Cervical Cancer Screening Practices Research Articles

General cancer screening practices among adult survivors of retinoblastoma: Results from the Retinoblastoma Survivor Study.

We assessed breast, cervical, and colorectal cancer screening practices in adult retinoblastoma (Rb) survivors and non-Rb controls. We found that most Rb survivors adhered to general population cancer screening recommendations. Rates did not differ among Rb survivors and non-Rb controls, or among survivors by laterality, even though bilateral survivors reported higher levels of concern about future health and cancer risk. Older age, being overweight/obese, and lack of recent contact with medical personnel were independently associated with decreased utilization of Pap smear among female Rb survivors. Future studies are warranted to determine whether these associations might provide an opportunity for intervention.

The importance of information, motivation, and behavioral skills (IMB): Healthcare provider perspectives on improving adherence to cervical cancer screening among at-risk women

ObjectiveTo understand the theoretical framework of how information, motivation, and behavioral skills (IMB) independently and collectively affect cervical cancer screening and testing adherence. Study designQualitative study. MethodsData collected from three focus groups and seven individual interviews, with 33 healthcare providers, ranging from community health navigators, Ob-Gyn MD’s, nurses, care coordinators, medical assistants, and outpatient managers, representing a grassroots community health agency, a large cancer center, and a public sector health clinic. We recruited providers over a five-month period in the summer to fall of 2019. Provider interviews and focus groups were structured with four to eleven participants per group and were audio-recorded. This study was rooted in grounded theory, analyzing data using the iterative process of Coding, Consensus, Co-occurrence, and Comparison to identify common themes. ResultsEmerging qualitative findings include the relevance of information, the interaction between information and motivation, the role of behavioral skills, and the symbiotic relationship between information, motivation, and behavioral skills (IMB). Most notable is this interdependency between IMB components, with the core of this relationship being the critical link of coordinating adherence. ConclusionThis knowledge will help advance and expand IMB intervention components to improve time to cervical cancer screening and follow-up adherence among at-risk communities. Particularly given COVID-19 barriers, which disproportionately affect at-risk women, this study has practice implications that inform the development of cervical cancer screening practice interventions and strategies to improve adherence, while ensuring safety for both patients and providers.

Knowledge, attitude, and practices of cervical cancer screening in health care providers in a teaching hospital

Introduction: Cervical cancer is the most common cause of mortality and morbidity among women of reproductive age group in the world and is one of the few cancers amenable for prevention. Healthcare providers in hospitals (medical and nursing staff) constitute the most visible, front-line personnel play an integral role in educating women in the prevention of diseases, they can influence regarding cervical cancer screening adherence and health promotion among women. Aim and Objectives: The purpose of this study is to assess knowledge, attitude, and level of awareness regarding cervical cancer among female health care providers with respect to risk factors, screening methods, vaccination, and the barriers in the acceptance of cervical cancer vaccine. Materials and Methods: A descriptive cross-sectional study with self-administered, predesigned, questionnaire for knowledge of symptoms, screening, risk factors for cervical cancer and HPV vaccine in health care providers (n = 100) comprising doctors, nurses over duration of 2 months from May to June 2018 in teaching hospital setting on women aged between 21 and 65 years. Data was analyzed with SPSS17. Chi-square test used for statistical significance. Results: Mean age of respondents was 32.9 years (range 21–54 years). Most participants were aware that cervical cancer is the most common female genital cancer (94%), majority were able to identify the HPV as most important etiological factor (88%) and believed that screening may prevent cervical cancer (92%), awareness about HPV vaccine and screening was known fully in doctors but only 72% of nurses. Knowledge about cancer etiology and screening was low among nurses than doctors. Self-practice and vaccination was low in total study population. Conclusions: Knowledge and awareness on risk factors, cervical cancer screening, and HPV vaccination is more among doctors than on nursing staff, but self-practice and vaccination was low in total study subjects. Knowledge and awareness of cervical cancer among health care providers can help in promoting screening and early diagnosis, reducing cervical cancer morbidity and mortality.

Knowledge, Attitude, and Practice on Cervical Cancer Screening and Associated Factors Among Women Aged 15-49 Years in Adigrat Town, Northern Ethiopia, 2019: A Community-Based Cross-Sectional Study.

