Socio-Demographic and Behavioural Risk Factors for Cervical Cancer and Knowledge, Attitude and Practice in Rural and Urban Areas of North Bengal, India

Background: Cervical cancer is common among women worldwide. A multitude of risk factors aggravatethe disease. This study was conducted to: (1) determine the prevalence and (2) make a comparative analysis ofthe socio-demographic and behavioural risk factors of cervical cancer and knowledge, attitude and practicebetween rural and urban women of North Bengal, India. Study Design: Community-based cross-sectional study.
Methods: A survey (first in North Bengal) was conducted among 133 women in a rural area (Kawakhali) and88 women in an urban slum (Shaktigarh) using predesigned semi-structured questionnaires. The respondentswere informed of the causes (including HPV), signs and symptoms, prevention of cervical cancer and treatment,and the procedure of the PAP test and HPV vaccination.
Results: The prevalence of risk factors like multiparity,early age of marriage, use of cloth during menstruation, use of condom and OCP, early age of first intercoursewas 37.2%, 82%, 83.3%, 5.4%, 15.8% and 65.6% respectively. Awareness about the cause, signs and symptoms,prevention of cervical cancer, PAP test and HPV vaccination was 3.6%, 6.3%, 3.6%, 9.5% and 14.5% respectively.Chi-square testing revealed that in the study population, significant differential at 5% exists between rural andurban residents with respect to number of children, use of cloth/sanitary napkins, family history of cancer andawareness regarding causes of cervical cancer. Regarding KAP, again using chi-square tests, surprisingly, levelof education is found to be significant for each element of KAP in urban areas in contrast to complete absence ofassociation between education and elements of KAP in rural areas.
Conclusions: A large number of risk factorswere present in both areas, the prevalence being higher in the rural areas. The level of awareness and role ofeducation appears to be insignificant determinants in rural compared to urban areas. This pilot study needs tobe followed up by large scale programmes to re-orient awareness campaigns, especially in rural areas.