Main Article Content
Abstract
RÉSUMÉ
Introduction. Le cancer du col de l’utérus est responsable d’environ 180 décès à Brazzaville chaque année, mais seulement moins de 10% de population à risque bénéficie du dépistage de cette affection. Notre étude visait à analyser les facteurs qui limitent l’accès au dépistage du cancer du col de l’utérus à Brazzaville. Méthodologie. Il s’agit d’une étude cas - témoins, menée du 19 octobre au 20 décembre 2020 à Brazzaville. La population d’étude était composée de deux groupes (groupe sujet: femmes sans antécédent du dépistage; groupe contrôle: femmes ayant bénéficié d’au moins une séance du dépistage). La collecte des données a été réalisée au Centre Hospitalier Universitaire de Brazzaville, à l’Hôpital de Talangaï, et de Makélékélé. Les données ont été collectées à l’aide d’un questionnaire pré-testé et validé, puis analysées à l’aide du logiciel SPSS version 20. L’analyse par régression logistique a été faite pour apprécier l’association entre les différentes variables et la participation des femmes au dépistage. Le seuil de signification était fixé à p < 5%. Résultats. Au total, 300 femmes ont été interrogées. Leur âge moyen était de 43 ± 7,25 ans. En analyse multivariable, les facteurs associés aux difficultés d’accès au dépistage du cancer du col de l’utérus étaient, le niveau d’étude primaire (AOR=5,12; IC95%=[3,42-7,65]), le «manque d’emploi» (AOR=4,39; IC95%=[3,22-6]), le «niveau de connaissances insuffisant» (AOR=6,77; IC95%=[5,41-8,47]); et l’«attitude défavorable» (AOR=5,58; IC95%=[4,41-7,06]). Conclusion. Les facteurs associés au non-dépistage sont le faible niveau de scolarisation, le statut de chômeur, les connaissances insuffisantes et l’attitude défavorable. Il est nécessaire de développer des stratégies afin d’améliorer l’accès aux services du dépistage du cancer du col de l’utérus à Brazzaville.
ABSTRACT
Introduction. Cervical cancer is responsible of about 180 deaths in Brazzaville each year, but less than 10% of the population at risk have been screened for this condition. Our study aimed to analyze the factors that limit access to cervical cancer screening in Brazzaville, Congo Methodology. This was an analytical case control study, conducted from October 19 to December 20, 2020 in Brazzaville. The study population was made up of two groups (subject group: women with no history of screening, control group: women who received at least one screening session). Data collection was done at the Brazzaville University Hospital, the Talangaï Hospital, and the Makélékélé Hospital. The data was collected using a pre-tested and validated questionnaire and analyzed using the software SPSS version 20. Logistic regression analysis was performed to assess the association between the different variables and the participation of women in screening. The significant threshold was set at p < 5%. Results. A total of 300 women were interviewed; their mean age was 43 ± 7.25 years. In multivariate analysis, factors associated with difficult access to cervical cancer screening were: education limited to primary (ORA=5.12; 95% CI=[3.42-7.65]), “lack of employment” (ORA=4.39; 95% CI=[3.22-6]), “insufficient level of knowledge” (ORA=6.77; 95% CI=[5.41-8. 47]); and "unfavorable attitude" (ORA=5.58; 95% CI=[4.41-7.06]). Conclusion. The main factors associated with non-screening are low level of education, lack of employment, insufficient level of knowledge and unfavorable attitude. It is necessary to develop strategies to improve access to cervical cancer screening services in Brazzaville.
Article Details
References
- Organisation mondiale de la Santé (OMS).Lignes directrices de l’OMS pour le dépistage et le traitement des lésions précancéreuses pour la prévention du cancer du col de l’utérus. Disponible en ligne: Disponible en ligne: www.who.int/reproductivehealth/publications/cancers/screening_and_treatment_of_precancerous_lesions/en/index.html
- Bhatla N, Aoki D, Sharma DN, Sankaranarayanan R. Cancer of the cervix uteri. Int J GynecolObstet2018;143:22–36.
- Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin .2018;68(6):394–424.
- Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359–86.
- Ferlay J, Shin H-R, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010;127(12):2893–17.
- Moore PS, Chang Y. Why do viruses cause cancer? Highlights of the first century of human tumour virology. Nat Rev Cancer .2010;10(12):878.
