Knowledge, Attitude and Practice Related to Cervical Cancer Prevention among Medical Students in Bangladesh: A cross-sectional study

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Mizanur Rahman, Azaz Bin Sharif, Bhuyian Md. Mahtab Uddin, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6164354/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 8 You are reading this latest preprint version Abstract Though it is a preventable and treatable illness, cervical cancer nevertheless causes a major global health burden, especially in low- and middle-income nations. With fatality rates above the worldwide norm, this is the second most common malignancy among women in Bangladesh. By encouraging HPV vaccination and screening campaigns, medical experts significantly help to prevent cervical cancer. This study evaluated medical students' knowledge, attitudes, and practices (KAP) on cervical cancer prevention in Bangladesh to highlight areas needing work and guide solutions. A medical student-based, cross-sectional survey was conducted from September 2022 to March 2023 among 533 medical students who were interviewed with a pretested, structured e-questionnaire disseminated through social media platforms and Data was analyzed using descriptive statistics and Chi-square. The study included self-reported practices, general knowledge of cervical cancer prevention, attitudes towards screening and vaccination, and socioeconomic traits. Most of the study participants demonstrated moderate knowledge (78.2%) and positive attitudes (73.6%) toward cervical cancer prevention. However, practical engagement with preventive measures was alarmingly low; none of the respondents had undergone a Pap smear, and only 11.23% reported receiving the HPV vaccine. Female students exhibited significantly higher knowledge and attitude scores compared to their male counterparts. Key gaps were identified in awareness of cervical cancer risk factors, symptoms, and prevention methods. Although the inadequate implementation of preventative techniques exposes important gaps in cervical cancer prevention among future healthcare workers in Bangladesh, the moderate degree of knowledge and positive attitudes do not reflect this. Medical students must be empowered as ambassadors of cervical cancer prevention through focused educational programs, curricular integration, and enhanced access to vaccine and screening facilities addressing those deficiencies. Cervical cancer prevention HPV vaccine Pap smear medical students KAP study Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Introduction The global Scenario Still a major global public health concern, cervical cancer ranks fourth most regularly occurring disease among women worldwide. With low to middle-income countries most affected, researchers reported around 604,000 new cases and 342,000 fatalities in 2020 alone [1]. Early detection and HPV vaccination have made cervical cancer preventable; this issue has driven global campaigns including the World Health Organization’s "90-70-90" strategy, which aims to vaccinate 90% of girls by age 15, screen 70% of women aged 35–45, and treat 90% of those suffering from cervical disease by 2030 [2]. Dealing with these objectives calls for a comprehensive understanding of knowledge, attitudes, and practices (KAP) about HPV and its immunization among several populations. National Scenario With an estimated 11,956 new cases and 6,502 fatalities in Bangladesh alone in 2012 alone, the second most frequent cancer among women greatly affects public health [3]. Though their adoption is still somewhat limited, there are preventative initiatives including the HPV vaccination and the Visual Inspection with Acetic Acid (VIA) test. Effective cervical cancer prevention strategies are more difficult to apply in the nation when faced with cultural stigma, false knowledge, and restricted access to healthcare facilities [4]. Dealing with these issues will help to ensure effective national cervical cancer prevention and control. The impact of HPVs Almost seventy percent of cervical cancer cases recorded worldwide are caused by ongoing infection with high-risk HPV genotypes particularly HPV-16 and HPV-18 [5]. Several bivalent, quadrivalent and, nonvalent variations of prophylactic HPV vaccinations have been demonstrated to be rather effective in preventing infections caused by these high-risk strains. Given prior HPV infection, these immunizations demonstrate the amazing capacity to drastically lower cervical cancer incidence [3]. Although HPV vaccinations are beneficial, their use in Bangladesh is still low; so, a thorough knowledge of the elements influencing KAP towards HPV and their vaccination is essential for developing targeted interventions to increase vaccine acceptance and coverage. Knowledge, Attitudes and Practice towards HPV A systematic review protocol focused on updating KAP on HPV and its vaccine for better policymaking in public health interventions [6]. The study shall compile existing data on KAP and analyze how certain variables, like, country income, geography, age, and gender-affect these attributes with vaccination acceptance. Such data allow tailoring solutions for specific barriers and facilitators within different demographic and socio-economic settings. Importance of the Study Since they will be the doctors of the future, it is quite highly important to know the KAP of Bangladeshi medical students. There could be formulation of programs for improving the education of this group to adequately reach them to effective advocacy for the HPV vaccination or cervical cancer screening through gaps and misconceptions. Such strategies are aligned with national health goals and global initiatives to reduce incidence and mortality from cervical cancer. The KAP analysis of Bangladeshi medical students could identify knowledge gaps and misconceptions that are barriers to the effective prevention of cervical cancer. Establishing such studies can help develop specialized training programs to equip future doctors with the knowledge and skills needed for advocacy on vaccination and screening. This strategy is critical to shaping a skilled, healthcare workforce that can efficiently address cervical cancer and contribute toward achieving global and national health goals. Objectives of the Research The current study focuses on the assessment of medical students as to their knowledge, attitudes, and practices on the prevention of cervical cancer by highlighting current deficiencies to aid in developing training programs that would empower future health professionals to advocate for or implement more cervical cancer prevention efforts. Methods Study Design A cross-sectional, descriptive medical students-based survey was conducted from September 2022 to March 2023. Data Source This study was conducted in Bangladesh at 21 medical colleges, both private and government- sponsored: Ad-Din Akij Medical College; Ad-Din Sakina Women's Medical College; Ashiyan Medical College; Bangabandhu Sheikh Mujib Medical College; Colonel Malek Medical College; Dhaka Medical College; Enam Medical College; East-West Medical College; Green Life Medical College; International Medical College; Jalalabad Ragib-Rabeya Medical College; Kumudini Women's Medical College; Marks Medical College; Mugda Medical College; Popular Medical College; Shaheed Monsur Ali Medical College; Sylhet Women's Medical College; Sylhet MAG Osmani Medical College; Sir Salimullah Medical College; Sheikh Hasina Medical College; and Tairunnessa Memorial Medical College. Respondents collection technique Convenience sampling was used to select the participants. The inclusion criteria were: 1) Medical students in Bangladesh; male or female; and 2) willing to fill out the survey questionnaire. Exclusion Criteria include: 1) students not wishing to take part in this research, and 2) other countries' medical students, not Bangladeshi. Sample Size Determination We utilized the following formula to calculate the sample size [3]: Here, n= sample size, Z= Z statistic for a level of confidence, (for 95% CI, Z=1.96), P = Expected prevalence (63% or 0.63 is prevalence from a previous study) [7], d=precision (5% or 0.05 is allowable error or precision). Using this formula, we calculated the recommended sample size of 358. To prevent data loss or missing and nonresponse issues the final sample size was 533. Research instrument A pretested, structured e-questionnaire was used in this study that was prepared based on previously conducted similar types of studies [8], developed through Google Forms and disseminated through social media platforms (Facebook, WhatsApp, and Messenger). The questionnaire comprises four parts: socio-demographic characteristics; general knowledge about cervical cancer prevention; attitudes regarding cervical cancer, screening, and prevention; self-reported practices regarding preventing cervical cancer. The questionnaires were accompanied by an informed consent form that allowed respondents to fill it out only if they were willing to participate in the study. Participants were encouraged to distribute the questionnaire to their peers without any rewards or incentives to foster participation. It included gathering all data after prior consent by the participants while still maintaining anonymity. The survey included information about the objectives of the study and the confidentiality of responses, with no incentives as well as the right to withdraw from the research at any moment. Measures An anonymous, self-administered questionnaire has been developed to collect data and adapt from some previously validated research [8]. Hence, the tool is constructed in both English and Bangla; it is pretested to establish clarity and relevance with it. The survey questionnaire is divided into four sections: Section A: This section concerns socio-demographic characteristics and has 14 items such as age, sex, marital status, type of institution, year of studying, mother's education and profession, socio-economic status, smoking and alcohol use, consumption of vegetables sources of information about cervical cancer. Section B: General knowledge about cervical cancer, its screening, and prevention, assessed by 20 items rated using a 5-point Likert scale (5 = Strongly Agree to 1 = Strongly Disagree). Classification of responses was according to specific thresholds: good (80-100%), moderate (60- 79%), and poor (<60%) [9, 10]. Section C: Attitudes towards cervical cancer screening and HPV vaccination were assessed through 22 items using the same 5-point Likert scale. The classification of attitudes was similar to those of the knowledge section: good (80-100%), moderate (60-79%), and poor (<60%) [9, 10]. Section D: Practices regarding cervical cancer prevention measured with the help of two yes/no items concerning HPV vaccination and Pap smear screening: `Practice scores were classified according to Bloom's cutoff points: good (80-100%), moderate (609-79%), and poor practice (<60%) [9, 10]. The reliability of the research instrument was derived from pilot studies (40 medical students) where slight modifications were made based on the feedback of both participants and experts. Consultation was taken from a Gynecologist and a Microbiologist at Enam Medical College & Hospital in Dhaka, Bangladesh. Cronbach's alpha was 0.87 and 0.77 for the knowledge and attitude sections, respectively, which was good enough for reliability. Statistical Analysis After collecting, all interviewed questionnaires, we checked for their completeness and correctness to exclude missing or incomplete data. Corrected data was entered into the computer and analyzed using Microsoft Excel 2019, and IBM SPSS (Statistical Package for the Social Sciences), version 26, was used to analyze the data. Microsoft Excel was used for completeness and correctness. We used Microsoft Excel to exclude missing or incomplete information, editing, sorting, and coding. The Excel file was later imported into SPSS software. To calculate socio-demographic parameters, descriptive statistics were used; for categorical variables, frequencies and percentages were also used. For continuous variables, the mean and standard deviation were calculated. We performed the Chi-square test was used to investigate the relationship between socio-demographic variables and outcome variables. A p-value less than 0.05 was considered statistically significant. Result Respondents’ Socio-Demographic Characteristics The socio-demographic characteristics of the respondents are summarized in Table 1. Table 1 Socio-demographic and characteristics of the respondents (N= 533) Variables Category Frequency Percentage (%) Age 17-20 years 156 29.3 21-23 years 336 63 24-28 years 41 7.7 Sex Male 168 31.5 Female 365 68.5 Religion Muslim 450 84.4 Hindu 77 14.4 Christian 2 0.4 Others 4 0.8 Marital status Unmarried 507 95.1 Married 26 4.9 Type of Institute Govt. Medical college 158 29.6 Private Medical college 375 70.4 Educational status 1 st -year MBBS 71 13.3 2 nd -year MBBS 221 41.5 3 rd -year MBBS 74 13.9 4 th -year MBBS 108 20.3 5 th -year MBBS 59 11.1 Location Dhaka 373 70 Khulna 75 14.1 Sylhet 78 14.6 Rajshahi 6 1.1 Barishal 1 0.2 Table 1 (continued) Socioeconomic status Low (10000 BDT) 13 2.4 Medium (10000-19,999 BDT) 495 92.9 High (˃20000 BDT) 25 4.7 Mothers education Illiterate 7 1.3 Primary school 23 4.3 High school 132 24.8 College 176 33 University 195 36.6 Mothers employment Unemployed / housewife 388 72.8 Public employed 83 15.6 Self-employed 26 4.9 Doctor/ health care provider 27 5.1 NGO 4 0.8 Banker 5 0.9 Source of information regarding cervical cancer, human papillomavirus, Pap smears Television 13 2.4 Health workers 22 4.1 Internet 106 19.9 Newspaper 17 3.2 Books 246 46.2 Friends 5 0.9 Family members 47 8.8 Schoolteacher 50 9.4 None of all 27 5.1 Consumption of green vegetables and fruits regularly Yes 429 80.5 No 104 19.5 Drinking status (alcohol) Yes 5 0.9 No 528 99.1 Smoking status Yes 7 1.3 No 526 98.7 Most participants (336, 63%) were between 21 and 23 years of age, with a female predominance (365, 68.5%). The remaining 168 (31.5%) were male. Most respondents (507, 95%) were unmarried, and the majority identified as Muslim (450, 84%), followed by Hindu (77, 14%), with less than 1% identifying as Christian or other religions. Regarding educational institutions, 375 respondents (70.4%) were enrolled in private medical colleges located in the Dhaka division. The response rate across academic years was distributed as follows: 1st year (71, 13.3%), 2nd year (221, 41.5%), 3rd year (74, 14%), 4th year (108, 20.3%), and 5th year (59, 11%). Sources of Information on Cervical Cancer The primary sources of information regarding cervical cancer, HPV, and Pap smear screening are illustrated in Fig. 1 . The primary source of information identified by the respondents was books (246, 46.2%), followed by the Internet (106, 20%), schoolteachers (50, 9.4%), family members (47, 8.8%), health workers (22, 4%), newspapers (17, 3%), and friends (5, 1%). Lifestyle and Dietary Habits Most respondents (429, 80.5%) reported regularly consuming green leafy vegetables, yellow fruits, and citrus fruits. Additionally, nearly all participants were non-alcoholic (528, 99%), and non-smokers (526, 99%). Knowledge of Cervical Cancer The