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. 2023 Dec 1;24(12):4269-4275.
doi: 10.31557/APJCP.2023.24.12.4269.

Cervical Cancer Screening Coverage at Tertiary Care Institutes Across India

Rakhi Rai  1 , Rohini Sehgal  1 , Seema Singhal  1 , Vanita Suri  2 , Poonam Shivkumar  3 , Latha Balasubramani  4 , Shalini Rajaram  5 , Saritha Shamsunder  6 , Rashmi Bagga  2 , Shachi Vashist  1 , Jyoti Meena  1 , Archana Mishra  6 , Latika Chawla  5 , Sarita Kumari  1 , Kalaivani Mani  7 , Neerja Bhatla  1
Affiliations

Cervical Cancer Screening Coverage at Tertiary Care Institutes Across India

Rakhi Rai et al. Asian Pac J Cancer Prev. .

Abstract

Objectives: The 70% screening coverage target proposed in the global cervical cancer elimination strategy is not achieved even at tertiary centres in India. A situational analysis was done to assess the currently existing facilities and barriers in tertiary care institutes.

Methods: This cross sectional multicentric study was conducted from August to September 2021 in six tertiary care institutes across India. Women aged 30-49 years attending outpatient services (OPD) were invited for cervical screening. Women and health care professionals (HCPs) were administered structured questionnaires to assess knowledge, attitude and practices regarding cervical cancer screening services.

Results: Out of 6709 eligible women who attended OPD, 1666 (24.8%; range:19-57%) received screening. Availability of screening kits was limited to 10-25 Pap/HPV tests per day. Visual inspection with acetic acid (VIA) and HPV testing were offered only at certain centres. Colposcopy and treatment facilities were optimal at all centres. Knowledge, attitude and practices were analysed for 1800 women: 45.7% had heard of cervical cancer, 78.0% did not know that it is preventable, 75.8% never heard about screening. Common symptoms correctly identified included postmenopausal bleeding (4.8%), postcoital bleeding (5.7%), intermenstrual bleeding (5.8%) and vaginal discharge (12.4%). Risk factors were identified by minority: poor menstrual hygiene (6.6%), oral contraceptive pill use (6.4%), multiparity (4.4%), and HPV infection (3.0%). Out of 21, mean total knowledge score (MTKS) was 2.07± 2.67. Out of 317 HCPs, 96.5% knew that cervical cancer is caused by HPV infection, is preceded by premalignant stage, and that it is preventable by screening and treatment (80.1%). Knowledge about screening modalities was present in 87.4% for cytology, 75.1% for VIA, 68.8% for HPV test. MTKS of HCPs was 20.88±6.61 out of 32.

Conclusion: Even at tertiary centres, limited availability of HPV tests, reluctance to implement VIA and lack of awareness among women remain the major barriers.

Keywords: Cervical cancer; Cytology; HPV; KAP; Screening.

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Conflict of interest statement

The authors state that there is no conflict of interest.

Figures

Figure 1
Figure 1
Screening Rate at Different Centres
Figure 2
Figure 2
Knowledge Assessment of Risk Factors amongst HCPs
See this image and copyright information in PMC

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