BackgroundCervical cancer, mainly attributed to persistent infection with a high-risk oncogenic human papillomavirus (HPV), is one of the most common types of women’s cancer globally, with more than 90% of new cases occurring in developing and resource-limited countries. In Ethiopia, cervical cancer ranks as the most frequent cancer among women and cause for 4732 deaths annually.ObjectiveTo assess knowledge, attitude, practice towards screening on cervical cancer and associated factors among women aged 15–49 years in Adigrat town, northern Tigray Ethiopia.MethodsA community based quantitative study design was conducted among 617 samples in Adigrat town, northern Tigray Ethiopia. Data were collected using a structured, semi-structured, and pre-tested questionnaire. Associations between dependent and independent variables were tested using logistic regression with the assumptions of p-values <0.05 and confidence interval 95% and considered to be statistically significant.ResultsThis study indicated that 46.4%, 53.3%, 38.1% of participants had knowledge, positive attitude, and screened on cervical cancer, respectively. Diploma and above [AOR=3.7, 95% CI (1.443, 9.433) were significant factors associated with knowledge of cervical cancer screening utilization. Primary school (1–8) [AOR=2.7, 95% CI (1.297, 5.699)], greater than 500 ETB household income [AOR = 4.8, 95% CI (2.783, 8.577)] were significant factors associated with attitude of cervical cancer screening utilization. Secondary school (9–12) [AOR = 3.4, 95% CI (1.565, 7.458)], not knowledgeable of cervical cancer [AOR = 1.8, 95% CI (1.156, 2.698)] were significant factors associated with practice of cervical cancer screening utilization.ConclusionFactors like age, educational status, anyone knowing with cervical cancer and ever received cancer information had a significant association with knowledge of cervical cancer screening utilization. Educational status and perceived income of the household had a significant association with an attitude of cervical cancer screening utilization. Educational status perceived income of the household, anyone knowing with cervical cancer, ever received cancer information, and knowledge of cervical cancer screening utilization were predictors of cervical cancer screening practice.

Factors Affecting Cervical Cancer Screening among Women Below 25 Years in Kithare Area, Tharaka Nithi County, Kenya

Cervical cancer is the most common neoplasm among women globally affecting approximately 500,000 women with 275,000 succumbing to the disease every year. The prevalence of cervical cancer is disproportionately high in sub-Saharan Africa where the screening rate is low. The study sought to assess the factors affecting cervical cancer screening among women aged 15 - 25 years in Kithare area Tharaka Nithi County. The study was a descriptive cross-sectional study and interviewer administered questionnaires were used to capture the level of knowledge, individual perspectives, attitude and barriers influencing cervical cancer screening. This study was conducted between August and September 2018 with the sample size being 80 respondents. From the findings a significant number of women had two or more sexual partners. The level of knowledge on cervical cancer was significantly low as (55%, n = 44) were aware about the disease, (45%, n = 36) had the correct knowledge when to seek screening, (40%, n = 32) knew the correct interval for attending screening and only (18.7%, n = 15) had been screened before. Reasons for seeking screening for the 18.7% were to know their health status, due to abnormal discharge or as a result of bleeding. (86.3%, n = 69) believed that screening was helpful with reasons being; for early detection of the disease, to know the health status, to prevent infertility and death. (13.7%, n = 11) believed that screening was not helpful with reasons being; the procedure is uncomfortable, painful, it leads to a low self-esteem, fear of wrong results and the diagnosis of cancer. Barriers citied to cervical cancer screening were; inadequate knowledge, negative attitude towards screening, lack of the screening services and cost of services. The knowledge and practice of cervical cancer screening was inadequate. More education on screening should be provided to reduce the misconceptions involved. Provision of free services and more participation in education and sensitization from the healthcare providers should also be done.

Effect of Age and Parity on Practice of Cervical Cancer Screening Among Women of Child Bearing Age in Anambra State

Effect of Age and Parity on Practice of Cervical Cancer Screening Among Women of Child Bearing Age in Anambra State

Fundamental Elements in Training Patient Navigators and Their Involvement in Promoting Public Cervical Cancer Screening Knowledge and Practices: A Systematic Review.

Background:Cervical cancer screening remains unsatisfactory in some regions due to hindrances. This study aims to explore fundamental elements in training patient navigators and their involvement in promoting screening knowledge and practices.Methods:This systematic review study included only English published articles between 2014 and 2019 from PubMed/Medline, EBSCO, Science Direct, and Wiley online library.Results:Healthcare professionals trained patient navigators in 3 days regarding screening basics, along with group discussions and role-plays. They delivered effective health education and navigation assistance.Conclusion:The group education session facilitated by patient navigators, coupled with navigation care, resulted in a high screening rate.

