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Wang M, Yang HL, Liu XL, Mo BR, Kynoch K, Ramis MA. Evaluating behavioral economic interventions for promoting cancer screening uptake and adherence in targeted populations: a systematic review protocol. JBI Evid Synth 2022; 20:1113-1119. [PMID: 35013041 DOI: 10.11124/jbies-21-00265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this review is to determine the effectiveness of behavioral economic interventions for promoting uptake of and adherence to cancer screening recommended by guidelines. INTRODUCTION Cancer screening has been found to help reduce incidence of and mortality from advanced cancer. However, adherence to recommended cancer screening services is low in asymptomatic adults with average risk possibly due to systematic decision biases. The findings of this review will demonstrate whether interventions informed by behavioral economic insights can help improve uptake of and adherence to cancer screening. INCLUSION CRITERIA This review will consider studies that meet the following inclusion criteria: experimental, quasi-experimental, and analytical observational studies that i) evaluate the effects of behavioral economic interventions in adults eligible for guideline-recommended cancer screening, and that ii) report the number/percentage of individuals who used screening services; number/percentage of individuals who completed screening recommended by guidelines; participant self-reported intentions, choice, and satisfaction regarding the use of screening services; detection rates of early-stage cancers; use of early intervention for cancers; and cancer-related mortality. METHODS A systematic literature search will be performed by one reviewer. After removing duplicates, two reviewers will independently screen and appraise eligible studies according to the JBI methodology for systematic reviews of effectiveness. Five databases will be searched: CINAHL, the Cochrane Library, PsycINFO, PubMed, and Web of Science. Sources of gray literature and registered clinical trials will also be searched for potential studies. There will be no limits to publication date or language. Data synthesis will be conducted using meta-analysis and narrative synthesis where appropriate. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42021258370.
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Affiliation(s)
- Mian Wang
- Department of Nursing, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, Guangdong Province, China Nanshan Evidence Based Nursing Centre: A JBI Affiliated Group, Shenzhen, Guangdong Province, China School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China College of Nursing and Midwifery, Charles Darwin University, Brisbane, QLD, Australia Mater Health, Evidence in Practice Unit, South Brisbane, QLD, Australia The Queensland Centre for Evidence Based Nursing and Midwifery: A JBI Institute Centre of Excellence, Brisbane, QLD, Australia
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Ilic I, Babic G, Dimitrijevic A, Ilic M, Sipetic Grujicic S. Internal consistency and validity of the Hospital Anxiety and Depression Scale (HADS) in women with abnormal Pap smear in Serbia. Women Health 2021; 61:363-371. [PMID: 33641629 DOI: 10.1080/03630242.2021.1893244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Receiving a report of an abnormal finding of Pap screening test in women often leads to anxiety and depression. The purpose of this study was to investigate the construct validity and internal consistency reliability of the Serbian version of the Hospital Anxiety and Depression Scale (HADS) in women with abnormal Pap smear results. In 2017, a cross-sectional study was done involving 142 consecutive women attending cervical cancer screening who had received abnormal Pap smear results at one University clinical center in Serbia. We used exploratory factor analysis to establish the structure of the HADS and Cronbach's alpha coefficient was used for assessing the internal consistency. In our study, the HADS demonstrated high internal consistency, for both subscales (Cronbach's alpha coefficient for subscale Anxiety was 0.862, and for subscale Depression was 0.851). The intra-class correlation coefficients for the two components were significant (0.860 and 0.843, p < .001). Principal component analysis with Oblimin rotation indicated a two-factor structure that explained 56.4% of variance. In conclusion, the Serbian version of the HADS showed satisfactory internal consistency reliability and construct validity and could be useful as a screening questionnaire for the assessment of anxiety and depression among women with abnormal Pap smear results.
