International Journal of Research and Review
Vol.7; Issue: 5; May 2020
Website: www.ijrrjournal.com
Original Research Article E-ISSN: 2349-9788; P-ISSN: 2454-2237
Knowledge Regarding Cervical Cancer among
Married Women in Rural Telangana:
A Cross Sectional Study
Kishore Yadav Jothula1, Sreeharshika D2
1
Department of Community and Family Medicine, All India Institute of Medical Sciences,
Bibinagar, Telangana,
2
Department of Forensic Medicine, ESIC Medical College, Hyderabad, Telangana
Corresponding Author: Sreeharshika D
ABSTRACT and may be completely asymptomatic.1
Cervical cancer is the fourth most frequent
Background: Cervical cancer is the fourth most cancer in women with an estimated 570,000
frequent cancer in women with an estimated new cases in 2018 representing 6.6% of all
570,000 new cases in 2018 representing 6.6% of female cancers. Approximately 90% of
all female cancers. Approximately 90% of
deaths from cervical cancer occurred in low
deaths from cervical cancer occurred globally.
Cervical cancer is the second most and middle-income countries.2 Cervical
common cancer among Indian women cancer is the second most common cancer
Methods: A cross-sectional study was among Indian women. Every year about
conducted among 250 women with a pre-tested, 96,922 new cases of cervical cancer
semi structured questionnaire in order to assess detected in India and 60,078 deaths were
their knowledge regarding Cervical Cancer. reported due to cervical cancer.3
Data collected was analysed using SPSS Unfortunately, most women in India are not
software. aware about the screening of cervical cancer
Results: 77.6% of the women heard about which can be preventable and treatable. In
cervical cancer. Women are less aware of the view of magnitude of the problem, India has
other risk factors of cervical cancer like
launched National Cancer Control
Multiparity (6.8%), Early marriage (4.8%),
Smoking, alcohol (4.4%). Most common source Programme in 1975-76, which is now
of information was Doctor/Health care workers integrated with National Programme on
(75.8%) Prevention and Control of Diabetes,
Conclusions: Most of the women participated Cardiovascular Disease and Stroke
in our study have inadequate knowledge and (NPCDCS). The services provided under
awareness regarding cervical cancer. this programme are health education, early
detection and diagnosis, strengthening of
Keywords: Cervical cancer, HPV, Smoking, existing institutions for palliative care.2
Women WHO urged the countries to lead the way
towards elimination of cervical cancer by
INTRODUCTION increasing coverage of human papilloma
Non communicable diseases are virus (HPV) vaccination, screening
ruling the world today with highest coverage with HPV testing, appropriate
morbidity and mortality rates and cancer is management of women who have screened
one among them. Cervical cancer is a positive and reduce mortality rates.4 Despite
malignant neoplasm arising from cells all these programmes, Cervical cancer still
originating in cervix uteri which in the early remains a public health concern and a
stages does not cause noticeable symptoms leading cause of cancer deaths in developing
International Journal of Research and Review (ijrrjournal.com) 238
Vol.7; Issue: 5; May 2020
Kishore Yadav Jothula et.al. Knowledge regarding cervical cancer among married women in rural Telangana:
a cross sectional study
countries. Awareness about cervical cancer Statistical Analysis: Data was analysed
screening can improve women’s approach using Microsoft Excel and SPSS Statistical
to increased rate of early diagnosis and Package version 22. Data was expressed in
treatment of cervical cancer which can proportions with 95% confidence interval
further reduce the morbidity and mortality. (CI). Pearson’s chi-square test was applied
With this background this study was taken as test of significance considering P < 0.05
up to assess the knowledge of women as statistically significant.
regarding cervical cancer.
RESULTS
METHODS Majority of study participants are
Study Design: Cross Sectional Study. between 40-50 years of age (38.8%),
Study Period: May, 2019 to July, 2019. Illiterates (51.2%), Home maker (54.8%)
Study Setting: 4 randomly selected villages and Below poverty line (59.2%). (Table 1)
out of 11 villages attached to rural health 77.6% of the women heard about
centre of a medical college in Telangana cervical cancer. Family history of cervical
state. cancer (63.6%), Poor hygiene (59.2%),
Sample size: 250 by using formula Z 2pq/l2, HPV Infection (47.2), multiple sexual
where Z=1.96, p=79.6% based on previous partners (27.6%) were known by most of the
study,5 l = 5%. women. More than half of the women
Study Subjects: Married Women of aged identified vaginal bleeding/discharge
20 – 60 years residing in the study area for (69.2%), lower abdominal pain (67.2%),
the last one year. post-menopausal bleeding (59.6%) as
symptoms of cervical cancer. (Table 2)
Sampling Method: Simple random The association between education
sampling method was followed to select status and knowledge about prevention of
villages and based on proportionate cervical cancer, awareness of HPV and Pap
sampling method, it was decided to collect smear was found to be statistically
data of 78 subjects, 56 subjects, 52 subjects significant (p=<0.05).
