Rijal Bishnu Maya, Dawadi Pratima
Ministry of Health and Population, Chandragiri Municipality, Kathmandu, Nepal.
Nepal Health Research Council, Kathmandu, Nepal.
Heliyon. 2024 Jul 20;10(14):e34886. doi: 10.1016/j.heliyon.2024.e34886. eCollection 2024 Jul 30.
Cervical cancer is a severe public health problem worldwide including developing countries like Nepal. Cervical cancer screening has decreased the incidence and mortality of cervical cancer worldwide. Although it is highly preventable disease, cervical cancer is the leading cause of mortality among Nepalese women due to poor knowledge, negative attitude, poor practice, and late diagnosis. 1928 women died from cervical cancer in Nepal in 2018, this number was higher than that in 2017.
This study aimed to identify the knowledge, attitudes, and associated factors related to cervical cancer and its screening practices among women in Nepal.
A community-based cross-sectional study was conducted after following the ethical approval from the Nepal Health Research Council, Ref No-115 in Kathmandu, Nepal. A total of 426 married women aged 18-49 were selected using a probability proportionate simple random sampling technique. After obtaining the written informed consent, the participants were interviewed using a validated questionnaire. Data entry and analysis were performed using IBM SPSS Statistics version 23, and we interpreted the findings using both descriptive and inferential statistics. To assess the factors associated with knowledge and attitude levels, we employed Chi-square analysis and subsequently conducted binary logistic regression analysis.
The average age of respondents was 31.18 ± 8.375 and 85 % of respondents heard about cervical cancer mainly from Television/Radio. Slightly more than half (51.8 %) of respondents had favorable attitude towards cervical cancer and its screening. Regarding knowledge, 46.5 % had adequate knowledge about cervical cancer and its screening. However, majority of (91.5 %) the respondents had never done cervical cancer screening test. In logistic regression analysis, respondent's education, occupation and heard about cervical cancer were significantly associated with adequate level of knowledge. Women with secondary education (AOR = 3.875 95 % CI: 1.741-8.623) and higher education (AOR = 7.818 95 % CI: 3.386-18.048) had more adequate knowledge compared with illiterate women. Age and heard about cervical cancer and type of family were positively associated with favorable attitude. There was a very weak positive correlation between knowledge and attitude of cervical cancer and its screening (r = 0.078).
Cervical cancer is a severe public health problem of Nepal. From the result, we can say that about half of the subjects had knowledge and favorable attitude towards cervical cancer, despite the fact that still there is gap to transform it in to practice. There is a need for some measures to improve the cervical cancer screening practice by using information, Education, Communication materials and Behavior Change Communication (IEC/BCC).
宫颈癌是包括尼泊尔等发展中国家在内的全球严重公共卫生问题。宫颈癌筛查已降低了全球宫颈癌的发病率和死亡率。尽管宫颈癌是一种高度可预防的疾病，但由于知识匮乏、态度消极、行为不佳和诊断延迟，它仍是尼泊尔女性死亡的主要原因。2018年，尼泊尔有1928名女性死于宫颈癌，这一数字高于2017年。
本研究旨在确定尼泊尔女性对宫颈癌及其筛查方法的知识、态度和相关因素。
在获得尼泊尔卫生研究委员会（编号115）的伦理批准后，在尼泊尔加德满都进行了一项基于社区的横断面研究。采用概率比例简单随机抽样技术，共选取了426名年龄在18 - 49岁的已婚女性。在获得书面知情同意后，使用经过验证的问卷对参与者进行访谈。使用IBM SPSS Statistics 23版进行数据录入和分析，并运用描述性和推断性统计方法解读研究结果。为评估与知识和态度水平相关的因素，我们采用卡方分析，随后进行二元逻辑回归分析。
受访者的平均年龄为31.18 ± 8.375岁，85%的受访者主要通过电视/广播听说过宫颈癌。略超过一半（51.8%）的受访者对宫颈癌及其筛查持积极态度。在知识方面，46.5%的人对宫颈癌及其筛查有足够的了解。然而，大多数（91.5%）受访者从未进行过宫颈癌筛查测试。在逻辑回归分析中，受访者的教育程度、职业以及是否听说过宫颈癌与足够的知识水平显著相关。与文盲女性相比，受过中等教育（比值比 = 3.875，95%置信区间：1.741 - 8.623）和高等教育（比值比 = 7.818，95%置信区间：3.386 - 18.048）的女性有更充足的知识。年龄、是否听说过宫颈癌以及家庭类型与积极态度呈正相关。宫颈癌及其筛查的知识与态度之间存在非常微弱的正相关（r = 0.078）。
宫颈癌是尼泊尔严重的公共卫生问题。从结果来看，我们可以说约一半的受试者对宫颈癌有一定知识和积极态度，尽管在将其转化为实际行动方面仍存在差距。需要采取一些措施，通过信息、教育、宣传材料和行为改变沟通（IEC/BCC）来改善宫颈癌筛查实践。
