American Journal of Cancer Prevention
ISSN (Print): 2328-7314 ISSN (Online): 2328-7322 Website: Editor-in-chief: Nabil Abdel-Hamid
Open Access
Journal Browser
American Journal of Cancer Prevention. 2017, 5(1), 10-16
DOI: 10.12691/ajcp-5-1-2
Open AccessArticle

Knowledge and Awareness about Cervical Cancer Screening and HPV Vaccine among Females Aged 15-49 Years in Rukum District of Nepal

Krishna Khadka1, Sanjeev Kumar Shah2, 3, , Sanal TS4, Jennifer Mathias5, Abinash Upadhayay6, Raju Ghimire6 and Sarita Ghimire7

1EPI, District Health Office, Rukum, Nepal

2Department of Health Sciences, National Open College, Pokhara University, Sanepa, Lalitpur, Nepal

3Department of Public Health, Asian College for Advance Studies, Lalitpur, Nepal

4Department of Biostatistics, KS Hegde Medical Academy, Nitte University, Mangalore, India

5Department of Research & Development, National Open College, Pokhara University, Sanepa, Lalitpur, Nepal

6Integrated management of Acute Malnutrition, IRHDTC, Maharajgunj, Nepal

7Nepal Cancer Care Foundation, Lalitpur, Nepal

Pub. Date: February 16, 2017

Cite this paper:
Krishna Khadka, Sanjeev Kumar Shah, Sanal TS, Jennifer Mathias, Abinash Upadhayay, Raju Ghimire and Sarita Ghimire. Knowledge and Awareness about Cervical Cancer Screening and HPV Vaccine among Females Aged 15-49 Years in Rukum District of Nepal. American Journal of Cancer Prevention. 2017; 5(1):10-16. doi: 10.12691/ajcp-5-1-2


Introduction: Cervical cancer is the first most common cancer and the leading cause of mortality among women in Nepal. The annual age standardized incidence rate of cervical cancer is 19.0 and the mortality rate is 12.0 per 100,000 women. Awareness and knowledge about cervical cancer among females is essential in the prevention of cancer. The objective of this study was to assess the level of knowledge and awareness about cervical cancer and to identify the screening practices among the women in Rukum district of Nepal. Methodology: This cross sectional study was conducted in Jan to Feb 2016 in Rukum, Nepal. Multistage sampling technique was used and 600 Female aged between 15-49 years were recruited. A semi structured interview questionnaire was used to collect the information. The inferential statistics, chi square test was used to summarize the data. For bivariate analysis, odds ratio and its 95% CI were obtained and binary logistic regression technique was used as a multivariate analysis. Results: Among the 600 women, 77.5% had heard about cervical cancer. Of these only 16% (72) were aware about cervical cancer screening and 7% were aware about the Pap smear test. Among these only 13.6 % (8/72) had ever undergone for cervical cancer screening. Only 5% had heard about HPV, among of them 30% knew that it can cause cervical cancer. Only 47% had adequate knowledge about cervical cancer, HPV and its screening. Education, occupation and monthly household income of the participants were significantly associated with knowledge of cervical cancer. Conclusion: This study identified that, there have been a low level of knowledge about cervical cancer among women. It indicates that there is a need to implement some strategies to enhance the knowledge of cervical cancer for these women.

