Abstract
BackgroundLack of awareness of risk factors and symptoms for cancer may lead to late diagnosis and poor prognosis.ObjectiveWe assessed community awareness about cervical cancer risk factors and symptoms and perceptions about prevention and cure of cervical cancer in order to contribute data to inform interventions to improve cervical cancer survival.DesignCross‐sectional population‐based survey.Setting and participantsWe conducted this study in Gulu, a post‐conflict district in Uganda in 2012. The sample included 448 persons aged 18 years and above, selected through a multi‐stage stratified cluster sampling process.Data collection methods and analysisWe collected data using a pretested structured questionnaire. Logistic regressions were used to determine magnitudes of associations between socio‐demographic and outcome variables.ResultsMost participants (444/448) had heard about cervical cancer. Known risk factors including multiple sexual partners, human papillomavirus infection, and early onset of sexual activity, were recognized by 88%, 82%, and 78% of respondents respectively. 63% of participants believed that prolonged use of family planning pills and injections caused cervical cancer. The majority of participants recognized symptoms of cervical cancer including inter‐menstrual bleeding (85%), post‐menopausal bleeding (84%), and offensive vaginal discharge (83%). 70% of participants believed that cervical cancer is preventable and 92% believed that it could be cured if diagnosed at an early stage.Discussion and conclusionsRecognition of cervical cancer risk factors and symptoms was high among study participants. Targeted interventions including increasing availability of HPV vaccination, population‐based cervical screening and diagnostic services can translate high awareness into actual benefits.
Highlights
Lack of awareness of risk factors and symptoms for cancer may lead to late diagnosis and poor prognosis
Known risk factors including multiple sexual partners, human papillomavirus infection, and early onset of sexual activity, were recognized by 88%, 82%, and 78% of respondents respectively. 63% of participants believed that prolonged use of family planning pills and injections caused cervical cancer
The majority of participants recognized symptoms of cervical cancer including intermenstrual bleeding (85%), post-menopausal bleeding (84%), and offensive vaginal discharge (83%). 70% of participants believed that cervical cancer is preventable and 92% believed that it could be cured if diagnosed at an early stage
Summary
Lack of awareness of risk factors and symptoms for cancer may lead to late diagnosis and poor prognosis. The reasons for the high incidence and mortality from cervical cancer in sub-Saharan Africa include lack of awareness of cervical cancer among the population, health-care providers and policymakers; limited access to high-quality health-care services and cervical screening programmes; and lack of functional referral systems. All these lead to advanced stage at diagnoses.[4] In developed countries, incidence and mortality from cervical cancer have been reduced through measures which include cytological screening and prompt treatment of early cervical lesions.[1,5] Introducing population-based cervical screening and increasing its uptake in the LMICs is an important goal in reducing cervical cancer mortality. Uptake of screening programmes may be assisted by raising awareness about cervical cancer risk factors including young age at first sexual intercourse,[6,7] multiple male sexual partners,[8] high parity,[9,10] infections with the human papillomavirus,[11,12] young age at first full-term pregnancy,[13] prolonged use of oral contraceptives[14,15,16] and HIV infections.[17,18] early help-seeking may be promoted if women in the LMICs become more aware of the symptoms of cervical cancer including intermenstrual vaginal bleeding, post-menopausal vaginal bleeding, post-coital vaginal bleeding, offensive vaginal discharge and lower abdominal pain.[19,20,21]
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