CERVICAL CANCER SCREENING UPTAKE AMONG RURAL WOMEN IN NORTHERN KERALA IN THE ERA OF ORGANIZED SCREENING PROGRAMS: A CROSS-SECTIONAL STUDY

Abstract

Background: Cervical cancer is a preventable public health problem in India, and organized population-based screening has been implemented under the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS). In Kerala, cervical cancer screening using Visual Inspection with Acetic Acid (VIA) is integrated into primary health-care services. However, utilization of these services in rural areas requires evaluation. This study assessed cervical cancer screening uptake and associated factors among rural women in Northern Kerala in the context of organized screening programs.

 Methods: A community-based cross-sectional study was conducted among 93 rural women aged 30 years and above. Data were collected using a pre-tested structured questionnaire covering socio-demographic and reproductive characteristics, awareness of cervical cancer and NPCDCS screening services, contact with frontline health workers, attitudes toward screening, and perceived barriers. Cervical cancer screening uptake (ever screened) was the primary outcome variable. Data were analyzed using descriptive statistics.

Results: All 93 study participants reported having undergone cervical cancer screening at least once. Among them, Pap smear was the most commonly utilized screening method (58, 62.4%), followed by VIA (35, 37.6%). Awareness of government-run cervical cancer screening services under NPCDCS was reported by 67.5% of participants. A high proportion of women (89.9%) reported having been contacted or counseled by Health Care Workers regarding cervical cancer screening. Despite screening uptake, commonly perceived barriers included absence of symptoms leading to low perceived risk (approximately 45%), fear or embarrassment related to pelvic examination (around 30%), and lack of time due to household or occupational responsibilities (about 25%). Conclusion:The findings indicate good penetration of organized cervical cancer screening services among rural women in Northern Kerala, supported by strong frontline health-worker engagement. However, persistent perceptual and attitudinal barriers highlight the need for continued behaviour change communication and community-based education to sustain screening participation and improve program effectiveness.