Comprehensive Knowledge towards Cervical Cancer and Associated Factors among Women in Durame Town, Southern Ethiopia.

Low awareness about cervical cancer and poor screening practice are some of the contributing factors for the high burden of cervical cancer in sub-Saharan Africa. The aim of this study was to assess comprehensive knowledge towards cervical cancer and associated factors among reproductive age women visiting Durame General Hospital. Institution-based cross-sectional study was conducted in April 2019. Systematic random sampling technique was employed to select study participants. Pretested interviewer administered questionnaire was used for data collection. Binary and multiple logistic regression analysis was done. Adjusted odds ratio with a 95% CI was used to determine the presence and strength of associations between independent and outcome variable. Variables with p value less than 0.05 were considered as statistically significant. Among the 237 women enrolled, more than half (55.7%) have ever heard about cervical cancer. Health professionals were major source of information. Half of respondents (51.5%) had good knowledge towards cervical cancer. Urban residence (AOR = 2.28, 95% CI (1.19-4.35)), having formal employment (AOR = 2.92, 95% CI (1.53-5.59)), and knowing someone with cervical cancer (AOR = 5.21, 95% CI (2.32-11.71)) were found to have significant association with good knowledge towards cervical cancer. The comprehensive knowledge of women towards cervical cancer was found to be insufficient. Provision of community-based health education with health professionals needs to be emphasized.

A cross-sectional study on knowledge and attitude towards cervical cancer screening methods among women of reproductive age group in an urban area

Cervical cancer, a malignant tumour of the cervix, the lowermost part of the uterus, is usually associated with Human Papilloma Virus (HPV) infection. Asymptomatic in early stages, it becomes symptomatic as the disease progresses. Cancer cervix can be prevented with HPV vaccines and regular screening practices like the Pap smear test. Poor awareness, lack of knowledge on risk factors, signs and symptoms and socioeconomic limitations serve as barriers for women to take up cancer screening. This study was done to assess the knowledge and attitude towards cervical cancer screening practices among women. A cross-sectional study was conducted using a self-structured questionnaire among urban women of reproductive age group. Data were recorded, tabulated and analysed. Of the 248 women of the reproductive age group who were interviewed, 63% knew that cervical cancer is a leading cause of death among Indian women. Although 68.5% knew that HPV is the causative organism, only a quarter of them knew about the vaccination schedule. Only 42% of those who were aware of the Pap smear test knew the age at which screening had to be started. In conclusion, most of the participants knew about cervical cancer and its causative organism. However, their knowledge on preventive measures, HPV vaccine and Pap smear test was poor.

Disparities in cervical cancer screening participation in Iran: a cross-sectional analysis of the 2016 nationwide STEPS survey

BackgroundOne of the most important concerns in every healthcare system is the elimination of disparities in health service utilization and achievement of health equity. This study aimed to investigate the disparities in cervical cancer screening participation in Iran.MethodsA cross-sectional study was conducted using data from the National Non-Communicable Risk Factors Survey in 2016 (STEPs 2016). Data on cervical cancer screening in addition to demographic and socio-economic factors from 15,975 women aged 18 and above were analyzed. The distribution of surveyed women with regard to cervical cancer screening practice was described. Chi square and logistic regression were used to assess the association of demographic and socio-economic factors with cervical cancer screening participation.ResultsOverall, 52.1% of women aged 30–59 years, had undergone cervical cancer screening at least once in their lifetime. Participation rate in cervical cancer screening programs varied between provinces; ranging from 7.6% in Sistan and Baluchestan to 61.2% in Isfahan. Single marital status, illiteracy, being employed, and having no insurance coverage were associated with lower participation. Age and area of residence were insignificant predictors for participating in cervical cancer screening program. Analysis of the cervical cancer uptake rates across the socio-economic levels revealed that the service is less utilised by high income groups.ConclusionsParticipation in cervical cancer screening program in Iran is not optimal and could be improved. With regard to the distribution of cervical cancer screening practice, social and geographical disparities indicate the need for further research and more comprehensive strategies in order to reduce them.

Knowledge and practice of cervical cancer screening and associated factors among reproductive age group women in districts of Gurage zone, Southern Ethiopia. A cross-sectional study.

