title: Knowledge about cervical cancer screening and perception of risk among women attending outpatient clinics in rural Kenya.
abstract: OBJECTIVE
  To evaluate cervical cancer knowledge, risk perception, and screening intention among women attending outpatient clinics in rural Kenya.
  
  
  METHODS
  A cross-sectional oral survey was conducted among non-pregnant women aged 23-64 years who attended one of 11 western Kenyan health facilities for any reason between March 25 and April 26, 2013. Demographic and clinical predictors were identified using bivariate and multivariate regression analyses.
  
  
  RESULTS
  Among 419 participants, 327 (78.0%) had heard of cervical cancer screening. Nevertheless, their specific knowledge was low (mean score 8.6±2.4 [out of 15.0]). Overall, 288 (68.7%) women felt at risk for cervical cancer, and 333 (79.5%) stated that they would undergo screening if offered. Women who intended to undergo screening were less likely to attend a district hospital (adjusted odds ratio [AOR] 0.4; 95% confidence interval [CI] 0.2-0.6) and more likely to have been diagnosed with HIV more than 4 years previously (AOR 0.4; 95% CI 0.2-0.6). Additionally, increased screening acceptance was associated with high knowledge scores (P=0.004).
  
  
  CONCLUSIONS
  Educational interventions to increase knowledge about cervical cancer might increase screening uptake in low-income settings. Additionally, improvements in services at local health facilities could have a large effect.
authors.affiliation: Department of Internal Medicine, University of Washington, Seattle, WA, USA. Electronic address: joelleir@uw.edu.
authors.forename: Joelle I
authors.initials: JI
authors.lastname: Rosser
authors.affiliation: Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya.
authors.forename: Betty
authors.initials: B
authors.lastname: Njoroge
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Megan J
authors.initials: MJ
authors.lastname: Huchko
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007630:Kenya; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care; D010465:Perception; D012044:Regression Analysis; D012306:Risk; D012424:Rural Population; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D055815:Young Adult
keywords: Behavior; Cervical cancer screening; Knowledge; Risk perception; Sub-Saharan Africa