scholarly journals Uptake and determinants of cervical cancer prevention services among female college students in Kenya: A cross-sectional survey

2020 ◽  
Author(s):  
Elisha Ngetich ◽  
Irene Nzisa ◽  
Alfred Osoti

AbstractIntroductionCervical cancer is the leading cause of cancer death in women in low- and middle-income countries. In Kenya, cervical cancer incidence and prevalence have been increasing and in 2018 alone, there were 3286 deaths from cervical cancer. Previously, studies on cervical cancer prevention strategies have focused on women above 30 years old. However, as the risk factors for cervical cancer are acquired as early as in the teen years, an understanding of the awareness, uptake and determinants of screening services among college female students will help inform prevention strategies. This study sought to determine the awareness, uptake, determinants and barriers to cervical cancer screening services among colleges students in Kenya.MethodsThis was a multicenter cross-sectional study conducted in eight universities spread all over Kenya. Participants were interviewed using a self-administered structured questionnaire on sociodemographics, reproductive history, awareness on cervical cancer including screening practices, and attitude towards cervical cancer prevention services. Descriptive statistics were summarized using means and standard deviation (SD) for parametric data and median and interquartile range (IQR) for non-parametric data. Univariable and multivariable logistic regression analyses were done to determine odds ratios of factors associated with uptake of cervical cancer screening services. P-value of <0.05 was considered statistically significant.ResultsBetween January 2017 and Sept 2017, we screened 800 and enrolled 600 female colleges students from eight universities in Kenya. In total, 549 of the 600 (92%) participants completed the questionnaire. The median age (IQR) was 21(20,22) years. Nearly two-thirds 338(62.7%) were sexually active, while 54(16%) had concurrent sexual partners. The main form of contraception was oral postcoital emergency pills 123(64.7%). Only 76(14.4%) had screened for cervical cancer, and the commonest approach was a Pap smear 47(61.8%). About one half 40(54.1%) did not like their experience due to pain, discomfort and bleeding. Four out of five participants (439, 80.7%) had poor knowledge on cervical cancer screening. On bivariate analysis, increased level of awareness (odds ratio [OR] 1.08 95% Confidence Interval [CI] 1.03,1.18, p = 0.004), knowledge of someone with cervical cancer(OR 0.43 CI 0.23,0.78 p=0.006) and a perception of self-risk (OR2.6 CI 1.38,4.98 p=0.003) were associated with increased odds of uptake of cervical cancer screening. In the multivariate analysis, high awareness was significantly associated with increased odds of cervical cancer screening (OR 1.12 CI 1.04, 1.20 p=0.002).ConclusionsFemale college students in Kenya had low levels of awareness on cervical cancer and had very low uptake of cervical cancer screening. However, high perception of self-risk and perceived benefit was associated with increased odds of cervical cancer screening.RecommendationsSince female colleges students are generally thought to be more knowledgeable and have better access to information compared to the general population, the low levels of knowledge and uptake of cervical cancer screening, calls for a rethink of strategies that focus on the younger population including those in primary, high school and universities. Such strategies include HPV vaccination and incorporation of cancer prevention in school curriculum.

2017 ◽  
Vol 16 (2) ◽  
pp. 18-22 ◽  
Author(s):  
Andrea Obročníková ◽  
Ľudmila Majerníková

AbstractAim. Cervical cancer is the most common genital malignancy and one of the leading causes of death among female population in Slovakia. At present, this location of cancer is preventable disease visible in screening for premalignant lesions if the women use and participate in such screening regularly. We assessed the knowledge on the cervical cancer screening, the attitude towards it and its utilization among women in Slovakia.Material and methods. A cross-sectional study evaluated the knowledge, attitude and practice of cervical cancer prevention and screening among women. The sample was composed of 239 women aged 18-64 years. Data collection was conducted by selfadministered questionnaire in a period from January to April 2015.Results. Respondents exhibited an average knowledge of cervical cancer, about risk factors and early signs, but awareness of cervical cancer screening was satisfactory. Despite the fact that respondents expressed good attitude to cervical cancer screening, their level of practice was low (64% participation in preventative gynaecology check-ups and 43% in Pap smear tests within one year and 44% within three years). In the study we could observe better results in women with higher education when it comes to an illness (p < .001), its prevention (p < .001) and risk behaviour (p < .001).Conclusions. The awareness of cervical cancer among women in Slovakia is limited. In the future there is a need to educate and promote awareness of cervical cancer among women to reduce the burden of morbidity and mortality.