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Affiliation(s)
- Irena Ilic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Goran Babic
- Department of Gynecology and Obstetrics, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Aleksandra Dimitrijevic
- Department of Gynecology and Obstetrics, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Milena Ilic
- Department of Epidemiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
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Ribeiro CM, Dias MBK, Pla MAS, Correa FM, Russomano FB, Tomazelli JG. [Parameters for programming line of care procedures for cervical cancer in Brazil]. CAD SAUDE PUBLICA 2019; 35:e00183118. [PMID: 31291431 DOI: 10.1590/0102-311x00183118] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 02/06/2019] [Indexed: 11/22/2022] Open
Abstract
The study estimated parameters for planning and programming the supply of procedures for screening, diagnostic workup, and treatment of precursor lesions of uterine cervical cancer. These estimates were used as the basis for assessing the adequacy of Brazil's production of procedures performed by the Brazilian Unified National Health System (SUS) in 2017. Estimates were calculated using as the reference the recommended management in the national screening guidelines. Data on screening tests were obtained from the Information System on Uterine Cervical Cancer and the follow-up data from patient charts in a referral center for cervical pathology. Brazil's production of procedures was obtained from data in the Outpatient and Hospital Information Systems of the SUS. For every one hundred thousand women in the target age bracket for screening (25 to 64 years) there was an estimated annual need for 44,134 cytopathology tests, 1,886 colposcopies, 275 biopsies, 236 type 1 and 2 outpatient exicision procedures, 236 type 2 and 3 hospital exicision procedures, and 39 high-complexity referrals for surgery, chemotherapy, and/or radiotherapy. Applying the estimated parameters to the number of women screened in Brazil in 2017, a deficit was identified in all the procedures for adequate follow-up of the women with altered test results, varying from 7% in colposcopies to 74% in type 3 excisions. The results point to the need to expand and upgrade the supply of line of care procedures for cervical cancer. The estimated parameters can support policymakers in programming and implementing organized screening programs.
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Affiliation(s)
| | | | | | | | - Fábio Bastos Russomano
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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Caporossi A, Olicard C, Seigneurin A, Garnier A. [Interval between two smear tests for cervical cancer screening and characteristics of women with a short interval: Study in the department of Isère]. Rev Epidemiol Sante Publique 2019; 67:143-147. [PMID: 30981595 DOI: 10.1016/j.respe.2019.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 02/13/2019] [Accepted: 02/15/2019] [Indexed: 12/24/2022] Open
Abstract
AIMS In France, guidelines for cervical cancer screening recommend that women between the ages of 25-65 have a smear test performed once every three years. However, some women are screened significantly more frequently. In this study, we used a data-driven approach as opposed to a traditional hypothesis-driven approach to characterise the population of women who are screened more frequently than advised. METHODS Data came from an organised cervical cancer screening programme of a French department in the Alps (Isère). We retrospectively selected women aged between 25 to 65 years old who had at least two smear tests during the follow up period (2011-2015). We used a data-driven clustering approach to compare the population of over-screened women with other populations. We then performed a descriptive analysis of the over-screened population using univariate (Chi2 test) and multivariate (logistic regression) methods. RESULTS A total of 10,000 patients were randomly chosen from a population of 54,073. In our univariate analysis, women in the over-screened population were significantly younger, participated less in organised screening, were more likely to be followed by a gynaecologist and had more smear test results showing inflammation than the other populations. Patient location (urban v.s. rural area) was not significant for this population. The multivariate analysis confirmed these results. CONCLUSION This data-driven approach based on an unsupervised learning method enables us to more accurately characterise the over-screened population. These data invite to improve communication with the youngest women and the gynecologists to recall the benefit of an interval between two normal smears complying with the recommendations. This approach could help to improve the prevention and have a real impact on this Public Health issue.
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Affiliation(s)
- A Caporossi
- Pôle santé publique, département de méthodologie de l'information de santé, CHU de Grenoble-Alpes, 38000 Grenoble, France.