cervical cancer HPV vaccine screening knowledge

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


[1]  Feraly J, Soerijomataram I, Ervik M, et al. GLOBOCAN 2012 v1.0,Cancer Incidence and Mortality worldwide: IARC Cancer Base No 11.Lyon,France:International Agency for Research on Cancer;2013. [Accessed on 2nd Sep 2015]. Available from:
[2]  Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012: Global Cancer Statistics, 2012. CA Cancer J Clin. 2015 Mar;65(2):87-108.
[3]  World Health Organization. Comprehensive cervical cancer prevention and control: a healthier future for girls and women. Geneva, Switzerland: World Health Organization Press. 2013. Available from:
[4]  Burd EM. Human papillomavirus and cervical cancer. Clin Microbiol Rev. 2003 Jan; 16(1):1-17.
[5]  CastellsaguĂ© X, Muñoz N. Chapter 3: Cofactors in human papillomavirus carcinogenesis--role of parity, oral contraceptives, and tobacco smoking. J Natl Cancer Inst Monogr. 2003; (31): 20-8.
[6]  Ribeiro AA, Costa MC, Alves RRF, Villa LL, Saddi VA, Carneiro MADS, et al. HPV infection and cervical neoplasia: associated risk factors. Infect Agent Cancer. 2015; 10: 16.
[7]  Bruni L, Barrionuevo-Rosas L, Albero G, et al. ICO information Centre on HPV and Cancer (HPV Information Centre).Human Papillomavirus and Related Diseases in Nepal. Summary Report 2015. [Accessed on 2nd Sep 2015]. Available from:
[8]  World Health Organization, World Health Organization, Reproductive Health and Research. Comprehensive cervical cancer control: a guide to essential practice. [Internet]. 2014 [cited 2015 Nov 1]. Available from:
[9]  Control of cancer of the cervix uteri. A WHO meeting. Bull World Health Organ. 1986; 64(4): 607-18.
[10]  Gakidou E, Nordhagen S, Obermeyer Z. Coverage of cervical cancer screening in 57 countries: low average levels and large inequalities. PLoS Med. 2008 Jun 17; 5(6): e132.
[11]  Johnson DC, Bhatta MP, Gurung S, Aryal S, Lhaki P, Shrestha S. Knowledge and awareness of human papillomavirus (HPV), cervical cancer and HPV vaccine among women in two distinct Nepali communities. Asian Pac J Cancer Prev APJCP. 2014; 15(19): 8287-93.
[12]  Liu FW, Vwalika B, Hacker MR, Allen S, Awtrey CS. Cervical cancer and HPV vaccination: Knowledge and attitudes of adult women in Lusaka, Zambia. J Vaccines Vaccin. 2012 Jun 12; 3(138).
[13]  Ugwu E, Obi S, Ezechukwu P, Okafor I, Ugwu A. Acceptability of human papilloma virus vaccine and cervical cancer screening among female health-care workers in Enugu, Southeast Nigeria. Niger J Clin Pract. 2013; 16(2):249.
[14]  Ortashi O, Raheel H, Shalal M, Osman N. Awareness and knowledge about human papillomavirus infection and vaccination among women in UAE. Asian Pac J Cancer Prev APJCP. 2013; 14(10): 6077-80.
[15]  Sabeena S, Bhat PV, Kamath V, Aswathyraj S, Arunkumar G. Knowledge, Attitude and Practice Concerning Human Papilloma Virus Infection and its Health Effects among Rural Women, Karnataka, South India. Asian Pac J Cancer Prev APJCP. 2015; 16(12): 5053-8.
[16]  Bansal AB, Pakhare AP, Kapoor N, Mehrotra R, Kokane AM. Knowledge, attitude, and practices related to cervical cancer among adult women: A hospital-based cross-sectional study. J Nat Sci Biol Med. 2015 Dec; 6(2): 324-8.
[17]  Joy T, Sathian B, Bhattarai C, Chacko J. Awareness of cervix cancer risk factors in educated youth: a cross-sectional, questionnaire based survey in India, Nepal, and Sri Lanka. Asian Pac J Cancer Prev APJCP. 2011; 12(7): 1707-12.
[18]  Saha A, Chaudhury AN, Bhowmik P, Chatterjee R. Awareness of cervical cancer among female students of premier colleges in Kolkata, India. Asian Pac J Cancer Prev APJCP. 2010; 11(4): 1085-90.
[19]  Assoumou SZ, Mabika BM, Mbiguino AN, Mouallif M, Khattabi A, Ennaji MM. Awareness and knowledge regarding of cervical cancer, Pap smear screening and human papillomavirus infection in Gabonese women. BMC Womens Health. 2015; 15: 37.
[20]  Ozyer S, Uzunlar O, Ozler S, Kaymak O, Baser E, Gungor T, et al. Awareness of Turkish female adolescents and young women about HPV and their attitudes towards HPV vaccination. Asian Pac J Cancer Prev APJCP. 2013; 14(8): 4877-81.
[21]  Cunningham MS, Skrastins E, Fitzpatrick R, Jindal P, Oneko O, Yeates K, et al. Cervical cancer screening and HPV vaccine acceptability among rural and urban women in Kilimanjaro Region, Tanzania. BMJ Open. 2015; 5(3): e005828.
[22]  Shrestha J, Saha R, Tripathi N. Knowledge, Attitude and Practice regarding Cervical Cancer Screening Amongst Women visiting Tertiary Centre in Kathmandu, Nepal. Nepal J Med Sci. 2013 Oct 14; 2(2): 85-90.
[23]  Ranabhat S, Tiwari M, Dhungana G, Shrestha R. Association of knowledge, attitude and demographic variables with cervical Pap smear practice in Nepal. Asian Pac J Cancer Prev APJCP. 2014; 15(20): 8905-10.
[24]  Shekhar S, Sharma C, Thakur S, Raina N. Cervical Cancer Screening: Knowledge, Attitude and Practices among Nursing Staff in a Tertiary Level Teaching Institution of Rural India. Asian Pac J Cancer Prev. 2013 Jun 30;14(6):3641-5.
[25]  Hoque ME, Ghuman S, Hal GV. Human Papillomavirus vaccination acceptability among female university students in South Africa. Asian Pac J Cancer Prev APJCP. 2013; 14(8): 4865-9.
[26]  Ebu NI, Mupepi SC, Siakwa MP, Sampselle CM. Knowledge, practice, and barriers toward cervical cancer screening in Elmina, Southern Ghana. Int J Womens Health. 2015; 7: 31-9.
[27]  Kim Y, Jun JK, Choi KS, Lee H-Y, Park E-C. Overview of the National Cancer screening programme and the cancer screening status in Korea. Asian Pac J Cancer Prev APJCP. 2011; 12(3): 725-30.
[28]  Sirovich BE, Welch HG. The Frequency of Pap Smear Screening in the United States. J Gen Intern Med. 2004 Mar 1; 19(3): 243-50.