Does Prior Experience Matter? Intention to Undergo Cervical Cancer Screening among Rural Women in South-Central Ethiopia
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design, Study Area, and Study Period
2.2. Population and Sampling
2.3. Measurement and Data Collection
2.4. Data Analysis
3. Results
3.1. Socio-Demographic Characteristics
3.2. Knowledge about Cervical Cancer and Previous CCS Practices
3.3. Intention to Undergo CCS
3.4. Factors Associated with the Intention to Undergo CCS
4. Discussion
Strengths and Limitations of the Study
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Sung, H.; Ferlay, J.; Siegel, R.L.; Laversanne, M.; Soerjomataram, I.; Jemal, A.; Bray, F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA A Cancer J. Clin. 2021, 71, 209–249. [Google Scholar] [CrossRef] [PubMed]
- IHME. Global Burden of Disease Study 2019; IHME: Seattle, WA, USA, 2019. [Google Scholar]
- Lei, J.; Ploner, A.; Elfström, K.M.; Wang, J.; Roth, A.; Fang, F.; Sundström, K.; Dillner, J.; Sparén, P. HPV Vaccination and the Risk of Invasive Cervical Cancer. N. Engl. J. Med. 2020, 383, 1340–1348. [Google Scholar] [CrossRef]
- Ersado, T.L. Cervical Cancer Prevention and Control. In Cervical Cancer; Rajamanickam, R., Ed.; IntechOpen: Rijeka, Croatia, 2021; p. Ch. 6. [Google Scholar]
- Duclos, P. Human papillomavirus vaccines: WHO position paper. Biologicals 2009, 37, 338–344. [Google Scholar]
- Kantelhardt, E.J.; Moelle, U.; Addissie, A.; Trocchi, P.; Yonas, B.; Hezkiel, P.; Stang, A.; Thomssen, C.; Vordermark, D.; Gemechu, T.; et al. Cervical cancer in Ethiopia: Survival of 1,059 patients who received oncologic therapy. Oncologist 2014, 19, 727–734. [Google Scholar] [CrossRef]
- Tekalign, T.; Teshome, M. Prevalence and determinants of late-stage presentation among cervical cancer patients, a systematic review and meta-analysis. PLoS ONE 2022, 17, e0267571. [Google Scholar] [CrossRef] [PubMed]
- World Health Organization. Human Papillomavirus (HPV) Vaccine Coverage Monitoring Manual; WHO: Geneva, Switzerland, 2020.
- Federal Ministry of Health E. National Cancer Control Plan 2016–2020 of Ethiopia. This Prev. Control Dir. 2015, 2015, 83. [Google Scholar]
- Ethiopian Ministry of Health. The 2013 EFY Performance Report of the Health Sector of Ethiopia; Ethiopian Ministry of Health: Addis Ababa, Ethiopia, 2021.
- Getahun, T.; Kaba, M.; Derseh, B.T. Intention to Screen for Cervical Cancer in Debre Berhan Town, Amhara Regional State, Ethiopia: Application of Theory of Planned Behavior. J. Cancer Epidemiol. 2020, 2020, 3024578. [Google Scholar] [CrossRef] [PubMed]
- Wollancho, W.; Amdissa, D.; Bamboro, S.; Wasihun, Y.; Tareke, K.G.; Gizaw, A.T. Determining behavioral intention and its predictors towards cervical cancer screening among women in Gomma district, Jimma, Ethiopia: Application of the theory of planned behavior. PLoS ONE 2020, 15, e0238472. [Google Scholar] [CrossRef]
- Ebu, N.I. Socio-demographic characteristics influencing cervical cancer screening intention of HIV-positive women in the central region of Ghana. Gynecol. Oncol. Res. Pract. 2018, 5, 3. [Google Scholar] [CrossRef]
- Zhang, J.; Sha, Z.; Gu, Y.; Li, Y.; Yang, Q.; Zhu, Y.; He, Y. Predicting Behavioral Intentions Related to Cervical Cancer Screening Using a Three-Level Model for the TPB and SCT in Nanjing, China. Int. J. Environ. Res. Public Health 2019, 16, 3575. [Google Scholar] [CrossRef]
- Egawa-Takata, T.; Ueda, Y.; Tanaka, Y.; Morimoto, A.; Kubota, S.; Yagi, A.; Terai, Y.; Ohmichi, M.; Ichimura, T.; Sumi, T.; et al. Mothers’ attitudes in Japan regarding cervical cancer screening correlates with intention to recommend cervical cancer screening for daughters. Int. J. Clin. Oncol. 2016, 21, 962–968. [Google Scholar] [CrossRef] [PubMed]
