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Published in: BMC Cancer 1/2024

Open Access 01-12-2024 | Cervical Cancer | Research

Baseline knowledge on risk factors, symptoms and intended behavior of women and men towards screening and treatment of cervical cancer in rural Uganda: a cross-sectional study

Authors: Carolyn Nakisige, Marlieke de Fouw, Miriam Nakalembe, Jackson Orem, Dan Atukonyera, Mwalimu Musheshe, Jaap Koot, Janine de Zeeuw, Jogchum Beltman, Jelle Stekelenburg

Published in: BMC Cancer | Issue 1/2024

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Abstract

Background

Knowledge of risk factors and symptoms of cervical cancer has been found to promote uptake of screening of cervical cancer. Most interventions targeted women without much involvement of men (husbands/decision makers) who are often decision makers in many low- and middle-income countries. This study aimed at assessing baseline knowledge and intended behavior of both women and men to enable design specific targeted messages to increase uptake of cervical cancer screening and promote early detection of women with symptoms.

Methods

This cross-sectional study was conducted in two districts in Western Uganda using the modified African Women Awareness of CANcer (AWACAN) questionnaire. Women aged 30—49 years and their husbands/decision makers were interviewed. Knowledge on risk factors and symptoms, intended behavior and barriers towards participation in cervical cancer screening and treatment were assessed. Descriptive and logistic regression analyses were done to establish the association between knowledge levels and other factors comparing women to men.

Results

A total of 724 women and 692 men were enrolled. Of these, 71.0% women and 67.2% men had ever heard of cervical cancer and 8.8% women had ever been screened. Knowledge of risk factors and symptoms of cervical cancer was high and similar for both women and men.
Lack of decision making by women was associated with low knowledge of risk factors (X2 = 14.542; p = 0.01), low education (X2 = 36.05, p < 0.01) and older age (X2 = 17.33, p < 0.01). Men had better help seeking behavior than women (X2 = 64.96, p < 0.01, OR = 0.39, 95% CI: 0.31—0.50) and were more confident and skilled in recognising a sign or symptom of cervical cancer (X2 = 27.28, p < 0.01, OR = 0.52, CI (0.40—0.67).

