Assess Level of Risk of Cervical
Cancer among Women in selected Community Area, Mangalore
Ms. Anusha
D Souza1*, Mr. Babu D2, Mr Gireesh GR3
1M.Sc Nursing Student, Medical Surgical Nursing Department, Yenepoya Nursing College Yenepoya University, Mangalore, Karnataka,
India
2Head of the Department, Medical Surgical nursing, Yenepoya Nursing College Yenepoya
University, Mangalore, Karnataka, India
3Associate Professor, Yenepoya
Nursing College, Yenepoya University Yenepoya Nursing College Yenepoya University, Mangalore, Karnataka,
India
*Corresponding
Author Email: anishags4@gmail.com
ABSTRACT:
Cervical cancer is the fourth most common
cancer in women, and the seventh overall, with an estimated 528,000 new cases
in 2012. The most important risk factor for cervical cancer is infection with a
virus known as Human Papilloma Virus. A study to assess the
level of risk of cervical cancer among
100 women in Ullal community area, Mangalore
with the objectives to assess the level risk of cervical cancer among women and
to find the association between risk factor of cervical cancer and selected
demographic variables of women. A modified cervical cancer risk assessment
questionnaire was used. Results showed that 65(65%) women were at moderate
level of risk of cervical cancer and 31(31%) at severe level and 4(4%) were at
mild level of risk. there was a significant association found between education
and age of the women at marriage(8.279), age at first child birth(14.949),
number of children(30.451), regular menstruation (15.932), perineal
hygiene practice(11.931) at p<0.05.Association was also found between
occupation of the women and number of children (20.813),regular
menstruation(11.794), practice of perineal hygiene (5.725),
gynecological consultation (4.071) at p<0.05.The findings of the study helps the investigator to identify the risk
factors of cervical cancer.
KEY WORDS: Cervical cancer, Human papilloma virus, perineal hygiene, risk factors, menstruation.
INTRODUCTION:
Health is the actualization of
inherent and acquired human potential through goal directed behavior competent
self care and satisfying relationship with others and harmony with environment.1Women and men share many
similar health problems but women also have their own health issues, which
deserve special consideration. Women's lives have changed over the centuries.2 Many
diseases affect both women and men alike but some diseases occur in women at a
higher frequency.
For example, gallstones are
three to four times more common in women than in men. About 18% of women
compared to 6% of men in the U.S suffer migraine headaches,
a male female ratio is 1:3. Autoimmune disorders afflict at least 12 million
Americans and 3/4 of them are women. One autoimmune disorder rheumatoid
arthritis affects approximately 1.3 million Americans, with 2/3 of the
sufferers being women. 3
Heart disease is the leading cause of death for women in the United States,
killing 292,188 women in 2009—that’s one in every four female
deaths.4
Major depression is nearly
twice as common in women as in men, with a lifetime occurrence of the illness
as high as 21 percent in women compared with 12.7% in men. According to
the WHO, 80% of women face health risks associated with diet and the environment.
While breast cancer is the most prevalent among women over 20, cervical cancer
is the second most common type of cancer.5 Breast, lung and bowel cancers together account for over
half (53%) of all new cases in females in the UK.6 According to GLOBOCAN
2008 database Guinea has the highest rate of cervical cancer, followed by
Zambia and Comoros. Cervical Cancer Global Crisis Card report by Cervical
Cancer-Free Coalition finding shows that cervical cancer kills an estimated
275,000 women every year and 500,000 new cases reported worldwide.7 Cervical
cancer is the fourth most common cancer in women, and the seventh overall, with
an estimated 528,000 new cases in 2012. High-risk regions, with estimated ASRs
over 30 per 100,000, include Eastern Africa (42.7), Melanesia (33.3), Southern
(31.5) and Middle (30.6) Africa. Rates are lowest in Australia/New Zealand
(5.5) and Western Asia (4.4). There were an estimated 266,000 deaths from
cervical cancer worldwide in 2012, accounting for 7.5% of all female cancer
deaths. Almost nine out of ten (87%) cervical cancer deaths occur in the less
developed regions.8
Data released by India's
Health Ministry based on the National Cancer Registry Programme (NCRP) report
in 2009 the number of cervical cancer cases were 101938 which has increased to
107690 in 2012.In Uttar Pradesh a total of 17367 cases were reported in 2009
and it increased to 18692 in 2012. After Uttar Pradesh the number of cases of
cervical cancer in 2012 which has shown an increasing trend are Maharashtra
(9892), Bihar (9824), West Bengal (8396), Andhra Pradesh (7907), Tamil Nadu
(7077) and others. According to Cervical cancer global crisis card 2013 more
women die from cervical cancer in India than in any other country in the world.