overall knowledge levels of respondents, based on Bloom’s cut-off scoring, are presented in Table 2 and Fig. 2 . Table 2 Knowledge, attitude and practice level of respondents (n=533) Variables Score range Frequency (%) Knowledge Good 80-100% 102 (19.1) Moderate Between 60 and 79% 417 (78.2) Poor ˂60% 14 (2.6) Attitude Good 80-100% 54 (10.1) Moderate Between 60 and 79% 452 (84.8) Poor ˂60% 27 (5.1) Practice (n=365)* Good 80-100% (Score=2) 0 Moderate Between 60 and 79% (Score=1) 41 (11.23) Poor ˂60% (Score=0) 324 (88.77) Note: *Female participants only The majority demonstrated a moderate level of knowledge (417, 78.2%), while 102 (19.1%) had a good level, and only 14 (2.6%) exhibited poor knowledge. Nearly all participants (494, 92.7%) recognized cervical cancer as one of the most common cancers among women, with 388 (72.8%) believing that cervical cancer is a leading cause of death among Bangladeshi women. A substantial proportion (423, 79.3%) agreed that cervical cancer is preventable. Awareness of Risk Factors and Symptoms Respondents awareness of cervical cancer risk factors and signs & symptoms are shown in Table 3 . Table 3 Knowledge regarding cervical cancer among respondents (N=533) Knowledge assessing questions Strongly agree n (%) Agree n (%) Neutral n (%) Disagree n (%) Strongly Disagree n (%) General knowledge Cervical cancer is one of the most common cancers among women 307 (57.6) 187 (35.1) 26 (4.9) 7 (1.3) 6 (1.1) Cervical cancer is preventable 183 (34.3) 240 (45) 90 (16.9) 13 (2.4) 7 (1.3) HPV can infect males 90 (16.9) 176 (33) 234 (43.9) 22 (4.1) 11 (2.1) There is a vaccine to prevent HPV infection 83 (15.6) 193 (36.2) 242 (45.4) 8 (1.5) 7 (1.3) HPV can cause anogenital warts 61 (11.4) 170 (31.9) 234 (43.9) 55 (10.3) 13 (2.4) Risk factors Early-onset of unprotected sexual activities cause cervical cancer 190 (35.6) 206 (38.6) 109 (20.5) 19 (3.6) 9 (1.7) Having multiple sexual partners is a risk factor for cervical cancer 230 (43.2) 188 (35.3) 83 (15.6) 27 (5.1) 5 (0.9) Smoking cigarettes causes cervical cancer 85 (15.9) 166 (31.1) 188 (35.3) 72 (13.5) 22 (4.1) Having a positive family history 91 (17.1) 155 (29.1) 173 (32.5) 76 (14.3) 38 (7.1) It is a sexually transmitted Infection 129 (24.2) 134 (25.1) 141 (26.5) 86 (16.1) 43 (8.1) Multiple pregnancies (≥ 4 vaginal Births) have been linked as risk factors for HPV infection as well as cervical cancer 89 (16.7) 175 (32.8) 207 (38.8) 41 (7.7) 21 (3.9) The use of combined oral contraceptive methods has been associated with an increased risk of cervical cancer 79 (14.8) 172 (32.3) 218 (40.9) 49 (9.2) 15 (2.8) Obesity increases the risk of cervical cancer 75 (14.1) 209 (39.2) 192 (36) 49 (9.2) 8 (1.5) Cervical cancer is most commonly associated with persistent HPV infection 137 (25.7) 237 (44.5) 144 (27) 14 (2.6) 1 (0.2) Sign and symptoms Irregular vaginal bleeding 91 (17.1) 217 (40.7) 200 (37.5) 17 (3.2) 8 (1.5) menstrual periods that are heavier or longer than usual 82 (15.4) 186 (34.9) 249 (46.7) 13 (2.4) 3 (0.6) the foul smell of the vaginal discharge 53 (9.9) 153 (28.7) 311 (58.3) 11 (2.1) 5 (0.9) vaginal itching or irritation 64 (12) 151 (28.3) 275 (51.6) 35 (6.6) 8 (1.5) low back pain 72 (13.5) 158 (29.6) 259 (48.6) 36 (6.8) 8 (1.5) Vaginal bleeding after sex 60 (11.3) 123 (23.1) 284 (53.3) 47 (8.8) 19 (3.6 A majority identified the early onset of unprotected sexual activities (396, 74.2%) and having multiple sexual partners (418, 78.5%) as major risk factors. Other identified risks included smoking (251, 47%), a positive family history (246, 46.2%), and multiple pregnancies (264, 49.5%). Fewer respondents were aware of links between cervical cancer and obesity (284, 53.3%), oral contraceptives (251, 47.1%), and cervical cancer as a sexually transmitted infection (263, 49.3%). Regarding symptoms, irregular vaginal bleeding (308, 57.8%) and prolonged or heavy menstrual periods (268, 50.3%) were the most recognized signs. Other symptoms included foul-smelling vaginal discharge (206, 38.6%), vaginal itching (215, 40.3%), low back pain (230, 43.1%), and postcoital vaginal bleeding (183, 34.4%). Associations Between Knowledge and Socio-Demographic Variables Knowledge of cervical cancer was significantly associated with respondents educational status (p< 0.001), as shown in Table 4. Table 4 Socio-demographic characteristics of the respondents and their association with knowledge, attitude and practice about cervical cancer (n=533) Variables Knowledge χ 2 p -value Attitude χ 2 p -value Practice (n=365) # χ 2 p -value Age (years) Poor a Good b Poor a Good b Poor a Good b n (%) n (%) n (%) n (%) n (%) n (%) 17-20 120 76.9 36 23.1 2.218 0.334 141 90.4 15 9.6 0.994 0.629 89 94.7 5 5.3 ¥ 0.178 21-23 277 82.4 59 17.6 303 90.2 33 9.8 220 89.9 25 10.2 14-28 34 82.9 7 17.1 35 85.4 6 14.6 22 84.6 4 15.4 Sex 0.557 0.480 0.092 0.877 Male 139 82.7 29 17.3 150 89.3 18 10.7 Female 292 80 73 20 329 90.1 36 9.9 Marital status 2.390 0.128 ¥ 0.322 ¥ 0.404 Unmarried 413 81.5 94 18.5 457 90.1 50 9.9 315 91 31 9 Married 18 69.2 8 30.8 22 84.6 4 15.4 16 84.2 3 15.8 Religion 3.450 0.069 0.910 0.430 0.893 0.448 Muslim 370 82.2 80 17.8 402 89.3 48 10.7 283 91.3 27 8.7 Non-muslim 61 73.5 22 26.5 77 92.8 6 7.2 48 87.3 7 12.7 Type of the medical college 3.944 0.054 0.100 0.758 1.008 0.330 Government 136 86.1 22 13.9 143 90.5 15 9.5 95 93.1 7 6.9 Private 295 78.7 80 21.3 336 89.6 39 10.4 236 89.7 27 10.3 Educational status 23.431 0.000* 1.068 0.316 1.384 0.280 Pre-clinical 258 88.4 34 11.6 266 91.1 26 8.9 181 92.3 15 7.7 Clinical 173 71.8 68 28.2 213 88.4 28 11.6 150 88.8 19 11.2 Location 1.231 0.282 1.011 0.351 2.035 0.181 Dhaka division 297 79.6 76 20.4 332 89.0 41 11.0 225 92.2 19 7.8 Outside of the Dhaka division 134 83.8 26 16.3 147 91.9 13 8.1 106 87.6 15 12.4 Mother’s Education ¥ 0.624 ¥ 1.000 ¥ 1.000 No education 5 71.4 2 28.6 7 100.0 0 0 2 100 0 0 Primary or more 426 81.0 100 19.0 472 89.7 54 10.3 329 90.6 34 9.4 Socioeconomic status 3.701 0.158 ¥ 0.815 ¥ 0.002* Low (10000) 8 61.5 5 38.5 12 92.3 1 7.7 6 85.7 1 14.3 Medium (10000-19,999) 404 81.6 91 18.4 443 89.5 52 10.5 315 92.1 27 7.9 High (20000+) 19 76.0 6 24.0 24 96.0 1 4.0 10 62.5 6 37.5 Note: * P value ≤0.05= significant; ¥ = Fisher Exact test done; a Poor = Score less than 60%; b Good= Score more than 60%; # female respondents only (n=365) Attitudes Toward Cervical Cancer Prevention The attitude levels of respondents are detailed in Table 5 and Fig. 3 . Table 5 Attitudes towards cervical cancer screening and human papillomavirus vaccination (N=533) Attitude assessing questions Strongly agree Agree Neutral Disagree Strongly Disagree n (%) n (%) n (%) n (%) n (%) It is important to have a Pap smear test for a woman to know she is healthy 182 (34.1) 220 (41.3) 115 (21.6) 12 (2.3) 4 (0.8) It is embarrassing for a woman to have a Pap smear test 36 (6.8) 125 (23.5) 155 (29.1) 102 (19.1) 115 (21.6) It is painful for a woman to have a Pap smear test 25 (4.7) 101 (18.9) 282 (52.9) 84 (15.8) 41 (7.7) Pap smear is expensive to test 29 (5.4) 111 (20.8) 287 (53.8) 72 (13.5) 34 (6.4) I do not know where to go to get a Pap smear test 93 (17.4) 181 (34) 116 (21.8) 84 (15.8) 59 (11.1) Pap smear test takes a long waiting time 26 (4.9) 71 (13.3) 340 (63.8) 71 (13.3) 25 (4.7) lack of health care providers for Pap smear test 67 (12.6) 204 (38.3) 220 (41.3) 34 (6.4) 8 (1.5) It is against my religion and cultural beliefs to do a Pap smear test 15 (2.8) 55 (10.3) 199 (37.3) 122 (22.9) 142 (26.6) The vaccine would be beneficial to teenage girls’ and boy’s future health 186 (34.9) 210 (39.4) 114 (21.4) 16 (3) 7 (1.3) Education on HPV should be implemented at school 257 (48.2) 178 (33.4) 84 (15.8) 11 (2.1) 3 (0.6) Men can get involved to prevent their partner from cervical cancer 195 (36.6) 173 (32.5) 141 (26.5) 16 (3) 8 (1.5) I believe the Government of Bangladesh must make the HPV vaccine affordable to all adolescents and young 232 (43.5) 199 (37.3) 87 (16.3) 10 (1.9) 5 (0.9) I would like to have the HPV vaccine 196 (36.8) 185 (34.7) 137 (25.7) 10 (1.9) 5 (0.9) I would like to know more about the HPV vaccine 274 (51.4) 182 (34.1) 64 (12) 9 (1.7) 4 (0.8) I would like to recommend HPV vaccination to others 22 (4.1) 39 (7.3) 187 (35.1) 102 (19.1) 183 (34.3) The HPV vaccine is against my religious or cultural belief 35 (6.6) 80 (15) 113 (21.2) 131 (24.6) 174 (32.6) It is difficult and embarrassing for me to ask for the HPV vaccine 25 (4.7) 60 (11.3) 120 (22.5) 130 (24.4) 198 (37.1) If I received the HPV vaccine, I would be embarrassed 227 (42.6) 195 (36.6) 95 (17.8) 9 (1.7) 7 (1.3) Physicians should recommend the HPV vaccine every teenage girl 274 (51.4) 169 (31.7) 72 (13.5) 12 (2.3) 6 (1.1) The vaccine is freely available in schools, clinics, hospitals 237 (44.5) 171 (32.1) 114 (21.4) 9 (1.7) 2 (0.4) Knowing the risks of HPV, I intended to take the HPV vaccine in the future 221 (41.5) 190 (35.6) 108 (20.3) 11 (2.1) 3 (0.6) Proper and regular use of condoms can prevent cervical cancer 168 (31.5) 203 (38.1) 136 (25.5) 17 (3.2) 9 (1.7) The majority, 452 (84.8%), demonstrated a moderate attitude toward cervical cancer prevention, while 54 (10.1%) exhibited a good attitude, and only 27 (5.1%) demonstrated a poor attitude. Most respondents (279, 76.4%) acknowledged the importance of Pap smear or VIA tests, while 103 (28.2%) felt these tests were embarrassing. Moreover, 84 (23%) believed they were painful, and 92 (25.3%) perceived them as expensive. Regarding HPV vaccination, 312 (85.5%) supported integrating HPV education into schools, and 300 (82.2%) felt the government should make the vaccine affordable. A substantial proportion (323, 88.5%) expressed willingness to receive the vaccine, while 316 (86.6%) believed physicians should recommend it for teenagers. Practices Related to Cervical Cancer Prevention The Respondents overall practice levels are summarized in Table 6, Fig. 4 and Fig. 5 . Table 6 Practice of cervical cancer prevention by screening tests and HPV vaccine (N= 365)* Practice related questions Frequency (%) Yes No n (%) n (%) I have done a Pap smear test 0 365 (100) I have completed the HPV vaccination 41 (11.23) 324 (88.77) *Female respondents only All participants (365, 100%) reported poor practice levels, with none having undergone a Pap smear test. Only 41 respondents (11.23%) had received an HPV vaccine. Practice levels were significantly associated with socioeconomic status (p = 0.002), as shown in Table 4 . Discussion To the greatest extent of our knowledge, this study represents the first comprehensive investigation into the knowledge, attitudes, and practices (KAP) regarding cervical cancer prevention among medical students in Bangladesh. As the first multicenter study of its kind in the country, it underscores the pivotal role that future healthcare providers play in promoting public interventions, particularly HPV vaccination and cervical cancer screening. While respondents displayed an encouraging level of knowledge and positive attitude, their preventive practices were alarmingly inadequate, mirroring challenges observed globally and regionally in low-and middle-income countries. The overall knowledge level among respondents (78.2%) was higher than the mean scores reported in similar types of cross-sectional studies in Nigeria (75.90%) and Malaysia (62.9%), but lower than studies conducted in tertiary care hospitals in India and Korea, where over 85% of participants demonstrated strong knowledge of cervical cancer screening [ 7 , 11 – 13 ]. Encouragingly, 70.2% of respondents recognized the causal role of persistent HPV infection, aligning closely with findings in Malaysia (65.5%) and India (79.1%) [ 7 , 14 ]. However, knowledge of specific risk factors such as smoking (47%), oral contraceptive use (47.1%), HPV can cause genital warts (43.3%) and multiple pregnancies (49.5%) remained poor. These findings mirror results from Ethiopia, and China, where less than 50% of participants identified these risk factors [ 15 , 16 ]. The respondents knowledge regarding the signs and symptoms were equally poor and the most common signs and symptoms included heavier or longer menstrual periods (50.3%), vaginal discharge with (38.6%) foul smell, vaginal itching or irritation (40.3%), low back pain (43.1%), vaginal bleeding following sex (34.4%) remained poor. These findings were aligned with the results from Saudi Arabia and Ethiopia, where most of the respondents were unaware of the symptoms and signs of cervical cancer [ 15 , 17 ]. The variation should be due to the lack of awareness programs, limited information access, cultural perceptions, stigma, study design and methodological differences that influence awareness and educational opportunities among the respondents [ 18 , 19 ]. This gap highlights the need to strengthen curricula on HPV and cervical cancer in Bangladesh’s medical institutes. Attitude is an important factor in determining health-seeking behavior. Even in the absence of clinical features, perceived risks may encourage women to get screened for cervical cancer [ 20 ]. Our study reveals that most of the participants (73.6%) exhibited a positive attitude toward cervical cancer prevention. This is consistence with studies in India, where more than 90% of healthcare professionals were willing to undergo cervical cancer screening and the HPV vaccine [ 11 , 14 , 21 ]. Comparably, studies in China and Zambia also show that 78.1% of the participants hope to get the HPV vaccination, demonstrating a proactive attitude, also reported in studies [ 22 , 23 ]. Still, there are ongoing misunderstandings. For example, 25.3% of respondents thought Pap smears were costly, and 28.2% felt they were embarrassing. These results match the obstacles found in Ethiopia [ 15 ]. Fostering health-seeking behaviors among healthcare professionals depends on addressing these attitudinal hurdles. Usually, it is thought that a good knowledge of disease will translate into appropriate practices when treating it with drugs and vaccinations. Still, the results of the present study were surprising as respondents had strong knowledge and a good attitude but inadequate screening and HPV vaccination behavior. Consequently, the respondents preventative behaviors were quite lacking despite their knowledge and attitudes. Only 11.23% of respondents said they had the HPV vaccination, in line with equally low rates found in China (9%) and Singapore (9.8%) [ 16 , 22 ] Comparatively, studies in India reported a vaccination rate of 7%, and in Malaysia a rate of just 3.6%, however, given the effectiveness of HPV vaccinations in preventing cervical cancer, these figures remain shockingly low [ 7 , 24 ]. Unbelievably, none of the participants in our study had a Pap smear test; this outcome is in line with studies done in Ethiopia [ 25 ]. The lack of preventative screening policies points to a more general problem in low-middle-income nations, where cultural shame, restricted access and ignorance inhibit involvement in early detection initiatives. This emphasizes the need for public health initiatives stressing the requirement of consistent screening. Furthermore, the clear discrepancy between poor preventive practices and high degrees of knowledge in our study follows a worldwide trend in low-and middle-income countries (LMICs). For example, just 3.6% of medical