See the published version of this preprint at BMC Women's Health.
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Background:
In South Africa, breast cancer is the most commonly diagnosed cancer and cervical cancer the leading cause of cancer mortality. Most cancers are diagnosed at a late-stage and following symptomatic presentation. The overall purpose of the study was to inform interventions aimed at improving timely diagnosis of breast and cervical cancer.
Methods:
In-depth interviews were conducted with women with potential breast or cervical cancer symptoms from urban and rural South Africa. Participants were recruited from a community-based cross-sectional study on breast and cervical cancer awareness. Data were analysed using a thematic analysis approach.
Results:
Eighteen women were interviewed (10 urban, 8 rural): the median age was 34.5 years (range 22-58). Most were unemployed, and five were HIV positive. Themes included impact and attribution of bodily changes; influence of social networks and health messaging in help-seeking; management of symptoms and help-seeking barriers. Breast changes were often attributed to manual activities or possible cancer. Women were often unsure how to interpret vaginal symptoms, attributing them to HIV, hormonal contraceptives, or partner infidelity. Concerns about cancer were based on health information from the radio, social networks, or from primary care providers. Prompt care seeking was triggered by impact of symptoms on personal lives. Rural women, especially with possible symptoms of cervical cancer, experienced challenges during help-seeking including judgmental attitudes of clinic staff. Most participants were skeptical of traditional medicine.
Conclusions:
This is the first study exploring interpretation of possible breast and cervical cancer symptoms at a community level in South Africa. The process of interpreting bodily changes, symptom attribution and help-seeking is complex and influenced by women’s everyday life experiences. Timely diagnosis interventions should not only include cancer symptom awareness but also address individual, structural and health systems related barriers to care.
Keywords
breast cancer, cervical cancer, qualitative research methods, South Africa, symptom appraisal, help- seeking
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Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Women's Health.
Version 2
Posted 29 Oct, 2020
No community comments so far
Editorial decision: Accept
On 04 Nov, 2020
Review #2 received
Received 02 Nov, 2020
Review #1 received
Received 27 Oct, 2020
Reviewer #2 agreed
On 26 Oct, 2020
Reviewer #1 agreed
On 24 Oct, 2020
Editor assigned
On 23 Oct, 2020
Reviewers invited
Invitations sent on 23 Oct, 2020
Submission checks complete
On 22 Oct, 2020
Editor invited
On 22 Oct, 2020
No comments provided
Editorial decision: Major revision
On 10 Oct, 2020
Review #4 received
Received 16 Sep, 2020
Review #3 received
Received 16 Sep, 2020
Reviewer #6 agreed
On 09 Sep, 2020
Reviewer #5 agreed
On 06 Sep, 2020
Review #2 received
Received 22 Aug, 2020
Review #1 received
Received 22 Aug, 2020
Reviewer #4 agreed
On 21 Aug, 2020
Editor assigned
On 20 Aug, 2020
Reviewers invited
Invitations sent on 20 Aug, 2020
Reviewer #1 agreed
On 20 Aug, 2020
Reviewer #2 agreed
On 20 Aug, 2020
Reviewer #3 agreed
On 20 Aug, 2020
Submission checks complete
On 18 Aug, 2020
Editor invited
On 17 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
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A new preprint design is coming!
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See the published version of this preprint at BMC Women's Health.
This is a preprint, 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
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
View the published article at BMC Women's Health.
Version 2
Posted 29 Oct, 2020
No community comments so far
Editorial decision: Accept
On 04 Nov, 2020
Review #2 received
Received 02 Nov, 2020
Review #1 received
Received 27 Oct, 2020
Reviewer #2 agreed
On 26 Oct, 2020
Reviewer #1 agreed
On 24 Oct, 2020
Editor assigned
On 23 Oct, 2020
Reviewers invited
Invitations sent on 23 Oct, 2020
Submission checks complete
On 22 Oct, 2020
Editor invited
On 22 Oct, 2020
No comments provided
Editorial decision: Major revision
On 10 Oct, 2020
Review #4 received
Received 16 Sep, 2020
Review #3 received
Received 16 Sep, 2020
Reviewer #6 agreed
On 09 Sep, 2020
Reviewer #5 agreed
On 06 Sep, 2020
Review #2 received
Received 22 Aug, 2020
Review #1 received
Received 22 Aug, 2020
Reviewer #4 agreed
On 21 Aug, 2020
Editor assigned
On 20 Aug, 2020
Reviewers invited
Invitations sent on 20 Aug, 2020
Reviewer #1 agreed
On 20 Aug, 2020
Reviewer #2 agreed
On 20 Aug, 2020
Reviewer #3 agreed
On 20 Aug, 2020
Submission checks complete
On 18 Aug, 2020
Editor invited
On 17 Aug, 2020
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 article at BMC Women's Health.
Background:
In South Africa, breast cancer is the most commonly diagnosed cancer and cervical cancer the leading cause of cancer mortality. Most cancers are diagnosed at a late-stage and following symptomatic presentation. The overall purpose of the study was to inform interventions aimed at improving timely diagnosis of breast and cervical cancer.
Methods:
In-depth interviews were conducted with women with potential breast or cervical cancer symptoms from urban and rural South Africa. Participants were recruited from a community-based cross-sectional study on breast and cervical cancer awareness. Data were analysed using a thematic analysis approach.
Results:
Eighteen women were interviewed (10 urban, 8 rural): the median age was 34.5 years (range 22-58). Most were unemployed, and five were HIV positive. Themes included impact and attribution of bodily changes; influence of social networks and health messaging in help-seeking; management of symptoms and help-seeking barriers. Breast changes were often attributed to manual activities or possible cancer. Women were often unsure how to interpret vaginal symptoms, attributing them to HIV, hormonal contraceptives, or partner infidelity. Concerns about cancer were based on health information from the radio, social networks, or from primary care providers. Prompt care seeking was triggered by impact of symptoms on personal lives. Rural women, especially with possible symptoms of cervical cancer, experienced challenges during help-seeking including judgmental attitudes of clinic staff. Most participants were skeptical of traditional medicine.
Conclusions:
This is the first study exploring interpretation of possible breast and cervical cancer symptoms at a community level in South Africa. The process of interpreting bodily changes, symptom attribution and help-seeking is complex and influenced by women’s everyday life experiences. Timely diagnosis interventions should not only include cancer symptom awareness but also address individual, structural and health systems related barriers to care.
This is a list of supplementary files associated with this preprint. Click to download.
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