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KNOWLEDGE, ATTITUDE AND PRACTICE CONCERNING CERVICAL CANCER SCREENING AMONG MARKET WOMEN

ABSTRACT

Cervical cancer is a spectrum that ranges from dysplasia to invasive cancer. The late stage of the disease result with distant metastasis involving surrounding tissues and deposits in organs like the liver, lungs and bones. Poor public health awareness has contributed to late diagnosis of this disease, therefore there is need to assess the knowledge, attitude and practice with regards to cervical cancer screening. Market women continue to be the economic driving force of families in many parts of Nigeria. The awareness will therefore reduce the burden of the disease. A cross-sectional descriptive study was carried out by using systematic sampling to collect data through administered questionnaires to 253 market women in Yola metropolis. The result showed majority of the market women have heard about cervical cancer (74.0%), 74.9% of them heard about screening, there was also good attitude, however the practice was poor. Women with formal education have taken up cervical cancer screening than those with non formal education, it was statistically not significant (x2 = 4.248, P = 0.120). As only 72 women have carried out cervical cancer screening. The study established that level of knowledge on cervical cancer screening was high but practice was low as 28.5% of the respondents ever had cervical cancer screening. Therefore, sustained public health awareness should be encouraged in order to increase the utilization of screening service in all health facilities.

CHAPTER ONE

INTRODUCTION

Background of the Study

Cervical cancer is a spectrum that ranges from Dysplasia to invasive cancer. Dysplasia describes an abnormal organization of cells i.e. premalignant changes in the squamous epithelium. It is graded as mild, moderate or severe. Cervical intraepithelial neoplasia is a closely related nomenclature that covers the entire spectrum of changes are graded CIN 1, CIN 2, and CIN 3 according to the third of the epithelium (Upper, Middle, Lower) respectively in which changes occur; corresponding to mild, moderate and severe1.

Invasive cancer is characterized by invasion of deeper tissues. It usually takes three forms; fungating (commonest), ulcerating and infilterating. Histologically, 95% of cells are large cell type either keratinized (well differentiated) or non keratinized (moderately differentiated). Adenocarcinoma arises from endocervical glance, situated anywhere from the internal to the external os. The late stage of the disease usually results into distant metastasis but however, local spread can occur either upward to involve all the cervix, downward to extend into the vaginal vault, laterally, it involves the ureters and anteriolly to involve the bladder, posteriolly to involve the rectum. Lymphytic spread occurs early, while haematogenous spread occurs through systemic circulation mainly depositing in the liver, lungs and bones1.

Pathogenesis of Cervical Cancer

Cervical cancer arises in the so-called transformation zone of the uterine cervix. This is the area which undergoes physiological metaplasia from glandular to squamous epithelium at the onset of adolescence. Human Papiloma Virus (HPV) is very common after the onset of sexual activity, and when it persists, the viral oncoprotein produce perturbation of the cell-cycle controls.