The effects of a lung cancer awareness intervention in KwaZulu-Natal (KZN): a stratified cluster based study in five representative communities=Imithelela yokungenelela ngokuqwashisa mayelana nomdlavuza wamaphaphu KwaZulu-Natali (KZN): Ucwaningo lwamaqoqo ngokohlelomikhakha emiphakathini emihlanu eqokelwe ucwaningo.

Abstract

Abstract

Background Lung cancer is the leading cause of cancer mortality worldwide, accounting for approximately 1.8 million cancer deaths in 2020. In South Africa, lung cancer is among the top four ranking cancers in terms of morbidity and mortality after breast, prostate, and cervical cancers. The objective of the study was, therefore, to investigate the level of awareness about lung cancer and its screening among communities in KZN, in an attempt to increase awareness of this disease across the province. Methodology A quasi-experiment study was conducted among the selected communities in KZN. In total, forty out of 879 clusters were selected, where a comparison between two cross-sectional surveys was done. An intervention employing community health workers aimed at raising awareness of lung cancer was developed, implemented and evaluated in these communities. A binary logistic regression model was used to measure the effects of the intervention. Results At baseline, approximately 59.9% (95% CI 52.0 - 67.3) of the participants had heard of lung cancer. About 5.7% (95% CI 3.9 - 8.1) were screened for lung cancer at the time. Coughing up blood was the most recognised symptom (61.0%, 95% CI 52.1 - 69.1). Post-intervention, the mean knowledge score increased to 59.9 (95% CI 53.8 – 66.0) (p<0.001). There was a reduction in the number of cigarettes smoked per day (p<0.001) and the number of packs smoked per week (p=0.026). However, the prevalence of smoking remained relatively the same before and after the intervention, at approximately 18% (p=0.958). The intervention had a statistically significant effect (aOR 4.370, 95% CI 1.477-12.928) on lung cancer knowledge in these communities (p<0.001). Conclusion The intervention in this study demonstrated the ability to raise awareness of lung cancer at a community level. It also reduced the number of cigarettes smoked among smokers. Therefore, integration into smoking cessation programmes should be explored. A national lung cancer screening programme should be introduced to encourage health-seeking behaviour. The integration of a lung cancer awareness intervention into the already existing community health worker programmes, such as the tuberculosis response strategy, is recommended.

Iqoqa

Isendlalelo Umdlavuza wamaphaphu ungenye yezimbangela eziphambili zokubulawa umdlavuza emhlabeni wonke jikelele. Kubantu ababulawa umdlavuza ngonyaka wezi-2020, bayi-1.8 wezigidi zabantu ababulawa umdlavuza wamaphaphu. ENingizimu Afrika umdlavuza wamaphaphu ungolunye lwezinhlobo ezine zomdlavuza ezihamba phambili eziphatha abantu futhi zibabulale emva komdlavuza webele, umdlavuza wamankwahlwa (iprostate), kanye nowesibeletho. Inhloso yalolu cwaningo kwakunguphenya ngamazinga olwazi mayelana nomdlavuza wamaphaphu kanye nokuhlolwa kwawo emiphakathini yaKwaZulu-Natali ngenjongo yokuqwashisa kabanzi ngalesi sifo esifundazweni jikelele.

Indlelakwenza Kwenziwa ucwaningo oluyisingalinge emiphakathini eqokelwe ucwaningo KwaZulu-Natali. Esewonke kwakhethwa amaqoqwana angama-879 lapho kwaqhathaniswa khona amasaveyi amabili across-sectional. Kwathuthukiswa, kwasetshenziswa kwaphinda kwahlolwa ukungenelela konompilo ngenhloso yokuqwashisa ngomdlavuza wamaphaphu kule miphakathi. Kwasetshenziswa imodeli yesilinganisobudlelwane ukulinganisa imithelela yalokhu kungenelela.

Imiphumela Ukusuka phansi, bangacishe babe ngama-59.9% (95% CI 52.0 - 67.3)kubabambiqhaza abake bezwa ngomdlavuza wamaphaphu. Okungenani u-5.7% (95% CI 3.9 - 8.1) wahlolwa umdlavuza wamaphaphu ngaleso sikhathi. Ukukhwehlela igazi yikhona okwakuyinkomba eyaziwayo (61.0%, 95% CI 52.1 - 69.1). Emva kokungenelela, imini yobungako bolwazi yanyukela ku-59.9% (95% CI 53.8 – 66.0) (p<0.001). Kwaba nokuncipha kwesibalo sosikilidi ababhenywa ngosuku (p<0.001) kanye namaphakethe abhenywa ngesonto (p=0.026). Kodwa-ke, ukuvama kokubhema akuzange kwehle ngaphambi kanye nasemuva kokungenelela; kwakumi ku-18% (p=0.958). Ukungenelela kwaba nomthelela omkhulu ngokwezibalomidanti (aOR 4.370, 95% CI 1.477-12.928)maqondana nolwazi ngomdlavuza wamaphaphu kule miphakathi (p<0.001).

Isiphetho Ukungenelela kulolu cwaningo kwakhombisa okungenzeka uma kuqwashiswa abantu ngomdlavuza wamaphaphu ezigabeni semiphakathi. Kwaphinda kwanciphisa isibalo sikasikilidi obhenywayo kubantu ababhemayo. Ngakho-ke kumele kuhlolwe izindlela zokuhlanganiswa kwezinhlelo zokuyekiswa ukubhema. Kumele kuqaliswe ngohlelo lukazwelonke lokuhlola umdlavuza wamaphaphu kubantu ukuze kukhuthazwe umkhuba wokufuna usizo lwezempilo. Kuphakanyiswa ukuthi kuhlanganiswe ukungenelela ngokuqwashisa abantu ngomdlavuza wamaphaphu ezinhlelweni zonompilo ezikhona emiphakathini ezifana namaqhinga okuhlangabezana nesifo sofuba.