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Citation: Akinlaja OA and Anorlu RI. Knowledge of Cervical Can cer, Awareness and Attitude to Screening amongPatients at a Cytology Clinic. Austin J Obstet Gynecol . 2014;1(1): 4.

Austin J Obstet Gynecol - Volume 1 Issue 1 - 2014Submit your Manuscript | www.austinpublishinggroup.comAkinlaja et al. © All rights are reserved

Austin Journal of Obstetrics andGynecology

Open AccessFull Text Article

Abst ract

Objective: Cervical carcinoma is the most common genital cancer in Nigeriaand a leading cause of cancer-associated deaths, but the success of large-scalescreening programs with the Pap test and the associated reduction in invasivecancer has been well described in developed nations. We determined the levelof knowledge of cervical cancer, awareness, and attitude toward the cervicalscreening program in Lagos.

Methods: Between December 1, 2003, and May 31, 2004, we studiedthe knowledge, awareness, and attitude of patients at a tertiary institutioncytology clinic concerning cervical cancer and screening methods using a self-administered questionnaire.

Results: Of the 255 patients surveyed, data were complete in 238 (93.3%);112 (47.1%) had heard of cervical cancer, while 94 (39.5%) knew about the Paptest, with health professionals being their most frequent source of information.Fifty-nine (24.9%) had had a prior Pap test, while after counseling on cervicalcancer and the screening methods, 213 (89.5%) were ready for routine periodicscreening if given the opportunity. Nineteen (8%) would still refuse due tovarious reasons, and six (2.5%) were not sure. Age and marital status did notin uence their knowledge, but the level of education and occupation were foundto positively in uence their knowledge of cervical cancer and their acceptanceof the Pap test.

Conclusion: Adequate health information and counseling on cervical cancerand regular Pap testing still need to be emphasized in developing countries so

as to reverse the morbidity and mortality associated with cervical cancer.

patients presenting with advanced disease thereby increasing boththe morbidity and mortality and putting undue strain on availablehealth acilities and resources. Our objectives were to determinethe awareness o cervical cancer and the screening program at theinstitution and highlight the role o enlightenment campaigns.

Materials and MethodDesign

A Prospective cross sectional survey was used.

Setting

Te study was conducted in the cytology clinic o the Lagosuniversity teaching hospital that holds once a week on a Wednesday.Doctors re er patients to the cytology clinics and only ew are sel -re errals with the bulk o patients being rom the gynecologicaloutpatients and postnatal clinics. An average o about 10 patientsattend the clinic each day. Cervical smears are routinely taken orcytology and abnormal smears are re erred to the gynecology clinic

or urther investigations and treatment.

Study population

Te study involved patients who attended the cytology clinic runby the Obstetrics and Gynecology department o the Lagos University

eaching Hospital between the months o December 2003 and May2004. A total o 238 patients were seen during this period.

Introduction

Cancer o the cervix is the second most common canceramong women worldwide ollowing breast cancer, accounting oran estimated 530,000 new cancer cases worldwide and or 275,000deaths in 2008 [1].

It is the commonest gynecological malignancy in Nigeria and aleading cause o cancer associated deaths [2] with an incidence rate oapproximately 3% o patients attending the gynecological clinic o theteaching hospital in Lagos [3] but with the aid o screening programs

or precancer as well as the availability o HPV vaccination, there hasbeen a 75 percent decrease in the incidence and mortality o cervicalcancer over the past 50 years in developed countries [4].

Te Pap smear is inexpensive and easily per ormed but loweducational status, prohibitive cost o healthcare, the expense oobtaining and retaining the in rastructure, the technical expertisethat are required or cytological screening as well as or trackingwomen with abnormal test result [5] and the predominance o theetiological actors or cancer o the cervix, have been inimical to itsimplementation.

Despite there been an increase in centers providing screeningover the recent years, it’s still not commensurate with the number

o patients availing themselves, o their use [6]. Tis results in

Research Articl e

Knowledge of Cervical Cancer, Awareness and Attitude toScreening among Patients at a Cytology Clinic

Akinlaja OA 1* and Anorlu RI 2

1Department of Obstetrics & Gynecology, University ofTennessee, USA 2Department of Obstetrics & Gynecology, LagosUniversity Teaching Hospital, Nigeria

*Corresponding author: Olukayode A Akinlaja,Department of Obstetrics & Gynecology, University ofTennessee, College of Medicine/ University of TennesseeHealth Science Center, USA, Tel: (347) 866-3011; Email:[email protected]

Received: June 20, 2014; Accepted: July 21, 2014;Published: July 22, 2014

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Data collection

Te purpose o the study was explained to the patients and verbalconsent was obtained be ore conducting a ace-to- ace interviewusing a structured questionnaire administered by the author.