| | - C Olicard
- Office de lutte contre le cancer en Isère, 38240 Meylan, France
| | - A Seigneurin
- Pôle santé publique, service de qualitique et d'évaluation médicale, CHU de Grenoble-Alpes, 38000 Grenoble, France
| | - A Garnier
- Office de lutte contre le cancer en Isère, 38240 Meylan, France
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Vale DB, Anttila A, Ponti A, Senore C, Sankaranaryanan R, Ronco G, Segnan N, Tomatis M, Žakelj MP, Elfström KM, Lönnberg S, Dillner J, Basu P. Invitation strategies and coverage in the population-based cancer screening programmes in the European Union. Eur J Cancer Prev 2019; 28:131-140. [PMID: 29570103 DOI: 10.1097/cej.0000000000000426] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The aim of this study was to describe the compliance of the population-based cancer screening programmes in the European Union Member States to the invitation strategies enumerated in the European Guidelines and the impact of such strategies on the invitational coverage. Experts in screening programme monitoring from the respective countries provided data. Coverage by invitation was calculated as the proportion of individuals in the target age range receiving a screening invitation over the total number of annualized eligible population. The invitation strategies of 30 breasts, 25 cervical and 27 colorectal national or regional population-based screening programmes are described. Individual mail invitations are sent by 28 breasts, 20 cervical and 25 colorectal screening programmes. Faecal occult blood test kits are sent by post in 17 of the colorectal cancer screening programmes. The majority of programmes claimed to have a population registry, although some use health insurance data as the database for sending invitations. At least 95% invitation coverage was reached by 16 breast, six cervical and five colorectal screening programmes. Majority of the programmes comply with the invitation strategies enumerated in the European guidelines, although there is still scope for improvements. Coverage by invitation is below the desirable level in many population-based cancer screening programmes in European Union.
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Affiliation(s)
- Diama B Vale
- Department of Obstetrics and Gynecology, State University of Campinas (Unicamp), Campinas, Brazil
| | | | - Antonio Ponti
- CPO Piemonte and University Hospital 'Cittàdella Salute e dellaScienza', Turin, Italy
| | - Carlo Senore
- CPO Piemonte and University Hospital 'Cittàdella Salute e dellaScienza', Turin, Italy
| | | | - Guglielmo Ronco
- CPO Piemonte and University Hospital 'Cittàdella Salute e dellaScienza', Turin, Italy
| | - Nereo Segnan
- CPO Piemonte and University Hospital 'Cittàdella Salute e dellaScienza', Turin, Italy
| | - Mariano Tomatis
- CPO Piemonte and University Hospital 'Cittàdella Salute e dellaScienza', Turin, Italy
| | - Maja P Žakelj
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | | | - Stefan Lönnberg
- Finnish Cancer Registry, Helsinki, Finland
- Cancer Registry of Norway, Oslo, Norway
| | | | - Partha Basu
- Screening Group, International Agency for Research on Cancer, Lyon, France
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Li Y, Ma L, Yang C, Chen Z, Zhao Y, Dang L, Lang J, Qiao Y. A study on service capacity of primary medical and health institutions for cervical cancer screening in urban and rural areas in China. Chin J Cancer Res 2019; 31:838-848. [PMID: 31814687 PMCID: PMC6856697 DOI: 10.21147/j.issn.1000-9604.2019.05.13] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objective To provide a decision-making basis for sustainable and effective development of cervical cancer screening. Methods This cross-sectional study assesses the service capacity to conduct cervical cancer screening with a sample of 310 medical staff, medical institutions and affiliated township health centers from 20 county-level/district-level areas in 14 Chinese provinces in 2016. Results The county-level/district-level institutions were the main prescreening institutions for cervical cancer screening. More medical staff have become engaged in screening, with a significantly higher amounts in urban than in rural areas (P<0.05). The number of human papillomavirus (HPV) testers grew the fastest (by 225% in urban and 125% in rural areas) over the course of the project. HPV testing took less time than cytology to complete the same number of screening tasks in both urban and rural areas. The proportion of mid-level professionals was the highest among the medical staff, 40.0% in urban and 44.7% in rural areas (P=0.406), and most medical staff had a Bachelor’s degree, accounting for 76.3% in urban and 52.0% in rural areas (P<0.001). In urban areas, 75.0% were qualified medical staff, compared with 68.0% in rural areas, among which the lowest proportion was observed for rural cytology inspectors (22.7%). The medical equipment for cervical pathology diagnosis in urban areas was better (P<0.001). HPV testing equipment was relatively adequate (typing test equipment was 70% in urban areas, and non-typing testing equipment was 70% in rural areas). Conclusions The service capacity of cervical cancer screening is insufficient for the health needs of the Chinese population. HPV testing might be an optimal choice to fill the needs of cervical cancer screening given current Chinese medical health service capacity.
