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Ozturk NY, Hossain SZ, Mackey M, Adam S, Brennan P. HPV and Cervical Cancer Awareness and Screening Practices among Migrant Women: A Narrative Review. Healthcare (Basel) 2024; 12:709. [PMID: 38610131 PMCID: PMC11011554 DOI: 10.3390/healthcare12070709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024] Open
Abstract
This narrative review explores the barriers and facilitators that migrant women face globally. The review explored a range of studies conducted in various countries, including the United States of America (USA), the United Kingdom (UK), Canada, Australia, and the United Arab Emirates (UAE). It also specialises in the experiences of migrant women living in Sydney, Australia, and women living in Ras Al Khaimah (RAK), UAE. Cervical cancer ranks as the fourth most prevalent form of cancer among women worldwide. It is the fourteenth most common cancer among women in Australia and the fourth most common cancer in the UAE. Despite the availability of vaccinations and cervical screening initiatives in many countries, including the USA, the UK, Canada, Australia, and the UAE, migrant women living in these countries continue to experience considerable health gaps when accessing cervical cancer screening services. Addressing these disparities is crucial to ensuring everyone has equal healthcare access. An electronic search was conducted using three databases to identify articles published between 2011 and 2021. Qualitative, quantitative, and mixed-methods research studies were included in the search. The identified factors were classified into categories of barriers and facilitators of cervical screening uptake, which were then sub-categorized. This narrative review examines the awareness of cervical cancer and screening behaviours, attitudes, barriers, and facilitators associated with cervical cancer screening. According to the study, several factors pose significant obstacles for migrant women worldwide, particularly those living in the USA, the UK, Canada, and Sydney, Australia, and Emirati and non-Emirati women (migrant women) residing in RAK when it comes to undergoing cervical cancer screening. These barriers include inadequate knowledge and emotional, cultural, religious, psychological, and organisational factors. On the other hand, social support, awareness campaigns, and the availability of screening services were found to promote the uptake of cervical cancer screening. The findings from this review suggest that healthcare providers should adopt culturally sensitive approaches to enhance awareness and encourage participation in screening programs among migrant women. Based on the findings of this narrative review, it is strongly suggested that healthcare providers and policymakers prioritise developing culturally sensitive screening initiatives for migrant women. It is essential to address the psychological and emotional barriers that prevent migrant women from accessing screening services. This can be accomplished by offering education and awareness campaigns in their native languages and implementing a community-based approach to encourage social support and increase awareness of cervical cancer and screening services. Furthermore, healthcare providers and organisations should provide educational tools that address common misconceptions based on cultural and religious factors that prevent women from accessing screening services.
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Affiliation(s)
- Nuray Yasemin Ozturk
- Faculty of Medicine & Health, The University of Sydney, Sydney, NSW 2000, Australia; (N.Y.O.); (M.M.); (P.B.)
| | - Syeda Zakia Hossain
- Faculty of Medicine & Health, The University of Sydney, Sydney, NSW 2000, Australia; (N.Y.O.); (M.M.); (P.B.)
| | - Martin Mackey
- Faculty of Medicine & Health, The University of Sydney, Sydney, NSW 2000, Australia; (N.Y.O.); (M.M.); (P.B.)
| | - Shukri Adam
- Faculty of Nursing, RAK Medical and Health Science University, Ras Al Khaimah 11172, United Arab Emirates;
| | - Patrick Brennan
- Faculty of Medicine & Health, The University of Sydney, Sydney, NSW 2000, Australia; (N.Y.O.); (M.M.); (P.B.)
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Wearn A, Shepherd L. Determinants of routine cervical screening participation in underserved women: a qualitative systematic review. Psychol Health 2024; 39:145-170. [PMID: 35296200 DOI: 10.1080/08870446.2022.2050230] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 03/02/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Routine, population-wide cervical screening programmes reduce cervical cancer incidence and mortality. However, socioeconomically deprived communities and ethnic minority groups typically have lower uptake in comparison to the general population and thus are described as 'underserved.' A systematic qualitative literature review was conducted to identify relevant determinants of participation for these groups. METHODS Online databases were searched for relevant literature from countries with well-established, call-recall screening programmes. Overall, 24 articles were eligible for inclusion. Data was synthesized via Framework synthesis. Dahlgren & Whitehead's social model of health was used as a broad a priori coding framework. RESULTS Participation was influenced by determinants at multiple levels. Overall, patient-provider relationships and peer support facilitated engagement. Cultural disparities, past healthcare experience and practical barriers hindered service access and exacerbated negative thoughts, feelings and attitudes towards participation. Complex interrelationships between determinants suggest barriers have a cumulative effect on screening participation. CONCLUSIONS These findings present a framework of psychosocial determinants of cervical screening uptake in underserved women and emphasise the role of policy makers and practitioners in reducing structural barriers to screening services. Additional work, exploring the experience of those living within socioeconomically disadvantaged areas, is needed to strengthen understanding in this area.
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Affiliation(s)
- Angela Wearn
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Lee Shepherd
- Department of Psychology, Northumbria University, Northumberland Building, Newcastle Upon Tyne, UK
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Hosseini Z, Seyrafi N, Homayuni A, Mouseli A, Homayuni A. Predicting cervical cancer screening behavior among women in southern Iran: a cross-sectional study with PEN-3 model. BMC Womens Health 2023; 23:260. [PMID: 37173665 PMCID: PMC10180674 DOI: 10.1186/s12905-023-02416-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/06/2023] [Indexed: 05/15/2023] Open
Abstract
INTRODUCTION Despite the fact that the Pap smear test is a simple, affordable, painless and relatively reliable method to diagnose cervical cancer in women, the majority of women are unaware of the value of this valuable diagnostic method. There are many cultural and social barriers to this diagnostic method. The present study was conducted to predict cervical cancer screening behavior with PEN-3 model among women residents of Bandar Abbas. METHODS The present descriptive-analytical study was conducted on 260 women aged 18 years and above who visited the comprehensive health centers of Bandar Abbas. The data were collected online using a demographic information questionnaire and a researcher-made questionnaire based on the PEN-3 model constructs and analyzed using Mann-Whitney U test, Pearson correlation test and logistic regression analysis in SPSS-23. RESULTS The participants' age ranged between 18 and 52 years with an average of 30.95 ± 5.47 years. 27.7% of the participants had done their last pap smear test less than 1 year before the study and 26.2% had not done a pap smear test until the time of study. The results showed that the mean scores of knowledge (11.28 ± 2.87), attitude (64.96 ± 4.96), enablers (44.66 ± 5.8), and nurturers (36.02 ± 8.83) in women who had done the cervical cancer screening behavior was more than those who had not done the behavior. Also, the results of logistic regression analysis showed that knowledge, attitude and nurturers were the major predictors of cervical cancer screening behavior. CONCLUSION The present findings showed that knowledge, attitude, enablers and nurturers play a major role in women's participation in Pap smear test. These findings should be considered in the development and implementation of educational interventions.
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Affiliation(s)
- Zahra Hosseini
- Health Promotion and Education, Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Niloofar Seyrafi
- Student Research Committee, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Atefeh Homayuni
- Student Research Committee, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| | - Ali Mouseli
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Atefeh Homayuni
- Health Promotion and Education, Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Hu Z, Sun Y, Ma Y, Chen K, Lv L, Wang L, He Y. Examining Primary Care Physicians' Intention to Perform Cervical Cancer Screening Services Using a Theory of Planned Behavior: A Structural Equation Modeling Approach. Front Public Health 2022; 10:893673. [PMID: 35685761 PMCID: PMC9171050 DOI: 10.3389/fpubh.2022.893673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/20/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundPromoting cervical cancer screening (CCS) is undoubtedly effective in combating severe public health problems in developing countries, but there are challenges to its implementation. Understanding the factors influencing primary care physicians' intentions to provide CCSs to rural women is crucial for the future implementation of screening programs. The aim of this study was to assess the intentions of primary care physicians to provide cervical cancer screening services (CCSSs) to rural women and their determinants.MethodsThis cross-sectional study included 1,308 primary care physicians in rural primary health care, and the data collection tool was developed based on the theory of planned behavior (TPB), which included demographic characteristics, the basic constructs of TPB, and the degree of knowledge of CCSSs as an extended variable of the TPB model. Structural equation modeling was used to analyze the relationships between each factor.ResultsPathway analysis found that TPB is an appropriate theoretical basis for predicting primary care physicians' intent to provide CCSSs (χ2/df = 2.234 < 3, RMSEA = 0.035, and SRMR = 0.034). Meanwhile, the structural equation model showed that attitude (β = 0.251, p < 0.001), subjective norm (β = 0.311, p < 0.001), perceived behavioral control (β = 0.162, p < 0.001), and knowledge level (β = 0.152, p < 0.01) positively predicted primary care physicians' intention to provide CCSSs.ConclusionsTPB model, with the addition of knowledge, was useful in predicting primary care physicians' intention to provide CCSSs for rural Chinese women. The findings of this study provide a reference for the government and hospitals to develop strategies to improve the intent of primary care physicians to provide CCSSs.