BackgroundCervical cancer is a malignant tumor of the lower-most part of the uterus and major cause of morbidity and mortality among women’s in the world. Its high mortality rate in the globe can be reduced through comprehensive approaches’ that include; primary prevention, early diagnosis, effective screening, and treatment packages. This study was aimed to assess the knowledge and practice of cervical cancer screening and its associated factors among reproductive age group women in districts of Gurage zone, Southern Ethiopia, 2019.MethodsA community-based cross-sectional study design was conducted from March 1–30, 2019. A total of 268 respondents were selected using a systematic sampling technique. Data was collected using pretested, semi-structured, and interviewer-administered questionnaires. Data were entered into Epi data version 3.1software and exported to SPSS 24 for analysis. Bivariate and multivariate analyses with a 95% confidence level was done and variables (P <0.05) were deemed statistically significant.ResultA total of 260 respondents participated in the study with a response rate of 97%. About 3.8% of the respondents had experiences cervical cancer screening and 26.2% of respondents had good knowledge. Early age at first sex [AOR = 6.05 (95%CI; 1.167–31.36)], having information about cervical cancer [(AOR = 10.2 (95% CI 1.9–96.4)], and multiple sexual partners [AOR = 3.96 (95% CI; 1.48–10.58)] were factors affecting the practice of cervical cancer screening. Being uneducated [AOR = 15.5 (95%CI; 3.82–62.967)], family history of cervical cancer [AOR = 14.158 (95%CI;3.88–51.7)], having plans to screen for cervical cancer [AOR = 0.352 (95%CI;.175-.710)], menarcheal age [AOR = 2.63 (95%CI;1.28–5.37)] and age at first sex [AOR = 3.17 (95%CI;1.283–7.837)] were factors affecting knowledge of cervical screening.ConclusionThe study findings indicate that respondents’ practice and knowledge of cervical cancer is mainly affected by early age at first sex, having information about cervical cancer, multiple sexual partners, Educational status, family history of cervical cancer, having plans to screen for cervical cancer, age at first sex and age of menarche. Therefore, all concerned bodies need to focus on women in the reproductive age group to increase the level of knowledge and practice of cervical cancer screening through appropriate interventions.

Effect of Age and Parity on Knowledge of Cervical Cancer Screening Among Women of Child Bearing Age in Anambra State

Identification of characteristics of women in terms of age and parity as related to their uptake of existing screening services can give significant data to forming cervical cancer screening administrations. This study was aimed to assess the effect of age and parity on knowledge of cervical cancer screening among women of child bearing age in Anambra State. The study adopted a quasi-experimental research design.The study was conducted at Chukwuemeka Odumegwu Ojukwu University Teaching Hospital Awka and General Hospital Onitsha between June 2019 to September 2019.Using multi-stage (purposive) sampling technique, the sample size for this study consisted of one hundred and eighty four (184) women (134) subjects for experimental group and 50 subjects for control group) attending antenatal in public hospitals in Anambra State. The instrument contained five questions on demographic data of the respondents, questions on knowledge of cervical cancer and practice questions with four point response options. The reliability of the instrument was established by using Cronbach alpha for estimating the internal consistency of the instrument. Data entry and analysis were done using Statistical Package for Social Science (SPSS) and inferential statistics (ANCOVA) was used to test the null hypotheses at 0.05 level of significance.The results showed that all the women of different age groups and women of all parity levels benefitted from the exposure to health education programme. The study therefore concludes that exposing women of child bearing age to health education programme improved the practice of cervical cancer screening practice. The knowledge of cervical cancer, knowledge of cervical cancer screening and knowledge of modes of prevention of cervical cancer are critical in determining cervical cancer screening uptake among the women. It is thus concluded that exposing women of child bearing age to health education programme improved the cervical cancer screening practice than not exposing them to any treatment. With adequate knowledge of cervical cancer and a positive perception of cervical cancer screening, utilization of cervical cancer screening services is uniform among women of all parity level.

