Awareness of cervical cancer and screening in Benin and Cameroon: an analysis of the Demographic and Health Survey, 2017-2018

Background: Cervical cancer is a leading cause of cancer death in many developing countries. Cervical cancer can be prevented by screening and treatment of premalignant lesions of the cervix. Primary healthcare centers are the health centers closest to the grassroots in Nigeria and thus may be appropriate for population-based cervical cancer screening programs. This study sought to assess awareness of cervical cancer and its screening methods among women attending primary healthcare centers in Zaria, Nigeria. Methodology: It was a cross-sectional study. Participants were women accessing healthcare in primary healthcare centers in Zaria. Eight primary healthcare centers in Zaria were purposively selected for the study. Data were obtained by focus group discussions (FGDs). The FGDs were tape-recorded and transcribed verbatim. The transcripts obtained were analyzed into themes based on the objectives of the study. Results: The mean age of respondents was 26 years (standard deviation 4.9 years). Many participants were aware of symptoms of cervical cancer; however, they were not aware of the risk factors. Pap smear was the only screening method known to participants. Conclusion: Awareness of cervical cancer and cervical screening did not reflect adequate knowledge about cervical cancer and screening methods. There is a need for healthcare providers to offer adequate health education about the disease and screening methods.

This study ascertained the awareness, attitude and acceptance of cervical cancer screening among mothers in Obowo and Owerri North L.G.A. in Imo State. The study was carried out using a descriptive cross sectional research design, having four research questions and two hypotheses. The population of the study comprised 1240 women in Obowo and Owerri North LGAs and a sample size of 302 women were selected from the two groups of women. This size was determined using the Taro Yamane formula. The instrument used for data collection was a questionnaire sectioned in 4 parts viz A for awareness of cervical cancer; B- attitude of women towards cervical cancer screening; C- acceptance level of cervical cancer screening; and D- barriers to uptake of cervical cancer screening. The research questions were answered using mean scores while the hypotheses were tested using chi-square statistics on SPSS 24. The major findings are that fifty-seven (57.00%) and (38.40%) of the respondents in Obowo and Owerri North have good awareness of cervical cancer while 43.00% and 61.50% have poor awareness of cervical cancer and this awareness is significantly related to demographic variables; majority of the respondents in Obowo and Owerri North have positive attitude towards cervical cancer screening (2.83 and 2.58 respectively). However, women of Obowo have a higher mean attitude score than women of Owerri North; among the women who have not undergone the test, only 33.30% of the women in Obowo are willing to take up the test and only 34.20% of the women in Owerri North are willing to take up cervical cancer screening implying that both women in the LGAs have low rate of acceptance of cervical cancer screening among them and acceptance is significantly related to awareness (p<.05); among the respondents who have not taken the screening, their major barriers are fear of pain (60%), cost implications (45.40%), fear of diagnosis (36.10%), free screening (48.80%) and many more. The researcher recommends among others that every woman of childbearing age should take up cervical cancer screening.

Major health inequalities exist surrounding the utilisation of cervical cancer screening services globally. Jordan, a low- and middle-income country, has poor screening rates (15.8%), with barriers to accessing services, including lack of education. Emerging studies demonstrate that intimate partner violence (IPV) impacts reproductive health decisions. As a large proportion of Jordanian women have reported experiencing IPV, this study examines the association between IPV and cervical cancer screening in Jordan, the first of its kind using national-level data. Using Jordan's Demographic Health Survey 2017-18, cervical cancer screening awareness and self-reported screening were estimated in participants who answered questions on IPV (n = 6679). After applying sample weights, Heckman's two-stage probit model determined the association of awareness and utilisation of cervical cancer screening with experience of IPV, adjusting for the socio-economic factors. Of the women with privacy to answer the IPV module, 180 (3.4%) were found to be victims of sexual violence, 691 of physical violence (12.6%) and 935 (16.2%) of emotional violence. Women subjected to sexual violence were less likely to admit to having awareness of a Pap smear test; however, this did not impact screening rates. Victims of emotional violence were more likely to be screened than non-victims. No association between physical violence and cervical cancer screening was found. A significant association between cervical screening awareness and IPV demonstrates that cancer screening policies must consider IPV among women to improve screening awareness. The paper further sheds light on the paradoxical association between emotional violence and screening. It is acknowledged this situation may be far worse than reported, as women without autonomy were unlikely to answer IPV questions that may endanger them-targeted surveys on cervical cancer screening warrant further investigation.

