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 Table of Contents  
ORIGINAL ARTICLE
Year : 2019  |  Volume : 16  |  Issue : 2  |  Page : 95-98

Awareness of cervical cancer and its risk factors among gynaecology clinic attendees


1 Department of Obstetrics and Gynaecology, YSUTH, Damaturu, Yobe State, Nigeria
2 Department of Obstetrics and Gynaecology, State Specialist Hospital, Damaturu, Yobe State, Nigeria

Date of Submission29-May-2019
Date of Decision14-Jul-2019
Date of Acceptance06-Sep-2019
Date of Web Publication19-Nov-2019

Correspondence Address:
Dr. Aisha A Buba
Department of Obstetrics and Gynaecology, Yobe State University Teaching Hospital, Damaturu, Yobe State
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/njbcs.njbcs_10_19

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  Abstract 


Background and Aims: Death from cervical cancer is preventable through effective cervical cancer screening and treatment of premalignant disease. Several studies have identified the lack of awareness and inadequate knowledge about cervical cancer among barriers to prevention of cervical cancer. Determining the level of awareness of cervical cancer may inform strategies that could empower women with adequate knowledge on cervical cancer and its prevention. This study aims at determining the level of awareness of cervical cancer and its risk factors among Gynaecology clinic attendees. Methods: The study was conducted in the State Specialist Hospital Damaturu, from July 2017 to May 2018. It was a descriptive cross sectional study conducted among 200 Gynae -clinic attendees, aged 15-60 years. The researchers administered structured questionnaires to obtain the data. Results: Of the 200 women interviewed, only 46 (23%) of them heard of cervical cancer. The radio (media) was the commonest source of information in majority (93%) of those that were aware of cervical cancer. 75% of the respondents did not know most of the risk factors of cervical cancer. Conclusion: The knowledge of cervical cancer and its risk factors was generally poor among the respondents. The media especially the radio could play an important role in raising awareness on cervical cancer.

Keywords: Awareness, cervical cancer, risk factors


How to cite this article:
Buba AA, Jalo II, Kawuwa MB. Awareness of cervical cancer and its risk factors among gynaecology clinic attendees. Niger J Basic Clin Sci 2019;16:95-8

How to cite this URL:
Buba AA, Jalo II, Kawuwa MB. Awareness of cervical cancer and its risk factors among gynaecology clinic attendees. Niger J Basic Clin Sci [serial online] 2019 [cited 2019 Dec 9];16:95-8. Available from: http://www.njbcs.net/text.asp?2019/16/2/95/270995




  Introduction Top


Cervical cancer is a preventable genital tract cancer, contributing 20-25% of all cancers among women in the sub-Saharan Africa. In Nigeria, it is the commonest gynaecological malignancy, killing one woman every hour and 9000 women every year.[1],[2] Its prevention is based on early detection and treatment of premalignant disease, a strategy that has reduced cervical cancer incidence in the developed countries. In developing countries like Nigeria, however, multiple barriers mitigate the prevention and control of cervical cancer. As a result, a large number of women remain unscreened leading to high incidence of advanced disease, low cure rates, poor survival and high death rate from the disease.[2]

Ignorance and inadequate knowledge on cervical cancer have been identified among barriers to effective cervical cancer prevention.[3] Determining the level of awareness of cervical cancer could be the first approach towards designing a successful cervical cancer prevention programme in a population. It may inform (healthcare planners) strategies of effective public health enlightenment that would encourage the uptake of cervical cancer screening, hence reducing cervical cancer incidence.

Studies have shown that raising awareness on cervical cancer and risk factors could reinforce women's participation in cervical cancer prevention, in addition to improving early health seeking behaviour among women.[4],[5],[6],[7],[8] Several studies have been conducted on cervical cancer awareness and knowledge across Nigeria,[9],[10],[11],[12],[13],[14],[15] but none has been done in Damaturu, the Yobe state capital. This study, is therefore aimed to determine the level of awareness of cervical cancer among the gynaecological clinic attendees in our centre. The outcome of this study could inform policy makers on strategies that would improve women's knowledge on cervical cancer and also their participation in cervical cancer screening.


  Methods Top


This is a cross-sectional study that was conducted from July 2017 to May 2018 in state specialist Hospital Damaturu, Yobe state. It is a 339 bedded health care facility, providing primary and secondary healthcare services across Yobe and its neighbouring states. Ethical approval of the study was obtained from the research and ethical committee State Specialist Hospital Yobe state. Verbal consent was obtained from each participant and the confidentiality of the participants was assured and ensured all through the study.

