scholarly journals Challenges of Communicating Cervical Cancer Screening Awareness and Uptake in Bungoma County, Kenya

Author(s):  
Faith Kisiangani ◽  
Regina Gachari ◽  
Leah Jerop Komen

There have been ongoing cervical cancer campaigns in Kenya, targeting cervical cancer awareness and the need to go for cervical cancer screening (National Cervical Cancer Prevention Program, 2012). However, data depicts that there is a low level of screening and uptake among the rural population (ICO Information Centre on HPV and Cancer, 2014). This study adopted a descriptive research design, taking on qualitative data methods of focus groups discussions and in depth interviews, with a purpose of finding out the communication challenges of cervical cancer screening awareness and uptake among rural women in Bungoma County, Kenya. The objectives of the study were to: find out the communication channels used during the campaigns; and to understand the challenges of communicating cervical cancer screening messages to rural women in Bungoma County. A total of 40 women were interviewed from the Mt. Elgon Constituency in Bungoman County. The data was analysed by using QSR-Nvivo. The findings of the research showed that the main communication channels of cervical cancer were media, health education, and road shows. The main communication challenges of cervical cancer screening and uptake were: lack of cervical cancer terminology; inadequate information on the communication channels; and fear among women. There were low levels of cervical cancer awareness and uptake among the participants. One of the recommendations was the need for educating media personalities and other key health informants on cervical cancer for increase in uptake of screening services.

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e3871 ◽  
Author(s):  
Hannah D. Rees ◽  
Alexandra R. Lombardo ◽  
Caroline G. Tangoren ◽  
Sara J. Meyers ◽  
Vishnu R. Muppala ◽  
...  

Background In Nicaragua, cervical cancer is the leading cause of cancer-related death for women ages 15–44, yet access to the HPV vaccine is limited to those with financial resources to pay for it. Cervical cytology is provided free of charge in public clinics; however, only 10% of women receive Pap smears at the nationally recommended frequency. Previous studies have not investigated how beliefs regarding cervical cancer screening may differ for urban and rural populations in Nicaragua. Furthermore, no investigation has assessed Nicaraguan women’s beliefs about a potential HPV immunization campaign. Given beliefs’ influence on health behavior, we investigated the structural, sociocultural, and knowledge-based factors influencing women’s beliefs regarding cervical cancer screening among urban and rural women in León, Nicaragua, and assessed acceptance of a potential HPV immunization program. Methods Our sequential explanatory mixed-methods study consisted of two phases: (1) a close-ended questionnaire, followed by (2) a qualitative, in-depth interview. Our quantitative sample contained 117 urban and 112 rural participants aged 18–49. We assessed beliefs regarding cervical cancer screening using a 22-item scale, with higher scores indicating screening-promoting beliefs in simple linear and multiple linear regressions. Twenty qualitative interviews, exploring the sociocultural dimensions of knowledge and attitudes indicated by our quantitative findings, were conducted with a sample of 13 urban and 7 rural women aged 19–46. Results The multiple linear regression indicates that greater knowledge of Pap smears, HPV, and cervical cancer is significantly associated with screening-promoting beliefs after adjusting for other relevant factors. There was no significant difference in screening knowledge and beliefs for urban and rural women. Four recurrent themes representing determinants of knowledge, beliefs, and attitudes regarding cervical cancer screening arose from interviews and built on quantitative findings: (1) women’s embarrassment due to the intimate nature of the Pap smear and male gender of exam provider discourages screening; (2) women believe Pap smears and cervical cancer are associated with sexual promiscuity, and this association stigmatizes women with the disease; (3) knowledge of cervical cancer prevention is limited to those who regularly attend health centers; and (4) women find screening inconvenient, believing understaffed clinics increase patient wait time, limit time patients spend with clinicians, and delay Pap results. A fifth theme indicates (5) participants’ acceptance of a potential HPV immunization program. Discussion Future interventions should focus on increasing access to information about cervical cancer prevention for women who do not regularly attend health centers. Furthermore, our results suggest that if funding were allocated to make the HPV vaccine accessible in Nicaragua, it would be well received.


