Email this article 
Étude des perceptions des Nigérianes en milieu rural à l’égard des programmes de dépistage du cancer du col de l’utérus
Abstract
Contexte : En Afrique subsaharienne, le cancer du col de l’utérus est encore l’une des principales causes de morbidité et de mortalité chez les femmes, le Nigéria payant un lourd tribut. Malgré l’existence de programmes de dépistage, le consentement au dépistage reste faible, surtout en milieu rural. Pour accroître l’efficacité de ces programmes, il est indispensable de savoir ce que les femmes savent de la colposcopie, qui est une méthode de dépistage du cancer du col de l’utérus.
Objectif : Examiner les expériences de Nigérianes en milieu rural, leurs perceptions et leurs attitudes à l’égard de la colposcopie; vérifier ce qu’elles savent du cancer du col de l’utérus, des méthodes servant à dépister cette maladie; et étudier les facteurs qui influent sur le consentement à subir un dépistage.
Méthodologie : On a fait des entrevues très détaillées auprès de 41 Nigérianes de 25 à 49 ans vivant en région rurale. Certaines étaient séropositives, d’autres, séronégatives; certaines avaient déjà subi un examen de dépistage du cancer du col de l’utérus, et d’autres encore n’avaient pas utilisé ces services. Les transcriptions des entrevues ont fait l’objet d’une analyse de contenu thématique.
Résultats : Quatre principaux thèmes ressortent de notre analyse : 1) des connaissances limitées sur le cancer du col de l’utérus et les méthodes de dépistage, 2) une ambivalence face aux expériences vécues et un manque d’information à la patiente avant l’examen; 3) l’existence de multiples obstacles au dépistage dont la peur, la stigmatisation, les coûts du transport élevés et des difficultés liées à la prestation de services; et 4) la nécessité d’améliorer les programmes de prévention en mettant l’accent sur la sensibilisation des collectivités et l’accessibilité aux services.
Conclusion : L’étude des perceptions des femmes fait ressortir de graves lacunes de connaissances, des difficultés liées à la prestation des services et des obstacles structurels entravant le dépistage. La mise en œuvre de vastes campagnes de sensibilisation sur le cancer du col de l’utérus, des services de meilleure qualité, une information de meilleure qualité sur les méthodes de dépistage et la mise en œuvre de programmes communautaires, toutes ces conditions sont essentielles pour améliorer les résultats des programmes de dépistage en milieu rural au Nigéria.
Mots-clés : cancer du col de l’utérus, dépistage, colposcopie, perceptions des femmes, obstacles, régions rurales au Nigéria, VPH, examen visuel
Full Text:
PDFReferences
Adamu, A., Mairiga, A. G., Klahaim, N., & Ibrahim, H. (2012). Cervical cancer screening: Knowledge, attitude and practice among market women in northeastern Nigeria. Nigerian Journal of Medicine, 21(1), 52–56.
Adewole, I. F., Benedet, J. L., Crain, B. T., & Follen, M. (2005). Evolving a strategic approach to cervical cancer control in Africa. Gynecologic Oncology, 99(3 Suppl 1), S209–S212. https://doi.org/10.1016/j.ygyno.2005.07.086
Akinlotan, M., Bolin, J. N., Helduser, J., Ojinnaka, C., Lichorad, A., & McClellan, D. (2017). Cervical cancer screening barriers and risk factor knowledge among uninsured women. Journal of Community Health, 42(4), 770–778. https://doi.org/10.1007/s10900-017-0316-9
Amadi, A., Khan, H. T. & Lawal, M. (2024) A systematic review of healthcare professionals and women’s experiences and perceptions of colposcopy method of cervical cancer screening in Nigeria. Journal of Global Social Sciences, 5(19), 1–14. https://doi.org/10.58934/jgss.v5i19.287
Arbyn, M., Weiderpass, E., Bruni, L., de Sanjosé, S., Saraiya, M., Ferlay, J., & Bray, F. (2020). Estimates of incidence and mortality of cervical cancer in 2018: A worldwide analysis. The Lancet Global Health, 8(2), e191–e203. https://doi.org/10.1016/S2214-109X(19)30482-6
Barbour, R. S. (2001). Checklists for improving rigour in qualitative research: A case of the tail wagging the dog? British Medical Journal (Clinical Research ed.), 322(7294), 1115–1117. https://doi.org/10.1136/bmj.322.7294.1115
Berger, R. (2015). Now I see it, now I don’t: Researcher’s position and reflexivity in qualitative research. Qualitative Research, 15(2), 219–234. https://doi.org/10.1177/1468794112468475
Boeije, H. (2002). A purposeful approach to the constant comparative method in the analysis of qualitative interviews. Quality and Quantity, 36(4), 391–409. https://doi.org/10.1023/A:1020909529486
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.