students in Malaysia said they had a Pap smear despite great knowledge about cervical cancer [ 7 ]. Comparably, a study conducted in Bangladesh revealed that although most women indicated they would be eager to have the HPV vaccination, logistical and budgetary restrictions significantly hindered adoption [ 3 ]. These results imply that, especially in environments with systematic impediments, knowledge by itself is not enough to motivate behavior modification. Further complicating these difficulties are socioeconomic differences. Higher-income students showed better practices, according to our study, consistent with other studies in Bangladesh, Malaysia, India, Ghana, and the USA that highlight financial constraints as major obstacles to HPV vaccination and screening [ 3 , 7 , 14 , 26 , 27 ]. This underlines the importance of subsidized or cheap HPV and easily available screening programs to close the knowledge-practice gap. Strengths and Limitations The strengths of this study include its multicenter design and a varied sample consisting of twenty- one medical facilities spread over four divisions of Bangladesh. Though diversified, its dependence on self-administered online questionnaires may bring recall bias and sample size, which would not entirely reflect the larger population of Bangladeshi medical students. Future research should use community-based designs to confirm these results and investigate treatments meant to remove the discovered obstacles. Conclusion This study emphasizes how urgently systematic changes and focused teaching interventions are needed to enhance cervical cancer prevention methods among Bangladeshi medical students. Including hands-on training and awareness campaigns in medical courses can help future doctors be more suited to advocate for and apply preventative actions. Furthermore, important for removing the institutional obstacles impeding low-and middle-income country (LMIC) development are government programs to subsidize HPV vaccinations and provide access to screening facilities. Declarations Ethics approval and consent to participate: Ethical approval was obtained from the institutional review board of North South University (reference no. 2022/OR-NSU/IRB/0903) in Bangladesh and performed under the Declaration of Helsinki. An informed consent form was included with the survey questionnaire. Participants respond anonymously to an online survey form that provides information about the research purpose, information confidentiality, and the right to refuse or withdraw from the study at any time. Consent for publication: Not applicable. Clinical trial number: Not applicable. Availability of data and material: The datasets generated and/or analysed during the current study are available in the Harvard Dataverse Repository; https://dataverse.harvard.edu/dataset.xhtml?persistentId=doi:10.7910/DVN/T7QXLG. Competing interests: The authors declare that they have no competing interests. Funding: This research received no specific grant from public, commercial, or not-for-profit funding agencies. Authors' contributions: Md. Mizanur Rahman: Writing-original draft, conceptualization, methodology, investigation, project administration, Data analysis, Data curation; Azaz Bin Sharif: Supervision, conceptualization, validation, methodology; Bhuyian Md. Mahtab Uddin: Conceptualization, methodology, validation; Sumia Bari: Conceptualization, methodology, validation; Saidul Islam Khan: Methodology, Data drafting; Ismoth Ara Jerin: Methodology, Data drafting; Farhana Rahman Rumki: Methodology, Data drafting; Samia Ullah Orthi: Conceptualization, methodology Acknowledgements We are grateful to the participants who participated in this study voluntarily and spontaneously. We also would like to express most profound gratitude to all the staff of the Public Health Department, North South University, Dhaka, Bangladesh. References Sung, H., et al. (2021). Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: a cancer journal for clinicians, 71(3), 209–249. https://doi.org/10.3322/caac.21660 Delie, A.M., et al. (2024). Healthcare providers' knowledge, attitude, and practice towards cervical cancer screening in Sub-Saharan Africa: systematic review and meta-analysis. 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Available: https://medcraveonline.com/MOJPH/knowledge-and-attitude-towards-cervical-cancer-screening-and-associated-factors-among-female-hawassa-university-college-of-medicine-and-health-sciences-students.html Liu, Y., Jiang, X., Xu, L., Di, N., Jiang, L., & Tao, X. (2021). Difference between medical and nonmedical students on knowledge, practice, and attitude towards the human papillomavirus vaccine in China: a cross-sectional study. Journal of Cancer Education , 36 , 1014–1021. https://doi.org/10.1007/s13187-019-01682-4 Aga, S. S., Yasmeen, N., & Khan, M. A. (2022). Cervical cancer and its screening: assessing the knowledge, awareness, and perception among health and allied students. Education Research International , 2022 (1), 4608643. https://doi.org/10.1155/2022/4608643 Chawla, B., Taneja, N., Awasthi, A. A., Kaur, K. N., & Janardhanan, R. (2021). Knowledge, attitude, and practice on screening toward cervical cancer among health professionals in India—A review. Women's Health , 17 , 17455065211017066. https://doi.org/10.1177/17455065211017066 Antic, L. G., Djikanovic, B. S., Antic, D. Z., Aleksopulos, H. G., & Trajkovic, G. Z. (2014). Differencies in the level of knowledge on cervical cancer among health care students, midwives and patients in Serbia. Asian Pacific Journal of Cancer Prevention, 15(7), 3011–3015. https://doi.org/10.7314/apjcp.2014.15.7.3011 Ndejjo, R., Mukama, T., Musabyimana, A., & Musoke, D. (2016). Uptake of cervical cancer screening and associated factors among women in rural Uganda: a cross sectional study. PloS one , 11 (2), e0149696. https://doi.org/10.1371/journal.pone.0149696 Thippeveeranna, C., Mohan, S. S., Singh, L. R., & Singh, N. N. (2013). Knowledge, attitude and practice of the pap smear as a screening procedure among nurses in a tertiary hospital in north eastern India. Asian pacific journal of cancer prevention , 14 (2), 849–852. https://doi.org/10.7314/apjcp.2013.14.2.849 Fu, C. J., Pan, X. F., Zhao, Z. M., Saheb-Kashaf, M., Chen, F., Wen, Y., … Zhong,X. N. (2014). Knowledge, perceptions and acceptability of HPV vaccination among medical students in Chongqing, China. Asian Pacific Journal of Cancer Prevention , 15 (15), 6187–6193. https://doi.org/10.7314/apjcp.2014.15.15.6187 Kabelenga, E., & Mwanakasale, V. (2018). Knowledge, Attitude and Practices towards cervical cancer screening among female medical students at the Copperbelt University School of Medicine, Zambia. Asian Pac J Health Sci , 5 , 89–96. https://doi.org/10.21276/apjhs.2018.5.3.12 Shetty, S., Prabhu, S., Shetty, V., & Shetty, A. K. (2019). Knowledge, attitudes and factors associated with acceptability of human papillomavirus vaccination among undergraduate medical, dental and nursing students in South India. Human vaccines & immunotherapeutics , 15 (7–8), 1656–1665. https://doi.org/10.1080/21645515.2019.1565260 Tilahun, T., Tulu, T., & Dechasa, W. (2019). Knowledge, attitude and practice of cervical cancer screening and associated factors amongst female students at Wollega University, western Ethiopia. BMC research notes , 12 , 1–5. https://doi.org/10.1186/s13104-019-4564-x Ebu, N. I., Mupepi, S. C., Siakwa, M. P., & Sampselle, C. M. (2014). Knowledge, practice, and barriers toward cervical cancer screening in Elmina, Southern Ghana. International journal of women's health , 31–39. https://doi.org/10.2147/ijwh.s71797 Rosen, B. L., Shepard, A., & Kahn, J. A. (2018). US health care clinicians' knowledge, attitudes, and practices regarding human papillomavirus vaccination: a qualitative systematic review. Academic pediatrics , 18 (2), S53-S65. https://doi.org/10.1016/j.acap.2017.10.007 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 03 May, 2025 Reviews received at journal 03 May, 2025 Reviewers agreed at journal 29 Apr, 2025 Reviewers agreed at journal 28 Apr, 2025 Reviewers invited by journal 01 Apr, 2025 Editor assigned by journal 25 Mar, 2025 Submission checks completed at journal 25 Mar, 2025 First submitted to journal 05 Mar, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6164354","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":445853252,"identity":"96a27256-b96f-40f5-9770-e45c3a177336","order_by":0,"name":"Md. 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1","display":"","copyAsset":false,"role":"figure","size":5759,"visible":true,"origin":"","legend":"\u003cp\u003eSources of information regarding cervical cancer, screening and HPV vaccination\u003c/p\u003e","description":"","filename":"Onlinedrawingimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-6164354/v1/cad91cab44a873f9dd724a04.png"},{"id":82084853,"identity":"69f4910a-7936-4f0f-9b0a-66735756d591","added_by":"auto","created_at":"2025-05-06 15:00:29","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":5167,"visible":true,"origin":"","legend":"\u003cp\u003eThe overall knowledge levels of respondents on cervical cancer prevention (N=533)\u003c/p\u003e","description":"","filename":"Onlinedrawingimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-6164354/v1/51812b9cd5db42918bd88d9f.png"},{"id":82083795,"identity":"aa839a82-b15b-461a-a861-eb2b3259fb04","added_by":"auto","created_at":"2025-05-06 14:52:29","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":5438,"visible":true,"origin":"","legend":"\u003cp\u003eThe overall level of attitude of respondents (N=533)\u003c/p\u003e","description":"","filename":"Onlinedrawingimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-6164354/v1/ba3632a245338d840739a6e8.png"},{"id":82083796,"identity":"eb224551-7c9a-498d-9a17-5c395ad93f97","added_by":"auto","created_at":"2025-05-06 14:52:29","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":4739,"visible":true,"origin":"","legend":"\u003cp\u003eThe Overall Pap smear and HPV vaccine status of respondents (N=365*)\u003c/p\u003e\n\u003cp\u003eNote: \u0026nbsp;\u0026nbsp;*female students only\u003c/p\u003e","description":"","filename":"Onlinedrawingimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-6164354/v1/474cd7ded69972021e99f12b.png"},{"id":82083797,"identity":"1b5ec883-c13a-4d9d-8a69-f4b287479bb7","added_by":"auto","created_at":"2025-05-06 14:52:29","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":4321,"visible":true,"origin":"","legend":"\u003cp\u003eThe overall level of practice of respondents (N=365)*\u003c/p\u003e\n\u003cp\u003eNote: female students only*\u003c/p\u003e","description":"","filename":"Onlinedrawingimage5.png","url":"https://assets-eu.researchsquare.com/files/rs-6164354/v1/87870110f7b5d5137b445d4c.png"},{"id":82086662,"identity":"da6e335c-acd8-478a-ae53-f732143f9bf1","added_by":"auto","created_at":"2025-05-06 15:16:30","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1376645,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6164354/v1/7355d434-2c1c-4a1a-95bb-6b1763e7cf94.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Knowledge, Attitude and Practice Related to Cervical Cancer Prevention among Medical Students in Bangladesh: A cross-sectional study","fulltext":[{"header":"Introduction","content":"\u003cp\u003e\u003cem\u003eThe global Scenario\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eStill a major global public health concern, cervical cancer ranks fourth most regularly occurring disease among women worldwide. With low to middle-income countries most affected, researchers reported around 604,000 new cases and 342,000 fatalities in 2020 alone [1]. Early detection\u0026nbsp;and\u0026nbsp;HPV\u0026nbsp;vaccination\u0026nbsp;have\u0026nbsp;made\u0026nbsp;cervical\u0026nbsp;cancer\u0026nbsp;preventable;\u0026nbsp;this\u0026nbsp;issue\u0026nbsp;has\u0026nbsp;driven\u0026nbsp;global campaigns including the World Health Organization\u0026rsquo;s \u0026quot;90-70-90\u0026quot; strategy, which aims to vaccinate 90% of girls by age 15, screen 70% of women aged 35\u0026ndash;45, and treat 90% of those suffering from cervical disease by 2030 [2]. Dealing with these objectives calls for a comprehensive understanding of knowledge, attitudes, and practices (KAP) about HPV and its immunization among several populations.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eNational Scenario\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eWith an estimated 11,956 new cases and 6,502 fatalities in Bangladesh alone in 2012 alone, the second most frequent cancer among women greatly affects public health [3]. Though their adoption\u0026nbsp;is\u0026nbsp;still\u0026nbsp;somewhat\u0026nbsp;limited,\u0026nbsp;there\u0026nbsp;are\u0026nbsp;preventative\u0026nbsp;initiatives\u0026nbsp;including\u0026nbsp;the\u0026nbsp;HPV\u0026nbsp;vaccination and the Visual Inspection with Acetic Acid (VIA) test. Effective cervical cancer prevention strategies are more difficult to apply in the nation when faced with cultural stigma, false knowledge,\u0026nbsp;and\u0026nbsp;restricted\u0026nbsp;access\u0026nbsp;to\u0026nbsp;healthcare\u0026nbsp;facilities\u0026nbsp;[4].\u0026nbsp;Dealing\u0026nbsp;with\u0026nbsp;these\u0026nbsp;issues\u0026nbsp;will\u0026nbsp;help\u0026nbsp;to ensure effective national cervical cancer prevention and control.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eThe impact of HPVs\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAlmost seventy percent of cervical cancer cases recorded worldwide are caused by ongoing infection with high-risk HPV genotypes particularly HPV-16 and HPV-18 [5]. Several bivalent, quadrivalent and, nonvalent variations of prophylactic HPV vaccinations have been demonstrated to be rather effective in preventing infections caused by these high-risk strains. Given prior HPV infection, these immunizations demonstrate the amazing capacity to drastically lower cervical cancer incidence [3]. Although HPV vaccinations are beneficial, their use in Bangladesh is still low; so, a thorough knowledge of the elements influencing KAP towards HPV and their vaccination is essential for developing targeted interventions to increase vaccine acceptance and coverage.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eKnowledge, Attitudes and Practice towards HPV\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eA systematic review protocol focused on updating KAP on HPV and its vaccine for better policymaking\u0026nbsp;in\u0026nbsp;public\u0026nbsp;health\u0026nbsp;interventions\u0026nbsp;[6].\u0026nbsp;The\u0026nbsp;study\u0026nbsp;shall\u0026nbsp;compile\u0026nbsp;existing\u0026nbsp;data\u0026nbsp;on\u0026nbsp;KAP\u0026nbsp;and analyze how certain variables, like, country income, geography, age, and gender-affect these attributes\u0026nbsp;with\u0026nbsp;vaccination\u0026nbsp;acceptance.\u0026nbsp;Such\u0026nbsp;data\u0026nbsp;allow\u0026nbsp;tailoring\u0026nbsp;solutions\u0026nbsp;for\u0026nbsp;specific\u0026nbsp;barriers\u0026nbsp;and facilitators within different demographic and socio-economic settings.