Improving cervical cancer continuum of care towards elimination in Ethiopia: a scoping review

Abstract

Introduction: Cervical cancer is the second-leading cause of death among all cancers in Ethiopia. Ethiopia plans to eliminate cervical cancer as a public health problem by 2030, following the World Health Organization's call for action. A scoping review was conducted on the status of the cervical cancer continuum towards elimination in Ethiopia. Methods: We searched articles in PubMed, Scopus and Google Scholar. All studies conducted on cervical cancer in Ethiopia, irrespective of date of publication, type of article, or language of publication were included. However, conference abstracts, commentaries, and letters to the editors were excluded. We used EndNote x9 software to merge articles from different databases and automatically remove duplicates. Screening of titles, abstracts, and full texts was performed by two co-authors independently. The cancer care continuum was employed as a framework to guide data synthesis and present the findings. Results: Of the 569 retrieved articles, 159 were included in the review. The found most of articles were about knowledge, attitude, and practice. There were few studies on health-seeking behaviour, perception and acceptability to cervical cancer services and availability and readiness of a screening programme. The review identified that there was inadequate knowledge, attitude and perception about cervical cancer. Screening for cervical cancer is not widely used in Ethiopia. Knowledge and attitude, education status, and income were repeatedly reported as precursors for cervical cancer screening. Most studies concluded a high prevalence of precancerous lesions and cervical cancer, as well as high mortality rates or short survival times. The review also identified that there is huge heterogeneity in findings under each component of the cancer care continuum across time and geographic settings. Conclusions: Overall, there is inadequate knowledge, perception, health seeking behaviour, screening and treatment services. This implies that the country is lagging behind the targets towards eliminating cervical cancer despite the availability of effective interventions and tools. We argue that an implementation research is needed to identify implementation issues, challenges and strategies to scale up both primary and secondary prevention services so that cervical cancer will not anymore be a public health problem.