Acceptance Of Cervical Cancer Screening And Prevention Among The Rural Women
Acceptance Of Cervical Cancer Screening And Prevention Among The Rural Women
Abstract
This study was carried out to examine the acceptance of cervical cancer screening and prevention among the rural women in Amukpe town Delta State. The study was carried out to determine women level of awareness of cervical cancer screening and prevention in Amukpe Town, determine the level of rural women acceptance of cervical cancer screening and prevention in Amukpe Town, and identify the factors influencing cervical cancer screening and prevention acceptance among rural women in Amukpe Town. The survey design was adopted and the simple random sampling techniques were employed in this study. The population size comprised of women residents in Amukpe town Delta State. In determining the sample size, the researcher conveniently selected 147 respondents and 141 were validated. Self-constructed and validated questionnaire was used for data collection. The collected and validated questionnaires were analyzed using frequency tables, and mean scores. While the hypotheses was tested Chi-square statistical tool. The result of the findings reveals that the level of rural women acceptance of cervical cancer screening and prevention in Amukpe Town is low. Furthermore, the study revealed that the factors influencing cervical cancer screening and prevention acceptance among rural women in Amukpe Town includes: knowledge about cervical cancer, severity of the disease, cultural practices, and accessibility of healthcare facility. Therefore, it is recommended that the government should show greater commitment for cervical cancer control by expediting policy making process and increasing funding for cervical cancer control. To mention but a few.
Chapter One
Introduction
1.1 Background of the Study
Cervical cancer is one of the most common forms of carcinoma among women worldwide, accounting for about 12% of all cancer cases globally, and if diagnosed early, it can be treated (WHO 2002). Analysis of an indicator of disease burden which measures years of life lost (YLL), has shown that cervical cancer caused a loss of 2.4 million weighted YLL among women aged 25-65 years in developing countries as compared with 0.3 million YLL in the developed countries (Yang et al., 2004). Cancer of the cervix has significant morbidity and mortality when detected at an advanced stage (Swaddiwudhipong et al., 1999). Conversely, early identification of this disease can lead to a cure rate as high as 85% (Shanta, 2005).
The uptake of cervical cancer screening has remained very low in Nigeria while the mortality and morbidity associated with cervical cancer has remained high. The disease progresses over many years, with an estimated 1.4 million women worldwide living with cervical cancer, and up to 7 million world-wide may have precancerous (PATH 2000) conditions that need to be identified and treated. If not detected and treated early, cervical cancer is nearly always fatal. The disease, which affects the poorest and most vulnerable women, sends a ripple effect through families and communities that rely heavily on women’s roles as providers and caregivers. (Hyacinth 2013)
Nigeria is the most populous country in sub-Saharan Africa, with over 150 million inhabitants, a life expectancy at birth of 49.3 years in men and 50.8 years in women, child mortality rate of 57.3 and 56.5 per 1,000 in males and females respectively. The incidence rate of cervical cancer in Nigeria is 25/100,000 while the reported prevalence rates for Human Papilloma Virus (HPV) in the general population and HPV in women with cervical cancer 6 are 26.3% and 24.8% respectively. (Information, Education and Entertainment 2013) A study in Maiduguri, Northern Nigeria aimed at ascertaining frequency patterns of female genital tract malignancies analyzed surgical biopsy materials retrospectively over a ten year –period, Cancer of the cervix was the most prevalent with a proportion of 70.5% compared to 16.3% for ovarian and 8.5% for uterine cancer.
According to Kyari et al(2004)A rapid gradient rise was found for cases of cervical tumor in association with a decline in age at presentation for all the tumors. Also, a ten year study in Ilorin-Nigeria, reported that carcinoma of the cervix constituted 63.1% of histologically confirmed cases of gynecological cancers.