Self-reported breast and cervical cancer screening practices among women in Ghana: predictive factors and reproductive health policy implications from the WHO study on global AGEing and adult health

BackgroundBreast and cervical cancers constitute the two leading causes of cancer deaths among women in Ghana. This study examined breast and cervical screening practices among adult and older women in Ghana.MethodsData from a population-based cross-sectional study with a sample of 2749 women were analyzed from the study on global AGEing and adult health conducted in Ghana between 2007 and 2008. Binary and multivariable ordinal logistic regression analyses were performed to assess the association between socio-demographic factors, breast and cervical screening practices.ResultsWe found that 12.0 and 3.4% of adult women had ever had pelvic screening and mammography respectively. Also, 12.0% of adult women had either one of the screenings while only 1.8% had both screening practices. Age, ever schooled, ethnicity, income quantile, father’s education, mother’s employment and chronic disease status were associated with the uptake of both screening practices.ConclusionNationwide cancer awareness campaigns and education should target women to improve health seeking behaviours regarding cancer screening, diagnosis and treatment. Incorporating cancer screening as a benefit package under the National Health Insurance Scheme can reduce financial barriers for breast and cervical screening.

Knowledge, attitudes, and practices of cervical Cancer screening among HIV-positive and HIV-negative women participating in human papillomavirus screening in rural Zimbabwe

BackgroundWomen in low- and middle-income countries are at the highest risk of cervical cancer yet have limited access to and participation in cervical cancer screening programs. Integrating self-collected, community-based screening offers a potential primary screening method in areas of limited resources. In this paper, we present a study evaluating knowledge, attitudes, and practices of cervical cancer and Human Papilloma Virus (HPV) in rural Zimbabwe.MethodsWe performed a community-based cross-sectional knowledge, attitudes and practices of HPV and cervical cancer study in rural Zimbabwe from January 2017–May 2017. Women were selected for the study via random number generation from complete lists of inhabitants in the study area if they satisfied the inclusion criteria (≥30-years-old, ≤65-years-old, not pregnant, intact uterus). If selected, they participated in a 19-question structured knowledge, attitudes and practices survey. The questionnaire included questions on demographics, education, knowledge of HPV, cervical cancer, and risk factors. Chi-squared tests were evaluated comparing knowledge, attitudes and practices relating to HPV and cervical cancer screening with actual infection with HPV. Women were also offered a voluntary HIV and self-collected HPV screening.ResultsSix hundred seventy-nine women were included in the knowledge, attitudes and practices survey. Most women (81%) had heard of cervical cancer while the majority had not heard of HPV (12%). The number of women that had been screened previously for cervical cancer was low (5%). There were no significant differences between and within groups regarding knowledge of cervical cancer and actual overall infection with HR-HPV, HPV 16, and HPV 18/45 test results.ConclusionsMost women in rural Zimbabwe have heard of cervical cancer, but the number that had been screened was low. Extending existing outreach services to include cervical cancer screening, potentially including HPV screening, should include cervical cancer/HPV education and screening triage. This approach would serve to bridge the gap between knowledge and screening availability to address some of the barriers to cervical cancer care still affecting women in many regions of the world.

Assessing Physician Adherence to Guidelines for Cervical Cancer Screening and Management of Abnormal Screening Results.

The aim of the study was to survey obstetrician-gynecologists' cervical cancer screening practices and management of cervical abnormalities to ascertain adherence to guidelines. From January to July 2019, obstetrician-gynecologists at 5 St. Louis area hospitals were surveyed online about cervical cancer screening and management practices through 13 clinical vignettes. Survey scores and the American Society of Colposcopy and Cervical Pathology (ASCCP) app use were compared using Mann-Whitney tests. When screening 30- to 65-year-old participants, 114 (98%) of the 116 total participants used co-testing, but only 71 (61%) screened at 5-year intervals. None used primary human papillomavirus (HPV) testing. For 21- to 29-year-old participants, 17 (15%) screened with annual cytology, whereas 14 (12%) used annual or every 3-year co-testing. Forty eight (41%) screened younger than 21 years, regardless of risk factors or only if immunocompromised. Eleven (9%) continued screening after total hysterectomy for benign indications. Only 2 (2%) responded to all clinical vignettes in adherence to guidelines. More than 30% of participants would pursue unnecessary HPV testing and/or loop electrosurgical excision procedure for persistent low-grade cytology. Fifty eight (48%) incorrectly reported hysterectomy as management for adenocarcinoma in situ on biopsy. Participants would undertreat young women with high-grade abnormalities including high-grade squamous intraepithelial lesion/cervical intraepithelial neoplasia 3 (48, 41%) and high-grade squamous intraepithelial lesion/cervical intraepithelial neoplasia 1 (65, 56%). Forty one (35%) reported exiting women from screening prematurely. The median score for participants using the ASCCP app was significantly greater than those who did not (79% vs 71%, p = .002). Midwestern obstetrician-gynecologists' adherence to the guidelines for cervical cancer screening and management of abnormal results is suboptimal. Although co-testing for women aged 30-65 years has been broadly adopted, primary HPV testing has not. Physicians overscreen, overtreat low-grade lesions, and undertreat high-grade lesions in young women.

