Experiences of cervical cancer survivors in Chitwan, Nepal: A qualitative study

Abstract

Introduction Cervical cancer is a global leading cause of morbidity and mortality. The majority of cervical cancer deaths occur in developing countries including Nepal. Though knowledge of cervical cancer is an important determinant of women’s participation in prevention and screening for cervical cancer, little is known about this topic in Nepal. This study explores the experiences of cervical cancer survivors and assesses the attitude of family and community towards it and stigma related to this disease in Bharatpur, Nepal. Methods The study design was qualitative methods involving two focus-group discussions. A total of 17 cervical cancer survivors, who have completed two years of cancer treatment were selected purposively from Chitwan. All qualitative data were transcribed and translated into English and were thematically analyzed. Results The majority of the participants had scant knowledge about cervical cancer, its causative agent, showed less cervical cancer screening, delayed healthcare-seeking behavior despite having persistent symptoms before the diagnosis. The main reasons identified for not uptaking the cervical screening methods were an embarrassment and having no symptoms at all. Most of them endured social stigma related to cervical cancer in the form of physical isolation and verbal abuse. Conclusions There is an urgent need for interventions to make women and the public aware of cervical cancer and launch effective health education campaigns, policies for cervical cancer prevention programs. This implementation can save the lives of hundreds of women and help them avoid going through all the negative experiences related to cervical cancer. More studies are required to gain the perspectives, knowledge, experiences, and attitudes of cervical cancer survivors to add to the research.

Knowledge, awareness, attitudes and screening practices towards breast and cervical cancer among women in Nepal: a scoping review

“…All studies were published between 2001 and 2021, and nearly half (45%) within the last 5 years. Twenty-seven (71%) studies focused on CC (Baral et al 2020;Bhatta et al 2020;Darj et al 2019;Ghimire and Pathak 2020;Andersen et al 2020;Gyenwali et al 2013;Johnson et al 2014;Joy et al 2011;Khadka et al 2017;Maharjan et al 2020;Pandey and Karmacharya 2017;Poudel and Sumi 2019;Rachana and Giri 2019;Ranabhat et al 2014;Ranjit et al 2016;Satyal 2013;Shakya et al 2016;Sherpa 2007;Sherpa et al 2020;Shrestha et al 2013;Shrestha 2014;Shrestha and Dhakal 2017;Shrestha et al 2020;Shrestha et al 2021a;Thapa 2018;Thapa et al 2018;). Ten studies (26%) concerned BC (Bhandari et al 2016;Bhandari et al 2021;Bhatt et al 2011;Braun and Itano 2011;Gupta et al 2015;Narasingrao et al 2013;Parajuli and Mandal 2010;Sathian et al 2014;Shrestha 2012;).…”

“…Most studies had a cross-sectional quantitative design; three studies were qualitative and used focus groups or indepth interviews (Darj et al 2019;Andersen et al 2020;Shrestha et al 2020). One case report (Braun and Itano 2011) and one conference abstract were included in the review.…”

“…The study with the highest percentage took place among 729 participants recruited for a community-based intervention study to improve cervical cancer screening uptake in Pokhara Metropolitan. Knowledge of signs and symptoms of CC varied widely among studies (Khadka et al 2017;Shakya et al 2016;Shah et al 2010;Shrestha 2014;Shrestha et al 2020;Shrestha et al 2021a;Thapa 2018;Thapa et al 2018). Although almost all women in the study by Shrestha et al (2021a) had heard about CC, only 26% were aware of symptoms and 6% knew that CC is an abnormal cell growth.…”

“…Shakya et al (2016) reported that in a group of 122 women aged 18 to 68 years, 96% mentioned one or more CC risk factors but 13% cited incorrect information. A qualitative study in 17 CC survivors showed that most were unaware of what causes CC, and some reported incorrect risk factors such as having fair skin or using homemade menstrual cloths (Shrestha et al 2020). Darj et al (2019) found that misconceptions about risk factors persisted even after participation in a CC awareness programme.…”

“…The most commonly reported reasons for not having CCS were lack of information about CC and screening and lack of symptoms or discomfort. Other reasons included illiteracy, lack of finance, shame or embarrassment, living in rural or low-income areas, concerns regarding side effects or that the procedure is painful, and fear that screening would result in positive results or a cancer diagnosis (Darj et al 2019;Maharjan et al 2020;Poudel and Sumi 2019;Ranjit et al 2016;Satyal 2013;Sherpa 2007;Sherpa et al 2020;Shrestha et al 2013;Shrestha 2014;Shrestha and Dhakal 2017;Shrestha et al 2020;Shrestha et al 2021a;Thapa 2018;Thapa et al 2018). Factors associated with higher uptake of CCS included older age, higher education, awareness about costs, knowledge of the availability of CCS services, urban residency, education programmes or a positive family history of cancer (Darj et al 2019;Ghimire and Pathak 2020;Ranabhat et al 2014;Thapa 2018;Thapa et al 2018).…”