The data appear on a crisis card developed by the US based research and
advocacy group Cervical Cancer-Free Coalition, which shows that most deaths
from cervical cancer occur in the two most populous nations in the world: India
and China.9
The most important risk factor
for cervical cancer is infection with a virus known as HPV (human papilloma virus). Women who smoke are about twice as likely
to get cervical cancer as those who don't. Women infected with HIV are more
likely to get cancer of the cervix. Having HIV seems to make a woman's immune
system less able to fight both HPV and early cancers. Women with diets low in
fruits and vegetables may have an increased risk for cervical cancer.
Overweight women are more likely to develop adenocarcinoma
of the cervix. Long-term use of birth control pills increases the risk of
cervical cancer. Research suggests that the risk goes up the longer a woman
takes the pill. Women who have had 3 or more full-term pregnancies have an
increased risk of this cancer. Women who are younger than 17 years when they
had their first full-term pregnancy are almost 2 times more likely to get
cervical cancer than in women who waite to get
pregnant until they are 25 years or older. Poor women have a greater risk for
cancer of the cervix. This may be because they cannot afford good health care,
such as regular Pap tests. If your mother or sister had cervical cancer,
chances of getting the disease are 2 to 3 times higher than if no one in the
family had it.8
Cervical cancer, an avoidable
cause of death among women in sub-Saharan Africa With 528 000 new cases every
year, it is most notable in the lower-resource countries of sub-Saharan Africa.
Almost 70% of the global burden falls in areas with lower levels of development
and more than one fifth of all new cases are diagnosed in India. In sub-Saharan
Africa, 34.8 new cases of cervical cancer are diagnosed per 100 000women
annually, and 22.5 per 100 000 women die from the disease. These figures
compare with 6.6 and 2.5 per 100 000 women, respectively, in North America. The
drastic differences can be explained by lack of access to effective screening
and to services that facilitate early detection and treatment.9
A case control study on risk factors for in situ cervical
cancer was conducted among
293 patients with in situ cervical cancer. Results revealed that
Relative risk (RR) was elevated among
women reporting multiple sexual partners, a history of an abnormal Papanicolaou smear
use of oral contraceptives , a history of nonspecific genital infection.
Age at first coitus and number of births was predictive of risk of in situ
disease.10
An exploratory study was conducted to identify the role of
awareness and knowledge of cervical cancer as a barrier to participation in
screening among 207 women in Chennai, Tamil Nadu, the findings revealed that
majority of the women 69.6% were not aware of cervical cancer and only very
few 16.4% were aware of screening
participation in cervical cancer. The authors concluded that providing
information about cervical cancer among women will break the barrier to
participation in screening program.11
A cross-sectional interview
based survey was conducted on awareness and knowledge of cervical cancer and
its prevention among the nursing staff of a tertiary health institute in Ahmedabad,
Gujarat. To assess the knowledge level regarding symptoms, risk factors,
prevention and screening of cervical carcinoma among nursing staff and to find
out the behavior of respondents regarding prevention and screening of cervical
carcinoma. Total 100 staff nurses were selected randomly and 15-item structured
questionnaire was designed. Results revealed only eight (11.5%) respondents
were aware of multiple sexual partners as one of the risk factors of cervical
carcinoma. Out of 69 respondents some knowledge regarding cervical carcinoma,
61 (88.4%) had knowledge regarding Pap test as one of the preventive measures.
Out of 61 staff nurses who knew about Pap test, only five (8%) had undergone
Pap test. Conclusion was levels of knowledge and understanding of cervical
cancer as well as its preventable nature should be improved. Continuing nurse
education may contribute to strengthen cervical cancer screening programs.