Cancer Knowledge and Practices Among Indigenous Women in Guatemala

PURPOSE Guatemala, a low- and middle-income country, has some of the poorest worldwide health indicators, including a high cancer incidence. We explored general cancer knowledge and breast and cervical cancer screening practices among Indigenous women in Lake Atitlán, Guatemala. METHODS We conducted 14 in-person, semistructured interviews and one focus group with 5 traditional midwives (comadronas). All participants were Mayan women from a rural community in Lake Atitlán (median age, 43.5 years; range, 18-72 years). The interviews and focus group were conducted in the participant’s preferred language, Spanish or Kaqchikel. Three coders analyzed the data using a process of inductive thematic analysis. RESULTS Participants had little knowledge and awareness about cancer in general, including screening and prevention. They associated the term cancer with death. Most had more knowledge about cervical cancer risk factors and screening compared with breast cancer. Participants voiced misinformation that breast cancer is caused by bad breast milk and that screenings for cervical cancer involve a hysterectomy. The terms uterine, ovarian, and cervical cancer were used interchangeably. None of the participants had ever been screened for breast cancer and all participants reported not knowing anyone who had been screened in the community. Some participants reported having received pap smears in the past. Major barriers reported include the cost and travel to health institutions and fear that the procedures may hurt. There was a strong preference for female doctors to conduct screenings given stigma. Participants reported experiencing discrimination and language barriers when attending hospitals. Participants mostly relied on family members and natural traditional medicine when they felt sick. Community and family support seemed to be key for health-seeking behaviors. CONCLUSION Findings highlight the lack of knowledge, limited screening practices, and numerous barriers among Mayan women in Guatemala. Efforts should focus on health promotion through educational workshops and increased accessibility to health services.

Midwives’ practices related to cervical cancer screening during pregnancy: A vignette-based study

ObjectiveTo describe midwives’ practices related to cervical cancer screening and women's eligibility for screening during pregnancy. Study designCross-sectional vignette-based study of French midwives during February-May 2018.Main outcome measures.Participants were asked to complete an internet-based questionnaire: a clinical case-vignette about a woman eligible for cervical cancer screening during pregnancy and a short self-administered questionnaire. ResultsWe obtained 273 complete questionnaires from eligible midwives. Of those responding, 15% reported that they never screened for cervical cancer during pregnancy, 63.7% did so for women 25 years or older, and 51% adhered to the recommended intervals between tests. Overall, 110 (40%) midwives adhered to the complete screening protocol (age at initiation and interval). In this clinical case vignette of a woman meeting the criteria for screening, only 29% of midwives reported they would perform a Pap test at 25 weeks of gestation, while 91% would at 10 weeks. ConclusionMidwives' practices of cervical cancer screening and their determination of women's eligibility during pregnancy vary, especially according to gestational age; Nevertheless, pregnancy is an appropriate time to screen women who meet the criteria for cervical cancer screening, especially if they are not receiving regular gynaecological care.

The Influence of Health Literacy on Knowledge of Cervical Cancer Prevention and Screening Practices among Female Undergraduates at a University in Southwest Nigeria

The global incidence of cancer is rising, and low-income and lower-middle-income countries have the worst figures. However, knowledge of cervical cancer prevention and cervical cancer screening practices remains poor in these regions. This study assessed the concept of health literacy as a potential determinant of knowledge of cervical cancer prevention and screening practices among female undergraduates. A descriptive cross-sectional study was conducted among 385 female undergraduates at a university in southwest Nigeria. A validated questionnaire composed of subscales on nine components of health literacy, knowledge of cervical cancer prevention, and cervical cancer screening practices was used for data collection. The majority of the respondents obtained a high score on most of the components of health literacy and 66% had good knowledge of cervical cancer prevention. Only 11% demonstrated good practices of Pap smear testing. Of all the components of health literacy, “feeling understood and supported by healthcare providers” (OR = 0.075; 95% CI [0.036–0.115]; p = 0.015) and “understanding health information well enough to know what to do” (OR = 0.055; 95% CI [0.006–0.104]; p = 0.029) were significantly associated with knowledge of cervical cancer prevention. Out of the major challenges related to cervical cancer screening among undergraduates, the feeling of being at risk (OR = 4.71; p &lt; 0.05) and uncomfortable experiences from past screening (OR = 0.12; p &lt; 0.05) were significantly associated with going for cervical cancer screening. The study concluded that levels of health literacy influenced knowledge of cervical cancer prevention among female undergraduates, but it did not affect their engagement in cervical cancer screening practices.