Aim. Cervical cancer is the most common genital malignancy and one of the leading causes of death among female population in Slovakia. At present, this location of cancer is preventable disease visible in screening for premalignant lesions if the women use and participate in such screening regularly. We assessed the knowledge on the cervical cancer screening, the attitude towards it and its utilization among women in Slovakia. Material and methods. A cross-sectional study evaluated the knowledge, attitude and practice of cervical cancer prevention and screening among women. The sample was composed of 239 women aged 18-64 years. Data collection was conducted by selfadministered questionnaire in a period from January to April 2015. Results. Respondents exhibited an average knowledge of cervical cancer, about risk factors and early signs, but awareness of cervical cancer screening was satisfactory. Despite the fact that respondents expressed good attitude to cervical cancer screening, their level of practice was low (64% participation in preventative gynaecology check-ups and 43% in Pap smear tests within one year and 44% within three years). In the study we could observe better results in women with higher education when it comes to an illness (p < .001), its prevention (p < .001) and risk behaviour (p < .001). Conclusions. The awareness of cervical cancer among women in Slovakia is limited. In the future there is a need to educate and promote awareness of cervical cancer among women to reduce the burden of morbidity and mortality.

BackgroundReducing cervical cancer mortality and morbidity using visual inspection with acetic acid (VIA) is a primary option, particularly in resource constrained countries. Although VIA screening is a priority program in Ethiopia, there is limited scientific evidence on prevalence of VIA screening service utilization and factors influencing screening practices in the community. This study aimed to assess the magnitude of visual inspection with acetic-acid (VIA) service utilization and associated factors in an urban community among women in Hawassa city, Southern Ethiopia.MethodsThis community-based cross-sectional study was conducted among women aged 30–49 years old who were residents of Hawassa city. The study population (n = 419) was recruited using a multistage random sampling technique. A pretested and structured interviewer-administered questionnaire was used to obtain information on sociodemographic characteristics, reproductive and behavioral variables, awareness of cervical cancer and VIA screening, and VIA screening practices. Multivariate logistic regression models were used to determine factors associated with VIA screening service utilization.ResultsA total of 411 women aged 30–49 were interviewed with a response rate of 98.1%. The visual inspection with acetic-acid (VIA) screening service was utilized by 85 women (20.7%). Multivariable logistic regression analysis showed that use of VIA screening service was significantly associated with older age (adjusted odds ratio (AOR) = 4.64, 95%CI: 2.15–10.01), having a history of sexually transmitted infection (STI), (AOR = 3.90, 95%CI: 2.02–7.53), having awareness about cervical cancer and VIA screening (AOR = 3.67, 95%CI:1.68–8.04), self-perceived susceptibility (AOR = 3.52,95%CI:1.74–7.13),receiving information from health workers (AOR = 4.519, 95%CI: 1.686–12.114) and having received community health education from health extension workers (AOR = 6.251, 95%CI:2.994–13.050).ConclusionSelf-reported use of VIA screening was low in the study area. Age of participants, history of STI, awareness of cervical cancer and VIA screening, self- perceived susceptibility, receiving information from health workers and community health education from health extension workers were associated with increased prevalence of VIA screening service utilization. These findings suggest that educational and clinical interventions at the community levels and in healthcare facilities should be strengthened to improve cervical cancer risk knowledge, and to encourage women to seek cervical cancer screening in approved settings to order to increase utilization of the service.

