Assessing knowledge, attitudes, and perceptions of personalized risk-stratified cervical cancer screening among Indian women using the COM-B framework: a mixed-methods study
1
Community Medicine, ESIC Medical College and Hospital, Andheri, Mumbai, India
Popul. Med. 2026;8(Supplement Supplement 1):A3017
ABSTRACT
INTRODUCTION:
Cervical cancer is one of the leading causes of cancer mortality among Indian women, despite being largely preventable through vaccination and screening. Awareness and uptake of screening methods such as Pap smear, visual inspection under acetic acid, and HPV testing remain low due to limited knowledge, access, and social barriers. This study was conducted to assess knowledge, opportunity, and motivation related to cervical cancer screening among women, and to explore barriers and facilitators influencing uptake of, and willingness to participate in, a risk-stratified screening programme.
METHODS:
A mixed-methods study was conducted among 430 women aged 18 – 60 years. Quantitative data were collected using a validated questionnaire assessing knowledge, attitudes, and perceptions related to cervical cancer screening. Qualitative data were obtained through in-depth interviews and focus group discussions to identify barriers and facilitators to risk-stratified screening. Quantitative data were analysed using descriptive statistics, and qualitative data were analysed thematically. Findings from both components were mapped to the Capability, Opportunity, Motivation–Behaviour (COM-B) framework.
RESULTS:
Mean age of participants was 36.8 ± 10.2 years; 78.4% were married and 62.3% lived in urban areas. Only 39.5% could identify major risk factors, and 22.3% had ever undergone cervical screening. Participants demonstrated limited awareness of cervical cancer risk factors, HPV testing, and risk-stratified screening, with fear, stigma, cost, privacy concerns, and health-system constraints emerging as key barriers. Willingness to participate increased when screening was free of charge, ensured privacy, and was endorsed by a physician or government programme.
CONCLUSIONS:
Despite high acceptability of cervical cancer screening under supportive conditions, gaps in knowledge and structural constraints limit participation. Programmes that combine risk-stratified screening with physician recommendation, assured privacy, and no-cost access may substantially improve uptake in similar populations.
Cervical cancer is one of the leading causes of cancer mortality among Indian women, despite being largely preventable through vaccination and screening. Awareness and uptake of screening methods such as Pap smear, visual inspection under acetic acid, and HPV testing remain low due to limited knowledge, access, and social barriers. This study was conducted to assess knowledge, opportunity, and motivation related to cervical cancer screening among women, and to explore barriers and facilitators influencing uptake of, and willingness to participate in, a risk-stratified screening programme.
METHODS:
A mixed-methods study was conducted among 430 women aged 18 – 60 years. Quantitative data were collected using a validated questionnaire assessing knowledge, attitudes, and perceptions related to cervical cancer screening. Qualitative data were obtained through in-depth interviews and focus group discussions to identify barriers and facilitators to risk-stratified screening. Quantitative data were analysed using descriptive statistics, and qualitative data were analysed thematically. Findings from both components were mapped to the Capability, Opportunity, Motivation–Behaviour (COM-B) framework.
RESULTS:
Mean age of participants was 36.8 ± 10.2 years; 78.4% were married and 62.3% lived in urban areas. Only 39.5% could identify major risk factors, and 22.3% had ever undergone cervical screening. Participants demonstrated limited awareness of cervical cancer risk factors, HPV testing, and risk-stratified screening, with fear, stigma, cost, privacy concerns, and health-system constraints emerging as key barriers. Willingness to participate increased when screening was free of charge, ensured privacy, and was endorsed by a physician or government programme.
CONCLUSIONS:
Despite high acceptability of cervical cancer screening under supportive conditions, gaps in knowledge and structural constraints limit participation. Programmes that combine risk-stratified screening with physician recommendation, assured privacy, and no-cost access may substantially improve uptake in similar populations.
| eISSN: | 2654-1459 |
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