Download PDF
CC BY-NC-ND 4.0 · South Asian J Cancer 2023; 12(01): 017-022
DOI: 10.1055/s-0042-1751093
Original Article
Cervical Cancer

Knowledge and Attitude of Cervical Cancer Screening and Vaccination in Patients Attending Gynecology Outpatient Clinic at a Tertiary Care Hospital in Pakistan

Shamaila Shamaun
1   Dow International Medical College (DIMC)/Dow University of Health Sciences (DUHS), Karachi, Pakistan
,
Riffat Jaleel
1   Dow International Medical College (DIMC)/Dow University of Health Sciences (DUHS), Karachi, Pakistan
2   Dr Ruth KM Pfau Civil Hospital, Karachi, Pakistan
,
Yasmeen Gull
3   Meer Jam Ghulam Qadir Hospital Hub District, Lasbella Balochistan, Pakistan
,
Afshan Shahid
1   Dow International Medical College (DIMC)/Dow University of Health Sciences (DUHS), Karachi, Pakistan
,
Mehreen Iqbal
1   Dow International Medical College (DIMC)/Dow University of Health Sciences (DUHS), Karachi, Pakistan
,
Tabinda Naseer Qazi
1   Dow International Medical College (DIMC)/Dow University of Health Sciences (DUHS), Karachi, Pakistan
› Author Affiliations Funding None to disclose.
› Further Information
Also available at
   Permissions and Reprints

Abstract

Zoom Image
Shamaila Shamaun

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.

Keywords

cervical cancer - cervical screening - HPV vaccination - awareness - knowledge - attitude - Pakistan

Note

Study was approved by the ethical review committee of the Dow International Medical College (DIMC)/Dow University of Health Sciences (DUHS).




Publication History

Article published online:
22 August 2022

© 2022. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 5 Batool SA, Sajjad S, Malik H. Cervical cancer in Pakistan: a review. J Pak Med Assoc 2017; 67 (07) 1074-1077
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    Search in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    Search in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefSearch in Google Scholar
  • 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
    CrossrefSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    Search in Google Scholar
  • 30 Sultana R, Hafeez M, Shafiq S. Awareness about cervical cancer in Pakistani women. PAFMJ 2019; 69 (01) 21-25
    Search in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar
  • 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
    Search in Google Scholar
  • 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
    CrossrefSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar