Knowledge and Use of Cervical Cancer Screening Among University Female Students at Kilimanjaro, Tanzania

Abstract

Cervical cancer is a major public and global health problem. According to the WHO, it is the fourth leading cancer among women worldwide, with most women being from low- or middle-income countries. It is the leading cause of cancer-related morbidity and mortality among women of reproductive age in Tanzania, where approximately 4,216 women die as a result of the disease annually. Women with HIV/AIDS, multiple sexual partners, history of human papillomavirus infections, contraceptive use, and early onset of sexual activity have increased risk of the disease, including among university students. Poor knowledge and limited screening programs are major contributors. This study was aimed at assessing the level of knowledge and use of cervical cancer screening among university female students in Moshi municipality. A cross-sectional study was conducted from June to July 2018 involving undergraduate female students age 18 years and older at three different universities in the Moshi municipality. A total of 322 participants were identified using multistage sampling; data were collected through a self-administered semistructured questionnaire and analyzed using SPSS version 20. Ninety-two participants (28.6%) had good knowledge, 104 (32.3%) had satisfactory knowledge, and 126 (39.1%) had poor knowledge. About 299 (92.9%) had heard about cervical cancer. The most frequent sources of information were the media (168 [52.2%]); family, neighbors, and friends (106 [32.9%]), health workers (102 [31.7%]); and teachers (75 [23.3%]). Few reported other sources of information. Only 31 women (9.6%) had been screened for cervical cancer. The reasons given for not attending cervical cancer screening were “I have just not decided” (114 [30.4%]), “I am healthy” (81 [21.6%]), “I’m not informed” (49 [13.0%]), and “It may be painful” (42 [11.2%]); 89 women (23.7%) reported other reasons. Lack of proper knowledge about cervical cancer contributes to low-screening use. Promotion to increase awareness about cervical cancer screening through radio, television, social media, and clubs would be of great importance. Although a lot has been done by the government and other stakeholders regarding screening, the campaigns should focus not only on women but also on university students specifically, who are more likely to have multiple sexual partners and to have engaged in sexual activity at younger than 18 years.