Factors influencing cervical cancer screening practice among female health workers in Nigeria: A systematic review

Investigating Factors Influencing the National Cancer Screening Program among Older Individuals in Republic of Korea-Data from the Korea National Health and Nutrition Examination Survey VIII

This study aims to determine the influencing factors of the participation of older individuals aged 65 years and above in South Korea's National Cancer Screening Program (NCSP) using data from the eighth wave (2019-2021) of the Korea National Health and Nutrition Examination Survey (KNHANES VIII), and discuss potential problems and coping strategies. Variables were selected based on Andersen's healthcare utilization model. "Participation in the NSCP" was considered the dependent variable, with independent variables including sociodemographic characteristics (sex, marital status, residence, education level, income level, economic activity, medical coverage type, and private insurance), health conditions (subjective health status, hypertension, and diabetes), and health behaviors (physical activity, monthly alcohol consumption, and current smoking status). The analysis revealed that higher participation rates correlated with being married, having an education level beyond elementary school, being employed, subscribing to private insurance, perceiving oneself as having average or poor health, engaging in physical activity, and not smoking. Sex, residence, income, medical coverage type, hypertension, diabetes, and monthly alcohol consumption were found to be insignificantly correlated. These findings underscore the importance of tailored promotion and health education for older individuals to boost NCSP participation rates, which could ultimately elevate public health standards.

Determinants of Cervical Cancer Screening among Female Health Professionals in Harar Town, Eastern Ethiopia: A Cross-Sectional Study

Background

Early screening for cervical cancer is a key life-saving intervention in reducing maternal mortality and morbidity. Despite the high burden of cervical cancer, the coverage of cervical cancer screening is low in developing countries, including Ethiopia. There is a paucity of information on the utilization of cervical cancer screening among female health professionals in eastern Ethiopia. This study aimedto assess the determinants of cervical cancer screening among female health professionals in Harar town, eastern Ethiopia.

Method

An institution-based cross-sectional study was conducted among 232 female health professionals in Harar town from September 01 to 30, 2022. Data were entered using EpiData version 3.1 and analyzed using SPSS version 27.0. Multivariable logistic regression analyses were conducted to identify significant factors for the level of cervical cancer screening. An adjusted odds ratio (AOR) with a 95% confidence interval was used to report the strength of association and statistical significance declared at p value < 0.05.

Results

The prevalence of cervical cancer screening among female health professionals was 16.8% (95% CI: 11%, 22%). Higher education level (AOR = 4.28, 95% CI: 1.68, 10.90), use of contraceptives (AOR = 2.71, 95% CI: 1.17, 6.23), training on cervical cancer screening (AOR = 2.53, 95% CI: 1.05, 6.08), good knowledge about cervical cancer screening (AOR = 3.37, 95% CI: 1.44, 7.91), and positive attitude toward cervical cancer screening (AOR = 5.31, 95% CI: 2.04, 13.83) were independent factors that increased the utilization of cervical cancer screening.

Conclusion

One in every six female health professionals was screened for cervical cancer. Education level, contraceptive use, cervical cancer screening training, cervical cancer screening knowledge, and attitude toward cervical cancer screening were the determinants of cervical cancer screening utilization among female health professionals. Improving the health professionals' knowledge and attitude toward cervical cancer screening through upgrading their education level and training on cervical cancer screening would be essential to improving the level of cervical cancer screening.

Comparative effectiveness of implementation strategies for Accelerating Cervical Cancer Elimination through the integration of Screen-and-treat Services (ACCESS study): protocol for a cluster randomized hybrid type III trial in Nigeria

BACKGROUND

Despite the increased risk of cervical cancer (CC) among women living with HIV (WLHIV), CC screening and treatment (CCST) rates remain low in Africa. The integration of CCST services into established HIV programs in Africa can improve CC prevention and control. However, the paucity of evidence on effective implementation strategies (IS) has limited the success of integration in many countries. In this study, we seek to identify effective IS to enhance the integration of CCST services into existing HIV programs in Nigeria.

