Barriers to Cervical Cancer Screening in Burkina Faso: Needs for Patient and Professional Education

Abstract

Background Cervical cancer is among the leading causes of cancer deaths for women in low-income African countries, such as Burkina Faso. Given that cervical cancer is a preventable disease through early detection and vaccination, this study aimed at understanding the barriers to cervical cancer early detection in Ouagadougou, the capital city of Burkina Faso. Women seeking screening and treatment for cervical cancer (n=351) during the period of May-August 2014, at the Yalgado Ouedraogo University Hospital were interviewed about their knowledge, attitudes, and practices toward cervical cancer. Interview questions elicited information about socio-demographic of participants, history of screening, knowledge of cervical cancer, and attitudes toward cervical screening. Scores were assigned to responses of questions and knowledge and tertites of distributions were used for comparison. A multivariate logistic regression was performed to predict cervical screening. Results Study participants were relatively young (37.5 ± 10.7 years), predominately resident of urban areas (83.8%), and over half had no or less than high school education. Over 90% of participants had heard about cervical cancer and about 55% of them had intermediate level knowledge of the disease, its screening, and/or risk factors. Knowledge level was lower among rural than urban residents. Predictors of screening included higher level of education (OR=2.2; 95% CI: 1.48–3.23), older age (OR=1.1; 95% CI: 1.06–1.12), higher socioeconomic standard (SES) (OR=1.5; 95% CI: 1–2.37), urban residence (OR= 2.0; 95% CI: 1.19–3.25), encouragement for screening by a healthcare worker (1.98; 95% CI: 1.06–3.69) and employment (OR=1.9; 95% CI: 1.13–3.11). Conclusion Low awareness and socioeconomic barriers lead to underutilization of screening services of women. Motivation and education by healthcare workers are important factors for increasing screening rates. Organized patient and professional education programs in gynecologic services are warranted for improving screening in Burkina Faso and other low-resources countries in Africa.

Determinants of precancerous cervical lesion among women screened for cervical cancer in south Ethiopia: A case-control study

“…Evidence from low and middle income countries has shown that low individual socio-economic status influences health outcomes through a lack of awareness about the health impact of lifestyle risk factors and reduced access to healthcare for financial reasons (27)(28)(29). Our study showed that women who reported monthly household income less than or equal to 66 USD were more likely to have a precancerous cervical lesion compared to those who reported an income of more than 66 USD.…”

Barriers to cervical cancer screening uptake among rural women in South West Nigeria: A qualitative study

“…Similar findings have been documented elsewhere. [9,12] Further barriers of significant concern are erroneous cultural beliefs that cervical cancer is not among the diseases that require orthodox medical intervention, and the high preference given to the use of herbs in the management of most diseases.…”

“…[3] Earlier studies attributed poor screening uptake to the presence of competing healthcare priorities, burdens of diseases other than cancers, and reduced public budgets resulting in failure to establish cervical cancer screening programmes. [9] In Nigeria, healthcare services have traditionally been based on curative interventions rather than preventive healthcare. War and civil strife have had consequences on the existing healthcare infrastructure.…”

Life-course socioeconomic status and breast and cervical cancer screening: analysis of the WHO's Study on Global Ageing and Adult Health (SAGE)

“…Although no formal definition for SES or life-course SES exists, education-based SES measures have emerged as stronger predictors of screening compared with employment-based measures. This suggests that factors related to literacy, awareness of the benefits of screening, low self-efficacy regarding cancer prevention and early detection options may be more important for health outcomes, including cancer screening,26 29 compared with income and financial factors 44. This is supported by our observation, as well as other studies showing a stronger influence of maternal education on cancer screening and daughter's adult health,43 45 that may be due to the fact that women may be strongly socialised and view their mothers as role models compared with their fathers.…”