TUAB035 – Cervical Cancer Knowledge And Screening Uptake

CERVICAL CANCER KNOWLEDGE & SCREENING UPTAKE AMONG WOMEN IN EMBU COUNTY,KENYA. ANNE MURUGI1,2 1.Amref Health Africa 2.University of Nairobi

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OUTLINE • • • • • •

Background Objectives Methodology Results Conclusion Recommendations

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BACKGROUND • Cancer is the leading cause of death worldwide and accounted for 8.2 million deaths in 2012. • Cervical cancer. leading cause of cancer deaths among women in developing countries. • 529,409 new cases occurred globally, with 274,883 of the women (52% of cases) dying. • 86% of the cases occur in developing countries • In SSA : magnitude of the problem is under-recognized and under-prioritized. • In Kenya-second most frequent cancer among women and the leading cause of cancer deaths in women of reproductive age. • 2454 new cases and 1676 deaths are reported every year • Only 3.2% of women in Kenya have been screened for cervical cancer. (WHO 2008,WHO2013) 3

PROBLEM STATEMENT • Morbidity and mortality of cervical cancer can be reduced through regular screening • Screening is available in most facilities (VIA/VILI) and Pap smear • Screening levels still remain low • Study findings will provide relevant information to increasing uptake in rural areas

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OBJECTIVES • Broad objective • To determine factors associated with cervical cancer screening uptake among women in Embu county, Kenya

• Specific objectives 1. To determine cervical cancer awareness & knowledge among women in Embu 2. To determine awareness & knowledge of cervical cancer screening 3. To determine the uptake of cervical cancer screening 4. To determine barriers to cervical cancer screening uptake 5

METHODOLOGY Study design Cross- sectional study survey Quantitative study

Study population

Data management and analysis

Study site

Women aged 18 years and above

Coding, data entry SPSS 17

Inclusion Criteria

Frequencies

All women aged 18 and above who gave consent

Bivariate analysis

Embu County

Sampling Multi stage cluster sampling Sample size 269 women

Exclusion Criteria Declined to consent Ethical Considerations

Data collection

Structured Questionnaire

Ethics approval Informed consent Confidentiality 6

SOCIO-DEMOGRAPHICS Characteristics Age in years

Marital status

Education level

Employment status

Classification 64 Total single (never married) Married Separated Divorced Widowed Total Primary Secondary Technical College University None Total Employed Fulltime Employed part time Unemployed Self-employed Full time home maker(house wife) Retired Others Total

Frequency 51 102 64 33 12 7 269 58 177 20 1 13 269 123 104 30 2 10 269 34 7 46 163 15 3 1 269

Percent 19.0 37.9 23.8 12.3 4.5 2.6 100 21.6 65.8 7.4 0.4 4.8 100 45.7 38.7 11.2 0.7 3.7 100 12.6 2.6 17.1 60.6 5.6 1.1 0.4 100

CERVICAL CANCER AWARENESS

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SIGNS AND SYMPTOMS Knowledge of signs of cervical cancer

Yes

No

Don't know

Vaginal bleeding between menses

31.6%

10.4%

58.0%

Persistent vaginal discharge with unpleasant smell

32.7%

10%

57.2%

Vaginal bleeding after menopause

34.6%

3.3%

62.1%

Bleeding during or after sex 29.0%

7.4%

63.6% 9

CERVICAL CANCER RISK FACTORS Risk factors of cervical cancer Infection with HPV

Disagree

Not sure

Agree

5.6%

70.6%

23.5%

Smoking cigarettes Weakened immune system Infection with STI's

14.1% 13.1%

51.7% 58.6%

34.2% 28.1%

9.3%

53.2%

37.3%

Having multiple sexual partners Having many children Having a sexual partner with multiple partners Not going for regular screening

11.6%

50.6%

37.7%

31.2%

58.7%

10.0%

13.4%

53.9%

32.7%

11.9%

52.8%

35.3% 10

CERVICAL CANCER SCREENING KNOWLEDGE

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CERVICAL CANCER SCREENING AWARENESS

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CERVICAL CANCER SCREENING UPTAKE

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BARRIERS TO CERVICAL CANCER SCREENING UPTAKE

Lack of information about ca cx

77%

Long distance to the HF

26.4%

Barriers to cervical cancer screening uptake

Not offered at nearest HF

31.6%

Lack of Designated rooms

15.2%

Screening is expensive

43.9%

Lack of convinient clinic time

33.8%

Attitude of HCWs

23%

Lack of female screeners at the facility

21%

Not suggested by HCW

19%

Not allowed by culture/religion

25%

Lack of partner approval

20%

Not knowing where to go

35%

Fear of vaginal exam

60%

Not at risk

63%

Ca cx screening is painful

39%

Little undestanding of ca cx

86% 0%

10%

20%

30%

40%

50% 60% Percentage

70%

80%

90%

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100%

ASSOCIATIONS Tests of association

p-value

Association between economic status and uptake of cervical cancer screening

0.027

Association between awareness of cervical cancer and age of respondent

0.031

Association between cervical cancer awareness and screening uptake