\u201cCervical cancer screening: awareness is not enough\u201d. Understanding barriers to screening among women in West Cameroon\u2014a qualitative study using focus groups.

Alida Manoëla Datchoua Moukam,Bruno Kenfack,Jessica Sormani,Pierre Vassilakos,Patrick Petignat,Nicole C Schmidt,Muriel Samartha Embolo Owono

doi:10.1186/s12978-021-01186-9

Abstract

BackgroundCervical cancer is the second leading cause of cancer-related death among women in sub-Saharan countries, constituting a major public health concern. In Cameroon, cervical cancer ranks as the second most common type of cancer among women and the leading cause of cancer-related deaths, mainly due to the lack of prevention.ObjectivesOur first and main objective was to understand the barriers affecting women’s decision-making process regarding participation in a cervical cancer screening program in the Dschang district (West Cameroon). Second, we aimed to explore the acceptability and perception of a single-visit approach (screen and treat).MethodsA qualitative study using focus groups (FGs) was conducted from February to March 2020. Female participants aged between 30 and 49 years and their male partners were invited to participate. Thematic analysis was used, and barriers were classified according to the three-delay model of Thaddeus and Maine.ResultsIn total, six FGs with 43 participants (31 women and 12 men) were conducted. The most important barriers were lack of health literacy, low accessibility of the program (in respect to cost and distance), and disrespectful treatment by healthcare workers.ConclusionsOur study identified three needs: (1) enhancing health literacy; (2) improving the delivery of cervical cancer screening in rural areas; and (3) providing training for healthcare providers and community healthcare workers to improve patient-provider-communication.Trial registration Ethical Cantonal Board of Geneva, Switzerland (CCER, N°2017-0110 and CER-amendment n°3) and Cameroonian National Ethics Committee for Human Health Research (N°2018/07/1083/CE/CNERSH/SP). NCT: 03757299

Highlights

According to the World Health Organization (WHO), 604,127 cervical cancer (CC) cases were diagnosed worldwide, and 341,831 deaths were registered in 2020, most of them occurring in low- and middle-income countries (LMICs) [1]
Organized screening programs with high coverage rates have led to a significant reduction in the number of new cases and mortality rates in high income countries, the incidence and mortality rate of CC remains high in Cameroon, and in many LMICs [3, 4]
In total, six focus group (FG) with 43 participants (31 women and 12 men) were conducted in the three districts; four groups consisted of women only, while two groups consisted of men only

Summary

Introduction

According to the World Health Organization (WHO), 604,127 cervical cancer (CC) cases were diagnosed worldwide, and 341,831 deaths were registered in 2020, most of them occurring in low- and middle-income countries (LMICs) [1]. Organized screening programs with high coverage rates have led to a significant reduction in the number of new cases and mortality rates in high income countries, the incidence and mortality rate of CC remains high in Cameroon, and in many LMICs [3, 4]. In response to this situation, the WHO launched a global strategy to accelerate the elimination of CC in November 2020 during the 73rd World Health Assembly. In Cameroon, cervical cancer ranks as the second most common type of cancer among women and the leading cause of cancer-related deaths, mainly due to the lack of prevention

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Conclusion