Role of gender in perspectives of discrimination, stigma, and attitudes relative to cervical cancer in rural Sénégal

Abstract

Cervical cancer is the leading cause of female cancer deaths in Sé né gal which is ranked 17 th in incidence globally, however, the screening rate there is very low. Nuanced gendered perceptions and health behaviors of both women and men play a significant role in women's health. Our study analyzed gender differences on perceptions of gender roles, discrimination, cancer attitudes, cancer stigma, and influences in healthcare decision making within our study population to inform ongoing cervical cancer prevention work in the rural region of Ké dougou, Sé né gal. We conducted a cross-sectional survey of 158 participants, 101 women and 57 men (ages 30-59) across nine non-probability-sampled communities from October 2018 through February 2019. Bivariate analysis was conducted to assess gender differences across all variables. We also conducted analyses to determine whether there were significant differences in beliefs and attitudes, by screening behavior and by education. We found significant gender differences regarding the perception of a woman's role (P < 0.001) and a man's role (P = 0.007) as well as in the everyday discrimination questions of "decreased respect by spouse" (P < 0.001). Regarding cancer stigma, among women, 18.00% disagreed and 10.00% strongly disagreed while among men, 3.6% disagreed and 1.8% strongly disagreed that "If I had cancer, I would want my family to know that I have it." When making decisions about one's healthcare, women are more likely than men to trust

Stigmatization towards cancer among university students in Malaysia

“…This result was supported by a previous study in England that investigated stigma with the same tools (16). Another study reported the same finding, which showed that people who had a family history of cancer had a positive attitude towards people with cancer (20,21). The consistency among these findings suggested that people will have a lower-level stigma if they have experience in dealing with people with cancer, specifically their family members, and thus they may be more knowledgeable and supportive toward cancer treatment.…”

Impact of stigma and stigma-focused interventions on screening and treatment outcomes in cancer patients

“…The prevalence of high cancer stigma in the studies reviewed range from 26.1% amongst a sample of patients with different types of cancer in Iran Shiri et al [ 64 ] to 35.5% amongst lung cancer patients in the USA [ 37 ]. The included articles showed that the stigma attached to cancer and cancer patients is expressed and experienced from different segments of the society, such as the general public [ 6 , 54 , 56 , 58 , 62 , 63 , 72 ], elites [ 50 ], media and advertising agencies [ 18 , 27 , 55 , 80 ], healthcare providers [ 28 , 34 ]), policy makers [ 49 ] and friends and family members [ 63 , 101].…”

“…Some authors attempted to make sense of the reasons behind stigma against cancer and those affected by cancer. Amongst the reasons adduced were: blame apportioning, disgust propensity, gender differences, having not experienced cancer or the behaviours that are thought to cause cancer and being a member of an ethnic minority [ 3 , 6 , 41 , 56 , 62 , 77 ]. The role of gender in cancer stigma is not consistent in literature.…”

“…The role of gender in cancer stigma is not consistent in literature. Whilst women were reported to be more likely than men to express stigmatic behaviours against people with cancer in a study [ 56 ], men were more probable culprits in others [ 62 , 77 ].…”

Behavior Change Communication: Family and Community Approaches

“…Nuanced gendered perceptions and health behaviors of both women and men play a significant role in women's ability to access the care they need. Men or older family members are often the decisionmakers for when and how women may gain access to healthcare (Ongtengco et al, 2020). In the context of early detection of cancer, before doing the IVA test, the wife usually requires permission from her husband.…”