200 consenting, sexually active women, aged 15-60 yrs who attended the Gynae clinic in the department, were serially recruited in the study, until the sample size was complete. Very ill women or those with diagnosis of cervical cancer were excluded from the study. Also excluded were sexually unexposed women and those that declined to participate in the study. Two trained research assistants and the principal researcher administered the pretested questionnaires to the participants. The sample size was calculated from the Kish formulae[16] using 95% prevalence level of awareness of cervical cancer from a previous study[11] within the same region. A sample size of 76 was obtained, but it was stepped up to 200 to increase the power of the study. The questionnaire elicited sociodemographic characteristics such as age, marital status, parity and educational level etc. Information on cervical cancer awareness, its risk factors and prevention were also obtained. The principal researcher reviewed the data collected regularly to ensure quality and comparability of data between research assistants. The data collected was analysed using Statistical Package for Social Science SPSS version 16. The findings were presented in frequency tables and cross tabulations.


  Results Top


The interview outcome of all two hundred participants was analysed. The ages of the respondents ranged between 15-60 years with a mean age of 31.9 ± 1.1 years. The mean parity was 2.8 ± 2.1. 123 (61.5%) of the respondents were aged 20-39 years, while 51 (25.5%) were 40 years and above. The rest 26 (13%) were less than 20 years. Most 178 (89%) of the respondents had conceived previously, and majority 100 (50) of them were grand multiparous, 22 (11) however have never conceived. Married women constituted 92.5%, while four (2%) were single, the rest were divorcees 6 (3%) and widows 5 (2.5%). More than half 132 (66%) of the respondents had no formal education, and only 20 (10) had tertiary education, the rest had primary 23 (11.5%) and secondary education 25 (12.5%) [Table 1].
Table 1: Sociodemographic characteristics

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[Table 2] depicts the level of awareness and respondents sources of information on cervical cancer. Only 46 (23%) of the respondents have ever heard of cervical cancer. The media especially the radio constitute the commonest source of information on cervical cancer, while books and newspapers contributed the least. About half of the respondents agreed that cervical cancer is preventable and also curable if detected early, however only few of the respondents are aware of the causative role of HPV and the role of vaccination in the prevention of cervical cancer.
Table 2: Awareness of cervical cancer, screening services and sources of information

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Awareness of cervical cancer risk factors and symptoms is shown on [Table 3]. More than two-third of the women knew that multiple sexual partners and post coital bleeding are risk factors and symptoms of cervical cancer, respectively. About half of the respondents identified excessive foul smelling vaginal discharge as a symptom of cervical cancer. The remaining variables were poorly identified as risk factors and symptoms by the participants. Overall, the knowledge on risk factors and symptoms was poor.
Table 3: Awareness of cervical cancer risk factors and symptoms n=46

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Respondent's awareness on cervical cancer screening is assessed in [Table 4]. All those that have heard of cervical cancer are aware of some form of cervical cancer screening services; however, only 12 (6%) of them have had smear. The major reasons given for not having the test were lack of knowledge, lack of recommendation by healthcare staff and lack of finance. However, 88% of them were ready to avail themselves for  Pap smear More Details.
Table 4: Respondents uptake of pap smears

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  Discussion Top


Most of the respondents in this study were young women, with poor formal education, and high parity. This is in consonance with findings of earlier studies[15] from the same region. High parity observed in this study could probably be due to the practice of early marriage and poor practice of modern contraception as observed by a previous survey.[17] In addition to reproductive risk they pose, early marriage and multiparity are known risk factors to developing cervical cancer. Mandatory girl child education could help reduce early marriage and its harmful ripple effects in the lives of women.

Only 23% of the respondents have ever heard of cervical cancer and this is comparable to the study from Maiduguri.[15] It is however lower than 94%, 66.9% and 65% reported among health workers, Market women and out-patient department (OPD) clinic attendees in, Maiduguri,[11] Zaria[13] and India,[8] respectively. The healthcare workers interviewed in other studies would naturally have more access to healthcare information compared to the respondents in our study. In addition, high level of formal education observed among the Indian study population which comprise mostly of women with tertiary level of education might be responsible for the high level of awareness observed in that study. The participants of the Zaria study were market women who have had community health outreach programs on cancer including cervical cancer screening prior to that study. They were therefore more likely to be more informed regarding cervical cancer than the women in our study.

Creating awareness on the ways of prevention, the nature and burden of cervical cancer across a population may therefore improve women's understanding and increase their participation in reducing cervical cancer incidence.