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Affiliation(s)
- Zhiqing Hu
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, China
- School of Marxism, Nanjing Medical University, Nanjing, China
| | - Yanjun Sun
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, China
- School of Marxism, Nanjing Medical University, Nanjing, China
| | - Yuhao Ma
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, China
- School of Marxism, Nanjing Medical University, Nanjing, China
| | - Kejin Chen
- Department of Women's Healthcare, Changzhou Maternal and Child Health Care Centre, Changzhou, China
| | - Ling Lv
- Department of Women's Healthcare, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Lingling Wang
- Department of Psychology, Kangning Hospital, Rushan, China
| | - Yuan He
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, China
- School of Marxism, Nanjing Medical University, Nanjing, China
- Research Center for Social Risk Management of Major Public Health Events (Key Research Base of Philosophy and Social Sciences of Universities in Jiangsu), Nanjing Medical University, Nanjing, China
- *Correspondence: Yuan He
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Alam Z, Deol H, Dean JA, Janda M. Reasons behind Low Cervical Screening Uptake among South Asian Immigrant Women: A Qualitative Exploration. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031527. [PMID: 35162550 PMCID: PMC8834789 DOI: 10.3390/ijerph19031527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/18/2022] [Accepted: 01/27/2022] [Indexed: 12/04/2022]
Abstract
Despite advancements in prevention strategies, cervical cancer remains a leading cause of death among underprivileged women. Although Australia has low age-standardized cervical cancer incidence rates compared with other countries, disparities exist in cervical screening uptake among certain population subgroups, especially those from culturally and linguistically diverse (CALD) backgrounds. South Asian immigrant women have been reported to have lower cervical screening uptake than Australian-born women and those from other immigrant backgrounds. The objective of this study was to gain insight into the reasons and barriers for low cervical screening participation among South Asian immigrant women, through qualitative exploration. Semi-structured, in-depth interviews were conducted with 20 women, aged 26–50 years, living in Queensland, Australia, who were recruited via purposive sampling. After translation and transcription of recorded interviews, data was analysed via inductive thematic approach. Resulting themes, illustrating barriers towards screening, included: lack of cervical cancer and screening knowledge, especially of the changes in the revised screening program; effect of preventive, health-seeking behaviours; health care system factors; role of practical constraints and influence of sociocultural beliefs. Results suggest that culturally informed interventions, that involve relevant information provision and behavioural change strategies, to clarify women’s misconceptions, are required.
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Affiliation(s)
- Zufishan Alam
- Centre for Health Services Research, Faculty of Medicine, Princess Alexandra Hospital Campus, The University of Queensland, Woolloongabba, QLD 4102, Australia;
- Correspondence:
| | - Hanoor Deol
- Faculty of Medicine, Herston Campus, The University of Queensland, Herston, QLD 4006, Australia;
| | - Judith Ann Dean
- School of Public Health, Faculty of Medicine, Herston Campus, The University of Queensland, Herston, QLD 4006, Australia;
| | - Monika Janda
- Centre for Health Services Research, Faculty of Medicine, Princess Alexandra Hospital Campus, The University of Queensland, Woolloongabba, QLD 4102, Australia;
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Alam Z, Ann Dean J, Janda M. Cervical screening uptake: A cross-sectional study of self-reported screening attitudes, behaviours and barriers to participation among South Asian immigrant women living in Australia. WOMEN'S HEALTH 2022; 18:17455057221096240. [PMID: 35509249 PMCID: PMC9087249 DOI: 10.1177/17455057221096240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction: Cervical cancer remains a major cause of morbidity and mortality among women
from low and lower middle-income countries, as well as underserved
population subgroups in high-income countries. Migration from South Asia to
Australia has increased over the last decade, and immigrant women from this
region have been reported as a subgroup, with less than optimal cervical
screening participation in Australia. This study examined cervical screening
uptake and associated behavioural attitudes among South Asian immigrant
women living in Queensland Australia. Methods: A cross-sectional, Internet-based survey was used to collect data from a
convenience sample of 148 South Asian women living in Queensland. The main
outcome measure was receipt of cervical screening test ever (yes/no) and its
recency (within 2 years/more than 2 years). The survey also examined
participants’ views on barriers towards screening and ways to enhance
it. Results: Of 148 women who completed the survey, 55.4% (n = 82) reported ever having a
cervical screening test before and 43.9% (n = 65) reported having it in
previous two years. Not having a previous cervical screening test was
significantly associated with duration of stay in Australia for less than
five years, not having access to a regular general practitioner (GP), not
being employed, having low cervical cancer knowledge level and not knowing
if cervical screening test is painful or not. Most commonly reported
barriers to screening uptake included considering oneself not at risk, lack
of time and lack of information. The most favoured strategy among
participants was encouragement by GP and awareness through social media
advertisements. Conclusion: This study provided insights into factors that need consideration when
developing future targeted interventions.
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Affiliation(s)
- Zufishan Alam
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Woolloongabba, QLD, Australia
| | - Judith Ann Dean
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
| | - Monika Janda
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Woolloongabba, QLD, Australia
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Scanlon B, Brough M, Wyld D, Durham J. Equity across the cancer care continuum for culturally and linguistically diverse migrants living in Australia: a scoping review. Global Health 2021; 17:87. [PMID: 34321015 PMCID: PMC8318324 DOI: 10.1186/s12992-021-00737-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/08/2021] [Indexed: 01/04/2023] Open
Abstract
International evidence suggests migrants experience inequitable access, outcomes and treatment quality across the cancer care continuum. There is currently limited research assessing equity across the cancer care continuum for culturally and linguistically diverse migrants living in Australia. A detailed protocol and search strategy were developed and used to identify all relevant literature, utilising the Joanna Briggs Institute Reviewer’s Manual. Systematic searching was conducted via multiple databases and identified studies were screened against pre-identified inclusion and exclusion criteria. 71 studies met the inclusion criteria for analysis. Most studies examined cancer detection via screening. Very few studies examined cancer prevention, diagnosis, treatment or palliative care. Most studies focused on patient-sided barriers to care and there was a paucity of information regarding institutional barriers to health. Cancer-related outcomes were seldom examined, and most studies were qualitative or behavioral analysis. Results highlighted significant communication issues spanning the cancer care continuum and a context of inadequate support for both patients and clinicians. There is a demonstrable need to examine equity in access and outcomes for culturally and linguistically diverse cancer populations. This requires the identification of cancer-related disparities and an examination of institutional barriers to care. Through addressing this dearth of information, future research and health policy can support the operationalisation of health equity.
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Affiliation(s)
- Brighid Scanlon
- Queensland University of Technology, 149 Victoria Park Road, QLD, 4059, Kelvin Grove, Australia. .,Royal Brisbane and Women's Hospital, Butterfield Street, QLD, 4029, Herston, Australia.
| | - Mark Brough
- Queensland University of Technology, 149 Victoria Park Road, QLD, 4059, Kelvin Grove, Australia
| | - David Wyld
- Queensland University of Technology, 149 Victoria Park Road, QLD, 4059, Kelvin Grove, Australia.,Royal Brisbane and Women's Hospital, Butterfield Street, QLD, 4029, Herston, Australia.,University of Queensland, 20 Weightman Street, QLD, 4006, Herston, Australia
| | - Jo Durham
- Queensland University of Technology, 149 Victoria Park Road, QLD, 4059, Kelvin Grove, Australia
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"Cervical cancer screening: awareness is not enough". Understanding barriers to screening among women in West Cameroon-a qualitative study using focus groups. Reprod Health 2021; 18:147. [PMID: 34243778 PMCID: PMC8268254 DOI: 10.1186/s12978-021-01186-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cervical cancer is the second leading cause of cancer-related death among women in sub-Saharan countries, constituting a major public health concern. In Cameroon, cervical cancer ranks as the second most common type of cancer among women and the leading cause of cancer-related deaths, mainly due to the lack of prevention. OBJECTIVES Our first and main objective was to understand the barriers affecting women's decision-making process regarding participation in a cervical cancer screening program in the Dschang district (West Cameroon). Second, we aimed to explore the acceptability and perception of a single-visit approach (screen and treat). METHODS A qualitative study using focus groups (FGs) was conducted from February to March 2020. Female participants aged between 30 and 49 years and their male partners were invited to participate. Thematic analysis was used, and barriers were classified according to the three-delay model of Thaddeus and Maine. RESULTS In total, six FGs with 43 participants (31 women and 12 men) were conducted. The most important barriers were lack of health literacy, low accessibility of the program (in respect to cost and distance), and disrespectful treatment by healthcare workers. CONCLUSIONS Our study identified three needs: (1) enhancing health literacy; (2) improving the delivery of cervical cancer screening in rural areas; and (3) providing training for healthcare providers and community healthcare workers to improve patient-provider-communication. Trial registration Ethical Cantonal Board of Geneva, Switzerland (CCER, N°2017-0110 and CER-amendment n°3) and Cameroonian National Ethics Committee for Human Health Research (N°2018/07/1083/CE/CNERSH/SP). NCT: 03757299.
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Bakan AB, Aslan G, Yıldız M. Determination of Breast Cancer Fatalism in Women and the Investigation of the Relationship Between Women's Cervical Cancer and Pap Smear Test Health Beliefs with Religious Orientation and Fatalism. JOURNAL OF RELIGION AND HEALTH 2021; 60:1856-1876. [PMID: 33123972 DOI: 10.1007/s10943-020-01108-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/06/2020] [Indexed: 06/11/2023]
Abstract
This study aims to determine breast cancer fatalism in women and investigate the relationship between women's cervical cancer and pap smear test health beliefs with religious orientation and fatalism. The study, which was conducted as a descriptive and relational screening one, was conducted in the eastern part of Turkey between July and August 2019. The study was conducted with 357 women who were not diagnosed with breast or cervical cancer, and who were not pregnant. A positive, significant relationship was found between the Religious Orientation Scale total mean score and Health Motivation and Pap smear Benefit Perception sub-scale mean score. A positive, significant relationship was found between the Fatalism Tendency Scale total mean score and Sensitivity, Importance Perception, Pap smear Benefit Perception and Pap smear Barrier Perception sub-scale mean scores (p < .05). The participating women were found to have a low level of breast cancer fatalism. Religious Orientation and Fatalism Tendency were found to have affected the Cervical Cancer and Pap Smear Test Health Beliefs. Similar studies are recommended to be conducted in larger groups and different regions.
