Cervical Cancer Risk Perceptions and Justifications Among Women in Rural El Salvador [22J

Abstract

INTRODUCTION: To describe cervical cancer risk perceptions and justifications among women in rural El Salvador. METHODS: Salvadoran women participating in a cervical cancer educational session were asked in an open-ended manner to describe their self-perceived cancer risk and explain their justification for that belief. Responses were recorded as close to verbatim as possible. Women were later given a cervical cancer screening appointment, for which attendance was recorded. Two investigators performed content analyses coding and categorized participant’s risk perceptions and justifications; agreement was assessed with Cohen’s Kappa correlations. Associations between self-perceived risk, risk perception justifications, and screening attendance were assessed with Pearson’s Chi-square statistics. RESULTS: Of 409 participants, 187 (45.7%) women viewed themselves at risk of cervical cancer, 65 (15.9%) not at risk, and 157 (38.4%) unsure. Justification for those beliefs included the perception of having an ability or inability to change their cancer risk and that cancer risk was associated with certain risk factors or indiscriminate. Women viewing themselves at risk of cervical cancer were less likely to attend screening. Women believing they lacked ability to affect their cancer risk and those believing cancer to be indiscriminate more frequently reported being at risk. Additionally, the perception that cancer risk is indiscriminate was associated with decreased attendance. CONCLUSION: This study revealed themes that women’s decisions to participate in cervical cancer screening is influenced by beliefs regarding personal risk and sense of control over those risks. Understanding these motivations may allow public health programs to tailor cervical cancer education to improve screening participation in Latin America.