Abstract
ObjectivesOur study aimed to assess adult women’s knowledge of human papillomavirus (HPV) and cervical cancer, and characterize their attitudes towards potential screening and prevention strategies.MethodsWomen were participants of an HIV-discordant couples cohort in Nairobi, Kenya. An interviewer-administered questionnaire was used to obtain information on sociodemographic status, and sexual and medical history at baseline and on knowledge and attitudes towards Pap smears, self-sampling, and HPV vaccination at study exit.ResultsOnly 14% of the 409 women (67% HIV-positive; median age 29 years) had ever had a Pap smear prior to study enrollment and very few women had ever heard of HPV (18%). Although most women knew that Pap smears detect cervical cancer (69%), very few knew that routine Pap screening is the main way to prevent ICC (18%). Most women reported a high level of cultural acceptability for Pap smear screening and a low level of physical discomfort during Pap smear collection. In addition, over 80% of women reported that they would feel comfortable using a self-sampling device (82%) and would prefer at-home sample collection (84%). Nearly all women (94%) reported willingness to be vaccinated to prevent cervical cancer if offered at no or low cost.ConclusionsThese findings highlight the need to educate women on routine use of Pap smears in the prevention of cervical cancer and demonstrate that vaccination and self-sampling would be acceptable modalities for cervical cancer prevention and screening.
Highlights
Cervical cancer is a preventable disease, yet the number of cases globally is expected to almost double by the year 2025 [1]
Infection with high-risk genotypes of human papillomavirus (HRHPV) is the primary cause of invasive cervical cancer; over 70% of all cervical cancers are attributable to infection with HPV-16 and 18 [2,3]
In 2008, WHO estimated that cervical cancer was the second most common cancer among Kenyan women [1], yet screening coverage is currently very low, according to the Kenyan national cervical cancer prevention strategic plan for 2012–2015 released in January of 2012 [5]
Summary
Cervical cancer is a preventable disease, yet the number of cases globally is expected to almost double by the year 2025 [1]. High rates of cervical cancer mortality persist due to lack of effective screening programs and low uptake of Pap smear testing [9]. Reasons cited for the low uptake of screening include lack of awareness, inadequate access, exam discomfort, fear of finding cancer and logistical issues associated with obtaining screening [10,11]. Newer technologies such as the careHPV DNA test (QIAGEN, Gaithersburg, MD, USA), cervico-vaginal self-sampling, and HPV vaccination have the potential to increase screening and reduce cervical cancer in developing countries [12,13,14]
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