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Anyolo E, Amakali K, Amukugo HJ. Attitudes of women towards screening, prevention and treatment of cervical cancer in Namibia. Health SA 2024; 29:2433. [PMID: 38445040 PMCID: PMC10913021 DOI: 10.4102/hsag.v29i0.2433] [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: 05/11/2023] [Accepted: 11/09/2023] [Indexed: 03/07/2024] Open
Abstract
Background Cervical cancer is among the top causes of cancer-related deaths among women globally. Aim The aim of the study was to assess the attitudes of women of reproductive age towards cervical cancer services in the Otjozondjupa region, Namibia. Setting The setting of this study was the Otjozondjupa region, one of the 14 regions of Namibia. Methods A quantitative, cross-sectional, descriptive study was used. The data were collected with a questionnaire from a stratified sample of 381 out of the 37066 study population of women of reproductive age across four districts of the region. Descriptive data analysis was performed using Statistical Package for Social Science version 25. Results The findings revealed that most respondents (83.1%) had an overall neutral attitude towards the screening, prevention, and treatment of cervical cancer; they were not concerned about the risk of cervical cancer and would not practice health-seeking behaviours regarding cervical cancer services. Conclusions The respondents were indifferent with regard to prevention, screening, and management services for cervical cancer, implying that they would not use available cervical cancer services. Contributions Attitudes of women of reproductive age towards cervical cancer services were highlighted. Subsequently, an educational programme for nurses to enhance the utilisation of cervical cancer services among women of reproductive age in the Otjozondjupa region, Namibia, was developed. Guidelines were developed to facilitate the implementation and evaluation of the educational programme activities to enhance the utilisation of cervical cancer screening services among women of reproductive age.
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Affiliation(s)
- Epafras Anyolo
- Department of General Nursing Science, Faculty of Health Science and Veterinary Medicines, University of Namibia, Windhoek, Namibia
| | - Kristofina Amakali
- Department of General Nursing Science, Faculty of Health Science and Veterinary Medicines, University of Namibia, Windhoek, Namibia
| | - Hans J. Amukugo
- Department of General Nursing Science, Faculty of Health Science and Veterinary Medicines, University of Namibia, Windhoek, Namibia
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Ampofo AG, Boyes AW, Asibey SO, Oldmeadow C, Mackenzie LJ. Prevalence and correlates of modifiable risk factors for cervical cancer and HPV infection among senior high school students in Ghana: a latent class analysis. BMC Public Health 2023; 23:340. [PMID: 36793003 PMCID: PMC9930033 DOI: 10.1186/s12889-022-14908-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 12/20/2022] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND While health risk behaviours are likely to co-occur, there is dearth of studies exploring the clustering of cervical cancer and HPV infection risk factors among adolescents. This study aimed to determine: 1) the prevalence of modifiable risk factors for cervical cancer and HPV infection, 2) the clustering of modifiable risk factors for cervical cancer and HPV infection, and 3) factors associated with the identified clusters. METHODS Female students (aged 16-24 years, N = 2400) recruited from 17 randomly selected senior high schools in the Ashanti Region, Ghana completed a questionnaire assessing modifiable risk factors for cervical cancer and HPV infection including sexual experience, early sexual intercourse (< 18 years), unprotected sex, smoking, sexually transmitted infections (STIs); multiple sexual partners (MSP) and smoking. Latent class analysis explored separate classes of students according to their risk factor profiles for cervical cancer and HPV infection. Latent class regression analysis explored factors associated with latent class memberships. RESULTS Approximately one in three students (34%, 95%CI: 32%-36%) reported exposure to at least one risk factor. Two separate classes emerged: high-risk and low-risk (cervical cancer: 24% and 76% of students, respectively; HPV infection: 26% and 74% of students, respectively). Compared to participants in the low-risk classes i) the cervical cancer high-risk class were more likely to report exposure to oral contraceptives; early sexual intercourse (< 18 years); STIs; MSP and smoking; and ii) the HPV infection high risk class were more likely to report exposure to sexual intercourse; unprotected sex and MSP. Participants with higher risk factor knowledge had significantly higher odds of belonging to cervical cancer and HPV infection high-risk classes. Participants with greater perceived susceptibility to cervical cancer and HPV infection were more likely to belong to the high-risk HPV infection class. Sociodemographic characteristics and greater perceived seriousness about cervical cancer and HPV infection had significantly lower odds of belonging to both high-risk classes. CONCLUSIONS The co-occurrence of cervical cancer and HPV infection risk factors suggests that a single school-based multi-component risk reduction intervention could concurrently target multiple risk behaviours. However, students in the high risk class may benefit from more complex risk reduction interventions.
