Knowledge of cervical cancer and screening barriers among mid-life women in Bangladesh

Objectives: Cervical cancer (CCa), a highly preventable disease, is the second most common cancer amongst women in Bangladesh. However, the uptake of screening for CCa in Bangladesh has been less than 10% in screened areas where it is offered. We have investigated the knowledge of CCa and CCa screening, and factors associated with women’s preparedness to undergo screening in Bangladesh. Method: A nationally representative cross-sectional survey of 1590 women aged 30 to 59 years was conducted in 7 districts of the 7 divisions in Bangladesh utilizing a multistage cluster sampling technique. The factors associated with the knowledge of CCa and screening uptake were investigated separately, using simple and multivariable logistic regression. Results: 81.3% and 48.6% of participants had ever heard of CCa and screening respectively. Of those who had heard of screening, 8.3% had been screened, 86% had no screening as they were asymptomatic and 37% did not know screening was needed. CCa knowledge was positively associated with age 40–49 years (adjusted OR 1.59, 95% CI: 1.15–2.0) and obesity (2.04, 1.23–3.36) and negatively associated with rural dwelling (0.42, 0.26–0.67) and no education (0.25, 0.16– 0.38). Having been screened was positively associated with age 40– 49 years (2.17, 1.19–3.94) and employment (3.83, 1.65–8.9), and negatively associated with rural dwelling (0.54; 0.30–0.98), and no education (0.29, 0.10–0.85). Conclusions: Knowledge was the main barrier for screening uptake. Therefore, targeted educational health programs are needed to increase the knowledge of CCa and screening in Bangladesh. This is likely to increase CCa screening uptake and reduce CCa incidence and mortality.