Knowledge and Screening Practices of Breast and Cervical Cancer in Rural and Urban South Africa

Background: The South African government has recently released cancer policies for breast and cervical cancer—the most common types and causes of cancer-related death in South African women. Increased mortality rates and advanced disease at presentation in comparison with developed countries suggests a need for greater awareness of risk factors, screening and preventative methods individualized for the population at risk. Aim: To characterize and compare the knowledge base and perceptions of women in urban and rural settings, we assessed these factors in two different cohorts in South Africa. Methods: A cross-sectional sample was taken in South Africa of women invited to participate in a survey regarding breast and cervical cancer knowledge, and awareness of risk factors, prevention and screening. Participants were approached in shopping malls and health facilities in urban Johannesburg in 2015 (“urban”) and semirural Bushbuckridge, 450 km northeast of Johannesburg (“rural”) in 2016. Results: 600 total women were surveyed, with 300 from each cohort. 83% of the urban cohort completed matriculation or higher, versus 60% of rural participants for whom high school was their highest level of education. Both groups demonstrated comparable levels of cancer awareness, and > 70% felt that cervical cancer is preventable. While the urban cohort was more knowledgeable about Pap smears (76% vs. 66%, P = 0.004), > 75% of both cohorts were willing to get one. Although both groups were largely unfamiliar with the role of HPV in cervical cancer, rural women were more aware of HIV (38% vs. 59%, P < 0.0001), smoking (43% vs. 62%, P < 0.0001) and parity (39% vs. 54%, P = 0.00019) as risk factors. Nevertheless, urban participants were more knowledgeable about breast self exams (71% vs. 59%, P = 0.001) and mammograms (62% vs. 42%, P < 0.0001), and more likely to undergo one (79% vs. 66%, P = 0.0002). Both groups identified family history and genetics as risk factors, but rural women appeared more aware of the roles of diet (30.67% vs. 39.93%, P = .011), oral contraceptives (17.33% vs. 34.77%, P < .0001), alcohol (26.67% vs. 52.15%, P < .0001) and lack of exercise (8.67% vs. 55.12%, P < .0001). Conclusion: Overall knowledge of breast and cervical cancer did not differ between both groups, despite varying levels of education and geographic setting. Women in the rural cohort demonstrated more awareness of several oncologic risk factors. Yet, the greater familiarity with and uptake of screening methods, especially for breast cancer, among women in the urban cohort may point to the benefits of proximity to health care infrastructure, such as tertiary care centers. This data supports a need for further implementation and distribution of cancer care services within cancer policies, to capitalize on increasingly sufficient levels of awareness among South African women.

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Letter to the Editor: Why do pregnant South African women drink alcohol? A call to action for more qualitative investigations

The International Journal of Alcohol and Drug Research ◽

10.7895/ijadr.v4i2.213 ◽

2015 ◽

Vol 4 (2) ◽

pp. 171-174

Author(s):

Olufunto A. Olusanya ◽

Adam E. Barry

Keyword(s):

Risk Factors ◽

South Africa ◽

Alcohol Consumption ◽

South African ◽

African Women ◽

Fetal Alcohol ◽

Call To Action ◽

Letter To The Editor ◽

Geographical Regions ◽

South African Women

Olusanya, O., & Barry, A. (2015). Letter to the Editor: Why do pregnant South African women drink alcohol? A call to action for more qualitative investigations. The International Journal Of Alcohol And Drug Research, 4(2), 171-174. doi:http://dx.doi.org/10.7895/ijadr.v4i2.213Even though the adverse effects of alcohol consumption during pregnancy have been well documented, millions of babies each year continue to be affected by fetal alcohol spectrum disorders (FASD). This is concerning given that FASD is completely preventable. FASDs have been documented across a variety of races and geographical regions worldwide, yet the highest known prevalence rates are recorded in Africa. Specifically, for every 1000 children born in the Western Cape Province of South Africa, approximately 59.3 to 91.0 are determined to have fetal alcohol syndrome, the most severe form of FASD. While the risk factors contributing to FASDs have been examined quantitatively among South African women, there is a dearth of qualitative investigations that articulate and contextualize the underling motivations, beliefs, and attitudes that influence these risk factors. Qualitative investigations have been conducted in other geographic regions (e.g., Australia), but are not generalizable to South Africa. Qualitative investigations, which explore the familial, social, cultural, and economic factors that influence maternal drinking, are needed to inform future health promotion programs and interventions aimed at decreasing and ultimately eliminating maternal alcohol consumption among South African women.