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Affiliation(s)
- Yang Li
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.,Division of Health Information Dissemination, Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100005, China
| | - Li Ma
- Department of Epidemiology, Dalian Medical University, Dalian 116027, China
| | - Chunxia Yang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Zhangya Chen
- Executive office, Taiyuan Health Supervision, Taiyuan 030001, China
| | - Yuqian Zhao
- Office of Cancer Prevention and Treatment, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science & Technology of China, Chengdu 610041, China
| | - Le Dang
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Jinghe Lang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College (CAMS/PUMC), Beijing 100730, China
| | - Youlin Qiao
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Li M, Roder D, Whop LJ, Diaz A, Baade PD, Brotherton JM, Canfell K, Cunningham J, Garvey G, Moore SP, O'Connell DL, Valery PC, Condon JR. Aboriginal women have a higher risk of cervical abnormalities at screening; South Australia, 1993-2016. J Med Screen 2018; 26:104-112. [PMID: 30419778 DOI: 10.1177/0969141318810719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Cervical cancer mortality has halved in Australia since the national cervical screening program began in 1991, but elevated mortality rates persist for Aboriginal and Torres Strait Islander women (referred to as Aboriginal women in this report). We investigated differences by Aboriginal status in abnormality rates predicted by cervical cytology and confirmed by histological diagnoses among screened women. METHODS Using record linkage between cervical screening registry and public hospital records in South Australia, we obtained Aboriginal status of women aged 20-69 for 1993-2016 (this was not recorded by the registry). Differences in cytological abnormalities were investigated by Aboriginal status, using relative risk ratios from mixed effect multinomial logistic regression modelling. Odds ratios were calculated for histological high grade results for Aboriginal compared with non-Aboriginal women. RESULTS Of 1,676,141 linkable cytology tests, 5.8% were abnormal. Abnormal results were more common for women who were younger, never married, and living in a major city or socioeconomically disadvantaged area. After adjusting for these factors and numbers of screening episodes, the relative risk of a low grade cytological abnormality compared with a normal test was 14% (95% confidence interval 5-24%) higher, and the relative risk of a high grade cytological abnormality was 61% (95% confidence interval 44-79%) higher, for Aboriginal women. The adjusted odds ratio of a histological high grade was 76% (95% confidence interval 46-113%) higher. CONCLUSIONS Ensuring that screen-detected abnormalities are followed up in a timely way by culturally acceptable services is important for reducing differences in cervical cancer rates between Aboriginal and non-Aboriginal women.
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Affiliation(s)
- Ming Li
- 1 School of Health Sciences, University of South Australia, Adelaide, Australia
| | - David Roder
- 1 School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Lisa J Whop
- 2 Menzies School of Health Research, Charles Darwin University, Casuarina, Australia
| | - Abbey Diaz
- 2 Menzies School of Health Research, Charles Darwin University, Casuarina, Australia
| | | | - Julia Ml Brotherton
- 4 Victorian Cytology Service, Carlton, Australia
- 5 School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Karen Canfell
- 6 Cancer Council NSW, Cancer Research Division, Kings Cross, Australia
- 7 School of Public Health, University of Sydney, Sydney, Australia
- 8 Prince of Wales Clinical School, University of NSW, Sydney, Australia
| | - Joan Cunningham
- 2 Menzies School of Health Research, Charles Darwin University, Casuarina, Australia
| | - Gail Garvey
- 2 Menzies School of Health Research, Charles Darwin University, Casuarina, Australia
| | - Suzanne P Moore
- 2 Menzies School of Health Research, Charles Darwin University, Casuarina, Australia
| | - Dianne L O'Connell
- 6 Cancer Council NSW, Cancer Research Division, Kings Cross, Australia
- 7 School of Public Health, University of Sydney, Sydney, Australia
| | - Patricia C Valery
