<b>Objectives:</b> The Primary Integrated Care for Four Chronic Diseases (PIC4C) is an initiative implemented by the Kenyan Ministry of Health and Moi Teaching & Referral Hospital to pilot screening, referral, treatment integration for diabetes, hypertension, breast cancer, cervical cancer in Busia and Trans-Nzoia counties, western Kenya. A major aspect of the qualitative phase of PIC4C sought to determine how localized knowledge affects perceptions of cervical cancer causes in the two counties and to use this information to develop targeted interventions. <b>Methods:</b> A total of 174 participants were included in 18 focus group discussions (FGDs), engaging patients, community members (CHVs), and health care providers (HCPs). A total of 14 patients with cervical cancer were included in the patient FGDs. The group sessions were facilitated by trained moderators and captured using audio recorders and field notes. Two analysts independently coded and analyzed the data using NVivo 12. Data were translated from Kiswahili to English as appropriate. <b>Results:</b> Overall, patients, CHVs, and HCPs perceived cervical cancer to be a chronic disease that could be treated but inevitably led to death. Several factors were implicated in causing cervical cancer among the three groups of participants (Table 1). All 174 participants alluded to sexual behavior etiologies, including multiple sexual partners, contracting sexually transmitted infections, and early engagement in sexual activities. Patients and CHVs cited unhealthy diet and use of selected family planning methods, while HCPs and CHVs added complications during delivery as causative. Only patients cited commercial sex, lack of vitamin B17, bacterial infections, smoking as factors. Additionally, CHVs added female circumcision, genetics, abortion, intercourse with men with long penises as causes. <b>Conclusions:</b> This study reports how localized knowledge affects perceptions of cervical cancer causes in Busia and Trans-Nzoia, western Kenya. Our study shows that misconceptions and inadequate knowledge about cervical cancer causes persist in these two counties. Our findings suggest a need for improved screening and treatment via dedicated health education campaigns, treatment resources, training for CHVs and HCPs to ensure communities receive accurate information. Eliciting local perceptions about cervical cancer ensures informed programming creation and implementation. Community interventions with buy-in from patients, CHVs, HCPs are essential to improve cervical cancer prevention, screening, treatment in western Kenya.