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Ranking lifestyle risk factors for cervical cancer among Black women: A case-control study from Johannesburg, South Africa

PLoS ONE ◽

10.1371/journal.pone.0260319 ◽

2021 ◽

Vol 16 (12) ◽

pp. e0260319

Author(s):

Mwiza Gideon Singini ◽

Freddy Sitas ◽

Debbie Bradshaw ◽

Wenlong Carl Chen ◽

Melitah Motlhale ◽

...

Keyword(s):

Risk Factors ◽

Cervical Cancer ◽

Black Women ◽

South African ◽

Case Control Study ◽

Rank Order ◽

Case Control ◽

African Women ◽

South African Women ◽

Control Study

Background Aside from human papillomavirus (HPV), the role of other risk factors in cervical cancer such as age, education, parity, sexual partners, smoking and human immunodeficiency virus (HIV) have been described but never ranked in order of priority. We evaluated the contribution of several known lifestyle co-risk factors for cervical cancer among black South African women. Methods We used participant data from the Johannesburg Cancer Study, a case-control study of women recruited mainly at Charlotte Maxeke Johannesburg Academic Hospital between 1995 and 2016. A total of 3,450 women in the study had invasive cervical cancers, 95% of which were squamous cell carcinoma. Controls were 5,709 women with cancers unrelated to exposures of interest. Unconditional logistic regression models were used to calculate adjusted odds ratios (ORadj) and 95% confidence intervals (CI). We ranked these risk factors by their population attributable fractions (PAF), which take the local prevalence of exposure among the cases and risk into account. Results Cervical cancer in decreasing order of priority was associated with (1) being HIV positive (ORadj = 2.83, 95% CI = 2.53–3.14, PAF = 17.6%), (2) lower educational attainment (ORadj = 1.60, 95% CI = 1.44–1.77, PAF = 16.2%), (3) higher parity (3+ children vs 2–1 children (ORadj = 1.25, 95% CI = 1.07–1.46, PAF = 12.6%), (4) hormonal contraceptive use (ORadj = 1.48, 95% CI = 1.24–1.77, PAF = 8.9%), (5) heavy alcohol consumption (ORadj = 1.44, 95% CI = 1.15–1.81, PAF = 5.6%), (6) current smoking (ORadj = 1.64, 95% CI = 1.41–1.91, PAF = 5.1%), and (7) rural residence (ORadj = 1.60, 95% CI = 1.44–1.77, PAF = 4.4%). Conclunsion This rank order of risks could be used to target educational messaging and appropriate interventions for cervical cancer prevention in South African women.

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THE SINS OF THE FATHER: GENDER- BASED VIOLENCE IN POST-APARTHEID SOUTH AFRICA

Commonwealth Youth and Development ◽

10.25159/1727-7140/1798 ◽

2017 ◽

Vol 14 (2) ◽

pp. 57-70 ◽

Cited By ~ 1

Author(s):

Lyn Snodgrass

Keyword(s):

South Africa ◽

Black Women ◽

South African ◽

African Women ◽

Gender Based Violence ◽

Political Issues ◽

Race And Gender ◽

Gender Based ◽

And Gender ◽

South African Women

This article explores the complexities of gender-based violence in post-apartheid South Africa and interrogates the socio-political issues at the intersection of class, ‘race’ and gender, which impact South African women. Gender equality is up against a powerful enemy in societies with strong patriarchal traditions such as South Africa, where women of all ‘races’ and cultures have been oppressed, exploited and kept in positions of subservience for generations. In South Africa, where sexism and racism intersect, black women as a group have suffered the major brunt of this discrimination and are at the receiving end of extreme violence. South Africa’s gender-based violence is fuelled historically by the ideologies of apartheid (racism) and patriarchy (sexism), which are symbiotically premised on systemic humiliation that devalues and debases whole groups of people and renders them inferior. It is further argued that the current neo-patriarchal backlash in South Africa foments and sustains the subjugation of women and casts them as both victims and perpetuators of pervasive patriarchal values.

