Misconceptions About Female Cancers Contributing to Late Presentation to Health Facilities in Ethiopia: A Qualitative Study

Abstract

Introduction Morbidity and mortality from female cancers is a major public health problem in low- and middle-income countries, including Ethiopia. More than three quarters of women visiting health facilities are diagnosed with late-stage cervical and breast cancer. Evidence reveals that misconception affects timely health seeking behavior which could have averted expensive treatment and poor survival. This study aimed to explore misconceptions about female cancers that may have contributed to late presentation of the problem to health facilities in Sidama region, Ethiopia. Methods A descriptive qualitative study was carried out in June 2021. Nine focus group discussions (six with women and three with men) and 14 key informants were conducted. Data were collected using interview guide until all information get saturated. Data were inductively coded and qualitative content analysis was applied. Results A total of 63 (24 men and 39 women) people participated in this study. Nearly all (12) key informant interviewees have awareness about cervical and breast cancer, yet reported that their community members clearly lack awareness and they are working to improve misconceptions regarding cervical and breast cancer. The focus group discussion participants (15 men and 36 women) reported lack of detailed information related to cervical and breast cancer. Women believe that cervical and breast cancer mainly resulted from poor hygiene, trauma, having multiple sexual partners, early marriage, breast exposure to heat, not breast feeding, birth complication, urinating in the sun, hereditary, devil’s intrusion and God’s punishment. Conclusion There were misconceptions among the community on what cervical and breast cancer mean, how they could happen, what the symptoms are, why and when to screen, when to seek health care and how to use modern treatment options. Therefore, we recommended the design of social and behavioral change strategies to address the misconceptions among different population groups.

Factors influencing the uptake and utilization of cervical cancer screening services among women attending public health centers in Addis Ababa, Ethiopia: mixed methods study

“…Our FGDs pointed to gaps in understanding the causes, risk factors, prevention mechanisms, screening, and treatment of cervical cancer though some of the respondents believed that screening identifies pre-cancer lesions and infections, and prevents death. Similar gaps were reported by various Ethiopian and Zimbabwean studies [ 20 – 23 ]. One of our FGD respondents had a wrong perception such as eating cabbage and papaya prevents cancer.…”

“…The FGD respondents reported that the major societal acts were discouraging screening, propagating that cancer is contagious and has no cure, and it is an act against God. Similar issues such as poor hygiene, the devil’s intrusion, God’s punishment, and belief in no cure for cervical cancer were reported by other Ethiopian studies [ 21 , 23 ]. Cultural issues such as “yebet tata”/ spiritual problems, traditional medicines treatment, and “holy water” were prevalent in the community.…”

“…One of our FGD respondents had a wrong perception such as eating cabbage and papaya prevents cancer. A study conducted in the Sidama region, south-central part of Ethiopia, revealed wrong perceptions such as poor hygiene, trauma, and urinating in the sun cause cervical cancer [ 23 ]. The modifying factors that affect women’s perceptions, knowledge, socioeconomic, and personality factors may influence the individual beliefs of women which in turn affect their behaviors and cues to action.…”

“…Furthermore, a study conducted in Addis Ababa reported an increase in cervical cancer screening uptake through the provision of one-on-one health education supported with printed educational materials [ 40 ]. To address the misconceptions about female cancers at the community level, an Ethiopian study put forward the importance of designing social and behavioral change strategies [ 23 ]. Most importantly, the recommendations of the WHO Cancer Resolution of 2017 must be implemented at the national level to reduce the cancer burden, avoid unnecessary suffering, and save as many lives as possible [ 1 ].…”