Knowledge, attitude, and practice on cervical cancer and screening among women living in Tirukalukundram, Kancheepuram district, India : a crosssectional survey

Abstract

Background: Cervical cancer is the fourth most typical cancer among Indian women. It is one of the leading public health problems in India where it holds 25% of the global burden on cervical cancer. Screening helps in detecting atypical cell changes in the cervix in prior they turn into cancer. Objectives: This study was aimed to identify the level of knowledge, attitude, and practice (KAP) on cervical cancer and its screening, the KAP predictors for cervical cancer, and the influence of knowledge on practice for cervical cancer screening among women aged 21 to 65 years in a private outpatient healthcare facility in Tirukalukundram, Kancheepuram district in 2018. Methods: A cross-sectional survey was conducted among women who visiting the K.R. Hospital, Tirukalukundram for their regular checkups. Interviewer administered questionnaire was done with all the eligible women during the study period. The KAP questionnaire was adopted from other studies. Descriptive analyses were done to describe the socio-demographic characteristics, knowledge, attitude and practice of the study participants. For the predictors, logistic and linear regression were used. Multivariable logistic regression was done to find the association between knowledge and practice on cervical cancer screening. Results: Overall, 382 participants completed the survey with the response rate 91.1% and the mean age 41.1 years. The mean percent knowledge, attitude, and practice score for the surveyed women was 6.7%, 62.7% and 7.3% respectively. The significant predictors of knowledge were educational status, marital status, accessibility, gynecologist advice for screening, employment status, and maternal education (p<0.05). Knowledge, age, gynecologist advice, maternal education, and father employment were identified as attitude predictors (p<0.05). Knowledge, attitude, age, gynecologist advice, and employment were identified as practice predictors (p<0.05). The multivariable logistic regression analysis Practice on cervical cancer screening was highly statistically significant associated (p <0.001) with the cervical cancer knowledge after adjusting for confounders and attitude as the mediator. Conclusion and Recommendations: The study identified that most of the participants had poor knowledge and poor practice on cervical cancer screening, however majority had a positive attitude towards screening. The influence of knowledge on practice of cervical cancer screening highlights the possibility of improving the screening practices by applying cervical cancer related awareness program in the communities.