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Bendahhou K, Serhier Z, Diouny S, Ouadii K, Barkouk A, Niyonsaba A, Bennani Othmani M. Women's Knowledge and Attitudes Towards Cervical Cancer Screening in Morocco. Cureus 2023; 15:e37989. [PMID: 37223139 PMCID: PMC10202561 DOI: 10.7759/cureus.37989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2023] [Indexed: 05/25/2023] Open
Abstract
High incidence rates of cervical cancer are still common in low- and middle-income countries (LMICs) with ineffective prevention policies. This study assessed Moroccan women's knowledge and practices regarding the cervical cancer screening program. A cross-sectional study was conducted in 2019 in four primary healthcare centers in Casablanca. Women over the age of 18 who came to these centers during the study period were invited to participate in the study. The variables collected were related to women's knowledge of cervical cancer, the screening program, and their reasons for not participating in the screening program. The main risk factors identified by the participants were multiple sexual partners (4.3%) and sexually transmitted diseases (4%). About 77% of the cases (95% confidence interval (CI): 72.1%; 80.4%) knew that a cervical cancer screening program exists in Morocco. However, a small proportion had an idea about the population targeted by the program (46%) and the recommended interval between two screening tests (20%). Only 28% (95% CI: 19.2%; 38.2%) of eligible women had ever been screened for cervical cancer. These results underline the importance of implementing a communication strategy to increase women's awareness of the cervical screening program and their involvement in it.
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Affiliation(s)
| | - Zineb Serhier
- Medical Informatics Laboratory, Hassan II University, Casablanca, MAR
- Clinical Neuroscience and Mental Health Laboratory, Hassan II University, Casablanca, MAR
| | - Samir Diouny
- Clinical Neuroscience and Mental Health Laboratory, Faculty of Dentistry, Hassan II University, Casablanca, MAR
| | - Karima Ouadii
- Medical School, Hassan II University, Casablanca, MAR
| | - Amal Barkouk
- Medical School, Hassan II University, Casablanca, MAR
| | | | - Mohamed Bennani Othmani
- Clinical Neuroscience and Mental Health Laboratory, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, MAR
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Ganeshkumar P. Audio-Visual Training Improves Awareness and Willingness of Cervical Cancer Screening among Healthy Indian Women: Findings from a Survey. South Asian J Cancer 2023; 12:23-29. [PMID: 36851929 PMCID: PMC9966178 DOI: 10.1055/s-0042-1751094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
Priya GaneshkumarObjectives We evaluated the impact of a standardized, simple audio-visual (AV) training video developed in regional languages on cervical cancer awareness among apparently healthy women and their willingness to undergo regular cervical cancer screening. Materials and Methods This cross-sectional noninterventional multicentric survey was conducted in 69 centers across 14 states in India and one center in UAE among women aged between 18 and 88 years attending clinics for a variety of indications. Using a short questionnaire, cervical cancer awareness and willingness to undergo cervical cancer screening were assessed before and after the AV training. Statistical Analysis In addition to descriptive analysis, improvement in awareness after the AV training was assessed using McNemar's test, and comparison of responses between subgroups was performed using Pearson chi-squared test. Results The survey was completed by 3,188 apparently healthy women (mean age: 36.8 ± 11.3 years). Before AV training, correct answers were given to only 4/6 questions by majority of the participants; most participants were unaware about the main cause of cervical cancer (1,637/3,188, 51.4%), availability of cervical cancer screening tests (1,601/3,188, 50.2%), and cervical cancer vaccines (1,742/3,188, 54.6%). Only 576 women (18.1%) had undergone cervical cancer screening in the past. After the AV training, the proportion of women correctly responding to all six questions improved significantly (p < 0.05), and 84.4% (2691/3188) women showed willingness to undergo periodic cervical cancer screening. Compared to unmarried and professional women, although married women and home-makers had lower awareness scores, the latter subgroups had more often undergone previous cervical cancer screening. Conclusion It is possible to improve cervical cancer awareness among healthy women, and to enhance their willingness to undergo regular cervical cancer screening tests using a simple, six minute-long, standardized AV training material.
