Cervical cancer survival in <scp>sub‐Saharan</scp> Africa by age, stage at diagnosis and Human Development Index: A population‐based registry study

Muchengeti, Mazvita; Joko‐Fru, Walburga Yvonne; Miranda‐Filho, Adalberto; Egue, Marcel; Akele‐Akpo, Marie‐Thérèse; N’da, Guy; Assefa, Mathewos; Buziba, Nathan; Korir, Anne; Manraj, Shyam; Lorenzoni, Cesaltina; Carrilho, Carla; Hansen, Rasmus Hvass; Finesse, Anne; Somdyala, Nontuthuzelo; Wabinga, Henry; Chingonzoh, Tatenda; Borok, Margaret; Chokunonga, Eric; Liu, Biying; Singh, Elvira; Kantelhardt, Eva Johanna; Parkin, Donald Maxwell

doi:10.1002/ijc.33120

Cited by 76 publications

(77 citation statements)

References 26 publications

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“…Between 2008 and 2015, the 5-year breast cancer survival rate in SSA was 66% which is similar to the survival rates observed 60 years ago in HICs [5]. Current cervical cancer survival rates in SSA are almost half that seen in the UK (5-year ASRS in SSA 33% compared to 67% in UK) [6].…”

Section: Introductionsupporting

confidence: 70%

“…Most African countries do not have cervical or breast cancer screening programmes and the majority of cancers are diagnosed symptomatically and at an advanced stage [4]. In sub-Saharan Africa (SSA), 64% of breast and 66% cervical cancers are diagnosed at an advanced stage [5,6]. By comparison, fewer than a quarter of breast and cervical cancers (21% and 25%, respectively) are diagnosed at an advanced stage in the UK [7].…”

Section: Introductionmentioning

confidence: 99%

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Anticipated help seeking behaviour and barriers to seeking care for possible breast and cervical cancer symptoms in Uganda and South Africa

Moodley¹,

Constant²,

Mwaka³

et al. 2021

ecancer

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Objectives: Breast and cervical cancers are leading causes of cancer morbidity and mortality in sub-Saharan Africa. Most women present with advanced-stage disease and have poor outcomes. This study aimed to describe anticipated help-seeking behaviour for possible breast and cervical cancer symptoms, barriers to accessing health care and factors associated with less timely anticipated help-seeking in urban and rural settings in Uganda and South Africa (SA). Methods: We conducted a cross-sectional community-based survey between August and December 2018. Data were collected from one randomly selected woman per household using the African Women Awareness of CANcer breast and cervical cancer tool. Anticipated help-seeking behaviour was dichotomised into waiting <1week or ≥1 week to seek care. Multivariable analysis identified factors associated with anticipated help-seeking behaviour. Results: One thousand, seven hundred fifty-eight women participated (Uganda 873, SA 885, median age 34, interquartile ranges 26-47). Most would discuss symptoms with someone close to them (87.7% for breast, 83.0% for cervical symptoms). The majority anticipated seeking care from a health facility in <1 week: 86.1% and 88.0%, respectively, for breast and cervical symptoms. 38.7% of women expected to encounter at least 1 barrier when seeking care. Lack of money for transport or clinic costs was the most common barrier (24.6% of participants). For both cancers and in both countries, women who reported more barriers were significantly less likely to anticipate seeking timely care. In SA, rural location was also associated with longer anticipated time to seek care, adjusted prevalence ratio (aPR) 2.92, 95% confidence interval (CI) 1.48-5.76 and aPR 2.42, 95% CI 1.08-5.45 for breast and cervical cancer, respectively. Research

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Section: Introductionsupporting

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Anticipated help seeking behaviour and barriers to seeking care for possible breast and cervical cancer symptoms in Uganda and South Africa

Moodley¹,

Constant²,

Mwaka³

et al. 2021

ecancer

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show abstract

“…Southern Africa reports the highest age standardized incidence rate (ASR) of CC worldwide (43.1 per 100,000) [2]. In a recent 11-country study, survival from cancer of the cervix in sub Saharan Africa is poor-33% at five years post diagnosis [3]. In 2018, 21.7% of all cancer deaths in SSA women were attributed to cervix cancer, making it the most common cause of cancer death in the region [2].…”

