Abstract
Introduction: In Zimbabwe, where cervical cancer is the leading female malignancy, no systematic cervical screening program has been introduced. However, selective or opportunistic screening has been performed since the late 1980s. The Ministry of Health and Child Care is relying on screening, which allows early detection of pre-cancerous cells and diagnosis at early stages but many women are not going for the test and no studies have been done to find out why. This study investigated the women’s perception about cervical cancer and its screening using health belief model (HBM) in Bulawayo, where they are two new screening clinics. Methods: We conducted an analytic cross-sectional study. Women from 18 years and above attending health facilities were included in the study. Interviewer administrated questionnaire was used to determine the proportion of screened women and elicit their perception about cervical cancer and its screening. Epi-info version 3.3.2 was used to do bivariate and multivariate analysis. Results: Two hundred women were recruited into the study. The proportion of women who had cervical cancer screening was 52 (26%). Pap smear only had 35 (17.5%) had VIAC only, 13 (6.5%) and Pap smear and VIAC had 4 (2%). Knowledge of cervical cancer and its screening was poor among participants. In multivariate analysis, awareness of cervical cancer screening [adjusted OR 42.05 (95% CI 5.63 - 314.04)] was associated with the uptake of cervical cancer screening and perceiving that having multiple sexual partners[adjusted OR 0.33 (95% CI 0.12 - 0.88)] was independently associated to the uptake of cervical cancer screening. Conclusion: This study demonstrated that lack of awareness of cervical cancer screening is a barrier to the uptake of the screening. Perceiving multiple sexual partners was associated to the uptake of cervical cancer screening. It is therefore necessary to increase awareness in Bulawayo City and educate the community about other risk factors.
Highlights
In Zimbabwe, where cervical cancer is the leading female malignancy, no systematic cervical screening program has been introduced
This study investigated the women’s perception about cervical cancer and its screening using health belief model (HBM) in Bulawayo, where they are two new screening clinics
This study demonstrated that lack of awareness of cervical cancer screening is a barrier to the uptake of the screening
Summary
In Zimbabwe, where cervical cancer is the leading female malignancy, no systematic cervical screening program has been introduced. Interviewer administrated questionnaire was used to determine the proportion of screened women and elicit their perception about cervical cancer and its screening. The proportion of women who had cervical cancer screening was 52 (26%). Awareness of cervical cancer screening [adjusted OR 42.05 (95% CI 5.63 - 314.04)] was associated with the uptake of cervical cancer screening and perceiving that having multiple sexual partners[adjusted OR 0.33 (95% CI 0.12 - 0.88)] was independently associated to the uptake of cervical cancer screening. The risk of developing these abnormal changes is associated with infection with human papillomavirus (HPV) [2]. Early sexual contact, multiple sexual partners, high parity and taking oral contraceptives (birth control pills) increase the risk of cervical cancer, because they increase exposure to HPV. Symptoms that may occur can include: abnormal vaginal bleeding between periods, after intercourse, or after menopause, continuous vaginal discharge, which may be pale, watery, pink, brown, bloody, or foul-smelling and periods become heavier and last longer than usual [4]
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