- Kakubari, R.; Egawa-Takata, T.; Ueda, Y.; Tanaka, Y.; Yagi, A.; Morimoto, A.; Terai, Y.; Ohmichi, M.; Ichimura, T.; Sumi, T.; et al. A survey of 20-year-old Japanese women: How is their intention to undergo cervical cancer screening associated with their childhood HPV vaccination status? Hum. Vaccine Immunother. 2021, 17, 434–442. [Google Scholar] [CrossRef] [PubMed]
- Anhang Price, R.; Koshiol, J.; Kobrin, S.; Tiro, J.A. Knowledge and intention to participate in cervical cancer screening after the human papillomavirus vaccine. Vaccine 2011, 29, 4238–4243. [Google Scholar] [CrossRef] [PubMed]
- Ogilvie, G.S.; Smith, L.W.; van Niekerk, D.J.; Khurshed, F.; Krajden, M.; Saraiya, M.; Goel, V.; Rimer, B.K.; Greene, S.B.; Hobbs, S.; et al. Women’s intentions to receive cervical cancer screening with primary human papillomavirus testing. Int. J. Cancer 2013, 133, 2934–2943. [Google Scholar] [CrossRef]
- Ogilvie, G.S.; Smith, L.W.; van Niekerk, D.; Khurshed, F.; Pedersen, H.N.; Taylor, D.; Thomson, K.; Greene, S.B.; Babich, S.M.; Franco, E.L.; et al. Correlates of women’s intentions to be screened for human papillomavirus for cervical cancer screening with an extended interval. BMC Public Health 2016, 16, 213. [Google Scholar] [CrossRef] [PubMed]
- Abamecha, F.; Tena, A.; Kiros, G. Psychographic predictors of intention to use cervical cancer screening services among women attending maternal and child health services in Southern Ethiopia: The theory of planned behavior (TPB) perspective. BMC Public Health 2019, 19, 434. [Google Scholar] [CrossRef] [PubMed]
- Roncancio, A.M.; Ward, K.K.; Fernandez, M.E. Understanding cervical cancer screening intentions among Latinas using an expanded theory of planned behavior model. Behav. Med. 2013, 39, 66–72. [Google Scholar] [CrossRef]
- Roncancio, A.M.; Ward, K.K.; Sanchez, I.A.; Cano, M.A.; Byrd, T.L.; Vernon, S.W.; Fernandez-Esquer, M.E.; Fernandez, M.E. Using the Theory of Planned Behavior to Understand Cervical Cancer Screening Among Latinas. Health Educ. Behav. 2015, 42, 62162–62166. [Google Scholar] [CrossRef]
- Ajzenm, I. The theory of planned behavior. Organ. Behav. Hum. Decis. Process. 1991, 50, 179–211. [Google Scholar] [CrossRef]
- Ethiopian Central Statistics Agency. Population Projection 2021; Ethiopian Central Statistics Agency: Addis Ababa, Ethiopia, 2021.
- Ethiopian Ministry of Health. Master Facility Registry; Ethiopian Ministry of Health: Addis Ababa, Ethiopia, 2022.
- Nwabichie, C.C.; Manaf, R.A.; Ismail, S.B. Factors Affecting Uptake of Cervical Cancer Screening Among African Women in Klang Valley, Malaysia. Asian Pac. J. Cancer Prev. 2018, 19, 825–831. [Google Scholar]
- Hosmer, D.W., Jr.; Lemeshow, S.; Sturdivant, R.X. Applied Logistic Regression; John Wiley & Sons: Hoboken, NJ, USA, 2013. [Google Scholar]
- Ebu, N.I.; Ogah, J.K. Predictors of cervical cancer screening intention of HIV-positive women in the central region of Ghana. BMC Womens Health 2018, 18, 43. [Google Scholar] [CrossRef] [PubMed]
- Huang, H.-C.; Chang, P.-C.; Li, S.-F.; Wang, C.-Y.; Huang, W.-T.; Chen, W.; Fan, S.-Y. The Significant Predictors for Breast, Cervical, Colorectal, or Oral Cancer Screening Intention and Behavior in Taiwan. Cancer Nurs. 2023, 46, E261–E267. [Google Scholar] [CrossRef]
- Sumarmi, S.; Hsu, Y.Y.; Cheng, Y.M.; Lee, S.H. Factors associated with the intention to undergo Pap smear testing in the rural areas of Indonesia: A health belief model. Reprod. Health 2021, 18, 138. [Google Scholar] [CrossRef] [PubMed]
