean scores for knowledge, attitude, and practice were 13.58 ± 5.41, 41.06 ± 4.53, and 13.35 ± 1.53, respectively. Positive associations were found between knowledge and attitude (r = 0.348, p < 0.001), knowledge and practice (r = 0.288, p < 0.001), and attitude and practice (r = 0.817, p < 0.001). Structural equation modelling confirmed direct positive associations between knowledge and attitude (path coefficient = 0.307, p < 0.001) and attitude and practice (path coefficient = 0.270, p < 0.001). Additionally, knowledge demonstrated an indirectly positive association with practice (path coefficient = 0.083, p = 0.007).

CONCLUSION

Ethnic minorities in Inner Mongolia exhibit insufficient knowledge, positive attitudes, and proactive practices toward cervical cancer screening. Implementing targeted educational initiatives is crucial to enhance their KAP.

The Role of Health Information Sources on Cervical Cancer Literacy, Knowledge, Attitudes and Screening Practices in Sub-Saharan African Women: A Systematic Review

Cervical cancer is the leading cause of cancer deaths among Sub-Saharan African women. This systematic review aimed to identify information sources and their relation to cervical cancer knowledge, literacy, screening, and attitudes. Peer-reviewed literature was searched on 2 March 2022, and updated on 24 January 2023, in four databases-CINAHL Plus, Embase, PubMed, and Web of Science. Eligible studies included those that were empirical, published after 2002, included rural women, and reported on information sources and preferences. The quality of the selected articles was assessed using the Mixed Methods Appraisal Tool. Data extraction was conducted on an Excel spreadsheet, and a narrative synthesis was used to summarize findings from 33 studies. Healthcare workers were the most cited information sources, followed by mass media, social networks, print media, churches, community leaders, the Internet, and teachers. Community leaders were preferred, while healthcare workers were the most credible sources among rural women. There was generally low cervical cancer knowledge, literacy, and screening uptake, yet high prevalence of negative attitudes toward cervical cancer and its screening; these outcomes were worse in rural areas. A content analysis revealed a positive association of health information sources with cervical cancer literacy, knowledge, screening, and positive screening attitudes. Disparities in cervical cancer prevention exist between rural and urban Sub-Saharan African women.

Improving cervical cancer continuum of care towards elimination in Ethiopia: a scoping review

BACKGROUND

Cervical cancer is the second-leading cause of death among all cancers in Ethiopia. Ethiopia plans to eliminate cervical cancer as a public health problem by 2030, following the World Health Organization's call for action. A scoping review was conducted on the status of the cervical cancer continuum towards elimination in Ethiopia.

METHODS

We searched articles in PubMed, Scopus, and Google Scholar. All studies conducted on cervical cancer in Ethiopia, from first date of publication to March 15, 2023, type of article, or language of publication, were included. However, conference abstracts, commentaries, and letters to the editors were excluded. We used EndNote X9 software to merge articles from different databases and automatically remove duplicates. Screening of titles, abstracts, and full texts was performed independently by two co-authors. The cancer care continuum was employed as a framework to guide data synthesis and present the findings.

RESULTS

Of the 569 retrieved articles, 159 were included in the review. They found that most of the articles focused on knowledge, attitude, and practice. However, there were few studies on health-seeking behavior, perception and acceptability of cervical cancer services, as well as the availability and readiness of a screening program. The review identified inadequate knowledge, attitude, and perception about cervical cancer, and highlighted that screening for cervical cancer is not widely utilized in Ethiopia. Knowledge, attitude, education status, and income were repeatedly reported as precursors influencing cervical cancer screening. Most studies concluded that there is a high prevalence of precancerous lesions and cervical cancer, as well as high mortality rates or short survival times. The review also identified significant heterogeneity in findings across time and geographic settings within each component of the cancer care continuum.

CONCLUSIONS

Overall, there is inadequate knowledge, perception, health-seeking behavior, screening, and treatment services, indicating that the country is falling behind its targets in eliminating cervical cancer, despite the availability of effective interventions and tools. We argue that implementation research is necessary to identify implementation issues, challenges, and strategies to scale up both primary and secondary prevention services. By doing so, Ethiopia can address cervical cancer as a public health problem and work towards its elimination.

