Cervical cancer is one of the most common types of cancer affecting women globally, especially in low- and middle-income countries. In India, it is the second most prevalent cancer among women, contributing to a substantial burden on healthcare resources. Himachal Pradesh, a northern state in India, also faces the challenge of cervical cancer incidence, making it crucial to evaluate the knowledge and awareness of women in the region [1-3].

Understanding the risk factors associated with cervical cancer is crucial for prevention and early intervention. Behavioral and lifestyle factors, such as early sexual activity, multiple sexual partners, smoking and a weakened immune system, have been identified as significant contributors to cervical cancer development. Additionally, the Human Papillomavirus (HPV) infection is a major risk factor for cervical cancer. Moreover, recognizing the symptoms, such as abnormal vaginal bleeding, pelvic pain and discomfort during sexual intercourse, can prompt women to seek medical attention promptly [4-8].

Regular cervical cancer screening is essential for early detection and treatment. Common screening methods include the Papanicolaou (Pap) test and HPV testing, which can identify pre-cancerous changes in the cervix before they develop into cancer. However, the effectiveness of screening programs heavily relies on women's awareness and willingness to participate [9-12].

This paper aims to assess the comprehension level of women attending the outpatient department of Civil Hospital Jogindernagar, Himachal Pradesh, regarding the risk factors associated with cervical cancer, its symptoms and the available screening methods. By evaluating their knowledge gaps, we can identify areas where educational interventions and awareness campaigns can be implemented to improve prevention and early detection rates.

The findings from this study will help healthcare providers and policymakers tailor targeted interventions to enhance women's knowledge about cervical cancer, encourage regular screening and ultimately reduce the burden of cervical cancer in Himachal Pradesh. Empowering women with accurate information will contribute to better health outcomes and a healthier community overall.

Objectives of the Study

To evaluate the awareness regarding the risk factors associated with cervical cancer, its symptoms and the available screening methods among women attending outpatient department of civil hospital, Jogindernagar, Himachal Pradesh

• Research Approach: Descriptive

• Research Design: Hospital based cross-sectional survey design

• Setting of the Study: OPD in Civil hospital Jogindernagar, Himachal Pradesh

• Study Duration: Between May 2022-April 2023

• Study Population: Women aged above 18 years came to OPD 

• Sample Size: About 400 women, assuming 50% have adequate knowledge regarding cervical cancer, 5% absolute error, 95% confidence level and 5% non- response rate

• Sampling Technique: Convenience Sampling technique

• Sampling Criteria: First five female patients who came to OPD were selected everyday till the completion of sample size after explaining the purpose of the study. Informed consent was taken from them and confidentiality of the selected participants was also maintained 

• Inclusive Criteria: Female patients who were willing to participate in the study

• Exclusion Criteria: Female patients who were not willing to participate in the study

Description of Tool

• Demographic Data Survey Instrument: The demographic form elicited information on participants’ background: AGE, marital status, religion, employment, education, family’s monthly income etc

• Questionnaire: The questionnaire contains 20 structured knowledge related questions having three options (yes, no, don’t know). The participants have to choose right one. One mark was given for each correct answer and zero for incorrect answer. The maximum score was 20 and minimum score was zero. Scoring was done on the basis of marks as >80%(16-20) = very good, 60-79%(12-15) = Good, 41-59% ( 8-11) = Fair, <40% (< 8) = poor

Validity of Tool

By the experts in this field.

Data collection

By under the guidance of supervisors and patients were given 30 minutes time to complete that questionnaire and collected at the end of the prescribed time.

Data Analysis

With Epi Info V7 Software with appropriate statistical test in terms of frequencies, percentage.

The goal of the current study was to assess the awareness regarding the risk factors associated with cervical cancer, its symptoms and the available screening methods among women attending outpatient department of civil hospital, Jogindernagar, Himachal Pradesh.

