3 BACKGROUNDCancer is the leading cause of death worldwide and accounted for 8.2 million deaths in 2012.Cervical cancer. leading cause of cancer deaths among women in developing countries.529,409 new cases occurred globally, with 274,883 of the women (52% of cases) dying.86% of the cases occur in developing countriesIn SSA : magnitude of the problem is under-recognized and under-prioritized.In Kenya-second most frequent cancer among women and the leading cause of cancer deaths in women of reproductive age.2454 new cases and 1676 deaths are reported every yearOnly 3.2% of women in Kenya have been screened for cervical cancer.(WHO 2008,WHO2013)
4 PROBLEM STATEMENTMorbidity and mortality of cervical cancer can be reduced through regular screeningScreening is available in most facilities (VIA/VILI) and Pap smearScreening levels still remain lowStudy findings will provide relevant information to increasing uptake in rural areas
5 OBJECTIVES Broad objective Specific objectives To determine factors associated with cervical cancer screening uptake among women in Embu county, KenyaSpecific objectivesTo determine cervical cancer awareness & knowledge among women in EmbuTo determine awareness & knowledge of cervical cancer screeningTo determine the uptake of cervical cancer screeningTo determine barriers to cervical cancer screening uptake
6 METHODOLOGY Study design Cross- sectional study survey Quantitative studyStudy populationWomen aged 18 years and aboveInclusion CriteriaAll women aged 18 and above who gave consentExclusion CriteriaDeclined to consentEthical ConsiderationsEthics approvalInformed consentConfidentialityStudy siteEmbu CountyData collectionStructured QuestionnaireSamplingMulti stage cluster samplingSample size269 womenData management and analysisCoding, data entry SPSS 17FrequenciesBivariate analysis
7 SOCIO-DEMOGRAPHICS Characteristics Classification Frequency Percent Age in years<255119.025-3410237.935-446423.845-543312.355-64124.5>6472.6Total269100 Marital statussingle (never married)5821.6Married17765.8Separated207.4Divorced10.4Widowed134.8 269 100 Education levelPrimary12345.7Secondary10438.7Technical College3011.2University20.7None103.7 Employment statusEmployed Fulltime3412.6Employed part timeUnemployed4617.1Self-employed16360.6Full time home maker(house wife)155.6Retired31.1Others
9 SIGNS AND SYMPTOMS Knowledge of signs of cervical cancer Yes No Don't knowVaginal bleeding between menses31.6%10.4%58.0%Persistent vaginal discharge with unpleasant smell32.7%10%57.2%Vaginal bleeding after menopause34.6%3.3%62.1%Bleeding during or after sex29.0%7.4%63.6%
10 CERVICAL CANCER RISK FACTORS Risk factors of cervical cancerDisagreeNot sureAgreeInfection with HPV5.6%70.6%23.5%Smoking cigarettes14.1%51.7%34.2%Weakened immune system13.1%58.6%28.1%Infection with STI's9.3%53.2%37.3%Having multiple sexual partners11.6%50.6%37.7%Having many children31.2%58.7%10.0%Having a sexual partner with multiple partners13.4%53.9%32.7%Not going for regular screening11.9%52.8%35.3%
15 ASSOCIATIONS Tests of association p-value Association between economic status and uptake of cervical cancer screening0.027Association between awareness of cervical cancer and age of respondent0.031Association between cervical cancer awareness and screening uptake<0.001Association between awareness of cervical cancer screening and uptakeAssociation between knowledge of prevention of cervical cancer and screening uptake
16 CONCLUSIONAwareness of cervical cancer screening among the respondents was highKnowledge of the signs and symptoms and risk factors associated with cervical cancer was low.Screening uptake was very low despite the high levels of awareness of cervical cancer and cervical cancer screening.Awareness of cervical cancer, awareness of cervical cancer screening and knowledge of modes of prevention of cervical cancer were critical in determining cervical cancer screening uptake among the women.
17 RECOMMENDATIONS To the Government and County Governments Awareness campaigns and education programmes to encompass signs and symptoms, risk factors and modes of prevention of the disease.Research institutionsStudies to explore the disparity between high awareness and low uptake should be conducted.
18 ACKNOWLEDGEMENTS University of Nairobi AMREF Kenya All women who participated