The media especially the radio was the commonest source of information on cervical cancer in this study. Similar findings were reported from Lagos[3] and Makurdi.[18] The media especially the radio, could play a huge role in disseminating health information across a large population in both rural and urban communities due to its mass impact and relative affordability. Empowering women with health information on cervical cancer using the mass media may increase the level of awareness and hopefully the utilisation of the available screening services.

Adequate knowledge on cervical cancer risk factors and symptoms could increase uptake of cervical cancer screening as well as enhance early presentation among women. Increased uptake of cervical cancer screening such as Pap smear can lead to early detection and treatment of premalignant lesions; a strategy that has successfully reduced the incidence of cervical cancer in the developed countries. Our study, however, has observed a low level of awareness on risk factors and symptoms of cervical cancer, which is in consonance with the findings of Omotara et al.[15] and Kahesa.[6] It is however lower than the findings of Bakari et al. from the same region[11] understandably, health care workers would have better access to health information.

The uptake of cervical cancer screening was very low even among the women that were aware. The commonest reason for not doing the test was lack of awareness. This concurs with earlier findings.[9],[13] Further studies may be needed to identify barriers to the utilisation of cervical cancer screening services among women in this part of the country.


  Conclusion Top


The awareness of cervical cancer and its risk factors are very low among women in this study. The media especially the radio could be an effective means of raising awareness on cervical cancer. Girl child education which has the potential to prevent early marriage and other reproductive risks should be made mandatory in every community.

Limitation of the study

This was a hospital based study and therefore findings cannot be generalised to the population.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Marlow LAV, Waller J, Wardle J. Barriers to cervical cancer screening among ethnic minority women: A qualitative study. J Fam Plann Reprod Health Care 2015;41:248-54.  Back to cited text no. 1
    
2.
Cervical Cancer. Estimated incidence, mortality and prevalence worldwide in 2012. The GLOBOCON 2012 database. International agency for research on cancer. Available from: http://publications.iarc.fr/Databases/Iarc-Cancerbases/GLOBOCAN-2012. [Last accessed on 2019 Aug 11].  Back to cited text no. 2
    
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Simon AE, Waller J, Robb K, Wardle J. Patient delay in presentation of possible cancer symptoms: The contribution of knowledge and attitudes in a population sample from the United Kingdom. Cancer Epidemiol Biomarkers Prev 2010;19:2272-77.  Back to cited text no. 3
    
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Oluwole EO, Mohammed AS, Akinyinka MR, Solako O. Cervical cancer awareness and screening uptake among rural women in Lagos, Nigeria. J Comm Med Prim Health Care 2017;29:81-8.  Back to cited text no. 4
    
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Bansai 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.  Back to cited text no. 8
    
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Idowu A, Olowookere SA, Fagbemi AT, Ogunlaja OA. Determinants of cervical cancer screening uptake among women in Ilorin, North Central Nigeria: A community-based study. J Cancer Epidemiol 2016;6469240. doi:10.1155/2016/6469240.  Back to cited text no. 10
    
11.
Bakari M, Takai IU, Bukar M. Awareness and utilisation of papanicoloau smear among health care workers in Maiduguri, Nigeria. Niger J Basic Clin Sci 2015;12:34-8.  Back to cited text no. 11
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Abiodum OA, Fatungase OK, Olu-Abiodun OO, Idowu-Ajiboye BA, Awosile JO. An assessment of women's awareness and knowledge about cervical cancer and screening and the barriers to cervical cancer screening in Ogun State, Nigeria. J Dent Med Sci 2013;10:52-8.  Back to cited text no. 12
    
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Ahmed SA, Sabitu K, Idris SH, Ahmed R. Knowledge, attitude and practice of cervical cancer screening among market women in Zaria, Nigeria. Niger Med J 2013;5;316-9.  Back to cited text no. 13
    
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Abiodun AB, Oluwasola TA, Durodola AO, Ajani MA, Abiodun AD, Adeomi AA. Awareness and perception of risk for cervical cancer among women in Ogbomoso, Nigeria. Trop J Obstet Gynaecol 2017;34;218-23.  Back to cited text no. 14
    
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Omotara BA, Yahya SJ, Amodu MO, Bimba JS. Assessment of the knowledge, attitude and practice of rural women of North-Eastern Nigeria on risk factors associated with cancer of the cervix. Health 2013;5:1367-71.  Back to cited text no. 15
    
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Survey KL. Sampling. New York: John Wiley and Sons Inc; 1965. p. 59-60.  Back to cited text no. 16
    
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Hyacinth HI, Adekeye OA, Ibeh JN, Osoba T. Cervical cancer and pap smear test among Federal civil servant in North Central Nigeria. PLoS One 2012;7:e46583.  Back to cited text no. 18
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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