Perceived role of hot food in the pathogenesis of oesophageal cancer: a qualitative study in the Arsi Zone, Oromia, Central Ethiopia

Why Am I Ill? Beliefs in Supernatural and Natural Causes of Ill Health at the Time of Diagnostic Workup of Patients With Esophageal Cancer in Tanzania

PURPOSE

An understanding of the cultural and context-specific perceptions of the causes of cancer is an important prerequisite for designing effective primary health prevention and early detection strategies. We aimed to use the Murdock Ill Health Theoretical Model to conceptualize views on illness causation among dysphagia-suffering patients undergoing diagnostic workup for esophageal cancer (EC) in Tanzania.

METHODS

At the end of a structured interview on lifestyle habits, patients with suspected EC were asked about beliefs on the reasons behind their illness through (1) a set of questions with fixed binary answers, whose determinants were analyzed using logistic regression, and (2) a single question with free-text answers. Responses were coded using a hierarchy of natural and supernatural (godly and social constructs) causes.

RESULTS

Among 322 patients interviewed between November 2015 and December 2019, we found complex and varied views about the origins of their illness. Overall, 49% of patients attributed illness to natural causes and 39% to supernatural causes. Natural causes ranged from infection, use of alcohol and tobacco, other ailments, and the environment. The supernatural causes included attributing illness to God, curses, and spells from personal acquaintances. Belief in supernatural causes was more common in the less educated and those who sought help first via a traditional healer.

CONCLUSION

The results underscore the need for increased community awareness of biomedical causes of ill health and patient-based participatory research to inform prevention programs. The results also highlight the importance of building health systems that support a series of health-seeking behaviors that acknowledge both biomedical and local traditional healing belief systems.

The Increasing Burden of Cancer Among Women and in Rural Areas: A Retrospective Population-Based Study

The retrospective study aimed to describe the epidemiological characteristics and trends of cancer in Anhui Province, China between 2010 and 2018. Cancer registry data were analyzed using the Joinpoint regression model to calculate trends in cancer incidence and mortality. Age-standardized incidence rate, calculated based on the world Segi's population (ASIRW) was higher in males (239.34 per 100 000) than in females (157.13 per 100 000), and higher in rural areas (203.98 per 100 000) compared to urban areas (189.93 per 100 000). The ASIRW for males decreased with an AAPC of -3.0%, while that of females showed an upward trend with an AAPC of 2.1%. At the same time, the ASIRW in urban areas decreased with an AAPC of -2.4%, whereas it remained relatively stable in rural areas. Among males, lung cancer was the most prevalent type of cancer, while breast cancer was the most frequent cancer among women. The age-standardized mortality rate according to the world Segi's population (ASMRW) was 115.32 per 100 000. The ASMRW was higher in males (156.70 per 100 000) than in females (75.51 per 100 000), and higher in rural areas (122.18 per 100 000) than urban areas (109.21 per 100 000). Lung cancer accounted for the majority of cancer-associated mortalities in the province. Attention needs to be focused on women and rural areas due to rapidly increasing incidence and mortality rates for cancer. Furthermore, an effective public health response is imperative, encompassing early screening, diagnosis, and treatment of prevalent cancers in high-risk populations and regions. It's crucial to promote healthy lifestyles among the public through health education.