- Visibility 241 Views
- Downloads 215 Downloads
- Permissions
- DOI 10.18231/j.ijfcm.v.12.i.3.6
-
CrossMark
Factors influencing the attitudes of rural women in Uttarakhand towards cervical cancer screening
- Author Details:
-
Neha Upadhyai
-
Raghav Upadhyai
-
Amit Mittal
-
Kajal Gupta *
Raghav Upadhyai
Amit Mittal
Kajal Gupta *
Background: Cervical cancer is a significant public health concern, particularly in low- and middle-income countries such as India. The uptake of cervical cancer screening is alarmingly low, especially in rural areas. The aim of the study was to assess the knowledge of rural women in Uttarakhand regarding cervical cancer, its screening and to identify factors influencing the uptake of screening methods.
Materials and Methods: A cross-sectional study was conducted for one year among 446 married women, aged 21-65 years, attending the outpatient department of a rural health training centre under community medicine department. Participants were interviewed using a pre-structured and pre-tested questionnaire covering socio-demographic details, knowledge and attitudes towards cervical cancer screening. Data was analysed using SPSS v23 applying logistic regression.
Results: The mean age of respondents was 38.1 years. Only 39% of women had heard of cervical cancer and just 19% were aware of the Pap test. Mere 10.8% women understood its correct purpose. The most common source of information were healthcare providers. Key barriers to screening included negligence, perceived good health, embarrassment, and financial or time constraints. Women’s inclusion in family decision making and women with gynaecological complaint were significantly more likely to take screening.
Conclusion: Awareness and uptake of cervical cancer screening among rural women is critically low, primarily due to lack of knowledge and socio-cultural barriers. Targeted health education, empowerment of women in health-related decision-making and opportunistic screening during healthcare visits are recommended to improve screening of cervical cancer.
References
- Global Cancer Observatory. Globocan 2022. Available from https://gco.iarc.who.int/media/globocan/factsheets/cancers/23- cervix-uteri-fact-sheet
- Singh D, Vignat J, Lorenzoni V, Eslahi M, Ginsburg O, Lauby- Secretan B, et al. Global estimates of incidence and mortality of cervical cancer in 2020: a baseline analysis of the WHO Global Cervical Cancer Elimination Initiative. Lancet Glob Health. 2023;11(2):e197–206.
- X, Zeng Q, Cai W, Ruan W. Trends of cervical cancer at global, regional, and national level: data from the Global Burden of Disease study 2019. BMC Public Health. 2021;21(1):894.
- Ferlay J, Ervik M, Lam F, Laversanne M, Colombet M, Mery L, et al. Global cancer observatory: cancer today [Internet]. Lyon, France: International Agency for Research on Cancer; 2024. Available from: https://gco.iarc.who.int/today. Accessed 15 May 2025.
- Srivastava AN, Misra JS, Srivastava S, Das BC, Gupta S. Cervical cancer screening in rural India: Status & current concepts. Indian J Med Res. 2018;148(6):687–96.
- International Agency for Research on Cancer (IARC). IARC Handbooks of Cancer Prevention Volume 18: Evaluation of cervical cancer screening methods [Internet]. Lyon, France: World Health Organization; 2021. Available from: https://www.iarc.who.int/wp- content/uploads/2021/11/pr305_E.pdf. Accessed 15 May 2025.
- World Health Organization. Global Health Observatory. Geneva: World Health Organization. Available from: https://www.who.int/data/gho/data/themes/topics/indicator- groups/indicator-group-details/GHO/sdg-target-3.4- noncommunicable-diseases-and-mental-health. Accessed Sep 1,
- Banerjee B. National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS). In: Taneja DK, ed. Health Policies and Programmes in India. New Delhi: Jaypee Brothers Medical Publishers; 2017. p. 429.
- Budget allocation and expenditures of non-communicable disease programme. [Internet]. Available from: https://sansad.in/getFile/annex/259/AU3141.pdf?source=pqars. Accessed 11 May 2025.
- International Institute for Population Sciences (IIPS) and ICF. National Family Health Survey (NFHS-5), 2019-21 [Internet]. Mumbai: IIPS; 2021. Available from: https://dhsprogram.com/pubs/pdf/FR375/FR375.pdf. Accessed Mar
- Gopika MG, Prabhu PR, Thulaseedharan JV. Status of cancer screening in India: An alarm signal from the National Family Health Survey (NFHS-5). J Family Med Prim Care. 2022;11(11):7303–7.
