Knowledge, attitudes and associated factors regarding cervical cancer and its screening practice among women of central Nepal.

Background: Cervical cancer is a severe public health problem worldwide including developing countries like Nepal. Cervical cancer screening has decreased the incidence and mortality of cervical cancer worldwide. Although it is highly preventable disease, cervical cancer is the leading cause of mortality among Nepalese women due to poor knowledge, negative attitude, poor practice, and late diagnosis. 1928 women died from cervical cancer in Nepal in 2018, this number was higher than that in 2017. Objectives: This study aimed to identify the knowledge, attitudes, and associated factors related to cervical cancer and its screening practices among women in Nepal. Methods: A community-based cross-sectional study was conducted after following the ethical approval from the Nepal Health Research Council, Ref No-115 in Kathmandu, Nepal. A total of 426 married women aged 18-49 were selected using a probability proportionate simple random sampling technique. After obtaining the written informed consent, the participants were interviewed using a validated questionnaire. Data entry and analysis were performed using IBM SPSS Statistics version 23, and we interpreted the findings using both descriptive and inferential statistics. To assess the factors associated with knowledge and attitude levels, we employed Chi-square analysis and subsequently conducted binary logistic regression analysis. Results: The average age of respondents was 31.18 ± 8.375 and 85 % of respondents heard about cervical cancer mainly from Television/Radio. Slightly more than half (51.8 %) of respondents had favorable attitude towards cervical cancer and its screening. Regarding knowledge, 46.5 % had adequate knowledge about cervical cancer and its screening. However, majority of (91.5 %) the respondents had never done cervical cancer screening test. In logistic regression analysis, respondent's education, occupation and heard about cervical cancer were significantly associated with adequate level of knowledge. Women with secondary education (AOR = 3.875 95 % CI: 1.741-8.623) and higher education (AOR = 7.818 95 % CI: 3.386-18.048) had more adequate knowledge compared with illiterate women. Age and heard about cervical cancer and type of family were positively associated with favorable attitude. There was a very weak positive correlation between knowledge and attitude of cervical cancer and its screening (r = 0.078). Conclusion: Cervical cancer is a severe public health problem of Nepal. From the result, we can say that about half of the subjects had knowledge and favorable attitude towards cervical cancer, despite the fact that still there is gap to transform it in to practice. There is a need for some measures to improve the cervical cancer screening practice by using information, Education, Communication materials and Behavior Change Communication (IEC/BCC).