Non-uptake of colposcopy in a resource-poor setting

Abstract Objective To determine the rate of acceptance/refusal of colposcopy and the reasons for refusal by women referred for the procedure in southeast Nigeria. Methods An audit was performed of the computerized database for all women referred for colposcopy at the University of Nigeria Teaching H...

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Bibliographic Details
Published in:International journal of gynecology and obstetrics 2011-05, Vol.113 (2), p.100-102
Main Authors: Chigbu, Chibuike O., Aniebue, Uzo U.
Format: Article
Language:English
Subjects:
Adult
Africa
Age Factors
Biological and medical sciences
Colposcopy
Colposcopy - methods
Colposcopy - utilization
Databases, Factual
Fear
Female
Gynecology. Andrology. Obstetrics
Humans
Medical sciences
Middle Aged
Nigeria
Obstetrics and Gynecology
Patient Acceptance of Health Care - statistics & numerical data
Patient Education as Topic
Refusal
Spiritual Therapies - methods
Surveys and Questionnaires
Treatment Refusal - psychology
Uterine Cervical Neoplasms - diagnosis
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Summary:Abstract Objective To determine the rate of acceptance/refusal of colposcopy and the reasons for refusal by women referred for the procedure in southeast Nigeria. Methods An audit was performed of the computerized database for all women referred for colposcopy at the University of Nigeria Teaching Hospital, Enugu, from August 1, 2009, to July 31, 2010. The characteristics of those who accepted colposcopy were compared with those who refused the procedure. An interviewer-administered questionnaire was used to assess reasons for refusal and the subsequent treatment chosen. Results During the study period, 154 women were referred for colposcopy: 103 (66.9%) accepted and 51 (33.1%) refused. Those who refused were younger and tended to be nulliparous ( P = 0.029 and P = 0.004, respectively). The most common reasons for refusal were fears of possible diagnosis of cervical cancer and compromise of future fertility. Most women who refused resorted to spiritual healing. Conclusion The rate of refusal of colposcopy in southeast Nigeria was high, indicating an urgent need for appropriate remedial measures instituted through intensive education of women regarding cervical cancer and its prevention. Targeted counseling should be initiated early as part of prescreening counseling.
ISSN:0020-7292
1879-3479
DOI:10.1016/j.ijgo.2010.11.017