The role of knowledge, risk perceptions, and cues to action among Iranian women concerning cervical cancer and screening: a qualitative exploration

Abstract

Background Iran has a low incidence but higher rate of death from cervical cancer (CC). The country is in the process of implementing an organized screening program including HPV testing and cytology. Studies show high dropout in continued testing among eligible women. This qualitative study aimed to explore women’s awareness regarding CC and CC testing and the role of knowledge, perceived risk, and cues to action in this process. Method Through a qualitative study based on the Framework Method, we recruited 81 women aged 25–65 who participated in 15 focus group discussions (FGDs) and two in-depth interviews in Tehran. The interviewees were selected purposefully during January to May 2015 from households belonging to different socioeconomic classes until data saturation. The data were acquired through 11 open-ended questions and 32 related probe questions. All interviews were transcribed and independently analyzed by two researchers (Kappa and agreement testing respectively: 0.77, 97.11%). Results The coded texts were categorized under three themes and 13 subthemes. The three thematic areas referred to knowledge, cues to action, and perceived risks regarding CC and screening. The results showed that women had limited and unspecified knowledge about CC and screening, compounded by misconceptions regarding infection and cancer prevention measures. Social and cultural barriers hindered proper communication between health system/providers and clients and within communities on subjects related to CC and screening. The perceived risk of getting CC was low because of overestimating the role of hereditary factors for CC, difficulty in differentiating between cancer and sexually transmitted infections (STI), and the absence of visible symptoms. Conclusion The results indicate a strong need to invest more efforts to improve health education and communication in the current national health program to promote awareness of the need to screen for CC through, for example, establishing correct knowledge and risk perceptions among women. In addition, this intervention should address women’s social environment in order to prevent misconceptions being communicated to women.

Cervical cancer screening “see and treat approach”: real-life uptake after invitation and associated factors at health facilities in Gondar, Northwest Ethiopia

“…This is consistent with a study in Kenya in 2014 [ 31 ]. Similarly other studies revealed that physician advice for cervical cancer screening [ 40 ], someone they knew screened before, information from mass media and educational talks were important cues for women to attend the screening test [ 41 ]. This finding implies the need to consider important cues to take action in cervical cancer screening programs to improve the screening uptake by women.…”

Awareness of human papillomavirus and acceptability of the vaccine among women in Palestine: is it time for policy adjustment?

“…In addition, most women would agree to their daughters receiving the HPV vaccine for free or at a cost to themselves. Availability and uptake of the HPV vaccine could play a crucial role in the prevention and reduction of morbidity and mortality of CC [41,42]. This study assessed the Palestinian women's awareness level of HPV in addition to its vaccine and examined the acceptability of the HPV vaccine to provide baseline information for the implementation of future awareness campaigns and to facilitate the launch of HPV immunization programs.…”

“…Effective implementation of HPV vaccination programs is considered one of the cornerstones to reducing the burden of CC, particularly in low-and middle-income countries [14,[41][42][43]. For a vaccination program to be effective, both awareness of its benefits and availability are important to ensure wide uptake among the population [43].…”

Cervical Cancer Prevention on Instagram: Content and Social Interaction Analysis of Brazilian Accounts

“…The addressing of both cervical cancer risk factors and protective factors, as well as content about myths and stigmas of the disease, are mandatory for better engagement of women in health-educational strategies focusing on self-care practices related to cervical cancer prevention (Cooper et al, 2020;Taghizadeh et al, 2020;Sitaresmi et al, 2020). It seems that guaranteeing only informative content on Instagram underestimates the potential of this social network as a driver of behavioral changes based on improving knowledge about self-care in health.…”