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Affiliation(s)
- Priya Ganeshkumar
- Sainiwas Healthcare, Shivaji Nagar, Wagle Estate, Thane, Maharashtra, India
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Dsouza JP, Van den Broucke S, Pattanshetty S, Dhoore W. Factors explaining men's intentions to support their partner's participation in cervical cancer screening. BMC Womens Health 2022; 22:443. [PMID: 36369003 PMCID: PMC9652784 DOI: 10.1186/s12905-022-02019-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 10/20/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cervical cancer represents a high burden of disease. Many women in low- and middle-income countries face opposition from their partners and families to undergo cervical cancer screening. Identifying the social, cultural, and psychological factors that underly the opposition to screening by male partners is an important step towards reducing barriers for men to support their wives' participation in cervical screening. This study explored the role of structural and psychological factors deriving from theoretical models as determinants of Indian men's opposition to their partners being screened for cervical cancer. METHODS A survey among 500 sexually active males was conducted between April 2020 and August 2020 to measure knowledge of cervical cancer and screening, awareness of screening possibilities, attitude towards screening, perceived barriers to screening, and health literacy. Regression analysis was performed to assess which of the potential factors contributed to the intention to support their wives' screening. RESULTS The majority of participants had very poor knowledge and awareness about cervical cancer and screening procedures, tended towards a negative attitude towards screening, and perceived several structural barriers. Attitude towards the screening procedure and routine participation in general screening significantly predicted their intention to support their wives' screening for cervical cancer. Education moderated the association between knowledge and awareness and the intention to support their wives' screening. CONCLUSION As women often rely on their spouses' financial and emotional support of cervical screening, there is a need for men to be encouraged to support their wives' screening participation. Programs to encourage men to support their wives' cervical screening should focus on their attitude towards screening, educate about cervical cancer and screening procedures, and reduce perceived barriers.
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Affiliation(s)
- Jyoshma Preema Dsouza
- Psychological Sciences Research Institute, Université catholique de Louvain, Ottignies-Louvain-la-Neuve - Louvain-la-Neuve, Belgium.
- Institute of Health and Society, School of Public Health, 1200 Woluwe-Saint-Lambert, Belgium.
| | - Stephan Van den Broucke
- Psychological Sciences Research Institute, Université catholique de Louvain, Ottignies-Louvain-la-Neuve - Louvain-la-Neuve, Belgium
| | - Sanjay Pattanshetty
- Prasanna School of Public Health, Manipal Academy of Higher education, Manipal, India
| | - William Dhoore
- Institute of Health and Society, School of Public Health, 1200 Woluwe-Saint-Lambert, Belgium
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Budukh A, Maheshwari A, Bagal S, Singh A, Deodhar K, Panse N, Palyekar V, Dikshit R, Badwe R. Factors influencing women to participate in cervical cancer screening by providing menstrual pads: A population-based study from rural areas of Maharashtra state, India. Indian J Cancer 2022; 59:462-468. [PMID: 34380839 DOI: 10.4103/ijc.ijc_910_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background India accounts for a quarter of the world cervical cancer burden. Cervical cancer is highly preventable. However, low level of participating women in screening is one of the major issues. The aim of this work was to study the factors that influence women to participate in cervical cancer screening by providing menstrual pads for human papillomavirus (HPV) testing. Methods Menstrual clothes were collected from two different populations from the rural areas of Maharashtra state for HPV testing to screen for cervical cancer. For this study, out of 945 participated women, 557 (58.9%) provided their menstrual pads. Multivariate logistic regression was applied to calculate the odds ratio (OR) and 95% confidence interval (95% CI). Results The probability of providing the menstrual pads was high among the women who were highly educated compared to those with less education (OR: 1.4; 95% CI: 1.0-1.9), having mobile phone facilities as compared to those with no mobile phones (OR: 1.4; 95% CI: 1.0-2.0), who were using new cloths as menstrual pads compared to those who did not use the same (OR: 8.5; 95% CI: 5.0-14.3), who did not have tobacco habit as compared to those who had tobacco habit (OR: 1.4; 95% CI: 1.1-1.9) and in the village where health worker was stationed as compared to the village where health worker was not stationed (OR: 1.8; 95% CI: 1.4-2.5). Conclusion Factors including health worker availability, using mobile phones for communication and high education level facilitate women's participation. To improve the participation, there is need to apply special strategies for older age group, less educated women and women having tobacco habit.
