KNOWLEDGE, ATTITUDES, AND PRACTICES TOWARD CERVICAL CANCER SCREENING AMONG HEALTHCARE PROVIDERS IN SAUDI ARABIA

Abstract

Background: As healthcare in the Kingdom of Saudi Arabia continues to advance rapidly, cervical cancer (CC) is becoming a significant public health concern. Alarmingly, Saudi has experienced a dramatic increase in CC, with about 453.6% increase in cases since 1990. This trend highlights the urgency of addressing this issue. Effective screening strategies, particularly through regular Pap smear tests and Human papillomavirus vaccine, were proven to reduce the incidence and mortality rates of CC. However, in KSA, the promotion and implementation of screening practices among healthcare providers (HCPs) remain inadequate. There is lack in practice/ recommendation of CC screening and the absence of screening recommendation contributes to the increased risk of late-stage diagnoses, which are often linked to poor outcomes. Thus, there remains a significant gap in understanding the knowledge, attitudes, and practices (KAP) of HCPs’ related to CC screening and the barriers and facilitators that may influence CC screening practices/recommendations across five regions of KSA. Specific aims: this study aimed to a) explore the knowledge, attitudes, and practices of Saudi HCPs regarding CC screening, particularly the use of the Pap test; b) examine the intersectional variations in CC screening practices based on gender and the type of the healthcare professional; c) identify the barriers and facilitators of HCP’s CC screening practice/recommendation based on Socio- Ecological Model (SEM) at various levels. Methods: a cross-sectional, descriptive design was employed using an online survey and a convenience sampling approach. The total number of subjects included in the study was 289. They are Saudi and non- Saudi male and female HCPs, who are employed in healthcare settings across Saudi. The sample included general practitioners (GPs), gynecologists, specialists, and nurses. Data were collected using a validated KAP scale that was originally developed in a previous Saudi research study. Face and content validity were established through expert reviews. Data were analyzed using IBM SPSS Version 25. Descriptive statistics summarized demographic and professional characteristics and knowledge and attitudes scores. Bivariate analyses (chi-square and t-tests) examined associations between screening practice/ recommendation and independent variables. Logistic regression assessed multivariate relationships, evaluating how knowledge, attitudes, and intersectional factors influenced CC screening practices. Statistical assumptions were checked, and significance was set at p < 0.05. Barriers and facilitators to CC screening were assessed using both hierarchal logistic regression and open-ended questions analyzed descriptively to explores both the resources and support HCPs need to effectively implement CC screening in their practices. The responses were grouped by frequency and organized across SEM levels. Conclusion: the study sheds light on how knowledge, attitudes, and screening practices/ recommendations for CC are shaped in KSA. The findings point to a clear need for better screening guidelines, focused training for HCPs, and culturally appropriate awareness efforts to help reduce the impact of CC and support the country’s Vision 2030 health goals.