Individual-Level Factors that Contribute to Delayed Cervical Cancer Diagnosis among Patients in Kenya; A Hospital-Based Assessment.

Abstract

Cervical cancer ranks 4th as the most prevalent cancer among women worldwide. In Kenya, it is the 2nd most frequently diagnosed cancer and the leading cause of cancer-related deaths among women. Globally, more than 50% of Cervical Cancer diagnoses are made late, with this proportion rising to over 80% in developing countries. This study aimed to determine the individual-level factors contributing to delayed cervical cancer diagnosis. A cross-sectional hospital-based study was adopted to collect data on; Socio-demographics, affordability and use of health insurance, Cervical cancer and Human Papillomavirus (HPV) screening awareness, Prior HPV screening, Diagnosis circumstances, Time taken to seek medical attention, Fears and social support experiences, from 139 cervical cancer patients systematically sampled at the Kenyatta National Hospital, using a semi-structured questionnaire. Additionally, 8 Key Informants were purposively selected, to provide in-depth information. Associations between stage at diagnosis and individual-level factors were tested using logistic regression at 95% Confidence Interval. The mean age was 51 years and all participants were African and Christians. Majority (63.31%) were married and educated up to primary level, and more than half (61.15%) were unemployed. The prevalence of delayed diagnosis was 86(61.9%). The Risk Factors for delayed diagnosis were; Older age; 50-59 (p-value=0.049) & 60-69 years (0.013), Lack of HPV screening awareness (P-value=0.017), and Seeking medical attention only due to a symptomatic trigger (P-value=0.030). In corroboration, qualitative information reported that, inability to afford diagnosis costs, lack of awareness and poor medical care seeking habits, contribute to delayed diagnosis. The study identified gaps in awareness of Cervical Cancer and HPV screening among women and affordability of diagnosis costs. More community-level awareness should be created and, increase of centers and resources for diagnosis and free screening. Women should also be encouraged to pay for the National Health Insurance Fund (NHIF), so as to lessen their financial burden of diagnosis.