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Affiliation(s)
- Ayse Berivan Bakan
- Department of Nursing, Agri Ibrahim Cecen University School of Health, Agri, Turkey.
| | - Gulpinar Aslan
- Public Health Nursing, Ataturk Unıversity Health Sciences Institute, Erzurum, Turkey
| | - Metin Yıldız
- Department of Nursing, Agri Ibrahim Cecen University School of Health, Agri, Turkey
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Alam Z, Shafiee Hanjani L, Dean J, Janda M. Cervical Cancer Screening Among Immigrant Women Residing in Australia: A Systematic Review. Asia Pac J Public Health 2021; 33:816-827. [PMID: 33829888 DOI: 10.1177/10105395211006600] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Since the introduction of systematic population-based cervical cancer screening in Australia in 1991, age-standardized incidence of cervical cancer has halved. Given recent advances in human papillomavirus (HPV) vaccination and screening, cervical cancer may be eliminated nationally within 20 years. However, immigrant women are not equitably reached by screening efforts. This study systematically reviewed evidence on cervical cancer screening practices among immigrant women in Australia. A systematic search of MEDLINE, Embase, PubMed, CINAHL, and PsycINFO and gray literature for English language studies published till March 1, 2019, was conducted. Observational and qualitative studies evaluating cervical cancer screening awareness and participation of immigrant women were screened. Of 125 potentially relevant studies, 25 were eligible: 16 quantitative (4 cohort, 12 cross-sectional), 6 qualitative, and 3 mixed-methods studies. Quantitative studies indicated 1% to 16% lower screening rates among migrant women compared with Australian-born women, with participation of South Asian women being significantly lower (odds ratio = 0.54, 95% confidence interval = 0.48-0.61). Qualitative studies illustrated factors affecting women's willingness to participate in screening, including insufficient knowledge, low-risk perception, and unavailability of a female health professionals being key barriers. Future studies should focus on South Asian women, due to recent increase in their immigration.
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Affiliation(s)
- Zufishan Alam
- The University of Queensland, Woolloongabba, Queensland, Australia
| | | | - Judith Dean
- The University of Queensland, Herston, Queensland, Australia
| | - Monika Janda
- The University of Queensland, Woolloongabba, Queensland, Australia
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Enhancing equitable access to cancer information for culturally and linguistically diverse (CALD) communities to complement beliefs about cancer prognosis and treatment. Support Care Cancer 2021; 29:5957-5965. [PMID: 33768373 DOI: 10.1007/s00520-021-06125-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 03/02/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Populations affected by cancer from culturally and linguistically diverse (CALD) backgrounds with low English proficiency have poorer health outcomes than the Australian population. They also have limited access to cancer information and may hold health beliefs that affect health-seeking behaviour. A leading cancer support organisation in Australia conducted research with the largest language groups in Australia with the lowest English proficiency to guide the development of appropriate translated resources. METHOD Six focus groups were conducted with Arabic, Chinese (Mandarin and Cantonese) and Vietnamese speaking cancer survivors, carers and those significantly affected by cancer to understand their health beliefs, information needs and preferred modes of access. Thirteen interviews were also conducted with service providers supporting these communities. RESULTS Communities lacked access to, and knowledge of, cancer information in their language on Australian cancer-related websites. They had easier access to information in their language from overseas health and local ethnic organisations, and from family and friends. Participants trusted health professionals but were dissatisfied with the information and care provided. Cultural beliefs, combined with a lack of information in their language, were not conducive to accessing appropriate information. The impact of beliefs about fate was significant, but they did not rule out using Western treatment or actively seeking cancer information. CONCLUSIONS The results reinforce the need to fully explore the cultural beliefs and the structural barriers to accessing cancer information. They also demonstrate that religious-based fatalistic beliefs need not prevent access to information but can co-exist with Western medical treatments.
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Barriers and Facilitators to Cervical Screening among Migrant Women of African Origin: A Qualitative Study in Finland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207473. [PMID: 33066565 PMCID: PMC7602139 DOI: 10.3390/ijerph17207473] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/08/2020] [Accepted: 10/12/2020] [Indexed: 12/31/2022]
Abstract
Globally, cervical cancer constitutes a substantial public health concern. Evidence recommends regular cervical cancer screening (CCS) for early detection of "precancerous lesions."Understanding the factors influencing screening participation among various groups is imperative for improving screening protocols and coverage. This study aimed to explore barriers and facilitators to CCS participation in women of Nigerian, Ghanaian, Cameroonian, and Kenyan origin in Finland. We utilized a qualitative design and conducted eight focus group discussions (FGDs) in English, with women aged 27-45 years (n = 30). The FGDs were tape-recorded, transcribed verbatim, and analyzed utilizing the inductive content analysis approach. The main barriers to CCS participation included limited language proficiency, lack of screening awareness, misunderstanding of screening's purpose, and miscomprehension of the CCS results. Facilitators were free-of-charge screening, reproductive health services utilization, and women's understanding of CCS's importance for early detection of cervical cancer. In conclusion, among women, the main barriers to CCS participation were language difficulties and lack of screening information. Enhancing screening participation amongst these migrant populations would benefit from appropriate information about the CCS. Those women with limited language skills and not utilizing reproductive health services need more attention from healthcare authorities about screening importance. Culturally tailored screening intervention programs might also be helpful.
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Nagendiram A, Bidgood R, Banks J, Heal C. Women's attitudes and understanding of cervical cancer and the new National Cervical Screening Program. Health Promot J Austr 2020; 32:372-377. [PMID: 32475013 DOI: 10.1002/hpja.365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 04/26/2020] [Accepted: 05/19/2020] [Indexed: 01/21/2023] Open
Abstract
ISSUES ADDRESSED The new National Cervical Screening Program (NCSP) has recently been implemented. Little research is available on women's attitudes towards the program. This study aims to quantitatively assess Australian women's understanding and attitudes towards the new guidelines and their barriers to screening. METHOD Authors designed a cross-sectional survey which was piloted and distributed as a waiting room survey to eligible women who attended a private general practice in North Queensland. RESULTS Of the respondents, 53.8% had accurate knowledge of the new NCSP. Most participants (75.8%) believed they were not provided sufficient information about the NCSP and 60.2% wished to receive this information from their general practitioner. The screening test itself remains an issue, with embarrassment and discomfort listed as the most common barriers to screening. CONCLUSION Many women do not have accurate knowledge of the new NCSP. Further health promotion in this area is warranted, where the general practitioner may play a key role. SO WHAT?: While the new NCSP will lead to further reduction in cervical cancer mortality, it appears from the data that women did not fully understand cervical cancer and its screening. This suggests the need for further health education to women about updated screening guidelines.
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Affiliation(s)
- Archana Nagendiram
- Mackay Clinical School, College of Medicine and Dentistry, James Cook University, Mackay, QLD, Australia
| | | | - Jennifer Banks
- Mackay Clinical School, College of Medicine and Dentistry, James Cook University, Mackay, QLD, Australia
| | - Clare Heal
- Mackay Clinical School, College of Medicine and Dentistry, James Cook University, Mackay, QLD, Australia
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Factors Associated with Cervical Cancer Screening Uptake: Implications for the Health of Women in Jordan. Infect Dis Obstet Gynecol 2020; 2020:9690473. [PMID: 32256030 PMCID: PMC7114762 DOI: 10.1155/2020/9690473] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 02/24/2020] [Indexed: 12/04/2022] Open
Abstract
Purpose The existing factors that influence cervical cancer screening uptake worldwide do not necessarily reflect the situation in Jordan. Therefore, the aim of this study was to determine the factors associated with cervical cancer screening uptake among Jordanian women. Methods In this cross-sectional study, 500 married Jordanian women aged 21 to 65 years were recruited from eight nongovernmental organisations and community settings in Amman. Data were collected with a self-administered questionnaire regarding sociodemographic and reproductive data, a health utilisation data form, and scales on the perceived benefits of screening, perceived barriers to screening, perceived susceptibility to cervical cancer, and perceptions regarding the severity of cervical cancer. Descriptive statistics, multivariate logistic regressions, and independent t-tests were used in the data analysis. Results Among the 500 age-eligible women, only 156 (31.2%) had been screened for cervical cancer. Healthcare provider encouragement, years of marriage (odds ratio (OR) = 5.24, confidence interval (CI) = 95%, p = 0.00), and use of the private healthcare sector (OR = 2.20, CI = 95%, p = 0.012) were significant predictors of cervical cancer screening. Conclusion Cervical cancer screening uptake among Jordanian women is significantly low; determining factors for the decision to undergo screening include encouragement from the healthcare provider, the number of years of marriage, and use of the private healthcare sector. To improve uptake, structured screening programmes need to be implemented in collaboration with national partners and institutions to decrease the incidence of cervical cancer in Jordan.
