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)

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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 objectives1.To determine cervical cancer awareness &

knowledge among women in Embu2.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

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METHODOLOGY

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Study design

Cross- sectional study survey

Quantitative study Study population

Women aged 18 years and above

Inclusion Criteria

All women aged 18 and above who gave consent

Exclusion Criteria

Declined to consent

Ethical Considerations

Ethics approval

Informed consent

Confidentiality

Study site

Embu County

Data collection

Structured Questionnaire

Sampling

Multi stage cluster sampling

Sample size

269 women

Data management and analysis

Coding, data entry SPSS 17

Frequencies

Bivariate analysis

SOCIO-DEMOGRAPHICS

Characteristics Classification Frequency Percent

Age in years <25 51 19.025-34 102 37.935-44 64 23.845-54 33 12.355-64 12 4.5>64 7 2.6Total 269 100

 Marital status single (never married) 58 21.6Married 177 65.8Separated 20 7.4Divorced 1 0.4Widowed 13 4.8Total  269  100

 Education level Primary 123 45.7Secondary 104 38.7Technical College 30 11.2University 2 0.7None 10 3.7Total  269  100

 Employment status Employed Fulltime 34 12.6Employed part time 7 2.6Unemployed 46 17.1Self-employed 163 60.6Full time home maker(house wife) 15 5.6Retired 3 1.1Others 1 0.4Total  269  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%

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CERVICAL CANCER RISK FACTORS Risk factors of cervical cancer

Disagree Not sure Agree

Infection with HPV 5.6% 70.6% 23.5%

Smoking cigarettes 14.1% 51.7% 34.2% Weakened immune system

13.1% 58.6% 28.1%

Infection with STI's 9.3% 53.2% 37.3%

Having multiple sexual partners

11.6% 50.6% 37.7%

Having many children

31.2% 58.7% 10.0%

Having a sexual partner with multiple partners

13.4% 53.9% 32.7%

Not going for regular screening

11.9% 52.8% 35.3%

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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

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ASSOCIATIONS

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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

<0.001

Association between awareness of cervical cancer screening and uptake

<0.001

Association between knowledge of prevention of cervical cancer and screening uptake

<0.001

CONCLUSION• Awareness of cervical cancer screening

among the respondents was high • Knowledge of the signs and symptoms and

risk factors associated with cervical cancer was low.

• Screening uptake was very low despite the high levels of awareness of cervical cancer and cervical cancer screening.

• Awareness of cervical cancer, awareness of cervical cancer screening and knowledge of modes of prevention of cervical cancer were critical in determining cervical cancer screening uptake among the women.

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RECOMMENDATIONS

To the Government and County Governments• Awareness campaigns and education

programmes to encompass signs and symptoms, risk factors and modes of prevention of the disease.

Research institutions • Studies to explore the disparity between high

awareness and low uptake should be conducted.

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ACKNOWLEDGEMENTS

• University of Nairobi

• AMREF Kenya

• All women who participated