- 2 Menzies School of Health Research, Charles Darwin University, Casuarina, Australia
- 9 QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - John R Condon
- 2 Menzies School of Health Research, Charles Darwin University, Casuarina, Australia
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Affiliation(s)
- K. Canfell
- Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia
- Sydney Medical School, School of Public Health, University of Sydney, Sydney, Australia
- Prince of Wales Clinical School, UNSW Australia, Sydney, Australia
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Silver MI, Gage JC, Schiffman M, Fetterman B, Poitras NE, Lorey T, Cheung LC, Katki HA, Locke A, Kinney WK, Castle PE. Clinical Outcomes after Conservative Management of Cervical Intraepithelial Neoplasia Grade 2 (CIN2) in Women Ages 21-39 Years. Cancer Prev Res (Phila) 2018; 11:165-170. [PMID: 29437696 DOI: 10.1158/1940-6207.capr-17-0293] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 12/07/2017] [Accepted: 01/25/2018] [Indexed: 11/16/2022]
Abstract
Cervical intraepithelial neoplasia grade 2 (CIN2) frequently regresses, is typically slow-growing, and rarely progresses to cancer. Some women forgo immediate treatment, opting for conservative management (heightened surveillance with cytology and colposcopy), to minimize overtreatment and increased risk of obstetric complications; however, there are limited data examining clinical outcomes in these women. We performed a retrospective cohort analysis of younger women diagnosed with initially untreated CIN1/2, CIN2 and CIN2/3 lesions at Kaiser Permanente Northern California between 2003 and 2015. Clinical outcomes were categorized into five mutually exclusive hierarchical groups: cancer, treated, returned to routine screening, persistent high-grade lesion, or persistent low-grade lesion. Median follow-up for the 2,417 women was 48 months. Six women were diagnosed with cancer (0.2%), all with history of high-grade cytology, and none after a negative cotest. Thirty percent of women were treated, and only 20% returned to routine screening; 50% remained in continued intensive follow-up, of which 86% had either low-grade cytology/histology or high-risk human papillomavirus (HPV) positivity, but not necessarily persistence of a single HPV type. No cancers were detected after a single negative cotest in follow-up. Almost half of initially untreated women did not undergo treatment, but remained by protocol in colposcopy clinic for 2 or more years in the absence of persisting CIN2+ Their incomplete return to total negativity was possibly due to sequential new and unrelated low-grade abnormalities. The prolonged colposcopic surveillance currently required to return to routine screening in the absence of persisting CIN2+ might not be necessary after a negative cotest.Significance: Many younger women under conservative management following an initial CIN2 result remain in a clinical protocol of prolonged intensified surveillance without a subsequent diagnosis of CIN2 or more severe diagnoses. More research is needed to determine whether such prolonged management might be unnecessary following a negative cotest for those women with an initial CIN2 but otherwise only low-grade findings. Cancer Prev Res; 11(3); 165-70. ©2018 AACR.
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Affiliation(s)
- Michelle I Silver
- Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Bethesda, Maryland.
| | - Julia C Gage
- Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Bethesda, Maryland
| | - Mark Schiffman
- Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Bethesda, Maryland
| | - Barbara Fetterman
- Regional Laboratory, Kaiser Permanente Northern California, Berkeley, California
| | - Nancy E Poitras
- Regional Laboratory, Kaiser Permanente Northern California, Berkeley, California
| | - Thomas Lorey
- Regional Laboratory, Kaiser Permanente Northern California, Berkeley, California
| | - Li C Cheung
- Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Bethesda, Maryland
| | - Hormuzd A Katki
- Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Bethesda, Maryland
| | - Alexander Locke
- Department of Women's Health, Kaiser Permanente Medical Care Program, South Sacramento, California
| | - Walter K Kinney
- Regional Laboratory, Kaiser Permanente Northern California, Berkeley, California
| | - Philip E Castle
