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J Cancer Educ. 2016 Dec;31(4):760-766. doi: 10.1007/s13187-015-0898-9.

Barriers to Cervical Cancer Screening in Burkina Faso: Needs for Patient and Professional Education.

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Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198, USA.
Centre Hospitalier Universitaire Yalgado Ouedraogo de Ouagadougou (CHU/YO), Ouagadougou, Burkina Faso.
Institut de Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso.
Institut Africain de Sante Publique, Ouagadougou, Burkina Faso.
Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
Department of Epidemiology, MD Anderson Cancer Center, University of Texas, Houston, TX, USA.
Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198, USA.


Cervical cancer is among the leading causes of cancer deaths for women in low-income African countries, such as Burkina Faso. Given that cervical cancer is a preventable disease through early detection and vaccination, this study aimed at understanding the barriers to cervical cancer early detection in Ouagadougou, the capital city of Burkina Faso. Women seeking screening and treatment for cervical cancer (n = 351) during the period of May-August 2014, at the Yalgado Ouedraogo University Hospital, were interviewed about their knowledge, attitudes, and practices toward cervical cancer. Interview questions elicited information about sociodemographic of participants, history of screening, knowledge of cervical cancer, and attitudes toward cervical screening. Scores were assigned to responses of questions and knowledge, and tertitles of distributions were used for comparison. A multivariate logistic regression was performed to predict cervical screening. Study participants were relatively young (37.5 ± 10.7 years) and predominately resident of urban areas (83.8 %), and over half had no or less than high school education. Over 90 % of participants had heard about cervical cancer, and about 55 % of them had intermediate-level knowledge of the disease, its screening, and/or risk factors. Knowledge level was lower among rural than urban residents. Predictors of screening included higher level of education (odds ratio (OR) = 2.2; 95 % confidence interval (CI) 1.48-3.23), older age (OR = 1.1; 95 % CI 1.06-1.12), higher socioeconomic standard (SES) (OR = 1.5; 95 % CI 1-2.37), urban residence (OR = 2.0; 95 % CI 1.19-3.25), encouragement for screening by a health care worker (1.98; 95 % CI 1.06-3.69), and employment (OR = 1.9; 95 % CI 1.13-3.11). Low awareness and socioeconomic barriers lead to underutilization of screening services of women. Motivation and education by healthcare workers are important factors for increasing screening rates. Organized patient and professional education programs in gynecologic services are warranted for improving screening in Burkina Faso and other low-resource countries in Africa.


Attitude; Barriers; Burkina Faso; Cervical cancer; Knowledge; Practice developing countries; Screening

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