Te questionnaire was in three parts; the rst part containedthe socio-demographic characteristics relating to the age at rstintercourse, rst and last pregnancies, ethnic background, maritalstatus, place o abode, occupation and educational background. Tesecond related to the knowledge o cervical cancer and the screeningprogramme viz a viz any in ormation the patient might haveconcerning them and the third part related to the patient’s attitudeto cervical cancer and the screening programme. Tis is elicted afersome in ormation had been given concerning cervical cancers andthe screening programme.

AnalysisTe responses were analysed with descriptive statistics or

continous variables and simple percentages or categorical variablesusing the statistical package SPSS or MS Windows with p30 2 0.8%

No answer 21 8.8%

Table 2:

Table 3: Sexual Characteristics of Respondents.

NO. OF SEXUAL PARTNERS FREQUENCY PERCENTAGE

None 1 0.4%

1-3 171 71.8%

4-7 45 18.95

>7 9 3.8%

No answer 12 5.0%

EVER HEARD OF CANCER OF CERVIX? FREQUENCY PERCENTAGE

YES 94 39.5%

NO 144 60.5%

Table 4: Respondents Awareness of Cervical Cancer.

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Anorlu et al amongst women attending a primary health care acility[7]. Tis might actually be a reection o the specialist nature o the

tertiary institution as well as differences in the social status o thepatients attending the two acilities. Te low level o knowledge washowever in contrast to a high knowledge level o 72.9% demonstratedconcerning Pap smear by emale health workers in Abuja in a studyo Olaniyan et al [8].

Tis immediately signies that adequate counseling is not givento the patients on both cervical cancer and Pap smear be ore they aresent or the test at the cytology clinic.

Age or marital status did not affect having a Pap smear done inthis study but this is in contrast to ndings in a study in Aberdeenwhere single and nulliparous women were more likely to have beenscreened [9]. Tis might be a reection o the tendency or earlier

marriages in our population.Te commonest reason given or lack o routine screening among

SOURCE OF INFORMATION FREQUENCY PERCENTAGE

Print Media 8 8.5%

Electronic Media 15 16.0%

Health Professional 55 58.55

Friends and Relatives 10 10.6%

School 5 5.3%

Worship Centre 1 1.1%

Table 5: Source of Information on Cervical Cancer.

KNOWLEDGE OF CANCER OF CERVIX FREQUENCY PERCENTAGE

NO/POOR KNOWLEDGE 176 73 .9%

MODERATE KNOWLEDGE 56 23.5%

ADEQUATE KNOWLEDGE 6 2.5%

Table 6: Knowledge of Cervical Cancer.

EVER HEARD OF PAP SMEAR? FREQUENCY PERCENTAGE

YES 112 47.1%

NO 126 52.9%

Table 7: Awareness of pap Smear.

SOURCE OF INFORMATION FREQUENCY PERCENTAGE

Print Media 3 2.75

Electronic Media 2 1.8%

Health Professionals 102 91.0%

Worship Centre 5 4.5%

Table 8: Source of Information on pap Smear.

EVER BEEN SCREENED BEFORE? FREQUENCY PERCENTAGE

YES 36 15.1%

NO 202 84.9%

Table 9:

RESPONSE FREQUENCY PERCENTAGE

YES 213 89.5%

NO 19 8.0%

Don’t Know Yet 6 2.5%

Table 10: Response to whether respondent was ready for Screening afterCounselling.

women at the cytological clinic is lack o adequate health in ormationand this was elicited by a high percentage comprising 84.9% beenpresent at the clinic or a repeat Pap smear but still with little or noknowledge about the test.

Physicans and health care institutions must attempt to changethe perception by educating and personalizing the message so thatpatients can accept their disease susceptibility as well as have adequatein ormation concerning the procedure and its use ulness.

Awareness and enlightenment campaign have to be intiatedwith emphasis on the risk actors with proper highlighting o sexualexposure as the major underlying risk actor and the act that everywoman is at risk.

Te most requent reason given by women or non-attendanceo a Pap smear test in Northern Ireland was that it was not regarded

as necessary at their age [10] but it should be emphasized that age isnot a actor as cervical intraepithelial neoplasia have been ound tosometimes develop in young teenagers [11].

Te level o education and the occupation o the respondentswere also ound to inuence their knowledge o cervical cancer andits screening procedure with a high percentage o those with tertiaryeducation having at least a little knowledge. Tis is not inuenced bythe religion or ethnicity o the respondents, highlighting the role omass education in our nation.

Most respondents agreed afer counseling that Pap smear is ause ul test and nearly 90% were eager or routine screening i giventhe opportunity.

