Women's experiences with cervical cancer screening in a colposcopy referral clinic in Cape Town, South Africa: a qualitative analysis

Abstract

ObjectiveThe aim of this study was to explore and understand women's experience with cervical cancer screening and with the referral pathways for abnormal Papanicolau (Pap) smears.Design and settingFocus group discussions were conducted with first time colposcopy clinic attendees at a tertiary hospital colposcopy clinic in Cape Town, South Africa during November 2014. A thematic analysis was conducted to identify key themes. Initial coding categories were drawn from the interview guide.Participants27 women participated in 4 focus group discussions.ResultsParticipants mean age was 34 years, most did not complete secondary level education and were unemployed. Negative community opinions relating to Pap smears and colposcopy referral might deter women from seeking treatment. Having a gynaecological symptom was the most commonly cited reason for having a Pap smear. Fear of having a HIV test performed at the same time as Pap smear and low encouragement from peers, were factors identified as potential access barriers. Participants commented on insufficient or lack of information from primary providers on referral to the colposcopy clinic and concerns and apprehension during waiting periods between receiving results and the colposcopy appointment were discussed.ConclusionsThere is a strong and urgent need to improve current knowledge about cervical cancer and Pap smears and the necessity and benefits of timely access to screening programmes, results and treatment. Strategies such as community health education programmes and mass media interventions could be employed to disseminate cervical cancer information and address negative community perceptions. Better training and support mechanisms to equip healthcare providers with the skills to convey cervical cancer information to women are needed. The use of short message service (SMS) to deliver Pap smear results and provide patients with more information should be considered to improve waiting times for results and alleviate apprehension during waiting periods.

Exploring the feasibility of using mobile phones to improve the management of clients with cervical cancer precursor lesions

“…In developed regions, organized cervical screening programs supported by well-functioning recall systems have resulted in reduced cervical cancer incidence and mortality [7, 8]. However, in developing countries, cervical cancer remains a persistent concern due to ineffective or absent screening programs, lack of awareness, health system challenges and resource constraints [7, 9–11].…”

Exploring women's preferences for HPV‐based cervical cancer screening in South Africa

“…Only one‐third of all South African women undergo Papanicolaou smear testing at the recommended intervals; furthermore, approximately 50% of the smears taken are found to be of poor quality and so the test must often be repeated . Among women who require follow‐up visits, waiting times for specialist gynecology clinics can be as long as 6–9 months; consequently, there is a high level of attrition from care …”

Perceptions of Midwives on Pap Smear Tests during Pregnancy

“…Table 2 was drawn for quick judgement and decision of relating themes. The same process was followed by the independent coder and thus ensuring research results trustworthiness (Momberg et al, 2017). Comparing the researchers coding and that of independent coder lead to consensus.…”

“…An interview guide with central probing question was used to interview midwives for 30-45 minutes. Data saturation was reached at the 10th participants when no new information was obtained (Momberg et al, 2017). In the process, research trustworthiness was ensured through peer reviews where the data collection instrument was subjected to critique by two co-authors.…”