Nursing staff, if properly aware of this disease, can educate the masses and
hence increase health-seeking behavior in women.12
Each
year, it is estimated that 1,300 new cases of cervical cancer are diagnosed in
Canada. Among these cases, 390
women will not survive their cancer. The lifetime probability of a Canadian
woman developing cervical cancer is estimated to be 1 in 148. Fortunately,
almost all cervical cancer can be cured when diagnosed and treated at an early
stage. The cure rate for stage 1 cervical cancer (cancer limited to the cervix)
is 80% to 90%.13
Cervical cancer is a
preventable disease and, if detected early, a cancer that can be successfully
treated. Avoid infection with HPV by practicing safer sex. Having only one
sexual partner, who is infection free. Limit the
number of sexual partners. Don’t smoke. All women should begin cervical cancer
testing at age 21. Women aged 21 to 29 should receive a Pap test every 3 years.
HPV testing should not be used for screening in this age group unless used as a
follow-up for an abnormal Pap test. Women between the ages of 30 and 65 should have
a Pap test plus an HPV test every 5 years. The HPV vaccine protects against the
types of HPV that are most likely to cause cancer. It’s most effective if a
person is vaccinated before becoming sexually active. The vaccine is
recommended for girls who are age 11 to 12. Girls may also be vaccinated at age
9 or 10. Young women age 19 to 26 who have never been vaccinated may also get
the vaccine.14
A study was conducted on role
of the chosen general practitioner in educating women on the importance of
regular gynecological examinations to assess the motivation of women to have
regular gynecological examinations and to estimate the role
of the chosen general practitioner. A survey was performed on the basis of the
prospective study done at the Health Centre "Novi
Sad" in 2009 during the systematic regular examinations carried out by
general practitioners. It was found that 60.8% of the examined women had
regular checkups; 21.5% visited their doctor once in the period of two to five
years and 4.9% had undergone the examination in a period > 10 years, whereas
1.9 women had never had an examination. Other examinees had occasional
check-ups with various time laps between them. According to the obtained
results, it has been concluded that the chosen general practitioner has a very
important role in motivating women to have regular
gynecological examinations and in educating them on the risk factors for
developing malignant diseases and on the possible prevention.15
Nurses strive to achieve the best possible
quality of life for their patients, regardless of disease or disability. Nurses
use clinical judgment to protect, promote, and optimize health, prevent illness
and injury, alleviate suffering, and advocate in health care for individuals,
families, communities, and populations. A nurse is a healthcare professional
who is focused on caring for individuals, families, and communities, ensuring
that they attain, maintain, or recover optimal health and functioning.16
A retrospective, exploratory
correlation study was conducted on
engaging parents and schools improves uptake of the human HPV vaccine Examining
the role of the public health nurse to examine the relationship between
school-based strategies and uptake of HPV vaccine. HPV vaccine initiation was
significantly associated with Public Health Nurses
providing reminder calls for: consent return (p=0.017) and missed school clinic
(p=0.004); HPV education to teachers (p<0.001), and a thank-you note to
teachers (p<0.001). Completion of the HPV series was associated with vaccine
consents being returned to the students' teacher (p=0.003), and a Public Health
Nurse being assigned to a school (p=0.025).Study
was concluded suggesting these findings can be used to help guide school-based
immunization programs for optimal uptake of the HPV vaccine among the student
population.17
Material
and Methods:
In view of the nature of the problem selected for the study
and objectives to be accomplished, a descriptive approach was used to assess
the level of risk of cervical cancer. Based on the geographic proximity to the
setting, feasibility to conduct the study, familiarity and availability of the
subjects 100 women who are willing to participate in the study and available at
the time of study from
Ullal community area, Mangalore were selected for the
study.
Demographic profile
and Modified risk assessment tool was used to assess the level of risk of
cervical cancer among women. Categorized as mild, moderate
and severe level of risk. Statistical analysis was done using mean,
standard deviation, Chi square test and Fishers exact test.
Results:
·
Distribution of women based on selected
demographic variables
From the findings of the study
it was evident that majority of women 69(69%) were above 33years and only 1(1%)
was below 18years.The results pertaining to the above table 80(80%) women were
married and only 1(1%) was separated. Results pertaining to religion shows that
45(45%) were Christian and 17(17%) Muslim and 30(30%) of women had primary
level education,30(30%) had high school level
education and only 1% (1)was graduate. The women under the study 49(49%) were
housewife and only 2(2%) were working under Government sector. The monthly
income of majority women 42(425) was Rs.5000-10000 and only 3(3%) women had
below 3000 monthly income.