and 64 subjects from 4 villages. Houses (Table 3)
were selected by systematic random Most common source of information
sampling method. After visiting the selected was found to be doctor/health care workers
house, elder eligible subject among the (75.8%) followed by relatives or friends
available was included in the study. (71.6%), newspaper, magazines (19.1%)
Study Tool: A semi-structured and internet (10.8%). (Table 4)
questionnaire was prepared and suitable
modifications were made after Table: 1 Socio demographic profile of study participants
(n=250)
administering in a pilot study. The Age Frequency (%)
questionnaire consists of the demographic 20 - 30 27 (10.8)
30 - 40 90 (36)
information and a series of questions to 40 - 50 97 (38.8)
assess the knowledge, Practice and source 50 - 60 36 (14.4)
Education Frequency (%)
of information regarding breast cancer Illiterate 128 (51.2)
Method of Data Collection: Data was School 95 (38)
collected by face to face interview method College 27 (10.8)
Working status Frequency (%)
after obtaining consent. The importance of Home maker 137 (54.8)
this study was explained and ensured that Student 10 (4)
Working women 103 (41.2)
confidentiality of the participant’s Socio economic status Frequency (%)
responses. Above poverty line 102 (40.8)
Below poverty line 148 (59.2)
International Journal of Research and Review (ijrrjournal.com) 239
Vol.7; Issue: 5; May 2020
Kishore Yadav Jothula et.al. Knowledge regarding cervical cancer among married women in rural Telangana:
a cross sectional study
Table: 2 Knowledge about preventive aspects, risk factors and symptoms of cervical cancer among study participants (n=250)
Preventive aspects of Cervical cancer Total Subjects answered Yes (%) 95% CI
Heard about cervical cancer 194 (77.6) 71.9, 82.6
Cervical cancer can be prevented 28 (11.2) 7.6, 15.8
Heard about HPV Vaccine 6 (2.4) 0.9, 5.2
Heard about pap smear 93 (37.2) 31.2, 43.5
Risk factor Total Subjects answered Yes (%) 95% CI
HPV Infection 118 (47.2) 40.9, 53.6
Poor hygiene 148 (59.2) 52.8, 65.4
Multiparity 17 (6.8) 4, 10.7
Family history of cervical cancer 159 (63.6) 57.3, 69.6
Multiple sexual partners 69 (27.6) 22.2, 33.6
Early marriage 12 (4.8) 2.5, 8.2
Smoking, alcohol 11 (4.4) 2.2, 7.7
Symptom Total Subjects answered Yes (%) 95% CI
Vaginal bleeding/discharge 173 (69.2) 63.1, 74.9
Post coital bleeding 10 (4) 1.9, 7.2
Lower Abdominal pain 168 (67.2) 61, 73
Post-menopausal bleeding 149 (59.6) 53.2, 65.7
Inter menstrual bleeding 64 (25.6) 20.3, 31.5
Urinary symptoms 19 (7.6) 4.6, 11.6
Table: 3 Association between education of the subjects and knowledge about Cervical cancer (n=250)
Question Illiterates (%) School (%) College (%) P value
(n=128) (n=95) (n=27)
Heard about cervical cancer 99 (77.3) 74 (77.9) 21 (77.8) 0.99
Cervical cancer can be prevented 4 (3.1) 7 (7.4) 17 (62.9) 0.01
Heard about HPV Vaccine 1 (0.8) 1 (1.1) 4 (14.8) 0.01
Heard about pap smear 34 (26.6) 39 (41.1) 20 (74.1) 0.01
Table:4 Source of information (n=194) study where only 33% knew about pap
Source of information Frequency (%)
Television, Radio 12 (6.2) smear.10 All these findings in current study
Newspaper, Magazines 37 (19.1) explains that more awareness should be
Relatives or friends 139 (71.6)
Internet 21 (10.8) created among women regarding cervical
Doctor/Health care workers 147 (75.8) cancer. In current study when asked about
risk factors of CC, Family history of
DISCUSSION cervical cancer (63.6%), Poor hygiene
In present study, majority of study (59.2%), HPV Infection (47.2), Multiple
participants are between 40 – 50 years of sexual partners (27.6%) were known by
age (38.8%), Illiterates (51.2%), Home most of the women. According to Khadka K
maker (54.8%) and Below poverty line et al and Devi S et al studies most of them
(59.2%). In present study, about 77.6% of cited sexual intercourse, multiple sex and
the women heard about cervical cancer (CC) poor personal hygiene as some of the major
similar to findings of Kar M et al study risk factors of CC.11, 12 According to
where 70.7% of women heard about Karunakaran U et al study, 76% of women
cervical cancer.6 In a study conducted by don’t know about the risk factors of CC.13
Aweke YH et al., about 35.8% of the In present study, women are less aware of
women were not aware of CC.7 Only 11.2% the other risk factors of CC like Multiparity
of the women in present study knew that (6.8%), Early marriage (4.8%), Smoking,
cervical cancer can be prevented contrary to alcohol (4.4%) similar to findings of
Krishnaveni K et al study where 60.2% of Kosambiya RJ et al study where the above
study subjects answered that cervical cancer risk factors were known by few of the study
can be prevented.8 When asked about HPV subjects.14 These findings reveal that much
vaccine, only 2.4% of the women from importance must be given to create
present study heard about it similar to the awareness among women about CC which
findings of Reichheld A et al study in which is a preventable disease. There is poor
less than 1% heard about HPV.9 In current knowledge among women in our study
study, only 37.2% of study subjects heard regarding symptoms of CC. More than half
about pap smear similar to Hussain RS et al
International Journal of Research and Review (ijrrjournal.com) 240
Vol.7; Issue: 5; May 2020
Kishore Yadav Jothula et.al. Knowledge regarding cervical cancer among married women in rural Telangana:
a cross sectional study
of the women identified Vaginal Ethical approval: The study was approved
bleeding/discharge (69.2%), Lower by the Institutional Ethics Committee
Abdominal pain (67.2%), Post-menopausal
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a cross sectional study
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Study on knowledge and practice of
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