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Affiliation(s)
- Atul Budukh
- Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Amita Maheshwari
- Department of Gynecologic Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Sonali Bagal
- Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Arpit Singh
- Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Kedar Deodhar
- Department of Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Nandkumar Panse
- Rural Cancer Registry, Nargis Dutt Memorial Cancer Hospital, Barshi, Maharashtra, India
| | - Vrushali Palyekar
- Department of Clinical Research, National Institute for Research and Reproductive Health, Mumbai, Maharashtra, India
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Rajendra Badwe
- Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
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Birje S, Patil AD, Munne KR, Chavan V, Joshi BN, Akula A, Salvi N, Nair S, Valawalkar SP, Tandon D, Chauhan S, Patil D, Babu BV. Enablers & challenges of tribal women & health system for implementation of screening of non-communicable diseases & common cancers: A mixed-methods study in Palghar district of Maharashtra, India. Indian J Med Res 2022; 156:319-329. [PMID: 36629192 PMCID: PMC10057353 DOI: 10.4103/ijmr.ijmr_3240_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background & objectives Non-communicable diseases (NCDs) and cancers of breast, oral cavity and cervix contribute to around 5.87 million (60%) deaths in India. Despite this, there is limited evidence on preparedness of the tribal health system in mitigating these conditions. This mixed-methods study aimed at identifying enablers and challenges using a multistakeholder approach for the screening of NCDs and common cancers in a tribal block of Maharashtra, India. Methods This study was conducted in a tribal community of Dahanu taluka in Palghar district of Maharashtra. A total of nine focus group discussions (FGDs) among tribal women and accredited social health activists (ASHAs), 13 key informant interviews (KIIs) among auxiliary nurse midwives (ANMs) and community health officers (CHO) and facility surveys of five public health facilities were conducted. The FGDs and KIIs were conducted using guides, recorded digitally, transcribed, analyzed and triangulated to identify emerging themes. Results The tribal women had limited knowledge about NCDs and common cancers. Paucity of health facilities, out-of-pocket expenditure, misconceptions, belief on traditional healers and inability to prioritize health were identified as major challenges. The ASHAs were recognized as a key connecting link between health system and community while provision of culturally appropriate IEC materials and adequate training were recognized as critical enablers by healthcare providers in implementing screening for NCDs and common cancers. Interpretation & conclusions The study recommends incorporating socioculturally relevant strategies in the tribal population and strengthening health facilities in terms of infrastructure and training with involvement of ASHAs for successful implementation of the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) through health and wellness centres.
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Affiliation(s)
- Shantanu Birje
- Department of Clinical Research, ICMR-National Institute for Research in Reproductive & Child Health, Mumbai, Maharashtra, India
| | - Anushree Devashish Patil
- Department of Clinical Research, ICMR-National Institute for Research in Reproductive & Child Health, Mumbai, Maharashtra, India
| | - Kiran Ramdas Munne
- Department of Clinical Research, ICMR-National Institute for Research in Reproductive & Child Health, Mumbai, Maharashtra, India
| | - Vidya Chavan
- Department of Preventive & Social Medicine, Seth G. S. Medical College & KEM Hospital
| | - Beena Nitin Joshi
- Department of Operational Research, ICMR-National Institute for Research in Reproductive & Child Health, Mumbai, Maharashtra, India
| | - Anamika Akula
- Department of Clinical Research, ICMR-National Institute for Research in Reproductive & Child Health, Mumbai, Maharashtra, India
| | - Neha Salvi
- Department of Health Research, Model Rural Health Research Unit, Palghar, Maharashtra, India
| | - Smitha Nair
- Centre for Health & Mental Health, School of Social Work, Tata Institute of Social Sciences, Mumbai, Maharashtra, India
| | | | - Deepti Tandon
- Department of Clinical Research, ICMR-National Institute for Research in Reproductive & Child Health, Mumbai, Maharashtra, India
| | - Sanjay Chauhan
- Department of Operational Research, ICMR-National Institute for Research in Reproductive & Child Health, Mumbai, Maharashtra, India
| | | | - Bontha V Babu
- Division of Socio-Behavioural & Health Systems Research, Indian Council of Medical Research, New Delhi, India
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McFarlane SJ, Morgan SE. Evaluating Culturally-targeted Fear Appeal Messages for HPV Self-Sampling among Jamaican Women: A Qualitative Formative Research Study. HEALTH COMMUNICATION 2021; 36:877-890. [PMID: 32037883 DOI: 10.1080/10410236.2020.1723047] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Despite the disproportionate burden of cervical cancer among Caribbean women, evaluations of targeted communication interventions to increase screening behaviors are sparsely represented in extant literature. Informed by data on the cognitive, affective and sociocultural factors associated with low cervical screening in the English-speaking island of Jamaica, the current study aimed to explore how theory-based message design, coupled with innovative solutions, might increase screening. In this formative research study, we first described the process used to develop culturally-targeted fear appeal messages embedded within an HPV self-sampling kit developed by the researchers. Then, we shared the results of an evaluation of the kit, which was reviewed by 36 Jamaican women in 8 focus groups, to understand the potential impact of the messages and the utility of HPV self-sampling to increase screening behaviors in this population. The results provide data on effective messages for cervical cancer prevention among Jamaican women, which may be further applicable to underscreened women in the English-speaking Caribbean. Additionally, results from this research suggest support for HPV self-sampling to address salient cultural and structural barriers to screening, which provides an impetus for experimental research in message design to inform policy and practice.
