Women’s appraisal, interpretation and help-seeking for possible symptoms of breast and cervical cancer in South Africa: a qualitative study

Article Authors: Harries J, Scott SE, Walter FM, Mwaka A.D, Moodley J.

    • Abstract


    Abstract
    Background: In South Africa, breast cancer is the most commonly diagnosed cancer and cervical cancer the leading cause of cancer mortality. Most cancers are diagnosed at a late-stage and following symptomatic presentation. The overall purpose of the study was to inform interventions aimed at improving timely diagnosis of breast and cervical cancer.
    Methods: In-depth interviews were conducted with women with potential breast or cervical cancer symptoms from urban and rural South Africa. Participants were recruited from a community-based cross-sectional study on breast and cervical cancer awareness. Data were analysed using a thematic analysis approach.
    Results: Eighteen women were interviewed (10 urban, 8 rural): the median age was 34.5 years (range 22-58). Most were unemployed, and five were HIV positive. Themes included impact and attribution of bodily changes; influence of social networks and health messaging in help-seeking; management of symptoms and help-seeking barriers. Breast changes were often attributed to manual activities or possible cancer. Women were often unsure how to interpret vaginal symptoms, attributing them to HIV, hormonal contraceptives, or partner infidelity. Concerns about cancer were based on health information from the radio, social networks, or from primary care providers. Prompt care seeking was triggered by impact of symptoms on personal lives. Rural women, especially with possible symptoms of cervical cancer, experienced challenges during help-seeking including judgmental attitudes of clinic staff. Most participants were skeptical of traditional medicine.
    Conclusions: This is the first study exploring interpretation of possible breast and cervical cancer symptoms at a community level in South Africa. The process of interpreting bodily changes, symptom attribution and help-seeking is complex and influenced by women’s everyday life experiences. Timely diagnosis interventions should not only include cancer symptom awareness but also address individual, structural and health systems related barriers to care.

    Bibliographical metadata

    Volume 20
    Issue No. 1
    DOI https://doi.org/10.1186/s12905-020-01120-4
    Related Faculties/Schools
    Affiliation
    • 1Women’s Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa. Jane.Harries@uct.ac.za.
    • 2Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King’s College London, London, UK.
    • 3The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
    • 4Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
    • 5Women’s Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
    • 6Cancer Research Initiative, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925, South Africa.
    • 7SAMRC Gynaecology Cancer Research Centre, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925, South Africa.