Cervical cancer screening in urban clinics in eThekwini municipal area

Abstract

Cancer of the cervix is a signifcant burden on women's health throughout the world despite it being a largely preventable disease. In South Africa, the launch of the National Guideline on Cervical Cancer Screening in 2000 aimed to reduce the incidence of cervical cancer in the country. The aim of this research is to review the status of cervical screening in clinics of eThekwini municipal area in Durban, KwaZulu-Natal, South Africa. A cross-sectional, descriptive study of clinics involving 22 nurses working in fxed clinics offering cervical screening in the eThekwini municipal area was carried out. Interviews were conducted with professional nurses from the clinics using a semi-structured questionnaire. Questions focused on the availability of resources to implement cervical screening, nurses' knowledge, attitudes and beliefs towards cervical screening. Interview data were verifed and complemented by direct observation of screening facilities. The equipment in the clinics was always adequate for taking cervical smears. No patient education material was available to promote cervical screening or provide information about cervical cancer. The median number of women screened was 20 per month in accordance with a quota system currently in place. When given a hypothetical cytology result to interpret, 27% of nurses identifed the correct management regimen; 64% recognised that they needed more training in the interpretation of cytology results. Most cervical screening in the clinics was done for diagnostic reasons rather than as population-based screening. Barriers to effective cervical screening included: insuffcient nursing staff, a quota system limiting the number of smears that could be taken and inadequate patient educational material on cervical cancer.