Knowledge, Awareness, and Screening Practices of Cervical Cancer Among Women in Arunachal Pradesh: A Cross-Sectional Study

Abstract

Background: Cervical cancer is the second most common cancer among women in India, and Arunachal Pradesh records some of the highest incidence, mortality, and disability-adjusted life-year (DALY) rates in the country, particularly in Papumpare district and its neighbouring areas. Despite this burden, awareness and screening uptake in the region remain poor.

Objective: To assess the knowledge, awareness, and screening practices related to cervical cancer among women aged 18–60 years in Ziro, Lower Subansiri district, Arunachal Pradesh, and to identify the socio-demographic and systemic factors associated with these outcomes.

Methods: A cross-sectional, descriptive, and analytical study was conducted over six months (January–June 2025) among 465 women recruited through multistage stratified random sampling from schools, colleges, and government offices in Ziro. Data were collected using a structured, interviewer-administered questionnaire covering socio-demographic characteristics, knowledge, awareness, screening practice, and perceived barriers. Chi-square tests and multivariate logistic regression were used to explore associations between socio-demographic variables and screening uptake.

Results: Most respondents (71.6%) had heard of cervical cancer, but only 43.2% correctly identified human papillomavirus (HPV) as the cause, and misconceptions attributing the disease to poor hygiene or multiple sexual partners were common. Awareness of the HPV vaccine was moderate (55.9%), while actual screening uptake was extremely low (9.9%). Lack of awareness (85.6%), absence of a healthcare provider's recommendation (28%), and low monthly household income (p = 0.004) emerged as significant barriers to screening; marital status was also significantly associated with screening uptake (p < 0.001).

Conclusion: Despite reasonable baseline awareness among young, educated women, comprehensive knowledge of risk factors, symptoms, and preventive measures, along with actual screening uptake, remains critically low in Arunachal Pradesh. Targeted, culturally sensitive awareness campaigns, provider-driven recommendations, and accessible, subsidised screening services are urgently needed to reduce the cervical cancer burden in this high-risk region.