3. TITLE
Knowledge and Attitude towards, and the
Utilisation of Cervical and Breast Cancer
Screening Services by Female Healthcare
Professionals at a Tertiary Care Hospital of
Eastern India : A Cross-sectional Study
4. Journal
• The Nigerian postgraduate medical journal
• Volume 29
• January 2022
• Issue 1
• Peer reviewed
5. Journal
• Open Access journal
• Published – 28/01/2022
• Website: www.npmj.org
• DOI: 10.4103/npmj.npmj_760_21
6. Journal
• Indexing-
1. DOAJ,
2. Emerging Sources Citation Index,
3. MEDLINE/ Index Medicus,
4. Scimago Journal Ranking,
5. SCOPUS,
6. Web of Science
• Impact factor- 0.667 (2023)
7. Authors
1. Sonu Hangma Subba
2. Swayam Pragyan Parida
3. Dinesh Prasad Sahu
4. Janki Kumari
Department of Community Medicine and Family Medicine, AlIMS,
Bhubaneswar, Odisha, India
Corresponding Author: Dr. Swayam Pragyan Parida,
Department of Community and Family Medicine, AlIMS,
Bhubaneswar, Odisha, India
8. Introduction
• Carcinoma of cervix and breast are the leading causes
of cancer related morbidity and mortality
amongst women in world.
• In India, breast and cervical cancers are two
most common cancers amongst females accounting
for 27.7 % and 16.5%, respectively.
9. Introduction
• Regular screening of women in reproductive age group
reduces morbidity and mortality to 50%-70%
in these two cancers.
• Under the National Programme for Prevention and Control of Cancer,
Diabetes, Cardiovascular Diseases and Stroke in India,
Pap smear test and CBE are available in primary healthcare settings.
10. Introduction
• In India, the utilization of cancer screening services
is low amongst the healthcare professionals (HCPs).
• Poor knowledge regarding availability of screening methods
and information on signs and symptoms of cancer
among the population is leading to late detection of cancer.
11. Aim
To assess the knowledge and utilization
of breast and cervical cancer screening amongst
HCPs and also to find out the reasons
for its non-utilisation amongst HCPs.
12. Material and method
• Study Area- A tertiary care hospital in Eastern India
• Study Period - May - July 2017
• Study Participants- 200 female HCPs
• Study Design- A Cross- sectional study
13. Material and method
• Inclusion criteria -
All female HCPs (faculty, junior, and senior
residents and nursing staff) irrespective of their age.
• Exclusion criteria -
Those who were not willing to participate.
14. Sample size
• Sample size- 200
• Calculating formula- Z α²pq/d2
• From study by Rahman and Kar- Taking pap smear practice of
11.6%, absolute precision of 5% and desired confidence level of
95%.
• Sample size - 158.
• After assuming a non-response rate of 20%, the sample size -
189 which was ~ to 200.
• Convenience sampling.
15. Study tool and data collection
• A pre-designed and pre tested self administered questionnaire
1. Sociodemographic profile of female HCPs.
2. Their knowledge of symptoms and risk factors regarding
breast and cervical cancer.
3. Utilisation of screening methods for these two cancers.
4. Knowledge and practice regarding cancer screening.
16. Statistical analysis
• Data entered in MS excel word 2010, analysed using SPSS
version 20, IBM Armonk, NY, USA.
• Proportion, mean, standard deviation- used to find out the
result
• Chi square test- to assess the level of significance between two
groups for categorical variables
• Binary logistic regression- to find out the association
• P<0.05 – was considered statistically significant.
26. Discussions
Current study
findings
Author Discussion
Only 1/10th of doctors &
< 1% of the nurses had
undergone screening
Pegu et al Pap smear test practice in
Indian studies ranged -
0% to 18.4%
The mean age was 30
years
Anantharaman et al The mean age was 44.07
years
27. Discussions
Current study
findings
Author Discussion
Lack of symptoms - major
reason for not undergoing
screening
Thippeveeranna et al. Absence of symptoms -
most common reason
35% of HCPs didn't advise
eligible beneficiaries to
undergo screening.
Shekhar et al. ~ 90% of them had never
referred patients for
screening.
28. Discussions
Current findings of
study
Author Findings
Cancer prevention and
screening- affected by
knowledge of disease
Swapnajaswanth et al Knowledge about risk
factors was better
amongst doctors than
nurses.
Major symptoms of
cervical cancer -
post-coital bleeding (85%)
and foul-smelling
discharge (88.5%)
Kosambiya et al in Surat, major symptoms
of cervical cancer- foul
smelling discharge
(57.4%) and post-coital
bleeding (40.6%)
30. Strength
1. First of its kind in eastern part of India
2. Comprehensive assessment of knowledge,
attitude and practice of cervical and breast cancer
Screening.
31. Limitations
1. Convenient sampling of the study participants,
which affects the external validity.
