Abstract
Background and ObjectiveChina has a high burden of cervical cancer (CC) and wide disparities in CC burden exist among different socio-economic regions. In order to reduce these disparities, China’s government launched the National Cervical Cancer Screening Program in Rural Areas (NCCSPRA) in 2009. Understanding the factors associated with underutilization of CC screening among target populations is important to improve the screening participation rate, and a high participation rate is key to achieving the goals of a screening program. However, data on the knowledge of CC among target populations in program areas is lacking in China. This study will investigate the knowledge of CC prevention and control among women in specific project counties to develop a better understanding of factors that might influence CC screening participation in order to improve the implementation of the NCCSPRA.Materials and MethodsA cross-sectional survey was conducted and face-to-face interview questionnaires were completed by 308 women who received CC screening services in 6 project counties of NCCSPRA across different socio-economic regions of China. ANOVA and Chi-square tests were used to compare the knowledge rates and scores across the different subgroups. Logistic regression was conducted to examine factors associated with knowledge level.ResultsThe overall CC knowledge rate of the target population was only 19.5%. Regional socio-economic level, advice from doctors, age, and educational status were strong predictors of knowledge level of CC screening. Significantly lower knowledge rates and scores were identified in older women (55–64 years old), less educated women (with primary school or illiterate), women in less developed regions and women who did not receive any advice about screening results from doctors.ConclusionThe knowledge of CC screening among women in the project counties of NCCSPRA was found to be very poor. Given the importance of knowledge in encouraging women to participate in screening is key to reducing CC burden in rural women in China, it is urgent that a targeted health promotion intervention is developed and implemented in project counties, especially targeting older women, women with less education and women in less developed regions, and focus on improving their CC knowledge and encouraging them to communicate with health care providers. The health promotion intervention targeting health care providers is also important to improve their knowledge of CC and provide best advice to women.
Highlights
IntroductionCervical cancer caused by sexually-acquired persistent infection with high risk human papillomavirus (HPV), continues to be a global public health problem in the world, and the vast majority of CC deaths occur in women living in developing countries, like China [1]
China has a high burden of cervical cancer (CC) and wide disparities in CC burden exist among different socio-economic regions
This study will investigate the knowledge of CC prevention and control among women in specific project counties to develop a better understanding of factors that might influence CC screening participation in order to improve the implementation of the National CC Screening Program in Rural Areas (NCCSPRA)
Summary
Cervical cancer caused by sexually-acquired persistent infection with high risk human papillomavirus (HPV), continues to be a global public health problem in the world, and the vast majority of CC deaths occur in women living in developing countries, like China [1]. Experience in developed countries has shown that organized high quality screening programs can significantly reduce the number of new cases of CC and the mortality rate associated with them [9, 10]. Beginning in 2009, a free National CC Screening Program in Rural Areas (NCCSPRA), sponsored by government was launched in 221 counties, covering every province and autonomous region [11]. From 2009 to 2011, 11.69 million rural women aged between 35 and 59 years in 221 pilot counties, covering 31 provinces and autonomous regions received this free service [13]. In order to reduce these disparities, China’s government launched the National Cervical Cancer Screening Program in Rural Areas (NCCSPRA) in 2009.
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