·
Distribution of risk factors among women
Results pertaining to age at
marriage 62 (62%) were at risk of cervical cancer. Results pertaining to age at
first child birth 38(38%) had first child before the age of 23 years. Results
related to number of children only 24(24%) women had more than 3 children.
Results related to regular menstruation 29(29%) had irregular menstruation and
were at risk of cervical cancer.
Table1: Association between risk factors of cervical cancer and
marital status of women N=100
|
Sl.No |
Risk
factors |
Married |
Others |
Χ2 |
||
|
f |
% |
f |
% |
|||
|
1 |
Age at marriage a.
No
risk b.
At
Risk |
32 48 |
40.0 60.0 |
6 14 |
30.0 70.0 |
0.679 0.410 |
|
2 |
Age at first child birth a.
No
risk b.
At
Risk |
52 28 |
65.0 35.0 |
10 10 |
50.050.0 |
1.528 0.216 |
|
3 |
No. of children a.
No
risk b.
At
Risk |
65 15 |
81.3 18.8 |
11 9 |
55.0 45.0 |
6.044 0.014 S* |
|
4 |
Regular menstruation a.
No
risk b.
At
Risk |
66 14 |
82.5 17.5 |
5 15 |
25.0 75.0 |
25.692 0.000 S* |
|
5 |
Oral contraceptive use a.
No
risk b.
At
Risk |
4 76 |
5.0 95.0 |
2 18 |
10.0 90.0 |
0.100 0.752 |
|
6 |
History of miscarriage a.
No
risk b.
At
Risk |
59 21 |
73.8 26.3 |
13 7 |
65.0 35.0 |
0.608 0.436 |
|
7 |
Leucorrhea a.
No
risk b.
At
Risk |
67 13 |
83.8 16.3 |
19 1 |
95.0 5.0 |
0.877 0.349 |
|
8 |
Perineal hygiene a.
No
risk b.
At
Risk |
46 34 |
57.5 42.5 |
7 13 |
35.0 65.0 |
3.252 0.071 |
|
9 |
Perineal infection a.
No
risk b.
At
Risk |
70 10 |
87.5 12.5 |
18 2 |
90.0 10.0 |
0.000 1.000 |
|
10 |
Gynecological consultation a.
No
risk b.
At
Risk |
27 53 |
33.8 66.3 |
10 10 |
50.0 50.0 |
1.813 1.178 |
|
11 |
Screening test a.
No
risk b.
At
Risk |
17 63 |
21.3 78.8 |
4 16 |
20.0 80.0 |
0.000 1.000 |
|
12 |
Vaccination a.
No
risk b.
At
Risk |
2 78 |
2.5 97.5 |
0 20 |
0 100 |
0.638 |
|
13 |
Family history a.
No
risk b.
At
Risk |
77 3 |
96.3 3.8 |
19 1 |
95.0 5.0 |
0.000 1.000 |
|
14 |
Exercise a.
No
risk b.
At
Risk |
41 39 |
51.3 48.8 |
9 11 |
45.0 55.0 |
0.250 0.009 |
df=1 S* = p<0.05
Results pertaining to use of
oral contraceptives 94%(94) at risk of cervical cancer
28(28%) women had history of miscarriage
(1-2 times) and 14(14%) women had complaints leucorrhea. Results related to
practice of perineal hygiene 12(12%) were not
practicing perineal hygiene and were at risk of
cervical cancer. Results pertaining to gynecological consultation 37(37%) had
consulted gynecologist other than at the time of pregnancy and remaining
63(63%) were at risk of cervical cancer.
Results of the study revealed
that 79(79%) had not undergone regular cervical screening test and were at risk
of cervical cancer .Results pertaining to vaccination 98(98%) have not taken
cervical cancer vaccination and were at risk of cervical cancer. Results
related to family history only 4(4%) were at risk of cervical cancer. Results related
to regular practice of exercise 50(50%) of women do practice regular exercise
and are at risk of cervical cancer.
Discussion:
Age
In the present
study majority of women 69(69%) were
in the age group of above 33years and only 1(1%) woman belong to the age group
of ≤18.