Impact of mobile technologies on cervical cancer screening practices in Lagos, Nigeria (mHealth-Cervix): Protocol for a randomised controlled trial

Background: Incidence and mortality from cervical cancer have remained high due to many obstacles facing the implementation of organized screening programs in resource-constrained countries such as Nigeria. The application of mobile technologies (mHealth) to health services delivery has the potential to reduce inequalities, empower patients to control their health, and improve the cost-effectiveness of health care delivery. Aim: To assess the efficacy of mobile technology intervention on Pap test screening adherence compared to a control condition and also determine the factors affecting the uptake of Pap smear screening practices among women in Lagos. Methods: This is a multi-center randomized controlled trial that will involve women aged 25 to 65 years attending the General Outpatient clinics of the two tertiary health institutions in Lagos, Nigeria between April and December 2020. At baseline, a total of 200 National Health Insurance Scheme (NHIS) enrollees will be randomized to either a text message arm or usual care (control) arm. The primary outcome is the completion of a Pap smear within 6 months of enrolment in the study. The associations between any two groups of continuous variables will be tested using the independent sample t-test (normal distribution) or the Mann-Whitney U test (skewed data) and that of two groups of categorical variables with Chi-square X 2or Fisher's exact test where appropriate. Using binary logistic regression model, we will adjust for age and other relevant sociodemographic and clinical variables and adherence to Pap test screening. Statistical significance will be defined as P-value less than 0.05. Discussion: The mHealth-Cervix study will evaluate the impact of mobile technologies on cervical cancer screening practices in Lagos, Nigeria as a way of contributing to the reduction in the wide disparities in cervical cancer incidence through early detection facilitated using health promotion to improve Pap smear screening adherence. Registration: PACTR202002753354517 13/02/2020

Utilization of cervical cancer screening and associated factors among women in Debremarkos town, Amhara region, Northwest Ethiopia: Community based cross-sectional study.

Cervical cancer is the most common type of malignancy among all malignancies for women worldwide with 266 000 deaths every year. Even though there is a proven importance of cervical cancer screening, the death of women due to cervical cancer in Ethiopia is high. We, therefore, did this study to investigate the utilization of cancer screening and its associated factors among women in Debremarkos town, Amhara region, Ethiopia. A community-based cross-sectional study was conducted among women from 30-49 years in Debremarkos town, from July 1 to August 30, 2018. A multistage sampling procedure was used to select 822 women in the study. We used EPI info version 7 for data entry and SPSS version 24 software for cleaning and analysis. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with the utilization of cervical cancer screening. Variables with a p-value of less than 0.05 were taken as significant variables. The study revealed that 44 (5.4%) of women have been screened for cervical cancer. Women's age [AOR:3.126(1.246,7.845)], marital status (AOR:3.41(1.299,8.972)], educational status(secondary education level [AOR: 4.578(95% CI: 1.19, 17.65)] and College and above education level [AOR:7.27,95%CI: 2.07,25.513)]), started sexual intercourse for the first time below 16 years[AOR:3.021(1.84,4.97)], history of multiple sexual partners [AOR:2.51(1.040, 6.06)], history of sexually transmitted disease [AOR:4.04(1.68, 9.72),], knowledge on cervical cancer screening [AOR:4.02(2.07,7.77)] and attitude towards cervical cancer screening [AOR:3.23(2.52,4.12)] were significant factors for utilization of cervical cancer screening. This study showed the magnitude of the utilization of cervical cancer screening is very low. Women's age, marital status, educational status, age at first sex history of multiple sexual partners and sexually transmitted disease, knowledge and attitude were important factors of screening. Therefore, intervention programs that are aimed at improving cervical cancer screening practice among women should focus on the identified factors.