Alemayehu Rahel, Stroetmann Clara Yolanda, Wondimagegnehu Abigiya, Rabe Friedemann, Addissie Adamu, Kantelhardt Eva Johanna, Gizaw Muluken
Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Global Health Working Group, Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
Oncologist. 2025 Jul 4;30(7). doi: 10.1093/oncolo/oyae305.
Even though it is preventable, cervical cancer contributes significantly to cancer-related mortality among Ethiopian women. Follow-up visits after treatment of precancerous lesions are essential to monitor lesion recurrence. In our previous study, we found a level of adherence to follow-up of 44.7%, but the reasons for low adherence have not been comprehensively explored within the Ethiopian context. This study aimed to identify these reasons by interviewing 167 women who had missed their follow-up appointments as well as 30 health professionals with experience in the field.
The study employed a mixed-methods approach: Quantitative data were collected through a telephone questionnaire conducted with 167 women who had a positive visual inspection with acetic acid (VIA) and had missed their follow-up appointments. Subsequently, in-depth interviews were conducted with 30 healthcare professionals, and an inductive content analysis was carried out.
In the patient interviews, the reasons given most often were "lack of information about the follow-up" (35; 21.1%), "forgetting the appointment" (30; 18.1%), and "not seeing the need for follow-up" (24; 14.5%). Healthcare professionals identified various reasons such as lack of knowledge, living in a remote area/changing living area, forgetfulness, fear, poor counseling, a shortage of trained healthcare providers to give counseling and follow-up, and reminder-related barriers.
Lack of knowledge, forgetfulness, poor health-seeking behavior, and a lack of reminders were identified as barriers contributing to the low uptake of rescreening. Further interventions should target these by creating community awareness, improving patient counseling, tracing patients in need of follow-up, and making reminder calls or using SMS.
尽管宫颈癌是可预防的，但它在埃塞俄比亚女性癌症相关死亡率中占很大比例。癌前病变治疗后的随访对于监测病变复发至关重要。在我们之前的研究中，我们发现随访依从率为44.7%，但在埃塞俄比亚的背景下，依从率低的原因尚未得到全面探究。本研究旨在通过采访167名错过随访预约的女性以及30名该领域有经验的卫生专业人员来确定这些原因。
本研究采用混合方法：通过电话问卷对167名醋酸肉眼观察法（VIA）检查呈阳性且错过随访预约的女性收集定量数据。随后，对30名医疗保健专业人员进行了深入访谈，并进行了归纳性内容分析。
在患者访谈中，最常给出的原因是“缺乏随访信息”（35人；21.1%）、“忘记预约”（30人；18.1%）和“认为无需随访”（24人；14.5%）。医疗保健专业人员指出了各种原因，如知识缺乏、居住在偏远地区/生活区域改变、健忘、恐惧、咨询不佳、缺乏提供咨询和随访的训练有素的医疗保健人员以及与提醒相关的障碍。
知识缺乏、健忘、不良的就医行为以及缺乏提醒被确定为导致二次筛查接受率低的障碍。进一步的干预措施应针对这些问题，通过提高社区意识、改善患者咨询、追踪需要随访的患者以及进行提醒电话或使用短信。