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Nagendiram A, Bidgood R, Banks J, Heal C. Knowledge and perspectives of the new National Cervical Screening Program: a qualitative interview study of North Queensland women-'I could be that one percent'. BMJ Open 2020; 10:e034483. [PMID: 32156766 PMCID: PMC7064076 DOI: 10.1136/bmjopen-2019-034483] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To investigate women's understanding and attitudes towards the National Cervical Screening Program (NCSP) and to explore methods to improve screening participation. DESIGN Semi-structured face-to-face interviews were conducted through convenience and snowball sampling. Thematic analysis occurred using the interpretivist framework. SETTING A private general practice in North Queensland. PARTICIPANTS Women between the ages of 18 and 74 who attended the general practice were eligible to participate. Fourteen women between 20 and 58 years old were interviewed. RESULTS Participants were concerned that the new NCSP would miss cancer due to longer screening intervals and reliance on primary human papilloma virus (HPV) testing. They believed that young women are at increased risk of cervical cancer, due to perceived HPV vaccine ineffectiveness and parent objection to vaccination. Most participants were not agreeable to self-sampling and preferred their doctor to perform screening. Personal and practitioner beliefs influenced a woman's screening participation. Personal factors include being healthy for themselves and their family, previous abnormal smears and family history of cancer. Emphasis was placed on feeling 'comfortable' with their practitioner which included patient rapport and gender preference. Proposed methods to improve cervical screening included education programmes, advertising campaigns, general practitioner interventions and improving accessibility. CONCLUSIONS It is apparent that women are hesitant about the new NCSP. However, when provided with additional information they were more amenable to the changes. This highlights the need to improve awareness of cervical screening and the new NCSP.
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Affiliation(s)
- Archana Nagendiram
- School of Medicine and Dentistry, James Cook University, Mackay, Queensland, Australia
| | | | - Jennifer Banks
- School of Medicine and Dentistry, James Cook University, Mackay, Queensland, Australia
| | - Clare Heal
- School of Medicine and Dentistry, James Cook University, Mackay, Queensland, Australia
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16
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Brevik TB, Laake P, Bjørkly S. Effect of culturally tailored education on attendance at mammography and the Papanicolaou test. Health Serv Res 2020; 55:457-468. [PMID: 31994187 PMCID: PMC7240773 DOI: 10.1111/1475-6773.13271] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objectives To determine the effectiveness of culturally tailored education on attendance at breast and cervical cancer screening among ethnic minority women. Data Sources Systematic database searches in Ovid MEDLINE, ProQuest, PubMed, PsycINFO, and Cochrane CENTRAL. Study Design Randomized controlled trials (RCTs) of culturally tailored educational interventions to ethnic minority women in Western countries were investigated for a meta‐analysis. RCTs that assessed attendance at mammography or the Papanicolaou test (Pap test) were eligible for inclusion. Data Collection Methods Study characteristics and results were extracted separately. Independent raters assessed risk of bias by using Cochrane Collaboration's tool. Principal Findings Seven RCTs (n = 4246) were included in the meta‐analysis of mammography attendance, and four RCTs (n = 1750) were included in the meta‐analysis of Pap test attendance. The effect of culturally tailored educational interventions on attendance at mammography was an increase of 18 percent (RR = 1.18, 95% CI, 1.09‐1.28, P < .001), with low heterogeneity (I2 = 30.0, P = .237), and a 54 percent increase at the Pap test (RR = 1.54, 95% CI, 1.14‐2.09, P = .005), with substantial heterogeneity (I2 = 75.9%, P = .001). Conclusions Interpreted within the limitations set by the low number of studies and substantial heterogeneity for the Pap test, findings from the current meta‐analyses indicate that culturally tailored educational interventions may increase attendance of ethnic minority women at breast and cervical cancer screenings. There is a need for more studies, in particular RCTs conducted outside the United States, to determine if such findings are similar in other countries.
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Affiliation(s)
- Thea Beate Brevik
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway.,Clinic of Surgery, Møre and Romsdal Hospital Trust, Molde Hospital, Molde, Norway
| | - Petter Laake
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway.,Oslo Centre for Statistics and Epidemiology, Department of Biostatistics, University of Oslo, Oslo, Norway
| | - Stål Bjørkly
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway.,Centre for Forensic Research, Oslo University Hospital, Oslo, Norway
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17
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Olanlesi-Aliu AD, Martin PD, Daniels FM. Towards the development of a community-based model for promoting cervical cancer prevention among Yoruba women in Ibadan Nigeria: application of PEN-3 model. SOUTHERN AFRICAN JOURNAL OF GYNAECOLOGICAL ONCOLOGY 2019. [DOI: 10.1080/20742835.2019.1679528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- AD Olanlesi-Aliu
- School of Nursing, University of Western Cape, Cape Town, South Africa
| | - PD Martin
- School of Nursing, University of Western Cape, Cape Town, South Africa
| | - FM Daniels
- School of Nursing, University of Western Cape, Cape Town, South Africa
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18
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Abstract
OBJECTIVES To explore barriers to free cervical cancer screening among rural women in China from the perspective of women, healthcare providers and women's husbands to inform intervention planning. DESIGN A qualitative study framed around potential policy and practice options, drawing on the concepts of descriptive phenomenology and implementation research. SETTING This study was carried out at township level within two counties in Jining Prefecture of eastern China. PARTICIPANTS AND DATA COLLECTION Semi-structured in-depth interviews with 21 women and five healthcare providers, focus group discussions with nine healthcare providers and key informant interviews with four husbands of women eligible for screening. RESULTS Thematic analysis generated five major themes: (1) gaps in knowledge of cervical cancer and health awareness, (2) fear of cancer and screening outcomes, (3) cultural barriers including reticence for intimate examinations, (4) influence of close contacts on screening decisions and (5) inconvenience. These demonstrate key knowledge gaps challenging current community health education. Important barriers, including fear of treatment cost and the time needed for screening, were also raised. CONCLUSION Our study details important barriers to cervical cancer screening relating to knowledge gaps, attitudes of fear or embarrassment and the role of contacts and service models. These provide data for policy and planning to improve the screening that will decrease the incidence and mortality rates of cervical cancer in China.
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Affiliation(s)
- Huan Yang
- Shandong University, Jinan, China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Shun-Ping Li
- Shandong University, Jinan, China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Qing Chen
- Shandong University, Jinan, China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Christopher Morgan
- Burnet Institute, Melbourne, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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P E, M S. Automatic Approach for Cervical Cancer Detection and Segmentation Using Neural Network Classifier. Asian Pac J Cancer Prev 2018; 19:3571-3580. [PMID: 30583685 PMCID: PMC6428557 DOI: 10.31557/apjcp.2018.19.12.3571] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Cervical cancer leads to major death disease in women around the world every year. This cancer can be cured if it
is initially screened and giving timely treatment to the patients. This paper proposes a novel methodology for screening
the cervical cancer using cervigram images. Oriented Local Histogram Technique (OLHT) is applied on the cervical
image to enhance the edges and then Dual Tree Complex Wavelet Transform (DT-CWT) is applied on it to obtain
multi resolution image. Then, features as wavelet, Grey Level Co-occurrence Matrix (GLCM), moment invariant
and Local Binary Pattern (LBP) features are extracted from this transformed multi resolution cervical image. These
extracted features are trained and also tested by feed forward back propagation neural network to classify the given
cervical image into normal and abnormal. The morphological operations are applied on the abnormal cervical image
to detect and segment the cancer region. The performance of the proposed cervical cancer detection system is analyzed
in the terms of sensitivity, specificity, accuracy, positive predictive value, negative predictive value, Likelihood Ratio
positive, Likelihood ratio negative, precision, false positive rate and false negative rate. The performance measures for
the cervical cancer detection system achieves 97.42% of sensitivity, 99.36% of specificity, 98.29% of accuracy, PPV
of 97.28%, NPV of 92.17%, LRP of 141.71, LRN of 0.0936, 97.38 % precision, 96.72% FPR and 91.36% NPR. From
the simulation results, the proposed methodology outperforms the conventional methodologies for cervical cancer
detection and segmentation process.
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Affiliation(s)
- Elayaraja P
- Department of Ece, Kongunadu College of Engineering and Technology, Trichy, Tamilnadu, India.
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20
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Anaman JA, Correa-Velez I, King J. Knowledge Adequacy on Cervical Cancer Among African Refugee and Non-Refugee Women in Brisbane, Australia. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:716-723. [PMID: 27796876 DOI: 10.1007/s13187-016-1126-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Cervical cancer is a significant public health issue, especially in the developing countries of sub-Saharan Africa. To examine knowledge adequacy on cervical cancer and screening test among African refugee and non-refugee women in Brisbane and further examine whether the level of knowledge vary between refugee and non-refugee women. A cross-sectional survey was conducted among 254 African-born women conveniently sampled from the Brisbane local government area. The outcome measures were knowledge on cervical cancer and Pap smear. In the multivariate logistic regression analysis non-refugees were more likely than refugees to have adequate knowledge about cervical cancer. Also, non-refugee women who were older and educated beyond secondary school, were more likely to have good knowledge about Pap smear test than refugee women. Overall, knowledge level about cervical cancer is limited among the participants and non-refugee women were more likely than refugee women to have good knowledge about cervical cancer and the screening test. These findings may inform the development of health education interventions for the targeted population to improve knowledge and awareness about cervical cancer and the screening guidelines in Australia.
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Affiliation(s)
- Judith A Anaman
- University of Health and Allied Sciences School of Nursing and Midwifery, PMB 31, Ho, Volta Region, Ghana.
