Cervical Cancer Screening Program – A Camp Based Cross Sectional Study Among Rural Women in North Kerala
Science Journal of Public Health
Volume 5, Issue 3, May 2017, Pages: 215-223
Received: Feb. 15, 2017;
Accepted: Mar. 4, 2017;
Published: Mar. 27, 2017
Views 1952 Downloads 97
Usha Karunakaran, Department of Community Medicine, Academy of Medical Sciences, Pariyaram, Kannur, Kerala
Namitha Thekkandathil, Department of Obstetrics and Gynecology, Academy of Medical Sciences, Pariyaram, Kannur, Kerala
Binoo Divakaran, Department of Community Medicine, Academy of Medical Sciences, Pariyaram, Kannur, Kerala
Mini Mol Joseph, Department of Community Medicine, Academy of Medical Sciences, Pariyaram, Kannur, Kerala
Salini Kannankai, Department of Community Medicine, Academy of Medical Sciences, Pariyaram, Kannur, Kerala
Jayasree Anandabhavan Kumaran, Department of Community Medicine, Academy of Medical Sciences, Pariyaram, Kannur, Kerala
Cervical cancer is ranked as the most frequent cancer in women in India and still remains a leading cause of cancer deaths because of high HPV infection rates and lack of comprehensive cervical Pap smear testing of susceptible women. There has been a regular campaign against cervical cancer for 30 years in India, but impact on the morbidity and mortality has been low, with India ranking fourth worldwide. A key challenge for cancer programs is encouraging women in the 30-55 year age group at highest risk for treatable, precancerous lesions, to seek pap smear screening camps. To increase attendance it is important to work in the community by approaching local women's groups and with their help increasing awareness, knowledge and accessibility of screening among women. In this study the investigators made an effort to increase camp attendance by involving women’s groups. We assessed the effect of involvement of women groups in comparison to previous camps, the awareness, attitude and practice of the disease, and its prevention, and the HPV vaccine among the women and finally studied the Pap smear results. A camp based cross sectional study was done in Karindalam village to assess pap smear tests, knowledge, attitude and practice regarding cancer cervix and its screening method. Community level women volunteers were used to mobilise women for the camp. Quantitative data was collected through face to face interview using a pre tested questionnaire and the pap smear test done. Analysis was done with descriptive statistics using epi info. There were 319 women who attended the camp. Out of these 99.7% were ever married. In our studied population 55% of the women were married before 20 years of age and 36% had their first child before 20 years of age. Fifty percent studied up to 10th grade and around 50% belonged to the lower class. Majority of the women had inadequate knowledge about the disease symptoms (52.7%), risk factors (76%), preventive measures (65.5%), Pap smear method (91%) and HPV vaccine (8.4%). Reasons for not doing a Pap smear test so far were inadequate knowledge about the disease and test, fear of procedure and result, non availability of the test locally, being non symptomatic, and cultural factors. The Pap smear tests identified 2 (0.6%) women with high intra epithelial lesions, 4 (1.2%), endocervicitis and 3 (1%) with bacterial vaginosisand adequate follow up was offered. The government of India has to respond to the need of the hour and strengthen information, education and communication efforts on cervical cancer along with providing widespread screening facilities.
Mini Mol Joseph,
Jayasree Anandabhavan Kumaran,
Cervical Cancer Screening Program – A Camp Based Cross Sectional Study Among Rural Women in North Kerala, Science Journal of Public Health.
Vol. 5, No. 3,
2017, pp. 215-223.
Robbins Basic Pathology, 9th Edition, Vinay Kumar, Abul K. Abbas, Jon Aster.
Ibeanu OA, Molecular pathogenesis of cervical cancer; Cancer Biol Ther. 2011 Feb 1; 11 (3): 295-306.
ICO Information Centre on HPV and cancer (Summary Report 2014-08-22). Human Papillomavirus and Related Diseases in India. 2014.
K. Kaarthigeyan, Cervical cancer in India and HPV vaccination; Indian J Med Paediatr Oncol. 2012 Jan-Mar; 33 (1): 7–12.
Symptoms of cervical cancer, Canadian Cancer society: available at https://www.cancer.ca/en/cancer-information/cancer-type/cervical/signs-and-symptoms/?region=on.
Signs and symptoms of cervical cancer, American Cancer society: available at https://www.cancer.org/cancer/cervical-cancer/detection-diagnosis-staging/signs-symptoms.html.
Dutta PK, Upadhyay A, Dutta M, et al, A case control study of cancer cervix patients attending Command Hospital, Pune; Indian J Cancer. 1990 Jun; 27 (2): 101-8.
Human Papilloma Virus ICMR: High power Committee to Evaluate Performance of ICMR, 2012–2013. New Delhi, India: ICMR; 2014. Disease Specific Documents for XII plan.
Cherian Varghese, 50 Years of Cancer Control in India; cancer prevention and control in India, Supportive care in Oncology: Historical perspectives and future options; MOHFW India.
Jacqueline Sherris, Cristina Herdman, Christopher Elias, Cervical cancer in the developing world; West J Med. 2001 Oct; 175 (4): 231–233.
Rosa Catarino, Patrick Petignat, Gabriel Dongui, Pierre Vassilakos, Cervical cancer screening in developing countries at a crossroad: Emerging technologies and policy choices, World HYPERLINK "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4675913/" J Clin Oncol. 2015 Dec 10; 6 (6): 281–290.
