Cervical cancer screening: Current knowledge & practice among women in a rural population of Kerala, India.

Background & objectives: Cervical cancer has a major impact on woman's lives worldwide and one in every five women suffering from cervical cancer belongs to India. Hence the objectives of this study were to find the knowledge of women regarding cervical cancer, to determine screening practices and determinants, and to identify factors for non screening. Methods: A cross-sectional study was conducted in Vypin Block of Ernakulam District, Kerala, India where four of the seven Panchayats were randomly chosen. Households were selected by systematic random sampling taking every second house in the tenth ward of the Panchayat till at least 200 women were interviewed. Thus, 809 women were interviewed from four Panchayats. Results: Mean age of the study population was 34.5 + 9.23 yr. Three fourths of the population (74.2%) knew that cervical cancer could be detected early by a screening test. Majority of respondents (89.2%) did not know any risk factor for cervical cancer. Of the 809 women studied, only 6.9 per cent had undergone screening. One third of the population were desirous of undergoing screening test but had not done it due to various factors. These factors related to knowledge (51.4%) such as no symptoms, not being aware of Pap test, not necessary, etc. This was followed by resource factors (15.1%) like no time, no money, etc. and psychosocial factors (10.2%) included lack of interest, fear of procedure, etc. Independent predictors for doing Pap test included age >35, having knowledge of screening for cervical cancer and Pap test (P<0.05). Interpretation & conclusions: Specific knowledge on cervical cancer screening is a critical element in determining whether a woman will undergo Pap test in addition to making cancer screening facilities available in the primary health centre.

Maternal and child health services utilization in married women of age 15- 45 years.

A house-to-house survey was carried out in Edavanakad Panchayat in Ernakulam district of Kerala to study the utilization and satisfaction from the MCH services provided by the Government and private hospitals. In all 92 women of age 15-45 were selected for the study. The use of private hospital for delivery increased with education. Younger women (age <20 years) used equally both the Government and private hospitals. Overall Government hospital was preferred over private. Antenatal practices were very good with 99% of the women having visited a doctor at least 3 times during pregnancy and women who received TT injection (99%) & IFA tablets (98%) respectively were also very good. More housewives used Government services as compared to the workingwomen and found them convenient and satisfying. The further satisfaction in services may be increased by encouraging community participation.

Self reported morbidity and awareness regarding common cancers in elderly women.

A study based on 198 women above 45 years of age was undertaken using interview methods in a house to house survey, to find the self reported morbidity and awareness regarding common cancers and screening tests. In this study the most commonly reported morbidity was due to reproductive system and related problems. Among reported problems the most common was visual (66.5%) followed by joint pains(58.9%).There was a highly significant relationship between Hypertension, Diabetes and age and also highly significant relationship between education and reported morbidity like low back ache, easy fatiguability, Hypertension and Diabetes. Women in the age group (45-55years) had a significantly better awareness about common cancers. 29.7% women were aware of breast self examination (BSE) and 20.6% practicing BSE. It was also found that women belonging to nuclear families were significantly more likely to practice BSE. Two thirds of the respondents did not know about the screening test for Breast Cancer and 83.7% were unaware of the test for cervical cancer.