Women's Health World Conference 2026

Abstract

Background: Cancer stigma contributes to low cervical cancer screening rates among Nepali women. However, no stigma reduction interventions have been implemented thus far in Nepal. This study assessed the effectiveness of a muti-faceted cervical cancer stigma reduction intervention on cancer stigma scores and cervical cancer screening uptake rates among urban Nepali women.

Methods: We conducted an intervention study among 310 women in Budhanilkantha municipality in central Nepal, randomly assigning 12 wards in a 1:1 ratio in the intervention and control groups. Cancer stigma was measured with the Cancer Stigma Scale  before and after intervention. The 3-hour intervention involved featuring video of cervical cancer survivors, participatory group discussions and delivery of myth versus fact education. Primary outcomes were cancer stigma scores measured two months post-intervention and cervical cancer screening uptake measured six months post-intervention. Data were analyzed using intent-to-treat and as treated approaches with a generalized estimation equation logistic regression.

Results: From June 2022 to February 2023, 310 women were recruited for the study: 156 for the intervention group and 154 for the control group. Intent-to-treat analysis revealed 0.25 times lower odds of experiencing cancer stigma in the intervention group than in the control group post intervention (95% CI: 0.08–0.6, p=0.022). In the intervention group, severity (OR=0.31, CI: 0.1–0.9, p=0.048) and awkwardness (OR=0.21, CI: 0.08–0.5, p=0.001)   decreased significantly, with no differences in other subdomains. The odds of cervical cancer screening was 3.9 times greater in the intervention group than in the control group (95% CI: 1.1–13.2, p=0.028). As treated analysis reinforced these findings, with lower odds of stigma (AOR:0.09, 95% CI: 0.01-0.53, p=0.008), severity (AOR:0.08, 95% CI: 0.02-0.26, p<0.001), and awkwardness (AOR:0.09, 95% CI: 0.01-0.4, p=0.003). Cervical cancer screening odds was 4.02 times higher in the intervention group (95% CI:1.1-13.7, p=0.026).

Conclusions: Cervical cancer stigma reduction interventions reduce stigma and increase cervical cancer screening uptake among urban Nepali women. This intervention can be utilized in low- and middle-income countries similar to Nepal to increase screening coverage.