2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Sunday Joseph Ayamolowo ◽  
Lydia Feyisayo Akinrinde ◽  
Monisola Omoyeni Oginni ◽  
Love Bukola Ayamolowo

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 < 0.05) and uncomfortable experiences from past screening (OR = 0.12; p < 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.


2018 ◽  
Vol 139 (4) ◽  
pp. 199-205 ◽  
Author(s):  
K Boom ◽  
M Lopez ◽  
M Daheri ◽  
R Gowen ◽  
A Milbourne ◽  
...  

Background:The Rio Grande Valley (RGV) and Laredo regions located along the Texas–Mexico border consist of seven counties with a population of approximately 1.5 million people and a high uninsured rate (33.5%). Cervical cancer mortality in these border counties is approximately 30% higher than the rest of Texas. The RGV and Laredo areas were studied to better understand the state of access to cervical cancer prevention services along the Texas–Mexico border.Methods:Data on the population served and the services provided were analyzed to determine the gap between cervical cancer screenings recommended versus those received. Through interviews, we gathered the perspectives of 16 local stakeholders regarding cervical cancer screening for underserved individuals in the region.Findings:It is estimated that 69,139 uninsured women aged 21–64 years in the RGV/Laredo per year are recommended to undergo cervical cancer screening with Papanicolaou (Pap) and/or human papillomavirus (HPV) testing, but only 8941 (12.9%) Pap tests are being performed by the Federally Qualified Health Center (FQHC) serving uninsured women in these regions. Systemic barriers identified include insufficient provider clinical capacity, the high cost of healthcare, and uncertainty about government funding sources. Patient barriers identified include inadequate knowledge on navigating the local healthcare system, low health literacy, lack of money and childcare, an inability to miss work, limited transportation, and fear of deportation.Conclusion:Decreasing the disparity between cervical cancer screening services provided and those recommended requires addressing the barriers, identified by local experts, which prevent uninsured women from accessing care. These challenges are being addressed through ongoing programs and collaborations.


2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Mercy Kokuro ◽  
Abigail Kusi-Amponsah Diji

Cervical cancer is the second most frequently diagnosed and the fourth commonest cause of cancer death among women worldwide. Even though cervical cancer is preventable, its screening rate has been reported to be low in Ghana. To the best of our knowledge, no study has focused on the utilisation and perceptions of cervical cancer among women in their reproductive age in Ghana. The present study aimed at assessing the utilisation and perceptions of cervical cancer screening services among women who seek reproductive healthcare services. A descriptive cross-sectional study was carried out among women aged 18 years and above. Using a two-stage sampling technique, 369 participants were selected from 2 out of 4 eligible study sites. Data on the perceptions and utilisation of cervical cancer screening services were collected following ethical approval. The data were collected using both English and Twi versions of the questionnaire. The data were descriptively and inferentially analysed. A few of the participants had been previously screened for cervical cancer (n = 69; 18.7%), while a greater proportion of the participants appropriately perceived the screening benefits (> 70%), and an equally greater percentage of them harboured negative perceptions which prevented them from engaging in such endeavours (> 80%). Significant differences in perception were, however, observed in two-fifths of the studied areas (6/14) among the screened and unscreened participants. Cervical cancer screening services were not utilised by the majority of the participating women. Screening was associated with socio-demographic characteristics such as marital status, parity, education, and employment status. Inappropriate perceptions on cervical cancer screening may account for the low utilisation of cervical cancer screening. Therefore, all-inclusive health education on the benefits of cervical cancer screening for both women and men should be a priority for stakeholders and all health organisations.


2021 ◽  
Vol 13 (4) ◽  
pp. 115
Author(s):  
J. O. Egede ◽  
L. O. Ajah ◽  
U. M. Agwu ◽  
M. I. Ajah ◽  
F. O. Edegbe ◽  
...  

