Misconceptions About Female Cancers Contributing to Late Presentation to Health Facilities in Ethiopia: A Qualitative Study

Introduction Morbidity and mortality from female cancers is a major public health problem in low- and middle-income countries, including Ethiopia. More than three quarters of women visiting health facilities are diagnosed with late-stage cervical and breast cancer. Evidence reveals that misconception affects timely health seeking behavior which could have averted expensive treatment and poor survival. This study aimed to explore misconceptions about female cancers that may have contributed to late presentation of the problem to health facilities in Sidama region, Ethiopia. Methods A descriptive qualitative study was carried out in June 2021. Nine focus group discussions (six with women and three with men) and 14 key informants were conducted. Data were collected using interview guide until all information get saturated. Data were inductively coded and qualitative content analysis was applied. Results A total of 63 (24 men and 39 women) people participated in this study. Nearly all (12) key informant interviewees have awareness about cervical and breast cancer, yet reported that their community members clearly lack awareness and they are working to improve misconceptions regarding cervical and breast cancer. The focus group discussion participants (15 men and 36 women) reported lack of detailed information related to cervical and breast cancer. Women believe that cervical and breast cancer mainly resulted from poor hygiene, trauma, having multiple sexual partners, early marriage, breast exposure to heat, not breast feeding, birth complication, urinating in the sun, hereditary, devil’s intrusion and God’s punishment. Conclusion There were misconceptions among the community on what cervical and breast cancer mean, how they could happen, what the symptoms are, why and when to screen, when to seek health care and how to use modern treatment options. Therefore, we recommended the design of social and behavioral change strategies to address the misconceptions among different population groups.

[1]  Tilahun Teklehaymanot,et al.  Comparison of self-collected versus clinician collected cervicovaginal specimens for detection of high risk human papillomavirus among HIV infected women in Ethiopia , 2022, BMC Women's Health.

[2]  A. Jemal,et al.  Perspectives of patients, family members, and health care providers on late diagnosis of breast cancer in Ethiopia: A qualitative study , 2019, PloS one.

[3]  Amos Milanzi,et al.  Women’s knowledge, attitudes and practices (KAP) relating to breast and cervical cancers in rural Zimbabwe: a cross sectional study in Mudzi District, Mashonaland East Province , 2019, BMC Public Health.

[4]  A. Jemal,et al.  Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries , 2018, CA: a cancer journal for clinicians.

[5]  N. M. Shah,et al.  A qualitative study among breast cancer patients on chemotherapy: experiences and side-effects , 2018, Patient preference and adherence.

[6]  S. Rayne,et al.  A survey of knowledge and attitudes relating to cervical and breast cancer among women in Ethiopia , 2018, BMC Public Health.

[7]  N. Vyas,et al.  A qualitative study on experiences and needs of breast cancer survivors in Karnataka, India , 2017, Clinical Epidemiology and Global Health.

[8]  S. Y. Ayanto,et al.  Knowledge, attitude and practice for cervical cancer prevention and control among women of childbearing age in Hossana Town, Hadiya zone, Southern Ethiopia: Community-based cross-sectional study , 2017, PloS one.

[9]  Alan D. Lopez,et al.  Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015: A Systematic Analysis for the Global Burden of Disease Study , 2017, JAMA oncology.

[10]  C. Adebamowo,et al.  Qualitative study of barriers to cervical cancer screening among Nigerian women , 2016, BMJ Open.

[11]  Moya L. Alfonso,et al.  Cultural Beliefs and Understandings of Cervical Cancer Among Mexican Immigrant Women in Southeast Georgia , 2015, Journal of Immigrant and Minority Health.

[12]  P. Jolly,et al.  Factors Associated with the Uptake of Cervical Cancer Screening Among Women in Portland, Jamaica , 2015, North American journal of medical sciences.

[13]  A. Moore,et al.  Knowledge of Cervical Cancer Risk Factors Among Educated Women in Lomé, Togo , 2014 .

[14]  D. Money,et al.  Understanding the role of embarrassment in gynaecological screening: a qualitative study from the ASPIRE cervical cancer screening project in Uganda , 2014, BMJ Open.

[15]  R. Schwab,et al.  Reproductive risk factors and breast cancer subtypes: a review of the literature , 2014, Breast Cancer Research and Treatment.

[16]  F. Mazengia,et al.  Comprehensive knowledge about cervical cancer is low among women in Northwest Ethiopia , 2013, BMC Cancer.

[17]  A. Deribew,et al.  Health seeking behavior for cervical cancer in Ethiopia: a qualitative study , 2012, International Journal for Equity in Health.

[18]  John S. Luque,et al.  HPV AWARENESS AMONG LATINA IMMIGRANTS AND ANGLO‐AMERICAN WOMEN IN THE SOUTHERN UNITED STATES: CULTURAL MODELS OF CERVICAL CANCER RISK FACTORS AND BELIEFS , 2010 .

[19]  M. Plummer,et al.  Differences in the risk of cervical cancer and human papillomavirus infection by education level , 2009, British Journal of Cancer.

[20]  N. Al-Tawil,et al.  Antiperspirant use as a risk factor for breast cancer in Iraq. , 2006, Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit.

[21]  I. Nyamongo,et al.  An ethnographic study of cervical cancer among women in rural Kenya: is there a folk causal model? , 2004, International Journal of Gynecologic Cancer.

[22]  J. Peto,et al.  Human papillomavirus is a necessary cause of invasive cervical cancer worldwide , 1999, The Journal of pathology.

[23]  F. Fylan.  Screening for cervical cancer: a review of women's attitudes, knowledge, and behaviour. , 1998, The British journal of general practice : the journal of the Royal College of General Practitioners.

[24]  Esayas Kebede Gudina,et al.  Caring for Life-Limiting Illness in Ethiopia: A Mixed-Methods Assessment of Outpatient Palliative Care Needs. , 2018, Journal of palliative medicine.

[25]  K. Rampal,et al.  Understanding barriers to Malaysian women with breast cancer seeking help. , 2012, Asian Pacific journal of cancer prevention : APJCP.

[26]  John S. Luque,et al.  HPV AWARENESS AMONG LATINA IMMIGRANTS AND ANGLO AMERICAN WOMEN IN THE SOUTHERN U.S.: CULTURAL MODELS OF CERVICAL CANCER RISK FACTORS AND BELIEFS. , 2010, NAPA bulletin.

[27]  C. M. Ibekwe.  Factors influencing cervical cancer screening uptake among women attending Mahalapye district hospital in Botswana-use of the health belief model , 2009 .

[28]  P. Karnaki.  Attitudes, practices and knowledge regarding cervical cancer screening among Greek women in the area of Perth , 2000 .