Cervical Cancer Screening Program – A Camp Based Cross Sectional Study Among Rural Women in North Kerala

Cervical cancer is ranked as the most frequent cancer in women in India and still remains a leading cause of cancer deaths because of high HPV infection rates and lack of comprehensive cervical Pap smear testing of susceptible women. There has been a regular campaign against cervical cancer for 30 years in India, but impact on the morbidity and mortality has been low, with India ranking fourth worldwide. A key challenge for cancer programs is encouraging women in the 30-55 year age group at highest risk for treatable, precancerous lesions, to seek pap smear screening camps. To increase attendance it is important to work in the community by approaching local women's groups and with their help increasing awareness, knowledge and accessibility of screening among women. In this study the investigators made an effort to increase camp attendance by involving women’s groups. We assessed the effect of involvement of women groups in comparison to previous camps, the awareness, attitude and practice of the disease, and its prevention, and the HPV vaccine among the women and finally studied the Pap smear results. A camp based cross sectional study was done in Karindalam village to assess pap smear tests, knowledge, attitude and practice regarding cancer cervix and its screening method. Community level women volunteers were used to mobilise women for the camp. Quantitative data was collected through face to face interview using a pre tested questionnaire and the pap smear test done. Analysis was done with descriptive statistics using epi info. There were 319 women who attended the camp. Out of these 99.7% were ever married. In our studied population 55% of the women were married before 20 years of age and 36% had their first child before 20 years of age. Fifty percent studied up to 10 th grade and around 50% belonged to the lower class. Majority of the women had inadequate knowledge about the disease symptoms (52.7%), risk factors (76%), preventive measures (65.5%), Pap smear method (91%) and HPV vaccine (8.4%). Reasons for not doing a Pap smear test so far were inadequate knowledge about the disease and test, fear of procedure and result, non availability of the test locally, being non symptomatic, and cultural factors. The Pap smear tests identified 2 (0.6%) women with high intra epithelial lesions, 4 (1.2%), endocervicitis and 3 (1%) with bacterial vaginosisand adequate follow up was offered. The government of India has to respond to the need of the hour and strengthen information, education and communication efforts on cervical cancer along with providing