Health care seeking behaviour towards cervical cancer screening among women aged 30-49 years in Arbaminch town, Southern Ethiopia, 2023

BACKGROUND

Cervical cancer is a preventable disease. However, it remains the commonest and deadly cancer in women worldwide. Health care seeking behaviour is not well studied in Ethiopia even though it is crucial in averting cervical cancer by maximizing cervical cancer screening utilization. Therefore, this study amid to assess health care seeking behaviour towards cervical cancer screening and its associated factors among women aged 30-49 years in Arba Minch town, Southern Ethiopia, 2023.

METHODS

A community-based cross-sectional study design was conducted on 414 women who are in the age range of 30-49 in Arba Minch town from January 2-February20, 2023. Study participants were selected by a simple random sampling technique from all kebeles and data were collected using pretested interviewer administered questionnaires. SPSS version 27 was used to conduct binary and multivariable logistic regression analysis. Socio-demographic characteristics of the respondents were described using descriptive statistics. Furthermore, binary and multivariable logistic regression analyses were made to find the factors associated with health care seeking behaviour. Variables with a p-value less than 0.25 on binary logistic regression were selected for multivariable logistic regression. Variables with a p-value < 0.05 were considered statistically significant. The reliability and internal consistency of the constructs of health belief model were calculated independently using Cronbach's alpha.

RESULT

The prevalence of health care seeking behaviour towards cervical cancer screening was 197(47.6%) [95%CI: 42.7-52.5%]. Respondents' good knowledge [AOR = 1.55, 95%CI: 1.01-2.39], positive perceived susceptibility [AOR = 3.63, 95%CI: 2.06-6.42], positive perceived severity [AOR = 2.65, 95%CI: 1.71-4.09], positive perceived benefits [AOR = 4.85, 95%CI: 2.92-7.87] were significantly associated with health seeking behaviour.

CONCLUSION

The prevalence of health care seeking behaviour towards cervical cancer screening is low in this study. To maximize the health care seeking behavior of women, further acting on perceived susceptibility, respondents' knowledge, perceived severity, and perceived benefit of the woman are crucial.

Women's willingness for cervical cancer screening and associated factors among women attending health services in Addis Ababa, Ethiopia

Background

Cervical cancer is one of the most common causes of cancer-related morbidity and mortality globally. In developed countries, effective screening programs reduced its burden. However, in Ethiopia, cervical cancer remains a major public health problem despite the screening service being available free of charge.

Objective

The aim of this study was to assess women's willingness for cervical cancer screening services and associated factors among women attending health services in Addis Ababa, Ethiopia.

Design

An institutional-based, analytic, cross-sectional study was conducted among sexually active women attending health facilities from August to September 2022.

Methods

A pretested interviewer-administered questionnaire was used for data collection. Data were analyzed using SPSS version 25. Logistic regression was used to determine different variables' frequencies and associated factors. A p value of <0.05 was considered statistically significant.

Result

Four hundred twenty-two women were approached, and 394 (93.4%) met the study inclusion criteria. Study participants had a minimum of 1 and a maximum of 6 sexual partners in their lives. A total of 256 (64.9%) study participants had heard about cervical cancer. Among those who heard about cervical cancer, only 22 (8.6%) had been tested for cervical cancer. Of those who did not receive cervical cancer screening, only 175 (47.0%) are willing to receive cervical cancer screening. Age, religion, marital status, place of residence, educational level, occupation, and hearing about cervical cancer were found to be statistically significant. Women who heard about cervical cancer were 15.2 times more likely to take the test compared to those who never heard about cervical cancer before the study.

Conclusion

Women's willingness to be screened for cervical cancer is low despite many of the study participants having more than one partner in their lives and being at risk for cervical cancer. Only a few participants had been screened for cervical cancer. Women who had heard about cervical cancer were more likely to take the screening service compared to those who had never heard it before. This highlights the need to prioritize raising awareness about the benefits of cervical cancer screening services.

Knowledge, attitude, and practice of cervical cancer screening and its associated risk factors among family planning service users at Debre Tabor town health facilities, North Central Ethiopia: A cross-sectional study

Background

The fourth most common cancer in women worldwide is cervical cancer. Over 87% of deaths from cervical cancer occur in developing nations. One of the risks of developing cervical cancer is the use of oral contraceptives. However, there is limited evidence on the knowledge, attitude, and practice of cervical cancer screening among family planning service users in Ethiopia.