METHODS

Our proposed study has formative and experimental activities across the four phases of the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework. Through an implementation mapping conducted with stakeholders in the exploration phase, we identified a core package of IS (Core) and an enhanced package of IS (Core+) mostly selected from the Expert Recommendations for Implementing Change. In the preparation phase, we refined and tailored the Core and Core+ IS with the implementation resource teams for local appropriateness. In the implementation phase, we will conduct a cluster-randomized hybrid type III trial to assess the comparative effectiveness of Core versus Core+. HIV comprehensive treatment sites (k = 12) will be matched by region and randomized to Core or Core+ in the ratio of 1:1 stratified by region. In the sustainment phase, we will assess the sustainment of CCST at each site. The study outcomes will be assessed using RE-AIM: reach (screening rate), adoption (uptake of IS by study sites), IS fidelity (degree to which the IS occurred according to protocol), clinical intervention fidelity (delivery of CC screening, onsite treatment, and referral according to protocol), clinical effectiveness (posttreatment screen negative), and sustainment (continued integrated CCST service delivery). Additionally, we will descriptively explore potential mechanisms, including organizational readiness, implementation climate, CCST self-efficacy, and implementation intentions.

DISCUSSION

The assessment of IS to increase CCST rates is consistent with the global plan of eliminating CC as a public health threat by 2030. Our study will identify a set of evidence-based IS for low-income settings to integrate evidence-based CCST interventions into routine HIV care in order to improve the health and life expectancy of WLHIV.

TRIAL REGISTRATION

Prospectively registered on November 7, 2023, at ClinicalTrials.gov no. NCT06128304. https://classic.

CLINICALTRIALS

gov/ct2/show/study/NCT06128304.

Factors Associated With the Uptake of Cervical Cancer Screening Among Family Medicine Physicians, Compared With Women of the Community in Riyadh, Saudi Arabia

BACKGROUND

Cervical cancer is the ninth diagnosed cancer among Saudi women. The majority of cervical cancer cases occur in women who did not undergo screening. However, the screening rates in several countries, including Saudi Arabia, remain suboptimal. It is important to identify the factors associated with the uptake of screening and predictors of screening in order to increase the uptake rate.

AIM

To determine the factors associated with the uptake of cervical cancer screening among family medicine physicians (FMPs), compared with women of the community.

METHODS

This was a cross-sectional study conducted in the central region (Riyadh), Kingdom of Saudi Arabia from February 2021 for 12 months on female physicians and women of the community. An electronic questionnaire was used to investigate the demographics of women and variables related to the uptake of screening.

RESULTS

A total of 126 FMP and 127 women from the community were included. The factors affecting screening among FMP included age (P=0.013), health insurance (P=0.002), availability of Pap smear (P˂0.001), and physician encouragement (P˂0.001). The factors affecting the screening of community women included the availability of Pap smears (P˂0.001) and physician encouragement (P˂0.001). Multivariate analysis revealed that physician encouragement of Pap smear was a significant predictor of screening among FMP (OR=8.26, P˂0.001) and community women (OR=6.67, P˂0.001). The perceived benefit was the only predictor for screening among FMP (OR=0.75, P=0.004).

CONCLUSION

The uptake of cervical cancer screening was higher in the community women. The factors linked to the uptake differed among the two groups, but the support of doctors played a significant role in the likelihood of uptake, regardless of the group of women. It is recommended to enhance the guidance of medical personnel in recommending screening during clinic visits for the specific target group. Additionally, there should be increased education on the significance of screening and efforts to educate the community about cervical cancer and screening.

Predictors of non-adherence to cervical cancer screening among immigrant women in Ontario, Canada

Cervical cancer is one of the most common types of cancer among women and is largely preventable with regular screening using Papanicolau (Pap) tests. In Canada, all provinces have regular screening programs, although with slightly differing recommendations. Previous research has found that immigrant women, who are a large proportion of the Canadian population, are at higher risk of being under-screened, or non-adherent to the recommended screening frequency. Using data from the 2017 Canadian Community Health Survey, this study examined: (1) the extent to which immigration status and time since immigration are associated with Pap test adherence in Ontario, and (2) predictors of Pap test adherence for immigrants and Canadian born populations in Ontario, Canada's most populous province, with a focus on the role of racial or ethnic identity among immigrants. Estimates of 3-year test adherence were 71.3 % (95 %CI: 66.9-75.7) among immigrant women and 75.4 % (95 %CI: 73.1-77.1) among non-immigrant women. Recent immigrants (6-10 years in Canada) had lower adherence (63.5 %, 95 %CI: 48.0-80.0). Logistic regression models found that immigrant women had lower adherence than Canadian-born women, controlling for age, household income, education, and having a primary care physician. Subgroup analysis found that South Asian immigrant women were least likely to be adherent. These results support targeted programming to increase screening adherence among recent immigrants and raise concerns regarding potential barriers to screening. Data that allow better disaggregation of racial and ethnic identities are important for better understanding the potential implications of these patterns for racial inequities in health.

