Breast and Cervical Cancer Symptom Awareness in South Africa

Prof Jennifer Moodley

Project ended 30 June 2020

Prof Jennifer Moodley

• Cancer Research Initiative, Faculty of Health Sciences, University of Cape Town
• Email

Title of the project

Breast and cervical cancer symptom awareness in South Africa.

Project Description

Breast and cervical cancer are the leading causes of cancer morbidity and mortality among women in South Africa (SA), with the majority of patients presenting with late-stage disease. Studies have shown that for symptomatic cancer shorter time to presentation to a health care provider is associated with early-stage disease and a better prognosis. Hence understanding processes related to cancer symptom awareness and responses to symptoms are important in developing interventions to promote earlier cancer diagnosis. Accurate measurement of cancer symptom awareness and beliefs will allow for the identification of knowledge and beliefs that need to be targeted in interventions.

The main objectives of this project are to measure community breast and cervical cancer awareness and beliefs in an urban and rural setting in SA using a locally validated measurement tool; assess how symptom overlap with common infectious diseases influences the interpretation of cancer symptoms, and explore factors associated with primary health care provider interpretation and management of breast and cervical cancer signs and symptoms. Quantitative and qualitative research methods will be used to meet the study objectives. Findings will contribute to the evidence base for the development of future interventions to promote timely diagnosis of symptomatic breast and cervical cancer in SA.

Value of the project in the struggle against cancer

Breast and cervical cancer are leading causes of cancer morbidity and mortality in women in Sub-Saharan Africa (SSA). The vast majority of women in SSA present symptomatically and with an advanced-stage disease which is associated with a poor prognosis. The earlier stage at presentation, enabling more opportunities for curative treatment and improved outcomes, is, therefore, an important goal in any comprehensive cancer care policy.

This project comprises 3 interrelated studies undertaken in one urban and one rural site in South Africa (SA). We identified important and specific gaps in community breast and cervical cancer risk and symptom awareness, as well as cancer-related lay beliefs in rural and urban settings in SA, that could be addressed through targeted interventions Further our results, show that interventions to decrease clinic waiting times, reduce transport-related costs clinics and address broader economic issues are important in facilitating timely access to health care. Our findings also provide an important baseline measure for the evaluation of future interventions.

Future plans for this research project

We plan on advancing the early diagnosis of breast and cervical cancer in southern Africa by developing a toolkit of evidence-based interventions that are cost-effective and affordable, operationally and economically feasible, and socio-culturally acceptable to patients and healthcare providers.

Publications

1. Towards timely diagnosis of symptomatic breast and cervical cancer in South Africa (2018)
2. Symptom awareness measures for breast and cervical cancer in sub-Saharan Africa: A scoping review (2019)
3. Development and validation of the African Women Awareness of CANcer (AWACAN) tool for breast and cervical cancer (2019)
4. Mapping awareness of breast and cervical cancer risk factors, symptoms and lay beliefs in Uganda and South Africa (2020)
5. Effectiveness of interventions for improving timely diagnosis of breast and cervical cancers in low and middle-income countries: a systematic review protocol (2020)
6. Women’s appraisal, interpretation and help‑seeking for possible symptoms of breast and cervical cancer in South Africa: a qualitative study (2020)
7. Knowledge of cervical cancer risk factors and symptoms among women in a refugee settlement: a cross-sectional study in northern Uganda (2020)
8. Symptom appraisal, help-seeking and perceived barriers to healthcare seeking in Uganda: an exploratory study among women with potential symptoms of breast and cervical cancer (2021)
9. Anticipated help seeking behaviour and barriers to seeking care for possible breast and cervical cancer symptoms in Uganda and South Africa (2021)
10. Timeliness of diagnosis of breast and cervical cancers and associated factors in low-income and middle-income countries: a scoping review protocol (2021)