Baseline knowledge on risk factors, symptoms and intended behaviour of women and men towards screening and treatment of cervical cancer in rural Uganda: A cross-sectional study

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Abstract Background Knowledge of risk factors and symptoms of cervical cancer has been found to promote uptake of screening of cervical cancer. Most interventions targeted women without much involvement of men (husbands) who are often decision makers in many low- and middle-income countries. This study aimed at assessing baseline knowledge and intended behaviour of both women and men to enable design specific targeted messages to increase uptake of cervical cancer screening and promote early detection of women with symptoms. Methods This cross-sectional study was conducted in two districts in Western Uganda using the modified African Women Awareness of CANcer (AWACAN) questionnaire. Women aged 30–49 years and their husbands/decision makers were interviewed. Knowledge on risk factors and symptoms, intended behaviour and barriers towards participation in cervical cancer screening and treatment were assessed. Descriptive and logistic regression analyses were done to establish the association between knowledge levels and other factors comparing women to men. Results A total of 724 women and 692 men were enrolled. Of these, 71.0% women and 67.2% men had ever heard of cervical cancer and 8.8% women had ever been screened. Knowledge of risk factors and symptoms of cervical cancer was high and similar for both women and men. Lack of decision making by women was associated with low knowledge of risk factors (X2 = 14.542; p = 0.01), low education (X2 = 36.05, p < 0.01) and older age (x2 = 17.33, p < 0.01). Men had better help seeking behaviour than women (X2 = 64.96, p < 0.01, OR = 0.39, 95% CI: 0.31 - 0.50) and were more confident and skilled in recognising a sign or symptom of cervical cancer (X2 = 27.28, p < 0.01, OR = 0.52, CI (0.40 - 0.67). Conclusion The baseline knowledge for cervical cancer was high in majority of participants and similar in both women and men. Their intended behaviour towards screening was also positive but screening uptake was very low. This study suggests developing messages on multiple interventions to promote screening behaviour in addition to education, consisting of male involvement, women empowerment and making services available, accessible and women friendly.

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