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York.,Global Coalition Against Cervical Cancer, Arlington, Virginia
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Smith M, Canfell K. Impact of the Australian National Cervical Screening Program in women of different ages. Med J Aust 2017; 205:359-364. [PMID: 27736623 DOI: 10.5694/mja16.00289] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 05/24/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The Australian National Cervical Screening Program (NCSP) will transition in 2017 from cytology-based screening every two years, starting from age 18-20 years, to HPV-based screening every 5 years, starting from age 25. To examine the impact of the program before this transition we analysed trends in the incidence of cervical cancer, by age and histological subtype. DESIGN, SETTING AND PARTICIPANTS National cervical cancer incidence data, 1982-2010. MAIN OUTCOME MEASURES Standardised rate ratios (SRR) for 3-yearly average cervical cancer incidence, relative to the rate during 1988-1990, by age group and histological type. RESULTS Between 1988-1990 and 2008-2010, cervical cancer incidence fell substantially in women aged 25-49 (SRR, 0.55; 95% CI, 0.51-0.59), 50-69 (SRR, 0.46; 95% CI, 0.42-0.51) and 70 years or more (SRR, 0.50; 95% CI, 0.43-0.58), but not in women aged 20-24 years (SRR, 0.70; 95% CI, 0.46-1.05). These declines were primarily driven by drops in squamous cell carcinoma (SCC) in women aged 25-49 (SRR, 0.50; 95% CI, 0.46-0.55), 50-69 (SRR, 0.39; 95% CI, 0.35-0.45) and more than 70 years (SRR, 0.43; 95% CI, 0.36-0.51). However, rates have now plateaued in women aged 25-69 years. The incidence of adenocarcinoma did not consistently decline across the program period in any age group. The incidence of neither SCC (SRR, 0.91; 95% CI, 0.55-1.51) nor adenocarcinoma (SRR, 0.91; 95% CI, 0.35-2.40) declined in women aged 20-24 years. CONCLUSION Although women aged 20-24 years have been included in the NCSP since its inception, no significant impact on cervical cancer incidence was observed in this age group. The NCSP has had a substantial impact on SCC and overall cervical cancer incidence in women aged 25 years and over. Its impact on the incidence of adenocarcinoma, in contrast, has been limited.
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Lew JB, Simms KT, Smith MA, Hall M, Kang YJ, Xu XM, Caruana M, Velentzis LS, Bessell T, Saville M, Hammond I, Canfell K. Primary HPV testing versus cytology-based cervical screening in women in Australia vaccinated for HPV and unvaccinated: effectiveness and economic assessment for the National Cervical Screening Program. LANCET PUBLIC HEALTH 2017; 2:e96-e107. [DOI: 10.1016/s2468-2667(17)30007-5] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 12/23/2016] [Accepted: 12/23/2016] [Indexed: 01/25/2023]
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Simms KT, Smith MA, Lew JB, Kitchener HC, Castle PE, Canfell K. Will cervical screening remain cost-effective in women offered the next generation nonavalent HPV vaccine? Results for four developed countries. Int J Cancer 2016; 139:2771-2780. [DOI: 10.1002/ijc.30392] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 06/27/2016] [Accepted: 07/14/2016] [Indexed: 12/26/2022]
Affiliation(s)
- Kate T. Simms
- Cancer Research Division; Cancer Council NSW; Woolloomooloo Sydney NSW Australia
- Prince of Wales Clinical School; The University of New South Wales; Australia
| | - Megan A. Smith
- Cancer Research Division; Cancer Council NSW; Woolloomooloo Sydney NSW Australia
- Prince of Wales Clinical School; The University of New South Wales; Australia
- School of Public Health; University of Sydney; Australia
| | - Jie-Bin Lew
- Cancer Research Division; Cancer Council NSW; Woolloomooloo Sydney NSW Australia
- Prince of Wales Clinical School; The University of New South Wales; Australia
| | | | - Philip E. Castle
- Department of Epidemiology and Population Health; Albert Einstein College of Medicine; Bronx NY
- Global Coalition against Cervical Cancer; Arlington VA
| | - Karen Canfell
- Cancer Research Division; Cancer Council NSW; Woolloomooloo Sydney NSW Australia
- Prince of Wales Clinical School; The University of New South Wales; Australia
- School of Public Health; University of Sydney; Australia