A signicant minority were either not decided or would nothave the test even i offered or ree. A ear o the consequence odetecting cancer or a atalistic attitude towards cancer detectionand treatment may account or this disposition and the lack o earo the consequence o investigation had been alluded to be the mostimportant predictor o attendance at the cytology clinic or cervicalsmear [12].

None o the respondents cited the cost o services as the reasonor non-compliance and perhaps this is reective o the status o

patients attending clinics at the tertiary hospital.

Healthcare providers have a very important role to play in getting

people interested in the screening programmes and some authorshave suggested that cervical cancer should be included in pre-employment medical examination [13].

Medical institutions must collaborate to develop standards orcancer screening with particular attention being paid to the cost, todetermine how limited resources can best be spent in cancer control.

A lot o attention should also be paid to adequate enlightenmento patients as regards the procedure and its benets.

References1. Cervical Cancer Incidence, Mortality and prevalence worldwide in 2008.

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8. Olaniyan OB, Aghoroma OC, Oladipo OP. Knowledge and practise of cervicalScreening among female health workers in Government Hospitals in Abujametropolis, Nigeria. Tropical journal of Obstetrics and Gynaecology. 2000;17: 18-20.

9. Nicoll PM, Narayan KV, Paterson JG. Cervical cancer screening: women’s knowledge, attitudes and preferences. Health Bull (Edinb). 1991; 49: 184-190.

10. Murray M, McMillan C. Social and behavioural predictors of women’s cancer screening practices in Northern Ireland. J Public Health Med. 1993; 15: 147-153.

11. Womeodu RJ, Bailey JE. Barriers to cancer screening. Med Clin North Am. 1996; 80: 115-133.

12. Omigbodun AO. Management of cervical intraepithelial neoplasia where colposcopy is not available. Cent Afr J Med. 1991; 37: 7-11.

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Citation: Akinlaja OA and Anorlu RI. Knowledge of Cervical Can cer, Awareness and Attitude to Screening amongPatients at a Cytology Clinic. Austin J Obstet Gynecol . 2014;1(1): 4.

Austin J Obstet Gynecol - Volume 1 Issue 1 - 2014Submit your Manuscript | www.austinpublishinggroup.comAkinlaja et al. © All rights are reserved
http://www.ncbi.nlm.nih.gov/pubmed/7839937http://www.ncbi.nlm.nih.gov/pubmed/10102852http://www.ncbi.nlm.nih.gov/pubmed/10102852http://www.ncbi.nlm.nih.gov/pubmed/10102852http://www.ncbi.nlm.nih.gov/pubmed/9643156http://www.ncbi.nlm.nih.gov/pubmed/9643156http://www.popline.org/node/294106http://www.popline.org/node/294106http://www.popline.org/node/294106http://www.ncbi.nlm.nih.gov/pubmed/1917453http://www.ncbi.nlm.nih.gov/pubmed/1917453http://www.ncbi.nlm.nih.gov/pubmed/1917453http://www.ncbi.nlm.nih.gov/pubmed/8353004http://www.ncbi.nlm.nih.gov/pubmed/8353004http://www.ncbi.nlm.nih.gov/pubmed/8353004http://www.ncbi.nlm.nih.gov/pubmed/8569291http://www.ncbi.nlm.nih.gov/pubmed/8569291http://www.ncbi.nlm.nih.gov/pubmed/2060008http://www.ncbi.nlm.nih.gov/pubmed/2060008http://www.ncbi.nlm.nih.gov/pubmed/2060008http://www.ncbi.nlm.nih.gov/pubmed/2060008http://www.ncbi.nlm.nih.gov/pubmed/8569291http://www.ncbi.nlm.nih.gov/pubmed/8569291http://www.ncbi.nlm.nih.gov/pubmed/8353004http://www.ncbi.nlm.nih.gov/pubmed/8353004http://www.ncbi.nlm.nih.gov/pubmed/8353004http://www.ncbi.nlm.nih.gov/pubmed/1917453http://www.ncbi.nlm.nih.gov/pubmed/1917453http://www.ncbi.nlm.nih.gov/pubmed/1917453http://www.popline.org/node/294106http://www.popline.org/node/294106http://www.popline.org/node/294106http://www.ncbi.nlm.nih.gov/pubmed/9643156http://www.ncbi.nlm.nih.gov/pubmed/9643156http://www.ncbi.nlm.nih.gov/pubmed/10102852http://www.ncbi.nlm.nih.gov/pubmed/10102852http://www.ncbi.nlm.nih.gov/pubmed/10102852http://www.ncbi.nlm.nih.gov/pubmed/7839937

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