Navigating cervical cancer treatment in South Africa’s public health system: Women’s experiences at a tertiary hospital
1
Health Economics Unit, UNIVERSITY OF CAPETOWN, Cape Town, South Africa
2
Division of Public Health Medicine, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
3
South African Medical Research Council, Gynaecology Cancer Research Centre, Department Obstetrics and Gynaecology, Faculty of Health Sciences, UNIVERSITY OF CAPETOWN, Cape Town, South Africa
4
Radiation Oncology, Groote Schuur Hospital, Cape Town, South Africa
5
Faculty of Medicine and Health Sciences, University of Zimbabwe, Zimbabwe, University of Zimbabwe, Harare,, Zimbabwe
Popul. Med. 2026;8(Supplement Supplement 1):A2981
ABSTRACT
INTRODUCTION:
Cervical cancer remains a leading cause of cancer morbidity and mortality among women in South Africa, despite free screening and subsidised treatment in the public health sector. While access to services has improved, less is known about how women experience and navigate the treatment pathway.
METHODS:
This qualitative study explored women’s experiences of cervical cancer treatment at a tertiary public sector hospital in South Africa. In-depth interviews were conducted with 22 women receiving treatment. Data were analysed thematically, guided by the Model of Pathways to Treatment to examine symptom appraisal, help-seeking, diagnosis, and treatment navigation, alongside Page’s psychosocial costs framework to capture intangible treatment burdens.
RESULTS:
Women recognised symptoms early and initially sought care at primary-level facilities, often making repeated visits due to persistent symptoms and perceived misdiagnosis. Delays were compounded by unclear or “normal” Pap smear results despite ongoing symptoms, generating perceptions of missed opportunities for earlier diagnosis. Treatment imposed substantial intangible costs, including physical suffering, psychological distress, loss of income, strained household roles, and disruptions to intimacy and identity. Health system experiences shaped treatment navigation, with long waiting times, fragmented information, and uneven interactions with healthcare workers, particularly at lower levels of care. Peer misinformation and fears of stigma contributed to selective non-disclosure and emotional isolation. Religion and faith emerged as coping resources, providing meaning, hope, and emotional endurance. Women’s sense of womanhood was challenged through impacts on intimacy but re-anchored in resilience, caregiving roles, and personal strength. Participants proposed system-level improvements, including decentralised services, peer support, clearer patient information, transport flexibility, and sustained psychosocial support.
CONCLUSIONS:
Women’s experiences highlight how psychosocial burdens, and health system gaps shape cervical cancer treatment navigation, even within free public-sector. Addressing these challenges requires improved communication, integrated service delivery, and patient-centred psychosocial support to enhance treatment experiences
Cervical cancer remains a leading cause of cancer morbidity and mortality among women in South Africa, despite free screening and subsidised treatment in the public health sector. While access to services has improved, less is known about how women experience and navigate the treatment pathway.
METHODS:
This qualitative study explored women’s experiences of cervical cancer treatment at a tertiary public sector hospital in South Africa. In-depth interviews were conducted with 22 women receiving treatment. Data were analysed thematically, guided by the Model of Pathways to Treatment to examine symptom appraisal, help-seeking, diagnosis, and treatment navigation, alongside Page’s psychosocial costs framework to capture intangible treatment burdens.
RESULTS:
Women recognised symptoms early and initially sought care at primary-level facilities, often making repeated visits due to persistent symptoms and perceived misdiagnosis. Delays were compounded by unclear or “normal” Pap smear results despite ongoing symptoms, generating perceptions of missed opportunities for earlier diagnosis. Treatment imposed substantial intangible costs, including physical suffering, psychological distress, loss of income, strained household roles, and disruptions to intimacy and identity. Health system experiences shaped treatment navigation, with long waiting times, fragmented information, and uneven interactions with healthcare workers, particularly at lower levels of care. Peer misinformation and fears of stigma contributed to selective non-disclosure and emotional isolation. Religion and faith emerged as coping resources, providing meaning, hope, and emotional endurance. Women’s sense of womanhood was challenged through impacts on intimacy but re-anchored in resilience, caregiving roles, and personal strength. Participants proposed system-level improvements, including decentralised services, peer support, clearer patient information, transport flexibility, and sustained psychosocial support.
CONCLUSIONS:
Women’s experiences highlight how psychosocial burdens, and health system gaps shape cervical cancer treatment navigation, even within free public-sector. Addressing these challenges requires improved communication, integrated service delivery, and patient-centred psychosocial support to enhance treatment experiences
| eISSN: | 2654-1459 |
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