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Khodakarami N, Farzaneh F, Yavari P, Akbari ME. Cervical Cancer Screening: Recommendations for Muslim Societies. Asian Pac J Cancer Prev 2016; 17:239-47. [PMID: 26838217 DOI: 10.7314/apjcp.2016.17.1.239] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The overall cervical cancer incidence rate is low in Iran; however, because of a higher risk of death for cervical cancer, a disease that kills women in middle age, a cervical cancer control program is needed. The aim of this study was to provide consensus recommendation for cervical cancer prevention in Iran and other Muslim societies with low incidences of cervical cancer. MATERIALS AND METHODS Through a practical guideline development cycle, we developed six questions that were relevant to produce the recommendation. We reviewed 190 full text records of cervical cancer in Iran (1971 to 2013) of which 13 articles were related to the data needed to answer the recommendation questions. We also reviewed World Health Organization, IARC, GLOBOCAN report, Iran Ministry of Health cancer registry report and 8 available foreign countries guidelines. Lastly, we also evaluated the Pap smear results of 825 women who participated in the Iranian HPV survey, of whom 328 were followed-up after a 5-year interval. RESULTS The obtained data highlighted the burden of HPV and cervical cancer situation in Iran. Experts emphasized the necessity of a cervical cancer screening program for Iranian women, and recommended an organized screening program with a cytological evaluation (Pap smear) that would start at the age of 30 years, repeated every 5 years, and end at the age of 69 years. Meanwhile, there is no need for screening among women with a hysterectomy, and screening should be postponed to post-partum among pregnant women. CONCLUSIONS An organized cervical cancer screening is a necessity for Iran as more than 500-900 women in middle age diagnosed with an invasive cervical cancer every year cannot be ignored. This recommendation should be taken into account by the National Health System of Iran and Muslim countries with shared culture and behavior patterns. CUBA HPV test could be consideration in countries Muslim country with appropriate budget, resources and facility.
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Affiliation(s)
- Nahid Khodakarami
- Cancer Research Center Shahid Beheshti University of Medical Sciences Tehran, Iran E-mail :
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14
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Serraino D, Gini A, Taborelli M, Ronco G, Giorgi-Rossi P, Zappa M, Crocetti E, Franzo A, Falcini F, Visioli CB, Stracci F, Zorzi M, Federico M, Michiara M, Fusco M, Ferretti S, Pannozzo F, Tisano F, Zanetti R, Zucchetto A. Changes in cervical cancer incidence following the introduction of organized screening in Italy. Prev Med 2015; 75:56-63. [PMID: 25818232 DOI: 10.1016/j.ypmed.2015.01.034] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 01/13/2015] [Accepted: 01/18/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To quantify the impact of organized cervical screening programs (OCSPs) on the incidence of invasive cervical cancer (ICC), comparing rates before and after activation of OCSPs. METHODS This population-based investigation, using individual data from cancer registries and OCSPs, included 3557 women diagnosed with ICC at age 25-74years in 1995-2008. The year of full-activation of each OCSP was defined as the year when at least 40% of target women had been invited. Incidence rate ratios (IRRs) with 95% confidence intervals (95% CIs) were calculated as the ratios between age-standardized incidence rates observed in periods after full-activation of OCSPs vs those observed in the preceding quinquennium. RESULTS ICC incidence rates diminished with time since OCSPs full-activation: after 6-8years, the IRR was 0.75 (95% CI: 0.67-0.85). The reduction was higher for stages IB-IV (IRR=0.68, 95% CI: 0.58-0.80), squamous cell ICCs (IRR=0.74, 95% CI: 0.64-0.84), and particularly evident among women aged 45-74years. Conversely, incidence rates of micro-invasive (stage IA) ICCs increased, though not significantly, among women aged 25-44years (IRR=1.34, 95% CI: 0.91-1.96). Following full-activation of OCSPs, micro-invasive ICCs were mainly and increasingly diagnosed within OCSPs (up to 72%). CONCLUSION(S) Within few years from activation, organized screening positively impacted the already low ICC incidence in Italy and favored down-staging.