Lazcano-Ponce EC, Moss S, Alonso de Ruíz P, Salmerón Castro J, Hernández AvilaCervical cancer screening in developing countries: why is it ineffective? The case of Mexico. Arch Med Res. 1999 May-Jun; 30 (3): 240-50.
B Das, K Gupta, R Ranjan, M Singh, Knowledge, attitude and practice of cervical cancer screening in women visiting a tertiary care hospital of Delhi; Indian Journal of Cancer, Vol. 51, No. 3, July-September, 2014, pp. 319-323.
Abha Mangal, Varun Kumar et al, Updated BG Prasad socioeconomic classification, 2014: A commentary; Indian Journal of Public Health, 2015 vol 59, Issue 1: 42-44.
Partha Basu, Cervical Cancer Screening in India- Need, Feasibility & Guidelines for Implementation, available at http://www.bogs.org.in/Review_Article_of_the_month.pdf.
Karla M, Julia C Gage et al, Factors affecting attendance to cervical cancer screening among women in the Paracentral Region of El Salvador: a nested study within the CAPE HPV screening program, BMC Public Health, 2015; 15: 1058.
Laura Camilloni, Eliana Ferroni, Beatriz Jimenez Cendales et al, Methods to increase participation in organised screening programs: a systematic review: BMC Public Health 2013; 13: 464.
Emilia Alfonzo, Agneta Andersson Ellstrom, Szilard Nemes et al Effect of fee on Cervical cancer screening Attendance – screen fee, a Swedish Population based Randomised Trial, Plos One: March 17, 2016.
Amelia Acera, Josep Maria Manresa, Diego Rodriguez et al; Increasing cervical cancer screening coverage: A Randomised, Community - based Clinical trial -Plos One; Jan 24, 2017.
Shahina Begum, Naik DD, Sarith Nair et al, Mobilising Women from a low income Community to attend cervical cacer screening camps: Insights from a study in an urban slum of Mumbai, Gynecology and Obstetrics, 2014, Vol 4; Issue 1: 4: 1.
Report of a WHO Consultation, Cervical cancer screening in developing countries, WHO 2002.
Monali Desai, An Assessment of Community based cancer screening program among Indian women using Anganwadi workers, Obstet Gynecol Ind; Vol 54, No: 5: Sept-Oct 2004. 483-87.
National Family Health Survey 3: 2005-2006.
Dutta P, Upadhyay A, Dutta M et al: A case control study of cancer cervix patients attending command hospital, Pune, Indian J of cancer 1990; 27: 101-8.
GJ Vani, Padmaja, Well Woman Clinic-Screening Program For Cervical Carcinomas. Journal of evolution of medical and dental sciences, Feb 2014, vol 3 issue 8, 1910-14.
Bayrami R, Taghipour A, Ebrahimpour H et al, Personal and socio cultural barriers to cervical cancer screening in Iran, patient and provider perceptions: A qualitative study; Asian Pac J cancer Prev. 2015; 16 (9): 3729-34.
Michelle S, Williams K, A qualitative assessment of the social cultural factors that influence cervical cancer screening behaviors and the health communication preferences of women in Kumasi, Ghana; J Cancer Educ. 2014 Sept; 29 (3): 555-562.
Tokin Akinyemiju, Kemi Ogunsina, Swati Sakhuja et al; Life-course socioeconomic status and breast and cervical cancer screening: Analysis of the WHO study on Global ageing and adult health (SAGE), BMJ Open. 2016; 6 (11): e012753.
Aswathy S., Mariya Amin Quereshi, Beteena Kurian & Leelamoni K, Cervical cancer screening: Current knowledge & practice among women in a rural population of Kerala, India; Indian J Med Res 136, August 2012, pp 205-210.
H N Harsh Kumar, Shubham Tanya, A Study on Knowledge and Screening for Cervical Cancer among Women in Mangalore City, Ann Med Health Sci Res. 2014 Sep-Oct; 4 (5): 751– 756.
Agam B. Bansal, Abhijit B Pakhare, Neelkamal Kapoor et al, Nat Sci Biol Med; Knowledge, attitude, and practices related to cervical cancer among adult women: A hospital- based cross-sectional study, 2015 Jul-Dec; 6 (2): 324–328.
Sunita A. Bamanikar, Dadaso S. Baravkar, Shirish S. Chandanwale, Prachet Dapkekar, Padmashree; Study of Cervical Pap Smears in a Tertiary Hospital: Indian Medical Gazette - July 2014.
S Yasmin et al; A Cyto-Epidemiological Study on Married Women in Reproductive Age Group (15-49 Years) Regarding Reproductive Tract Infection in a Rural Community of West Bengal: Indian J Public Health 56 (3), 204-209.
M Basu, The relevance of cervical cancer screening and the future of cervical cancer control in India in the light of the approval of the vaccine against cervical cancer; Letter To Editor; Indian Journal of Cancer, Vol. 43, No. 3, July-September, 2006, pp. 139.
K Karthigeyan, Cervical cancer in India and HPV vaccination; Indian J Med Paediatr Oncol, 2012 Jan-Mar; 33 (1): 7–12.
Rajendra A Kerkar, Yogesh V Kulkarni, Screening for cervical cancer: an overview; J Obstet Gynecol India Vol. 56, No. 2: March/April 2006 Pg 115-122.