Abstract
BackgroundCervical cancer is the most common cancer among women in Kenya. However, only 3% of women are routinely screened. This study aimed to assess women’s knowledge and attitudes towards cervical cancer and cervical cancer screening in Kenya’s Isiolo and Tharaka Nithi counties.MethodsA cross-sectional survey was conducted between January and March 2017. Using a multistage cluster sampling methodology, 451 women 18 years of age and older participated in the study. Interviewers administered a 35-item questionnaire collecting demographic information, knowledge of risk factors and attitudes towards cervical cancer and cervical cancer screening. Bivariate and multivariate analyses of cervical cancer knowledge and demographic characteristics were conducted.ResultsThe response rate for the study was 98% (451/460). Two-thirds of the study participants originated from Tharaka Nithi county (n = 318). Respondents reported a median age of 32; 70.5% were married; and 35.0% had primary education. Eighty percent of the participants were aware of cervical cancer, 25.6% of whom had previously undergone a cervical screening examination, and 44.4% had above-average knowledge of risk factors of cervical cancer. Knowledge of cervical cancer risk factors was significantly associated with employment status (adjusted odds ratio = 1.6; 95% CI: 1.0–2.6) and county of origin (adjusted odds ratio = 2.8; 95% CI: 1.6–5.0). Almost all (89.2%) of those who had heard of cervical cancer categorised it as “scary”. There was a marginal significant difference in the overall attitude assessment score towards cervical cancer between participants from Isiolo and Tharaka Nithi counties; the mean (SD) score was 2.13 (0.34) and 2.20 (0.30) respectively. The score was comparatively higher among participants residing in Tharaka Nithi (95% CI: 0.002–0.146; p = 0.043).ConclusionsInterventions to increase cervical cancer knowledge are needed in Isiolo and Tharaka Nithi counties, Kenya. Additional research is needed to further understand and assess the effectiveness of different strategies to improve attitudes regarding cervical cancer in order to increase the uptake of screening services, particularly among less-educated women and those in hard-to-reach areas.
Highlights
Cervical cancer is the most common cancer among women in Kenya
The participants in Tharaka Nithi county were significantly older, 64.5% were over the age of 29 years of age compared to the participants in Isiolo county (51.1%) (OR = 1.7; 95% confidence intervals (CI): 1.1–2.7)
Over half of the participants in Tharaka Nithi (54.1%) had attained primary level of education compared to the participants in Isiolo (25.6%) (OR = 3.4; 95% CI: 2.1–5.5)
Summary
Cervical cancer is the most common cancer among women in Kenya. only 3% of women are routinely screened. The highest incidence rates of cervical cancer occur in eastern, western and southern Africa, with age-standardised rates of 34.5, 33.7 and 26.8 cases per 100,000 population, respectively [1]. This high burden of disease is largely a result of lack of access to screening services and inadequate screening uptake due to female patients’ limited knowledge or fears about cervical cancer screening [2,3,4]. In resource-poor settings, it is estimated that less than 5 % of women are screened for cervical cancer compared to 40.0 to 50.0% in high-income countries [6]
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