Religious Gathering as a Tool for Collaborative Cervical Cancer Prevention: Report From Nigeria

Abstract

Background and context: Cervical cancer is the second most common cancer and a leading cause of mortality affecting Nigerian women. There is prevalent ignorance about the disease and reduced access to screening services in Nigeria due to a variety of reasons. Many religious leaders often view cancer as evil, thus perpetuating a culture of fear and denial. Religious events have been used to promote health awareness and access to preventive services in Nigeria, but not usually for cancer screening. A cancer survivor might use a religious event to provide a strong avenue for improving cancer awareness and access to screening. Aim: Report describes a successful collaborative integration of cervical cancer screening into a religious event led by a breast cancer survivor. Strategy/Tactics: The 2018 Annual Women's Gospel Forum at Susanna Homes was used by a cancer survivor to teach women about cervical cancer and early diagnosis. Information was circulated among the Church of Christ fellowship in southern Nigeria. Program/Policy process: A medical team (gynecologist and pathologist) provided free cancer screening to consenting women using Papanicolaou test VIA simultaneously, with Pap preceding VIA. All smears were handled according to standard protocol and the findings were classified using the Bethesda system for reporting Papanicolaou test. Participants were taught about cervical cancer, counseled on screening and follow-up care prior to consent. Data were analyzed using descriptive statistics. Outcomes: Seventy-nine women at the event consented to the screening. The average participant was aged 51 years, but 90.6% (58/64) were above 30 years. Most (92.4%; 73/79) women were negative for squamous intraepithelial lesions (SILs), and six women had a low grade squamous intraepithelial lesion (LSIL). The prevalence of abnormal cervical cytology in this outreach was 7.6% (6/79), and mostly affected women aged 61-60 years. Table 1 describes the Papanicolaou test results. The result of VIA was recorded as positive or negative. What was learned: Participants provided positive feedback regarding integrating cervical cancer screening into a religious event, as it improved access and addressed ignorance. Leadership by a cancer survivor helped demystify the disease and encouraged women to be screened. Having a pathologist on site improved slides quality and reporting turn-around time. Project shows that collaboration between clinicians and religious leaders can improve cancer prevention. More physicians should be trained to provide these services and collaborate with community/religious organizations to provide screening outside of the clinical setting.[Table: see text]