- Tebeu P-M, Petignat P, Mhawech-Fauceglia P. Gynecological malignancies in Maroua, Cameroon. Int Fed Gynaecol Obstet. 2009;104(2):1489.
- Sando Z, Fouogue JT, Fouelifack FY, Fouedjio JH, Mboudou ET, Essame JLO. [Profile of breast and gynecological cancers in Yaoundé-Cameroon]. Pan Afr Med J 2014;17:28.
- Tebeu PM, Antaon JSS, Woromogo SH, Tatsipie WL, Kibimi C, Njiki R. Knowledges, attitudes, and practices on cervical cancer screening by women in Brazzaville-Congo. J Cancer ResPract 2020;7:60.
- Kelsey JL, Whittemore AS, Evans AS, Thompson WD. Methods of sampling and estimation of sample size. Methods Obs Epidemiol. 1996;311:340.
- Harder E, Juul KE, Jensen SM, Thomsen LT, Frederiksen K, Kjaer SK. Factors associated with non-participation in cervical cancer screening–a nationwide study of nearly half a million women in Denmark. Prev Med 958*2018;111:94–100.
- Tiruneh FN, Chuang K-Y, Ntenda PAM, Chuang Y-C. Individual-level and community-level determinants of cervical cancer screening among Kenyan women: a multilevel analysis of a Nationwide survey. BMC Womens Health 2017;17:109.
- Bouslah S, Soltani MS, Ben Salah A, Sriha A. Knowledge, attitudes and practices of Tunisian women with regard to breast and cervical cancer screening. Psycho Oncol2014;8:12332
- AlMeer FM, Aseel MT, AlKhalaf J, AlKuwari MG, Ismail MF. Knowledge, attitude and practices regarding cervical cancer and screening among women visiting primary health care in Qatar. East Mediterr Health J 2011;17:85561
- Nwankwo KC, Aniebue UU, Aguwa EN, Anarado AN, Agunwah E. Knowledge attitudes and practices of cervical cancer screening among urban and rural Nigerian women: A call for education and mass screening. Eur J Cancer Care 2011;20:3627
- Organisation mondiale de la santé (OMS) [En ligne]. Une lutte soutenue pour vaincre les cancers du sein et du col de l’utérus au Congo. [Cité le 16 avril 2021, mise en ligne le 21 Mars 2021] .Disponible sur https://www.afro.who.int/node/14316
- Faye A, Mbengue ET, Tal-Tal A. Facteurs associés au dépistage du cancer du col de l’utérus en milieu rural Sénégalais. RevDÉpidémiologie Santé Publique 2017;65:S77.
- Kristensson JH, Sander BB, von Euler-Chelpin M, Lynge E. Predictors of non-participation in cervical screening in Denmark. Cancer Epidemiol2014;38:174–80.
- Tiruneh FN, Chuang K-Y, Ntenda PAM, Chuang Y-C. Individual-level and community-level determinants of cervical cancer screening among Kenyan women: a multilevel analysis of a Nationwide survey. BMC Womens Health2017;17:109.
- Antaon JSS, Leuwe FE, Mamche R, Nkene Mawamba Y, TebeuPM. Impact of an intra-hospital awareness strategy on the attendance to cervical cancer screening unit of the Yaoundé University Hospital Centre - Cameroon . J Cancer ResPract 2021. Express
- Naz MSG, Kariman N, Ebadi A, Ozgoli G, Ghasemi V, Fakari FR. Educational interventions for cervical cancer screening behavior of women: a systematic review. Asian Pac J Cancer Prev APJCP 2018;19:875.
- Idehen EE, Korhonen T, Castaneda A, Juntunen T, Kangasniemi M, Pietilä AM, et al. Factors associated with cervical cancer screening participation among immigrants of Russian, Somali and Kurdish origin: a population-based study in Finland. BMC Womens Health2017;17
References
Organisation mondiale de la Santé (OMS).Lignes directrices de l’OMS pour le dépistage et le traitement des lésions précancéreuses pour la prévention du cancer du col de l’utérus. Disponible en ligne: Disponible en ligne: www.who.int/reproductivehealth/publications/cancers/screening_and_treatment_of_precancerous_lesions/en/index.html
Bhatla N, Aoki D, Sharma DN, Sankaranarayanan R. Cancer of the cervix uteri. Int J GynecolObstet2018;143:22–36.