Table 1: Socio Demographic Characteristics of the Participants

A total of 400 respondents including 145 (36.25%) were from urban area and 255(63.75%) were from rural area were participated in the study. Among the total of 400 female patients came to OPD, maximum 118(29.5%) were having age between 21-30 years, educated up to Matric and Senior Secondary 166(41.5%), Hindu 376(94.0%) and were housewives 301(75.25%) (Table 1 and 2).

Table 2: Knowledge Regarding Risk Factors Associated with Cervical Cancer, its Symptoms and the Available Screening Methods

In the present study 15.5% (62) participants had very good knowledge (16-20 marks) towards risk factors associated with cervical cancer, its symptoms and the available screening methods 51.25% (205) had good knowledge (12-15 marks), 23.75% (95) had fair knowledge (8-11 marks) and 9.5%(138) having poor knowledge (<8 marks) (Table 3).

Table 3: Knowledge Score Regarding Risk Factors Associated with Cervical Cancer, Its Symptoms and the Available Screening Methods

The study aimed to assess the comprehension level of women attending the outpatient department of Civil Hospital Jogindernagar, Himachal Pradesh, regarding the risk factors for cervical cancer, its symptoms and the available screening methods. 

The study revealed several knowledge gaps and misconceptions among women regarding cervical cancer. Many participants had limited awareness of the risk factors associated with cervical cancer, such as the role of early sexual activity, multiple sexual partners, smoking and HPV infection. This lack of knowledge indicates a need for targeted educational interventions to increase awareness about the modifiable risk factors.

Furthermore, the comprehension of cervical cancer symptoms was also found to be inadequate. Women often failed to recognize abnormal vaginal bleeding, pelvic pain and discomfort during sexual intercourse as potential warning signs. This highlights the importance of raising awareness about these symptoms to facilitate early detection and timely medical intervention.

The study assessed the understanding of cervical cancer screening methods among the participants. While some women were aware of the Pap test and its purpose, there was limited knowledge about HPV testing and its significance in detecting early cervical abnormalities. This indicates the need for improved education regarding the different screening methods available and their benefits.

Moreover, the study highlighted the low utilization of cervical cancer screening services among the participants. Various reasons were identified, including fear, lack of awareness and societal barriers. Efforts should be made to address these barriers by implementing community-based awareness campaigns, providing accessible screening facilities and ensuring confidentiality and privacy during the screening process.

Based on the study findings, several strategies can be implemented to enhance awareness and prevention of cervical cancer among women in Jogindernagar, Himachal Pradesh. Targeted awareness campaigns should be developed to educate women about the risk factors, symptoms and importance of regular screening. These campaigns can be conducted through community health centers, schools and local organizations to reach a larger audience. Healthcare professionals play a crucial role in disseminating accurate information about cervical cancer. Collaboration with local healthcare providers can help in organizing workshops, awareness sessions and regular screening camps to improve knowledge and encourage women to undergo screening. Empowering women to take charge of their health is essential. Providing them with information booklets, pamphlets and online resources can help them make informed decisions and take necessary preventive measures. Efforts should be made to enhance accessibility to cervical cancer screening services in the region. This can be achieved by establishing screening centers in remote areas, providing mobile screening units and ensuring cost-effective or subsidized screening services. Policymakers should prioritize cervical cancer prevention and control by allocating resources, developing guidelines and integrating cervical cancer screening into existing healthcare programs.

Limitations and Future Research

The study had certain limitations, such as a small sample size and a specific geographical focus. Future research can aim to address these limitations by conducting larger-scale studies involving diverse populations. Additionally, qualitative research exploring cultural beliefs, societal norms and barriers specific to the region can provide valuable insights for developing targeted interventions.

In conclusion, the study highlighted the knowledge gaps and misconceptions regarding cervical cancer risk factors, symptoms and screening methods among women in Jogindernagar, Himachal Pradesh. Addressing these comprehension gaps is crucial for effective prevention and early detection. Expanding screening facilities and providing outreach services in remote locations can significantly increase screening rates among women who face geographical and financial barriers to healthcare. By implementing targeted educational interventions and improving access to screening services, healthcare providers and policymakers can contribute to reducing the burden of cervical cancer in the region, ultimately leading to improved health outcomes for women.

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