Awareness of cervical cancer risk factors and symptoms: cross‐sectional community survey in post‐conflict northern Uganda

Abstract

BackgroundLack of awareness of risk factors and symptoms for cancer may lead to late diagnosis and poor prognosis.ObjectiveWe assessed community awareness about cervical cancer risk factors and symptoms and perceptions about prevention and cure of cervical cancer in order to contribute data to inform interventions to improve cervical cancer survival.DesignCross‐sectional population‐based survey.Setting and participantsWe conducted this study in Gulu, a post‐conflict district in Uganda in 2012. The sample included 448 persons aged 18 years and above, selected through a multi‐stage stratified cluster sampling process.Data collection methods and analysisWe collected data using a pretested structured questionnaire. Logistic regressions were used to determine magnitudes of associations between socio‐demographic and outcome variables.ResultsMost participants (444/448) had heard about cervical cancer. Known risk factors including multiple sexual partners, human papillomavirus infection, and early onset of sexual activity, were recognized by 88%, 82%, and 78% of respondents respectively. 63% of participants believed that prolonged use of family planning pills and injections caused cervical cancer. The majority of participants recognized symptoms of cervical cancer including inter‐menstrual bleeding (85%), post‐menopausal bleeding (84%), and offensive vaginal discharge (83%). 70% of participants believed that cervical cancer is preventable and 92% believed that it could be cured if diagnosed at an early stage.Discussion and conclusionsRecognition of cervical cancer risk factors and symptoms was high among study participants. Targeted interventions including increasing availability of HPV vaccination, population‐based cervical screening and diagnostic services can translate high awareness into actual benefits.

Awareness and Self-Perceived Risk of Cervical Cancer among Women Living in Namuwongo, an Informal Settlement in Kampala, Uganda

“…Having ever heard about cervical cancer was found to be high in other studies in urban and peri-urban areas such in Dares Salaam and Kerala, with prevalence of 53.0% and 74.2%, respectively [27,30]. In rural Uganda, two recent studies in Masaka [6] and northern Uganda [7] showed that more than 90% of participants had ever heard about cervical cancer. The study in Northern Uganda however included both male and female unlike our current study.…”

“…In addition, only 54.0% acknowledged that having sexual intercourse with uncircumcised men increases a woman's risk for developing cervical cancer. Similarly, low levels of HPV awareness was also found in northern, eastern Uganda and Botswana [7,29,31,32]. Clearly this widespread low levels of awareness about the HPV and vaccination against the HPV as primary control measure for cervical cancer is concerning.…”

“…The high incidence of cervical cancer has been attributed to several factors including scarce and inadequate screening services; high prevalence of sexually transmitted diseases including, HIV/AIDS, Human Papillomavirus Infection (HPV), early onset of sexual activity; polygamy; and high parity [6]. Poverty, low education levels, and gender inequalities are also important contributing factors to the high incidence and mortality of cervical cancer in Uganda [7]. This high disease burden among economically active young women undermines their reproductive and economic potential, leading to high losses to the affected families and the nation at large.…”

“…These include prevention through HPV vaccination of girls aged 15 years and above, screening and early treatment for women with precancerous lesions using cytopathology examination, visual inspection with acetic acid (VIA) and cryotherapy and appropriate management of women with invasive cervical cancer. However, financial constraints, lack of trained staff, unavailability of vaccines in peripheral areas and in slum populations among others have made full policy implementation difficult [7,22,23]. These structural constraints are made worse by the fact that most Ugandan women are unaware of the predisposing factors to cervical cancer and importance of timely screening, early diagnosis and prompt treatment of symptomatic cervical cancer [24].…”

Knowledge, awareness and prevention of cervical cancer among women attending a rural based tertiary care centre, Theni, South India

“…In a study conducted in China, 22.1% and 13.3% of the study population had heard of HPV and HPV vaccine respectively. 6 The knowledge level about cervical cancer was low among the participants in spite of the introduction of National Cancer Control Programme in India. This is probably because of the lack of awareness of cervical cancer and its screening methods which is available in the nearby primary health care facilities.…”