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eImportance of the Study\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eSince they will be the doctors of the future, it is quite highly important to know the KAP of Bangladeshi medical students. There could be formulation of programs for improving the education of this group to adequately reach them to effective advocacy for the HPV vaccination or cervical cancer screening through gaps and misconceptions. Such strategies are aligned with national\u0026nbsp;health\u0026nbsp;goals\u0026nbsp;and\u0026nbsp;global\u0026nbsp;initiatives\u0026nbsp;to\u0026nbsp;reduce\u0026nbsp;incidence\u0026nbsp;and\u0026nbsp;mortality\u0026nbsp;from\u0026nbsp;cervical cancer.\u003c/p\u003e\n\u003cp\u003eThe KAP analysis of Bangladeshi medical students could identify knowledge gaps and misconceptions that are barriers to the effective prevention of cervical cancer. Establishing such studies\u0026nbsp;can\u0026nbsp;help\u0026nbsp;develop\u0026nbsp;specialized\u0026nbsp;training\u0026nbsp;programs\u0026nbsp;to\u0026nbsp;equip\u0026nbsp;future\u0026nbsp;doctors\u0026nbsp;with\u0026nbsp;the\u0026nbsp;knowledge and\u0026nbsp;skills\u0026nbsp;needed\u0026nbsp;for\u0026nbsp;advocacy\u0026nbsp;on\u0026nbsp;vaccination\u0026nbsp;and\u0026nbsp;screening.\u0026nbsp;This\u0026nbsp;strategy\u0026nbsp;is\u0026nbsp;critical\u0026nbsp;to shaping\u0026nbsp;a\u0026nbsp;skilled,\u0026nbsp;healthcare\u0026nbsp;workforce\u0026nbsp;that\u0026nbsp;can\u0026nbsp;efficiently\u0026nbsp;address\u0026nbsp;cervical\u0026nbsp;cancer\u0026nbsp;and\u0026nbsp;contribute toward achieving global and national health goals.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eObjectives of the Research\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe current study focuses on the assessment of medical students as to their knowledge, attitudes, and practices on the prevention of cervical cancer by highlighting current deficiencies to aid in developing training programs that would empower future health professionals to advocate for or implement more cervical cancer prevention efforts.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cem\u003eStudy Design\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eA cross-sectional, descriptive medical students-based survey was conducted from September 2022 to March 2023.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eData Source\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted in Bangladesh at 21 medical colleges, both private and government- sponsored: Ad-Din Akij Medical College; Ad-Din Sakina Women\u0026apos;s Medical College; Ashiyan Medical\u0026nbsp;College;\u0026nbsp;Bangabandhu\u0026nbsp;Sheikh\u0026nbsp;Mujib\u0026nbsp;Medical\u0026nbsp;College;\u0026nbsp;Colonel\u0026nbsp;Malek\u0026nbsp;Medical\u0026nbsp;College; Dhaka\u0026nbsp;Medical\u0026nbsp;College;\u0026nbsp;Enam\u0026nbsp;Medical\u0026nbsp;College;\u0026nbsp;East-West\u0026nbsp;Medical\u0026nbsp;College;\u0026nbsp;Green\u0026nbsp;Life\u0026nbsp;Medical College; International Medical College; Jalalabad Ragib-Rabeya Medical College; Kumudini Women\u0026apos;s Medical College; Marks Medical College; Mugda Medical College; Popular Medical College; Shaheed Monsur Ali Medical College; Sylhet Women\u0026apos;s Medical College; Sylhet MAG Osmani Medical College; Sir Salimullah Medical College; Sheikh Hasina Medical College; and Tairunnessa Memorial Medical College.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eRespondents collection technique\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eConvenience\u0026nbsp;sampling\u0026nbsp;was\u0026nbsp;used\u0026nbsp;to\u0026nbsp;select\u0026nbsp;the\u0026nbsp;participants.\u0026nbsp;The\u0026nbsp;inclusion\u0026nbsp;criteria\u0026nbsp;were:\u0026nbsp;1) Medical\u0026nbsp;students\u0026nbsp;in\u0026nbsp;Bangladesh;\u0026nbsp;male\u0026nbsp;or\u0026nbsp;female;\u0026nbsp;and\u0026nbsp;2)\u0026nbsp;willing\u0026nbsp;to\u0026nbsp;fill\u0026nbsp;out\u0026nbsp;the\u0026nbsp;survey\u0026nbsp;questionnaire. Exclusion Criteria include: 1) students not wishing to take part in this research, and 2) other countries\u0026apos; medical students, not Bangladeshi.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eSample Size Determination\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eWe\u0026nbsp;utilized the following\u0026nbsp;formula\u0026nbsp;to calculate\u0026nbsp;the\u0026nbsp;sample\u0026nbsp;size [3]:\u003c/p\u003e\n\u003cp\u003e\u003cimg src=\"data:image/png;base64,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\"\u003e\u003c/p\u003e\n\u003cp\u003eHere, n= sample size, Z= Z statistic for a level of confidence, (for 95% CI, Z=1.96), P = Expected prevalence (63% or 0.63 is prevalence from a previous study) [7], d=precision (5% or 0.05 is allowable error or precision). Using this formula, we calculated the recommended sample size of\u003c/p\u003e\n\u003cp\u003e358. To prevent data loss or missing and nonresponse issues the final sample size was 533.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eResearch instrument\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eA pretested, structured e-questionnaire was used in this study that was prepared based on previously conducted similar types of studies [8], developed through Google Forms and disseminated through social media platforms (Facebook, WhatsApp, and Messenger). The questionnaire comprises four parts: socio-demographic characteristics; general knowledge about\u003c/p\u003e\n\u003cp\u003ecervical cancer prevention; attitudes regarding cervical cancer, screening, and prevention; self-reported\u0026nbsp;practices\u0026nbsp;regarding\u0026nbsp;preventing\u0026nbsp;cervical\u0026nbsp;cancer.\u0026nbsp;The\u0026nbsp;questionnaires\u0026nbsp;were\u0026nbsp;accompanied\u0026nbsp;by an informed consent form that allowed respondents to fill it out only if they were willing to participate\u0026nbsp;in\u0026nbsp;the\u0026nbsp;study.\u0026nbsp;Participants\u0026nbsp;were\u0026nbsp;encouraged\u0026nbsp;to\u0026nbsp;distribute\u0026nbsp;the\u0026nbsp;questionnaire\u0026nbsp;to\u0026nbsp;their\u0026nbsp;peers without any\u0026nbsp;rewards or incentives to foster participation. It included gathering\u0026nbsp;all data after prior consent by the participants while still maintaining anonymity. The survey included information about the objectives of the study and the confidentiality of responses, with no incentives as well as the right to withdraw from the research at any moment.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMeasures\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAn\u0026nbsp;anonymous,\u0026nbsp;self-administered\u0026nbsp;questionnaire\u0026nbsp;has\u0026nbsp;been\u0026nbsp;developed\u0026nbsp;to\u0026nbsp;collect\u0026nbsp;data\u0026nbsp;and\u0026nbsp;adapt\u0026nbsp;from some\u0026nbsp;previously\u0026nbsp;validated\u0026nbsp;research\u0026nbsp;[8].\u0026nbsp;Hence,\u0026nbsp;the\u0026nbsp;tool\u0026nbsp;is\u0026nbsp;constructed\u0026nbsp;in\u0026nbsp;both\u0026nbsp;English\u0026nbsp;and\u0026nbsp;Bangla; it is pretested to establish clarity and relevance with it. The survey questionnaire is divided into four sections:\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eSection A:\u0026nbsp;\u003c/em\u003eThis section concerns socio-demographic characteristics and has 14 items such as age, sex, marital status, type of institution, year of studying, mother\u0026apos;s education and profession, socio-economic status, smoking and alcohol use, consumption of vegetables sources of information about cervical cancer.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eSection B:\u0026nbsp;\u003c/em\u003eGeneral knowledge about cervical cancer, its screening, and prevention, assessed by 20 items rated using a 5-point Likert scale (5 = Strongly Agree to 1 = Strongly Disagree). Classification of responses was according to specific thresholds: good (80-100%), moderate (60- 79%), and poor (\u0026lt;60%) [9, 10].\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eSection C:\u0026nbsp;\u003c/em\u003eAttitudes towards cervical cancer screening and HPV vaccination were assessed through 22 items using the same 5-point Likert scale. The classification of attitudes was similar to those of the knowledge section: good (80-100%), moderate (60-79%), and poor (\u0026lt;60%) [9, 10].\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eSection D:\u0026nbsp;\u003c/em\u003ePractices regarding cervical cancer prevention measured with the help of two yes/no items concerning HPV vaccination and Pap smear screening: `Practice scores were classified according to Bloom\u0026apos;s cutoff points: good (80-100%), moderate (609-79%), and poor practice (\u0026lt;60%) [9, 10].\u003c/p\u003e\n\u003cp\u003eThe reliability of the research instrument was derived from pilot studies (40 medical students) where slight modifications were made based on the feedback of both participants and experts. Consultation was taken from a Gynecologist and a Microbiologist at Enam Medical College \u0026amp; Hospital\u0026nbsp;in\u0026nbsp;Dhaka,\u0026nbsp;Bangladesh.\u0026nbsp;Cronbach\u0026apos;s\u0026nbsp;alpha\u0026nbsp;was\u0026nbsp;0.87\u0026nbsp;and\u0026nbsp;0.77\u0026nbsp;for\u0026nbsp;the\u0026nbsp;knowledge\u0026nbsp;and\u0026nbsp;attitude sections, respectively, which was good enough for reliability.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eStatistical Analysis\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAfter collecting, all interviewed questionnaires, we checked for their completeness and correctness to exclude missing or incomplete data. Corrected data was entered into the computer and analyzed using Microsoft Excel 2019, and IBM SPSS (Statistical Package for the Social Sciences), version 26, was used to analyze the data. Microsoft Excel was used for completeness and correctness. We used Microsoft Excel to exclude missing or incomplete information, editing, sorting, and coding. The Excel file was later imported into SPSS software. To calculate socio-demographic parameters, descriptive statistics were used; for categorical variables, frequencies and percentages were also used. For continuous variables, the mean and standard deviation were calculated. We performed the Chi-square test was used to investigate the relationship between socio-demographic variables and outcome variables. A p-value less than 0.05 was considered statistically significant.\u003c/p\u003e"},{"header":"Result","content":"\u003cp\u003e\u003cem\u003eRespondents\u0026rsquo; Socio-Demographic Characteristics\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe socio-demographic characteristics of the respondents are summarized in \u003cstrong\u003eTable 1.\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 591px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 1\u0026nbsp;\u003c/strong\u003eSocio-demographic and characteristics of the respondents (N= 533)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eAge\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e17-20 years\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e156\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e29.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e21-23 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e336\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e24-28 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e7.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eSex\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eMale\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e168\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e31.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eFemale\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e365\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e68.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eReligion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eMuslim\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e450\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e84.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eHindu\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e14.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eChristian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eMarital status\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eUnmarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e507\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e95.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e4.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eType of Institute\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eGovt. Medical college\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e158\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e29.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003ePrivate Medical college\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e375\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e70.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eEducational status\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e1\u003csup\u003est\u003c/sup\u003e -year MBBS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e13.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e2\u003csup\u003end\u003c/sup\u003e -year MBBS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e221\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e41.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e3\u003csup\u003erd\u003c/sup\u003e-year MBBS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e13.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e4\u003csup\u003eth\u003c/sup\u003e -year MBBS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e20.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e5\u003csup\u003eth\u003c/sup\u003e -year MBBS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e11.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eLocation\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eDhaka\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e373\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e70\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eKhulna\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e14.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eSylhet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e14.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eRajshahi\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eBarishal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 591px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 1\u0026nbsp;\u003c/strong\u003e(continued)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eSocioeconomic status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eLow (10000 BDT)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eMedium (10000-19,999 BDT)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e495\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e92.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eHigh (˃20000 BDT)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e4.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eMothers education\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eIlliterate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e1.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003ePrimary school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e4.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eHigh school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e132\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e24.