Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Biometris, Wageningen University, Wageningen, Netherlands, and StatUA (Core Facility for Statistical Analysis), University of Antwerp, Antwerp, Belgium.
BMC Public Health. 2019 May 4;19(1):508. doi: 10.1186/s12889-019-6874-2.
In Zambia, cervical cancer screening was started in 2006 and the human papillomavirus vaccine was piloted in 2013. Nevertheless, cervical cancer remains the leading cancer. It is assumed that knowledge, social interaction, health behaviors and religion are factors that can influence screening and vaccination practices. This study addresses the question, what is the relationship between knowledge about cervical cancer, attitudes, self-reported behavior, and immediate support system, towards screening and vaccination of cervical cancer of Zambian women and men. The results of this study serve as a basis for future research, an input for improvement and adjustment of the existing prevention program and build on documented health behavior frameworks.
A cross-sectional mixed methods study was conducted from February to May 2016. Two separate questionnaires were used to collect data from women (N = 300) and men (N = 300) residing in Chilenje and Kanyama (two townships in the capital city Lusaka). Respondent's knowledge of cervical cancer was operationalized by grading their ability to correctly identify causes and protective factors if they were aware of cervical cancer. Besides providing descriptive statistics of all study variables, we tested four research hypotheses concerning the link between knowledge, attitudes and practices suggested by the literature, by applying appropriate statistical tests (chi square test, analysis of variance, logistic regression).
Less than half of the respondents (36.8%) had heard of cervical cancer, 20.7% of women had attended screening and 6.7% of the total sample had vaccinated their daughter. Knowledge of causes and prevention was very low. There was a strong association between having awareness of cervical cancer and practicing screening (odds ratio = 20.5, 95% confidence interval = [9.214, 45.516]) and vaccination (odds ratio = 5.1, 95% confidence interval = [2.473, 10.423]). Social interactions were also found to greatly influence screening and vaccination behaviors.
The low level of knowledge of causes and prevention of cervical cancer suggests a need to increase knowledge and awareness among both women and men. Interpersonal interactions have great impact on practicing prevention behaviors, for instance, vaccination of daughters.
在赞比亚，宫颈癌筛查始于 2006 年，人乳头瘤病毒疫苗于 2013 年进行试点。然而，宫颈癌仍是主要癌症。据推测，知识、社会互动、健康行为和宗教是影响筛查和接种疫苗实践的因素。本研究探讨了赞比亚男女对宫颈癌筛查和接种疫苗的知识、态度、自我报告行为和即时支持系统之间的关系。本研究的结果为未来的研究提供了依据，为改进和调整现有的预防计划提供了投入，并建立在有文件记录的健康行为框架之上。
本研究采用横断面混合方法，于 2016 年 2 月至 5 月进行。使用两份单独的问卷从居住在奇伦杰和卡尼亚马（首都卢萨卡的两个城镇）的女性（n=300）和男性（n=300）中收集数据。对宫颈癌相关知识的评估通过评估他们识别宫颈癌相关病因和保护因素的能力来实现。除了提供所有研究变量的描述性统计数据外，我们还通过应用适当的统计检验（卡方检验、方差分析、逻辑回归），检验了文献中建议的知识、态度和行为之间的四个研究假设。
不到一半的受访者（36.8%）听说过宫颈癌，20.7%的女性接受过筛查，6.7%的总样本为女儿接种过疫苗。对病因和预防的认识非常低。对宫颈癌的认识与筛查（比值比=20.5，95%置信区间=[9.214，45.516]）和接种（比值比=5.1，95%置信区间=[2.473，10.423]）之间存在很强的关联。社会互动也被发现对筛查和接种行为有很大影响。
对宫颈癌病因和预防的低知识水平表明，需要提高妇女和男子的知识和认识。人际互动对预防行为（例如，为女儿接种疫苗）有很大的影响。