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Affiliation(s)
- Diego Serraino
- Epidemiology and Biostatistics, CRO Aviano National Cancer Institute, Aviano, Italy
| | - Andrea Gini
- Epidemiology and Biostatistics, CRO Aviano National Cancer Institute, Aviano, Italy
| | - Martina Taborelli
- Epidemiology and Biostatistics, CRO Aviano National Cancer Institute, Aviano, Italy
| | - Guglielmo Ronco
- Center for Cancer Epidemiology and Prevention, City of Health and Science Hospital, Torino, Italy
| | - Paolo Giorgi-Rossi
- Interinstitutional Epidemiology Unit, Local Health Unit, Reggio Emilia, Italy; IRCCS Santa Maria Nuova Hospital, Reggio Emilia, Italy
| | - Marco Zappa
- Cancer Prevention and Research Institute, Firenze, Italy
| | | | | | - Fabio Falcini
- Romagna Cancer Registry, IRCCS "Istituto scientifico romagnolo per lo studio e la cura dei tumori" Institute, Meldola, Italy
| | | | - Fabrizio Stracci
- Department of Medical and Surgical Specialties and Public Health, Perugia University, Perugia, Italy
| | - Manuel Zorzi
- Veneto Tumour Registry, Veneto Region, Padova, Italy
| | - Massimo Federico
- Department of Oncology, Hematology and Respiratory Diseases, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Mario Fusco
- Napoli 3 South Local Health Unit, Brusciano, Italy
| | - Stefano Ferretti
- Ferrara University and Ferrara Local Health Unit, Ferrara, Italy
| | | | | | - Roberto Zanetti
- Center for Cancer Epidemiology and Prevention, City of Health and Science Hospital, Torino, Italy
| | - Antonella Zucchetto
- Epidemiology and Biostatistics, CRO Aviano National Cancer Institute, Aviano, Italy.
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15
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Consedine NS, Tuck NL, Ragin CR, Spencer BA. Beyond the black box: a systematic review of breast, prostate, colorectal, and cervical screening among native and immigrant African-descent Caribbean populations. J Immigr Minor Health 2015; 17:905-24. [PMID: 24522436 DOI: 10.1007/s10903-014-9991-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Cancer screening disparities between black and white groupings are well-documented. Less is known regarding African-descent subpopulations despite elevated risk, distinct cultural backgrounds, and increasing numbers of Caribbean migrants. A systematic search of Medline, Web of Science, PubMed and SCOPUS databases (1980-2012) identified 53 studies reporting rates of breast, prostate, cervical, and colorectal screening behavior among immigrant and non-immigrant Caribbean groups. Few studies were conducted within the Caribbean itself; most work is US-based, and the majority stem from Brooklyn, New York. In general, African-descent Caribbean populations screen for breast, prostate, colorectal, and cervical cancers less frequently than US-born African-Americans and at lower rates than recommendations and guidelines. Haitian immigrants, in particular, screen at very low frequencies. Both immigrant and non-immigrant African-descent Caribbean groups participate in screening less frequently than recommended. Studying screening among specific Caribbean groups of African-descent may yield data that both clarifies health disparities between US-born African-Americans and whites and illuminates the specific subpopulations at risk in these growing immigrant communities.
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Affiliation(s)
- Nathan S Consedine
- Department of Psychological Medicine, The University of Auckland, Private Bag 92019, Auckland, New Zealand,
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Scalzo K, Mullins R. The recommended interval for cervical cancer screening: Victorian women's attitudes to an extended interval. Aust N Z J Public Health 2015; 39:153-6. [DOI: 10.1111/1753-6405.12340] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 07/01/2014] [Accepted: 10/01/2014] [Indexed: 12/01/2022] Open
Affiliation(s)
- Katherine Scalzo
- Centre for Behavioural Research in Cancer; Cancer Council Victoria
| | - Robyn Mullins
- Centre for Behavioural Research in Cancer; Cancer Council Victoria
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17
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Sitas F, Gibberd A, Kahn C, Weber MF, Chiew M, Supramaniam R, Velentzis L, Nickson C, Smith DP, O’Connell D, Smith MA, Armstrong K, Yu XQ, Canfell K, Robotin M, Feletto E, Penman A. Cancer incidence and mortality in people aged less than 75 years: Changes in Australia over the period 1987–2007. Cancer Epidemiol 2013; 37:780-7. [DOI: 10.1016/j.canep.2013.09.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 09/10/2013] [Accepted: 09/12/2013] [Indexed: 12/12/2022]
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