2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 137s-137s
Author(s):  
C. Onwuka ◽  
C. Umezurike ◽  
C.-E. Hendricks ◽  
K. Eguzo

Background and context: Cervical cancer is the second most common cancer and a leading cause of mortality affecting Nigerian women. There is prevalent ignorance about the disease and reduced access to screening services in Nigeria due to a variety of reasons. Many religious leaders often view cancer as evil, thus perpetuating a culture of fear and denial. Religious events have been used to promote health awareness and access to preventive services in Nigeria, but not usually for cancer screening. A cancer survivor might use a religious event to provide a strong avenue for improving cancer awareness and access to screening. Aim: Report describes a successful collaborative integration of cervical cancer screening into a religious event led by a breast cancer survivor. Strategy/Tactics: The 2018 Annual Women's Gospel Forum at Susanna Homes was used by a cancer survivor to teach women about cervical cancer and early diagnosis. Information was circulated among the Church of Christ fellowship in southern Nigeria. Program/Policy process: A medical team (gynecologist and pathologist) provided free cancer screening to consenting women using Papanicolaou test VIA simultaneously, with Pap preceding VIA. All smears were handled according to standard protocol and the findings were classified using the Bethesda system for reporting Papanicolaou test. Participants were taught about cervical cancer, counseled on screening and follow-up care prior to consent. Data were analyzed using descriptive statistics. Outcomes: Seventy-nine women at the event consented to the screening. The average participant was aged 51 years, but 90.6% (58/64) were above 30 years. Most (92.4%; 73/79) women were negative for squamous intraepithelial lesions (SILs), and six women had a low grade squamous intraepithelial lesion (LSIL). The prevalence of abnormal cervical cytology in this outreach was 7.6% (6/79), and mostly affected women aged 61-60 years. Table 1 describes the Papanicolaou test results. The result of VIA was recorded as positive or negative. What was learned: Participants provided positive feedback regarding integrating cervical cancer screening into a religious event, as it improved access and addressed ignorance. Leadership by a cancer survivor helped demystify the disease and encouraged women to be screened. Having a pathologist on site improved slides quality and reporting turn-around time. Project shows that collaboration between clinicians and religious leaders can improve cancer prevention. More physicians should be trained to provide these services and collaborate with community/religious organizations to provide screening outside of the clinical setting.[Table: see text]


2018 ◽  
Vol 4 (Supplement 1) ◽  
pp. 13s-13s
Author(s):  
Mauricio Maza ◽  
Mario Melendez ◽  
Miriam Cremer ◽  
Rachel Masch ◽  
Todd Alonzo ◽  
...  

Abstract 29 Purpose In high-income countries, human papillomavirus (HPV) self-sampling has been demonstrated to increase adherence to cervical cancer prevention initiatives in underscreened women. El Salvador recently completed the Cervical Cancer Prevention in El Salvador (CAPE) program using a high-risk HPV test as the screening method. Although successful, 12% of targeted women did not attend their screening appointments. HPV self-sampling may offer the opportunity to reach these nonattending women. In the current study, we evaluated HPV self-sampling as a way to increase screening among CAPE nonattenders and to report factors that impact self-sampling acceptability in a low- to middle-income country. Methods Nonattending and underscreened women age 30 to 59 years from the Paracentral region of El Salvador were invited to participate (N = 2,019). Women were visited at home and offered self-sampling with an HPV test. Women who provided consent also received a series of questionnaires to collect demographic and test acceptability data. After tests were analyzed, women were provided with results during another home visit. HPV-positive women were asked to make an appointment at a local clinic to undergo colposcopy, biopsy, and, if eligible, cryotherapy treatment. Women with contraindications for cryotherapy were referred to appropriate treatment or follow-up. Results Of 1,989 eligible women, 94% accepted the HPV self-sampled test. Of these, 11.8% (n = 221) tested positive. All but 13 women attended the colposcopy appointment, and 190 women received cryotherapy. Biopsy results revealed low-grade precancer in 6.3% of women, whereas 12.6% received diagnoses of high-grade precancer. Reasons for not attending the original CAPE appointment included logistic concerns, but also discomfort with male providers, confidentiality fears, and misconceptions regarding HPV, cervical cancer, and the screening procedure. Conclusion HPV self-sampling was shown to be overwhelmingly acceptable to nonattending and underscreened rural women in El Salvador. This method may be a feasible alternative that circumvents barriers to cervical cancer screening in low- to middle-income countries. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors


