Cervical Cancer Attitudes and Beliefs—A Cape Town Community Responds on World Cancer Day

Abstract

Background Attitudes and beliefs affect women’s cervical cancer screening behavior. Methods We surveyed 228 women in Cape Town, South Africa about their screening history, knowledge, beliefs, and access barriers regarding Papanicolaou (Pap) smears and cervical cancer. Results More than half of the participants had never had a Pap smear or had 1 more than 10 years ago. One third did not know what a Pap smear was. Lengthy wait times and fatalistic beliefs also affected screening behavior. Ethnicity was associated with differences in beliefs. Conclusions Opportunistic cancer screening events are an effective way that women can obtain Pap smears and cancer education.

The influence of gender roles and traditional healing on cervical screening adherence amongst women in a Cape Town peri-urban settlement

“…6 Up to 80% of South Africa's population consult traditional healers prior to primary health care consultations, 7 as cervical cancer is often framed in terms of sociocultural beliefs rather than biomedically. 2 Allopathic health care, often fraught with economic, practical and other issues (Figure 1), is only sought out when traditional or home-based methods fail. 4,5 Traditional healers' explanations and treatments of medical complaints also tend to resonate more powerfully with individuals' belief systems.…”

“…3 This myriad of complications is often reflected in fatalistic attitudes and beliefs regarding cervical screening with consequent low adherence to treatment on receipt of an abnormal Pap smear result. 2,4 Few published studies have explored factors relating to cervical screening adherence amongst South African women. An urgent need to comprehensively determine screening barriers specific to currently disadvantaged South African women exists in order to end continued unnecessary suffering and death.…”

“…1 Despite its high prevalence, the slow growing nature of the cancer renders it almost entirely preventable if detected at an early stage. 2,3 An extreme disparity of annual mortality and new diagnoses exists between developed and developing countries (comprising 85% of global cases). 1 This dichotomy is caused by differences in the implementation of, and adherence to, cervical screening programmes, as well as other psychosocial factors such as poverty, HIV/AIDS, and gender inequality.…”

“…Black women are most likely to die of this disease. 2 Currently disadvantaged black South African women face a multitude of the known barriers to screening including, poor knowledge, low socio-economic status (SES), unemployment, poor health care accessibility, lack of health insurance, language barriers, and opposing cultural beliefs (Figure 1). 3 This myriad of complications is often reflected in fatalistic attitudes and beliefs regarding cervical screening with consequent low adherence to treatment on receipt of an abnormal Pap smear result.…”

Integrating cervical cancer prevention initiatives with HIV care in resource-constrained settings: A formative study in Durban, South Africa

“…This is particularly pronounced in the public sector, where SA's screening program has had difficulty securing routine and widespread implementation resulting in screening estimates as low as 1% (Cronje, 2005; van Schalkwyk, Maree, & Wright, 2008). Studies have documented varied challenges to participation in cervical cancer screening in SA, including psychological and sociocultural factors such as limited knowledge and stigma (Anorlu, 2008; Francis et al, 2011; Mosavel, Simon, Oakar, & Meyer, 2009; Wellensiek, Moodley, Moodley, & Nkwanyana, 2002), weak health infrastructure, and unsupportive medical staff (Harris et al, 2011). Additionally, financial constraints and lack of time are reported barriers to cervical cancer screening (Horo et al, 2012).…”