Conclusion

The baseline knowledge for cervical cancer was high in majority of participants and similar in both women and men. Their intended behavior towards screening was also positive but screening uptake was very low. This study suggests developing messages on multiple interventions to promote screening behavior in addition to education, consisting of male involvement, women empowerment and making services available, accessible and women friendly.
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Literature
1.
go back to reference WHO. Global Strategy to accelerate the elimination of cervical cancer as a public health problem. 2020. WHO. Global Strategy to accelerate the elimination of cervical cancer as a public health problem. 2020.
2.
go back to reference Landy R, Windridge P, Gillman MS, Sasieni PD. What cervical screening is appropriate for women who have been vaccinated against high risk HPV? A simulation study. Int J Cancer. 2018;142:709–18.CrossRefPubMed Landy R, Windridge P, Gillman MS, Sasieni PD. What cervical screening is appropriate for women who have been vaccinated against high risk HPV? A simulation study. Int J Cancer. 2018;142:709–18.CrossRefPubMed
3.
go back to reference Falcaro M, Castañon A, Ndlela B, et al. The effects of the national HPV vaccination programme in England, UK, on cervical cancer and grade 3 cervical intraepithelial neoplasia incidence: a register-based observational study. Lancet. 2021;398:2084–92.CrossRefPubMed Falcaro M, Castañon A, Ndlela B, et al. The effects of the national HPV vaccination programme in England, UK, on cervical cancer and grade 3 cervical intraepithelial neoplasia incidence: a register-based observational study. Lancet. 2021;398:2084–92.CrossRefPubMed
4.
go back to reference Moodley J, Constant D, Mwaka AD, Scott SE, Walter FM. Anticipated help seeking behavior and barriers to seeking care for possible breast and cervical cancer symptoms in Uganda and South Africa. eCancer. 2021;15:1171.CrossRef Moodley J, Constant D, Mwaka AD, Scott SE, Walter FM. Anticipated help seeking behavior and barriers to seeking care for possible breast and cervical cancer symptoms in Uganda and South Africa. eCancer. 2021;15:1171.CrossRef
10.
go back to reference Twinomujuni C, Nuwaha F, Babirye JN. Understanding the low level of cervical cancer screening in Masaka Uganda using the ASE model: a community-based survey. PLoS One. 2015;10(6):e0128498.CrossRefPubMedPubMedCentral Twinomujuni C, Nuwaha F, Babirye JN. Understanding the low level of cervical cancer screening in Masaka Uganda using the ASE model: a community-based survey. PLoS One. 2015;10(6):e0128498.CrossRefPubMedPubMedCentral
23.
25.
go back to reference Moodley J, Scott SE, Mwaka AD, Constant D, Githaiga JN, Stewart TS, et al. Development and validation of the African Women Awareness of CANcer (AWACAN) tool for breast and cervical cancer. PLoS One. 2019;14(8):e0220545.CrossRefPubMedPubMedCentral Moodley J, Scott SE, Mwaka AD, Constant D, Githaiga JN, Stewart TS, et al. Development and validation of the African Women Awareness of CANcer (AWACAN) tool for breast and cervical cancer. PLoS One. 2019;14(8):e0220545.CrossRefPubMedPubMedCentral
27.
31.
go back to reference Chigbu CO, Onyebuchi AK, Onyeka TC, Odugu BU, Dim CC. The impact of community health educators on uptake of cervical and breast cancer prevention services in Nigeria. Int J Gynaecol Obstet. 2017;137(3):319–24.CrossRefPubMed Chigbu CO, Onyebuchi AK, Onyeka TC, Odugu BU, Dim CC. The impact of community health educators on uptake of cervical and breast cancer prevention services in Nigeria. Int J Gynaecol Obstet. 2017;137(3):319–24.CrossRefPubMed
32.
go back to reference Mbachu C, Dim C, Ezeoke U. Effects of peer health education on perception and practice of screening for cervical cancer among urban residential women in south-East Nigeria: a before and after study. BMC Womens Health. 2017;17(1):41.CrossRefPubMedPubMedCentral Mbachu C, Dim C, Ezeoke U. Effects of peer health education on perception and practice of screening for cervical cancer among urban residential women in south-East Nigeria: a before and after study. BMC Womens Health. 2017;17(1):41.CrossRefPubMedPubMedCentral
33.
go back to reference Montano DE, Kasprzyk D. Theory of reasoned action, theory of planned behavior, and the integrated behavioral model. Health Behavior. 2015;70(4):231. Montano DE, Kasprzyk D. Theory of reasoned action, theory of planned behavior, and the integrated behavioral model. Health Behavior. 2015;70(4):231.
34.
go back to reference Ndikom CM, Ofi BA, Omokhodion FO, Adedokun BO. Effects of educational intervention on women’s knowledge and uptake of cervical cancer screening in selected hospitals in Ibadan. Nigeria Int J Health Promot Educ. 2017;55(5–6):259–71.CrossRef Ndikom CM, Ofi BA, Omokhodion FO, Adedokun BO. Effects of educational intervention on women’s knowledge and uptake of cervical cancer screening in selected hospitals in Ibadan. Nigeria Int J Health Promot Educ. 2017;55(5–6):259–71.CrossRef
39.
go back to reference Moses E, Pedersen HN, Mitchell SM, Sekikubo M, Mwesigwa D, Singer J, Biryabarema C, Byamugisha JK, Money DM, Ogilvie GS. Uptake of community-based, self-collected HPV testing vs visual inspection with acetic acid for cervical cancer screening in Kampala, Uganda: preliminary results of a randomised controlled trial. Trop Med Int Health. 2015;20(10):1355–67. https://doi.org/10.1111/tmi.12549. Epub 2015 Jun 28. PMID: 26031572.CrossRefPubMed Moses E, Pedersen HN, Mitchell SM, Sekikubo M, Mwesigwa D, Singer J, Biryabarema C, Byamugisha JK, Money DM, Ogilvie GS. Uptake of community-based, self-collected HPV testing vs visual inspection with acetic acid for cervical cancer screening in Kampala, Uganda: preliminary results of a randomised controlled trial. Trop Med Int Health. 2015;20(10):1355–67. https://​doi.​org/​10.​1111/​tmi.​12549. Epub 2015 Jun 28. PMID: 26031572.CrossRefPubMed
40.
42.
go back to reference Okeke EN, Adepiti CA, Ajenifuja KO. What is the price of prevention? New evidence from a field experiment. J Health Econ. 2013;32(1):207–18.CrossRefPubMed Okeke EN, Adepiti CA, Ajenifuja KO. What is the price of prevention? New evidence from a field experiment. J Health Econ. 2013;32(1):207–18.CrossRefPubMed
44.
go back to reference Abiodun OA, Olu-Abiodun OO, Sotunsa JO, Oluwole FA. Impact of health education intervention on knowledge and perception of cervical cancer and cervical screening uptake among adult women in rural communities in Nigeria. BMC Public Health. 2014;14:814.CrossRefPubMedPubMedCentral Abiodun OA, Olu-Abiodun OO, Sotunsa JO, Oluwole FA. Impact of health education intervention on knowledge and perception of cervical cancer and cervical screening uptake among adult women in rural communities in Nigeria. BMC Public Health. 2014;14:814.CrossRefPubMedPubMedCentral
Metadata
Title
Baseline knowledge on risk factors, symptoms and intended behavior of women and men towards screening and treatment of cervical cancer in rural Uganda: a cross-sectional study
Authors
Carolyn Nakisige
Marlieke de Fouw
Miriam Nakalembe
Jackson Orem
Dan Atukonyera
Mwalimu Musheshe
Jaap Koot
Janine de Zeeuw
Jogchum Beltman
Jelle Stekelenburg
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2024
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-024-12223-8

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