Background: Cervical cancer poses a significant disease burden on the public health system, particularly in low- and middle-income countries (LMICs), such as India, which is responsible for almost one-fifth of cervical cancer cases reported globally. The primary causative factor is the persistent Infection caused by high-risk types of human papillomavirus (HPV), especially types 16 and 18. Pap smear screening and HPV vaccination are primary prevention methods, yet awareness of both measures and participation levels remain low, even among urban populations with easier access to healthcare than rural populations. Purpose: This article aims to evaluate urban women's level of knowledge and awareness of cervical cancer and Pap smear screening and HPV infection, particularly in regard to barriers to the effective uptake of preventive practice. Methodology: The study was a hospital-based cross-sectional design that took place over a year, enrolling 96 urban women aged 21-65 years who were identified from a tertiary care hospital in Bihar, India. Data were collected using the pretested structured questionnaire through a 'face-to-face interview' that provided sociodemographic data along with questions related to cervical cancer knowledge, Pap smear screening, and HPV. Statistical analysis was done using a SPSS v27 version, with significance level set at p<0.05. Results: Low levels of initial awareness of cervical cancer risk factors, Pap smear screening, and HPV infection were evident. Significant barriers that influenced screening and vaccination uptake included misconceptions, cultural stigma, and a lack of sufficient counselling. Conclusion: There are significant gaps in knowledge for urban women on cervical cancer prevention. There is an urgent need for programs delivering community education, the provision of affordable screening programs, and timely HPV vaccination campaigns to be offered to communities to manage the disease burden.

Background:Cervical cancer is the second most common cancer in women in Nigeria and is largely preventable. However, in Nigeria, the absence of universal screening means individual awareness and knowledge significantly impact screening uptake. Previous studies have reported mixed results regarding awareness and screening rates.The study assessed cervical screening uptake rate among women of reproductive age.Methodology:It was a descriptive cross-sectional study among women of reproductive age across the three senatorial districts in Ogun State, Nigeria, using interviewer-administered questionnaires following ethical approval. Data analysis was performed using IBM SPSS version 25. The outcome variables included the level of awareness and knowledge of cervical cancer and its pre-malignant screening, as well as the level of uptake of cervical cancer.Results:A total of 1310 women were interviewed, with 1233 responses analyzed. The mean age of the respondents was 32.33 ± 6.25 years. Of the respondents, 592 (48.0%) were aware of cervical cancer, 281 (22.8%) were aware of cervical screening, and 141 (11.4%) had good knowledge of cervical cancer. Eighty (6.49%) participants had been screened at least once, and only nine had been screened at least twice. The majority of the women, despite the poor awareness and knowledge levels, were willing to be screened in the future. There was a statistically significant association between cervical cancer awareness and uptake of screening (X2 = 9.282, df =1, P-value = 0.002).Conclusion:Awareness, knowledge, and screening uptake remain low among women in Ogun State. However, awareness of cervical cancer positively influences screening participation. Therefore, extensive awareness campaigns are recommended to improve screening rates and reduce cervical cancer prevalence.

BackgroundCervical cancer is a disease of public health importance affecting many women and contributing to avoidably high levels of cancer deaths in Nigeria. In spite of the relative ease of prevention, the incidence is on the increase. This study aimed to determine the effect of health education on the awareness, knowledge and perception of cervical cancer and screening among women in rural Nigerian communities.MethodsThe study design was quasi-experimental. The study was carried out among adult women in Odogbolu (intervention) and Ikenne (control) local government areas (LGA) of Ogun state. Three hundred and fifty (350) women were selected per group by multistage random sampling technique. Data was collected by semi structured interviews with the aid of questionnaire. The intervention consisted of structured health education based on a movie.ResultThe intervention raised the level of awareness of cervical cancer and screening to 100% (p < 0.0001). The proportion of women with very good knowledge of cervical cancer and screening rose from 2% to 70.5% (χ2 = 503.7, p < 0.0001) while the proportion of those with good perception rose from 5.1% to 95.1% (p < 0.0001). The mean knowledge and mean perception scores were also increased (p < 0.0001). There was increase in the proportion of women who had undertaken cervical screening from 4.3% to 8.3% (p = 0.038). The major reason stated by the women for not having had cervical screening done was lack of awareness about cervical cancer and screening. There was statistically significant difference between the intervention and control groups concerning their knowledge attitude and practice towards cervical and screening (p < 0.05) after the intervention.ConclusionMultiple media health education based on a movie is effective in creating awareness for and improving the knowledge and perception of adult women about cervical cancer and screening. It also improves the uptake of cervical cancer screening. The creation of awareness is very crucial to the success of a cervical cancer prevention programme.

