Title: Impact of Health Education Intervention on Uptake of Random Screening for Cervical & Breast Cancers among Rural Women in Villages of Gurgaon Cluster, Haryana, India

Authors: P. Cheena Chawla, Anil Kumar Chawla, Seema Chaudhary

 DOI:  https://dx.doi.org/10.18535/jmscr/v4i12.31

Abstract

Disease awareness and socio-cultural practices together influence the treatment-seeking behavior of rural women as well as their uptake for preventive screening of breast and cervical cancers. This study was carried out to assess the awareness and knowledge of rural women about cervical and breast cancers and their attitude and uptake for primary screening of these cancers in villages of Gurgaon, randomly selected by our financial partner, DLF Foundation, Gurgaon. A cross-sectional study was conducted among 603 women, aged 21-65 years, who attended the awareness and screening camps on women’s cancers where random primary screening for breast and cervical cancers was done. Out of 603 women who participated in different camps held at various villages of Gurgaon, during 2014-2016, a volunteer sample comprising 235 women (39%) were screened for cervical and breast cancers. Further, 365 women (61%) were taught how to conduct self-breast examination. There were 88 cases (37.44%) out of 235 screened who were found to have genital infections for which they were given free medicines. Out of 235 screened women, 99 were suspected (42%) to have abnormalities in cervix or breast and were recommended for advanced tests (46 women for Pap smear test, 33 women for USG Abdomen and 20 cases for Mammography) for disease confirmation and guidance for proper treatment. Only 38 cases, however, adhered to the follow-up schedule. Specially designed, easy-to-understand leaflets (in Hindi) on the four women’s cancers (Endometrial Cancer, Breast Cancer, Ovarian Cancer and Cervical Cancer) were distributed to all participating women. The main finding was that rural women had poor knowledge about cervical and breast cancer screening and there was complete lack of awareness regarding the symptoms, risk factors and preventive screening of these cancers. Effective education and large-scale primary screening are necessary for alleviating the burden of cervical and breast cancers in India. It came to light that low family income and lack of transport contribute to women’s inability to reach health centres when faced with distressing symptoms of these cancers. The study concluded that cancer awareness programmes along with on-site primary screening of cervical and breast cancers, using simple, cost-effective techniques, would significantly benefit rural women as a majority of them never get a preventive screening done for these cancers.

Keywords: Cervical/Breast Cancer, Awareness, Preventive Screening, Follow-up.

References

1.      Shankar ARath GRoy SMalik ABhandari RKishor KBarnwal KUpadyaya SSrivastava VSingh R. Level of awareness of cervical and breast cancer risk factors and safe practices amo-ng college teachers of different states in india: do awareness programmes have an impact on adoption of safe practices? Asi-an Pac J Cancer Prev.2015;16(3):927-32.

2.      S. AswathyMariya Amin Queres-hiBeteena Kurian, and K. Leelamoni. Cervical cancer screening: Current knowledge & practice among women in a rural population of Kerala, India. Indian J Med Res. 2012 Aug; 136(2): 205–210.

3.      Isa Modibbo F, Dareng E, Bamisaye P, et al. Qualitative study of barriers to cervical cancer screening among Nigerian women. BMJ Open 2016; 6: e008533. doi:10.1136/bmjopen-2015- 008533

4.      Human Papillomavirus and Related Canc-ers, Fact Sheet 2016 (June 14, 2016). ICO Information Centre on HPV and Cancer.

http://www.hpvcentre.net/statistics/reports/IND_FS.pdf

5.      Kumar V, Abbas AK, Fausto N, Mitchel RN: Robbins Basic Pathology. 2007, Lon-don: WB Saunders Elsevier, 718-721. 8

6.      P. Cheena Chawla, Anil Chawla, Seema Chaudhary, Richa Shrivastava and Anju Shrivastava,  Community Sensitization Of Women Cancers Through Awareness Cum Screening Programme- A Pilot Study,” Journal of International Academic Resear-ch for Multidisciplinary, 2014a, (2) 21-30.

7.      Royal Thai College of Obstetricians and Gynaecologists (RTCOG)/JHPIEGO Cervi-cal Cancer Prevention Group: Safety, acceptability, and feasibility of a single-visit approach to cervical cancer prevention in rural Thailand: a demonst-ration project. Lancet. 2003, 361: 814-820.

8.      Jane Wardle, Kathryn Robb., Sally Vernon, Jo Waller. Screening for Prevention and Early Diagnosis of Cancer, 2015 American Psychological Association 0003-066X/15 Vol. 70, No. 2, 119 –133

9.      P. Cheena Chawla, Anil Kumar Chawla, Richa Shrivastava, Anju Shrivastava, Seema Chaudhary, “Situation Analysis of Existing Facilities for Screening, Treatment and Prevention of Cervical Cancer in Hospitals/Primary health Centers of Delhi-NCR Region, India,” Asian Pacific Journal of Cancer Prevention, 2014b (15) 5479-5482.

10.  Mo PKH, Mak WWS, Chong ESK, Shen H, Cheung RYM (2014) The Prevalence and Factors for Cancer Screening Behavior among People with Severe Mental Illness in Hong Kong. PLoS ONE 9(9): e107237. 

11.  Juszczyk, D., Simon, A. E., Waller, J., Ramirez, A. J., & Wardle, J. (2011). Do the UK public realise that colorectal cancer is a common cancer? Colorectal Disease, 13(2), 227–228. doi:10.1111/j.1463-1318 .2010.02489.x

12.  Jamel, A., Bray, F., Center, M. M., Ferlay, J., Ward, E., & Forman, D. (2011). Global cancer statistics. CA Cancer J Clin, 61, 69-90. http://dx.doi.org/10.3322/caac.20107

13.  Salleh, R. M., Shahar, S., Ghazali, A. R., Haron, N., & Koon, P. B. (2011). Risk factor for breast cancer among women in Klang Valley, Malaysia. Health and the Environment Journal, 2(2), 29-33.

14.  Wong, L. P., Wong, Y. L., Low, W. Y., Khoo, E. M., & Shuib, R. (2009). Knowle-dge and awareness of cervical cancer and screening among Malaysian women who have never had a Pap smear: A qualitative study. Singapore Medical Journal, 50(1), 49-53.

15.  P. Cheena Chawla, “Role of Healthcare Providers in Patient Education on HPV Infection and Cervical Cancer Prevention - A Cross-Sectional Study in Public & Private Health Centers of Delhi-NCR, India” International Journal of Latest Research in Science and Technology, 2014 (3) 140-146.

Corresponding Author

P. Cheena Chawla

World Healthal Trust, 34, Knowledge Park 1, Greater Noida -201310

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