Cervical cancer knowledge and screening behaviors among female university graduates of year 2012 attending national graduate orientation program, Bhutan

Abstract

BackgroundCervical cancer is the leading female cancer in Bhutan. This study describes the level of cervical cancer knowledge and screening behaviors among female university graduates attending the National Graduate Orientation Program (NGOP), 2012.MethodsA cross-sectional study of female graduates attending NGOP was conducted using self-administered anonymous questionnaire developed through literature reviews and expert discussions to elicit information on demographic characteristics, knowledge, screening behaviors and determinants of cervical cancer. The association of demographic and other important study characteristics with uptake of Pap test was investigated using cross tabulation and Fischer Exact test. Frequencies and percentages were calculated for all the questions.ResultsThe average age of the participants was 23.43 ± SD 2.73. About 92% (n = 513) of the respondents were aged 25 years or less and 7.9% (n = 44) of the respondents were aged 26 or more. The study revealed low cervical cancer knowledge and poor screening behavior among the graduates. The mean knowledge score was 3.571 (SD1.75, Range 0–8). About 6% (n=34) of the respondents reported undergoing Pap test at least once and 94% reported as never having done Pap test. The most commonly cited reasons for not doing Pap test included “never thought I needed one” (57%, n = 320), “embarrassment of being examined by male health professional” and “fear of finding out cancer”. The study revealed evidence of significant association between increasing age, those who are married, knowledge score and those recommended for screening by health professionals with the uptake of Pap test.ConclusionOur study revealed poor knowledge and screening behaviors among female university graduates in Bhutan. This may be suggestive of even poorer awareness and screening practices among young unmarried women who are less educated or with no education. Although our study group is not appropriate for measuring practice of cervical cancer screening in the country, the findings are expected to highlight the shortcomings and trigger development of comprehensive cervical cancer control programs in Bhutan.

Attitudes and Practice of Cervical Cancer Screening among Female University Students from 25 Low, Middle Income and Emerging Economy Countries

“…The study found, among a large sample of female university students across 25 low and middle and emerging economy countries, an overall low participation rate in cervical cancer screening, which is comparable to previous studies in low and middle income countries (Ayinde et al, 2004;Akujobi et al, 2008;Oladepo et al, 2008;2009;Abotchie and Shokar, 2009 Dhendup and Tshering, 2014). In particular because of the high burden cervical cancer in low and middle income countries, more should be done to promote cervical cancer screening in this population.…”

“…This is especially important in those countries participating in this study with a very low participation rate (0-7.1%) among 21-26 year-old students from Southeast Asian countries, India, Pakistan, China, Tunesia, Turkey, Cameroon, Ivory Coast, Madagascar, and Mauritius. Country variations in the prevalence of cervical cancer screening may be due to various country specific factors, including cervical cancer screening policy, publicity on cervical cancer, systematic and active promotion of screening, accessibility of cancer screening services, and social-and cultural factors specific to the Asian population (Lu et al, 2012;Dhendup and Tshering, 2014). Further, the study found that women who rated cervical cancer screening as more important carried it out more often.…”

“…While studies among female university students in high income countries found a higher participation rate in screening for cervical cancer, e.g. 44.8% in Greece (Bakogianni et al, 2012) and 41% in USA (Durvasula et al, 2006).…”

“…Supa Pengpid 1,2 , Karl Peltzer 1,3,4 * in low and middle income countries have reported a low participation rate in screening for cervical cancer, e.g., 6% in Bhutan (Dhendup and Tshering, 2014), 12% in Ghana (aged 20 to 35 years) (Abotchie andShokar, 2009), 6% in Malaysia (Al-Naggar et al, 2010), 0% to 8.3% in Nigeria, 0% (Ayinde et al, 2004;Akujobi et al, 2008;Oladepo et al, 2008;2009;Aniebue and Aniebue, 2010), and 10.7% among sexually active female students in South Africa (Hoque, 2013). While studies among female university students in high income countries found a higher participation rate in screening for cervical cancer, e.g.…”

Awareness on Cervical Cancer-Risk Assessment

“…75 members are daily wages and 45 members are workers. (table 6) Out of these members, 410 members were married and 595 members were unmarried [17].…”