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Gendered Lending Practices: Enabling South African Women Entrepreneurs to Access Start-Up Capital

Journal of Enterprising Culture ◽

10.1142/s0218495814500137 ◽

2014 ◽

Vol 22 (03) ◽

pp. 313-330 ◽

Cited By ~ 8

Author(s):

Evelyn Derera ◽

Pepukayi Chitakunye ◽

Charles O'Neill ◽

Amandeep Tarkhar-Lail

Keyword(s):

South Africa ◽

South African ◽

Women Entrepreneurs ◽

Financial Institution ◽

African Women ◽

Future Research ◽

Snowball Sampling ◽

Start Up ◽

South African Women ◽

Depth Interviews

This study explores gendered lending and marketing practices of start-up capital to women entrepreneurs in South Africa. A multi-method research design, comprising of 6 in-depth interviews with experts, and a survey of 50 women entrepreneurs was adopted using convenience and snowball sampling techniques, respectively. The findings revealed that women entrepreneurs are experiencing gendered discriminatory practices embedded in lending practices used by financial institutions, thereby discouraging them to venture into non-traditional industries. Whilst financial providers may know their products well, many emerging women entrepreneurs in South Africa may find it difficult and costly to obtain information on the thousands of financial products available. Hence, women entrepreneurs resort to taking greater risks than necessary in order to get their businesses off the ground. Educating women on financial matters is extremely important if South Africa is to benefit fully from the untapped entrepreneurial talent that women possess. The study adds voice to the discriminatory lending practices faced by women entrepreneurs in developing countries. Future research could explore the feasibility of establishing a financial institution which caters specifically for the needs of women.

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Health system experiences of breast cancer survivors in urban South Africa

Women s Health ◽

10.1177/1745506520949419 ◽

2020 ◽

Vol 16 ◽

pp. 174550652094941

Author(s):

Madeleine Lambert ◽

Emily Mendenhall ◽

Andrew Wooyoung Kim ◽

Herbert Cubasch ◽

Maureen Joffe ◽

...

Keyword(s):

Breast Cancer ◽

South Africa ◽

Black Women ◽

Health System ◽

South African ◽

Breast Cancer Survivors ◽

Radiation Treatment ◽

African Women ◽

Total Mastectomy ◽

South African Women

Background: Breast cancer is the most common cancer globally and among South African women. Women from socioeconomically disadvantaged South African communities more often present later and receive total mastectomy compared to those from more affluent communities who have more breast conserving surgery (which is less invasive but requires mandatory radiation treatment post-operatively). Standard chemotherapy and total mastectomy treatments are known to cause traumatizing side effects and emotional suffering among South African women; moreover, many women face limited communication with physicians and psychological support. Objective: This article investigates the experiences of women seeking breast cancer treatment at the largest public hospital in South Africa. Methods We interviewed 50 Black women enrolled in the South African Breast Cancer Study to learn more about their health system experiences with detection, diagnosis, treatment, and follow-up care for breast cancer. Each interview was between 2–3 hours, addressing perceptions, experiences, and concerns associated with breast cancer and comorbidities such as HIV and hypertension. Results: We found most women feared diagnosis, in part, because of the experience of chemotherapy and physical mutilation related to mastectomy. The importance of social support from family, religion, and clinical staff was fundamental for women coping with their condition and adhering to treatment and medication. Conclusions: These findings exemplify how interventions might promote early detection of breast cancer and better adherence to treatment. Addressing community perceptions of breast cancer, patient needs and desires for treatment, structural barriers to intensive therapies, and the burden of invasive treatments are imperative next steps for delivering better breast cancer care in Soweto and other resource-constrained settings.

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