Assessment of psychological barriers to cervical cancer screening among women in Kumasi, Ghana using a mixed methods approach

Abstract

Background: Cervical cancer is the leading cause of cancer death among women in Ghana, West Africa. The cervical cancer mortality rate in Ghana is more than three times the global cervical cancer mortality rate. Pap tests and visual inspection with acetic acid wash are widely available throughout Ghana, yet less that 3% of Ghanaian women get a cervical cancer screening at regular intervals. Objective: This exploratory study was to identify psychological barriers to cervical cancer screening among Ghanaian women with and without cancer using a mixed methods approach. Methods: Semi-structured interviews were conducted with 49 Ghanaian women with cancer and 171 Ghanaian women who did not have cancer. Results: The results of the quantitative analysis indicated that cancer patients where not more likely to have greater knowledge of cancer signs and symptoms than women without cancer. Analysis of the qualitative data revealed several psychological barriers to cervical cancer screening including, common myths about cervical cancer, misconceptions about cervical cancer screening, the lack of spousal support for screening, cultural taboos regarding the gender of healthcare providers, and the stigmatization of women with cervical cancer. Conclusion: The results of this study can be used to inform the development of culturally relevant cervical cancer education interventions aimed at addressing the psychological barriers to cervical cancer screening perceived by Ghanaian women.

Barriers to utilisation of cervical cancer screening in Sub Sahara Africa: a systematic review

“…In one study, participants believed that the procedure involved removal and re‐insertion of the uterus and that this is a very painful process (Williams et al . ). The fear of untoward effects of the procedure was another factor stated in this study, where some participants believed it can lead to infertility and that HIV can be contracted through the procedure.…”

“…Participants also cited the fear of being screened for HIV during the procedure as barrier to utilisation (Gatune & Nyamongo ; Williams et al . ).…”

“…After full article examination, only one study (Williams et al . ) met the inclusion criteria. The rest were excluded for reasons being, prevalence studies, cross‐sectional studies examining knowledge score and perceived susceptibility and risk, policy documents, and those that did not address barriers or facilitators.…”

A Cervical Cancer Screening Trainer for Use in Low-Resource Settings

“…29,30 In Ghana, where cervical cancer is the number one cause of cancer-related death for women, less than 5% of women have been screened. 31 There are limited organized efforts in Ghana to ensure that women are screened often and accurately for cervical cancer. 32 Following the completion of the design ethnography study, the development of a training model to support midwives and other healthcare providers as they learn to screen for cervical cancer was pursued.…”

Barriers to Pap-smear Testing From the Viewpoint of Postmenopausal Women in Kashan

“…These obstacles include lack of knowledge, religious beliefs, fatalism, fear, embarrassment and lack of trust in the interpreters (3). Common myths about cervical cancer are misconceptions about cervical cancer screening, lack of spousal support for screening, cultural taboos regarding gender of healthcare providers and stigmatization of women with cervical cancer (4). This study was conducted due to high incidence and mortality rates of cervical cancer and lack of published evidence on barriers of Pap smear testing in Kashanian postmenopausal women.…”