- School of Public Health and Social Work, Queensland University of Technology (QUT)-Brisbane, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia.
| | - Ignacio Correa-Velez
- School of Public Health and Social Work, Queensland University of Technology (QUT)-Brisbane, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia
| | - Julie King
- School of Public Health and Social Work, Queensland University of Technology (QUT)-Brisbane, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia
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21
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Gu C, Chan CWH, Chow KM, Yang S, Luo Y, Cheng H, Wang H. Understanding the cervical screening behaviour of Chinese women: The role of health care system and health professions. Appl Nurs Res 2018; 39:58-64. [PMID: 29422178 DOI: 10.1016/j.apnr.2017.09.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 06/24/2017] [Accepted: 09/23/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND In China, cervical cancer cases are increasing, making an impact on the worldwide burden of cervical cancer. Despite the initiatives undertaken by the Chinese government, the current coverage of cervical screening in China remains suboptimal. There is an urgent need to identify the facilitators and barriers associated with the uptake of cervical cancer screening among the Chinese population. PURPOSE The study aimed to explore the experiences and perceptions of cervical cancer screening of mainland Chinese women in relation to their screening behaviour, particularly in the aspects of health care system and health profession roles. METHODS A qualitative research was conducted using semi-structured interviews. A total of 27 Chinese women aged 25 to 50 (both screened and non-screened women) completed the interviews. The analysis of the interview data was undertaken inductively using latent content analysis. DISCUSSION AND CONCLUSION Results showed that organised health examination programmes provide a good basis for integrating cervical screening into broader checks on the health of women, and utilising different networks of social support facilitate the utilisation of the screening service. However, education on cervical cancer and screening must be made more generally available. More importantly, there is a need for a more participatory and empowering exchange in the encounter between health professions and these women. Appropriate training program is strongly recommended for health professions about communicate skills with patients. Future work should focus on identifying strategies to overcome the barriers to cervical screening related to health care system and medical professions among this population.
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Affiliation(s)
- Can Gu
- Xiangya School of Nursing, Central South University, Changsha, PR China.
| | - Carmen W H Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong.
| | - Ka Ming Chow
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong.
| | - Shengbo Yang
- Third Xiangya Hospital, Central South University, Changsha, PR China.
| | - Yang Luo
- Xiangya School of Nursing, Central South University, Changsha, PR China.
| | - Huilin Cheng
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong.
| | - Honghong Wang
- Xiangya School of Nursing, Central South University, Changsha, PR China.
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A Systematic Review of the Factors Influencing Ethnic Minority Women's Cervical Cancer Screening Behavior: From Intrapersonal to Policy Level. Cancer Nurs 2017; 40:E1-E30. [PMID: 28081032 DOI: 10.1097/ncc.0000000000000436] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cervical cancer can be prevented by effective screening using Papanicolaou tests, but the utilization rate is lower among ethnic minorities than in the general population. Understanding the factors influencing minorities' use of such screening can aid the design of an appropriate intervention to increase their uptake rate. OBJECTIVE The aims of this study were to examine the factors that influence ethnic minority women in using cervical cancer screening and the similarities and differences in associated factors across different groups and to explore the interrelationships between the factors identified. METHODS A literature search was conducted using Ovid MEDLINE, Cumulative Index to Nursing and Allied Health Literature Plus, Scopus, PsycINFO, and PubMed. Furthermore, 1390 articles were retrieved, of which 24 met the inclusion criteria. Critical appraisal was performed by means of a quality assessment tool. The findings were summarized in tabular and narrative forms. RESULTS The findings showed that certain factors commonly affected ethnic minority women's screening behavior, including knowledge, attitude and perceptions, physician's recommendation, quality of care and service, language, and acculturation. Culture-related factors, religion, and acculturation exhibited close interrelationships with the attitude and perceptions factor, resulting in behavioral change. CONCLUSIONS The review sheds light on how common or unique are the factors across ethnic minorities and how these factors interact to influence behavior. Further studies are warranted to develop and test empirically a comprehensive model leading to a better understanding of the interrelationships between multiple factors. IMPLICATIONS FOR PRACTICE The model should be useful in informing policy makers about appropriate resource allocation and in guiding the development of culturally relevant programs to increase screening uptake.
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23
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James LJ, Wong G, Craig JC, Hanson CS, Ju A, Howard K, Usherwood T, Lau H, Tong A. Men's perspectives of prostate cancer screening: A systematic review of qualitative studies. PLoS One 2017; 12:e0188258. [PMID: 29182649 PMCID: PMC5705146 DOI: 10.1371/journal.pone.0188258] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 11/01/2017] [Indexed: 02/01/2023] Open
Abstract
Background Prostate cancer is the most commonly diagnosed non-skin cancer in men. Screening for prostate cancer is widely accepted; however concerns regarding the harms outweighing the benefits of screening exist. Although patient’s play a pivotal role in the decision making process, men may not be aware of the controversies regarding prostate cancer screening. Therefore we aimed to describe men’s attitudes, beliefs and experiences of prostate cancer screening. Methods Systematic review and thematic synthesis of qualitative studies on men’s perspectives of prostate cancer screening. Electronic databases and reference lists were searched to October 2016. Findings Sixty studies involving 3,029 men aged from 18–89 years, who had been screened for prostate cancer by Prostate Specific Antigen (PSA) or Digital Rectal Examination (DRE) and not screened, across eight countries were included. Five themes were identified: Social prompting (trusting professional opinion, motivation from family and friends, proximity and prominence of cancer); gaining decisional confidence (overcoming fears, survival imperative, peace of mind, mental preparation, prioritising wellbeing); preserving masculinity (bodily invasion, losing sexuality, threatening manhood, medical avoidance); avoiding the unknown and uncertainties (taboo of cancer-related death, lacking tangible cause, physiological and symptomatic obscurity, ambiguity of the procedure, confusing controversies); and prohibitive costs. Conclusions Men are willing to participate in prostate cancer screening to prevent cancer and gain reassurance about their health, particularly when supported or prompted by their social networks or healthcare providers. However, to do so they needed to mentally overcome fears of losing their masculinity and accept the intrusiveness of screening, the ambiguities about the necessity and the potential for substantial costs. Addressing the concerns and priorities of men may facilitate informed decisions about prostate cancer screening and improve patient satisfaction and outcomes.
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Affiliation(s)
- Laura J. James
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Centre for Kidney Research, The Children’s Hospital at Westmead, Westmead, Australia
- * E-mail:
| | - Germaine Wong
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Centre for Kidney Research, The Children’s Hospital at Westmead, Westmead, Australia
- Centre for Transplant and Renal Research, Westmead Hospital, Westmead, Australia
| | - Jonathan C. Craig
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Centre for Kidney Research, The Children’s Hospital at Westmead, Westmead, Australia
| | - Camilla S. Hanson
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Centre for Kidney Research, The Children’s Hospital at Westmead, Westmead, Australia
| | - Angela Ju
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Centre for Kidney Research, The Children’s Hospital at Westmead, Westmead, Australia
| | - Kirsten Howard
- Centre for Kidney Research, The Children’s Hospital at Westmead, Westmead, Australia
| | - Tim Usherwood
- Department of General Practice, Westmead Clinical School, The University of Sydney, Sydney, Australia
- The George Institute for Global Health, Sydney, Australia
| | - Howard Lau
- Department of Urology, Westmead Hospital, Westmead, Australia
| | - Allison Tong
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Centre for Kidney Research, The Children’s Hospital at Westmead, Westmead, Australia
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24
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Barriers and facilitators of cervical cancer screening practices among African immigrant women living in Brisbane, Australia. Eur J Oncol Nurs 2017; 31:22-29. [PMID: 29173823 DOI: 10.1016/j.ejon.2017.09.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 08/27/2017] [Accepted: 09/26/2017] [Indexed: 11/21/2022]
Abstract
PURPOSE To describe barriers and facilitators of cervical screening practices among African immigrant women living in Brisbane, Australia. METHOD Nineteen African immigrant women (10 refugee and 9 non-refugee) were recruited using convenience sampling. The interviews were conducted with a semi-structured and open-ended questionnaire guide. All the interviews were audio recorded and transcribed verbatim. The data was manually analysed using interpretative thematic analysis. Thematic categories were identified and organised into coherent broader areas. RESULTS Lack of knowledge about cervical cancer and Pap smear, the absence of warning signs, embarrassment, fear, concern about the gender of the service provider, lack of privacy, cultural and religious beliefs, and healthcare system factors were identified as barriers to screening. The results did not show any major differences between refugee and non-refugee women. Recommendation of the test by health professionals, provision of standardised information on the test, and preferences for female service providers were identified as facilitators of cervical screening. CONCLUSION There is a need to provide culturally appropriate approaches to cervical screening practices and to enhance cultural competence among health professionals to apply service delivery models that honour group cultures.