Three quarters of the cases were at an advanced stage. A similar review of histopathology reports on frequencies of malignant diseases of the female genital tract in Port-Harcourt also showed that cervical cancer accounts for 63.1% of gynecological (Nwosu & Ana (2014)cancers. Another study in Lagos, Nigeria reported that 71.8% of cervical cancer patients who reported at the clinic did so at an advanced stage of the disease. This was due to delay in referral by their health care providers and patients’ delay in seeking health care.
Cervical cancer can be prevented at the primary, secondary or tertiary stage [WHO 2016]. Secondary prevention by screening remains the most effective control strategy of cervical cancer [Sankaranarayanan et al 2001]. In developed countries, organised cytology-based screening programmes using Papanicolaou (Pap) smears with coverage of high-risk groups have resulted in a significant reduction of cervical cancer incidence and mortality [Shrestha et al 2013]. It has effectively reduced the incidence of cervical cancer by 75-90% in developed countries [WHO 2016], however, screening in developing countries remains underutilised [Shrestha 2013]. Cervical cancer screening coverage in SA is still at 20% nationally for women over the age of 30 years. This is much lower than the Department of Health´s goal of screening at least 70% of women nationally [Centers for Disease Control and Prevention 2014]. Lack of knowledge about cervical cancer screening has been highlighted as one of the major challenges affecting cervical cancer screening programmes (Liu 2017).
In a quest to increase cervical cancer screening uptake, i.e. the acceptance of cervical cancer screening,and preventionamong women in rural areas, this study aimed to assess the acceptance of cervical cancer screening and prevention among the rural women in Amokpe town.
1.2 Statement of the Problem
Cancer of the cervix is a major burden on women’s health worldwide (Ibekwe et al., 2011). It is ranked as the second most frequent cancer among women in Africa and the second most frequent cancer among women aged 15 to 44 (WHO/ICO,2010). Although cervical cancer is preventable, many women continue to die because of diagnosis at an advanced stage. Cervical cancer screening is a universally accepted early detection strategy that reduces the morbidity and mortality rates associated with the disease. The long transition period from a premalignant cervical lesion to cancer of the cervix affords possibilities for early detection and effective treatment. (Araoye 2004).
However, Successfully organized, population based cervical cancer screening programmes have not yet been implemented in most developing countries, despite the great burden of cervical cancer in these countries. This is largely related to poverty, lack of resources and infrastructure and marginalization of women. (Ibekwe et al., 2011). Due to a lack of an organized screening system in most developing countries for detecting precursor lesions, mortality rates from cervical cancer are used as a measure of its severity. When screening programmes are absent or ineffective, Lomalisa (2000), cervical cancer leads to death. Overall, the impact on women, their families, and the communities in developing countries is devastating. If early detection of precursor lesions by screening and treatment were made available, much suffering and many deaths could be prevented. (Lomalisa 2000). Women living in rural areas of Nigeria are generally known to be suffering from general deprivation including access to information resources, rural women most often fail to access various information resources and services even when such is available. A study within rural communities was important in order to reveal the acceptance of cervical cancer screening and prevention among the rural women in Amukpe townDelta State, Nigeria.
1.3 Objectives of the Study
The primary objective of this study is to examine the acceptance of cervical cancer screening and prevention among the rural women in Amukpe town Delta State, Nigeria. Other objectives of this study are:
- Determine women level of awareness of cervical cancer screening and prevention in Amukpe Town.
- Determine the level of rural women acceptance of cervical cancer screening and prevention in Amukpe Town.
- Identify the factors influencing cervical cancer screening and prevention acceptance among rural women in Amukpe Town.
1.4 Research Questions
The following questions have been prepared for the study.
- What is the women level of awareness of cervical cancer screening and prevention in Amukpe Town?
- What is the level of rural women acceptance of cervical cancer screening and prevention in Amukpe Town?
- What are the factors influencing cervical cancer screening and prevention acceptance among rural women in Amukpe Town?
1.5 Research Hypothesis
- Ho: The level of rural women acceptance of cervical cancer screening and prevention in Amukpe Town is high.
