Study on knowledge and practice of screening for cervical cancer among women from rural communities in central Kerala, India
Keywords:Cancer cervix screening, Human papilloma virus, HPV vaccine Pap smear
Background: Early detection of cervical cancer is possible with Pap smear tests. The proportion of women who undergo Pap smear testing ranges from 68% to 84% in developed countries as compared to India where the rates range from 2.6% to 6.9% among women in communities. This study is to assess the knowledge of women about cervical cancer, its screening, role of doctor and source of information.
Methods: Cross-sectional study – observational study of Women attending gynecology camps/op clinics held in rural areas of Ernakulam and Thrissur who are between 25 and 65 years of age Non-random sampling with Sequential inclusion of the women who met the study criteria. A questionnaire devised collecting Basic sociodemographic profile like age, parity, educational qualification, Questions to assess knowledge about symptoms of cervical cancer Questions to assess the knowledge about cervical cancer screening and prevention doctor as Source of knowledge from the subjects. Correct response for questions carried score of 1 mark. So, the maximum was 6 and minimum was 0. The knowledge was graded as: <2 being poor knowledge; 2-5 being satisfactory knowledge and ≥5 being good knowledge.
Results: 32.9% of women identified discharge per vaginum as the most common symptom. When 50.9% thought multiparity was a risk factor 30% identified early sexual activity. 2.3% women knew that pas smear screening has to be done repeatedly. 8.3% of participants already had screening done. Only 8.3%of doctors advised pap screening during their consultations. Uptake of pap smear after awareness program was 100%.
Conclusions: Awareness classes are needed for increasing the coverage for pap smear screening. The women should be educated about cervical cancer, its screening methods and the facilities available for screening in the hospitals. An Information Leaflet has to be provided to these women in the local language. Training programs should be conducted for general practitioners and gynecologists to conduct awareness classes for the public and also to motivate women to undergo screening at every possible opportunity.
Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010. 2013;15(127):2893-917.
Nandakumar A, Gupta PC, Gangadharan P, Visweswara RN. National Cancer Registry Programme (NCRP-ICMR): Development of an atlas of cancer in India. First All India Report. 2001-2002. Vol. I-II, Bangalore: NCRP, 2010.
Singhal T. Indian Academy of Pediatrics Committee on Immunisation (IAPCOI)- Consensus Recommendations on Immunization 2008. Indian Pediatr. 2008;45:635-48.
Sherris J, Wittet S, Kleine A, Sellors J, Luciani S, Sankaranarayanan R, Barone MA. Evidence-based, alternative cervical cancer screening approaches in low-resource settings. Int Perspect Sexual Reproduct Health. 2009;35(3):147-52.
Aswathy S, Quereshi MA, Kurian B, Leelamoni K. Cervical cancer screening: Current knowledge and practice among women in a rural population of Kerala, India. Indian J Med Res. 2012;136(2):205-10.
Cervical Cancer Awareness Measure Toolkit Version 2.1 Updated 09.02.2011. Cancer Research UK. Available at http:// www.cancerresearchuk.org/
Jia Y, Li S, Yang R, Zhou H, Xiang Q, Hu T, Zhang Q, Chen Z, Ma D, Feng L. Knowledge about cervical cancer and barriers of screening program among women in Wufeng County, a high-incidence region of cervical cancer in China. PloS one. 2013;8(7):e67005.
Siddharthar J, Rajkumar B, Deivasigamani K, Knowledge and Awareness of Cervical Cancer and Its Prevention in Women Attending a Tertiary Care Hospital J Clinic Diag Res. 2014;8(6):OC01-3
Kumar HH, Tanya S. A Study on Knowledge and Screening for Cervical Cancer among Women in Mangalore City Ann Med Health Sci Res 2014; 4(5):751-6.
Ackerson K, Gretebeck K. Factors influencing cancer screening practices of underserved women. J Am Acad Nurse Pract. 2007;19(11):591-601.
Radha KR, Reena RP. Factors Associated with Delayed Reporting of Invasive Carcinoma Cervix in a Rural Tertiary Care Center. J Obstet Gynecol India. 2016;66(1):417-21.