{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T05:11:31Z","timestamp":1767935491192,"version":"3.49.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T00:00:00Z","timestamp":1765584000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"publisher","award":["IZ08Z0_177319"],"award-info":[{"award-number":["IZ08Z0_177319"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Zambia has the third highest cervical cancer incidence rate globally, and it remains the leading cause of cancer-related death among women. We explored the experiences of Zambian women who accessed cervical cancer screening and precancer treatment services to understand factors influencing care-seeking and access across urban, peri-urban, and rural settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In 2020, we conducted eight focus group discussions with women living with and without Human Immunodeficiency Virus (HIV) who underwent cervical cancer screening between 2016 and 2020. To explore their care journey, participants were grouped by screening outcome\u2014those with cervical precancerous lesions and those without. We also conducted 18 in-depth interviews with healthcare workers providing antiretroviral treatment, cervical cancer screening, or precancer treatment at government health facilities. Transcripts were coded and analyzed using thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Care-seeking unfolded across five stages: recognition of need to screen, hesitation and consultation, screening, result interpretation, and treatment. Women were generally knowledgeable about cervical cancer and sought screening promptly, though some delayed due to fear. Social networks and interactions with healthcare workers facilitated screening, while logistical and financial barriers, along with delays in histopathology services particularly in rural areas, hindered access to timely diagnosis and treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Improving cervical cancer screening and precancer treatment in Zambia requires addressing systemic inefficiencies by strengthening laboratory capacity, decentralizing diagnostics, and training healthcare workers to provide respectful, consistent counselling. Expanding community engagement to counter misinformation, leveraging social networks, and providing financial protection are also critical to ensuring timely, equitable, and reassuring care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/oncolo\/oyaf412","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T13:15:31Z","timestamp":1765372531000},"source":"Crossref","is-referenced-by-count":0,"title":["The cervical cancer screening and precancer treatment journey: a qualitative study of experiences among Zambian women living with and without HIV"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3962-9204","authenticated-orcid":false,"given":"Misinzo","family":"Moono","sequence":"first","affiliation":[{"name":"Centre for Infectious Disease Research in Zambia Reproductive, Maternal, Newborn, and Child Health Department, , Lusaka 10101,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8189-0732","authenticated-orcid":false,"given":"Anjali","family":"Sharma","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Research in Zambia Social and Behavioural Science Department, , Lusaka 10101,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1955-1585","authenticated-orcid":false,"given":"Julia","family":"Bohlius","sequence":"additional","affiliation":[{"name":"Swiss Tropical and Public Health Institute Department of Epidemiology and Public Health, , Allschwil 4123,","place":["Switzerland"]},{"name":"University of Basel Department of Public Health, , Basel 4001,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mulindi","family":"Mwanahamuntu","sequence":"additional","affiliation":[{"name":"University Teaching Hospitals Women and Newborn Hospital, , Lusaka 10101,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0812-0069","authenticated-orcid":false,"given":"Katayoun","family":"Taghavi","sequence":"additional","affiliation":[{"name":"University of Bern, Institute of Social and Preventive Medicine, Bern CH-3012,","place":["Switzerland"]},{"name":"World Health Organization International Agency for Research on Cancer, , Lyon 69366,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chanda","family":"Mwamba","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Research in Zambia Social and Behavioural Science Department, , Lusaka 10101,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ntenje","family":"Katota","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Research in Zambia Social and Behavioural Science Department, , Lusaka 10101,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kabwe","family":"Mwamba","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Research in Zambia Social and Behavioural Science Department, , Lusaka 10101,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mwati","family":"Chipungu","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Research in Zambia Social and Behavioural Science Department, , Lusaka 10101,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"Hamweemba","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Research in Zambia Social and Behavioural Science Department, , Lusaka 10101,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6275-245X","authenticated-orcid":false,"given":"Albert","family":"Manasyan","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Research in Zambia Reproductive, Maternal, Newborn, and Child Health Department, , Lusaka 10101,","place":["Zambia"]},{"name":"University of Alabama at Birmingham Division of Neonatology, School of Medicine, , Birmingham, Alabama 35294-0019,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,12,13]]},"reference":[{"key":"2026010822164588000_oyaf412-B1","author":"Ferlay","year":"2025"},{"key":"2026010822164588000_oyaf412-B2","doi-asserted-by":"publisher","first-page":"e191","DOI":"10.1016\/S2214-109X(19)30482-6","article-title":"Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis","volume":"8","author":"Arbyn","year":"2020","journal-title":"Lancet Glob Health"},{"key":"2026010822164588000_oyaf412-B3","article-title":"Global Cancer Observatory: Cancer Today. 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