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Idehen EE, Korhonen T, Castaneda A, Juntunen T, Kangasniemi M, Pietilä AM, Koponen P. Factors associated with cervical cancer screening participation among immigrants of Russian, Somali and Kurdish origin: a population-based study in Finland. BMC WOMENS HEALTH 2017; 17:19. [PMID: 28284203 PMCID: PMC5346186 DOI: 10.1186/s12905-017-0375-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 03/04/2017] [Indexed: 11/21/2022]
Abstract
Background Previous studies revealed low participation in cervical cancer screening among immigrants compared with non-immigrants. Only a few studies about factors associated with immigrants’ lower participation rates have been conducted in European countries that have universal access for all eligible women. Our study aimed to explore factors associated with cervical screening participation among women of Russian, Somali, and Kurdish origin in Finland. Methods We used data from the Migrant Health and Well-being Survey, 2010-2012. Structured face-to-face interviews of groups of immigrants aged 25-60 yielded 620 responses concerning screening participation in the previous five years. Statistical analysis employed logistic regression. Results The age-adjusted participation rates were as follows: among women of Russian origin 73.9% (95% CI 68.1-79.7), for Somalis 34.7% (95% CI 26.4-43.0), and for Kurds 61.3% (95% CI 55.0-67.7). Multiple logistic regressions showed that the most significant factor increasing the likelihood of screening participation among all groups was having had at least one gynecological check-up in the previous five years (Odds ratio [OR] = 6.54-26.2; p < 0.001). Other factors were higher education (OR = 2.63; p = 0.014), being employed (OR = 4.31; p = 0.007), and having given birth (OR = 9.34; p = 0.014), among Kurds; and literacy in Finnish/Swedish (OR = 3.63; p = 0.003) among Russians. Conclusions Our results demonstrate that women who refrain from using reproductive health services, those who are unemployed and less educated, as well as those with poor language proficiency, might need more information on the importance of screening participation. Primary and occupational healthcare services may have a significant role in informing immigrant women about this importance.
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Affiliation(s)
- Esther E Idehen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistoranta 1, P. O. Box 1627, 7021, Kuopio, Finland. .,Department of Public Health, University of Helsinki, Helsinki, Finland.
| | - Tellervo Korhonen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistoranta 1, P. O. Box 1627, 7021, Kuopio, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Anu Castaneda
- Department of Welfare, Equality and Inclusion Unit, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Teppo Juntunen
- Department of Welfare, Equality and Inclusion Unit, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Mari Kangasniemi
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Anna-Maija Pietilä
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Päivikki Koponen
- Department of Public Health Solutions, National Institute for Health and Welfare (THL), Helsinki, Finland
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Chorley AJ, Marlow LAV, Forster AS, Haddrell JB, Waller J. Experiences of cervical screening and barriers to participation in the context of an organised programme: a systematic review and thematic synthesis. Psychooncology 2017; 26:161-172. [PMID: 27072589 PMCID: PMC5324630 DOI: 10.1002/pon.4126] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 02/04/2016] [Accepted: 03/07/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVE As uptake of cervical screening continues to decline, this systematic review synthesises the qualitative literature on women's perceptions and experiences of cervical screening in the context of an organised call-recall programme, in order to understand the barriers to informed uptake. METHODS We searched nine databases for English language peer-reviewed publications reporting on qualitative data from screening-eligible women, exploring barriers to cervical screening in countries that offer a nationally organised call-recall programme. Evidence was integrated using thematic synthesis. RESULTS Thirty-nine papers from the UK, Australia, Sweden and Korea were included. The majority of participants had attended screening at least once. Two broad themes were identified: (a) should I go for screening? and (b) screening is a big deal. In considering whether to attend, women discussed the personal relevance and value of screening. Women who had previously attended described how it was a big deal, physically and emotionally, and the varied threats that screening presents. Practical barriers affected whether women translated screening intentions into action. CONCLUSIONS The variation in women's understanding and perceptions of cervical screening suggests that interventions tailored to decisional stage may be of value in increasing engagement with the invitation and uptake of screening in those who wish to take part. There is also a need for further research with women who have never attended screening, especially those who remain unaware or unengaged, as their perspectives are lacking in the existing literature. © 2016 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd.
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Affiliation(s)
- Amanda J. Chorley
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public HealthUCLLondonUK
| | - Laura A. V. Marlow
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public HealthUCLLondonUK
| | - Alice S. Forster
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public HealthUCLLondonUK
| | - Jessica B. Haddrell
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public HealthUCLLondonUK
| | - Jo Waller
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public HealthUCLLondonUK
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Determinants of Uptake of Cervical Cancer Screening Services at a No-cost Reproductive Health Clinic Managed by Nurse-Midwives. Cancer Nurs 2016; 38:177-84. [PMID: 24831038 DOI: 10.1097/ncc.0000000000000156] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The incidence of cervical cancer (CC) has been rising in sub-Saharan Africa, and health authorities in this region have responded by increasing the availability of cheap or no-cost CC screening services (CCSS), public health education, and others. However, the efforts have not yet resulted into the expected uptake of CCSS. OBJECTIVE The aim of this study was to examine the determinants of uptake of CCSS at a no-cost reproductive health clinic managed by nurse-midwives. METHODS A descriptive design and a structured interview questionnaire were used to collect data from 236 women attending the reproductive health clinic. Logistic regression statistics were used to examine the determinants of uptake of CCSS. RESULTS The mean age of participants was 28.7 years, and only 29% had received CC screening. The significant determinants of uptake of CCSS were concern about the gender of the healthcare professional (HCP) (odds ratio [OR], 5.03; P = .001), age older than 25 years (OR, 3.09; P = .005), contraceptive use (OR, 0.28; P = .02), encouragement by HCPs (OR, 0.16; P = .00), and perceived quality of CCSS (OR, 0.08; P = .00). CONCLUSIONS Gender of the HCP and encouragement or reminders by the HCP influence uptake of CCSS. Because nurse-midwives have successfully led strategies to promote other integrated reproductive health services, they can also play a key role in enhancing uptake of CCSS in resource-poor settings. IMPLICATIONS FOR PRACTICE Interventions to enhance service quality and deliberate policies requiring HCP to recommend encourage and remind clients may help to enhance uptake of CCSS in resource-poor settings.
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Kwok C, Lim D. Evaluation of a Culturally Tailored Education to Promote Breast and Cervical Cancer Screening Among Chinese-Australian Women. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2016; 31:595-601. [PMID: 25985961 DOI: 10.1007/s13187-015-0859-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
UNLABELLED This paper aims to evaluate the impact of the culturally sensitive and linguistically appropriate education program on the following: (i) awareness of screening practices (breast awareness, mammogram, and Pap smear test); (ii) screening intention within the next six months; and (iii) knowledge about breast and cervical cancer among Chinese-Australian women. Titled "Happy and Healthy Life in Sydney," this was a quasi-experimental study with both pre- and post-test design. A convenience sample of 288 Chinese women was recruited through Chinese organizations such as churches and community centers. Participants completed the questionnaires before and after the educational program. The results show that the program was effective in promoting awareness of breast and cervical cancer screening and resulted in increased participative intentions in both mammogram and Pap smear testing within the next 6 months. Results also indicate that knowledge and belief scores were significantly increased. CONCLUSION Our study supports that educational programs which use culturally sensitive and linguistically appropriate strategies are effective in improving both knowledge of breast and cervical cancer and awareness of their early detection practices among Chinese-Australian women.
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Affiliation(s)
- Cannas Kwok
- School of Nursing & Midwifery, University of Western Sydney, Sydney, Australia.
| | - Danforn Lim
- University of Technology Sydney, Sydney, Australia
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Cullerton K, Gallegos D, Ashley E, Do H, Voloschenko A, Fleming M, Ramsey R, Gould T. Cancer screening education: can it change knowledge and attitudes among culturally and linguistically diverse communities in Queensland, Australia? Health Promot J Austr 2016; 27:140-147. [PMID: 27376437 DOI: 10.1071/he15116] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 04/11/2016] [Indexed: 11/23/2022] Open
Abstract
Issue addressed: Screening for cancer of the cervix, breast and bowel can reduce morbidity and mortality. Low participation rates in cancer screening have been identified among migrant communities internationally. Attempting to improve low rates of cancer screening, the Ethnic Communities Council of Queensland developed a pilot Cancer Screening Education Program for breast, bowel and cervical cancer. This study determines the impact of education sessions on knowledge, attitudes and intentions to participate in screening for culturally and linguistically diverse (CALD) communities living in Brisbane, Queensland.Methods: Seven CALD groups (Arabic-speaking, Bosnian, South Asian (including Indian and Bhutanese), Samoan and Pacific Island, Spanish-speaking, Sudanese and Vietnamese) participated in a culturally-tailored cancer screening education pilot program that was developed using the Health Belief Model. A pre- and post-education evaluation session measured changes in knowledge, attitudes and intention related to breast, bowel and cervical cancer and screening. The evaluation focussed on perceived susceptibility, perceived seriousness and the target population's beliefs about reducing risk by cancer screening.Results: There were 159 participants in the three cancer screening education sessions. Overall participants' knowledge increased, some attitudes toward participation in cancer screening became more positive and intent to participate in future screening increased (n=146).Conclusion: These results indicate the importance of developing screening approaches that address the barriers to participation among CALD communities and that a culturally-tailored education program is effective in improving knowledge, attitudes about and intentions to participate in cancer screening.So what?: It is important that culturally-tailored programs are developed in conjunction with communities to improve health outcomes.
