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

Abstract

15 Introduction 16 Cervical cancer is a global leading cause of morbidity and mortality. The majority of cervical 17 cancer deaths occur in developing countries including Nepal. Though knowledge of cervical 18 cancer is an important determinant of women's participation in prevention and screening for 19 cervical cancer, little is known about this topic in Nepal. This study explores the experiences of 20 cervical cancer survivors and assesses the attitude of family and community towards it and 21 stigma related to this disease in Bharatpur, Nepal.22 23 Methods 24The study design is qualitative methods involving two focus-group discussions. A total of 17 25 cervical cancer survivors were selected purposively from Chitwan. All qualitative data were 26 transcribed and translated into English and were thematically analyzed. 28 Results 29Majority of the participants had scant knowledge about cervical cancer, its causative agent, 30 showed less cervical cancer screening, delayed healthcare-seeking behavior despite having 31 persistent symptoms before the diagnosis. The main reasons identified for not uptaking the 32 cervical screening methods are an embarrassment and having no symptoms at all. Most of them 33 endured social stigma related to cervical cancer in the form of physical isolation and verbal 34 abuse. 35 36 Conclusions 3 37 There is an urgent need for interventions to make women and the public aware of cervical cancer 38 and launch effective health education campaigns, policies for cervical cancer prevention 39 programs. This implementation can save the lives of hundreds of women and help them avoid 40 going through all the negative experiences related to cervical cancer. More studies are required 41 to gain the perspectives, knowledge, experiences, and attitudes of cervical cancer survivors to 42 add to the research.43 44 45 46 4 47 48 Cervical cancer is the second most common cancer in females from low-to-middle-income 49 countries. Around 310,000 deaths occur annually due to cervical cancer [1]. Human 50 papillomavirus (HPV) infection is the major cause of cervical cancer. Although most cases of HPV 51 will resolve on their own, persistent infection with certain types of HPV (types 16 and 18) on the 52 cervix can lead to precancerous lesions that can progress to cervical cancer [2]. Nepal has a 53 population of 10.1 million women aged 15 years and older who are at higher risk of acquiring 54 cervical cancer. Cervical cancer is the most frequent cancer among women between 15-44 years 55 of age and it also ranks as 1 st most frequent cancer among women in Nepal. According to the latest 56 data around 1928 women die yearly out of a total of 2942 women who are diagnosed with cervical 57 cancer yearly in Nepal [3]. 58 Early detection of HPV infection through the utilization of Papanicolaou (Pap) testing has been 59 shown to decrease rates of cervical cancer. Because of restricted access to the health care facility 60 and limited knowledge about the preventive techniques for cervical malignancy, the greater part ...

Knowledge and practice for cervical cancer among female primary school teachers in Phnom Penh, Cambodia: A cross-sectional phone-based survey

“…In Asian countries including Cambodia, there is a strong hesitation to publically talk about sexual and reproductive health, and education regarding sexual and reproductive health can be difficult (10,(23)(24)(25). This may relate to the fact that the most common source of information on cervical cancer was family and friends.…”

“…On the other hand, it also suggests that correct knowledge does not necessarily lead directly to correct behavior. One of the barriers is that the concept and practice of prevention are not widely recognized in society, and people do not consider it necessary to visit health facilities unless they have serious symptoms (23,25,28). Some people do not want to be identified as having cervical cancer by screening for fear that having cervical cancer will lead to social stigma and interfere with their daily lives due to discrimination and prejudice in the community (23).…”

“…One of the barriers is that the concept and practice of prevention are not widely recognized in society, and people do not consider it necessary to visit health facilities unless they have serious symptoms (23,25,28). Some people do not want to be identified as having cervical cancer by screening for fear that having cervical cancer will lead to social stigma and interfere with their daily lives due to discrimination and prejudice in the community (23). Moreover, lack of access to treatment has a direct association between cervical cancer and death or giving up and is a factor that keeps people away from seeking health care (11,29,30).…”

The social and economic impacts of cervical cancer on women and children in low‐ and middle‐income countries: A systematic review

“…In all, 49 studies reported the impact of a woman's diagnosis of cervical cancer on social support 13–61 . Social support was most commonly reported through the European Organization for Research and Treatment of Cancer Core Quality of Life questionnaire (EORTC) tool using the categorization of social functioning ( n = 18) 17,19,23,26–28,30,33,34,44,45,48,51,55,57,59 .…”

“…For example, in South Africa, a woman reported that she continued to ask her partner for sex out of fear that he would have sex with another woman if she did not offer it 40 . However, it should be noted that several studies did report positive responses with regard to social support and their diagnosis of cervical cancer 15,24,40,41,52 . For example, a woman in Ghana reported that not only did her spouse help take care of her, but her children assisted with her care as well 15 …”