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Affiliation(s)
- Ama Gyamfua Ampofo
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, 2308, Australia. .,Equity in Health and Wellbeing Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia. .,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
| | - Allison W. Boyes
- grid.266842.c0000 0000 8831 109XHealth Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308 Australia ,grid.413648.cEquity in Health and Wellbeing Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW Australia ,grid.413648.cHunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Shadrack Osei Asibey
- grid.462504.10000 0004 0439 6970Faculty of Applied Sciences and Technology, Kumasi Technical University, Kumasi, Ghana
| | | | - Lisa J. Mackenzie
- grid.266842.c0000 0000 8831 109XHealth Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308 Australia ,grid.413648.cEquity in Health and Wellbeing Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW Australia ,grid.413648.cHunter Medical Research Institute, New Lambton Heights, NSW Australia
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Ampofo AG, Mackenzie L, Boyes AW. HPV vaccination: Intention to participate among female senior high school students in Ghana. Vaccine 2023; 41:159-169. [PMID: 36411133 DOI: 10.1016/j.vaccine.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Cervical cancer is the second most common cancer and the second leading cause of cancer death among women in Ghana. HPV vaccination is expected to be added to the national vaccination schedule in 2023. This study aimed to: i) describe intentions to participate in HPV vaccination and ii) explore factors associated with vaccination intentions among female senior high school students in Ghana. METHODS Female students (aged 16-24) were recruited from 17 senior high schools in Ashanti Region. A cross-sectional anonymous self-report paper-and-pen survey assessed students' HPV vaccination intentions using three items, and a range of correlates (individual, parent/family, social networks, service provision). Descriptive statistics were calculated for vaccination intentions, and correlates of intention scores (where higher scores indicate stronger intentions) were explored with a linear mixed-effect model. RESULTS Of 2400 participants, 64% (95%CI: 62%, 67%) agreed with at least one vaccination intention item. Uncertainty and disagreement with at least one item were endorsed by 51% (95%CI: 49%, 53%) and 44% (95%CI: 42%, 46%) of students, respectively. One-quarter of the students (25%, 95%CI: 23%, 26%) agreed, 12% (95% 11%, 13%) disagreed, and 11% (95%CI: 10%,13%) indicated uncertainty, on all three vaccination intention items. Vaccination uptake was 4.5%. Students were likely to have higher vaccination intention scores if: they had stronger beliefs about vaccine effectiveness; vaccination was recommended by parents, religious leaders and service providers, and vaccinated peers; and it was free. Students were likely to have lower vaccination intention scores if they perceived barriers to vaccination (e.g., side effects). CONCLUSIONS While two-thirds of students had some intention to participate in HPV vaccination, vaccine hesitancy (i.e., uncertainty or disagreement) was apparent. Alongside the rollout of a free national vaccination programme, messaging about vaccination benefits and effectiveness targeting students, as well as parents, religious leaders, service providers and peers would be beneficial given their influential role in students' vaccination intentions.
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Affiliation(s)
- Ama Gyamfua Ampofo
- Health Behavior Research Collaborative, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia; Equity in Health and Wellbeing Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
| | - Lisa Mackenzie
- Health Behavior Research Collaborative, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia; Equity in Health and Wellbeing Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Allison W Boyes
- Health Behavior Research Collaborative, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia; Equity in Health and Wellbeing Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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Maseko TN, Huang HC, Lin KC. Cervical cancer screening behavior of African women: The Rosenstock health belief model assessment. Health Care Women Int 2019; 42:976-991. [PMID: 31658000 DOI: 10.1080/07399332.2019.1677665] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Our paper is a narrative synthesis of the health belief model (HBM), which was developed in the early 1950s by social psychologists Hochbaum, Rosenstock, and Kegels working in the US Public Health Services. The HBM has been adapted to explore various long- and short-term health behaviors. In this narrative synthesis, we provide the analysis of the utilization of HBM and cervical cancer screening in Africa from 2009 to 2017 and critically evaluate the HBM in the context of different African countries. We also elucidate cervical cancer screening behavior among women living in Africa through a compassionate approach. Our results provide insights into individuals' health-seeking behavior and their place of residence, which provide valuable evidence for the development of further preventative medicine.