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eCollege\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e176\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eUniversity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e195\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e36.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eMothers employment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eUnemployed / housewife\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e388\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e72.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003ePublic employed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e15.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eSelf-employed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e4.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eDoctor/ health care provider\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e5.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eNGO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eBanker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"9\" valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eSource of information regarding cervical cancer, human papillomavirus, Pap smears\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eTelevision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eHealth workers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e4.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eInternet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e19.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eNewspaper\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e3.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eBooks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e246\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e46.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eFriends\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eFamily members\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e8.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eSchoolteacher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e9.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eNone of all\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e5.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eConsumption of green vegetables and fruits regularly\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e429\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e80.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e19.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eDrinking status (alcohol)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e528\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e99.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 179px;\"\u003e\n \u003cp\u003eSmoking status\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e1.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e526\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e98.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMost participants\u0026nbsp;(336,\u0026nbsp;63%)\u0026nbsp;were\u0026nbsp;between\u0026nbsp;21\u0026nbsp;and\u0026nbsp;23\u0026nbsp;years\u0026nbsp;of\u0026nbsp;age,\u0026nbsp;with\u0026nbsp;a\u0026nbsp;female\u0026nbsp;predominance (365,\u003c/p\u003e\n\u003cp\u003e68.5%). The remaining 168 (31.5%) were male. Most respondents (507, 95%) were unmarried, and the majority identified as Muslim (450, 84%), followed by Hindu (77, 14%), with less than 1% identifying as Christian or other religions.\u003c/p\u003e\n\u003cp\u003eRegarding educational institutions, 375 respondents (70.4%) were enrolled in private medical colleges located in the Dhaka division. The response rate across academic years was distributed as follows: 1st year (71, 13.3%), 2nd year (221, 41.5%), 3rd year (74, 14%), 4th year (108, 20.3%), and 5th year (59, 11%).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eSources of Information on Cervical Cancer\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe primary sources of information regarding cervical cancer, HPV, and Pap smear screening are illustrated in \u003cstrong\u003eFig.\u0026nbsp;1\u003c/strong\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe primary source of information identified by the respondents was books (246, 46.2%), followed by the Internet (106, 20%), schoolteachers (50, 9.4%), family members (47, 8.8%), health workers (22, 4%), newspapers (17, 3%), and friends (5, 1%).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eLifestyle and \u003cem\u003eDietary Habits\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eMost respondents (429, 80.5%) reported regularly consuming green leafy vegetables, yellow fruits, and citrus fruits. Additionally, nearly all participants were non-alcoholic (528, 99%), and non-smokers (526, 99%).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eKnowledge of Cervical Cancer\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe overall knowledge levels of respondents, based on Bloom\u0026rsquo;s cut-off scoring, are presented in \u003cstrong\u003eTable 2\u0026nbsp;\u003c/strong\u003eand \u003cstrong\u003eFig. 2\u003c/strong\u003e.\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"554\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 554px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 2\u0026nbsp;\u003c/strong\u003eKnowledge, attitude and practice level of respondents (n=533)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eScore range\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 153px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKnowledge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 153px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eGood\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003e80-100%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 153px;\"\u003e\n \u003cp\u003e102 (19.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eModerate\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eBetween 60 and 79%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 153px;\"\u003e\n \u003cp\u003e417 (78.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003ePoor\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003e\u0026nbsp;˂60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 153px;\"\u003e\n \u003cp\u003e14 (2.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAttitude\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 153px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eGood\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003e80-100%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 153px;\"\u003e\n \u003cp\u003e54 (10.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eModerate\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eBetween 60 and 79%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 153px;\"\u003e\n \u003cp\u003e452 (84.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003ePoor\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003e\u0026nbsp;˂60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 153px;\"\u003e\n \u003cp\u003e27 (5.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePractice (n=365)*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 153px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eGood\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003e80-100%\u003c/p\u003e\n \u003cp\u003e(Score=2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 153px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003eModerate\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003eBetween 60 and 79%\u003c/p\u003e\n \u003cp\u003e(Score=1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 153px;\"\u003e\n \u003cp\u003e41 (11.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 189px;\"\u003e\n \u003cp\u003ePoor\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 211px;\"\u003e\n \u003cp\u003e˂60%\u003c/p\u003e\n \u003cp\u003e(Score=0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 153px;\"\u003e\n \u003cp\u003e324 (88.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 554px;\"\u003e\n \u003cp\u003eNote: \u003cstrong\u003e*Female participants only\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The majority demonstrated a moderate level of knowledge (417, 78.2%), while 102 (19.1%) had a good level, and only 14 (2.6%) exhibited poor knowledge.\u003c/p\u003e\n\u003cp\u003eNearly\u0026nbsp;all\u0026nbsp;participants\u0026nbsp;(494,\u0026nbsp;92.7%)\u0026nbsp;recognized\u0026nbsp;cervical\u0026nbsp;cancer\u0026nbsp;as\u0026nbsp;one\u0026nbsp;of\u0026nbsp;the\u0026nbsp;most\u0026nbsp;common\u0026nbsp;cancers among\u0026nbsp;women,\u0026nbsp;with\u0026nbsp;388\u0026nbsp;(72.8%)\u0026nbsp;believing\u0026nbsp;that\u0026nbsp;cervical\u0026nbsp;cancer\u0026nbsp;is\u0026nbsp;a\u0026nbsp;leading\u0026nbsp;cause\u0026nbsp;of\u0026nbsp;death\u0026nbsp;among Bangladeshi women. A substantial proportion (423, 79.3%) agreed that cervical cancer is preventable.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAwareness of Risk Factors and Symptoms\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eRespondents awareness of cervical cancer risk factors and signs \u0026amp; symptoms are shown in \u003cstrong\u003eTable 3\u003c/strong\u003e.\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"651\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 651px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 3\u0026nbsp;\u003c/strong\u003eKnowledge regarding cervical cancer among respondents (N=533)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKnowledge assessing questions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStrongly agree\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgree\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNeutral\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDisagree\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStrongly Disagree\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGeneral knowledge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003col\u003e\n \u003cli\u003eCervical cancer is one of the most common cancers among women\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e307 (57.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e187 (35.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e26 (4.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e7 (1.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e6 (1.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003col start=\"2\"\u003e\n \u003cli\u003eCervical cancer is preventable\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e183 (34.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e240 (45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e90 (16.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e13 (2.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e7 (1.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003col start=\"3\"\u003e\n \u003cli\u003eHPV can infect males\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e90 (16.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e176 (33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e234 (43.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e22 (4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e11 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003col start=\"4\"\u003e\n \u003cli\u003eThere is a vaccine to prevent HPV infection\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e83 (15.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e193 (36.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e242 (45.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e8 (1.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e7 (1.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003col start=\"5\"\u003e\n \u003cli\u003eHPV can cause anogenital warts\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e61 (11.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e170 (31.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e234 (43.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e55 (10.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e13 (2.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRisk factors\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003col start=\"6\"\u003e\n \u003cli\u003eEarly-onset of unprotected sexual activities cause cervical cancer\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e190 (35.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e206 (38.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e109 (20.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e19 (3.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e9 (1.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003col start=\"7\"\u003e\n \u003cli\u003eHaving multiple sexual partners is a risk factor for cervical cancer\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e230 (43.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e188 (35.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e83 (15.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e27 (5.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e5 (0.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003col start=\"8\"\u003e\n \u003cli\u003eSmoking cigarettes causes cervical cancer\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e85 (15.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e166 (31.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e188 (35.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e72 (13.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e22 (4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003col start=\"9\"\u003e\n \u003cli\u003eHaving a positive family history\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e91 (17.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e155 (29.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e173 (32.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e76 (14.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e38 (7.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003col start=\"10\"\u003e\n \u003cli\u003eIt is a sexually transmitted Infection\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e129 (24.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e134 (25.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e141 (26.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e86 (16.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e43 (8.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003col start=\"11\"\u003e\n \u003cli\u003eMultiple pregnancies (\u0026ge; 4 vaginal Births) have been linked as risk factors for HPV infection as well as cervical cancer\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e89 (16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e175 (32.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e207 (38.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e41 (7.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e21 (3.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003col start=\"12\"\u003e\n \u003cli\u003eThe use of combined oral contraceptive methods has been associated with an increased risk of cervical cancer\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e79 (14.