Assessment of knowledge regarding cervical cancer among women aged 25 years and above attending Soavinandriana hospital, Madagascar: a cross-sectional study

Abstract

Background: Cervical cancer remains a major public health concern in low- and middle-income countries, where limited access to screening and vaccination contributes to late diagnosis and high mortality. This study aimed to evaluate the level of knowledge regarding cervical cancer among women aged 25 years and above attending Soavinandriana Hospital, Madagascar.

Methods: A cross-sectional descriptive and analytical study was conducted among 200 women aged ≥25 years. Data were collected using a structured questionnaire assessing socio-demographic characteristics and knowledge of cervical cancer, including definition, HPV etiology, signs, screening, and vaccination. Knowledge was evaluated using a score ranging from 0 to 10 and categorized as insufficient (≤4), medium (5-6), or satisfactory (≥7). Statistical analysis was performed using the Chi-square test, with significance set at p<0.05.

Results: Although 71.5% of participants reported knowing about cervical cancer, only 53% correctly defined it, and 38% identified HPV as the causal factor. While 87% were aware that cervical cancer can be screened, 47% could not identify any screening method. Knowledge of HPV vaccination was particularly low, with 86.5% unable to name any vaccine. Overall, 44.5% of participants had insufficient knowledge, 37% had medium knowledge, and 18.5% had satisfactory knowledge. Professional sector was significantly associated with knowledge level (p<0.001), with healthcare workers demonstrating higher scores.

Conclusions: Despite existing prevention initiatives, important gaps persist in knowledge of cervical cancer, particularly regarding HPV infection and vaccination. Strengthened, targeted health education strategies are needed to improve awareness and enhance participation in screening and vaccination programs.