Improving timely diagnosis of symptomatic breast and cervical cancer in Sub-Saharan Africa

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This research seeks to contribute to the evidence base for development of future interventions to promote timely diagnosis of breast and cervical cancer, the two leading causes of cancer mortality among women in Sub-Saharan Africa. The main objectives of this study are to: (1) develop and validate a tool to measure community breast and cervical cancer symptom awareness, knowledge and beliefs in Africa; (2) Describe and compare breast and cervical cancer symptom beliefs, knowledge and awareness in rural and urban settings in two countries in Sub-Saharan Africa -Uganda and South Africa; (3) Assess the degree to which symptom overlap between breast and cervical cancer and common infectious diseases influence symptom assessment and help-seeking behaviour, and;(4) Explore primary care level provider interpretation and management of breast and cervical cancer signs and symptoms.

The study is divided into four sub-studies corresponding with each of the four stipulated objectives, and will be conducted over a three year time frame. The overall research approach is guided by the Medical Research Council framework for the development and evaluation of complex interventions, which highlights the importance of adequate development and piloting work in designing interventions. The Model of Pathways to Treatment underpins the research enquiry and analysis. A mixed methods approach comprising cross-sectional community based surveys and qualitative in-depth interviews will be utilized in each of sub-study.

Collaborating institutions are: University of Cape Town, Kings College London, Cambridge University, Makerere University, Medical Research Council (UK), Medical Research Council (South Africa), and GlaxoSmithKline Research and Development Limited. To facilitate uptake of the research, project advisory committees will be set up in Uganda and South Africa at the start of the project. These will enable the research team to draw on the expertise of a broad group of stakeholders and provide advice on how best to address potential challenges, review the research results and assist in translating research findings into policy and practice.