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Affiliation(s)
| | - Hui-Chuan Huang
- School of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Kuan Chia Lin
- Hospital and Health Care Administration, National Yang-Ming University, Taipei City, Taiwan
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Stuart A, Obiri-Yeboah D, Adu-Sarkodie Y, Hayfron-Benjamin A, Akorsu AD, Mayaud P. Knowledge and experience of a cohort of HIV-positive and HIV-negative Ghanaian women after undergoing human papillomavirus and cervical cancer screening. BMC WOMENS HEALTH 2019; 19:123. [PMID: 31647013 PMCID: PMC6813105 DOI: 10.1186/s12905-019-0818-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 09/23/2019] [Indexed: 01/30/2023]
Abstract
Background Cervical cancer is the most common cancer in women in Ghana, but knowledge and experience of women who have had cervical screening is under-evaluated. This study examined knowledge and understanding of HPV and cervical cancer and evaluated experiences of screening in a cohort of women of mixed HIV status. Methods This was a mixed methods study using questionnaires and focus group discussions, with a knowledge score constructed from the questionnaire. HIV-positive and HIV-negative women were recruited from a larger cervical screening study in Ghana and were interviewed 6 months after receiving screening. Quantitative data was analyzed and triangulated with qualitative data following thematic analysis using the framework approach. Results A total of 131 women were included (HIV-positive, n = 60). Over 80% of participants had a knowledge score deemed adequate. There was no difference between HIV-status groups in overall knowledge scores (p = 0.1), but variation was seen in individual knowledge items. HIV-positive women were more likely to correctly identify HPV as being sexually-transmitted (p = 0.05), and HIV negative women to correctly identify the stages in developing cervical cancer (p = < 0.0001). HIV-positive women mostly described acquisition of HPV in stigmatising terms. The early asymptomatic phase of cervical cancer made it difficult for women to define “what” cancer was versus “what” HPV infection was. All women expressed that they found it difficult waiting for their screening results but that receiving information and counselling from health workers alleviated anxiety. Conclusions Knowledge of women who had participated in a cervical screening study was good, but specific misconceptions existed. HIV-positive women had similar levels of knowledge to HIV-negative, but different misconceptions. Women expressed generally positive views about screening, but did experience distress. A standardized education tool explaining cervical screening and relevance specifically of HPV-DNA results in Ghana should be developed, taking into consideration the different needs of HIV-positive women.
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Affiliation(s)
- Arabella Stuart
- University Hospital, Lewisham, London, UK.,Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Dorcas Obiri-Yeboah
- Department of Microbiology and Immunology, School of Medical Sciences, CoHAS, University of Cape Coast, Private Mail Bag, Cape Coast, Ghana.
| | - Yaw Adu-Sarkodie
- Department of Clinical Microbiology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Anna Hayfron-Benjamin
- Department of Maternal and Child Health, School of Nursing and Midwifery, University of Cape Coast, Cape Coast, Ghana
| | - Angela D Akorsu
- Institute of Development Studies, University of Cape Coast, Cape Coast, Ghana
| | - Philippe Mayaud
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
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Williams MS, Kenu E, Adanu A, Yalley RA, Lawoe NK, Dotse AS, Adu RF, Fontaine K. Awareness and Beliefs About Cervical Cancer, the HPV Vaccine, and Cervical Cancer Screening Among Ghanaian Women with Diverse Education Levels. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:897-903. [PMID: 29974412 DOI: 10.1007/s13187-018-1392-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Cervical cancer is the leading cause of cancer death among women in Ghana. Cost-effective tools for the primary and secondary prevention of cervical cancer, such as the Pap test, the HPV DNA test, and the HPV vaccine, are available in hospitals and clinics throughout Ghana. However, participation in cervical cancer prevention behaviors is low among Ghanaian women. Our objective was to determine if there were significant differences in cervical cancer awareness and stigmatizing beliefs about women with cervical cancer between Ghanaian women of different education levels. We surveyed 288 Ghanaian women who were at least 18 years old. Data on the participants' demographic characteristics, awareness of cervical cancer, cervical cancer screening, and the HPV vaccine, beliefs about cervical cancer screening, and stigmatizing beliefs about women with cervical cancer was collected. Chi-square tests for independence and Fisher's exact test of independence were preformed to determine if education level was associated with those factors. Participation in cervical cancer screening and uptake of the HPV vaccine was significantly lower among women with less than a senior high school education. Awareness about cervical cancer, cervical cancer screening, and the HPV vaccine was lower among women with less education. Women with lower levels of education were more likely to agree with the negative statements about cervical cancer screening and stigmatizing beliefs about women with cervical cancer. Cervical cancer education interventions that are tailored for Ghanaian women with different educational levels are needed to increase awareness of and participation in cervical cancer prevention strategies.
