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Knowledge and Attitude of Cervical Cancer Screening and Vaccination in Patients Attending Gynecology Outpatient Clinic at a Tertiary Care Hospital in PakistanFunding None to disclose.
Background Cervical cancer is the third most prevalent female cancer in Pakistan; nearly 70% present at a very advanced stage of malignancy due to lack of awareness, proper screening, and vaccination. Therefore, we aimed to assess the knowledge and attitude toward screening, vaccination, and risk factors of cervical cancer in sexually active women of Pakistan.
Methods This cross-sectional study was conducted at the gynecology outpatient clinic of a public sector hospital in Karachi, Pakistan, from December 2021 to March 2022. We included sexually active women with exception of diagnosed cases of cervical cancer, pregnancy, vaginal bleeding, and psychological disorder. Collected data were regarding demographic characteristics, awareness regarding cervical cancer, screening, human papillomavirus (HPV) vaccine, and risk factors, history of cervical screening, and wiliness to opt-in for cervical screening.
Results We included 226 women with a mean age of 41.25 ± 10.54 years. The mean parity level was observed to be 3.8 ± 1.95. A majority of women were housewives by profession (88.9%) and uneducated (61.9%). Only 41.2% (93) of women were aware of cervical cancer, 33.6% (76) were aware of cervical screening, and only 15.9% (36) had a history of cervical screening. Only four women (1.8%) were aware of the HPV vaccine and 31% (70) showed intention to opt-in for cervical screening. A vast majority of women (96.9%) were not aware of the risk factors of cervical cancer.
Conclusion(s) We have observed poor awareness regarding cervical cancer, HPV vaccination, and cervical screening among women in our population. Lack of awareness was not restricted to a certain segment but it prevails all across the demographic in our population.
Keywordscervical cancer - cervical screening - HPV vaccination - awareness - knowledge - attitude - Pakistan
Study was approved by the ethical review committee of the Dow International Medical College (DIMC)/Dow University of Health Sciences (DUHS).
Article published online:
22 August 2022
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- 1 Arbyn M, Weiderpass E, Bruni L. et al. Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. Lancet Glob Health 2020; 8 (02) e191-e203
- 2 Hanisch R, Gustat J, Hagensee ME. et al. Knowledge of Pap screening and human papillomavirus among women attending clinics in Medellín, Colombia. Int J Gynecol Cancer 2008; 18 (05) 1020-1026
- 3 Arrossi S, Temin S, Garland S. et al. Primary prevention of cervical cancer: American Society of Clinical Oncology resource-stratified guideline. J Glob Oncol 2017; 3 (05) 611-634
- 4 Manikandan S, Behera S, Naidu NM, Angamuthu V, Mohammed OFB, Debata A. Knowledge and awareness toward cervical cancer screening and prevention among the professional college female students. J Pharm Bioallied Sci 2019; 11 (Suppl. 02) S314-S320
- 5 Batool SA, Sajjad S, Malik H. Cervical cancer in Pakistan: a review. J Pak Med Assoc 2017; 67 (07) 1074-1077
- 6 Imam SZ, Rehman F, Zeeshan MM. et al. Perceptions and practices of a pakistani population regarding cervical cancer screening. Asian Pac J Cancer Prev 2008; 9 (01) 42-44
- 7 Jeronimo J, Castle PE, Temin S. et al. Secondary prevention of cervical cancer: ASCO resource-stratified clinical practice guideline. J Glob Oncol 2016; 3 (05) 635-657
- 8 Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin 2015; 65 (02) 87-108
- 9 Gana GJ, Oche MO, Ango JT, Kaoje AU, Awosan KJ, Raji IA. Educational intervention on knowledge of cervical cancer and uptake of Pap smear test among market women in Niger State, Nigeria. J Public Health Africa 2017; 8 (02) 575
- 10 Ferlay J, Soerjomataram I, Dikshit R. et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015; 136 (05) E359-E386
- 11 Jradi H, Bawazir A. Knowledge, attitudes, and practices among Saudi women regarding cervical cancer, human papillomavirus (HPV) and corresponding vaccine. Vaccine 2019; 37 (03) 530-537
- 12 Baloch Z, Yasmeen N, Li Y. et al. Knowledge and awareness of cervical cancer, human papillomavirus (HPV), and HPV vaccine among HPV-infected Chinese women. Med Sci Monit 2017; 23: 4269-4277
- 13 Hong Y, Zhang C, Li X, Lin D, Liu Y. HPV and cervical cancer related knowledge, awareness and testing behaviors in a community sample of female sex workers in China. BMC Public Health 2013; 13 (01) 696
