Abstract 2582: Cervical cancer screening in rural East Africa
Authors: Cummings Autumn , Rooney Brianna , Chamberlain Robert , Soliman Amr , Kahesa Crispin 
Published: July 2016

Abstract
Purpose: Cervical cancer screening (CCS) programs in rural east African communities often go unused by a majority the women residing in these areas. Most HIV-positive and HIV-negative women don't go for cervical cancer screening despite referrals at Bagamoyo District Hospital (BDH), Tanzania. The focus of this study was to understand what the patient barriers are to attending cervical cancer screening clinics.
Methods: Questionnaires were distributed to 114 female patients over the age of 18 within the BDH's Care and Treatment Center (CTC). A small sample of 15 patients was also approached from within the reproductive health clinic (RHC). Participants were asked about their age, religion, parity, marital status, village of birth, village of residence, education, and number of previous screens, why they decided to go (or not go) to screening, and how they first heard of cervical cancer as well as cervical cancer screening. We also gathered data on the number of times each patient had been previously screened, the date of the most recent screen, as well as the referral date for the next screen. Using this information, we then attempted to match the individual's records with that of the CCS clinic's records.
Results: The average age of women varied significantly between HIV-Positive and HIV-Negative patients (43 and 31, respectively). HIV-Positive women significantly varied among their education status. Parity and age varied significantly when comparing the screened women to those never before screened. When comparing by screen history, 22% of HIV-positive women had never been screened and all 15 (100%) of HIV-negative women had never had prior screening. Of the reasons given as to why women had not attended prior screening HIV-positive women reported that 36 (31.58%) think they were at risk; 25 (21.93%) had no reason; 20 (17.54%) didn't know when to go; and 19 (16.67%) didn't know where to go. As for the HIV-negative women, 11 (73.33%) said they didn't know where to go; 4 (26.67%) reported they didn't know when to go; 6 (40%) didn't think they were at risk. When analyzing reasons for not attending screening by whether or not prior screening had occurred, we found that most of the women who had never been screened reported to not know when or where to go for screening (36%).
Conclusion: There are many potential explanations that play a role in the low cervical cancer screening attendance rates. There are issues surrounding education, accessibility, and funding. Due to the high prevalence of HIV in these areas, it is important to address these issues in order to minimize the impact of cervical cancer. We found lack of education and knowledge about the screening program at BDH was the main explanation for why women did not utilize the screening services.
Citation Format: Autumn Cummings, Brianna Rooney, Robert Chamberlain, Amr Soliman, Crispin Kahesa. Cervical cancer screening in rural East Africa. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 2582.