Knowledge, attitudes, practices, and sociocultural factors influencing cervical cancer screening and vaccination among women in rural communities of Gujarat: A mixed-methods study

Abstract

Background: Cervical cancer is a leading cause of cancer mortality among women in India. Screening can help in early detection and improve outcomes. However, uptake remains low, especially in rural areas. Understanding multidimensional factors influencing screening in local contexts is essential to promote equitable access. This study examined knowledge, attitudes, practices, and sociocultural factors associated with cervical cancer screening and vaccination in rural India. Methods: A mixed methods study was conducted among 400 women aged 18–60 years in rural Maharashtra. Quantitative data were collected on knowledge, attitudes, and screening practices by using a structured questionnaire. Qualitative data were gathered through in-depth interviews with 30 participants on perspectives influencing screening. Quantitative data were analyzed using descriptive statistics and logistic regression. Thematic analysis was done for qualitative data. The integration provided complementary insights. Results: Quantitative results showed poor knowledge (17% had good knowledge) and positive attitudes (64%) but low screening uptake (9%). Qualitative findings revealed limited awareness, stigma around gynecological exams, gender inequities, fear, fatalism, and low prioritization of self-care as screening barriers. Conclusion: Multifaceted strategies addressing knowledge gaps, gender roles, stigma, and access are required to improve cervical cancer screening in marginalized rural communities. Mixed methods provide comprehensive evidence for designing context-specific interventions.

Keywords

• attitudes
• cervical cancer screening
• india
• knowledge
• mixed methods
• practices
• rural women