Abstract
Background: In developing countries like Pakistan, it is essential for health care professionals to have comprehensive knowledge regarding cervical cancer.
Methods: A cross-sectional self-administered paper-based questionnaire was administered to patients from 2016 to 2018. This study included 200 females who attended the gynecological OPD of Lady Willingdon Hospital Lahore, Punjab. We evaluated cervical cancer knowledge, screening, prevention, and acceptance towards the vaccination. Data entry and analysis were performed using SPSS version 20.
Results: The perception and knowledge related to cervical cancer (28%), screening (3%), prevention (3%), and vaccination (1%) among the females were poor, but a positive attitude was observed towards cervical cancer screening, vaccination, and awareness programs. An extreme lack of knowledge was observed regarding the risk factors associated with cervical cancer and the availability of the cervical cancer vaccine (99%). A significant association (p > 0.005) was noted among the level of education and awareness of cervical cancer, its mode of transmission, and screening tests.
Conclusion: The knowledge and perception of cervical cancer and its vaccine among the females of Punjab, Pakistan were inadequate. Efforts should be made to prevent and control cervical cancer in Pakistan by establishing proper strategies, such as health education programs through health care providers and media support.
References
1. Boulet GA, Horvath CA, Berghmans S, Bogers J. Human papillomavirus in cervical cancer screening: important role as biomarker. Cancer Epidemiol Biomarkers Prev. 2008;17:810–17.
2. Kumar V, Abbas AK, Fausto N, Mitchell RN. Robbins Basic Pathology. 8th edn. United States: Saunders Elsevier; 2007. p.718–21.
3. Haesebaert J, Lutringer-Magnin D, Kalecinski J, Barone G, Jacquard AC, Régnier V, et al. French women’s knowledge of and attitudes towards cervical cancer prevention and the acceptability of HPV vaccination among those with 14–18-year-old daughters: a quantitative-qualitative study. BMC Public Health. 2012;12:1034.
4. Heena H, Durrani S, AlFayyad I, Riaz M, Tabasim R, Parvez G, Abu-Shaheen A. Knowledge, attitudes, and practices towards cervical cancer and screening amongst female healthcare professionals: A cross-sectional study. BMC Women's Health. 2019:122.
5. Juckett G, Hartman-Adams H. Human papillomavirus: clinical manifestations and prevention. Am Fam Physician. 2010;82:1209.
6. Lehtinen M, Paavonen J, Wheeler CM, Jaisamrarn U, Garland SM, Castellsagué X, et al. Overall efficacy of HPV-16/18 AS04-adjuvanted vaccine against grade 3 or greater cervical intraepithelial neoplasia: 4-year end-of-study analysis of the randomised, double-blind PATRICIA trial. Lancet Oncol. 2012;13:89–99.
7. Endarti D, Satibi KSA, Farida MA, Rahmawanti Y, Andriani T. Knowledge, perception, and acceptance of HPV vaccination and screening for cervical cancer among women in Yogyakarta Province, Indonesia. Asian Pac J Cancer Prev. 2018;19;1105–11.
8. Reeler A, Qiao Y, Dare L, Li J, Zhang AL, Saba J. Women’s cancers in developing countries: from research to an integrated health systems approach. Asian Pac J Cancer Prev. 2009;10:519–26.
9. Zarchi MK, Behtash N, Chiti Z, Kargar S. Cervical cancer and HPV vaccines in developing countries. Asian Pac J Cancer. 2009;10:96974.
10. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet‐Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65:87–108.
11. Mortensen GL, Adeler AL. Qualitative study of women’s anxiety and information needs after a diagnosis of cervical dysplasia. J Public Health, 2010;18:473–82.
12. Burger EA, Nygård M, Gyrd-Hansen D, Moger TA, Kristiansen IS. Does the primary screening test influence women’s anxiety and intention to screen for cervical cancer? A randomized survey of Norwegian women. BMC Public Health. 2014;14:360.
13. León-Maldonado L, Wentzell E, Brown B, Allen-Leigh B, Torres-Ibarra L, Salmeron J, Billings DL, Thrasher JF, Lazcano-Ponce E. Perceptions and experiences of human papillomavirus (HPV) infection and testing among low-income Mexican women. PloS One. 2016;11.
14. Khazaee-Pool M, Yargholi F, Jafari F, Ponnet K. Exploring Iranian women’s perceptions and experiences regarding cervical cancer-preventive behaviors. BMC Women's Health, 2018;18:1–14.
15. Palmieri B, Poddighe D, Vadala M, Laurino C, Carnovale C, Clementi E. Severe somatoform and dysautonomic syndromes after HPV vaccination: Case series and review of literature. Immunol Res. 2017;65:106–16.
16. Brisson M, Kim JJ, Canfell K, Drolet M, Gingras G, Burger EA, et al. Impact of HPV vaccination and cervical screening on cervical cancer elimination: a comparative modelling analysis in 78 low-income and lower-middle-income countries. Lancet. 2020;395:575-90.
17. Joura EA, Pils S. Vaccines against human papillomavirus infections: protection against cancer, genital warts or both? Clin Microbiol Infect. 2016;22:S125–7.
18. World Health Organization. Human papillomavirus vaccines. WHO position paper. Weekly Epidemiological Record (WER). 2009;15:17–132.
19. Kaarthigeyan K. Cervical cancer in India and HPV vaccination. Indian J Med Paediatr Oncol. 2012;33:7-12.
20. Batool SA, Sajjad S, Malik H. 2017. Cervical cancer in Pakistan: A review. J Pak Med Assoc. 2017;67:1074–77.
21. Idrees R, Fatima S, Abdul-Ghafar J, Raheem A, Ahmad Z. Cancer prevalence in Pakistan: meta-analysis of various published studies to determine variation in cancer figures resulting from marked population heterogeneity in different parts of the country. World J Surg Oncol. 2018;16:129.