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Affiliation(s)
| | | | | | | | | | | | | | - Kevin Fontaine
- University of Alabama at Birmingham, Birmingham, AL, USA
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Williams MS, Kenu E, Dzubey I, Dennis-Antwi JA, Fontaine K. A qualitative study of cervical cancer and cervical cancer screening awareness among nurses in Ghana. Health Care Women Int 2018; 39:584-594. [DOI: 10.1080/07399332.2018.1424169] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
| | - Ernest Kenu
- Department of Epidemiology and Disease Control, University of Ghana, Legon, Ghana
| | | | | | - Kevin Fontaine
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Major T, Koyabe B, Ntsayagae E, Monare B, Molwane O, Gabaitiri L. Norms and beliefs related to cervical cancer screening amongst women aged 25-49 in Botswana: A pilot study. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2018; 9:141-147. [PMID: 31321207 DOI: 10.1016/j.ijans.2018.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Thenjiwe Major
- University of Botswana, Private Bag 00702, Gaborone, Botswana
| | - Bramell Koyabe
- University of Botswana, Private Bag 00702, Gaborone, Botswana
| | | | - Barati Monare
- Botswana-Upenn Partnership, P O Box AC 157 ACH, Gaborone, Botswana
| | - Olefile Molwane
- University of Botswana, Private Bag 00702, Gaborone, Botswana
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Experiences of cervical cancer patients in rural Ghana: An exploratory study. PLoS One 2017; 12:e0185829. [PMID: 29020099 PMCID: PMC5636100 DOI: 10.1371/journal.pone.0185829] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Accepted: 09/20/2017] [Indexed: 12/25/2022] Open
Abstract
Even though cervical cancer is quite a prevalent disease in Ghana, there is hardly any study on this disease. This paper sought to explore the experiences of cervical cancer patients living with the disease with emphasis on their knowledge about the disease before and after the diagnosis. Qualitative data were collected through in-depth interviews with cervical cancer patients undergoing treatment in a specialised cancer treatment health facility in rural Ghana. Cervical cancer patients had inadequate knowledge about the disease, its symptoms, risk factors, treatment and prevention prior to being diagnosed of the disease. These patients were diagnosed late because they usually sought treatment elsewhere before reporting to health facilities. They experienced physical, psychological, economic and social disruptions in their daily lives, which affected their quality of life. It is evident that lack of knowledge about cervical cancer constitutes a threat to its prevention and treatment. Intensive health education through the mass media and community health promotion outreaches can be a sure way of creating adequate knowledge about cervical cancer in Ghana. Treatment and care for cervical cancer patients should incorporate counselling sessions, which should take into consideration the different levels of disruption the women experience and the implications for their wellbeing and management of the condition.
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Tetteh DA, Faulkner SL. Sociocultural factors and breast cancer in sub-Saharan Africa: implications for diagnosis and management. ACTA ACUST UNITED AC 2016; 12:147-56. [PMID: 26757491 DOI: 10.2217/whe.15.76] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The incidence of breast cancer is on the rise in sub-Saharan Africa (SSA) and efforts at early diagnosis have not been very successful because the public has scant knowledge about the disease, a large percentage of breast cancer cases are diagnosed late and mainly rural SSA women's practice of breast self-examination is poor. In this paper, we argue that an examination of the social and cultural contexts of SSA that influence breast cancer diagnosis and management in the region is needed. We discuss the implications of sociocultural factors, such as gender roles and spirituality, on breast cancer diagnosis and management in SSA.
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Affiliation(s)
- Dinah A Tetteh
- Bowling Green State University, School of Media & Communication, 302 West Hall, Bowling Green, OH 43403, USA
| | - Sandra L Faulkner
- Bowling Green State University, School of Media & Communication, 302 West Hall, Bowling Green, OH 43403, USA.,Bowling Green State University, Women's Gender & Sexuality Studies, 236 Shatzel Hall, Bowling Green, OH 43403, USA
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Zhou X, Meng Y. Association between serum folate level and cervical cancer: a meta-analysis. Arch Gynecol Obstet 2015; 293:871-7. [PMID: 26319154 DOI: 10.1007/s00404-015-3852-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 08/13/2015] [Indexed: 01/28/2023]
Abstract
PURPOSE The aim of this study was to evaluate the association between serum folate level and cervical cancer. METHODS PubMed, Medline, Springer, Elsevier Science Direct, Cochrane Library and Google scholar were searched for relevant trials. Rev.Man5.1 and Stata 11.0 software were applied for this meta-analysis. Odds Ratio (OR) and 95 % confidence intervals (95 % CI) were collected and calculated in a fixed-effects model or a random-effects model when appropriate. Subgroup analysis was performed by sample size, participant's geographical location and definition of deficient serum folate level. RESULTS A total of 6 case-control studies including 2383 participants were included in the meta-analysis. The overall meta-analysis showed that there were significant differences between cases and controls, suggesting that deficient serum folate level was associated with the increased risk of cervical cancer. After stratification subgroup analysis, significant difference was also found in subgroup with sample size <500 as well as in Asian population, but not in subgroup with sample size ≥500, American populations as well as different definition of deficient serum folate level (<6.4 ng/ml or others). CONCLUSIONS Based on our meta-analysis, deficiency of serum folate level was associated with the increased risk of cervical cancer among Asian populations.
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Affiliation(s)
- Xinyue Zhou
- Department of Obstetrics and Gynecology, the General Hospital of PLA, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Yuanguang Meng
- Department of Obstetrics and Gynecology, the General Hospital of PLA, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China.
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