- Bedell SL, Goldstein LS, Goldstein AR, Goldstein AT. Cervical cancer screening: past, present, and future. Sex Med Rev. 2020;8(1):28–37.
- Thippeveeranna C, Mohan SS, Singh LR, Singh NN. Knowledge, attitude and practice of the pap smear as a screening procedure among nurses in a tertiary hospital in north eastern India. Asian Pac J Cancer Prev. 2013;14(2):849–52.
- Verma A, Verma S, Vashist S, Attri S, Singhal A. A study on cervical cancer screening in symptomatic women using Pap smear in a tertiary care hospital in rural area of Himachal Pradesh, India. Middle East Fertil Soc J. 2017;22(1):39-42.
- Tripathi N, Kadam YR, Dhobale RV, Gore AD. Barriers for early detection of cancer amongst Indian rural women. South Asian J Cancer. 2014;3(2):122–7.
- World Health Organization. Cervical Cancer Elimination Initiative [Internet]. Geneva: World Health Organization. Available from: https://www.who.int/initiatives/cervical-cancer-elimination- initiative. Accessed May 14, 2025.
- Shekhar S, Sharma C, Thakur S, Raina N. Cervical cancer screening: knowledge, attitude and practices among nursing staff in a tertiary level teaching institution of rural India. Asian Pac J Cancer Prev. 2013;14(6):3641–5.
- Dahiya N, Aggarwal K, Singh MC, Garg S, Kumar R. Knowledge, attitude, and practice regarding the screening of cervical cancer Upadhyai et al. / Indian Journal of Forensic and Community Medicine 2025;12(3):173–179 179 among women in New Delhi, India. Tzu Chi Med J. 2019;31(4):240–3.
- Coughlin SS, Breslau ES, Thompson T, Benard VB. Physician recommendation for Papanicolaou testing among U.S. women,
- Cancer Epidemiol Biomarkers Prev. 2005;14(5):1143–8.
- Dsouza JP, Van Den Broucke S, Pattanshetty S, Dhoore W. Exploring the barriers to cervical cancer screening through the lens of implementers and beneficiaries of the National Screening Program: a multi-contextual study. Asian Pac J Cancer Prev. 2020;21(8):2209–15.
- Sinha R, Kumar P, Singh G, Saha R. Opportunistic cervical cancer screening by papanicolaou stain Pap smear among women: a pilot study at urban health training centre of All India Institute of Medical Sciences, Patna, Bihar, India. Int J Reprod Contracept Obstet Gynecol. 2025;9(7):2714–20.
- Kadian L, Gulshan G, Sharma S, Kumari I, Yadav C, Nanda S, et al. A study on knowledge and awareness of cervical cancer among females of rural and urban areas of Haryana, North India. J Cancer Educ. 2021;36(4):844–9.
- Bansal AB, Pakhare AP, Kapoor N, Mehrotra R, Kokane AM. Knowledge, attitude, and practices related to cervical cancer among adult women: a hospital-based cross-sectional study. J Nat Sci Biol Med. 2015;6(2):324–8.
- Nigudgi A, Tiwari P, Chandel HS, Singh P. High incidence of abnormal pap smears and low awareness of cervical cancer among women in Rewa, Madhya Pradesh, India: Implications for screening and education. Cancer Epidemiol. 2025;95:102767.
- Singh K, Goel A, Attri M. Awareness of cervical cancer and its screening methods in Indian women. Int J Reprod Contracept Obstet Gynecol. 2021;10(8):3123–7.
- Mangold BR. Self collected samples in cervical cancer screening: results of HPV and Pap self-collected samples compared to physician-obtained specimens. Acta Cytol. 2019;63(5):379–84.
- Nishimura H, Yeh PT, Oguntade H, Kennedy CE, Narasimhan M. HPV self-sampling for cervical cancer screening: a systematic review of values and preferences. BMJ Glob Health. 2021;6(5):e003743.
- Oak A, Sivaranjini K, Pathak D, Rajesh. Human papillomavirus self-sampling for cervical cancer screening: review on the acceptance, accuracy, feasibility and incorporation in the National Screening Programme of India. Curr Med Res Pract. 2023;13(2):74–80. DOI: 10.4103/cmrp.cmrp_12_23
[Google Scholar]