Cervical cancer knowledge and screening uptake by marginalized population of women in inner-city Durban, South Africa: Insights into the need for increased health literacy

Abstract

Background: Cervical cancer in South Africa accounts for 15.85% of all female cancers and 30.29% of African female cancers, resulting in over 5000 deaths annually. South Africa’s proposed move towards universal healthcare places emphasis on health promotion through education and screening, but there is little data on the baseline levels of knowledge and screening uptake regarding cervical cancer. This study explored the levels of knowledge and screening rates of cervical cancer among vulnerable women living in the inner-city of Durban, South Africa. Methods: A mixed-method study was conducted within the context of a Women’s Health outreach initiative. Data were collected from women attending the outreach ( n = 109), many of whom were from marginalized communities. A pre-intervention survey was used to collect the data. This was followed by cervical cancer education sessions and the opportunity for a free Pap smear. Results: Knowledge of cervical cancer was low (<25%) and only a third of the women had previously been screened. After the educational sessions, 64% of women ( n = 70) took advantage of the opportunity for Pap smears, with many expressing the need for wider cervical cancer education, screening centres and support groups. Only 20% of the Pap smears were normal ( n = 14). Half of the women tested positive for infections ( n = 36; 51.4%), and a small proportion ( n = 8; 11.4%) tested positive for human papilloma virus. Abnormal cervical intra-epithelial neoplasia (CIN1 and CIN 2) were also detected in this population ( n = 12; 17.1%). Conclusion: Cervical cancer knowledge and screening among vulnerable women in Durban, South Africa, is inadequate, especially considering the high levels of abnormality found in the Pap smears. Education drives, accompanied with the provision of free testing, are required. Community health outreach initiatives in collaboration with non-government organizations set in accessible locations could be a possible course of action.

Knowledge and practice of cervical cancer screening and its associated factors among women attending maternal health services at public health institutions in Assosa Zone, Benishangul-Gumuz, Northwest Ethiopia, 2022: a cross-sectional study

“…The level of knowledge found in this study is comparable with the prevalence reported by the study done in Gondar University,Ethiopia (59.33%) 24. The present study’s finding is higher when compared with the studies done in Adama Town, Oromia, Gurage Zone in Southern Ethiopia, South Africa, and Tanzania City, which were 14.8%, 26.2%, 25% and 33%, respectively 11 14 20 21. The discrepancy might be due to the study period and the nature of the study participants.…”

“…8 9 In sub-Saharan Africa, the incidence and mortality rates of cervical cancer were 25.2% and 23.2%, respectively. 8 10 In South Africa, cervical cancer ranks as the second most frequent cancer among women and the first most frequent cancer, which accounts for 15.85% of all female cancers among women between 15 and 44 years of age 11 About 3.2% of women in the general population are estimated to harbour cervical infection at a given time, and 64.2% of invasive cervical cancers are attributed to HPVs. 12 In Tanzania, current estimates indicate that every year, 10 241 women are diagnosed with cervical cancer and 6525 die from the disease.…”

Cervical Cancer Screening Promotion in Eswatini: A Cross-Sectional Survey of Community Health Workers’ Perceived Barriers

“…Health education may alter beliefs and attitudes and empower women to make informed decisions and choices regarding screening (Saei Ghare Naz et al, 2018). Previous African research findings suggest that health education is viable for increasing cervical cancer screening uptake (Ducray et al, 2021;Téguété et al, 2021).…”

Knowledge and attitudes relating to cervical and breast cancer among women in Maseru, Lesotho

“… 22 It was observed that cervical cancer is mostly prevalent in regions with high HIV infection, such as SSA. 20 , 24 Cervical cancer was the most common cancer diagnosed in 2020 in Lesotho. 4 Key to the prevention of cervical cancer is the identification of the premalignant disease through cervical screen as well as vaccination against HPV.…”

“…4 Key to the prevention of cervical cancer is the identification of the premalignant disease through cervical screen as well as vaccination against HPV. 24 , 25 There is evidence of high acceptability of the HPV vaccine in SSA. 23 With the availability of screening and the HPV vaccine as well as generally slow progression of the disease, 22 cervical cancer is considered nearly completely preventable.…”