- Ha: The level of rural women acceptance of cervical cancer screening and prevention in Amukpe Town is low.
1.6 Significance of the Study
The information gathered will help policy makers to plan and implement necessary interventions that will enable women to have good knowledge of cervical cancer and provide access to cervical cancer screening services within the communities. Hence, this study was conducted in rural communities to determine the acceptance of cervical cancer screening and prevention among the rural women in Amokpe town. Finally, this study will serve as an existing material for future reference and further research.
1.7 Scope of the Study
This study will focus on the acceptance of cervical cancer screening and prevention among the rural women in Amukpe town. Hence, This study will only focus on Amukpe town Delta State, Nigeria.
1.8 Limitation of the Study
This study was constrained by a number of factors which are as follows:
- Just like any other research, ranging from unavailability of needed accurate materials on the topic under study, inability to get data
- Financial constraint , was faced by the researcher ,in getting relevant materials and in printing and collation of questionnaires
- Time factor: time factor pose another constraint since having to shuttle between writing of the research and also engaging in other academic work making it uneasy for the researcher.
1.9 Definition of Terms
Cervical Cancer:
A type of cancer that occurs in the cells of the cervix — the lower part of the uterus that connects to the vagina.
Cervical Screening:
For the purpose of this study refers to early detection of pre-cancerous lesions through a Papanicolaou (Pap) smear
1.10 Organization of the Study
This research work is organized in five chapters, for easy understanding, as follows.
- Chapter one is concern with the introduction, which consist of the (overview, of the study), historical background, statement of problem, objectives of the study, research hypotheses, significance of the study, scope and limitation of the study, definition of terms and historical background of the study.
- Chapter two highlights the theoretical framework on which the study is based, thus the review of related literature.
- Chapter three deals on the research design and methodology adopted in the study.
- Chapter four concentrate on the data collection and analysis and presentation of finding.
- Chapter five gives summary, conclusion, and recommendations made of the study.
Chapter Five
Summary, Conclusions and Recommendations:
5.1 Introduction
This chapter summarizes the findings on the acceptance of cervical cancer screening and prevention among the rural women in Amukpe town Delta State. The chapter consists of summary of the study, conclusions, and recommendations.
5.2 Summary of the Study
In this study, our focus was to examine the acceptance of cervical cancer screening and prevention among the rural women in Amukpe town Delta State. The study specifically was aimed to determine women level of awareness of cervical cancer screening and prevention in Amukpe Town, determine the level of rural women acceptance of cervical cancer screening and prevention in Amukpe Town, and identify the factors influencing cervical cancer screening and prevention acceptance among rural women in Amukpe Town.
The study adopted the survey research design and randomly enrolled participants in the study. A total of 141 responses were validated from the enrolled participants where all respondents are women residents in Amukpe town Delta State.
5.3 Conclusions
Based on the findings of this study, the researcher made the following conclusion.
- The women level of awareness of cervical cancer screening and prevention in Amukpe Town is low.
- The level of rural women acceptance of cervical cancer screening and prevention in Amukpe Town is low.
- The factors influencing cervical cancer screening and prevention acceptance among rural women in Amukpe Town includes: knowledge about cervical cancer, severity of the disease, cultural practices, and accessibility of healthcare facility.
5.4 Recommendation
Based on the findings the researcher recommends that;
- The government should show greater commitment for cervical cancer control by expediting policy making process and increasing funding for cervical cancer control.
- Stake holders for cervical cancer control including women, politicians, heads of medical institutions, MOH officers, NGOs, professional groups including Society for Gynecologists and Obstetricians of Nigeria (SOGON), Nigeria Cancer Society, Society of Oncology and Cancer Research in Nigeria should meet and decide on policy thrust.
- Health workers at the level of Health Centre II and above should be supported and trained on the cancer of the cervix and empowered to pass on knowledge to the populations they serve.
- Also, the National program on cervical cancer control should be integrated into the existing health system. Thus, it should be community or population based.
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