These findings
were consistent with the study findings of Raychaudhuri S and Mandal S who
found that majority of the subjects were 35-49 years old.18Similar findings of the present study were also
reported in a study conducted by Aswathy S et al in
Kerala among 809 women, mean age of women in the study population was 34.5 ±
9.23 yr with the age range from 15-50 yr.19
Table-2: Association between risk factors of cervical cancer and
education N=100
|
Sl.No |
Risk
factors |
Primary |
High
school and above |
Χ2 |
||
|
F |
% |
f |
% |
|||
|
1 |
Age at marriage a.
No
risk b.
At
Risk |
5 25 |
16.7 83.3 |
33 37 |
47.1 52.9 |
8.279 0.004 S* |
|
2 |
Age at first child birth a.
No
risk b.
At
Risk |
10 20 |
33.3 66.7 |
52 18 |
74.3 25.7 |
14.949 0.000 S* |
|
3 |
No. of children a.
No
risk b.
At
Risk |
12 18 |
40.0 60.0 |
64 6 |
91.4 8.6 |
30.451 0.000 S* |
|
4 |
Regular menstruation a.
No
risk b.
At
Risk |
13 17 |
43.3 56.7 |
58 12 |
82.9 17.1 |
15.932 0.000 S* |
|
5 |
Oral contraceptive use a.
No
risk b.
At
Risk |
1 29 |
3.3 96.7 |
5 65 |
7.1 92.9 |
0.076 0.783 |
|
6 |
History of miscarriage a.
No
risk b.
At
Risk |
21 9 |
70.0 30.0 |
51 19 |
72.9 27.1 |
0.085 0.771 |
|
7 |
Leucorrhea a.
No
risk b.
At
Risk |
26 4 |
86.7 13.3 |
60 10 |
85.7 14.3 |
0.000 1.000 |
|
8 |
Perineal hygiene a.
No
risk b.
At
Risk |
8 22 |
26.7 73.3 |
45 25 |
64.3 35.7 |
11.931 0.001 S* |
|
9 |
Perineal infection a.
No
risk b.
At
Risk |
29 1 |
96.7 3.3 |
59 11 |
84.3 15.7 |
1.989 0.158 |
|
10 |
Gynecological consultation a.
No
risk b.
At
Risk |
15 15 |
50.0 50.0 |
22 48 |
31.4 68.6 |
3.107 0.078 |
|
11 |
Screening test a.
No
risk b.
At
Risk |
9 21 |
30.0 70.0 |
12 58 |
17.1 82.9 |
2.092 0.148 |
|
12 |
Vaccination a.
No
risk b.
At
Risk |
0 30 |
0 100 |
2 68 |
2.9 97.1 |
0.488 |
|
13 |
Family history a.
No
risk b.
At
Risk |
29 1 |
96.7 3.3 |
67 3 |
4.3 95.7 |
0.000 1.000 |
|
14 |
Exercise a.
No
risk b.
At
Risk |
17 13 |
56.7 43.3 |
33 37 |
47.1 52.9 |
0.762 0.383 |
df=1 S* = p<0.05
Marital status:
In relation to marital status most of the
women 80(80%) and only 1(1%) was separated. These findings were similar with
the study findings of Raychaudhuri S and
Mandal S where majority of the subjects
88.7% were married.18 Study findings of Aswathy
S et al also revealed that 64.4% women were married.19
Level
of Education:
In the present
study majority of the women 30(30%) had high school level education. The above
findings were consistent with study findings of Aswathy
S et al who found that majority of the participants 114 had secondary level education.19
Occupation:
In relation to occupation majority of the
women 49(49%) were housewife. These findings were consistent with the study
findings of Raychaudhuri S and
Mandal S who found that majority of the
women 60.2% were housewife.18Study findings of Aswathy S
et al showed that majority of the women
(740, 91.4%) were non-working and most of them (651, 80.4%) were homemakers.19
Monthly income:
In the present
study majority of women 42(42%) had monthly income between 5000-10000 rupees.