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Affiliation(s)
- Katherine Cullerton
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia
| | - Danielle Gallegos
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia
| | - Ella Ashley
- Ethnic Communities Council of Queensland, 253 Boundary Street, West End, Qld 4101, Australia
| | - Hong Do
- Ethnic Communities Council of Queensland, 253 Boundary Street, West End, Qld 4101, Australia
| | - Anna Voloschenko
- Ethnic Communities Council of Queensland, 253 Boundary Street, West End, Qld 4101, Australia
| | - MaryLou Fleming
- School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia
| | - Rebecca Ramsey
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia
| | - Trish Gould
- School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia
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Wee LE, Lim LY, Koh GCH. Two sides of the coin: A qualitative study of patient and provider perspectives on colorectal, breast and cervical cancer screening in a low-income Asian community. PROCEEDINGS OF SINGAPORE HEALTHCARE 2016. [DOI: 10.1177/2010105815616404] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives: Patient and provider barriers to cancer screening in disadvantaged Asian populations are understudied. We conducted a qualitative study of attitudes to screening for colorectal, cervical and breast cancer within low-income communities in Singapore. Methods: Interviewers elicited perceptions of barriers/enablers to cancer screening amongst patients eligible for fecal occult blood test (FOBT)/Pap smear/mammograms, and providers serving these low-income communities. Interview transcripts were analyzed thematically using established qualitative methodology. Results: Twenty patients and nine providers were interviewed. Patient and provider comments were grouped into seven content areas: primary care characteristics (PCC), procedural issues, knowledge, costs, priorities, attitudes, and information sources. For FOBT, the most frequently mentioned content areas were knowledge (61.2%) and attitudes (16.9%) for patients, and knowledge (19.5%) and PCC (18.6%) for providers. For Pap smears, it was knowledge (23.6%) and costs (20.5%) for patients, and PCC (33.8%) and knowledge (19.1%) for providers. For mammograms, it was knowledge (41.4%) and sources of information (15.9%) for patients, and knowledge (28.8%) and procedural issues (19.2%) for providers. Conclusion: While PCC, knowledge and costs were the main contributors as perceived by physicians, knowledge and attitudes were the biggest barriers from patients’ perspectives. Differences in perceptions of cancer screening exist between low-income patients and providers serving them.
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Affiliation(s)
- Liang En Wee
- Department of Internal Medicine, Singapore General Hospital, Singapore
| | - Li Yan Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Khazaee-pool M, Majlessi F, Foroushani AR, Montazeri A, Nedjat S, Shojaeizadeh D, Tol A, Salimzadeh H. Perception of breast cancer screening among Iranian women without experience of mammography: a qualitative study. Asian Pac J Cancer Prev 2016; 15:3965-71. [PMID: 24935582 DOI: 10.7314/apjcp.2014.15.9.3965] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Iran, there are high rates of breast cancer. It is among the five most common cancers, the first among cancers diagnosed, and is the leading cause of cancer deaths among Iranian women. OBJECTIVES The purpose of this qualitative study was to explore perception of breast cancer screening among Iranian women who have never had a mammograph. MATERIALS AND METHODS The current study was part of a qualitative research conducted by means of content analysis method and purposive sampling of 16 women over the age of 30 years who had not undergone mammography using individual semi-structured interviews. Interviews were recorded and transcribed verbatim. The data were under continuous consideration and comparative analysis in order to achieve data saturation. RESULTS After codification of data, three concept categories were achieved including: i) low awareness, ii) worries, and iii) lack of motivation. CONCLUSIONS Although there is a tendency among Iranian women to participate in breast cancer screening, there is a powerful cultural belief that breasts are sexual organs that should not be discussed publicly. Due to the incidence of breast cancer in Iranian women, it is critical that breast awareness education be performed by health care experts to explore the concepts of breast cancer and breast cancer screening.
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Affiliation(s)
- Maryam Khazaee-pool
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran E-mail :
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Assoumou SZ, Mabika BM, Mbiguino AN, Mouallif M, Khattabi A, Ennaji MM. Awareness and knowledge regarding of cervical cancer, Pap smear screening and human papillomavirus infection in Gabonese women. BMC WOMENS HEALTH 2015; 15:37. [PMID: 25924940 PMCID: PMC4415219 DOI: 10.1186/s12905-015-0193-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 04/01/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND Cervical cancer is the commonest cancer and the leading cause of cancer mortality in women in Gabon. The age-standardized incidence of cervical cancer is 19.9 per 100 000 women and the mortality rate is 8.4 per 100 000. Various international studies have identified the lack of awareness and knowledge about cervical cancer as barriers to use preventive methods. This article assesses the awareness and knowledge about cervical cancer, Pap smear testing and its use and HPV among women living in Libreville, Gabon. METHODS This study was conducted in October 2014 in Libreville. A total of 452 women aged 16 years and above were recruited from different town locations. Logistic regression analysis was used to identify the effect of demographic characteristics on the level of knowledge about cervical cancer, Pap smear testing and HPV. Odds ratio and 95% confidence intervals were used to identify the strength of association. Associations were considered statistically significant at p < 0.05. RESULTS Of all the women interviewed, 91.6% (414/452) had heard about cervical cancer and only 27.9% (126/452) had heard of Pap smear test. Of these 126 women, only 65.1% (82/126) had done cervical cancer screening and 68.3% (56/82) on the suggestion of a doctor. The most common reason for not undergoing Pap smear testing was neglect (50%, 22/44) followed by lack of financial resources (13.6%, 6/44), fear of discovering a serious disease (13.6%, 6/44) and deeming it unimportant (13.6%, 6/44). Only 8% (40/452) of the participants had heard about HPV and their knowledge of HPV was fair. There is a very poor level of knowledge about cervical cancer among Gabonese women. CONCLUSION This study demonstrates a very low level of knowledge about cervical cancer, Pap smear testing and HPV in a sample of Gabonese women. There is a critical need for Gabonese women to be informed about cervical cancer and the Pap smear test to improve the use of this preventive method. The implication of health staff and Gabonese media should be included as a centerpiece in the effort to inform the population in order to reduce the burden of cervical cancer in Gabon and save women lives.
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Affiliation(s)
- Samira Zoa Assoumou
- Laboratoire de Virologie, Microbiologie et Qualité/Eco toxicologie et Biodiversité, Faculté des Sciences et Techniques de Mohammedia, Université Hassan II- Casablanca, Casablanca, Maroc. .,Laboratoire d'Agroalimentaire et Santé, Département de biologie, Faculté des Sciences et Techniques, Université Hassan I, Settat, Maroc.
| | - Barthelemy Mabika Mabika
- Département d'Anatomie et de Cytologie pathologiques, Faculté de Médecine et des Sciences de la Santé, Université des Sciences de la Santé, Libreville, Gabon.
| | - Angelique Ndjoyi Mbiguino
- Laboratoire de référence MST/Sida, Laboratoire de référence rougeole, rubéole et fièvre jaune, Département de Bactériologie et Virologie, Faculté de Médecine et des Sciences de la Santé, Université des Sciences de la Santé, Libreville, Gabon.
| | - Mustapha Mouallif
- Laboratoire de Virologie, Microbiologie et Qualité/Eco toxicologie et Biodiversité, Faculté des Sciences et Techniques de Mohammedia, Université Hassan II- Casablanca, Casablanca, Maroc. .,Laboratory of Experimental Pathology, University of Liege, Liege, Belgium.
| | - Abdelkim Khattabi
- Laboratoire d'Agroalimentaire et Santé, Département de biologie, Faculté des Sciences et Techniques, Université Hassan I, Settat, Maroc.
| | - My Mustapha Ennaji
- Laboratoire de Virologie, Microbiologie et Qualité/Eco toxicologie et Biodiversité, Faculté des Sciences et Techniques de Mohammedia, Université Hassan II- Casablanca, Casablanca, Maroc.
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Chan DNS, So WKW. A systematic review of randomised controlled trials examining the effectiveness of breast and cervical cancer screening interventions for ethnic minority women. Eur J Oncol Nurs 2015; 19:536-53. [PMID: 25840817 DOI: 10.1016/j.ejon.2015.02.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 02/13/2015] [Accepted: 02/23/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE To examine the effect that breast and/or cervical cancer screening programmes for ethnic minority women have on their knowledge of and beliefs about breast or cervical cancer and screening, and on their screening intentions and uptake rates. Recommendations are also made for the format and content of such programmes, based on existing evidence. METHODS A comprehensive literature search was carried out both manually and by means of five electronic databases. The findings are summarised and synthesised in narrative fashion. RESULTS The ten RCTs included here were conducted among ethnic minority women in the United States or Canada, where breast or cervical cancer screening programmes have led to improvements in screening intentions, knowledge of cervical cancer and pap test uptake. The Breast Cancer Screening Belief Scale and self-reporting were the methods commonly used to measure outcomes. The shared characteristics of both countries' programmes were that they were theory- and language-based, the instruction took place in a community setting, the materials were culturally relevant, the content highlighted key messages about breast or cervical cancer and screening measures, and there were multiple intervention strategies. CONCLUSION Breast or cervical cancer screening programmes in Western countries have demonstrated improvements in knowledge of the disease, screening intentions and pap test uptake, although evidence on the effectiveness of the interventions has been limited. The common characteristics of programmes are identified, but a comprehensive model is still needed to link these characteristics with other factors and mediators influencing outcomes.
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Affiliation(s)
- Dorothy N S Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Winnie K W So
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Ebu NI, Mupepi SC, Siakwa MP, Sampselle CM. Knowledge, practice, and barriers toward cervical cancer screening in Elmina, Southern Ghana. Int J Womens Health 2014; 7:31-9. [PMID: 25565902 PMCID: PMC4284003 DOI: 10.2147/ijwh.s71797] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Aims The aims of this study were: 1) to assess the level of knowledge of women about Pap smear tests, 2) to determine the practices of women regarding Pap smear tests, and 3) to determine the barriers to Pap smear tests in Elmina, Ghana. Methods A cross-sectional study was conducted with 392 randomly selected sexually active females aged 10–74 years using structured interview questions. The Institutional Review Board of the University of Cape Coast gave ethical approval for the study and informed consent was obtained from participants. Data were analyzed with SPSS software (v19.0) using frequencies, chi-square test, and exploratory factor analysis. Results The results revealed that 68.4% had never heard about cervical cancer, 93.6% had no knowledge on the risk factors, nine (2.3%) reported multiple sexual partners and being sexually active as risk factors, and 92% did not know about the prevention and treatment of cervical cancer. The majority (97.7%) had never heard of the Pap smear test. Only three (0.8%) women out of 392 had had a Pap smear test. Reasons for seeking a Pap smear test included referral, fear of cervical cancer, and radio campaigns. A significant association was found between institutional and personal barriers and having a Pap smear test. Conclusion Comprehensive education on cervical cancer screening and removal of access barriers are critical in reducing risk associated with the disease and promoting women’s health.