22. Mukama T, Ndejjo R, Musabyimana A, Halage AA, Musoke D. Women’s knowledge and attitudes towards cervical cancer prevention: a cross sectional study in Eastern Uganda. BMC Womens Health. 2017;17:9.
23. Mosavel M, Simon C, Oakar C, Meyer S. Cervical cancer attitudes and beliefs–a Cape Town community responds on World Cancer Day. J Cancer Educ. 2009;24:114–9.
24. Champion VL, Skinner CS. The health belief model. In Glanz K, Rimer BK, Viswanat K. Eds. Health Behavior and Health Education: Theory, Research, and Practice. San Francisco, CA: Jossey-Bass, 2008, p. 46–65.
25. Shama R, Sayeeda A, Sumera A. Knowledge and awareness regarding cervical cancer and uptake of pap smear among women in Karachi, Pakistan. EC Gynaecol. 2017;4:154–61.
26. 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;6:324–8.
27. Sherman SM, Nailer E, Minshall C, Coombes R, Cooper J, Redman CWE. Awareness and knowledge of HPV and cervical cancer in female students: A survey (with a cautionary note). J Obstet Gynaecol. 2016;36:76–80.
28. Narayana G, Suchitra MJ, Sunanda G, Ramaiah JD, Kumar BP, Veerabhadrappa KV. Knowledge, attitude, and practice toward cervical cancer among women attending Obstetrics and Gynecology Department: A crosssectional, hospital-based survey in South India. Indian J Cancer. 2017;54:481–7.
29. Abdullahi A, Copping J, Kessel A, Luck M, Bonell C. Cervical screening: Perceptions and barriers to uptake among Somali women in Camden. Public Health. 2009;123:680–5.
30. Bathija GV, Mallesh S, Gajula M. A study on awareness of cervical cancer among women of reproductive age group in urban slums of old Hubli, Karnataka, India. Int J Community Med Public Health. 2016;3:2579–83.
31. Khanna N, Ramaseshan A, Arnold S, Panigrahi K, Macek MD, Padhi BK, et al. Community awareness of HPV screening and vaccination in Odisha. Obstet Gynecol Int. 2015;2015:694560.
32. Ali SF, Ayub S, Manzoor NF, Azim S, Afif M, Akhtar N, et al. Knowledge and awareness about cervical cancer and its prevention amongst interns and nursing staff in tertiary care hospitals in Karachi, Pakistan. Plos One. 2010; 5:e11059.
33. Parmar S, Waskel B, Dixit S, Shivram G, Patidar A, Babu SS, et al. Cross sectional study of knowledge of cervical cancer and awareness, knowledge and vaccine acceptance human papillomavirus vaccine among school girls of government and private school of Central India. Int J Community Med Public Health. 2016;3:2987–92.
34. Goyal A, Vaishnav G, Shrivastava A, Verma R, Modi A. Knowledge, attitude & practices about cervical cancer and screening among nursing staff in a teaching hospital. Int J Med Sci Public Health. 2013;2:249–54.
35. Aswathy S, Quereshi MA, Kurian B, Leelamoni K. Cervical cancer screening: Current knowledge & practice among women in a rural population of Kerala, India. Indian J Med Res. 2012;136:205.
36. Imam SZ, Rehman F, Zeeshan MM, Maqsood B, Asrar S, Fatima N, et al. Perceptions and practices of a Pakistani population regarding cervical cancer screening. Asian Pac J Cancer Prev. 2008;9:42–4.
37. Aziz N, Yousfani S. Pattern of presentation of cervical carcinoma at Nuclear Institute of Medicine and Radiotherapy, Pakistan. Pak J Med Sci. 2013;29;814.
38. Saha A, Chaudhury AN, Bhowmik P, Chatterjee R. Awareness of cervical cancer among female students of premier colleges in Kolkata, India. Asian Pac J Cancer Prev. 2010;11:1085–90.
39. Blodt S, Holmberg C, Muller-Nordhorn J, Rieckmann N. Human Papillomavirus awareness, knowledge and vaccine acceptance: a survey among 18-25-year-old male and female vocational school students in Berlin, Germany. Eur J Public Health. 2012;22:808–13.
40. Samkange-Zeeb F, Spallek L, Klug S, Zeeb H. HPV infection awareness and self-reported HPV vaccination coverage in female adolescent students in two German cities. J Community Health. 2012;37:1151–6.
41. WHO. Vaccination greatly reduces disease, disability, death and inequity worldwide. Bull World Health Organ. 2008;86.
42. Wilyman J. HPV vaccination programs have not been shown to be cost-effective in countries with comprehensive Pap screening and surgery. Infect Agent Cancer. 2013;8:21.
43. Pandhi D, Sonthalia S. Human papilloma virus vaccines: Current scenario. Indian J Sex Transm Dis AIDS. 2011;32:75.
44. Nganwai P, Truadpon P, Inpa C, Sangpetngam B, Mekjarasnapa M, Apirakarn M, et al. Knowledge, attitudes and practices vis-a-vis cervical cancer among registered nurses at the Faculty of Medicine, Khon Kaen University, Thailand. Asian Pac J Cancer Prev. 2008;9:15–8.
45. Mortensen GL. Drivers and barriers to acceptance of human-papillomavirus vaccination among young women: A qualitative and quantitative study. BMC Public Health. 2010;10:68.
Recommended Citation
Minhas S, Sajjad A, Kashif M, Rehman Z, Idrees M, Ansari F, et al. Cervical cancer vaccination awareness and acceptance among the females of Punjab, Pakistan. Makara J Health Res. 2020;24.