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e172 (32.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e218 (40.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e49 (9.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e15 (2.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003col start=\"13\"\u003e\n \u003cli\u003eObesity increases the risk of cervical cancer\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e75 (14.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e209 (39.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e192 (36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e49 (9.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e8 (1.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003col start=\"14\"\u003e\n \u003cli\u003eCervical cancer is most commonly associated with persistent HPV infection\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e137 (25.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e237 (44.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e144 (27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e14 (2.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e1 (0.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSign and symptoms\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003col start=\"15\"\u003e\n \u003cli\u003eIrregular vaginal bleeding\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e91 (17.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e217 (40.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e200 (37.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e17 (3.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e8 (1.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003col start=\"16\"\u003e\n \u003cli\u003emenstrual periods that are heavier or longer than usual\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e82 (15.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e186 (34.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e249 (46.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e13 (2.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e3 (0.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003col start=\"17\"\u003e\n \u003cli\u003ethe foul smell of the vaginal discharge\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e53 (9.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e153 (28.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e311 (58.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e11 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e5 (0.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003col start=\"18\"\u003e\n \u003cli\u003evaginal itching or irritation\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e64 (12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e151 (28.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e275 (51.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e35 (6.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e8 (1.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003col start=\"19\"\u003e\n \u003cli\u003elow back pain\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e72 (13.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e158 (29.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e259 (48.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e36 (6.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e8 (1.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 282px;\"\u003e\n \u003col start=\"20\"\u003e\n \u003cli\u003eVaginal bleeding after sex\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e60 (11.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e123 (23.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e284 (53.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e47 (8.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e19 (3.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eA majority identified the early onset of unprotected sexual activities (396, 74.2%) and having multiple sexual partners (418, 78.5%) as major risk factors. Other identified risks included smoking (251, 47%), a positive family history (246, 46.2%), and multiple pregnancies (264, 49.5%). Fewer respondents were aware of links between cervical cancer and obesity (284, 53.3%), oral contraceptives (251, 47.1%), and cervical cancer as a sexually transmitted infection (263, 49.3%).\u003c/p\u003e\n\u003cp\u003eRegarding symptoms, irregular vaginal bleeding (308, 57.8%) and prolonged or heavy menstrual periods (268, 50.3%) were the most recognized signs. Other symptoms included foul-smelling vaginal discharge (206, 38.6%), vaginal itching (215, 40.3%), low back pain (230, 43.1%), and postcoital vaginal bleeding (183, 34.4%).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAssociations Between Knowledge and Socio-Demographic Variables\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eKnowledge of cervical cancer was significantly associated with respondents educational status (p\u0026lt; 0.001), as shown in \u003cstrong\u003eTable\u0026nbsp;4.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"954\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"19\" valign=\"top\"\u003e\n \u003cp\u003eTable 4 Socio-demographic characteristics of the respondents and their association with knowledge, attitude and practice about cervical cancer (n=533)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eKnowledge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026chi;\u003csup\u003e2\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAttitude\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026chi;\u003csup\u003e2\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePractice (n=365)\u003csup\u003e#\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026chi;\u003csup\u003e2\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003ePoor\u003cstrong\u003e\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eGood\u003cstrong\u003e\u003csup\u003eb\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003ePoor\u003cstrong\u003e\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eGood\u003cstrong\u003e\u003csup\u003eb\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003ePoor\u003cstrong\u003e\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eGood\u003cstrong\u003e\u003csup\u003eb\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17-20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e76.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e23.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2.218\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.334\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e141\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e90.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.994\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.629\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e94.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026yen;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.178\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21-23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e277\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e82.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e303\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e90.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e220\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e89.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e14-28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e82.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e85.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e14.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e84.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.557\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.480\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.092\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.877\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e139\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e82.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e89.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e292\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e329\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e90.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2.390\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.128\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026yen;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.322\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026yen;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.404\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUnmarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e413\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e81.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e457\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e90.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e315\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e69.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e30.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e84.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e84.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eReligion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e3.450\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.069\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.910\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.430\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.893\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.448\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMuslim\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e370\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e82.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e402\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e89.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e283\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e91.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNon-muslim\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e73.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e26.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e92.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e87.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of the medical college\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e3.944\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.054\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e0.100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e0.758\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.330\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eGovernment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e136\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e86.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e13.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e143\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e90.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e93.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePrivate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e295\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e78.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e336\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e89.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e236\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e89.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducational status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e23.431\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.000*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1.068\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.316\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1.384\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.280\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePre-clinical\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e258\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e88.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e266\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e91.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e181\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e92.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eClinical\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e173\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e71.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e213\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e88.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e88.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLocation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1.231\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.282\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1.011\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.351\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2.035\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.181\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDhaka division\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e297\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e79.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e332\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e89.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e225\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e92.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOutside of the Dhaka division\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e134\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e83.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e16.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e91.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e87.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMother\u0026rsquo;s Education\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026yen;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.624\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026yen;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026yen;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e71.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePrimary or more\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e426\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e81.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e19.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e472\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e89.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e329\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e90.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSocioeconomic status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e3.701\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.158\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026yen;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.815\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026yen;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.002*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLow (10000)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e61.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e38.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e92.