2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Sunday Joseph Ayamolowo ◽  
Lydia Feyisayo Akinrinde ◽  
Monisola Omoyeni Oginni ◽  
Love Bukola Ayamolowo

The global incidence of cancer is rising, and low-income and lower-middle-income countries have the worst figures. However, knowledge of cervical cancer prevention and cervical cancer screening practices remains poor in these regions. This study assessed the concept of health literacy as a potential determinant of knowledge of cervical cancer prevention and screening practices among female undergraduates. A descriptive cross-sectional study was conducted among 385 female undergraduates at a university in southwest Nigeria. A validated questionnaire composed of subscales on nine components of health literacy, knowledge of cervical cancer prevention, and cervical cancer screening practices was used for data collection. The majority of the respondents obtained a high score on most of the components of health literacy and 66% had good knowledge of cervical cancer prevention. Only 11% demonstrated good practices of Pap smear testing. Of all the components of health literacy, “feeling understood and supported by healthcare providers” (OR = 0.075; 95% CI [0.036–0.115]; p = 0.015) and “understanding health information well enough to know what to do” (OR = 0.055; 95% CI [0.006–0.104]; p = 0.029) were significantly associated with knowledge of cervical cancer prevention. Out of the major challenges related to cervical cancer screening among undergraduates, the feeling of being at risk (OR = 4.71; p < 0.05) and uncomfortable experiences from past screening (OR = 0.12; p < 0.05) were significantly associated with going for cervical cancer screening. The study concluded that levels of health literacy influenced knowledge of cervical cancer prevention among female undergraduates, but it did not affect their engagement in cervical cancer screening practices.


2018 ◽  
Vol 139 (4) ◽  
pp. 199-205 ◽  
Author(s):  
K Boom ◽  
M Lopez ◽  
M Daheri ◽  
R Gowen ◽  
A Milbourne ◽  
...  

Background:The Rio Grande Valley (RGV) and Laredo regions located along the Texas–Mexico border consist of seven counties with a population of approximately 1.5 million people and a high uninsured rate (33.5%). Cervical cancer mortality in these border counties is approximately 30% higher than the rest of Texas. The RGV and Laredo areas were studied to better understand the state of access to cervical cancer prevention services along the Texas–Mexico border.Methods:Data on the population served and the services provided were analyzed to determine the gap between cervical cancer screenings recommended versus those received. Through interviews, we gathered the perspectives of 16 local stakeholders regarding cervical cancer screening for underserved individuals in the region.Findings:It is estimated that 69,139 uninsured women aged 21–64 years in the RGV/Laredo per year are recommended to undergo cervical cancer screening with Papanicolaou (Pap) and/or human papillomavirus (HPV) testing, but only 8941 (12.9%) Pap tests are being performed by the Federally Qualified Health Center (FQHC) serving uninsured women in these regions. Systemic barriers identified include insufficient provider clinical capacity, the high cost of healthcare, and uncertainty about government funding sources. Patient barriers identified include inadequate knowledge on navigating the local healthcare system, low health literacy, lack of money and childcare, an inability to miss work, limited transportation, and fear of deportation.Conclusion:Decreasing the disparity between cervical cancer screening services provided and those recommended requires addressing the barriers, identified by local experts, which prevent uninsured women from accessing care. These challenges are being addressed through ongoing programs and collaborations.


