A survey of knowledge and attitudes relating to cervical and breast cancer among women in Ethiopia

Abstract

BackgroundBreast cancer and cervical cancer are the two leading cancers among women in Ethiopia. This study investigated knowledge and attitudes related to these two types of cancer among women in 4 zones of Ethiopia. This is the first study employing a validated questionnaire to investigate knowledge and attitudes relating to breast and cervical cancer in Ethiopia.MethodsA community based cross-sectional study was conducted from September to November 2015 in the North Shewa zone (Amhara region), Gamo Gofa zone (Southern Nations, Nationalities and Peoples’ region) and zones 1 and 3 (Afar region) of Ethiopia. A total of 799 women aged 18 years and older participated in the survey. Multiple logistic regression analysis was used to investigate the association of possible predictors with breast and cervical cancer knowledge.ResultsA total of 799 women aged 18 years and older participated in the survey. Of the women interviewed, 63.0% had heard of breast cancer and 42.2% had heard of cervical cancer. Among those who had heard of breast cancer, 21.3% (107/503) had heard of breast cancer screening and 1.4% of women aged 40 years and older had undergone at least one breast screening examination. Fewer than half of the participants provided the correct response to questions related to risk factors for breast and cervical cancer. Among those who had heard of cervical cancer, 41.5% (140/337) had heard of cervical cancer screening and 3.3% had undergone at least one cervical cancer screening examination. Women with primary and higher levels of education were more likely to have heard of breast cancers (OR = 3.0; 95% CI: 2.1–4.2; p < 0.001) and cervical cancer (OR = 1.9; 95% CI: 1.4–2.6; p < 0.001). From the overall attitude score, the majority of the women were found to have negative attitudes towards breast cancer (67.4%) and cervical cancer (70.6%).ConclusionsThis study found that the overall knowledge of risk factors for breast cancer and cervical cancer among women was low. Lack of cancer awareness, and lack of education in general, are the most potent barriers to access and care, and should be addressed through multi-faceted strategies including peer-education, mass media and other community-based interventions.

Communicative challenges among physicians, patients, and family caregivers in cancer care: An exploratory qualitative study in Ethiopia

“…These attitudes are motivated by a strong wish not to upset family members, but also by a fear of social stigma and discrimination, as cancer is widely perceived as God's punishment [6,20,49]. However, the practice impedes communication and contributes to a delay in obtaining healthcare and a diagnosis, adding to other factors revealed in our data and highlighted in other studies, such as illiteracy, lack of cancer awareness, limited knowledge about cancer, high travel costs to Addis Ababa, and preferences for traditional medicine [14,17,19,50]. Due to unnecessary delays in diagnosis, many patients are diagnosed with an advanced disease that cannot be cured and can only be offered palliative treatment, which makes it additionally difficult for physicians to communicate the prognosis [14,25].…”

“…The study adds to previous research describing a strong relationship between family and patient, which plays a paramount role in oncology care in Ethiopia in terms of informing patients about cancer [17], disclosure of diagnosis, experiences of stigma and fatalism [18], and in relation to decision-making and delivering bad news [24,42]. In addition, the analysis of interviews and video-recordings both illustrate how family caregivers function as informal interpreters and advocates for patients in interactions with physicians not mentioned earlier in research about Ethiopian cancer care.…”

“…Cancer awareness and knowledge in Ethiopia is low, especially relating to cervical cancer [15], but also regarding breast cancer [16]. In addition, the lack of a national screening system and low access to relevant healthcare service reportedly contribute to inefficient testing and late diagnosis and treatment, which results in many women seeking help too late [14,[17][18][19]. There are also barriers that prevent many Ethiopians from seeking medical help such as a sense of hopelessness and anxiety [9], a fatalistic attitude [20], stigmatization and social isolation in relation to particular diagnoses (for instance, the etiology of cervical cancer is thought to be due to breaching social taboos or engaging in unacceptable behaviors [18]), ignoring early signs and symptoms [21], a lack of resources to cover treatment costs, and a tendency to turn to traditional healers in the first instance [14,22].…”

Knowledge, Attitudes and Breast Cancer Screening Practices among Market Women in Thika Town, Kiambu County, Kenya

“…Findings from the Kakamega study (23) revealed that the participants would not go for screening due to some of their friends having mastectomies after being ISSN 2250-3153 http://dx.doi.org/10.29322/IJSRP.9.05.2019.p8953 www.ijsrp.org found with breast cancer. Chaka et.al (28) also found that a third of the respondents in their Ethiopian study felt that breast cancer would threaten their relationships with their spouses and partners. Majority of respondents in this study hated the embarrassment associated with CBE.…”

<p>A Descriptive Cross-Sectional Study on Awareness and Belief of People About Cancer in Southern Ethiopia: Special Focus on Breast and Cervical Cancers</p>

“…The increased level of awareness about cancer by the study subjects is partly attributed to their educational status and easy access to MM. [31][32][33][34] An intensive review conducted by Schliemann et al and original findings therein revealed that educational level of people and access to the MM and small media has a direct impact on the level of awareness and knowledge of people about cancers. 35 This study showed limited involvement and role of the frontline health care workers in fighting cancer.…”