Assessment of knowledge, awareness and attitude towards Cervical Cancer and its screening among women in Makkah KSA

AUTHORS

Dr. Hani A. Aziz JokhdarDr. Mohammed A. GaroutDr. Enas H. AlFalogyDr Rahma A. ALZahrany6th year medical students - UQU

Weaam S. Al-HarbiWafaa I. BahwainiHibah S. Alharbi

Introduction Cervical cancer is considered the 4th most common cancer of women worldwide and the 10th among Saudi women (international agency for research on cancer, 2013 ).

The cervical cancer incidence in Saudi Arabia is one of the lowest in the world, accounting for 2.3 % of diagnosed cases of cancer in female.(Tumor Registry, annual report. Nov. 2012 ).

Every year 241 women in Saudi Arabia are diagnosed with cervical cancer and 84 die from the disease (ICO Information Centre on HPV and Cancer, Fact Sheet 2014).

Screening of cervical precancerous lesion by Papanicolaou test (Pap test)results in a significant reduction of cervical cancer mortality and morbidity.

Unfortunately there is lack of well organized, systematic , structuredscreening program in KSA fore which most cases of cervical cancer presented tohealth care services late in advanced stage of disease.

The only organized screening program in Saudi Arabia is Jeddah Cervical Screening Program which was established 2 years ago .This program covers all Jeddah female community regardless of nationality and eligibility for treatment .

Unfortunately in other parts of the country there are sporadic Screening tests (Pap test) directed mainly for patients attending outpatient department for gynecological problems.

Introduction

UQU- UMC Program

UQU- medical center established a new unit for cervical cancer screening test .

This unit is branch of Jeddah Cervical Screening Program and follows the same protocol .

The unit will be the cornerstone for future MakkahCervical Screening Program .

UQU-MC Cervical Screening Lab.

Objectives of the study

To assess the level of knowledge regarding symptoms, risk factors and prevention(screening and vaccination) of cervical carcinoma among Makkah women population .

2)To find out the behavior (attitude) of respondents regarding prevention and screening of cervical cancer.

To assess and to plan for public education program accordingly.

Study design A questionnaire based cross-sectional study

Study populationWomen attending health care services in Makkah

SamplingA sample of 210 women was selected from female

attending outpatient clinics in 3 hospitals in Makah.

Data managementData was analyzed using SPSS Version 20

Qualifying Criteria

INCLUSION

Female (18-65 years)

Married, widow or divorced

Permanently living in Makkah.

EXCLUSION

Never been married women

Visitors Under 18 years or

above 65 years . Women with

cervical cancer .

Study setting A list of health care facilities (centers and hospitals)

was prepared.

Three facilities were randomly selected ( KAAH (Alzaher ), MCH and SFH ).

Female Patients were selected from outpatient clinics above.

Study tool and knowledge score

Collected using a semi-structured interview questionnaire

knowledge scoreThe cut of knowledge was taken as 50 % :

Knowing symptoms of cervical cancer.Knowing risk factors.Awareness of cervical cancer screening.Knowing about HPV vaccine. Knowing about preventing measures.

Ethical Consideration

The procedures of this study were approved by the Faculty of Medicine [Medical Ethics Board], UQU.

A simple and clear explanation of the Research Aims and Procedures was provided to the study population.

Verbal consent was obtained from the study population and heath facilities.

Results

87.1

12.9

poorgood

Level of knowledge about cervical Cancer

minority of the women have good knowledge about cervical cancer (12.9% [27/210])

Source of knowledge about screening

0.02.04.06.08.0

10.012.014.0

3.3

11.9 12.9

6.28.6

7.1percent

The knowledge mainly from the internet and mass media not from doctors

Awareness about cervical cancer screening

0

10

20

30

40

50

60

70

80

90

aware Not aware

percent

Only (13.8% [29/210]) are aware about screening.

Chart1

13.8

86.2

awareness

percent

Sheet1

knowledge about cancer cervixPercent

poor87.1

good12.9

awareness about cancer screeningPercent

aware13.8

Not aware86.2

awareness about cancer screening

awareness about cancer screening

awarenot aware

13.886.2

awarenessawareNot aware

13.886.2

awareness

aware13.8

Not aware86.2

awareness

aware13.8

Not aware86.2

awarenesspercent

aware13.8

Not aware86.2

awareness

good13.8

poor86.2

awareNot aware

awareness13.886.2

Sheet1

Sheet2

Sheet3

aware

aware

aware

aware

awareness

percent

awareness

awareness

percent

cancer cervix awareness

Prevalence of Pap smear

Only 21.4% women had undergone screening using Pap smear

01020304050607080

performed Pap test did not perform Paptest

21.4

78.6

Percent

Attitude towards screening

80%

20%

Attitude towards screening

positive negative

80% have positive attitude towards screening

Chart1

0.799

0.201

Percent

Attitude towards screening

Sheet1

knowledge about cancer cervixPercent

poor87.1

good12.9

awareness about cancer screening

aware

Not aware

awareness about cancer screening

awareness about cancer screening

aware

13.8

awarenessaware

13.8

awareness

aware13.8

Not aware86.2

awareness

aware13.8

Not aware86.2

awarenesspercent

aware13.8

Not aware86.2

awareness

good13.8

poor86.2

aware

awareness13.8

source of knoweledge about screening methods

Percent

magazine3.3

T.V11.9

Internet12.9

friends6.2

doctors8.6

other methods7.1

Attitude towards vaccination

FrequencyPercent

Validyes18990

no2110

Total210100

Percent

positive80%

negative20%

Prevalence of pap smearPercent

yes21.4

no78.6

Total100

Prevalence of pap smearPercent

performed Pap test21.4

did not perform Pap test78.6

taaking vaccinationPercent

vaccinated1.9

not vaccinated98.1

Sheet1

level of knowledge about cancer cervix

Sheet2

0

Sheet3

aware

aware

aware

aware

awareness

percent

awareness

awareness

percent

cancer cervix awareness

source of knoweledge about screening methods Percent

percent

Percent

Attitude towards screening

Percent

prevalence of Pap smear

Percent

takining vaccination to prevent cancer cervix

Taking vaccination to prevent cancer cervix

1.9

98.1vaccinatednot vaccinated

Only 1.9 % took the vaccine,

%

%

Postive Negtive

90% have positive attitude towards vaccination

Attitude towards vaccination

A small minority of the study group has undergonescreening test and only 1.9 % has been vaccinated.

Although the majority of women have poor knowledge,however, they have positive attitude towards screening andvaccination.

Conclusion

Massive awareness programs have to be implementedthrough various relevant groups to improve publicawareness.

Utilization of media such as television, newspaper and radioin addition to social media (Twitter, facebook and WhatsApp) will have great impact in the improvement of publicknowledge about cervical cancer screening.

Recommendations

THANK YOU

Slide Number 1AUTHORS Slide Number 3Slide Number 4UQU- UMC Program UQU-MC Cervical Screening Lab. Objectives of the study Slide Number 8Qualifying CriteriaSlide Number 10Slide Number 11Slide Number 12Slide Number 13Slide Number 14Source of knowledge about screeningAwareness about cervical cancer screeningPrevalence of Pap smearAttitude towards screeningTaking vaccination to prevent cancer cervixSlide Number 20Slide Number 21Slide Number 22Thank you