Abstract
BackgroundCervical cancer is the most common cancer and the leading cause of cancer death among women in Tanzania. Knowledge of and willingness to receive a cervical cancer screening are important determinants of prevention. This study aimed to describe women’s awareness of cervical cancer and to explore the attitudes toward, acceptability of and barriers to cervical cancer screening (CCS) in Zanzibar.MethodsA cross-sectional study was conducted from March to June 2018 involving 1483 women from 10 districts in Zanzibar who responded to questionnaires concerning their general demo-graphic characteristics, screening willingness and awareness of cervical cancer. Chi-square tests, analysis of variance (ANOVA) and stepwise multiple regression were conducted using STATA 15.1 software.ResultsThe average total knowledge score (TKS) was 7.84 ± 5.32 on a 23-point scale. Educational level and family income were positively correlated with the TKS. Previous schistosomiasis history and family genetic disease history were strong predictors of screening willingness. Women were less likely to be screened freely if they had 7 or more deliveries and were unaware of any previous family tumor history. Age and educational level were negatively associated non-free screening willingness, while family income was positively associated; being divorced/widowed or single and being unaware of any previous family tumor history were predictors of screening reluctance, while previous disease history was a strong predictor of non-free screening willingness. Fear of screening and inconvenience were the primary concerns among the Zanzibari interviewees. Compared to the 20–49 age group, more women in the less than 20 and 50 or more age groups thought cervical cancer screening was not necessary. The highest rate of cognitive accuracy in regard to cervical cancer warning signs and risk factors was only 37.76%.ConclusionsThe findings revealed that knowledge of cervical cancer was poor. Educational level, family income and awareness of previous disease history were significant influencing factors of screening uptake. Specific awareness programs to increase knowledge of cervical cancer and screening willingness should be designed and implemented in the public without delay, especially for younger and elderly women.
Highlights
Cervical cancer is the most common cancer and the leading cause of cancer death among women in Tanzania
A recent study from the Kilimanjaro region of Tanzania reported that only 6% of women had ever been screened for cervical cancer, while the majority of women perceived that they were susceptible to cervical cancer and were willing to accept screening if it were made available [5]
One-third (34.66%) of the participants had a previous disease history, including schistosomiasis history, which accounted for 7.28% of all women in the sur-vey
Summary
Cervical cancer is the most common cancer and the leading cause of cancer death among women in Tanzania. This study aimed to describe women’s awareness of cervical cancer and to explore the attitudes toward, acceptability of and barriers to cervical cancer screening (CCS) in Zanzibar. The reported uptake of this screening service remains low, suggesting that there are barriers preventing women from being screened [4]. A recent study from the Kilimanjaro region of Tanzania reported that only 6% of women had ever been screened for cervical cancer, while the majority of women perceived that they were susceptible to cervical cancer and were willing to accept screening if it were made available [5].
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