INTRODUCTION: Cervical cancer screening has significantly contributed to the detection of premalignant and malignant lesions of the cervix and prevention of the morbidity and mortality associated with the disease. In the developing countries, especially sub-Saharan Africa where the burden of cervical cancer is highest, the high-risk population may not know the screening schedules or be able to pay for the services, and so fail to benefit. OBJECTIVE: To determine the level of awareness of cervical cancer screening schedule and willingness to pay for cervical screening services among women in Abakaliki, southeast Nigeria. METHOD: The study design was a descriptive cross-sectional questionnaire-based and the population comprised 800 participants who came for free cervical cancer screening at well women centre, Alex Ekwueme Federal University Teaching Hospital, Abakaliki between January and December 2017. Data were analyzed using the Statistical Package for Sciences version 20.0. RESULT: Of the 756 (94.5%) questionnaires analyzed, the mean age was 41.4 years, modal parity 4; 83.6% had prior knowledge of cervical cancer while 81.0% knew that cervical cancer screening is a diagnostic tool. Surprisingly, only 32% of those aware of cervical cancer had previously done cervical cancer screening, while 10.8% knew the interval for cervical cancer screening. On screening for cervical cancer in future, 89.2% of the respondents were willing to repeat the test while 54.2% would be willing to pay for the screening services. Being 40 years of age or less, married, educated, of high socio-economic class and having first sexual intercourse at 18 years or less were associated with willingness to pay for screening. CONCLUSION: Although the knowledge of cervical cancer is high, cervical cancer screening uptake is low, many women are aware of the interval for cervical cancer screening, and many will not be willing to pay for cervical cancer screening out of their pockets.&nbsp;


Author(s):  
Anthonia O. C. Onyenwenyi ◽  
Gugu Gladness Mchunu

Abstract Aim: The study explored the knowledge and service delivery skills of primary health care (PHC) workers to conduct cervical cancer screening programmes in Sango primary health centre in Sango town, Ado-Odo Ota, Ogun State in Nigeria. Background: Cervical cancer is the second most common cancer affecting women. The prevention and control services in Nigeria are provided mainly at post-primary health facilities. Authorities have advocated the integration of cervical cancer prevention into reproductive health services provided at PHC centres. The service delivery capabilities of PHC workers are critical for successful implementation of screening programmes. Method: Exploratory qualitative research design was used. Data were collected among 10 PHC workers who were purposively sampled at Sango PHC. Semi-structured interview guide with broad items and a checklist were used to assess participants’ cervical cancer screening knowledge and service delivery skills using visual inspection screening methods. Data were analysed thematically and triangulated. Findings: A range of roles were represented in the interviews of the health care workers at the PHC studied. They had poor knowledge and skills about cervical cancer screening using visual inspection with acetic acid and visual inspection with Lugol’s iodine. Study participants perceived nurses as most equipped PHC workers to conduct screening at PHC level, followed by the community health officers. Participants reported no cervical cancer services at the centre and community. The findings provided useful insight that guided the training of primary health workers and the development of a community-based cervical cancer screening model for women in rural communities. Conclusion: Nurses and other PHC workers should be trained on visual inspection screening method. This low-cost but effective methodology could be incorporated into their training curricula as a strategy for scaling up cervical cancer prevention programmes across Nigeria.


2014 ◽  
Vol 19 (1) ◽  
Author(s):  
Melanie Y. Hami ◽  
Valerie J. Ehlers ◽  
Dirk M. Van der Wal

