Determinants of cervical cancer screening acceptance among women in urban and tribal communities of Maharashtra, India: a cross-sectional study.

Abstract

Although screening, treatment and HPV vaccination can prevent cervical cancer, 17.7% new Indian cases were still recorded in 2022. Illiteracy, undesirable attitudes, and ineffective screening services undermine the effectiveness of cervical cancer screening. We evaluated the knowledge (K), attitude (A) and practices (P) towards cervical cancer and their influence on screening acceptance among urban and tribal women of Maharashtra, India. A cross- sectional study was conducted among 500 urban and 500 tribal women, recruited to equally represent both populations. KAP data on cervical cancer was collected using a structured questionnaire. Participants received free cervical cancer screening. KAP scores were calculated, and their associations with sociodemographic factors and cervical cancer screening were assessed using logistic regression. Total 939 participants were enrolled. Considering both populations, total 530 (56%) participants were unaware about cervical cancer, 296 (72%) about its symptoms and 250 (61%) of risk factors. Common misconceptions were that only women with symptoms of cervical cancer (166, 18%), or a family history of cervical cancer (385, 41%) needed screening. Fear of pain, bad result and embarrassment were major perceived barriers. While 65 (6.85%) participants had previously undergone screening, 756 (81%) desired screening and 670 (71.40%) underwent screening. Although women had limited cervical cancer knowledge, their attitude for screening is favorable. Generating awareness and implementing socioculturally acceptable strategies is crucial for amplifying cervical cancer screening among vulnerable women.