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Developing and Implementing a Colorectal Cancer Screening Program in Uganda: Stakeholder Perceived Barriers and
Nicholas Matovu1, Helen G Coleman1,2, Gerald Mutungi3
1Centre for Public Health, Queen's University Belfast, Belfast, UK.
Cancer Medicine
|March 13, 2025
Summary
Uganda faces significant barriers to colorectal cancer (CRC) screening, including funding and awareness. Prioritizing primary prevention and education is crucial while addressing systemic challenges for future CRC screening programs.
Area of Science:
- Oncology
- Public Health
- Health Policy
Background:
- Colorectal cancer (CRC) incidence is rising in Uganda, with a high burden of early-onset and late-stage cases.
- Currently, no CRC screening program exists in Uganda, necessitating an understanding of local barriers and opportunities.
Purpose of the Study:
- To identify perceived barriers and opportunities for developing and implementing a CRC screening program in Uganda.
- To inform future CRC prevention and screening strategies within the Ugandan context.
Main Methods:
- Semi-structured key informant interviews were conducted with 11 stakeholders in cancer prevention, screening, and policy.
- Participants were recruited across Uganda using maximum variation sampling.
- Data analysis employed a deductive thematic analysis approach, guided by the social ecological model.
Main Results:
- Key barriers identified include lack of government priority, insufficient funding, inadequate facilities and workforce capacity, challenges in awareness delivery, and individual-level concerns.
- Opportunities include a draft national cancer control plan, cost-effective screening alternatives (like the faecal occult blood test), primary prevention measures, and community structures.
Conclusions:
- Substantive barriers hinder CRC screening program development and implementation in Uganda.
- The development of a national cancer control plan indicates a potential shift towards strategic resource allocation for cancer prevention.
- Immediate efforts should focus on primary prevention interventions, such as mass education to enhance CRC awareness.
