RAND Corporation, 1776 Main Street, Santa Monica, CA, 90411, USA.
School of Public Health, Makerere University, Kampala, Uganda.
BMC Cancer. 2024 Aug 1;24(1):933. doi: 10.1186/s12885-024-12671-2.
Cervical cancer remains a significant but preventable threat to women's health throughout much of the developing world, including Uganda. Cervical cancer screening and timely treatment of pre-cancerous lesions is a cost-effective means of mitigating cervical cancer morbidity and mortality. However, only 5% of women in Uganda have ever been screened. Barriers to screening, such as social stigma and access to safe conditions, have been previously identified, but insights into the role of male spouses in encouraging or discouraging screening have been limited. To our knowledge, no studies have compared barriers and facilitators among women who had or had not yet been screened and male partners of screened and unscreened women.
To resolve this gap, we conducted 7 focus groups- 3 among women who had been screened, 3 among those who had not been screened, and 1 among men whose female partners had or had not been screened. We performed qualitative thematic analysis on the focus group data.
We identified several important factors impacting screening and the decision to screen among women, ranging from stigma, availability of screening, false beliefs around the procedure and side effects, and the role of spousal support in screening promotion. Male spousal perspectives for screening ranged from full support to hesitancy around male-performed exams and possible prolonged periods without intercourse.
This exploratory work demonstrates the importance of dialogue both among women and their male partners in enhancing screening uptake. Efforts to address screening uptake are necessary given that it is an important means of mitigating the burden of cervical cancer. Interventions along these lines need to take these barriers and facilitators into account in order to drive up demand for screening.
在包括乌干达在内的许多发展中国家，宫颈癌仍然是对女性健康的重大但可预防的威胁。对宫颈癌进行筛查以及及时治疗癌前病变是减轻宫颈癌发病率和死亡率的一种具有成本效益的手段。然而，乌干达只有 5%的女性接受过筛查。先前已经确定了筛查的障碍，如社会耻辱感和获得安全条件的机会，但对男性配偶在鼓励或劝阻筛查方面的作用的了解有限。据我们所知，没有研究比较过已经接受过筛查和尚未接受过筛查的女性以及接受过筛查和未接受过筛查的女性的男性伴侣之间的障碍和促进因素。
为了解决这一差距，我们进行了 7 个焦点小组的研究，其中 3 个是在已经接受过筛查的女性中进行的，3 个是在尚未接受过筛查的女性中进行的，1 个是在其女性伴侣已经接受过或尚未接受过筛查的男性中进行的。我们对焦点小组数据进行了定性主题分析。
我们确定了一些影响女性筛查和决定筛查的重要因素，包括耻辱感、筛查的可获得性、对程序和副作用的错误信念以及配偶支持在筛查推广中的作用。男性配偶对筛查的看法从全力支持到对男性进行检查和可能长时间没有性生活的犹豫不等。
这项探索性工作表明，在提高筛查率方面，女性及其男性伴侣之间进行对话非常重要。鉴于筛查是减轻宫颈癌负担的重要手段，因此有必要努力提高筛查率。为了提高对筛查的需求，此类干预措施需要考虑这些障碍和促进因素。
