Cervical cancer knowledge, awareness and related health behaviours amongst women of reproductive age in Kiambu County, Kenya: a cross-sectional study.

Background: Data on cervical cancer knowledge, perceptions, screening practices and other relevant health behaviours among women in rural Kenya is limited. Yet understanding this information is a key first step in developing evidence-based interventions aimed at addressing the low uptake of screening services and heavy cervical cancer disease burden within Kenya. Consequently, our study sought to assess cervical cancer knowledge, attitude, and practice amongst women of reproductive age within Kiambu County, known for a high cervical cancer disease burden.

Methods: This was an analytical cross-sectional study undertaken in April 2022. Data was collected using interviewer-administered questionnaires from 472 females randomly selected from within the community. Data analysis included descriptive statistics (mean values, standard deviations, and frequencies) and logistic regression, using STATA version 13.

Results: More than 80% of respondents were aware of cervical cancer though only 54% answered at least half of the knowledge questions correctly. Knowledge of HPV was particularly low, likely because 55% of the study sample stated they had never heard of HPV. Though 89% of study participants deemed cervical cancer preventable, more than 60% had an unfavourable attitude towards cervical cancer screening, deeming the process expensive, painful, and embarrassing. In line with the latter observation, only 20% of our sample had ever been screened for cervical cancer and less than half of this group had undergone regular screening. Notably, knowing a place where cervical cancer screening services are provided had the largest increase in odds of being screened (3.94; 95% CI: 1.08-14.37). Fear of tests and outcomes was also noted to be a prime concern amongst our study participants.

Conclusion: A clear message from this study is the need to ensure community members are aware of where to access screening services and strategies are implemented to address prevalent fears and negative perceptions.Abbreviations: CHV: Community Health Volunteers; HPV: Human papillomavirus; HIV/AIDS: Human immunodeficiency virus/Acquired immune deficiency syndrome; LEEP: Loop Electrosurgical Excision Procedure; LMICs: Low- and Middle-Income Countries; NCI: National Cancer Institute; NACOSTI: National Commission for Science, Technology, and Innovation; VIA: Visual inspection with acetic acid; VILLI: Visual inspection with Lugol's iodine; WHO: World Health Organisation.