Walz Lucas, Mohamed Deqo, Haibah Adam, Harle Nikhil, Al-Ali Samir, Moussa Ayan Aden, Alawa Jude, Awale Mohamed Abdullahi, Khoshnood Kaveh
Yale School of Public Health, Yale University, New Haven, CT 06510, USA.
These authors contributed equally as first authors.
Ecancermedicalscience. 2022 Oct 7;16:1455. doi: 10.3332/ecancer.2022.1455. eCollection 2022.
Somali women face exceptionally high mortality and incidence rates from both breast cancer (BC) and cervical cancer (CC). They experience the highest age-standardised BC mortality rate in Africa and an age-standardised BC incidence rate of 41.7 per 100,000 women. Somalia's second-highest cancer-related mortality and incidence rates are due to CC, both behind BC. It is critical to identify the underlying factors that may influence healthcare workers' management of both cancers. At present, there is a lack of evidence regarding providers' knowledge of these two cancers and their screening in Somalia.
A cross-sectional questionnaire was administered with a purposive sampling strategy to 469 healthcare professionals and students and was completed by 405 (86%). Healthcare workers were recruited from Mogadishu-based hospitals.
One hundred and ninety-seven healthcare professionals and 207 students completed the survey and were included in the analysis. 89% and 73% of respondents demonstrated good knowledge of BC and CC, respectively. Only 46% knew that a vaccine could prevent CC, and 89% of healthcare professionals disagreed that human papillomavirus (HPV) vaccines were available to their patients. Attitudes towards cancer screening, in addition to breast self-examination (BSE), were overwhelmingly positive. For both BC and CC, 24% reported having treated a patient and 30% reported having conducted a screen for either disease.
Overall, while knowledge of both diseases and screening was good, there remain areas for clear educational targeting such as HPV vaccine availability and BC preventability. Attitudes to screening for both diseases were exceedingly positive but, with the exception of BSE, failed to translate into practice due to inadequate resources and patient refusal. Future investments into Somalia's chronic care management should prioritise technology necessary to conduct screenings for both diseases, expanding HPV vaccine access and understanding patients' potential motivations for refusing screening.
索马里妇女面临着极高的乳腺癌（BC）和宫颈癌（CC）死亡率与发病率。她们的年龄标准化乳腺癌死亡率在非洲最高，年龄标准化乳腺癌发病率为每10万名女性中有41.7例。索马里第二高的癌症相关死亡率和发病率归因于宫颈癌，仅次于乳腺癌。识别可能影响医护人员对这两种癌症管理的潜在因素至关重要。目前，关于索马里医护人员对这两种癌症及其筛查的知识缺乏证据。
采用目的抽样策略，对469名医护专业人员和学生进行了横断面问卷调查，405人（86%）完成了问卷。医护人员从摩加迪沙的医院招募。
197名医护专业人员和207名学生完成了调查并纳入分析。分别有89%和73%的受访者对乳腺癌和宫颈癌有良好的了解。只有46%的人知道有一种疫苗可以预防宫颈癌，89%的医护专业人员不同意他们的患者可以接种人乳头瘤病毒（HPV）疫苗。除乳房自我检查（BSE）外，对癌症筛查的态度总体上是积极的。对于乳腺癌和宫颈癌，分别有24%的人报告曾治疗过患者，30%的人报告曾对其中任何一种疾病进行过筛查。
总体而言，虽然对这两种疾病及其筛查的知识掌握良好，但仍有一些领域需要明确的教育目标，如HPV疫苗的可及性和乳腺癌的可预防性。对这两种疾病筛查的态度非常积极，但除了乳房自我检查外，由于资源不足和患者拒绝，未能转化为实际行动。未来对索马里慢性病管理的投资应优先考虑对这两种疾病进行筛查所需的技术，扩大HPV疫苗的可及性，并了解患者拒绝筛查的潜在动机。
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