Perceptions and Barriers to Cervical Cancer Screening: A Phenomenological Analysis in an Urban Health District in Cameroon

Abstract

Introduction: Cervical cancer (CC) is the second most common cancer among women in Cameroon, with 2,525 new cases and 1,837 deaths estimated in 2022. Despite the critical importance of screening, national participation remains low (8%–19.6%). This study explored perceptions and barriers to CC screening among non-screened women living in a densely populated urban district of Yaoundé. Methods: A qualitative phenomenological study was conducted in the Biyem-Assi Health District from September to October 2023. Eleven purposively selected women aged 24–57 years who had never undergone screening were interviewed using semi-structured guides. Data were analyzed through inductive thematic content analysis and interpreted using the Health Belief Model (HBM). Results: Participants perceived CC as severe but showed marked cognitive dissonance: eight women believed screening was unnecessary, often citing fatalism (“If I must be sick, it is God’s decision”). Barriers included cost, fear of results, mistrust of screening quality, and limited health promotion. Systemic gaps-particularly poor outreach and confusion between screening and late-stage diagnosis-further reduced perceived benefits. Conclusion: Non-participation in CC screening results from intertwined psychological, socioeconomic, and systemic barriers. Suggested implications include strengthening communication strategies to address fatalism, improving screening affordability, and enhancing community-level awareness.