Explanatory models of cervical cancer among women accessing cervical cancer disease care and treatment services in Lusaka, Zambia

Abstract

Greater than 20% of the world's annual deaths from cervical cancer occur in sub-Saharan African countries, like Zambia, where cervical cancer is the most common malignancy and the leading cause of cancer-related deaths. Despite the disease being highly preventable with screening and early detection, no more than 5% of women in these settings are screened for cervical cancer. Lay perspectives of cervical cancer among women may influence them to proactively seek cervical cancer prevention services or avoid it. The study sought to understand explanatory models of cervical cancer among women attending the Cancer Diseases Hospital (CDH) in Lusaka for treatment. Using qualitative case study design, data were collected using in-depth personal interviews from 20 women aged between 25 to 59 years and were recorded and transcribed. Data were analysed using Thematic Analysis. Women had different perceptions of disease aetiology with some believing it was witchcraft, while others believed it was because of eating foods sprayed with chemicals and from sexual intercourse with uncircumcised men. A few had no knowledge of the cause. As a result, women sought treatment from different avenues, ranging from prayer, traditional healers and witchdoctors, to conventional treatment. Some of the preventive measures mentioned were avoiding prostitution, good nutrition and male circumcision, while the majority reported not knowing how cervical cancer could be prevented. Of the 20 women interviewed, only two had been screened for cervical cancer. Some women revealed that they only heard of cervical cancer when they were referred to the CDH for management of their disease. Women’s lay perspectives of the disease differed significantly. How and whether they seek treatment and preventive measures is largely based on their construct of the disease. Those unaware of cervical cancer are more likely to believe they were bewitched and hence seek treatment from traditional healers and witch doctors. This study provided broad based insights on the constructions of cervical cancer among women with the disease. The study revealed that women do not have accurate information hence are less likely to seek screening and early detection of cervical cancer thereby leading to costly progression and management of the disease and poor treatment outcomes.