Evaluation of barriers to cervical cancer screening in Georgia

OBJECTIVES

The Cervical Cancer (CC) Screening Programme in Georgia provides insufficient coverage of the target population. The aim of the study is to identify the barriers to cervical cancer screening for women in Georgia in order to plan and implement adequate measures to increase the screening effectiveness.

METHODS

The study is based on the results of a survey of 582 women aged 25-60 years (mean age 42.11 + 12.17). Respondents were selected in out-patient clinics. The questionnaire included questions related to the place of residence, ethnicity, religion, marital status, education, employment, cervical cancer awareness and screening, screening participation practices, and barriers to participation.

RESULTS

The following factors reliably increase the chance of participating in the screening: residing in Tbilisi, OR = 1.84 (95% CI: 1.10-3.07); higher education, OR = 1.87 (95% CI: 1.09-3.19); being employed as a nurse, OR = 3.42 (95% CI: 1.49-7.85); receiving screening-related information from medical staff, OR = 2.43 (95% CI: 1.42-4.15); and from television, OR = 2.57 (95% CI: 1.47-4.50). The chance of participating in the screening is reduced due to incomplete secondary education, OR = 0.10 (95% CI: 0.01-0.77); single marital status, OR = 0.49 (95% CI: 0.28-0.87); employment in public service, OR = 0.39 (95% CI: 0.17-0.89); and receiving screening-related information from friends, OR = 0.26 (95% CI: 0.09-0.77). Women with higher education are undoubtedly more informed about screening, screening procedures and free programmes than those without higher education. The common barrier to participation in the screening was "fear of the manipulation-related pain" but the most frequent answer was "I'm afraid that the test will detect cancer (36.3%)." Women with a lower level of education are more likely to believe that "Pap testing is appropriate for the women who have active sexual life", and/or "have multiple sexual partners", and/or "have children," and "it is not necessary if a woman has no complaints".

CONCLUSION

Screening participation among women in Georgia depends on screening availability, formal education and awareness of CC, sources of information, and employment type.

Socio-demographic determinants of cervical cancer screening uptake among women of child-bearing age in Mangochi, Malawi: a facility-based cross-sectional study

Background

Cervical cancer (CC) is the number one leading cause of death among women in Malawi. However, it is generally viewed as preventable and treatable if diagnosed in an early stage. Despite the burden, Malawi registers low uptake of cervical cancer screening (CCS). This study examined the socio-demographic determinants of CCS uptake among women of child-bearing age (WCBA) in Mangochi district.

Methods

A cross-sectional quantitative study was conducted in five health facilities. A total of 482 women between the ages of 18–49 participated and were sampled using a multi-stage sampling method. An interviewer administered structured questionnaire was used to collect data from June to July, 2019. Multivariate logistic regression model was used to identify determinants of CCS uptake among WCBA.

Results

Few respondents (13.1%) had ever done CCS. Compared to respondents in the age-group of 18–24 years, those in the age-groups of 25–35 years and 36–49 years were 2.63 and 3.90 times more likely to undergo CCS (AOR = 2.63, 95% CI 1.30–5.31 and AOR = 3.90, 95% CI 1.62–9.38), respectively. Respondents who practiced Christianity were 2.77 times more likely to undergo CCS than those who practiced Islam (AOR = 2.77, 95% CI 1.23–6.22). Respondents of the Chewa ethnic group were 71% less likely to undergo CCS as compared to those of Yao ethnicity (AOR = 0.29, 95% CI 0.09–0.95). Respondents who lived in semi-urban areas were 2.57 times more likely to go for CCS than those who were village residents (AOR = 2.57, 95% CI 1.19–5.55).

Conclusion

Our study showed that CCS uptake was low in Mangochi and the results suggested that age, religion, ethnicity and place of residence were determinants of CCS uptake. We recommend that comprehensive health education on CC should specifically target the young women and Muslim women in places where they meet. We call upon the district health authorities to scale up CCS provision in all Antiretroviral Therapy (ART) and outreach clinics to improve CCS uptake among women residing in the villages and those of the Chewa ethnicity. We, further, call upon all CC program implementers to design programs that address the highlighted socio-demographic determinants of CCS uptake among WCBA in the district.