No woman left behind: tell, see, treat and care: a study of cervical cancer in Sub-Saharan Africa

Abstract

Cervical cancer is the first cancer to be targeted for global elimination, and yet, reflects global inequity more than any other cancer. This thesis aimed to facilitate knowledge and provide contextualized recommendations to improve cervical cancer control in Sub-Saharan Africa with a focus on secondary prevention.

Field research in Ethiopia showed that discussing cervical cancer in local coffee ceremonies can increase screening participation. Qualitative research in Uganda explored male perspectives on cervical cancer screening and HPV vaccination. Men play a significant role in the decision-making process regarding screening and vaccination, and therefore, their perspective should be considered in prevention programs.

In screening projects in low-resource settings, precancerous lesions were treated with cryotherapy. An effective treatment, but often unavailable due to logistical and technical constraints. Thermal ablation proved to be an effective and safe alternative treatment modality in this setting, with good acceptability among both women and healthcare workers.

Lastly, the dissertation emphasizes that it is essential to invest in prevention. In a tertiary referral hospital in Uganda, most women were diagnosed with advanced stage of disease. The limited availability of radiotherapy and palliative care further adds to the burden of the affected women and their families.