Objectives: Eastern Africa has the highest incidence and mortality rates from cervical cancer worldwide. It is important to describe the differences among women and their perceived risk of cervical cancer to determine target groups to increase cervical cancer screening.
Methods: In this cross-sectional study, we surveyed women seeking reproductive health services in Kisumu, Kenya to assess their perceived risk of cervical cancer and risk factors influencing cervical cancer screening uptake. χ2 statistics and t tests were used to determine significant factors, which were incorporated into a logistic model to determine factors independently associated with cervical cancer risk perception.
Results: Whereas 91% of the surveyed women had heard of cancer, only 29% of the 388 surveyed women had previously heard of cervical cancer. Most had received their information from health care workers. Few women (6%) had ever been screened for cervical cancer and cited barriers such as fear, time, and lack of knowledge about cervical cancer. Nearly all previously screened women (22/24 [92%]) believed that cervical cancer was curable if detected early and that screening should be conducted annually (86%). Most women (254/388 [65%]) felt they were at risk for cervical cancer. Women with perceived risk of cervical cancer were older (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.02–1.10), reported a history of marriage (OR, 2.08; CI, 1.00–4.30), were less likely to feel adequately informed about cervical cancer by health care providers (OR, 0.76; CI, 0.18–0.83), and more likely to intend to have cervical cancer screening in the future (OR, 10.59; CI, 3.96–28.30). Only 5% of the women reported that they would not be willing to undergo screening regardless of cost.
Conclusions: Cervical cancer is a major health burden for women in sub-Saharan Africa, yet only one third of the women had ever heard of cervical cancer in Kisumu, Kenya. Understanding factors associated with women’s perceived risk of cervical cancer could guide future educational and clinical interventions to increase cervical cancer screening.
*Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL; †Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; ‡Impact Research and Development Organization, Kisumu, Kenya; and §Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Address correspondence and reprint requests to Jennifer S Smith, PhD, MPH, Department of Epidemiology, Gillings School of Global Public Health, Lineberger Cancer Center, University of North Carolina at Chapel Hill, 2103 McGavran-Greenberg Hall, Campus Box# 7435, Chapel Hill, NC 27599-7435. E-mail: firstname.lastname@example.org.
This work was supported in part by National Institutes of Health Cancer Prevention and Control Training Grant (SLS R25CA47888 and AFR T32 CA009314) and by the National Cancer Institute, National Institutes of Health (R01 CA114773-04).
The authors declare no conflicts of interest.
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Received January 9, 2013
Accepted February 20, 2013