Cervical and uterine cancers pose significant public health challenges globally, particularly in low-resource settings where awareness and knowledge gaps often hinder effective prevention and early detection efforts. These cancers collectively account for a substantial burden of disease and mortality among women, making them a critical focus for healthcare interventions and awareness campaigns. In the context of District Shimla, Himachal Pradesh, where healthcare infrastructure and accessibility have improved over the years, it is essential to assess the level of awareness and knowledge regarding cervical and uterine cancers among the general public [1-3].

Cervical cancer is a malignant neoplasm arising from the cervix, primarily caused by persistent infection with high-risk human papillomavirus (HPV) types. On the other hand, uterine cancer encompasses several types of malignancies originating from the uterine lining or endometrium. While significant progress has been made in the understanding and management of these cancers, their incidence remains high due to inadequate awareness of risk factors, symptoms and preventive measures among the general population [4-6].

The effectiveness of public health interventions hinges on the knowledge, attitudes and practices of the target population. Studies conducted in various regions have consistently demonstrated that low awareness about cervical and uterine cancers contributes to delayed diagnosis and poor treatment outcomes. In this regard, assessing the awareness level of the public in District Shimla becomes crucial in designing tailored awareness programs, educational initiatives and early detection campaigns.

Objectives of the Study

The primary objective of this study is to evaluate the level of awareness and knowledge regarding Cervical and uterine Cancer among the general public of District Shimla, Himachal Pradesh.

Research Approach

The present study adopts a descriptive research approach, aiming to comprehensively assess the knowledge levels of the general public in District Shimla, Himachal Pradesh, regarding Cervical and uterine.

Research Design

A cross-sectional survey design was employed to collect data at a specific point in time, providing insights into the knowledge levels of participants.

Study Area

The research was conducted exclusively within District Shimla, Himachal Pradesh, ensuring the relevance and contextuality of the study findings.

Study Duration

The study was conducted over a period extending from April 2023 to July 2023, allowing for an adequate collection of data.

Study Population

The study targeted all adults aged 18 years and above, who had been residing within District Shimla, Himachal Pradesh, for a minimum duration of 12 months.

Sample Size

To ensure robust results, a sample size of 400 adults was determined based on the assumption that 50% of participants possessed adequate knowledge about Cervical and uterine cancer. The sample size estimation considered a 5% absolute error, a 95% confidence level and a 5% non-response rate.

Study Tool

A meticulously designed structured Google Form questionnaire served as the primary data collection instrument. The questionnaire underwent pre-testing among a small group of individuals to ensure its clarity, comprehensibility and suitability for the study's objectives.

Description of Tool

The questionnaire comprised two sections:

• Demographic Data Survey Instrument: This section collected key background information such as participants' age, gender, marital status, religion, employment status and educational background

• Questionnaire: This section encompassed 20 structured questions tailored to assess participants' knowledge of Cervical and uterine cancer. Correct answers were assigned one mark, while incorrect responses received zero marks. The scoring ranged from a minimum of zero to a maximum of 20. Knowledge levels were subsequently categorized into four tiers: >80% (16-20) - very good, 60-79% (12-15) - good, 41-59% (8-11) - fair and <40% (<8) - poor

Validity of Tool

The questionnaire's accuracy and appropriateness were meticulously validated by domain experts, ensuring its reliability as a robust instrument for data collection.

Data Collection

Supervised data collection was executed with vigilance. The Google Form questionnaire was strategically disseminated through diverse online platforms, including emails, social media groups such as WhatsApp, Facebook, Instagram and LinkedIn. Both rural and urban areas of District Shimla were included in the data collection process, ensuring comprehensive coverage. The process was concluded upon obtaining 400 valid responses.

Data Analysis

Collected data were meticulously entered into a Microsoft Excel spreadsheet and subjected to thorough error checks. Epi Info V7 software was employed for data analysis, wherein appropriate statistical methods such as frequencies and percentages were applied.

Ethical Considerations

Stringent adherence to ethical guidelines ensured the protection of participants' privacy and confidentiality throughout the research journey, affirming their trust and safeguarding their personal information.

Table 1: Knowledge Regarding Cervical and Uterine Cancer Among Study Participants

Table 2: Knowledge Scores Towards Cervical and Uterine Cancer Among Study Participants

The goal of the current study was to assess general public knowledge regarding Cervical and uterine Cancer through a non-experimental descriptive survey. A total of 400 respondents took part in the study, with 152 (38%) coming from urban areas and 248 (62%) from rural areas (Table 1).

