Knowledge, attitude, preventive practices and utilization of cervical cancer screening among women in Nepal: a community-based cross-sectional study

Abstract

Background Cervical cancer continues to be a global public health concern and a leading cause of cancer deaths among Nepalese women. In spite of the availability of screening and treatment services in Nepal, the utilization of screening has been low. This study investigated knowledge, attitude, preventive practices and utilization of cervical cancer screening among women in a semi-urban area of Pokhara Metropolitan City of Nepal.Methods A community-based cross-sectional survey was carried out among 729 women 30-60 years of age, between April and June 2019. Participants were selected by systematic random sampling, and a door-to-door home visit was conducted for data collection. A pretested interviewer-administered Nepali questionnaire was used to collect information on sociodemographic variables, knowledge, attitude and preventive practices regarding cervical cancer screening. ResultsThe mean age of the participants was 45.9 years (SD ±7.7); the majority were married (86.7%). Among the participants, 44.9% were ever screened for cervical cancer. However, only 10.4% of participants received timely repeated screening for cervical cancer. The median knowledge score achieved by participants was 2.0 [interquartile range (IQR) 1-4] on a scale of maximum score 36, the median attitude score was 31.0 on a scale of 40 and the median preventive practice score was 3.0 (IQR 3-4) on a scale of five. ConclusionThis study showed low knowledge and low utilization of cervical cancer screening among women in Nepal. We recommend a community-based educational intervention to educate and empower women to increase knowledge and utilization of cervical cancer screening.

Knowledge, awareness, attitudes and screening practices towards breast and cervical cancer among women in Nepal: a scoping review

“…All studies were published between 2001 and 2021, and nearly half (45%) within the last 5 years. Twenty-seven (71%) studies focused on CC (Baral et al 2020;Bhatta et al 2020;Darj et al 2019;Ghimire and Pathak 2020;Andersen et al 2020;Gyenwali et al 2013;Johnson et al 2014;Joy et al 2011;Khadka et al 2017;Maharjan et al 2020;Pandey and Karmacharya 2017;Poudel and Sumi 2019;Rachana and Giri 2019;Ranabhat et al 2014;Ranjit et al 2016;Satyal 2013;Shakya et al 2016;Sherpa 2007;Sherpa et al 2020;Shrestha et al 2013;Shrestha 2014;Shrestha and Dhakal 2017;Shrestha et al 2020;Shrestha et al 2021a;Thapa 2018;Thapa et al 2018;). Ten studies (26%) concerned BC (Bhandari et al 2016;Bhandari et al 2021;Bhatt et al 2011;Braun and Itano 2011;Gupta et al 2015;Narasingrao et al 2013;Parajuli and Mandal 2010;Sathian et al 2014;Shrestha 2012;).…”

“…The study with the highest percentage took place among 729 participants recruited for a community-based intervention study to improve cervical cancer screening uptake in Pokhara Metropolitan. Knowledge of signs and symptoms of CC varied widely among studies (Khadka et al 2017;Shakya et al 2016;Shah et al 2010;Shrestha 2014;Shrestha et al 2020;Shrestha et al 2021a;Thapa 2018;Thapa et al 2018). Although almost all women in the study by Shrestha et al (2021a) had heard about CC, only 26% were aware of symptoms and 6% knew that CC is an abnormal cell growth.…”

“…Knowledge of signs and symptoms of CC varied widely among studies (Khadka et al 2017;Shakya et al 2016;Shah et al 2010;Shrestha 2014;Shrestha et al 2020;Shrestha et al 2021a;Thapa 2018;Thapa et al 2018). Although almost all women in the study by Shrestha et al (2021a) had heard about CC, only 26% were aware of symptoms and 6% knew that CC is an abnormal cell growth. Shakya et al (2016) found that 61% lacked knowledge of symptoms, and of those who mentioned symptoms, 25% reported incorrect information.…”

“…(Champion 1984(Champion , 1993, SOSAS Surgeons OverSeas Assessment of Surgical need survey (Groen et al 2012, Ntirenganya et al 2014, STI sexually transmitted infection, VIA visual inspection with acetic acid attitudes and screening practices with respect to CC. The percentage of women who had heard of CC ranged from 6% (Shakya et al 2016) to 97% (Shrestha et al 2021a). The study with the lowest percentage was conducted in a rural area and involved 122 members of a micro-finance women's group.…”

“…Eleven studies reported on knowledge of CC risk factors (Darj et al 2019;Joy et al 2011, Khadka et al 2017Poudel and Sumi 2019;Shah et al 2010;Shakya et al 2016;Shrestha 2014;Shrestha et al 2021a, b;Thapa 2018;Thapa et al 2018). Shrestha et al (2021a) found that of the 729 women interviewed from an urban area, 61% correctly identified risk factors for CC. Thapa (2018) found that of 205 women living in an urban area, 85% were aware of at least one risk factor for CC.…”