2. Responses were self reported in the study.
32. Conclusion
• Knowledge about risk factors, symptoms, signs and screening
methods of breast and cervix cancer- satisfactory amongst HCPs
• Routine self screening among HCPs to be emphasized.
• Need of change of attitude and efforts from HCPs, by sensitizing
them with periodic training and CME.
33. Conclusion
• Regular awareness campaign on breast self-examination
needs to be done.
• Educating health seeking behavior to women
by knowledgeable HCPs, will lead to early detection of
cancer and better prognosis.
35. References
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https://gco.iarc. fr/today/data/factsheets/populations/900-world-fact-sheets.pdf. [Last accessed on 2020 Feb 03].
• 2. International Agency for Research on Cancer, World Health Organization. Globocan India; 2019. Available from:
https://gco.iarc. fr/today/data/factsheets/populations/356-india-fact-sheets.pdf. Last Accessed 20th January 2022.
• 3. Sankaranarayanan R. Screening for cancer in low- and middle-income countries. Ann Glob Heal 2014;80:412-7.
• 4. National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS).
Ministry of Health & Family Welfare Government of India. Available from: https://dghs.gov.
in/content/1363_3_NationalProgrammePreventionControl.aspx. [Last accessed on 2019 Nov 19].
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cancer screening in five developing countries. N Engl J Med 2005;353:2158-68.
• 6. Thippeveeranna C, Mohan SS, Singh LR, Singh NN. Knowledge, attitude and practice of the pap smear as a screening
procedure among nurses in a tertiary hospital in north eastern India. Asian Pac J Cancer Prev 2013;14:849-52.
• 7. Seah M, Tan SM. Am I breast cancer smart? Assessing breast cancer knowledge among health professionals. Singapore
Med J 2007;48:158-62.
• 8. Rahman H, Kar S. Knowledge, attitudes and practice toward cervical cancer screening among Sikkimese nursing staff in
India. Indian J Med Paediatr Oncol 2015;36:105-10.
• 9. Anantharaman VV, Sudharshini S, Chitra A. A cross-sectional study on knowledge, attitude, and practice on cervical
cancer and screening among female health care providers of Chennai corporation, 2013. J Acedmic Med Sci 2012;2:124-8.
• 10. Pegu B, Dhiman N, Chaturvedi J, Sharma SK. Nurse’s knowledge and attitude regarding cervical cancer screening at a
tertiary care hospital. Int J Reprod Contracept Obstet Gynecol 2017;6:907-10.
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nursing staff of a tertiary health institute in Ahmedabad, Gujarat, India. Ecancermedicalscience 2012;6:270.
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36. References
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Cancer Prev 2014;15:6095-8.
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college hospital in South India. Int J Res Heal Sci 2014;2:1085-90.
• 15. KosambiyaRJ, GohilA, Kamdar ZN, Patel P, ModiA. Knowledge, attitude and practices about cervical cancer and
screening among nurses of a tertiary care centre in western India. Natl J Community Med 2018;9:391-5.
• 16. Udigwe GO. Knowledge, attitude and practice of cervical cancer screening (PAP smear) among female nurses in
Nnewi, South Eastern Nigeria. Niger J Clin Pract 2006;9:40-3.
• 17. Singh E, Seth S, Rani V, Srivastava DK. Awareness of cervical cancer screening among nursing staff in a tertiary
institution of rural India. J Gynecol Oncol 2012;23:141-6.
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care centre in India. IJSS J Surg 2017;3:57-60.
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practices towards breast cancer among nurses in Indira Gandhi Medical College, Shimla, Himachal Pradesh, India. Asian
Pac J Cancer Prev 2013;14:117-20.
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nursing staff working in a tertiary-care hospital located in south India. Int J Med Sci Public Heal 2016;5:1650-5.
• 21. Lemlem SB, Sinishaw W, Hailu M, Abebe M, Aregay A. Assessment of knowledge of breast cancer and screening
methods among nurses in university hospitals in Addis Ababa, Ethiopia, 2011. ISRN Oncol 2013;2013:470981
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Family Med Prim Care 2020;9:2214-8
37. Critical Appraisal
Heading
Title Informative, study area, study design, study
population, area and aim of the study is
mentioned.
Could have used word Attitude rather than
Utilization
Abstract words limit is 150, structured with appropriate
headings, summarizes the key results
Key Words Appropriate key words has been mentioned
38. Critical Appraisal
Heading
Background Explains scientific background and rationale for
the investigation being reported.
Need for the study Explained
Objective Doesn’t specify objectives
Doesn’t mention female HCPs specifically
42. Critical Appraisal
Heading
Results Bar diagrams and tables – used to explain
Discussion Results have been explained and compared with good
number of studies
43. Critical Appraisal
Heading
Limitations Has been mentioned
Strength Has been mentioned
Conclusion Has been mentioned along with recommendations
References As per Vancouver style