This study is supported by the study conducted among 221 women at urban (Shakthigarh) and rural areas (Kawakhali)
of north Bengal where the monthly income of the subjects 38.9% was between
2001-3000 rupees.18 Study findings of Aswathy
S et al revealed Most of the women (386,
59.6%) belonged to poor socio-economic status.19
Table – 3: Association between risk factors of cervical cancer and
occupation N =100
|
Sl.No |
Risk
factors |
Housewife |
Working |
Χ2 |
|||
|
F |
% |
f |
% |
||||
|
1 |
Age at marriage a.
No
risk b.
At
Risk |
14 35 |
28.6 71.4 |
24 27 |
47.1 52.9 |
3.625 0.057 |
|
|
2 |
Age at first child birth a.
No
risk b.
At
Risk |
25 24 |
51.0 49.0 |
37 14 |
72.5 27.5 |
4.916 0.027 |
|
|
3 |
No. of children a.
No
risk b.
At
Risk |
27 22 |
55.1 44.9 |
49 2 |
96.1 3.9 |
20.813 0.000 S* |
|
|
4 |
Regular menstruation a.
No
risk b.
At
Risk |
27 22 |
55.1 44.9 |
44 7 |
86.3 13.7 |
11.794 0.001 S* |
|
|
5 |
Oral contraceptive use a.
No
risk b.
At
Risk |
0 49 |
0 100 |
6 45 |
11.8 88.2 |
0.015 S* |
|
|
6 |
History of miscarriage a.
No
risk b.
At
Risk |
34 15 |
69.4 30.6 |
38 13 |
74.5 25.5 |
0.325 0.568 |
|
|
7 |
Leucorrhea a.
No
risk b.
At
Risk |
40 9 |
81.6 18.4 |
46 5 |
90.2 9.8 |
1.522 0.217 |
|
|
8 |
Perineal hygiene a.
No
risk b.
At
Risk |
20 29 |
40.8 59.2 |
33 18 |
64.7 35.3 |
5.725 0.017 S* |
|
|
9 |
Perineal infection a.
No
risk b.
At
Risk |
42 7 |
85.7 14.3 |
46 5 |
90.2 9.8 |
0.475 0.491 |
|
|
10 |
Gynecological consultation a.
No
risk b.
At
Risk |
23 26 |
46.9 53.1 |
14 37 |
27.5 72.5 |
4.071 0.044 S* |
|
|
11 |
Screening test a.
No
risk b.
At
Risk |
12 37 |
24.5 75.5 |
9 42 |
17.6 82.4 |
0.705 0.401 |
|
|
12 |
Vaccination a.
No
risk b.
At
Risk |
0 49 |
0 100 |
2 49 |
3.9 96.1 |
0.258 |
|
|
13 |
Family history a.
No
risk b.
At
Risk |
48 1 |
98.0 2.0 |
48 3 |
94.1 5.9 |
0.221 0.639 |
|
|
14 |
Exercise a.
No
risk b.
At
Risk |
28 21 |
57.1 42.9 |
22 29 |
43.1 56.9 |
1.961 0.161 |
|
df=1
S*= p<0.05
Distribution of women based on cervical
cancer risk factors
The present
study findings showed that 62% women had early marriage, 38% women had first
child birth before the age of 18-23 years and were at risk of cervical cancer.
The results revealed that 29% women had irregular menstruation, 94% women were
using oral contraceptives. The findings of the study also showed that 28% women
had history of miscarriage, 14% had complaints of leucorrhea, 47% women were
not practicing perineal hygiene and 12% were
diagnosed with perineal infection. About 79% women
were not performing regular gynecological screening test,98%
were not vaccinated against cervical cancer and 50% were not performing regular
exercise. From the present study findings 65% women were at moderate level of
risk of cervical cancer.
The findings
of the present study were constituted with the study findings of Aparajita D et al which was
conducted among 103 rural women of West Bengal. Results of this study revealed
that 33% women were between the age group of 30-34 years, 40% women age at
marriage was between 15-48 years, 49.5% women gave birth to their first child
they were 18 years old, 33% women were with the parity higher than three.71%
women were practicing unsatisfactory perineal hygiene
and 36.89% women had symptoms of reproductive tract infection like
leucorrhea.20.38% women were using oral contraceptives.20
Similar study findings were seen in Natphopsuk S et al study. In this study mean age at first sexual intercourse
was 20.85 years. Age at first delivery ≤18 years, age at first sexual
intercourse ≤16 years, prolonged use of oral contraceptives >2years,
multiple pregnancies ≥3 were at risk of cervical cancer.21
Table-4:Association between risk factors
of cervical cancer and monthly income N =100
|
Sl.No |
Risk
factors |
≤
5000 |
≥ 5000 |
Χ2 |
||
|
f |
% |
f |
% |
|||
|
1 |
Age at marriage a.
