Introduction
In India, carcinoma cervix is the second most common cancer among women of reproductive age group.1 Each year about 0.5 million women are diagnosed with invasive carcinoma of cervix and they were never screened for carcinoma cervix. In south Asia, India ranks highest in age standardized incidence of carcinoma cervix.2 Nearly 10% of the all cancer related deaths in India are due to carcinoma cervix.3 In developed countries, screening with PAP test has significantly reduced mortalility.4 In our country diagnosis of cervical cancer is usually delayed due to poor knowledge of screening facilities. For the prevention of carcinoma cervix, screening is mandatory, as majority of women are asymptomatic and not seeks medical advise.
Awareness about the disease, Screening procedure and preventive measures are important for prevention and control of carcinoma cervix.5
Symptoms of carcinoma cervix vary from foul smelling blood stained vaginal discharge to abnormal vaginal bleeding.6 Risk factors are early sexual activity, multiple sexual partners, multiparity, sexually transmitted diseases, co-infection with HIV, smoking etc.7 Worldwide, about 99.7% of all carcinoma cervix are due to HPV Infection.8
Despite the availability of methods of screening and prevention majority of the women had not screened9 The main barrier to screening are unawareness of risk factors, symptoms, screening & preventive methods along with paucity of organized screening facilities in India.10, 11
In India, because of low levels of awareness, early detection and screening remain a major area of concern. Our nursing staff plays a major role as a facilitator of imparting health care services. The staff nurses can be deputed to spread awareness about cervical cancer and to conduct pap smear screening tests among rural women.12
For successful cervical cancer control programmes, nurses with positive attitude should be given sufficient knowledge about cervical cancer and its screening methods.
Keeping all these things in mind, the study was conducted among nursing staff working in the rural medical college, at Amausi Lucknow.
Material and Methods
This study was descriptive cross sectional study which has been conducted in T.S. Misra Medical College, Amausi from January 2021 to March 2021. Out of 300 nurses working in the hospital, about 150 were agreed for participation and only 100 profrormas were complete and analyzed.
Inclusion criteria
Nursing staff, who were willing to participate and ready to give consent were included in the study.
Exclusion criteria
Nursing staff who were not agreed to participate in the study.
Out of the nursing staff, volunteers were chosen, given consent forms along with a questionnaire sheet. Data was collected regarding demography, knowledge about carcinoma cervix symptoms, risk factors and attitude and practice towards preventive methods. All the questionnaire sheets were collected and reviewed. The data and the names of all participants were confidential.
Results
Table 1
Demographic profile
Table 2
Knowledge of symptoms for carcinoma cervix
Table 3
Knowledge of risk factors for carcinoma cervix
|
The Risk Factors |
Percentage |
|
Early sexual activity |
20(20%) |
|
Multiple sexual partner |
30(30%) |
|
HPV infection |
55(55%) |
|
Smoking |
20(20%) |
|
Multi parity |
35(35%) |
Table 4
Knowledge of screening and preventive method for carcinoma cervix
Table 5
Attitude and practice towards cervical screening
Among all the respondents, most of them 86% were belong to 20 to 30 years of age at the time of first sexual intercourse. About 80% of the participants were married (Table 1).
In this study 95% of the participants knew that cervical cancer is preventable and 85% knew that pap smear can detect cervical cancer. 50% were knew that pap smear is used as screening. About 90% of the participants knew that cervical cancer can present as foul smelling blood mixed discharge (Table 2). About 55% knew that HPV infection is the risk factor of cervical cancer (Table 3).
The attitude about pap smear screening showed that about 90% of participants thought that pap smear is a procedure of health care workers. About 60% staff nurse stated that they should undergo cervical screening, but only 30% have ever been screened (Table 5).
Regarding practice of pap smear screening, only 30% have undergone screening for cervical cancer. Most of the respondent who were not willing for screening, due to fear of procedure or found themselves not at risk. (Table 5).
Discussion
In our study, most of the staff were aware of carcinoma cervix and its screening methods in terms of pap smear, they also had the knowledge regarding preventive measures of carcinoma cervix with judicious use of vaccination among females.
Most of the study population belongs to younger age group 26-30 yrs consist of 55% which was similar to study conducted by Bhatija GV et al.13 It was also noticed that 80% respondent were married as compared to 86% participant in study done by Vishwarkarma S et al.14
Regarding Knowledge of screening methods 80% respondent were aware that pap smear is a screening method for prevention of carcinoma cervix, which was similar to the study done by Shah V et al.15 where about 88.4% respondents had knowledge of this. Among study participants 80% staff had a good Knowledge regarding the symptoms of carcinoma cervix as per their knowledge 80% says foul smelling vaginal discharge is the commonest symptoms of carcinoma cervix which was similar to study done by Khanna D et al16 had similar response in 81.6%.
Our study population is well aware about the risk factors of carcinoma cervix as they know about HPV infection as a causative agent for progression of carcinoma cervix 55% had this opinion which was comparable to 54% done by Singh E et al12 very high as compared to study done by Shashank et al17 where only 23% knows causative association.
In the view of assessment of attitude and practice of study population 85% respondents were agreed that pap smear had to be taken by health care professional only which was similar 80% to study done by Singh E et al.12 Screening methods are harmless as per 60% of study participants in our study but only 30% of them screened themselves and 60% were agreed that they should undergo cervical screening but had not done yet due to some minor issues
In our study only 30% participants had gone through pap screening which is higher as compared to study done by Rahman H et al18 showing 16% staff had screened themselves.
Among the reason of not getting pap test about 40% agreed that they are not at risk comparable to 41% in study done by Rahman H et al18 and 61% by Singh E et al.12
Conclusion
As a ground worker in health care system nursing staff plays a major role in prevention of carcinoma cervix by spreading the knowledge of screening and awareness of methodology among general population. They can motivate others to participate in this campaign of early detection and treatment of this dreadful disease and improve health status of community and reduce the burden of treatment cost. They can also be part of imparting knowledge of its preventive measures and availability of vaccine and its use.
