Review Article

Symptom awareness measures for breast and cervical cancer in sub-Saharan Africa: A scoping review

Jennifer N. Githaiga, Fiona M. Walter, Suzanne E. Scott, Amos D. Mwaka, Jennifer Moodley
South African Journal of Oncology | Vol 3 | a78 | DOI: https://doi.org/10.4102/sajo.v3i0.78 | © 2019 Jennifer N. Githaiga, Fiona M. Walter, Suzanne E. Scott, Amos D. Mwaka, Jennifer Moodley | This work is licensed under CC Attribution 4.0
Submitted: 15 March 2019 | Published: 26 June 2019

About the author(s)

Jennifer N. Githaiga, Women’s Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
Fiona M. Walter, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, London, United Kingdom
Suzanne E. Scott, Centre for Oral, Clinical and Translational Sciences, King’s College London, London, United Kingdom
Amos D. Mwaka, Department of Medicine, Makerere University, Kampala, Uganda
Jennifer Moodley, Women’s Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa; and, Cancer Research Initiative, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; and, SAMRC Gynaecology Cancer Research Centre, University of Cape Town, Cape Town, South Africa


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Abstract

Background: In sub-Saharan Africa (SSA), breast cancer is the most commonly diagnosed cancer among women, while cervical cancer remains the leading cause of cancer death. Women often fail to recognise or misinterpret possible symptoms, so breast and cervical cancer symptom awareness information can promote timely help-seeking behaviour, diagnosis and start of treatment.

Aim: To identify tools that have been utilised to measure breast and cervical cancer symptom awareness in SSA and to establish if such tools have been validated in SSA populations.

Methods: A scoping review of articles published between January 1997 and February 2017, written in English and describing primary research in breast and/or cervical cancer symptom awareness-related topics in SSA contexts, was undertaken across five databases. The approach was supported by Colquhoun et al.’s methodological framework for scoping reviews.

Results: A total of 41 studies were included from 11 SSA countries. Almost half (20/41) used breast and/or cervical cancer symptom awareness tools but did not report on tool validation processes. The rest (21/41) made reference to some tool validation, yet only two reported a detailed account of their tool validation processes. One explored lay perceptions of breast cancer, while the other sought to establish the validity and reliability of a UK tool in a Kenyan context.

Conclusion: The findings point to the dearth of comprehensively validated and culturally relevant tools to measure breast and cervical cancer symptom awareness in the SSA context. They have informed the development and validation of an African Women Awareness of CANcer (AWACAN) tool, which can support the development and evaluation of interventions relevant to the SSA context.


Keywords

scoping review; breast and cervical cancer; symptom awareness measures; sub-Saharan Africa

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