Abstract C121: Cervical cancer knowledge and perceptions among women in Malawi: Qualitative data from a high-burden, low-resource setting

Abstract

Abstract Introduction: Coverage of routine cervical cancer screening in Malawi is very low, even though it has the highest cervical cancer burden in the world. We performed a multi-level assessment of Malawian women’s knowledge and perceptions of cervical cancer risk and screening, following recent scale-up of screening and treatment programs. Methods: Based on the Multi-Level Health Outcomes Framework, we conducted interviews with 60 adult Malawian women at facilities that offer cervical cancer screening; eligible participants were recruited regardless of HIV status or history of cervical cancer screening. Trained female researchers asked women about their experiences with and opinions of cervical cancer disease and screening. Interviews were audio recorded with permission, transcripts were translated from Chichewa (the local language) to English, and a theory-informed codebook was developed. Analysis focused on thematic differences across groups by age, HIV status and screening history. Results: Half of the sample (n=30) had either never been screened for cervical cancer or were at the facility for their first-ever screen. Most women said that cervical cancer is dangerous, and many knew someone affected. Many women spoke about the importance of screening for prevention of cancer. Risk factors were generally well-understood, including increased risk with HIV, although this was misunderstood by some HIV-negative women to mean they were not at risk. Gender issues were highly salient, relating to sexual transmissibility, husbands’ support of screening, and modesty if screened by a male clinician. Women had commonly heard rumors about the procedure being painful or dangerous. Conclusions: Despite high knowledge among Malawian women about cervical cancer disease and the importance of screening, there remain significant challenges. This study highlights the role of interpersonal and system-level barriers. Future work should work to strengthen service delivery, target social networks and spouses, and develop targeted language for HIV-positive and -negative groups especially in high-burden settings. Citation Format: Corrina Moucheraud, Paul Kawale, Savel Kafwafwa, Roshan Bastani, Risa M Hoffman. Cervical cancer knowledge and perceptions among women in Malawi: Qualitative data from a high-burden, low-resource setting [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C121.