In the present study 28% (112) participants had very good knowledge (16-20 marks) towards Cervical and uterine Cancer, 37% (148) had good knowledge (12-15 marks), 24.25% (97) had fair knowledge (8-11 marks) and 10.75% (43) having poor knowledge (<8 marks) (Table 2).

The findings of this study shed light on the level of awareness and knowledge regarding cervical and uterine cancer among the general public of District Shimla, Himachal Pradesh. The study results indicate a diverse range of knowledge levels among participants, which highlights both areas of strength and potential areas for improvement in terms of awareness and education about these cancers.

The majority of participants were aware of the existence of cervical and uterine cancer, which signifies a baseline level of recognition. However, the nuanced understanding of these cancers varied. A notable proportion of respondents could briefly describe what these cancers are, showing a basic comprehension. This is in line with similar studies conducted in various regions that also noted a general awareness of these cancers among the public [7,8].

While some participants could identify common risk factors associated with cervical and uterine cancers, the responses were not uniformly accurate. This suggests a need for targeted education to improve the understanding of risk factors and prevention strategies. A concerning gap was observed in participants' knowledge of symptoms and available screenings. This echoes findings from other studies, indicating a common blind spot in the public's knowledge about early detection and symptoms of these cancers [7,8].

Interestingly, the awareness of the HPV vaccine was relatively low, suggesting a need for increased dissemination of information about this preventive measure. The participants' understanding of the purpose of a Pap test varied, indicating that efforts should be directed towards explaining its significance in early detection. It is encouraging that many participants recognized the importance of men's awareness of these cancers, reflecting an evolving perception that men should also be informed about health matters related to women.

The study also revealed that a significant number of participants were not aware of any public awareness campaigns related to cervical and uterine cancer. This emphasizes the potential for expanded awareness initiatives to reach a wider audience. The participants' interest in participating in educational events signifies a receptiveness to learning and engagement in these matters, which can be leveraged for future awareness campaigns.

A noteworthy aspect of the study is the distribution of knowledge levels across rural and urban areas. While there might be certain variations, the overall pattern of knowledge remains consistent, emphasizing the need for comprehensive awareness campaigns that target both settings.

It is important to acknowledge that the findings of this study align with similar research endeavors conducted elsewhere, highlighting a global challenge in disseminating accurate information about cervical and uterine cancers to the public. The study serves as a reference point for the design and implementation of tailored awareness programs and educational initiatives that address the identified knowledge gaps.

The study provides valuable insights into the awareness and knowledge of cervical and uterine cancer among the general public of District Shimla, Himachal Pradesh. While the findings indicate a commendable level of awareness, there are still specific areas that require targeted interventions, such as educating about different uterine cancer types and promoting regular screenings. The outcomes of this study can serve as a foundation for designing effective awareness campaigns, educational initiatives and policy interventions to bridge the remaining information gaps and improve overall community knowledge regarding these cancers.

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2. Ferlay, J. et al. "Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012." International Journal of Cancer, vol. 136, no. 5, 2015, pp. E359-E386. https://doi.org/10.1002/ijc.29210.

3. Sreedevi, A. et al. "Epidemiology of cervical cancer with special focus on India." International Journal of Women's Health, vol. 7, 2015, pp. 405-414. https://doi.org/10.2147/IJWH.S50001.

4. Indian Council of Medical Research. Guidelines for Screening of Cervical Cancer. Department of Health Research, Ministry of Health and Family Welfare, Government of India, 2021.

5. World Health Organization. Comprehensive Cervical Cancer Control: A Guide to Essential Practice. 2nd ed., World Health Organization, 2021.

6. Sankaranarayanan, R. and J. Ferlay. "Worldwide burden of gynaecological cancer: The size of the problem." Best Practice and Research Clinical Obstetrics and Gynaecology, vol. 20, no. 2, 2006, pp. 207-225. https://doi.org/10.1016/j.bpobgyn.2005.10.007.

7. Smith, R.A. et al. "Cancer screening in the united states, 2015: A review of current American cancer society guidelines and current issues in cancer screening." CA: A Cancer Journal for Clinicians, vol. 65, no. 1, 2015, pp. 30-54. https://doi.org/10.3322/caac.21261.

8. Marlow, L.A.V. et al. "Understanding cervical screening non-attendance among ethnic minority women in England." British Journal of Cancer, vol. 96, no. 5, 2007, pp. 770-774. https://doi.org/10.1038/sj.bjc.6603623.