- Wilson, R.; Quinn-Scoggins, H.; Moriarty, Y.; Hughes, J.; Goddard, M.; Cannings-John, R.; Whitelock, V.; Whitaker, K.L.; Grozeva, D.; Townson, J.; et al. Intentions to participate in cervical and colorectal cancer screening during the COVID-19 pandemic: A mixed-methods study. Prev. Med. 2021, 153, 106826. [Google Scholar] [CrossRef]
- Bai, Y.; Liu, Q.; Chen, X.; Gao, Y.; Gong, H.; Tan, X.; Zhang, M.; Tuo, J.; Zhang, Y.; Xiang, Q.; et al. Protection motivation theory in predicting intention to receive cervical cancer screening in rural Chinese women. Psychooncology 2018, 27, 442–449. [Google Scholar] [CrossRef] [PubMed]
- Alemnew, W.; Debalkie, G.; Azale, T. Intention to Screen for Cervical Cancer Among Child Bearing Age Women in Bahir Dar City, North-West Ethiopia: Using Theory of Planned Behavior. Int. J. Women’s Health 2020, 12, 1215–1222. [Google Scholar] [CrossRef]
- Heidari Sarvestani, M.; Khani Jeihooni, A.; Moradi, Z.; Dehghan, A. Evaluating the effect of an educational program on increasing cervical cancer screening behavior among women in Fasa, Iran. BMC Womens Health 2021, 21, 41. [Google Scholar] [CrossRef]
- Crăciun, I.C.; Todorova, I.; Băban, A. “Taking responsibility for my health”: Health system barriers and women’s attitudes toward cervical cancer screening in Romania and Bulgaria. J. Health Psychol. 2020, 25, 2151–2163. [Google Scholar] [CrossRef]
- Ethiopian Ministry of Health. Reproductive Health Strategic Plan (2021–2025); Ethiopian Ministry of Health: Addis Ababa, Ethiopia, 2021.
- Fleming, K.; Simmons, V.N.; Christy, S.M.; Sutton, S.K.; Romo, M.; Luque, J.S.; Wells, K.J.; Gwede, C.K.; Meade, C.D. Educating Hispanic Women about Cervical Cancer Prevention: Feasibility of a Promotora-Led Charla Intervention in a Farmworker Community. Ethn. Dis. 2018, 28, 69–76. [Google Scholar] [CrossRef] [PubMed]
- Fung, L.C.; Nguyen, K.H.; Stewart, S.L.; Chen, M.S., Jr.; Tong, E.K. Impact of a cancer education seminar on knowledge and screening intent among Chinese Americans: Results from a randomized, controlled, community-based trial. Cancer 2018, 124, 1622–1630. [Google Scholar] [CrossRef]
- Nkwonta, C.A.; Hilfinger Messias, D.K.; Felder, T.; Luchok, K. Increasing Human Papillomavirus Vaccination and Cervical Cancer Screening in Nigeria: An Assessment of Community-Based Educational Interventions. Int. Q. Community Health Educ. 2020, 41, 89–99. [Google Scholar] [CrossRef] [PubMed]
Variables | Variable Categories | Frequency | Percentage (%) |
---|---|---|---|
Religion (no. = 420) | Orthodox | 171 | 40.7 |
Muslim | 154 | 36.7 | |
Protestant/catholic | 95 | 22.6 | |
Educational Status (no. = 420) | Secondary and above | 44 | 10.5 |
Primary | 85 | 20.2 | |
Can only read and write | 98 | 23.3 | |
Cannot read and write | 193 | 46 | |
Occupational Status (no. = 420) | Employed | 185 | 44 |
Housewife | 235 | 56 | |
Parity (no. = 420) | Nulliparous (No birth) | 11 | 2.6 |
Primiparous (1 birth) | 9 | 2.1 | |
Multiparous (2 to 4 births) | 224 | 53.3 | |
Grand multiparous (more than 4 births) | 176 | 41.9 | |
Marital status (no. = 420) | Married/living together | 360 | 85.7 |
Non-married a | 60 | 14.3 | |
Spouse’s education (no. = 360) | Secondary and above | 68 | 16.2 |
Primary | 80 | 19 | |
Only read and write | 122 | 29 | |
Cannot read and write | 90 | 21.4 | |
Spouse’s occupation (no. = 360) | Employed | 98 | 23.3 |
Farmer | 262 | 62.4 |
Variables | Variable Categories | Frequency (no. = 420) | Percentage (%) |
---|---|---|---|
Cervical cancer is treatable if detected early | No | 228 | 54.3 |
Yes | 192 | 45.7 | |
Risk factors for cervical cancer (multiple responses possible) | Having multiple sexual partners | 94 | 22.4 |
Family history of cervical cancer | 81 | 19.3 | |
Uncircumcised sexual partner | 30 | 7.1 | |