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e85.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e14.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMedium (10000-19,999)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e404\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e81.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e443\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e89.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e315\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e92.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHigh (20000+)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e76.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e96.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e62.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e37.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"19\" valign=\"top\"\u003e\n \u003cp\u003eNote: \u003csup\u003e*\u003c/sup\u003e\u003cem\u003eP\u0026nbsp;\u003c/em\u003evalue \u0026le;0.05= significant; \u003csup\u003e\u0026yen;\u003c/sup\u003e= Fisher Exact test done; \u003csup\u003ea\u003c/sup\u003ePoor = Score less than 60%; \u003csup\u003eb\u003c/sup\u003eGood= Score more than 60%; \u003csup\u003e#\u003c/sup\u003e female respondents only (n=365)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAttitudes\u0026nbsp;Toward\u0026nbsp;Cervical\u0026nbsp;Cancer Prevention\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe attitude levels of respondents are detailed in \u003cstrong\u003eTable 5\u0026nbsp;\u003c/strong\u003eand \u003cstrong\u003eFig. 3\u003c/strong\u003e.\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"693\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 693px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 5\u0026nbsp;\u003c/strong\u003eAttitudes towards cervical cancer screening and human papillomavirus vaccination (N=533)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 252px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAttitude assessing questions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStrongly agree\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgree\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNeutral\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDisagree\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStrongly Disagree\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 252px;\"\u003e\n \u003col\u003e\n \u003cli\u003eIt is important to have a Pap smear test for a woman to know she is healthy\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e182 (34.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e220 (41.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e115 (21.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e12 (2.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e4 (0.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 252px;\"\u003e\n \u003col start=\"2\"\u003e\n \u003cli\u003eIt is embarrassing for a woman to have a Pap smear test\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e36 (6.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e125 (23.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e155 (29.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e102 (19.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e115 (21.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 252px;\"\u003e\n \u003col start=\"3\"\u003e\n \u003cli\u003eIt is painful for a woman to have a Pap smear test\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e25 (4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e101 (18.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e282 (52.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e84 (15.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e41 (7.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 252px;\"\u003e\n \u003col start=\"4\"\u003e\n \u003cli\u003ePap smear is expensive to test\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e29 (5.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e111 (20.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e287 (53.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e72 (13.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e34 (6.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 252px;\"\u003e\n \u003col start=\"5\"\u003e\n \u003cli\u003eI do not know where to go to get a Pap smear test\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e93 (17.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e181 (34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e116 (21.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e84 (15.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e59 (11.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 252px;\"\u003e\n \u003col start=\"6\"\u003e\n \u003cli\u003ePap smear test takes a long waiting time\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e26 (4.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e71 (13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e340 (63.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e71 (13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e25 (4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 252px;\"\u003e\n \u003col start=\"7\"\u003e\n \u003cli\u003elack of health care providers for Pap smear test\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e67 (12.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e204 (38.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e220 (41.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e34 (6.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e8 (1.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 252px;\"\u003e\n \u003col start=\"8\"\u003e\n \u003cli\u003eIt is against my religion and cultural beliefs to do a Pap smear test\u0026nbsp;\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e15 (2.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e55 (10.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e199 (37.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e122 (22.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e142 (26.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 252px;\"\u003e\n \u003col start=\"9\"\u003e\n \u003cli\u003eThe vaccine would be beneficial to teenage girls\u0026rsquo; and boy\u0026rsquo;s future health\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e186 (34.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e210 (39.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e114 (21.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e16 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e7 (1.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 252px;\"\u003e\n \u003col start=\"10\"\u003e\n \u003cli\u003eEducation on HPV should be implemented at school\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e257 (48.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e178 (33.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e84 (15.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e11 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e3 (0.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 252px;\"\u003e\n \u003col start=\"11\"\u003e\n \u003cli\u003eMen can get involved to prevent their partner from cervical cancer\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e195 (36.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e173 (32.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e141 (26.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e16 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e8 (1.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 252px;\"\u003e\n \u003col start=\"12\"\u003e\n \u003cli\u003eI believe the Government of Bangladesh must make the HPV vaccine affordable to all adolescents and young\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e232 (43.5)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e199 (37.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e87 (16.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e10 (1.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e5 (0.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 252px;\"\u003e\n \u003col start=\"13\"\u003e\n \u003cli\u003eI would like to have the HPV vaccine\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e196 (36.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e185 (34.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e137 (25.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e10 (1.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e5 (0.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 252px;\"\u003e\n \u003col start=\"14\"\u003e\n \u003cli\u003eI would like to know more about the HPV vaccine\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e274 (51.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e182 (34.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e64 (12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e9 (1.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e4 (0.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 252px;\"\u003e\n \u003col start=\"15\"\u003e\n \u003cli\u003eI would like to recommend HPV vaccination to others\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e22 (4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e39 (7.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e187 (35.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e102 (19.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e183 (34.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 252px;\"\u003e\n \u003col start=\"16\"\u003e\n \u003cli\u003eThe HPV vaccine is against my religious or cultural belief\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e35 (6.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e80 (15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e113 (21.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e131 (24.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e174 (32.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 252px;\"\u003e\n \u003col start=\"17\"\u003e\n \u003cli\u003eIt is difficult and embarrassing for me to ask for the HPV vaccine\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e25 (4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e60 (11.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e120 (22.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e130 (24.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e198 (37.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 252px;\"\u003e\n \u003col start=\"18\"\u003e\n \u003cli\u003eIf I received the HPV vaccine, I would be embarrassed\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e227 (42.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e195 (36.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e95 (17.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e9 (1.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e7 (1.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 252px;\"\u003e\n \u003col start=\"19\"\u003e\n \u003cli\u003ePhysicians should recommend the HPV vaccine every teenage girl\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e274 (51.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e169 (31.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e72 (13.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e12 (2.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e6 (1.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 252px;\"\u003e\n \u003col start=\"20\"\u003e\n \u003cli\u003eThe vaccine is freely available in schools, clinics, hospitals\u0026nbsp;\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e237 (44.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e171 (32.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e114 (21.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e9 (1.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e2 (0.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 252px;\"\u003e\n \u003col start=\"21\"\u003e\n \u003cli\u003eKnowing the risks of HPV, I intended to take the HPV vaccine in the future\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e221 (41.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e190 (35.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e108 (20.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e11 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e3 (0.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 252px;\"\u003e\n \u003col start=\"22\"\u003e\n \u003cli\u003eProper and regular use of condoms can prevent cervical cancer\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e168 (31.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e203 (38.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e136 (25.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e17 (3.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e9 (1.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe\u0026nbsp;majority,\u0026nbsp;452\u0026nbsp;(84.8%), demonstrated a moderate attitude toward cervical cancer prevention, while 54 (10.1%) exhibited a good attitude, and only 27 (5.1%) demonstrated a poor attitude.\u003c/p\u003e\n\u003cp\u003eMost respondents (279, 76.4%) acknowledged the importance of Pap smear or VIA tests, while 103 (28.2%) felt these tests were embarrassing. Moreover, 84 (23%) believed they were painful, and 92 (25.3%) perceived them as expensive.\u003c/p\u003e\n\u003cp\u003eRegarding\u0026nbsp;HPV\u0026nbsp;vaccination,\u0026nbsp;312\u0026nbsp;(85.5%)\u0026nbsp;supported\u0026nbsp;integrating\u0026nbsp;HPV\u0026nbsp;education\u0026nbsp;into\u0026nbsp;schools,\u0026nbsp;and 300 (82.2%) felt the government should make the vaccine affordable. A substantial proportion (323,\u0026nbsp;88.5%)\u0026nbsp;expressed\u0026nbsp;willingness\u0026nbsp;to\u0026nbsp;receive\u0026nbsp;the\u0026nbsp;vaccine,\u0026nbsp;while\u0026nbsp;316\u0026nbsp;(86.6%)\u0026nbsp;believed\u0026nbsp;physicians should recommend it for teenagers.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003ePractices Related to Cervical Cancer Prevention\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe Respondents overall practice levels are summarized in \u003cstrong\u003eTable\u0026nbsp;6, Fig.\u0026nbsp;4\u0026nbsp;and Fig. 5\u003c/strong\u003e.\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"660\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 660px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 6\u0026nbsp;\u003c/strong\u003ePractice of cervical cancer prevention by screening tests and HPV vaccine (N= 365)*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 362px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePractice related questions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 297px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 362px;\"\u003e\n \u003col\u003e\n \u003cli\u003eI have done a Pap smear test\u0026nbsp;\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e365 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 362px;\"\u003e\n \u003col start=\"2\"\u003e\n \u003cli\u003eI have completed the HPV vaccination\u003c/li\u003e\n \u003c/ol\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e41 (11.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e324 (88.