Objective: To find out the knowledge, attitude and practice regarding cervical cancer screening among women. Materials and methods: A descriptive cross-sectional study design was used to collect data from 96 women. Each woman was selected alternately from Gynae Out-Patient Department of Teaching Hospital. Data was collected by using semi-structured interview schedule to find out knowledge and practice and Likert scale to find out the attitude regarding cervical cancer screening. Data was analyzed by using SPSS version 20.0 and interpreted in terms of descriptive and inferential statistics.Results: Out of 96 women, mean age was 38.83 ± 6.57 and 90.6% respondents followed Hinduism. More than three fourth (85.4%) were literate and 59.4% were housewife. Only 9.4% were involved in cervical cancer prevention and screening awareness programme and 2.1% had family history of cervical cancer. As per the findings, only 34.4% and 27.8% had adequate knowledge and practice respectively whereas cent percent women had favorable attitude. Only education level of women was statistically significant with level of knowledge regarding cervical cancer screening (p = 0.041). There was strong negative correlation between knowledge score and practice score regarding cervical cancer screening among women (r = -0.194).Conclusion: Considerable proportions of women have inadequate knowledge and practice regarding cervical cancer screening. Therefore cervical cancer screening health camps and awareness program should be conducted at community level for women to increase the level of knowledge and practice regarding cervical cancer screening.

Background: Cervical cancer is the third most common cancer affecting Malaysian women despite being highly preventable through screening. A national cervical cancer screening program has been established since 1969 to ensure early detection of cervical cancer. Nonetheless, the prevalence of cervical cancer in Malaysia remains high. Malaysia has been offering Pap tests for free in community health clinics since 1995, however only 47.3% of women have been screened. It has also been reported that nearly 40% of patients with cervical cancer presented at advanced stages of the disease. Government community healthcare professionals are the main stakeholders in the national cervical screening program. Therefore, understanding these healthcare professionals’ perspective of barriers associated with underutilization of cervical cancer screening is key to increase overall screening uptake. Aim: This study aimed to explore healthcare professionals’ views on perceived barriers to cervical screening in Malaysia. Methods: Qualitative in-depth semistructured interviews were carried out with 44 primary healthcare professionals consisting of family medicine specialists (N = 5), medical officers (N = 9), matrons and nurses (N = 20), laboratory technician (N = 5), registration staff and IT technicians (N = 5) involved in the cervical screening program at 5 different urban government healthcare clinics in Petaling district. The interviews were transcribed verbatim and analyzed using a thematic analysis approach. Results: Themes emerged were individual and system barriers. Individual barriers include knowledge/risk perception (lack of knowledge and awareness of cervical screening, low perceived risk), distress (Pap test is embarrassing or painful, previous negative Pap test experience and fear of a cancer diagnosis) and coping skills (remembering the appointment, managing responsibilities such as getting child care/elder care/coverage at work, ability to get transportation), social-cultural barrier (family support); while system barriers highlight the long waiting time for cervical screening, poor documentation, no national call-recall system, patient overload, lack of resources and manpower, lack of educational materials and problems with opportunistic screening. Conclusion: Sustainable screening interventions require approaches that address and resolve both individual and system barriers, such as exploring new methods and delivery of cervical screening, and providing education for the public and healthcare providers.

