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Research article
Challenges and opportunities associated with cervical cancer screening programs in a low income, high HIV prevalence context
Adebola Alade Adedimeji
Albert Einstein College of Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8012-9124
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Women's Health.
Background Cervical cancer is a leading cause of death among Cameroon women. The burden of cervical cancer is in part traceable to the inadequate understanding of contextual determinants of access to expanding screening and prevention opportunities. We explored multilevel individual, community and structural factors that facilitate or inhibit cervical cancer prevention in women at risk in a high HIV prevalence context.
Methods We utilized an exploratory qualitative approach to obtain data through focus group discussions and in-depth interviews from May to August, 2018. A two-stage systematic sampling strategy was used to select 80 women and 20 men who participated in 8 focus group discussions and 8 in-depth interviews. The socio-ecological model guided data analyses to identify micro-, meso-, and macro-level determinants of cervical cancer screening.
Results Micro-level factors including lack of awareness and knowledge about cervical cancer, lack of access to information on and excessive costs for cervical cancer screening, low risk perceptions, and poor health seeking behaviors were major barriers for women seeking cervical cancer screening. Meso-level factors, such as social networks, socio-cultural norms, perceptions of the role of men and HIV-related stigma when screening is integrated into HIV care, also engender negative attitudes and behaviors. Macro-level barriers to cervical cancer screening included poorly equipped health facilities and a lack of national cancer prevention policies and programs.
Conclusion In the context of the call for elimination of cervical cancer as a public health problem, our findings highlight challenges and opportunities that should be considered when implementing interventions to increase uptake of cervical cancer screening in low-middle income settings.
Keywords
cervical cancer screening, human immunodeficiency virus (HIV), Cameroon, low-income, social determinants
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On 20 Dec, 2020
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Received 15 Dec, 2020
Reviewer #2 agreed
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Received 28 Nov, 2020
Reviewer #1 agreed
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Editor invited
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Editorial decision: Minor revision
On 08 Apr, 2020
Review #1 received
Received 16 Mar, 2020
Reviewer #1 agreed
On 01 Mar, 2020
Reviewers invited
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This preprint is under consideration at BMC Women's Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Challenges and opportunities associated with cervical cancer screening programs in a low income, high HIV prevalence context
Adebola Alade Adedimeji
Albert Einstein College of Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8012-9124
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 3
Posted 14 Jan, 2021
Published
On 18 Feb, 2021
No community comments so far
Editorial decision: Minor revision
On 21 Jan, 2021
Review #1 received
Received 18 Jan, 2021
Reviewers invited
Invitations sent on 10 Jan, 2021
Reviewer #1 agreed
On 10 Jan, 2021
Editor assigned
On 03 Jan, 2021
Submission checks complete
On 03 Jan, 2021
Editor invited
On 03 Jan, 2021
No comments provided
Editorial decision: Major revision
On 20 Dec, 2020
Review #2 received
Received 15 Dec, 2020
Reviewer #2 agreed
On 07 Dec, 2020
Review #1 received
Received 28 Nov, 2020
Reviewer #1 agreed
On 10 Nov, 2020
Reviewers invited
Invitations sent on 24 Apr, 2020
Editor assigned
On 16 Apr, 2020
Submission checks complete
On 15 Apr, 2020
Editor invited
On 15 Apr, 2020
No comments provided
Editorial decision: Minor revision
On 08 Apr, 2020
Review #1 received
Received 16 Mar, 2020
Reviewer #1 agreed
On 01 Mar, 2020
Reviewers invited
Invitations sent on 26 Jan, 2020
Editor assigned
On 09 Jan, 2020
Submission checks complete
On 09 Jan, 2020
Editor invited
On 09 Jan, 2020
First submitted
On 31 Dec, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Women's Health.
Background Cervical cancer is a leading cause of death among Cameroon women. The burden of cervical cancer is in part traceable to the inadequate understanding of contextual determinants of access to expanding screening and prevention opportunities. We explored multilevel individual, community and structural factors that facilitate or inhibit cervical cancer prevention in women at risk in a high HIV prevalence context.
Methods We utilized an exploratory qualitative approach to obtain data through focus group discussions and in-depth interviews from May to August, 2018. A two-stage systematic sampling strategy was used to select 80 women and 20 men who participated in 8 focus group discussions and 8 in-depth interviews. The socio-ecological model guided data analyses to identify micro-, meso-, and macro-level determinants of cervical cancer screening.
Results Micro-level factors including lack of awareness and knowledge about cervical cancer, lack of access to information on and excessive costs for cervical cancer screening, low risk perceptions, and poor health seeking behaviors were major barriers for women seeking cervical cancer screening. Meso-level factors, such as social networks, socio-cultural norms, perceptions of the role of men and HIV-related stigma when screening is integrated into HIV care, also engender negative attitudes and behaviors. Macro-level barriers to cervical cancer screening included poorly equipped health facilities and a lack of national cancer prevention policies and programs.
Conclusion In the context of the call for elimination of cervical cancer as a public health problem, our findings highlight challenges and opportunities that should be considered when implementing interventions to increase uptake of cervical cancer screening in low-middle income settings.