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp; *Female respondents only\u003c/p\u003e\n\u003cp\u003eAll participants (365, 100%) reported poor practice levels, with none having undergone a Pap smear test. Only 41 respondents (11.23%) had received an HPV vaccine. Practice levels were significantly associated with socioeconomic status (p = 0.002), as shown in \u003cstrong\u003eTable 4\u003c/strong\u003e.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eTo the greatest extent of our knowledge, this study represents the first comprehensive investigation into the knowledge, attitudes, and practices (KAP) regarding cervical cancer prevention among medical students in Bangladesh. As the first multicenter study of its kind in the country, it underscores the pivotal role that future healthcare providers play in promoting public interventions, particularly HPV vaccination and cervical cancer screening. While respondents displayed an encouraging level of knowledge and positive attitude, their preventive practices were alarmingly inadequate, mirroring challenges observed globally and regionally in low-and middle-income countries.\u003c/p\u003e \u003cp\u003eThe overall knowledge level among respondents (78.2%) was higher than the mean scores reported in similar types of cross-sectional studies in Nigeria (75.90%) and Malaysia (62.9%), but lower than studies conducted in tertiary care hospitals in India and Korea, where over 85% of participants demonstrated strong knowledge of cervical cancer screening [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan additionalcitationids=\"CR12\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Encouragingly, 70.2% of respondents recognized the causal role of persistent HPV infection, aligning closely with findings in Malaysia (65.5%) and India (79.1%) [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. However, knowledge of specific risk factors such as smoking (47%), oral contraceptive use (47.1%), HPV can cause genital warts (43.3%) and multiple pregnancies (49.5%) remained poor. These findings mirror results from Ethiopia, and China, where less than 50% of participants identified these risk factors [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe respondents knowledge regarding the signs and symptoms were equally poor and the most common signs and symptoms included heavier or longer menstrual periods (50.3%), vaginal discharge with (38.6%) foul smell, vaginal itching or irritation (40.3%), low back pain (43.1%), vaginal bleeding following sex (34.4%) remained poor. These findings were aligned with the results from Saudi Arabia and Ethiopia, where most of the respondents were unaware of the symptoms and signs of cervical cancer [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe variation should be due to the lack of awareness programs, limited information access, cultural perceptions, stigma, study design and methodological differences that influence awareness and educational opportunities among the respondents [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. This gap highlights the need to strengthen curricula on HPV and cervical cancer in Bangladesh\u0026rsquo;s medical institutes.\u003c/p\u003e \u003cp\u003eAttitude is an important factor in determining health-seeking behavior. Even in the absence of clinical features, perceived risks may encourage women to get screened for cervical cancer [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Our study reveals that most of the participants (73.6%) exhibited a positive attitude toward cervical cancer prevention. This is consistence with studies in India, where more than 90% of healthcare professionals were willing to undergo cervical cancer screening and the HPV vaccine [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eComparably, studies in China and Zambia also show that 78.1% of the participants hope to get the HPV vaccination, demonstrating a proactive attitude, also reported in studies [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eStill, there are ongoing misunderstandings. For example, 25.3% of respondents thought Pap smears were costly, and 28.2% felt they were embarrassing. These results match the obstacles found in Ethiopia [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Fostering health-seeking behaviors among healthcare professionals depends on addressing these attitudinal hurdles.\u003c/p\u003e \u003cp\u003eUsually, it is thought that a good knowledge of disease will translate into appropriate practices when treating it with drugs and vaccinations. Still, the results of the present study were surprising as respondents had strong knowledge and a good attitude but inadequate screening and HPV vaccination behavior.\u003c/p\u003e \u003cp\u003eConsequently, the respondents preventative behaviors were quite lacking despite their knowledge and attitudes. Only 11.23% of respondents said they had the HPV vaccination, in line with equally low rates found in China (9%) and Singapore (9.8%) [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] Comparatively, studies in India reported a vaccination rate of 7%, and in Malaysia a rate of just 3.6%, however, given the effectiveness of HPV vaccinations in preventing cervical cancer, these figures remain shockingly low [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eUnbelievably, none of the participants in our study had a Pap smear test; this outcome is in line with studies done in Ethiopia [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. The lack of preventative screening policies points to a more general problem in low-middle-income nations, where cultural shame, restricted access and ignorance inhibit involvement in early detection initiatives. This emphasizes the need for public health initiatives stressing the requirement of consistent screening.\u003c/p\u003e \u003cp\u003eFurthermore, the clear discrepancy between poor preventive practices and high degrees of knowledge in our study follows a worldwide trend in low-and middle-income countries (LMICs). For example, just 3.6% of medical students in Malaysia said they had a Pap smear despite great knowledge about cervical cancer [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Comparably, a study conducted in Bangladesh revealed that although most women indicated they would be eager to have the HPV vaccination, logistical and budgetary restrictions significantly hindered adoption [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. These results imply that, especially in environments with systematic impediments, knowledge by itself is not enough to motivate behavior modification.\u003c/p\u003e \u003cp\u003eFurther complicating these difficulties are socioeconomic differences. Higher-income students showed better practices, according to our study, consistent with other studies in Bangladesh, Malaysia, India, Ghana, and the USA that highlight financial constraints as major obstacles to HPV vaccination and screening [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. This underlines the importance of subsidized or cheap HPV and easily available screening programs to close the knowledge-practice gap.\u003c/p\u003e \u003cdiv id=\"Sec27\" class=\"Section2\"\u003e \u003ch2\u003eStrengths and Limitations\u003c/h2\u003e \u003cp\u003eThe strengths of this study include its multicenter design and a varied sample consisting of twenty- one medical facilities spread over four divisions of Bangladesh. Though diversified, its dependence on self-administered online questionnaires may bring recall bias and sample size, which would not entirely reflect the larger population of Bangladeshi medical students. Future research should use community-based designs to confirm these results and investigate treatments meant to remove the discovered obstacles.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study emphasizes how urgently systematic changes and focused teaching interventions are needed to enhance cervical cancer prevention methods among Bangladeshi medical students. Including hands-on training and awareness campaigns in medical courses can help future doctors be more suited to advocate for and apply preventative actions. Furthermore, important for removing the institutional obstacles impeding low-and middle-income country (LMIC) development are government programs to subsidize HPV vaccinations and provide access to screening facilities.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics approval and consent to participate:\u003c/p\u003e\n\u003cp\u003eEthical approval was obtained from the institutional review board of North South University (reference no. 2022/OR-NSU/IRB/0903) in Bangladesh and performed under the Declaration of Helsinki. \u0026nbsp;An informed consent form was included with the survey questionnaire. Participants respond anonymously to an online survey form that provides information about the research purpose, information confidentiality, and the right to refuse or withdraw from the study at any time.\u003c/p\u003e\n\u003cp\u003eConsent for publication: Not applicable.\u003c/p\u003e\n\u003cp\u003eClinical trial number: Not applicable.\u003c/p\u003e\n\u003cp\u003eAvailability of data and material:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analysed during the current study are available in the Harvard Dataverse Repository; https://dataverse.harvard.edu/dataset.xhtml?persistentId=doi:10.7910/DVN/T7QXLG.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCompeting interests: The authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003eFunding: This research received no specific grant from public, commercial, or not-for-profit funding agencies.\u003c/p\u003e\n\u003cp\u003eAuthors\u0026apos; contributions:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMd. Mizanur Rahman: Writing-original draft, conceptualization, methodology, investigation, project administration, Data analysis, Data curation; Azaz Bin Sharif: Supervision, conceptualization, validation, methodology; Bhuyian Md. Mahtab Uddin: Conceptualization, methodology, validation; Sumia Bari: Conceptualization, methodology, validation; Saidul Islam Khan: \u0026nbsp; Methodology, Data drafting; Ismoth Ara Jerin: Methodology, Data drafting; Farhana Rahman Rumki: Methodology, Data drafting; Samia Ullah Orthi: Conceptualization, methodology\u003c/p\u003e\n\u003cp\u003eAcknowledgements\u003c/p\u003e\n\u003cp\u003eWe are grateful to the participants who participated in this study voluntarily and spontaneously. We also would like to express most profound gratitude to all the staff of the Public Health Department, North South University, Dhaka, Bangladesh.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eSung, H., et al. (2021). 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US health care clinicians' knowledge, attitudes, and practices regarding human papillomavirus vaccination: a qualitative systematic review. \u003cem\u003eAcademic pediatrics\u003c/em\u003e, \u003cem\u003e18\u003c/em\u003e(2), S53-S65. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.acap.2017.10.007\u003c/span\u003e\u003cspan address=\"10.1016/j.acap.2017.10.007\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"diedu","sideBox":"Learn more about [Discover Education](https://www.springer.com/journal/44217)","snPcode":"44217","submissionUrl":"https://submission.nature.com/new-submission/44217/3","title":"Discover Education","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Cervical cancer prevention, HPV vaccine, Pap smear, medical students, KAP study","lastPublishedDoi":"10.21203/rs.3.rs-6164354/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6164354/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThough it is a preventable and treatable illness, cervical cancer nevertheless causes a major global health burden, especially in low- and middle-income nations. With fatality rates above the worldwide norm, this is the second most common malignancy among women in Bangladesh. By encouraging HPV vaccination and screening campaigns, medical experts significantly help to prevent cervical cancer. This study evaluated medical students' knowledge, attitudes, and practices (KAP) on cervical cancer prevention in Bangladesh to highlight areas needing work and guide solutions. A medical student-based, cross-sectional survey was conducted from September 2022 to March 2023 among 533 medical students who were interviewed with a pretested, structured e-questionnaire disseminated through social media platforms and Data was analyzed using descriptive statistics and Chi-square. The study included self-reported practices, general knowledge of cervical cancer prevention, attitudes towards screening and vaccination, and socioeconomic traits. Most of the study participants demonstrated moderate knowledge (78.2%) and positive attitudes (73.6%) toward cervical cancer prevention. However, practical engagement with preventive measures was alarmingly low; none of the respondents had undergone a Pap smear, and only 11.23% reported receiving the HPV vaccine. Female students exhibited significantly higher knowledge and attitude scores compared to their male counterparts. Key gaps were identified in awareness of cervical cancer risk factors, symptoms, and prevention methods.\u003c/p\u003e \u003cp\u003eAlthough the inadequate implementation of preventative techniques exposes important gaps in cervical cancer prevention among future healthcare workers in Bangladesh, the moderate degree of knowledge and positive attitudes do not reflect this. Medical students must be empowered as ambassadors of cervical cancer prevention through focused educational programs, curricular integration, and enhanced access to vaccine and screening facilities addressing those deficiencies.\u003c/p\u003e","manuscriptTitle":"Knowledge, Attitude and Practice Related to Cervical Cancer Prevention among Medical Students in Bangladesh: A cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-06 14:52:25","doi":"10.21203/rs.3.rs-6164354/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-05-04T01:59:20+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-03T13:04:04+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"13823227903974997647208470116851344900","date":"2025-04-29T09:23:37+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"157922401522823900606571313711904198250","date":"2025-04-29T00:16:58+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-04-01T14:35:27+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-03-25T07:57:51+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-03-25T07:56:32+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Education","date":"2025-03-05T16:21:54+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"diedu","sideBox":"Learn more about [Discover Education](https://www.springer.com/journal/44217)","snPcode":"44217","submissionUrl":"https://submission.nature.com/new-submission/44217/3","title":"Discover Education","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b8afe1eb-05c9-4565-b261-570e5dd09f47","owner":[],"postedDate":"May 6th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-06-30T11:53:39+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-06 14:52:25","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6164354","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6164354","identity":"rs-6164354","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}