- 14 Feng S, Xu X, Jin Y, Yao X. Women's knowledge of human papillomavirus (HPV) and their attitudes toward HPV vaccine: preparing for HPV vaccination in China. Asia Pac J Public Health 2012; 24 (03) 522-531
- 15 Waller J, Jackowska M, Marlow L, Wardle J. Exploring age differences in reasons for nonattendance for cervical screening: a qualitative study. BJOG 2012; 119 (01) 26-32
- 16 Tung IL, Machalek DA, Garland SM. Attitudes, knowledge and factors associated with human papillomavirus (HPV) vaccine uptake in adolescent girls and young women in Victoria, Australia. PLoS One 2016; 11 (08) e0161846
- 17 Loke AY, Chan ACO, Wong YT. Facilitators and barriers to the acceptance of human papillomavirus (HPV) vaccination among adolescent girls: a comparison between mothers and their adolescent daughters in Hong Kong. BMC Res Notes 2017; 10 (01) 390
- 18 Ramathuba DU, Ngambi D, Khoza LB, Ramakuela NJ. Knowledge, attitudes and practices regarding cervical cancer prevention at Thulamela Municipality of Vhembe District in Limpopo Province. Afr J Prim Health Care Fam Med 2016; 8 (02) e1-e7
- 19 Rees HD, Lombardo AR, Tangoren CG, Meyers SJ, Muppala VR, Niccolai LM. Knowledge and beliefs regarding cervical cancer screening and HPV vaccination among urban and rural women in León, Nicaragua. PeerJ 2017; 5: e3871
- 20 Krishnaveni K, Roy P, Sambathkumar R. Knowledge, attitude and practice related to cervical cancer and screening among women: community based cross-sectional study. Int J Pharm Sci Res 2018; 9 (02) 722-729
- 21 Mofolo N, Sello M, Leselo M. et al. Knowledge of cervical cancer, human papillomavirus and prevention among first-year female students in residences at the University of the Free State. Afr J Prim Health Care Fam Med 2018; 10 (01) e1-e5
- 22 Pegu B, Dhiman N, Chaturvedi J, Sharma SK. Nurse's knowledge and attitude regarding cervical cancer screening at a tertiary care hospital. Int J Reprod Contracept Obstet Gynecol 2017; 6: 907-910
- 23 Liddon N, Hood J, Wynn BA, Markowitz LE. Acceptability of human papillomavirus vaccine for males: a review of the literature. J Adolesc Health 2010; 46 (02) 113-123
- 24 Maharajan MK, Rajiah K, Sze Fang KN, Lui LY. Cervical cancer prevention in Malaysia: knowledge and attitude of undergraduate pharmacy students towards Human Papillomavirus infection, screening and vaccination in Malaysia. J Cancer Educ 2017; 32 (01) 166-174
- 25 Ganju SA, Gautam N, Barwal V, Walia S, Ganju S. Assessment of knowledge and attitude of medical and nursing students towards screening for cervical carcinoma and HPV vaccination in a tertiary care teaching hospital. Int J Community Med Public Health 2017; 4 (11) 4186-4193
- 26 Baskar K, Lakshmi T. Knowledge, attitude and practices regarding HPV vaccination among undergraduate and postgraduate dental students in Chennai. J Pharm Res Int 2020; •••: 95-100
- 27 Swarnapriya K, Kavitha D, Reddy GMM. Knowledge, attitude and practices regarding HPV vaccination among medical and para medical in students, India a cross sectional study. Asian Pac J Cancer Prev 2015; 16 (18) 8473-8477
- 28 Karasu AFG, Adanir I, Aydin S, Ilhan GK, Ofli T. Nurses' knowledge and opinions on HPV vaccination: a cross-sectional study from Istanbul. J Cancer Educ 2019; 34 (01) 98-104
- 29 Minhas S, Sajjad A, Kashif M, Rehman Z, Idrees M, Ansari F. Cervical cancer vaccination awareness and acceptance among the females of Punjab, Pakistan. Makara J Health Res 2020; 24 (01) 8
- 30 Sultana R, Hafeez M, Shafiq S. Awareness about cervical cancer in Pakistani women. PAFMJ 2019; 69 (01) 21-25
- 31 Hirani S, Khan S, Akram S. et al. Knowledge, awareness, and practices of cervical cancer, its risk factors, screening, and prevention among women in Karachi, Pakistan. Eur J Cancer Prev 2021; 30 (01) 97-102
- 32 Khan M, Zafar A, Muneer R, Siddiqui A, Khan SAK, Zafar A. Knowledge, attitude, and practices regarding cervical cancer and human papilloma virus (HPV) vaccination. Pak J Med Dentist 2021; 10 (02) 94-100
- 33 Ayub N, Maqsud M, Tahseen H, Sharif M, Waris N, Rai AF. Knowledge and awareness of cervical cancer and screening practices among nurses at Lahore General Hospital, Pakistan. J Pharm Res Int 2020; •••: 7-12
- 34 Hafeez R, Perveen F, Zafar SN, Hafeez A. Educational effect on knowledge, attitude and practice among registered nurses regarding cervical cancer, its prevention and screening in Karachi, Pakistan. J Pak Med Assoc 2020; 70 (04) 674-678