Psychological experiences and coping strategies among women with precancerous cervical lesions ineligible for ablative therapy: a qualitative study
Year: 2026
Type: preprint
Abstract: Background Cervical cancer (CC) remains a significant public health concern in Kenya, with only about 40% of age-eligible women accessing screening services. Women with precancerous cervical lesions who are ineligible for same-day screen-and-treat with thermal ablation often face multiple challenges beyond treatment costs that may delay timely linkage to care. Despite this, there is limited published evidence on the psychological and psychosocial experiences of these women, as well as the coping strategies they employ during this period. Methods Between September 2024 and February 2025, we conducted in-depth interviews (IDIs) at ten reproductive health clinics in Kenya among women with abnormal cervical cancer screening results ineligible for ablative therapy who were referred for further treatment. The IDI guide explored women’s psychological and psychosocial experiences and coping strategies. Thematic analysis was used to analyze the data Results We interviewed 20 women with a median age of 40 years (interquartile range [IQR]: 35–44); 35% (7/20) were married, and half (10/20) had received treatment. Reactions to screen-positive results included denial, with some questioning why they screened positive despite having no prior symptoms, fear of progression to cancer and death. Anxiety during linkage to care was driven by unclear referral instructions and health system frustrations, such as delays in accessing treatment due to multiple clinic visits and healthcare provider unavailability. Women expressed fear of treatment including concerns about physical exposure, femininity, and pain during surgical procedures such as hysterectomy, and myths and misconceptions that associate treatment with infertility or death. Emotional relief followed treatment with improved self-confidence and social interaction. Women coped through shifting perspectives and prioritizing health, trust in healthcare providers, social withdrawal, individual information-seeking and social support. Conclusions Women diagnosed with precancerous cervical lesions who are ineligible for ablative therapy face considerable psychological distress, including fear and anxiety, as they navigate treatment. Access to care is shaped by facilitating factors such as social support and trust in healthcare providers but is hindered by health system challenges and stigma. These findings underscore the need for integrated cervical cancer care that addresses psychological needs, improves referral clarity, and strengthens health systems to enhance timely linkage to care.
Source: Research Square
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7213987573