Abstract
Cervical cancer is the leading cause of cancer death among women in Ghana. Cost-effective tools for the primary and secondary prevention of cervical cancer, such as the Pap test, the HPV DNA test, and the HPV vaccine, are available in hospitals and clinics throughout Ghana. However, participation in cervical cancer prevention behaviors is low among Ghanaian women. Our objective was to determine if there were significant differences in cervical cancer awareness and stigmatizing beliefs about women with cervical cancer between Ghanaian women of different education levels. We surveyed 288 Ghanaian women who were at least 18 years old. Data on the participants’ demographic characteristics, awareness of cervical cancer, cervical cancer screening, and the HPV vaccine, beliefs about cervical cancer screening, and stigmatizing beliefs about women with cervical cancer was collected. Chi-square tests for independence and Fisher’s exact test of independence were preformed to determine if education level was associated with those factors. Participation in cervical cancer screening and uptake of the HPV vaccine was significantly lower among women with less than a senior high school education. Awareness about cervical cancer, cervical cancer screening, and the HPV vaccine was lower among women with less education. Women with lower levels of education were more likely to agree with the negative statements about cervical cancer screening and stigmatizing beliefs about women with cervical cancer. Cervical cancer education interventions that are tailored for Ghanaian women with different educational levels are needed to increase awareness of and participation in cervical cancer prevention strategies.
Similar content being viewed by others
References
Bruni L, Barrionuevo-Rosas L, Albero G et al (2017) Human papillomavirus and related diseases in Ghana. Summary report. In: ICO information centre on HPV and cancer (HPV information centre)
Agyei-Mensah S, de-Graft Aikins A (2010) Epidemiological transition and the double burden of disease in Accra, Ghana. J Urban Health 87(5):879–897
de-Graft Aikins A, Addo J, Ofei F, Bosu W, Agyemang C (2012) Ghana’s burden of chronic non-communicable diseases: future directions in research, practice and policy. Ghana Med J 46:1–3
Forman D, Bray F, Brewster DH et al (eds) (2014) Cancer incidence in five continents. International Agency for Research on Cancer, Lyon
Jeronimo J, Bansil P, Lim J et al (2014) A multicountry evaluation of careHPV testing, visual inspection with acetic acid, and papanicolaou testing for the detection of cervical cancer. Int J Gynecol Cancer 24:576–585
Quentin W, Adu-Sarkodie Y, Terris-Prestholt F, Legood R, Opoku BK, Mayaud P (2011) Costs of cervical cancer screening and treatment using visual inspection with acetic acid (VIA) and cryotherapy in Ghana: the importance of scale. Tropical Med Int Health 16:379–389
Campos NG, Sharma M, Clark A, Kim JJ, Resch SC (2016) Resources required for cervical cancer prevention in low- and middle-income countries. PLoS One 11:e0164000
Mvundura M, Tsu V (2014) Estimating the costs of cervical cancer screening in high-burden Sub-Saharan African countries. Int J Gynecol Obstet 126:151–155
Gakidou E, Nordhagen S, Obermeyer Z (2008) Coverage of cervical cancer screening in 57 countries: low average levels and large inequalities. PLoS Med 5:e132
Blumenthal PD, Gaffikin L, Deganus S et al (2007) Cervical cancer prevention: safety, acceptability, and feasibility of a single-visit approach in Accra, Ghana. Am J Obstet Gynecol 196:407 e1–8 discussion 407 e8–9
Bosu WK (2012) A Comprehensive review of the policy and programmatic response to chronic non-communicable disease in Ghana. Ghana Med J 46:69–78
Awua AK, Sackey ST, Osei YD, Asmah RH, Wiredu EK (2016) Prevalence of human papillomavirus genotypes among women with cervical cancer in Ghana. Infect Agents Cancer 11:4
Handlogten KS, Molitor RJ, Roeker LE, Narla NP, Bachman MJ, Quayson S, Owusu-Afriyie O, Adjei E, Ankobea F, Clayton A, Roberts L, MacLaughlin K, Ansong D (2014) Cervical cancer screening in Ghana, West Africa: prevalence of abnormal cytology and challenges for expanding screening. Int J Gynecol Pathol 33(2):197–202