Early onset of sexual intercourse | 76 | 18.1 | |
Cigarette smoking | 48 | 11.4 | |
Sign or symptom of cervical cancer (multiple responses possible) | Vaginal bleeding | 138 | 32.9 |
Foul vaginal discharge | 163 | 38.8 | |
Pelvic/back pain | 111 | 26.4 | |
Post-coital bleeding | 55 | 13.1 | |
CCS method you know (multiple responses possible) | VIA | 10 | 2.4 |
Pap smear | 16 | 3.8 | |
HPV test | 2 | 0.5 | |
‘I don’t know any’ | 392 | 93.3 | |
Purpose of undergoing CCS (multiple responses possible) | To prevent cervical cancer | 145 | 34.4 |
To detect cervical cancer earlier | 214 | 50.8 | |
To treat cervical cancer | 143 | 34.0 | |
‘I don’t know’ | 110 | 26.2 | |
Previous CCS experience | Has ever had CCS | 83 | 19.8 |
Never had CCS | 337 | 80.2 | |
Reasons for having CCS (no. = 83) * | Health professional’s recommendation | 70 | 84.34 |
Relative’s/friend’s recommendation | 5 | 6.02 | |
Campaign or community mobilisation | 5 | 6.02 | |
Television, radio, magazines, brochures | 3 | 3.61 |
TPB Constructs | Intended to Undergo CCS | Not Intended to Undergo CCS | p-Value | ||
---|---|---|---|---|---|
Mean | SD | Mean | SD | ||
Attitude | 13.35 | 3.12 | 13.23 | 3.0 | 0.659 |
Subjective norm | 12.95 | 3.9 | 12.29 | 4.08 | 0.095 |
Perceived behavioural control | 11.77 | 2.05 | 12.55 | 1.95 | <0.001 |
Variables | Variable Categories | Intention | COR | p-Value | AOR | 95% CI | ||
---|---|---|---|---|---|---|---|---|
Intended to Undergo CCS (n) | Did not Intend to Undergo CCS (n) | |||||||
Educational Status | Secondary and above | 25 | 19 | 3.604 | 0.058 | 2.714 | 0.846–8.707 | |
Primary | 45 | 40 | 3.42 | 0.064 | 1.324 | 0.685–2.561 | ||
Only read and write | 46 | 52 | 0.955 | 0.328 | 1.527 | 0.814–2.863 | ||
Cannot read and write | 79 | 114 | Ref | Ref | ||||
Spouses’ education | Secondary and above | 34 | 34 | 1.143 | 0.678 | 0.587 | 0.239–1.442 | |
Primary | 44 | 36 | 1.397 | 0.279 | 1.068 | 0.515–2.216 | ||
Only read and write | 45 | 77 | 0.668 | 0.153 | 0.591 | 0.311–1.125 | ||
Cannot read and write | 42 | 48 | Ref | Ref | ||||
Previous CCS experience | Never had | 145 | 192 | 0.498 | 0.005 | 0.498 * | 0.27–0.92 | |
Ever had | 50 | 33 | Ref | Ref | ||||
Wealth quintile | Lowest | 40 | 44 | 0.826 | 0.537 | 1.002 | 0.440–2.28 | |
Second | 37 | 47 | 0.716 | 0.280 | 0.733 | 0.317–1.69 | ||
Middle | 39 | 45 | 0.788 | 0.441 | 1.044 | 0.463–2.36 | ||
Fourth | 35 | 49 | 0.649 | 0.165 | 0.712 | 0.309–1.64 | ||
Highest | 44 | 40 | Ref | Ref | ||||
Knowledge | Poor | 124 | 137 | 1.122 | 0.569 | 1.314 | 0.81–2.132 | |
Good | 71 | 88 | Ref | Ref | ||||
Attitude | 1.014 | 0.658 | 1.006 | 0.912–1.109 | ||||
Subjective norm | 1.042 | 0.095 | 1.043 | 0.972–1.12 | ||||
Perceived behavioural control | 0.816 | <0.001 | 0.823 * | 0.728–0.930 |
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Share and Cite
Ketema, B.; Addissie, A.; Negash, S.; Kantelhardt, E.J.; Kaba, M. Does Prior Experience Matter? Intention to Undergo Cervical Cancer Screening among Rural Women in South-Central Ethiopia. Curr. Oncol. 2024, 31, 4908-4916. https://doi.org/10.3390/curroncol31090363
Ketema B, Addissie A, Negash S, Kantelhardt EJ, Kaba M. Does Prior Experience Matter? Intention to Undergo Cervical Cancer Screening among Rural Women in South-Central Ethiopia. Current Oncology. 2024; 31(9):4908-4916. https://doi.org/10.3390/curroncol31090363
Chicago/Turabian StyleKetema, Bezawit, Adamu Addissie, Sarah Negash, Eva Johanna Kantelhardt, and Mirgissa Kaba. 2024. "Does Prior Experience Matter? Intention to Undergo Cervical Cancer Screening among Rural Women in South-Central Ethiopia" Current Oncology 31, no. 9: 4908-4916. https://doi.org/10.3390/curroncol31090363