Background: Malawi provides cervical cancer screening services free of charge at some public health facilities. Few women make use of these cancer screening services in Malawi and many women continue to be diagnosed with cervical cancer only during the late inoperable stages of the condition. Objectives: The purpose of this study was to discover whether the perceived susceptibility to cervical cancer, amongst Malawian women aged 42 and older, influenced their intentions to utilise the available free cervical cancer screening services.Method: A quantitative, cross-sectional descriptive study design was adopted. Structured interviews were conducted with 381 women who visited 3 health centres in the Blantyre District of Malawi.Results: A statistically-significant association existed between women’s intentions to be screened for cervical cancer and their knowledge about cervical cancer (X² = 8.9; df = 1; p = 0.003) and with having heard about HPV infection (X² = 4.2; df = 1; p = 0.041) at the 5% significance level. Cervical cancer screening services are provided free of charge in government health institutions in Malawi. Nevertheless, low perceived susceptibility to cervical cancer amongst women, aged 42 and older, might contribute to limited utilisation of cervical screening services, explaining why 80% of cervical cancer patients in Malawi were diagnosed during the late inoperable stages.Conclusion: Malawian women lacked awareness regarding their susceptibility to cervical cancer and required information about the available cervical cancer screening services. Malawi’s women, aged 42 and older, must be informed about the advantages of cervical cancer screening and about the importance of effective treatment if an early diagnosis has been made. Women aged 42 and older rarely attend antenatal, post-natal, well baby or family-planning clinics, where health education about cervical cancer screening is often provided. Consequently, these women aged 42 and older should be informed about cervical screening tests when they utilise any health services.Vroue se vermeende vatbaarheid en benutting van servikale kanker dienste in Malawi Agtergrond: Malawi verskaf gratis servikale kanker siftings dienste by sommige openbare gesondheids instansies. Min vrouens maak gebruik van die kanker siftings dienste in Malawi en baie vrouens word steeds gediagnoseer met servikale kanker tydens die laat onopereerbare fases van die toestand.Doelwitte: Die doel van die studie was was om te bepaal of Malawiese vrouens wat 42 en ouer is se waargenome vatbaarheid vir servikale kanker hulle beïnvleod om beskikbare gratis servikale siftingsdienste te gebruik. ’n Kwantitatiwe, deursnee beskrywende navorsingsontwerp was gekies.Metode: Gestruktureerde onderhoude is met 381 vrouens gevoer wat drie gesondheidsdiensentrums in die Blantyre Distrik van Malawi besoek het.Resultate: ’n Statistiese beduidende verhouding het bestaan tussen vrouens se voornemens om vir servikale kanker getoets te word en hulle kennis oor servikale kanker (X² = 8.9; df = 1; p = 0.003) en dat hulle al gehoor het van MPV infeksies (X² = 4.2; df = 1; p = 0.041) op die 5% vlak van beduidenis. Servikale kanker siftingsdienste is gratis beskikbaar in openbare gesondheidsdiensinrigtings in Malawi. Desnieteenstaande was daar ’n lae waargenome risiko van servikale kanker onder vrouens wat 42 jaar oud en ouer was en dit het bygedra tot die beperkte benutting van siftingsdienste, wat verduidelik waarom 80% van servikale kankergevalle in Malawi gedurende die laat onopereerbare fases gediagnoseer is.Gevolgtrekkings: Malawiese vrouens was onbewus van hulle vatbaarheid vir servikale kanker en het inligting benodig oor servikale kanker siftingsdienste. Malawi se vrouens wat 42 jaar oud en ouer is, moet ingelig word aangaande die voordele van servikale sifting en die belangrikheid van effektiewe behandeling indien ’n vroë diagnose gemaak is. Vrouens van 42 of ouer benut selde voorgeboorte, nageboorte gesonde baba, of gesinsbeplanningsklinieke waar voorliging aangaande servickale kanker verskaf word. Gevolglik behoort die vrouens ingelig te word oor servikale siftingstoetse wanneer hulle enige gesondheidsdienste benut.


Author(s):  
Sarah Feldman ◽  
Jennifer S Haas

Abstract These past months of the coronavirus disease-2019 (COVID-2019) pandemic have given us ample opportunity to reflect on the US health-care system. Despite overwhelming tragedy, it is an opportunity for us to learn and to change. As we postpone routine visits because of the pandemic, we worry about risks for patients who delay cancer screening. We use cervical cancer screening and prevention as an example of how we can use some “lessons learned” from the pandemic to prevent “collateral losses,” such as an increase in cancers. COVID-2019–related health-system changes, like the more rapid evaluation of diagnostic tests and vaccines, the transition to compensated virtual care for most counseling and education visits, and broadened access to home services, offer potential benefits to the delivery of cervical cancer screening and prevention. While we detail the case for cervical cancer prevention, many of the issues discussed are generalizable to other preventative measures. It would be a tragedy if the morbidity and mortality of COVID-2019 are multiplied because of additional suffering caused by delayed or deferred cancer screening and diagnostic evaluation—but maybe with creativity and reflection, we can use this pandemic to improve care.


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