Laryea DO, Awuah B, Amoako YA, Osei-Bonsu E, Dogbe J, Larsen-Reindorf R, Ansong D, Yeboah-Awudzi K, Oppong JK, Konney TO, Boadu KO, Nguah SB, Titiloye NA, Frimpong NO, Awittor FK, Martin IK (2014) Cancer incidence in Ghana, 2012: evidence from a population-based cancer registry. BMC Cancer 14:362
Denny L, Hendricks B, Gordon C, Thomas F, Hezareh M, Dobbelaere K, Durand C, Hervé C, Descamps D (2013) Safety and immunogenicity of the HPV-16/18 AS04-adjuvanted vaccine in HIV-positive women in South Africa: a partially-blind randomised placebo-controlled study. Vaccine 31:5745–5753
Morhason-Bello IO, Odedina F, Rebbeck TR, Harford J, Dangou JM, Denny L, Adewole IF (2013) Challenges and opportunities in cancer control in Africa: a perspective from the African Organisation for Research and Training in Cancer. Lancet Oncol 14(4):e142–e151
(2014) Comprehensive cervical cancer control: a guide to essential practice. In. second ed. Geneva: World Health Organization
Kwan TTC, Lo SST, Tam K-F, Chan KKL, Ngan HYS (2012) Assessment of knowledge and stigmatizing attitudes related to human papillomavirus among Hong Kong Chinese healthcare providers. Int J Gynecol Obstet 116:52–56
Williams MS, Kuffour G, Ekuadzi E et al (2013) Assessment of psychological barriers to cervical cancer screening among women in Kumasi, Ghana using a mixed methods approach. Afr Health Sci 13(4):1048–1055
Williams MS (2014) A qualitative assessment of the social cultural factors that influence cervical cancer screening behaviors and the health communication preferences of women in Kumasi, Ghana. J Cancer Educ 29(3):555–562
Adanu RM (2002) Cervical cancer knowledge and screening in Accra, Ghana. J Women's Health Gend Based Med 11:487–488
Abotchie PN, Shokar NK (2009) Cervical cancer screening among college students in Ghana: knowledge and health beliefs. Int J Gynecol Cancer 19(3):412–416
Ebu NI, Mupepi SC, Siakwa MP, Sampselle CM (2015) Knowledge, practice, and barriers toward cervical cancer screening in Elmina, Southern Ghana. Int J Women’s Health 7:31–39
Coleman MA, Levison J, Sangi-Haghpeykar H (2011) HPV vaccine acceptability in Ghana, West Africa. Vaccine 29:3945–3950
Gavi (2013) Annual progress report 2012. In: Gavi
Goldie SJ, O’Shea M, Campos NG, Diaz M, Sweet S, Kim SY (2008) Health and economic outcomes of HPV 16,18 vaccination in 72 GAVI-eligible countries. Vaccine 26:4080–4093
Edwin AK (2010) Is routine human papillomavirus vaccination an option for Ghana? Ghana Med J 44:70–75
Education and Literacy Statistics for Ghana. http://uis.unesco.org/en/country/GH
Acknowledgements
Special thanks to the women who participated in this study. Sincere appreciation goes to Dorothy Kelly for supporting this study. Thank you to Chee Paul Linn for his assistance with the data analysis and Drs. Bettina Beech and Derek Griffith for their review of the manuscript. This project was supported by a Career Enhancement Award from the University of Alabama at Birmingham Office of Postdoctoral Education. The content is solely the responsibility of the authors and does not necessarily represent the official views of the author’s institutions.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Approval to conduct this study was provided by the Institutional Review Boards at the University of Alabama at Birmingham (UAB) in Birmingham (X150218005), and the Noguchi Memorial Institute for Medical Research in Accra (077/14-15). The scientific protocol was approved by the UAB Comprehensive Cancer Center Protocol Review Committee.
Conflict of Interest
The authors declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Williams, M.S., Kenu, E., Adanu, A. et al. Awareness and Beliefs About Cervical Cancer, the HPV Vaccine, and Cervical Cancer Screening Among Ghanaian Women with Diverse Education Levels. J Canc Educ 34, 897–903 (2019). https://doi.org/10.1007/s13187-018-1392-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13187-018-1392-y