No
risk b.
At
Risk |
9 20 |
31.0 69.0 |
29 42 |
40.8 59.2 |
0.841 0.359 |
|
2 |
Age at first child birth a.
No
risk b.
At
Risk |
18 11 |
62.1 37.9 |
44 27 |
62.0 38.0 |
0.000 0.993 |
|
3 |
No. of children a.
No
risk b.
At
Risk |
21 8 |
72.4 27.6 |
55 16 |
77.5 22.5 |
0.288 0.592 |
|
4 |
Regular menstruation a.
No
risk b.
At
Risk |
18 11 |
62.1 37.9 |
53 18 |
74.6 25.4 |
1.582 0.208 |
|
5 |
Oral contraceptive use a.
No
risk b.
At
Risk |
1 28 |
3.4 96.6 |
5 66 |
7.0 93.0 |
0.472 0.492 |
|
6 |
History of miscarriage a.
No
risk b.
At
Risk |
21 8 |
72.4 27.6 |
51 20 |
71.8 28.2 |
0.003 0.953 |
|
7 |
Leucorrhea a.
No
risk b.
At
Risk |
24 5 |
82.8 17.2 |
62 9 |
87.3 12.7 |
0.356 0.550 |
|
8 |
Perineal hygiene a.
No
risk b.
At
Risk |
9 20 |
31.0 69.0 |
44 27 |
62.0 38.0 |
7.911 0.005 S* |
|
9 |
Perineal infection a.
No
risk b.
At
Risk |
27 2 |
93.1 6.9 |
61 10 |
85.9 14.1 |
0.442 0.506 |
|
10 |
Gynecological consultation a.
No
risk b.
At
Risk |
12 17 |
41.4 58.6 |
25 46 |
35.2 64.8 |
0.336 0.562 |
|
11 |
Screening test a.
No
risk b.
At
Risk |
5 24 |
17.2 82.8 |
16 55 |
22.5 77.5 |
0.348 0.555 |
|
12 |
Vaccination a.
No
risk b.
At
Risk |
1 28 |
3.4 96.6 |
1 70 |
1.4 98.6 |
0.000 1.000 |
|
13 |
Family history a.
No
risk b.
At
Risk |
28 1 |
96.6 3.4 |
68 3 |
95.8 4.2 |
0.000 1.000 |
|
14 |
Exercise a.
No
risk b.
At
Risk |
17 12 |
58.6 41.4 |
33 38 |
46.5 53.5 |
1.214 0.271 |
df=1
S*=p<0.05
Association between risk factors and
selected demographic variables of women
In the present study there was
significant association between the marital status and number of children
marital status and regular menstruation p>0.05 at 0.05 level of
significance. There was significant association between the level of education
and age at marriage, age at first child birth, number of children, practice of perineal hygiene.
Significant association was found between
occupation and age at first child birth, number of children, regular
menstruation, use of oral contraceptives, perineal
hygiene practice, gynecological consultation. There
was significant association between monthly income and perineal
hygiene practice.
Similar study
findings were found in Durowade KA et al study
statistically significant association was found between the respondents’ age at
marriage and coitarche and the development of
cervical cancer.22 The result was also in concordance with that of
the case-control study in Iran which identified age at first coitus or marriage
of less than 15years as being significantly associated with cervical cancer.23
References:
1.
Potter
A P, Perry G A. Fundamentals of Nursing.6th
ed. Elsevier India Private limited. New Delhi.2006:90-1
2.
Melissa S C. Women’s health.
Medicine Net.com.2013 Dec 18.
3.
Stoppler M C,
William C, Shiel J, Women’s Health. 2014 Apr 28.
Received on 19.08.2014 Modified on 15.09.2014
Accepted on 28.09.2014 © A&V Publication all right reserved
Asian
J. Nur. Edu. and Research 4(4): Oct.- Dec.,
2014; Page 461-468