BMC Public Health (Oct 2021)

Knowledge of Palestinian women about cervical cancer warning signs: a national cross- sectional study

  • Mohamedraed Elshami,
  • Ibrahim Al-Slaibi,
  • Hanan Abukmail,
  • Mohammed Alser,
  • Afnan Radaydeh,
  • Alaa Alfuqaha,
  • Mariam Thalji,
  • Salma Khader,
  • Lana Khatib,
  • Nour Fannoun,
  • Bisan Ahmad,
  • Lina Kassab,
  • Hiba Khrishi,
  • Deniz Elhussaini,
  • Nour Abed,
  • Aya Nammari,
  • Tumodir Abdallah,
  • Zaina Alqudwa,
  • Shahd Idais,
  • Ghaid Tanbouz,
  • Ma’alem Hajajreh,
  • Hala Abu Selmiyh,
  • Zakia Abo-Hajouj,
  • Haya Hebi,
  • Manar Zamel,
  • Refqa Skaik,
  • Lama Hammoud,
  • Siba Rjoub,
  • Hadeel Ayesh,
  • Toqa Rjoub,
  • Rawan Zakout,
  • Amany Alser,
  • Nasser Abu-El-Noor,
  • Bettina Bottcher

DOI
https://doi.org/10.1186/s12889-021-11792-8
Journal volume & issue
Vol. 21, no. 1
pp. 1 – 15

Abstract

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Abstract Background Timely presentation and diagnosis of cervical cancer (CC) are crucial to decrease its mortality especially in low- and middle-income countries like Palestine. This study aimed to evaluate the knowledge of Palestinian women about CC warning signs and determine the factors associated with good knowledge. Methods This was a national cross-sectional study conducted between July 2019 and March 2020 in Palestine. Stratified convenience sampling was used to recruit adult women from hospitals, primary healthcare centers, and public spaces of 11 governorates. A translated-into-Arabic version of the validated CC awareness measure (CeCAM) was used to assess women’s knowledge of 12 CC warning signs. Results Of 8086 approached, 7223 participants completed the CeCAM (response rate = 89.3%). A total of 7058 questionnaires were included in the analysis: 2655 from the Gaza Strip and 4403 from the West Bank and Jerusalem (WBJ). The median age [interquartile range] for all participants was 34.0 [24.0, 42.0] years. Participants recruited from the WBJ were older, getting higher monthly income, and having more chronic diseases than those recruited from the Gaza Strip. The most frequently identified warning sign was ‘vaginal bleeding after menopause’ (n = 5028, 71.2%) followed by ‘extreme generalized fatigue’ (n = 4601, 65.2%) and ‘unexplained weight loss’ (n = 4578, 64.9%). Only 1934 participants (27.4%) demonstrated good knowledge of CC warning signs. Participants from the Gaza Strip were slightly more likely than participants from the WBJ to have a good level of knowledge. Factors associated with having good knowledge included having a bachelor or postgraduate degree, being married, divorced, or widowed as well as knowing someone with cancer. Conclusion The overall awareness of CC warning signs was low. Educational interventions are needed to increase Palestinian women’s awareness of CC warning signs.

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