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin .2018;68(6):394–424.
Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359–86.
Ferlay J, Shin H-R, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010;127(12):2893–17.
Moore PS, Chang Y. Why do viruses cause cancer? Highlights of the first century of human tumour virology. Nat Rev Cancer .2010;10(12):878.
Tebeu P-M, Petignat P, Mhawech-Fauceglia P. Gynecological malignancies in Maroua, Cameroon. Int Fed Gynaecol Obstet. 2009;104(2):1489.
Sando Z, Fouogue JT, Fouelifack FY, Fouedjio JH, Mboudou ET, Essame JLO. [Profile of breast and gynecological cancers in Yaoundé-Cameroon]. Pan Afr Med J 2014;17:28.
Tebeu PM, Antaon JSS, Woromogo SH, Tatsipie WL, Kibimi C, Njiki R. Knowledges, attitudes, and practices on cervical cancer screening by women in Brazzaville-Congo. J Cancer ResPract 2020;7:60.
Kelsey JL, Whittemore AS, Evans AS, Thompson WD. Methods of sampling and estimation of sample size. Methods Obs Epidemiol. 1996;311:340.
Harder E, Juul KE, Jensen SM, Thomsen LT, Frederiksen K, Kjaer SK. Factors associated with non-participation in cervical cancer screening–a nationwide study of nearly half a million women in Denmark. Prev Med 958*2018;111:94–100.
Tiruneh FN, Chuang K-Y, Ntenda PAM, Chuang Y-C. Individual-level and community-level determinants of cervical cancer screening among Kenyan women: a multilevel analysis of a Nationwide survey. BMC Womens Health 2017;17:109.
Bouslah S, Soltani MS, Ben Salah A, Sriha A. Knowledge, attitudes and practices of Tunisian women with regard to breast and cervical cancer screening. Psycho Oncol2014;8:12332
AlMeer FM, Aseel MT, AlKhalaf J, AlKuwari MG, Ismail MF. Knowledge, attitude and practices regarding cervical cancer and screening among women visiting primary health care in Qatar. East Mediterr Health J 2011;17:85561
Nwankwo KC, Aniebue UU, Aguwa EN, Anarado AN, Agunwah E. Knowledge attitudes and practices of cervical cancer screening among urban and rural Nigerian women: A call for education and mass screening. Eur J Cancer Care 2011;20:3627
Organisation mondiale de la santé (OMS) [En ligne]. Une lutte soutenue pour vaincre les cancers du sein et du col de l’utérus au Congo. [Cité le 16 avril 2021, mise en ligne le 21 Mars 2021] .Disponible sur https://www.afro.who.int/node/14316
Faye A, Mbengue ET, Tal-Tal A. Facteurs associés au dépistage du cancer du col de l’utérus en milieu rural Sénégalais. RevDÉpidémiologie Santé Publique 2017;65:S77.
Kristensson JH, Sander BB, von Euler-Chelpin M, Lynge E. Predictors of non-participation in cervical screening in Denmark. Cancer Epidemiol2014;38:174–80.
Tiruneh FN, Chuang K-Y, Ntenda PAM, Chuang Y-C. Individual-level and community-level determinants of cervical cancer screening among Kenyan women: a multilevel analysis of a Nationwide survey. BMC Womens Health2017;17:109.
Antaon JSS, Leuwe FE, Mamche R, Nkene Mawamba Y, TebeuPM. Impact of an intra-hospital awareness strategy on the attendance to cervical cancer screening unit of the Yaoundé University Hospital Centre - Cameroon . J Cancer ResPract 2021. Express
Naz MSG, Kariman N, Ebadi A, Ozgoli G, Ghasemi V, Fakari FR. Educational interventions for cervical cancer screening behavior of women: a systematic review. Asian Pac J Cancer Prev APJCP 2018;19:875.
Idehen EE, Korhonen T, Castaneda A, Juntunen T, Kangasniemi M, Pietilä AM, et al. Factors associated with cervical cancer screening participation among immigrants of Russian, Somali and Kurdish origin: a population-based study in Finland. BMC Womens Health2017;17