Section: Introductionmentioning

confidence: 99%

Trends in cervical cancer incidence in sub-Saharan Africa

et al. 2020

Self Cite

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Background Cervical cancer is the second most common cancer and the leading cause of cancer death in women in sub-Saharan Africa (SSA). Methods Trends in the incidence of cervical cancer are examined for a period of 10–25 years in 10 population-based cancer registries across eight SSA countries (Gambia, Kenya, Malawi, Mauritius, Seychelles, South Africa, Uganda and Zimbabwe). A total of 21,990 cases of cervical cancer were included in the analyses. Results Incidence rates had increased in all registries for some or all of the periods studied, except for Mauritius with a constant annual 2.5% decline. Eastern Cape and Blantyre (Malawi) registries showed significant increases over time, with the most rapid being in Blantyre (7.9% annually). In Kampala (Uganda), a significant increase was noted (2.2%) until 2006, followed by a non-significant decline. In Eldoret, a decrease (1998–2002) was followed by a significant increase (9.5%) from 2002 to 2016. Conclusion Overall, cervical cancer incidence has been increasing in SSA. The current high-level advocacy to reduce the burden of cervical cancer in SSA needs to be translated into support for prevention (vaccination against human papillomavirus and population-wide screening), with careful monitoring of results through population-based registries.

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“…However, in Sub-Saharan Africa cervical cancer is still the second most common cause of cancer death among women [4,5]. In Sub-Saharan Africa, 65-85% of cervical cancer patients are diagnosed at advanced stage and have poor treatment outcomes [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Knowledge of cervical cancer risk factors and symptoms among women in a refugee settlement: a cross-sectional study in northern Uganda

et al. 2020

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Background There are limited data on awareness of cervical cancer risk factors and symptoms among refugee populations living in Uganda. In this study, we sought to determine the awareness and knowledge of cervical cancer risk factors and symptoms among women in Palabek refugee settlement, northern Uganda. Methods We conducted a cross-sectional study. 815 women (aged 18–60 years) were randomly selected using multistage sampling in Palabek refugee settlement. Data were collected using pre-tested, structured questionnaires. Logistic regression models were used to determine magnitudes of association between socio-demographic and health system factors, and knowledge on cervical cancer risk factors and symptoms. Results The majority of participants (53%, n = 433) were young (18–29 years), married (68%, n = 553), and did not have formal employment (93%, n = 759). Less than half (40%, n = 325) had heard of cervical cancer. Of those who had heard, most recognized multiple male sexual partners, early onset of sexual intercourse and HPV infections as risk factors for cervical cancer (93%, n = 295; 89%, n = 283; and 86%, n = 271 respectively). Median knowledge score for risk factor recognition = 7 (IQR: 3–9). Median knowledge score for symptoms recognition = 7 (IQR: 1–10). Half of women (50%, n = 409) correctly recognized 7 to 11 symptoms of cervical cancer, with vaginal bleeding between menstrual periods, pelvic pain, and vaginal bleeding during/after sexual intercourse recognized by 58, 52 and 54% respectively. Single women (OR = 0.59 (95%CI: 0.38–0.94), and women that lived farther than 1 kilo meter from nearest health facility in South Sudan (OR = 0.36–0.49 (95%CI: 0.26–0.84) were less likely to be knowledgeable of symptoms of cervical cancer. Conclusion A significant proportion of women in Palabek refugee settlement had not heard about cervical cancer. Refugee health services providers could increase awareness of cervical cancer risk factors and symptoms through health education in order to promote risk reduction behaviours and guide women during symptoms appraisal. Single women and those who lived more than one kilo metre from nearest health facility in home country could be a priority group for awareness intervention in the settlement.

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Cervical cancer survival in sub‐Saharan Africa by age, stage at diagnosis and Human Development Index: A population‐based registry study

Abstract: Cervical cancer is the leading cause of cancer death in African women. We sought to estimate population-based survival and evaluate excess hazards for mortality in African women with cervical cancer, examining the effects of country-level Human

Cited by 76 publications

References 26 publications

Anticipated help seeking behaviour and barriers to seeking care for possible breast and cervical cancer symptoms in Uganda and South Africa

Anticipated help seeking behaviour and barriers to seeking care for possible breast and cervical cancer symptoms in Uganda and South Africa

Trends in cervical cancer incidence in sub-Saharan Africa

Knowledge of cervical cancer risk factors and symptoms among women in a refugee settlement: a cross-sectional study in northern Uganda

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