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Affiliation(s)
| | - Sylvia C Mupepi
- Kirkhof College of Nursing, Grand Valley Sta University, Grand Rapids, MI, USA
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Weber MF, Chiew M, Feletto E, Kahn C, Sitas F, Webster L. Cancer Screening among immigrants living in urban and regional Australia: results from the 45 and up study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:8251-66. [PMID: 25153460 PMCID: PMC4143860 DOI: 10.3390/ijerph110808251] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 07/30/2014] [Accepted: 08/06/2014] [Indexed: 12/23/2022]
Abstract
Over 25% of the Australian population are immigrants, and are less active participants in cancer screening programmes. Most immigrants live in urban areas of Australia, but a significant proportion (~20%), live in regional areas. This study explored differences in cancer screening participation by place of birth and residence. Self-reported use of mammogram, faecal occult blood test (FOBT), and/or prostate specific antigen (PSA) tests was obtained from 48,642 immigrants and 141,275 Australian-born participants aged 50 years or older in the 45 and Up Study (New South Wales, Australia 2006-2010). Poisson regression was used to estimate relative risks of test use, adjusting for key socio-demographic characteristics. Overall, immigrants from Asia and Europe were less likely to have had any of the tests in the previous two years than Australian-born participants. Regional Australian-born participants were more likely to have had any of the tests than those living in urban areas. Regional immigrant participants were more likely to have had an FOBT or PSA test than those living in urban areas, but there were no differences in mammograms. This report identifies key immigrant groups in urban and regional areas that policymakers and healthcare providers should target with culturally appropriate information to promote cancer screening.
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Affiliation(s)
- Marianne F Weber
- Cancer Research Division, Cancer Council NSW, P.O. Box 572 Kings Cross, NSW 1340, Australia.
| | - May Chiew
- Cancer Research Division, Cancer Council NSW, P.O. Box 572 Kings Cross, NSW 1340, Australia.
| | - Eleonora Feletto
- Cancer Research Division, Cancer Council NSW, P.O. Box 572 Kings Cross, NSW 1340, Australia.
| | - Clare Kahn
- Cancer Research Division, Cancer Council NSW, P.O. Box 572 Kings Cross, NSW 1340, Australia.
| | - Freddy Sitas
- Cancer Research Division, Cancer Council NSW, P.O. Box 572 Kings Cross, NSW 1340, Australia.
| | - Lucy Webster
- School of Biomedical Sciences, Charles Sturt University, Boorooma Street, Wagga Wagga, NSW 2650, Australia.
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McRae J, Martin C, O'Leary J, Sharp L. "If you can't treat HPV, why test for it?" Women's attitudes to the changing face of cervical cancer prevention: a focus group study. BMC WOMENS HEALTH 2014; 14:64. [PMID: 24885650 PMCID: PMC4135323 DOI: 10.1186/1472-6874-14-64] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Accepted: 04/25/2014] [Indexed: 11/28/2022]
Abstract
Background The relationship between infection with high-risk strains of human papillomavirus (HPV) and cervical cancer is transforming prevention through HPV vaccination and HPV oncogenic testing. In Ireland, a national cervical cancer screening programme and HPV vaccination were recently launched; HPV testing is currently being integrated into the screening programme. Women’s views on the transformation of cervical cancer prevention have been relatively little investigated. Methods Using qualitative focus groups, we determined women’s knowledge, attitudes towards, and acceptability of cervical cancer screening, HPV oncogenic testing and vaccination of HPV. Fifty nine women, recruited through primary care in Ireland, participated in ten focus groups. A dynamic topic guide was developed from literature reviewed. Women were provided with standardised information about HPV infection, HPV testing. Discussion transcripts were analysed thematically. Results The primary themes that emerged regarding HPV infection were: knowledge, emotional response and societal influences; especially those of healthcare practitioners. Knowledge, logistics, and psychological impact were the primary themes relating to HPV testing. Women’s attitudes towards HPV testing changed during discussion as issues were explored, thus demonstrating the complexity of this issue; lack of existing treatment for HPV infection influenced women’s attitudes, attachment to existing cervical cancer screening also was a significant factor. Conclusions Women currently have a strong attachment to cytology and any changes towards HPV primary testing will need to be managed carefully. To ensure that future cervical cancer prevention strategies will be acceptable to women, sufficient thought will have to be given to information provision and education. We identified the importance to women of healthcare practitioners’ opinions regarding HPV. Appropriate and timely information on HPV will be crucial in order to minimise possible psychological effects women may have.
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Affiliation(s)
- Judith McRae
- National Cancer Registry, Building 6800, Cork Airport Business Park, Kinsale Road, Cork, Ireland.
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Oshima S, Maezawa M. Perception of cervical cancer screening among Japanese university students who have never had a pap smear: a qualitative study. Asian Pac J Cancer Prev 2014; 14:4313-8. [PMID: 23991995 DOI: 10.7314/apjcp.2013.14.7.4313] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
This study aimed to explore attitudes towards cervical cancer screening among Japanese university students who had never had a Pap smear. Four focus-group discussions, each with 15 female university students, took place in November and December 2009. Discussions were recorded and transcripts were analyzed to extract attitudes of young women towards cervical cancer screening. The four themes that emerged were: i) a low sense of reality about cervical cancer; ii) a lack of knowledge about both cervical cancer and Pap smears; iii) a lack of motivation to get screened, and iv) a reluctance to visit the gynecologist. Participants who were interested in undergoing screening for cervical cancer cited the influence of conversations with friends and family, a diagnosis of cancer within their family, and relevant information from the media. The results indicate the importance of getting young women more interested in cervical cancer screening and overcoming their tendency to avoid visiting a gynecologist.
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Affiliation(s)
- Sumiko Oshima
- Department of Psychology and Communication, School of Humanities, Hokusei Gakuen University, Japan.
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Cho EJ. A Path Analysis on Factors Influencing Women's Embarrassment undergoing Papanicolaou Tests for Uterine Cervical Neoplasms Screening. ASIAN ONCOLOGY NURSING 2014. [DOI: 10.5388/aon.2014.14.3.162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Eun-Jung Cho
- School of Nursing, Yeungnam University College, Daegu, Korea
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Ogunsiji O, Wilkes L, Peters K, Jackson D. Knowledge, attitudes and usage of cancer screening among West African migrant women. J Clin Nurs 2013; 22:1026-33. [PMID: 23336438 DOI: 10.1111/jocn.12063] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2012] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To explore West African migrant women's knowledge, attitude and usage of cancer screening in Australia. BACKGROUND Despite strong evidence that cancer screening saves lives through early detection and treatment, there is lack of empirical studies on West African migrant women's knowledge, attitude and usage of cancer screening in Australia. DESIGN Qualitative naturalistic inquiry. METHODS Twenty-one West African migrant women who consented to participate in the study were recruited through a snowballing technique. These women were engaged in face-to-face audiotaped in-depth interviews which lasted for about 90 minutes. Interviews were transcribed verbatim and thematically analysed. RESULTS The following three themes emerged from the data: knowledge of cancer screening, attitude towards cancer screening and usage of cancer screening Irrespective of the women's place of birth in Africa, twenty of the participants had no knowledge of cancer screening prior to migration, and most had a negative attitude towards screening. Women who had given birth after migrating to Australia were more likely to have had cervical cancer screening. Women who had passed their child-bearing years or had not presented to healthcare facilities for medical issues were more likely to be unaware of cancer screening. CONCLUSIONS Improved health promotion strategies that provide accessible information and education to West African migrant women regarding cancer screening are required to enhance the uptake of such screening in this migrant group. RELEVANCE TO CLINICAL PRACTICE Nurses who encounter West African migrant women in their day-to-day practice have the opportunity to provide this group with education related to the importance of cancer screening.
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Affiliation(s)
- Olayide Ogunsiji
- School of Nursing and Mmidwifery, University of Western Sydney, Sydney, NSW, Australia.
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Team V, Manderson LH, Markovic M. From state care to self-care: cancer screening behaviours among Russian-speaking Australian women. Aust J Prim Health 2013; 19:130-7. [DOI: 10.1071/py11158] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Accepted: 05/22/2012] [Indexed: 11/23/2022]
Abstract
In this article, we report on a small qualitative scale study with immigrant Russian-speaking Australian women, carers of dependent family members. Drawing on in-depth interviews, we explore women’s health-related behaviours, in particular their participation in breast and cervical cancer screening. Differences in preventive health care policies in country of origin and Australia explain their poor participation in cancer screening. Our participants had grown up in the former Soviet Union, where health checks were compulsory but where advice about frequency and timing was the responsibility of doctors. Following migration, women continued to believe that the responsibility for checks was their doctor’s, and they maintained that, compared with their experience of preventive medicine in the former Soviet Union, Australian practice was poor. Women argued that if reproductive health screening were important in cancer prevention, then health care providers would take a lead role to ensure that all women participated. Data suggest how women’s participation in screening may be improved.
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