Abstract
An important component of cancer control programs for the growing burden in sub-Saharan Africa is a population’s awareness of risk factors. Studies thereof have focused on single rather than multiple cancers and carcinogens. During March and April 2015, we undertook a survey to assess awareness of multiple cancer risk factors and symptoms in the Kilimanjaro Region, North Tanzania. General population (n = 620) and attendees at HIV care-and-treatment clinics (CTCs) were included (n = 207). Participants’ mean age was 43.8 (interquartile range 30–52) years; 58% were female. Awareness of cancer risk was highest for tobacco (90%) and alcoholic spirits (67%), but tended to be lower for infections (41% for HIV (42.2% and 41.4% for CTC and community group, respectively) and 16% for HPV (16.0% and 16.6% for CTC and community group, respectively)), while that of moldy maize and peanuts was 35% for both. Awareness of specific cancer signs and symptoms ranged between 70% and 90%. Awareness of alcohol and tobacco was higher in men than women (odds ratio = 1.82 (1.38, 2.40) and 3.96 (2.14, 7.31), respectively). In relation to cancer treatment, 70% preferred modern medicine and 10% preferred traditional medicine alone. Sixty percent was not aware of any local cancer early detection services. Only 20% had ever been examined for cancer, and of those screened, CTC group was 1.5 times more likely to screen than community participants. Awareness did not differ by age or HIV status. There are good levels of cancer risk factor awareness for certain lifestyle-related carcinogens in Tanzania; however, increased awareness is needed especially for infections and cancer warning symptom both in the general and HIV-positive population, as well as some myths to be dispelled.
Highlights
Sub-Saharan Africa (SSA) is experiencing an increasing burden of cancer
The population can avail of a free cancer early detection or diagnostic services at two major hospitals (Mawenzi and the Kilimanjaro Christian Medical Center (KCMC)) in the region’s capital town of Moshi
Prostaticspecific antigen (PSA) is available to symptomatic men presenting to the urology department
Summary
Sub-Saharan Africa (SSA) is experiencing an increasing burden of cancer. GLOBOCAN estimates that the risk of getting and dying of cancer in SSA before age 75 is 12.5% and 9.5%, respectively [1]. It is projected that between 2010 and 2030, this region will have a 77% increase in cancer deaths [2]. As cancer is relatively new in SSA’s disease profile, the full spectrum of cancer control measures needs strengthening—from prevention strategies to accelerated presentation, diagnosis, and treatment. Due to barriers throughout this process, as in many low- and middle-income countries, cancer is commonly diagnosed at very advanced disease stages in SSA which contributes to low survival rates [3,4,5].
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