2017 ◽  
Vol 16 (2) ◽  
pp. 18-22 ◽  
Author(s):  
Andrea Obročníková ◽  
Ľudmila Majerníková

AbstractAim. Cervical cancer is the most common genital malignancy and one of the leading causes of death among female population in Slovakia. At present, this location of cancer is preventable disease visible in screening for premalignant lesions if the women use and participate in such screening regularly. We assessed the knowledge on the cervical cancer screening, the attitude towards it and its utilization among women in Slovakia.Material and methods. A cross-sectional study evaluated the knowledge, attitude and practice of cervical cancer prevention and screening among women. The sample was composed of 239 women aged 18-64 years. Data collection was conducted by selfadministered questionnaire in a period from January to April 2015.Results. Respondents exhibited an average knowledge of cervical cancer, about risk factors and early signs, but awareness of cervical cancer screening was satisfactory. Despite the fact that respondents expressed good attitude to cervical cancer screening, their level of practice was low (64% participation in preventative gynaecology check-ups and 43% in Pap smear tests within one year and 44% within three years). In the study we could observe better results in women with higher education when it comes to an illness (p < .001), its prevention (p < .001) and risk behaviour (p < .001).Conclusions. The awareness of cervical cancer among women in Slovakia is limited. In the future there is a need to educate and promote awareness of cervical cancer among women to reduce the burden of morbidity and mortality.


2020 ◽  
Author(s):  
Elisha Ngetich ◽  
Irene Nzisa ◽  
Alfred Osoti

AbstractIntroductionCervical cancer is the leading cause of cancer death in women in low- and middle-income countries. In Kenya, cervical cancer incidence and prevalence have been increasing and in 2018 alone, there were 3286 deaths from cervical cancer. Previously, studies on cervical cancer prevention strategies have focused on women above 30 years old. However, as the risk factors for cervical cancer are acquired as early as in the teen years, an understanding of the awareness, uptake and determinants of screening services among college female students will help inform prevention strategies. This study sought to determine the awareness, uptake, determinants and barriers to cervical cancer screening services among colleges students in Kenya.MethodsThis was a multicenter cross-sectional study conducted in eight universities spread all over Kenya. Participants were interviewed using a self-administered structured questionnaire on sociodemographics, reproductive history, awareness on cervical cancer including screening practices, and attitude towards cervical cancer prevention services. Descriptive statistics were summarized using means and standard deviation (SD) for parametric data and median and interquartile range (IQR) for non-parametric data. Univariable and multivariable logistic regression analyses were done to determine odds ratios of factors associated with uptake of cervical cancer screening services. P-value of <0.05 was considered statistically significant.ResultsBetween January 2017 and Sept 2017, we screened 800 and enrolled 600 female colleges students from eight universities in Kenya. In total, 549 of the 600 (92%) participants completed the questionnaire. The median age (IQR) was 21(20,22) years. Nearly two-thirds 338(62.7%) were sexually active, while 54(16%) had concurrent sexual partners. The main form of contraception was oral postcoital emergency pills 123(64.7%). Only 76(14.4%) had screened for cervical cancer, and the commonest approach was a Pap smear 47(61.8%). About one half 40(54.1%) did not like their experience due to pain, discomfort and bleeding. Four out of five participants (439, 80.7%) had poor knowledge on cervical cancer screening. On bivariate analysis, increased level of awareness (odds ratio [OR] 1.08 95% Confidence Interval [CI] 1.03,1.18, p = 0.004), knowledge of someone with cervical cancer(OR 0.43 CI 0.23,0.78 p=0.006) and a perception of self-risk (OR2.6 CI 1.38,4.98 p=0.003) were associated with increased odds of uptake of cervical cancer screening. In the multivariate analysis, high awareness was significantly associated with increased odds of cervical cancer screening (OR 1.12 CI 1.04, 1.20 p=0.002).ConclusionsFemale college students in Kenya had low levels of awareness on cervical cancer and had very low uptake of cervical cancer screening. However, high perception of self-risk and perceived benefit was associated with increased odds of cervical cancer screening.RecommendationsSince female colleges students are generally thought to be more knowledgeable and have better access to information compared to the general population, the low levels of knowledge and uptake of cervical cancer screening, calls for a rethink of strategies that focus on the younger population including those in primary, high school and universities. Such strategies include HPV vaccination and incorporation of cancer prevention in school curriculum.


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