Mapping awareness of breast and cervical cancer risk factors, symptoms and lay beliefs in Uganda and South Africa
Creators: name: Moodley, J.
name: Constant, D.
name: Mwaka, A. D.
name: Scott, S. E.
name: Walter, F. M.
Publisher: name: Apollo - University of Cambridge Repository
Year: 2020
Subjects: subject: Research Article
subject: Medicine and health sciences
subject: People and places
subject: Research and analysis methods
subject: Physical sciences
subject: FOS: Physical sciences
subject: FOS: Physical sciences
subject: Social sciences
subject: FOS: Social sciences
subject: FOS: Social sciences

description: Funder: Cancer Association of South Africa
description: Funder: University of Cape Town; funder-id: http://dx.doi.org/10.13039/501100007112
description: Funder: South African Medical Research Council; funder-id: http://dx.doi.org/10.13039/501100001322
description: Funder: National Department of Health; funder-id: http://dx.doi.org/10.13039/100009041
description: Funder: UK Medical Research Council
description: Funder: Newton Fund; funder-id: http://dx.doi.org/10.13039/100010897
description: Background: Breast and cervical cancer are leading causes of cancer burden in Sub-Saharan Africa (SSA). We measured breast and cervical cancer symptom and risk factor awareness and lay beliefs in Uganda and South Africa (SA). Methods: Between August and December 2018 we conducted a cross-sectional survey of women ≥18 years in one urban and one rural site per country. Households were selected using systematic random sampling, then one woman per household randomly selected to participate. Data were collected by interviewers using electronic tablets customised with the locally validated African Women Awareness of Cancer (AWACAN) tool. This has unprompted questions (testing recall) followed by prompted questions (testing recognition) on risk factor, symptom awareness and lay beliefs for breast and cervical cancer. Mann Whitney and Kruskal Wallis tests were used to compare the association between socio-demographic variables and outcomes. Poisson regression with robust variance was conducted to identify independent socio-demographic predictors. Results: Of the 1758 women interviewed, 90.8% had heard of breast and 89.4% of cervical cancer. 8.7% recalled at least one breast risk factor and 38.1% recalled at least one cervical cancer risk factor. 78.0% and 57.7% recalled at least one breast/cervical cancer symptom respectively. Recognition of risk factors and symptoms was higher than recall. Many women were unaware that HPV, HIV, and not being screened were cervical cancer risk factors (23.7%, 46.8%, 26.5% respectively). In SA, urban compared to rural women had significantly higher symptom and risk factor awareness for both cancers. In Uganda married women/living with a partner had higher awareness of breast cancer risk factors and cervical cancer symptoms compared to women not living with a partner. Women mentioned several lay beliefs (e.g. putting money in their bra as a breast cancer risk factor). Conclusion: We identified gaps in breast and cervical cancer symptom and risk factor awareness. Our results provide direction for locally targeted cancer awareness intervention programs and serve as a baseline measure against which to evaluate interventions in SSA.