CHAPTER ONE

INTRODUCTION

1.1 Background of Study

Cervical cancer is a malignant proliferation of the cells of the uterine cervix and can be treated if diagnosed earlier. Cervical cancer occurs when abnormal cells in the lining of the cervix grow in an uncontrolled way. The cervix is the lower part of the womb. It is the opening to the vagina from the womb. The main symptom of cervical cancer is unusual bleeding from the vagina. Finding changes in the cells through screening can help to prevent cancer from developing (Kaufman  ,2010).

Cervical cancer is a leading cause of morbidity and mortality among women in the low‐ and middle income countries (LMICs). Of 500 000 new cervical cancer cases diagnosed annually worldwide, 83% occurred in LMICs where more than 80% are diagnosed at advanced stage and have poor treatment outcomes (Kaufman ,2010).

The reasons for the high incidence and mortality from cervical cancer in sub Saharan Africa include lack of awareness of cervical cancer among the population, health‐care providers and policymakers; limited access to high‐quality health‐care services and cervical screening programmes; and lack of functional referral systems. All these lead to advanced stage at diagnoses. (Dryers, 2012) . In developed countries, incidence and mortality from cervical cancer have been reduced through measures which include cytological screening and prompt treatment of early cervical lesions. Introducing population based cervical screening and increasing its uptake in the LMICs is an important goal in reducing cervical cancer mortality. Uptake of screening programmes may be assisted by raising awareness about cervical cancer risk factors including young age at first sexual intercourse, multiple male sexual partners, high parity, infections with the human papillomavirus, young age at first full term pregnancy, prolonged use of oral contraceptives and HIV infections. (Kulasingam, 2014)

 Similarly, early help seeking may be promoted if women in the LMICs become more aware of the symptoms of cervical cancer including intermenstrual vaginal bleeding, post‐menopausal vaginal bleeding, post‐coital vaginal bleeding, offensive vaginal discharge and lower abdominal pain. There is evidence that raising awareness of cancer symptoms and signs might increase people’s ability to detect early symptoms and signs of cancer. (Kulasingam, 2014)

In Cameroon knowledge and understanding of cancer risk factors and outcomes of cancer treatments influenced individuals’ intentions and actual participation in cancer prevention programmes. In addition, better knowledge of cancer warning signs has also been linked with early help‐seeking. Regarding cervical cancer, a substantial body of research has shown that awareness of cervical cancer and knowledge of its risk factors and symptoms can increase uptake of cervical screening and encourage early help‐seeking for symptoms suggestive of cervical cancer (Rosenberg, 2001).

However, in Cameroon, there are limited data on levels of population awareness about cervical cancer, including perceptions, beliefs and knowledge about cervical cancer risk factors and symptoms. The objective of this study was to investigate community awareness about cervical cancer risk factors, symptoms and preventive measures of cervical cancer in the Ndongo Community of Buea.  

1.2 Statement of the Problem

In Cameroon, Cervical cancer (CC) is the second most encountered cancer in women after breast cancer with 7.1million women with ages 15 years and above who are at risk of developing the diseases. Cervical cancer is the 2^nd leading cause of cancer deaths in women aged 15 to 44 years in Cameroon (Macon, 2014). According to the National Committee for the Fight against Cancers, Cervical Cancer accounts for 24% of female cancers. In Cameroon, about 1,993 new cervical cancer cases are documented with 1,120 cervical cancer deaths (Macon, 2014) In 2010, 30% of deaths among women were attributed to cervical cancer. The cervical cancer registry in Yaoundé estimates incidence at 107 cases for 100,000 inhabitants. The epidemiology rightfully points out the dire situation of the morbidity and mortality from cervical cancer beginning from global, to regional and country with the need for primary prevention interventions (screening and treatment of precancerous lesions). Despite all these challenges as identified from literature associated with the low uptake, there is low cervical cancer awareness in Cameroon and particularly in the rural communities. Thus, there is need to acertain the level of awareness of the women of the Ndongo community of Buea on the risks, symptoms and preventive measures of cervical cancer.

1.3. Research Questions

1. What is the level of awareness of women of the Ndongo Community of Cervical cancer risk factors?
2. What is the knowledge on the strategies used in the prevention of cervical cancer among female in Ndongo community?

1.4. Research Objectives

1 .4.1 General objective

To assess awareness of cervical cancer risk factors, symptoms and preventive measures among females aged 14-30 years in the Ndongo community of Buea

1.4.2 Specific objectives

1. To assess the level of awareness of women of Ndongo Community of Cervical cancer risk factors
2. To asses the knowledge on the different strategies used in the prevention of cervical cancer among woman in ndongo community