Buchanan Lunsford Natasha, Ragan Kathleen, Lee Smith Judith, Saraiya Mona, Aketch Millicent
Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Oncologist. 2017 Feb;22(2):173-181. doi: 10.1634/theoncologist.2016-0213. Epub 2017 Feb 6.
Cervical cancer is the second most commonly diagnosed cancer in females and is a leading cause of cancer-related mortality in Kenya; limited cervical cancer screening services may be a factor. Few studies have examined men's and women's perceptions on environmental and psychosocial barriers and benefits related to screening.
In 2014, 60 women aged 25-49 years and 40 male partners participated in 10 focus groups (6 female and 4 male), in both rural and urban settings (Nairobi and Nyanza, Kenya), to explore perceptions about barriers to and benefits of cervical cancer screening. Focus groups were segmented by sex, language, geographic location, and screening status. Data were transcribed, translated into English, and analyzed by using qualitative software.
Participants identified screening as beneficial for initiating provider discussions about cancer but did not report it as a beneficial method for detecting precancers. Perceived screening barriers included access (transportation, cost), spousal approval, stigma, embarrassment during screening, concerns about speculum use causing infertility, fear of residual effects of test results, lack of knowledge, and religious or cultural beliefs. All participants reported concerns with having a male doctor perform screening tests; however, men uniquely reported the young age of a doctor as a barrier.
Identifying perceived barriers and benefits among people in low- and middle-income countries is important to successfully implementing emerging screening programs. The novel findings on barriers and benefits from this study can inform the development of targeted community outreach activities, communication strategies, and educational messages for patients, families, and providers. 2017;22: 173-181 This article provides important information for stakeholders in clinical practice and research when assessing knowledge, beliefs, and acceptability of cervical cancer screening and treatment services in low- and middle-resourced countries. Formative research findings provide information that could be used in the development of health interventions, community education messages, and materials. Additionally, this study illuminates the importance of understanding psychosocial barriers and facilitators to cervical cancer screening, community education, and reduction of stigma as important methods of improving prevention programs and increasing rates of screening among women.
宫颈癌是女性中第二大最常被诊断出的癌症，并且是肯尼亚癌症相关死亡的主要原因之一；宫颈癌筛查服务有限可能是一个因素。很少有研究考察男性和女性对与筛查相关的环境及社会心理障碍和益处的看法。
2014年，60名年龄在25至49岁的女性及其40名男性伴侣参与了10个焦点小组（6个女性组和4个男性组），地点包括农村和城市地区（肯尼亚内罗毕和尼扬扎），以探讨对宫颈癌筛查障碍和益处的看法。焦点小组按性别、语言、地理位置和筛查状况进行划分。数据被转录、翻译成英文，并使用定性软件进行分析。
参与者认为筛查有利于启动与医疗服务提供者关于癌症的讨论，但并未将其视为检测癌前病变的有效方法。察觉到的筛查障碍包括可及性（交通、费用）、配偶的同意、耻辱感、筛查期间的尴尬、担心使用窥器会导致不孕、对检测结果遗留影响的恐惧、知识缺乏以及宗教或文化信仰。所有参与者都表示担心由男医生进行筛查检测；然而，男性特别提到医生年龄小是一个障碍。
识别低收入和中等收入国家人群察觉到的障碍和益处对于成功实施新的筛查项目很重要。本研究关于障碍和益处的新发现可为针对患者、家庭和医疗服务提供者的社区外展活动、沟通策略及教育信息的制定提供参考。2017；22：173 - 181 本文为临床实践和研究中的利益相关者在评估资源匮乏国家宫颈癌筛查及治疗服务的知识、信念和可接受性时提供了重要信息。形成性研究结果提供了可用于制定健康干预措施、社区教育信息及材料的信息。此外，本研究阐明了理解社会心理障碍及促进因素对宫颈癌筛查、社区教育以及减少耻辱感的重要性，这些是改善预防项目及提高女性筛查率的重要方法。