Objective

To assess the knowledge, attitude, and practice toward cervical cancer screening and its associated factors among family planning service users.

Methods

A facility-based cross-sectional study was conducted from January 1 to February 28, 2023. A total of 816 participants were selected using a systematic sampling technique. Data were collected using a pretested, structured, and interviewer-administered questionnaire. The collected data were entered into EPI Data 3.1 and exported to SPSS version 24 (IBM, Armonk, NY, USA) for analysis. Logistic regression was used to identify risk factors. An odds ratio with a 95% confidence interval and a p-value < 0.05 were used to declare statistical significance.

Results

Overall, 42.5%, 36.6%, and 20.1% of the participants had good knowledge, a positive attitude, and practiced cervical cancer screening, respectively. Being single (adjusted odds ratio (AOR) = 3.39, 95% confidence intervals: 1.15-6.26), having college or university level of education (AOR = 8.03, 95% confidence intervals: 3.45-19.23), having a family history of cervical cancer (AOR = 3.14, 95% confidence intervals: 1.82-8.84), and having a source of information from the media (AOR = 1.74, 95% confidence intervals: 1.09-2.54) were significantly associated with good knowledge of cervical cancer screening. Women who were aged 15-23 years (AOR = 5.62, 95% confidence intervals: 2.76-14.56), had college- or university-level education (AOR = 3.69, 95% confidence intervals: 1.65-8.22), and had good knowledge of cervical cancer (AOR = 4.71, 95% confidence intervals: 3.08-7.55) were significantly associated with a positive attitude toward cervical cancer screening. An earlier age of first sexual intercourse (AOR = 5.0, 95% confidence intervals: 3.80-9.20) and good knowledge of cervical cancer (AOR = 1.52, 1.21-5.82) were positively associated with good practice of cervical cancer screening. Women who attended high school were negatively associated with good practice in cervical cancer screening (AOR = 0.46, 0.23-0.73).

Conclusion

Knowledge, attitude, and practice toward cervical cancer screening were low. As a result, during patient visits for care delivery, healthcare providers should inform and educate patients about cervical cancer screening.

Non-adherence to cervical cancer screening recommendations among women in Eswatini: a cross-sectional study

BACKGROUND

In 2018, Eswatini had the world's highest age-standardised cervical cancer incidence rate. Cervical cancer screening reduces women's risk of invasive cervical cancer. Data on adherence to cervical cancer screening recommendations in Eswatini are scarce. The purpose of the current study was to determine Eswatini women's self-reported adherence to cervical cancer screening recommendations, attitudes toward screening, and factors associated with non-adherence.

METHODS

A cross-sectional survey of women (n = 377) aged 25 to 59 accessing primary healthcare clinics (n = 4) in Eswatini assessed screening participation, attitudes and knowledge regarding cervical cancer screening, and socio-demographic variables. Adjusted logistic regression was used to assess factors associated with non-adherence to Eswatini cervical cancer screening recommendations.

RESULTS

One hundred and sixty-six (44%) women were classified as adherent to cervical cancer screening recommendations. Attitudinal barriers endorsed by over one-third of participants included a perceived low risk of cervical cancer (n = 161, 43%) and a view that screening is likely to be painful (n = 146, 38%). Participants had higher odds of being classified as non-adherent if they: were single compared with married (OR = 1.78, 95% CI: 1.05, 3.01, p = 0.03), perceived screening as likely painful (OR = 4.43, 95% CI: 2.62, 7.46, p < 0.001); and had not been advised by a doctor/ nurse to screen (OR = 2.82, 95% CI: 1.71, 4.64, p < 0.001). Also, a 1-year increase in age was associated with an increase in the odds of being classified as non-adherent (OR = 1.42, 95% CI: 1.39, 1.45, p = 0.01).

CONCLUSIONS

Self-reported adherence was moderate among this group of women. Tailored interventions are needed to increase participation in cervical cancer screening, especially for those women with characteristics associated with being classified as non-adherent. Primary healthcare clinic nurses (and other health providers) may contribute toward improving participation in cervical cancer screening by advising eligible women to screen and providing health education addressing negative attitudes toward screening.