Background: The awareness of cervical cancer, Papanicolaou’s smear and its utilization is of great importance especially in our environment where cervical cancer is the number one cancer affecting women. This study was aimed at investigating the risk factors and awareness of cervical cancer screening with Papanicolaou’s (Pap) smear and its utilization among female undergraduates. Materials and Method: This is a descriptive cross-sectional study that was conducted among 397 female undergraduates of the Benue State University, Makurdi between May and June 2016. Results: One hundred and eighty-six (49.6%) of the respondents were sexually active and ninety-six (51.6%) of the sexually active respondents had been exposed before the age of 20 years. Their ages for sexual debut ranged from 13 to 25 years. Their mean age at sexual debut was 18.3 (±2.3) while the modal age was 19 years. Fifty-one (27.4%) of the sexually active students had multiple sexual partners, sixty-three (33.9%) had been pregnant at one time or the other, and only 32 (17.2%) of these sexually active students were using condom during intercourse. Two hundred and eighty-six (72.0%) were aware of cervical cancer. There was a fair level (55.7%) of awareness of cervical cancer as a preventable cancer but there was poor knowledge of individual preventive methods. Only 26.2% were aware of Pap smear and worse still, only 3.3% of them had ever done the test. The main source of awareness was through the mass media. Conclusion: This study showed that there was good knowledge of cervical cancer among respondent but there was poor knowledge of Pap smear and its utilization. It is therefore important that concerted efforts be made to educate students at the university about cervical cancer and its prevention methods.

Caribbean women experience a cervical cancer incidence rate that is three times higher than that among their North American counterparts. In this study, we performed a needs assessment of the knowledge and awareness of HPV, HPV vaccination, and cervical cancer and receipt of cervical cancer screening among an indigenous Caribbean community. We purposively recruited individuals aged ≥18 from a community health care clinic (n = 58) to complete a 57-item structured interview including items on demographics, cancer history, knowledge and awareness of HPV, HPV vaccines, cervical cancer, and cervical cancer screening. Participants’ mean age was 47.1 years (SD: 14.4). Most were female (74.1%), were married/partnered (51.7%), had primary education (63.8%), and identified as Kalinago (72.4%). Whereas 79.5% had heard of cervical cancer, few had heard of HPV (19.6%) or the HPV vaccine (21.8%). Among those who knew someone with cancer, 90.9% had heard of the HPV vaccine, compared with only 9.1% of those who did not know anyone with cancer (p = 0.02). Access to HPV vaccination is an immediate, cost-effective cancer prevention priority for reducing the disproportionate burden of HPV-related cancers, particularly cervical cancer, in the Caribbean. We recommend culturally targeted education interventions to improve knowledge about HPV vaccination and the link between HPV and cervical cancer.

Cervical cancer is the 4^th most prevalent cancer among women worldwide. The incidence rate of cervical cancer is low in Australia. Despite the use of vaccinations and cervical screening programs in Australia, migrant women living in Sydney still face significant health disparities when accessing cervical cancer screening services. Overall, there are limited studies that explore the barriers and facilitators that migrant women are exposed to when accessing cervical screening tests. The aim of this study is to describe the attitudes, beliefs, knowledge and awareness of cervical cancer screening and screening practices amongst migrant women aged 25 and above living in Sydney, Australia for more than one year with no history of cervical cancer. Fifty-two women (30 South-East Asian, 12 Middle Eastern & 10 African) were recruited using two non-probabilistic sampling methods, convenience and snowball sampling. Data was collected through Focus Group Discussions (FGDs). In total, 5 FGDs were conducted in homogenous groups of 8-12 participants. Each FGD was audio-recorded and verbatim transcribed. The data were analysed using thematic analysis. Results show that average age of the participants were 38 years, majority were from South East Asia (58%), married (87%), unemployed (65%), had tertiary education (67%), were in low income categories (84%), and a third (35%) living in Australia for < 5 years. Results further show that migrant women living in Sydney displayed a lack of awareness and knowledge about cervical cancer and screening practices. Individual and system-level barriers and facilitators that influenced screening attendance were identified. Factors such as lack of knowledge, emotional barriers, cultural and religious barriers, psychological barriers, and organisational factors influence screening practices. Furthermore, results also revealed that African migrants were less likely to be aware of cervical cancer and screening compared to South-East Asian and Middle Eastern women. Our study also reported that short-term migrants had an overall lack of awareness about cervical screening and therefore, differences in migration status must be considered when administering health education programs. Understanding migrant women’s experiences, facilitators, and barriers to accessing cervical screening is essential in assisting health care professionals and policy makers to provide culturally appropriate services. Provision of training or programs to increase culturally appropriate health services amongst health care providers is also recommended. To increase cervical cancer screening uptake of migrant women living in Sydney, culturally appropriate education programs and health promotion strategies targeted towards different ethnic groups need to be administered.

