Exploring knowledge, perceptions and health care seeking behaviours among women diagnosed with cervical cancer at Ocean Road Cancer Institute, Tanzania: Review Article

Shija H Matulanga; Belinda Balandya; Manase Kilonzi; Fadhlun Alwy Al-beity; Deodatus Kakoko

doi:10.58372/2835-6276.1396

Authors

Shija H Matulanga Temeke Regional Referral HospitAL
Belinda Balandya
Manase Kilonzi
Fadhlun Alwy Al-beity
Deodatus Kakoko

DOI:

https://doi.org/10.58372/2835-6276.1396

Keywords:

late stage cervical cancer, knowledge, perceptions, behaviours

Abstract

Background: Globally, cervical Cancer (CC) ranks the fourth most common cancer in women. In Tanzania, CC is the leading female malignancy, and a major cause of cancer related mortality and morbidity among women. Several initiatives have been used to improve awareness on the disease, nevertheless more than 80% of patients with CC are diagnosed at an advanced stage. This study aimed to explore knowledge, perception and barriers to health seeking behaviour among women diagnosed with CC at Ocean Road Cancer Institute (ORCI) in Tanzania.

Methodology: A hospital based qualitative study using in-depth interview (IDI)was conducted between November to December 2021 at the ORCI. A purposive selection of women diagnosed with late stage CC was made, and eleven IDI were conducted. The interviews were audio recorded and transcribed verbatim. Data analysis was done manually using a thematic approach.

Results: The results showed that participants had poor knowledge about CC disease, its causes, risk factors, preventive measures and treatment options. Women perceived and misinterpreted the CC symptoms as other non-serious urogenital conditions like fungus and urinary tract infection. In addition, financial challenges, long distances to health facilities and poor services at primary level facilities were the barriers to early diagnosis and appropriate care.

Conclusion: Participants demonstrated poor knowledge of the CC disease and at an early stage confuse the symptoms of CC with those of UTI. The study recommends intensive health promotion efforts and education on cervical cancer disease and the importance of regular screening.

References

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.

Arbyn M, Weiderpass E, Bruni L, de Sanjosé S, Saraiya M, Ferlay J, et al. Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. Lancet Glob Heal. 2020;8(2):e191–203.

Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65(2):87–108.

Bruni L, Albero G, Serrano B, Mena M, Gómez D, Muñoz J, et al. Human Papillomavirus and Related Diseases in the World- Summary report. ICO/IARC Inf Cent HPV Cancer (HPV Inf Centre) [Internet]. 2019;(June):307. Available from: https://hpvcentre.net/statistics/reports/XWX.pdf

T Kabalimu GKM, Muindi R. Social and Cultural factors affecting treatment seeking behaviour of Patients with Cancer of Cervix at Ocean Road Cancer Institute in Dar es Salaam, Tanzania. Huria J. 2018;25(2):54–63.

Castellsagué X. Natural history and epidemiology of HPV infection and cervical cancer. Gynecol Oncol. 2008;110(3 SUPPL.2):4–7.

Strategy G, Accelerate TO, Elimination THE, Cervical OF, As C, Health AP. Global strategy to accelerate the elimination of cervical cancer as a public health problem.

Test T, Follow-up T. WHO guidelines for screening and treatment of precancerous lesions for cervical cancer prevention.

Ali F, Kuelker R, Wassie B. Understanding cervical cancer in the context of developing countries. 2012;5(1).

Jedy-Agba E, Joko WY, Liu B, Buziba NG, Borok M, Korir A, et al. Trends in cervical cancer incidence in sub-Saharan Africa. Br J Cancer [Internet]. 2020;123(1):148–54. Available from: http://dx.doi.org/10.1038/s41416-020-0831-9

GLOBOCAN. Cervix uteri Source: Globocan 2020. Int Agent Res Cervic Uteri. 2020;419:1–10.

The United Republic of Tanzania Ministry of Health and Social Welfare. National Cancer Control Strategy (NCCS) 2013 - 2022. 2013 [Internet]. 2013;72. Available from: http://iccp-portal.org

WHO. WHO Cancer Report 2020 Global Profile. 2020 [Internet]. 2020;(2019):2019–20. Available from: www.paho.org

Republic U. United Republic of Tanzania. Popul Policy Compend. 1980;1–6.

Gesink MP, Chamberlain RM, Mwaiselage J, Kahesa C, Jackson K, Mueller W, et al. Quantifying the under-estimation of cervical Cancer in remote regions of Tanzania. BMC Cancer. 2020;20(1):1–8.

Williams P, Murchie P, Bond C. Patient and primary care delays in the diagnostic pathway of gynaecological cancers : 2019;(February):106–11.

Schalkwyk SL Van, Maree JE, Louise S, Maree JE. Cervical cancer: the route from signs and symptoms to treatment in South Africa. 2008;8080.

Harries J, Scott SE, Walter FM, Mwaka AD, Moodley J. Women’s appraisal, interpretation and help-seeking for possible symptoms of breast and cervical cancer in South Africa: a qualitative study. BMC Womens Health [Internet]. 2020;20(1):251. Available from: https://doi.org/10.1186/s12905-020-01120-4

Study AQ. Zambian Women ’ s Experiences and Understanding of Cervical Cancer A Qualitative Study. 2014;24(6):1065–71.

Mwaka AD, Okello ES, Kiguli J, Rutebemberwa E. Understanding cervical cancer : an exploration of lay perceptions , beliefs and knowledge about cervical cancer among the Acholi in northern Uganda. 2014;1–9.

Mlange R, Matovelo D, Rambau P, Kidenya B. Patient and disease characteristics associated with late tumour stage at presentation of cervical cancer in northwestern Tanzania. BMC Womens Health [Internet]. 2016;16(1):1–6. Available from: http://dx.doi.org/10.1186/s12905-016-0285-7

9118-12908-1-PB (1).pdf.

Mwaka AD, Okello ES, Wabinga H, Walter FM. Symptomatic presentation with cervical cancer in Uganda: A qualitative study assessing the pathways to diagnosis in a low-income country. BMC Womens Health. 2015;15(1):1–13.