Brislin, R. W. (1970). Back-translation for cross-cultural research. Journal of Cross-Cultural Psychology, 1(3), 185–216.
Creswell, J. W., & Poth, C. N. (2018). Qualitative inquiry and research design: Choosing among five approaches (4th ed.). Sage.
Ebu, N. I., Mupepi, S. C., Siakwa, M. P., & Sampselle, C. M. (2015). Knowledge, practice, and barriers toward cervical cancer screening in Elmina, Southern Ghana. International Journal of Women’s Health, 7, 31–39. https://doi.org/10.2147/IJWH.S71797
Emmel, N., Hughes, K., Greenhalgh, J., & Sales, A. (2007). Accessing socially excluded people: Trust and the gatekeeper in the researcher-participant relationship. Sociological Research Online, 12(2), 43–55.
Eze, J. N., Umeora, O. U., Obuna, J. A., Egwuatu, V. E., & Ejikeme, B. N. (2012). Cervical cancer awareness and cervical screening uptake at the Mater Misericordiae Hospital, Afikpo, Southeast Nigeria. Annals of African Medicine, 11(4), 238–243. https://doi.org/10.4103/1596-3519.102856
Ezechi, O. C., Gab-Okafor, C. V., Ostergren, P. O., & Pettersson, K. O. (2013). Willingness and acceptability of cervical cancer screening among HIV positive Nigerian women. BMC Public Health, 13(1), 46. https://doi.org/10.1186/1471-2458-13-46
Ezechi, O. C., Pettersson, K. O., Lind, A., & Gbajabiamila, T. A. (2019). SOGON cervical cancer prevention guideline development committee. Clinical practice guidelines for cervical cancer prevention in Nigeria. Tropical Journal of Obstetrics and Gynaecology, 36(2), 161–164.
Federal Ministry of Health Nigeria. (2023). National strategic plan for prevention and control of cancer of the cervix in Nigeria 2023–2027.
Galaal, K., Bryant, A., Deane, K. H., Al-Khaduri, M., & Lopes, A. D. (2011). Interventions for reducing anxiety in women undergoing colposcopy. Cochrane Database of Systematic Reviews, 12, CD006013.
Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. Aldine.
Globocan. (2020). Cancer statistics for Nigeria. International Agency for Research on Cancer. Retrieved from https://gco.iarc.fr/today/data/factsheets/populations/566-nigeria-fact-sheets.pdf
Green, J., & Thorogood, N. (2018). Qualitative methods for health research (4th ed.). Sage.
Guest, G., Bunce, A., & Johnson, L. (2006). How many interviews are enough? An experiment with data saturation and variability. Field Methods, 18(1), 59–82. https://doi.org/10.1177/1525822X05279903
Hennink, M., Hutter, I., & Bailey, A. (2020). Qualitative research methods (2nd ed.). Sage.
Hyacinth, H. I., Adekeye, O. A., Ibeh, J. N., & Osoba, T. (2012). Cervical cancer and pap smear awareness and utilization of pap smear test among Federal civil servants in North Central Nigeria. PLoS ONE, 7(10), e46583. https://doi.org/10.1371/journal.pone.0046583
Ifemelumma, C. C., Anikwe, C. C., Okorochukwu, B. C., Onu, F. A., Obuna, J. A., Ejikeme, B. N., & Ezeonu, O. P. (2019). Cervical cancer screening: Assessment of perception and utilisation of services among health workers in low resource setting. International Journal of Reproductive Medicine, 2019, 6505482. https://doi.org/10.1155/2019/6505482
Kim, Y. (2011). The pilot study in qualitative inquiry: Identifying issues and learning lessons for culturally competent research. Qualitative Social Work, 10(2), 190–206. https://doi.org/10.1177/1473325010362001
Liamputtong, P. (2010). Performing qualitative cross-cultural research. Cambridge University Press.
Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Sage.
Marshall, C., & Rossman, G. B. (2016). Designing qualitative research (6th ed.). Sage.
Massad, L. S., Einstein, M. H., Huh, W. K., Katki, H. A., Kinney, W. K., Schiffman, M., Solomon, D., Wentzensen, N., & Lawson, H. W., for 2012 ASCCP Consensus Guidelines Conference. (2013) 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. Obstetrics and Gynecology, 121(4), 829–846.
Ndikom, C. M., & Ofi, B. A. (2012). Awareness, perception and factors affecting utilization of cervical cancer screening services among women in Ibadan, Nigeria: A qualitative study. Reproductive Health, 9(1), 11. https://doi.org/10.1186/1742-4755-9-11
Nwankwo, K. C., Aniebue, U. U., Aguwa, E. N., Anarado, A. N., & Agunwah, E. (2011). Knowledge, attitudes and practices of cervical cancer screening among urban and rural Nigerian women: A call for education and mass screening. European Journal of Cancer Care, 20(3), 362–367. https://doi.org/10.1111/j.1365-2354.2009.01175.x
Patton, M. Q. (2015). Qualitative research and evaluation methods (4th ed.). Sage.
Perkins, R. B., Guido, R. S., Castle, P. E., Chelmow, D., Einstein, M. H., Garcia, F., Huh, W. K., Kim, J. J., Moscicki, A. B., Nayar, R., Saraiya, M., Sawaya, G. F., Wentzensen, N., Schiffman, M., & 2019 ASCCP Risk-Based Management Consensus Guidelines Committee (2020). 2019 ASCCP risk-based management consensus guidelines for abnormal cervical cancer screening tests and cancer precursors. Journal of Lower Genital Tract Disease, 24(2), 102–131. https://doi.org/10.1097/LGT.0000000000000525
Pope, C., & Mays, N. (1995). Reaching the parts other methods cannot reach: An introduction to qualitative methods in health and health services research. British Medical Journal, 311(6996), 42–45.
Pope, C., Ziebland, S., & Mays, N. (2000). Analysing qualitative data. British Medical Journal, 320(7227), 114–116.
QSR International. (2020). NVivo 12 [Computer software]. QSR International.
Robinson, O. C. (2014). Sampling in interview-based qualitative research: A theoretical and practical guide. Qualitative Research in Psychology, 11(1), 25–41. https://doi.org/10.1080/14780887.2013.801543
Saldaña, J. (2021). The coding manual for qualitative researchers (4th ed.). Sage.
Santos, H. P., Black, A. M., & Sandelowski, M. (2015). Timing of translation in cross-language qualitative research. Qualitative Health Research, 25(1), 134–144. https://doi.org/10.1177/1049732314549603
Squires, A. (2009). Methodological challenges in cross-language qualitative research: A research review. International Journal of Nursing Studies, 46(2), 277–287. https://doi.org/10.1016/j.ijnurstu.2008.08.006
Sultana, F. (2007). Reflexivity, positionality and participatory ethics: negotiating fieldwork dilemmas in international research. ACME: An International E-Journal for Critical Geographies, 6(3), 374–385. https://doi.org/10.14288/acme.v6i3.786
Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F. (2021). Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 71(3), 209–249. https://doi.org/10.3322/caac.21660
Wentzensen, N., Schiffman, M., Palmer, T., & Arbyn, M. (2017). Triage of HPV positive women in cervical cancer screening. Journal of Clinical Virology, 76(Suppl 1), S49–S55. https://doi.org/10.1016/j.jcv.2015.11.015
World Health Organization. (2020). Global strategy to accelerate the elimination of cervical cancer as a public health problem.
World Health Organization. (2021). WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention (2nd ed.).
World Health Organization. (2022). Cervical cancer fact sheet. Retrieved from https://www.who.int/news-room/fact-sheets/detail/cervical-cancer
Wright, K. O., Aiyedehin, O., Akinyinka, M. R., & Ilozumba, O. (2014). Cervical cancer: Community perception and preventive practices in an urban neighborhood of Lagos (Nigeria). ISRN Preventive Medicine, 2014, 950534. https://doi.org/10.1155/2014/950534
Refbacks
- There are currently no refbacks.