e18006 Background: Widespread cervical cancer screening has led to a dramatic reduction in cervical-cancer related mortality in resource-rich regions. However, cervical cancer remains a leading cause of cancer-related death in SSA due in part to a lack of accessible screening and treatment options. Methods: The DHS is a nationally representative household survey designed by ICF International and typically implemented every 5 years. In addition to demographic characteristics, select surveys collect data on cervical cancer awareness and screening. We included women aged ≥21 years from Côte d'Ivoire, Kenya, Namibia, and Zimbabwe who participated in the DHS. After sample weights were applied, we used logistic regression to examine associations of demographics and national cervical cancer incidence (as per the International Agency on Research on Cancer) with cervical cancer screening. Factors with p &lt; 0.20 in bivariate analyses were included in a multivariate model. Results: We analyzed data from 45,947 women aged 21 to 49 years (mean = 32.2); 69% were married with an average of 3 children. Nearly half had completed secondary education (47%), 73% were literate, and 48% belonged to the highest two wealth quintiles. Over 70% of women were aware of cervical cancer; 24% of all women reported a previous screening exam with variation by country. Namibia, with the highest rates of screening (46%), had the lowest incidence. In multivariate analyses, cervical cancer screening was associated with increasing age (OR = 1.06; CI = 1.05, 1.07), education (OR = 1.48; CI = 1.30, 1.69), literacy (OR = 1.80; CI = 1.53, 2.13), and wealth (OR = 1.14; CI = 1.09, 1.20). Higher cervical cancer incidence at the national level (OR = .980; CI = .976, .983) and rural residence (OR = .839; CI = .738, .953) were inversely associated with odds of cervical cancer screening. Conclusions: Based on DHS data from four SSA countries, awareness of cervical cancer is high, but receipt of cervical cancer screening is low and may be associated with reductions in cervical cancer incidence. Targeted efforts to increase utilization of cervical cancer screening in SSA are warranted to reduce the preventable burden of cervical cancer.

Aim:Screening for early detection and treatment of cervical cancer is a cornerstone of prevention. The purpose of this study was to assess the awareness in women about the utilization of cervical cancer screening services in Vhembe District, South Africa.Methods:This cross-sectional study involved a random selection of 500 women aged 20-59 years in Vhembe District, Limpopo Province, South Africa. Data was collectedviaa self-structured questionnaire on the demographic variables, provision, utilization and awareness of cervical cancer screening services.Results:The majority of the participants agreed to have cervical cancer screening services in their clinics (79.2%), and never had a Pap smear (58.6%). Most women would not go for cervical cancer screening, mainly because of a lack of facilities (30.0%), fear of pain (24.4%), and embarrassment (15.2%). Most participants indicated that Pap smear test meant scraping the cervix to detect abnormal cancerous cells (39.2%) and 34.2% did not know a Pap smear. Majority of the participants indicated Pap smears should be done every 10 years (65.8%); Pap smears could detect cervical cancer earlier (66.8%), and had heard about cervical cancer (71.6%). The majority of the participants considered cervical cancer as a serious problem to warrant considerable attention (59.4%); and some perceived cervical cancer as transmittable through multiple sexual partners (22.2%). The majority of the participants were aware of a vaccine against cervical cancer for girls at school (69.0%), and it was indicated that government should use health education to encourage women to attend cervical screening services (51.6%).Conclusion:Despite the free availability of cervical cancer screening services and awareness, the utilization of cervical cancer screening services is low. There is a need to intensify cervical screening health talks and campaigns, and to provide alternative accessible options for screening services for women in rural areas.