Knowledge, attitude, practice and barriers of cervical cancer screening among women living in mid-western rural, Nepal

Abstract

ObjectiveTo find out the knowledge, attitude, practice, and barriers of cervical cancer screening in mid-western rural, Nepal.MethodsA hospital-based cross-sectional study was conducted. Women aged 20 or more were interviewed using a structured questionnaire regarding the socio-demographic information, knowledge, attitude, practice, and barriers to the cervical cancer screening.ResultsTotal of 360 participants were recruited for this study, mean age was 30.13±10.4 years. More than 87% of participants had inadequate knowledge, but around 72% had a favorable attitude towards cervical cancer screening. There was a significant portion of women (86.4%) had never done any cervical cancer screening test. Despite being higher literacy rate of Brahmin and Chhetri ethnic group, they were less likely to attend the cervical cancer screening than Dalit and Janajati (p<0.001); and those who had a positive family history of cancer were more likely to attend the cervical cancer screening (p<0.001). Similarly, married women, who had adequate knowledge and or favorable attitude, were more likely to practice cervical cancer screening, though statistically not significant. Factors such as “No symptoms,” “Lack of awareness,” “Embarrassment,” etc. were the most common barriers for the cervical cancer screening.ConclusionThe adequate knowledge and practice of cervical cancer screening were meager among rural Nepalese women, but most of them had a favorable attitude. There is an imperative need for related awareness programs to promote the uptake of cervical cancer screening tests.

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“…Second, the barriers to cervical cancer screening identified from the study are feeling well or having no symptoms at all and the fear of embarrassment that results from showing their private parts to the health professionals. In addition to this, other studies in Nepal identified illiteracy [6,10,11], lack of awareness about cervical cancer and its screening methods, embarrassment, having no symptoms at all [12,13], fear of finding out cancer [8], sociocultural barriers, service providers’ behavior, geographical challenges, poor financial condition [13] as a significant barrier to cervical cancer screening uptake behavior, while living in a rural area [11], participating in awareness program, support from family and women’s group [13] act as a facilitator to increase the screening uptake in women. Similarly, a cross-sectional study in Morocco also reported poor awareness in women about cervical cancer and have no symptoms at all as a cause for poor Pap screening uptake practice [14].…”