Breast and Cervical Cancer Screening and Associated Factors among Older Adult Women in South Africa

Abstract

Background: Little is known about the cancer screening prevalence and correlates in older adults from different racial backgrounds. In the context of heightened efforts for prevention and early diagnosis, we collected information on screening for two major types of cancers: cervical and breast cancer in order to establish their prevalence estimates and correlates among older South African women who participated in the Study of Global Ageing and Adults Health (SAGE) in 2008. Materials and Methods: We conducted a national population-based cross-sectional study with a multi-stage stratified cluster sample of 3,840 individuals aged 50 years or older in South Africa in 2008. In this analysis, we only considered the female subsample of (n=2202). The measures used included socio-demographic characteristics, health variables, anthropometric and blood pressure measurements. Multivariable regression analysis was performed to assess the association of socio-demographic factors, health variables and cancer screening. Results: Overall, regarding cervical cancer screening, 24.3% ever had a Papanicolaou (PAP) smear test, and regarding breast cancer screening, 15.5% ever had a mammography. In multivariate logistic regression analysis, younger age, higher education, being from the White or Coloured population group, urban residence, greater wealth, and suffering from two or more chronic conditions were associated with cervical cancer screening, and higher education, being from the White or Indian/Asian population group, greater wealth, having a health insurance, and suffering from two or more chronic condtions were associated with breast cancer screening. Conclusions: Cancer screening coverage remains low among elderly women in South Africa in spite of the national guideline recommendations for regular screening in order to reduce the risk of dying from these cancers if not detected early. There is a need to improve accessibility and affordability of early cervical and breast cancer screening for all women to ensure effective prevention and management of cervical and breast cancer.

Cervical cancer screening programs and guidelines in low‐ and middle‐income countries

“…In the year 2000, a national cervical screening policy was formulated in South Africa that allowed for three free cervical smear tests, conducted at 10‐year intervals from the age of 30 years [24,26]. Individuals who underwent screening for the first time aged 55 years or older will only receive one test if the first test result is normal [27]. This policy has been implemented in some areas; however, there is currently no population‐wide screening program in South Africa [24].…”

Socio-demographic characteristics and associated factors influencing cervical cancer screening among women attending in St. Paul’s Teaching and Referral Hospital, Ethiopia

“…Effective screening program reduces the incidence and mortality of cervical cancer as the disease is potentially preventable [15][16][17]. In developed countries, routine cervical cancer screening prevents up to 80% through early detection and management of pre-cancerous cervical lesions [18][19][20]. Whereas in developing countries, the proportion of pelvic examination was very low (< 1% in Ethiopia to 23% in South-Africa) [18].…”

Attitudes of South Asian Women to Breast Health and Breast Cancer Screening: Findings from a Community Based Sample in the United States

“…Yet, utilization of breast cancer screening services is poor in South Asian women living in Asia (Maqsood et al, 2009;Bhatt et al, 2011;Grosse Frie et al, 2013), the US (Islam et al, 2006;Glenn et al, 2009;Lee et al, 2010) as well as other western countries (Sutton et al, 2001;Szczepura et al, 2008;Price et al, 2010;Rajan et al, 2011;Peltzer and Phaswana-Mafuya, 2014). Across the various studies among South Asians, the mammography rates range from 30-56%.…”