Document Type : Original Article

Authors

Department of Health Promotion and Education, All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India

Abstract

BACKGROUND: Despite the implementation of various cervical cancer preventive strategies by 
the Government of India, there is a scarcity of knowledge and consequent low utilization of cervical 
cancer screening services among women in India. This contributes to the burden of cervical cancer 
among Indian women. This study was conducted to assess perceived threat‑regarding cervical cancer 
among women and to identify its explanatory factors in a slum area of Kolkata.
MATERIALS AND METHODS: A cross‑sectional study was conducted among 192 adult women 
from May to September 2019 in Kolkata. The multistage sampling technique was used using a 
structured schedule. Perceived threat to cervical cancer was measured using a composite score 
including perceived susceptibility and perceived severity constructs of the health belief model. Data 
were analyzed by descriptive statistics and multivariable logistic regression model using SPSS 
software version 16.
RESULTS: Overall, 22.9% of the participants had satisfactory levels of perceived threat to cervical 
cancer. Statistically significant association was found between unsatisfactory levels of perceived 
threat with reproductive age group (adjusted odds ratio [AOR] = 3.01; P = 0.036), education level up 
to primary (AOR = 2.89; P = 0.026), and unsatisfactory knowledge (AOR = 2.94; P < 0.001) among 
respondents. The multivariable regression model was of good fit.
CONCLUSION: The study population had very unsatisfactory levels of perceived threat to cervical 
cancer. Thus, to increase cervical cancer screening uptake among women, it is necessary to tailor 
robust behavior change communication campaigns to increase the perception of susceptibility and 
severity, thereby increasing the perception of threat of cervical cancer among women.

Keywords

1. Global Cancer Observatory: India Globocon 2018 Factsheet. World 
Health Organization. Available from: http://cancerindia.org.in/
globocan‑2018‑india‑factsheet/. [Last accessed on 2020 Dec 24].
2. Banerjee B. National Programme for Prevention and Control of 
Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS). 
In: DK Taneja’s Health Policies and Programmes in India. New 
Delhi: Jaypee Brothers Medical Publishers (P) Ltd.; 2017. p. 429.
3. Operational Framework Management of Common Cancers. 
Ministry of Health and Family Welfare. Available from: http://
cancerindia.org.in/wp‑content/uploads/2017/11/Operational_
Framework_Management_of_Common_Cancers.pdf/. [Last 
accessed on 2020 Dec 24].
4. Hou SI. Health education: Theoretical concepts, effective strategies 
and core competencies. Health Promot Pract 2014;15:619‑21.
5. Feng GC, Lin Z, Ou W, Su X, Yan Q. A model‑based meta‑analysis 
of willingness to participate in cancer screening. Int J Environ Res 
Public Health 2021;18:2580.
6. Ahmed SR, Esa AS, MohamedEl‑zayat OS. Health Belief 
Model‑based educational program about cervical cancer 
prevention on women knowledge and beliefs. Egypt Nurs J 
2018;15:39.
7. Thulaseedharan JV, Frie KG, Sankaranarayanan R. Challenges 
of health promotion and education strategies to prevent 
cervical cancer in India: A systematic review. J Educ Health 
Promot 2019;8:216.
8. Bobdey S, Sathwara J, Jain A, Balasubramaniam G. Burden of 
cervical cancer and role of screening in India. Indian J Med 
Paediatr Oncol 2016;37:278‑85.
9. Veerakumar AM, Kar SS. Awareness and perceptions regarding 
common cancers among adult population in a rural area of 
Puducherry, India. J Educ Health Promot 2017;6:38.
10. District Census Book Kolkata West Bengal: Census of India 2011. 
Government of India. Available from: https://censusindia.gov.
in/2011census/dchb/1916_PART_B_DCHB_KOLKATA.pdf/. 
[Last accessed on 2021 Mar 17].
11. Narayana G, Suchitra MJ, Sunanda G, Ramaiah JD, Kumar BP, 
Veerabhadrappa KV. Knowledge, attitude, and practice 
toward cervical cancer among women attending Obstetrics and 
Gynecology Department: A cross‑sectional, hospital‑based survey 
in South India. Indian J Cancer 2017;54:481‑7.
12. Pandey VK, Aggarwal P, Kakkar R. Modified BG prasad 
socio‑economic classification, update – 2019. Indian J Community 
Health 2019;31:150‑2.
13. McFarland DM. Associations of demographic variables and the 
Health Belief Model constructs with Pap smear screening among 
urban women in Botswana. Int J Womens Health 2013;5:709‑16.
14. Marlow LA, Waller J, Wardle J. Barriers to cervical cancer 
screening among ethnic minority women: A qualitative study. 
J Fam Plann Reprod Health Care 2015;41:248‑54.
15. Roy B, Tang TS. Cervical cancer screening in Kolkata, India: 
Beliefs and predictors of cervical cancer screening among women 
attending a women’s health clinic in Kolkata, India. J Cancer Educ 
2008;23:253‑9.
16. HaworthRJ, MargalitR, Ross C, Nepal T, Soliman AS. Knowledge, 
attitudes, and practices for cervical cancer screening among the 
Bhutanese refugee community in Omaha, Nebraska. J Community 
Health 2014;39:872‑8.
17. Shirazi Zadeh Mehraban S, Namdar A, Naghizadeh MM. 
Assessment of preventive behavior for cervical cancer with the 
health belief model. Asian Pac J Cancer Prev 2018;19:2155‑63.
18. Chisale Mabotja M, Levin J, Kawonga M. Beliefs and perceptions 
regarding cervical cancer and screening associated with Pap 
smear uptake in Johannesburg: A cross‑sectional study. PLoS 
One 2021;16:e0246574.
19. Hajializadeh K, Ahadi H, Jomehri F, Rahgozar M. Health beliefs 
and screening behavior of cervical cancer among the women of 
Bandar Abbas. Life Sci J 2013;10:545‑51.