Community-Engaged Approaches to Cervical Cancer Prevention and Control in Sub-Saharan Africa: A Scoping Review

Abstract

Background: Cervical cancer remains one of the top causes of cancer mortality among African women. Cervical cancer screening and early detection and treatment of precancer is one of the evidence-based interventions to reduce incidence and mortality. The application of community-based participatory research (CBPR) has been used in the United States to improve participation in screening and reduce cervical cancer disparities. However, it is unclear whether these engaged approaches have been used in sub-Saharan African to address disparities related to cervical cancer mortality.Objectives: Highlight community engagement in cervical cancer prevention and control in Sub-Saharan Africa (SSA), describe the community engagement efforts that are currently being used, and to describe the best practices for community engagement toward the end-goal of cervical cancer prevention and control.Methods: We searched PubMed, Embase, CINHAL, African Journals Online (AJOL), and African Index Medicus-WHO from inception until June 8, 2020. After screening 620 titles and abstracts, and reviewing 56 full-text articles according to inclusion and exclusion criteria, 9 articles met the selection criteria and were included. Relevant data variables were extracted from the included articles and a narrative synthesis was performed.Results: Between 2005 and 2019, 9 articles describing research in Ghana, Kenya, Zambia, Senegal, South Africa, and Nigeria were included. These articles described work that largely took place in rural settings predominantly among women age 15–65 years. Leveraging community networks such as community health workers, religious organizations, traditional leaders, and educational institutions increased awareness of cervical cancer. Working within existing social structures and training community members through the research effort were promising methods for addressing the disparities in cervical cancer incidence and mortality among communities.Discussion: The findings of this scoping review have contributed to the understanding of which novel approaches to community-based practices can be used to address cervical cancer disparities among SSA communities that carry a disproportionate disease burden. Community engagement in the research process, while effortful, has shown to be beneficial to researchers and to the communities that they serve, and provides valuable next steps in the effort to address cervical cancer disparities in SSA.

The lived experiences and caring needs of women diagnosed with cervical cancer: A qualitative study in Dar es Salaam, Tanzania

“…It was also revealed that the disruption imposed by cervical cancer on social and economic aspects of patients’ life was a source of constant stress, low self-esteem, and isolation [ 14 , 32 ]. This finding in the current study implies that healthcare providers should conduct a regular individualized assessment to explore patients’ social and financial needs to ascertain the extent of socio-economic disruptions for early and proper linkage to social support groups [ 33 ].…”

Brief Report: Prevalence and Predictors of Concern About Anal Cancer Among Sexual and Gender Minorites Living With HIV in Abuja, Nigeria

“…Fourteen were excluded because they did not report a history of anal sex with another male partner. Descriptive analyses found that 307 (38.4%) were aged $35 years, with a median (interquartile range [IQR]) age of 32 (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38) years, and 297 (27.1%) received HIV clinical care at TRUST. Of the 297, 200 (67.3%) were first diagnosed with HIV at TRUST.…”

“…22 Screening guidelines are under development and will eventually be forthcoming worldwide. Existing literature from SSA highlights disparities in accessing secondary prevention, such as colorectal 23,24 and cervical 25,26 cancer screening, and similar patterns may emerge for anal cancer. Thus, additional consideration of this area is timely to best ensure its future implementation and proper adherence.…”

Development and Adaptation of a Patient-Centered Communication Survey for Parents of Children With Cancer in Guatemala

“…Finally, our process emphasizes the importance of community-based participatory research, an approach that has been widely applied to studies across the cancer continuum, 40 including global settings. 41 Although the study team for this project included members of the local community with years of experience providing care to this population, a thorough approach to pilot testing revealed many unanticipated barriers to survey administration. All survey instruments, particularly those involving Likert scales, should be not only translated but also culturally adapted and carefully tested in research settings.…”