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The challenges of implementing low-dose computed tomography for lung cancer screening in low- and middle-income countries. NATURE CANCER 2020; 1:1140-1152. [PMID: 35121933 DOI: 10.1038/s43018-020-00142-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 10/09/2020] [Indexed: 12/12/2022]
Abstract
Lung cancer accounts for an alarming human and economic burden in low- and middle-income countries (LMICs). Recent landmark trials from high-income countries (HICs) by demonstrating that low-dose computed tomography (LDCT) screening effectively reduces lung cancer mortality have engendered enthusiasm for this approach. Here we examine the effectiveness and affordability of LDCT screening from the viewpoint of LMICs. We consider resource-restricted perspectives and discuss implementation challenges and strategies to enhance the feasibility and cost-effectiveness of LDCT screening in LMICs.
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Ampofo AG, Adumatta AD, Owusu E, Awuviry-Newton K. A cross-sectional study of barriers to cervical cancer screening uptake in Ghana: An application of the health belief model. PLoS One 2020; 15:e0231459. [PMID: 32352983 PMCID: PMC7192489 DOI: 10.1371/journal.pone.0231459] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 03/24/2020] [Indexed: 02/02/2023] Open
Abstract
Background The high incidence (32.9, age-standardized per 100,000) and mortality (23.0, age-standardized per 100,000) of cervical cancer (CC) in Ghana have been largely attributed to low screening uptake (0.8%). Although the low cost (Visual inspection with acetic acid) screening services available at various local health facilities screening uptake is meager. Objective The purpose of the study is to determine the barriers influencing CC screening among women in the Ashanti Region of Ghana using the health belief model. Methods A analytical cross-sectional study design was conducted between January and March 2019 at Kenyase, the Ashanti Region of Ghana. The study employed self-administered questionnaires were used to collect data from 200 women. Descriptive statistics were used to examine the differences in interest and non-interest in participating in CC screening on barriers affecting CC screening. Multivariable logistic regression was used to determine factors affecting CC screening at a significance level of p<0.05. Results Unemployed women were less likely to have an interest in CC screening than those who were employed (adjustes odds ratio (aOR) = 0.005, 95%CI:0.001–0.041, p = 0.005). Women who were highly educated were 122 times very likely to be interested in CC screening than those with no or low formal education (aOR = 121.915 95%CI: 14.096–1054.469, p<0.001) and those who were unmarried were less likely to be interested in CC screening than those with those who were married (aOR = 0.124, 95%CI: 0.024–0.647, p = 0.013). Also, perceived threat, perceived benefits, perceived barriers and cues for action showed significant differences with interest in participating in screening with a P-values <0.003. The association was different for long waiting time, prioritizing early morning and late evening screening which showed no significant difference (P-value > 0.003). Conclusions Married women, unemployed and those with no formal education are less likely to participate in CC screening. The study details significant barriers to cervical cancer screening uptake in Ghana. It is recommended that the Ghana health services should develop appropriate, culturally tailored educational materials to inform individuals with no formal education through health campaigns in schools, churches and communities to enhance CC screening uptake.
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Affiliation(s)
- Ama G. Ampofo
- Department of Nursing, Garden City University College, Kumasi, Ghana
- Health Behaviour Research Collaborative, Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
- * E-mail:
| | - Afia D. Adumatta
- Department of Nursing, Garden City University College, Kumasi, Ghana
| | - Esther Owusu
- Department of Nursing, Garden City University College, Kumasi, Ghana
| | - Kofi Awuviry-Newton
- Priority Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
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10
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Valent F, Sammartano F, Degano S, Dellach C, Franzo A, Gerin D, Gnesutta D, Mentil S, Stel S, Pattitoni C, Gongolo F. Reasons for non-participation in public oncological screening programs in the Italian region Friuli Venezia Giulia. Public Health 2020; 181:80-85. [PMID: 31958673 DOI: 10.1016/j.puhe.2019.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 11/14/2019] [Accepted: 12/06/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES In the Italian region Friuli Venezia Giulia, public screening is offered for cervical cancer, breast cancer, and colorectal cancer. Participation of the target population is lower than 70%. Our aim was to investigate reasons for non-participation. STUDY DESIGN This is a qualitative survey. METHODS A telephone survey was conducted in 2018 on a random sample of persons not adhering in 2017. Only one question about the reason for non-participation was asked. The answers were transcribed verbatim with no personal identifiers and no additional information. The transcribed anonymous answers were then read and classified into mutually exclusive macrocategories and subcategories. RESULTS A total of 4456 non-adhering persons were surveyed. Personal practical issues were the most common type of barrier reported in all three screening programs, followed by personal beliefs. Program-related issues were more common in cervical cancer screening than in the others. Almost half of the women not participating in the public breast cancer screening and 40% of those not adhering to the public cervical cancer screening had mammography or Pap test out of the public program. CONCLUSIONS In this region, practitioners should work to overcome practical barriers and discuss personal beliefs. Surveys of non-participants in other geographic areas would be important to adequately inform local policymaking.
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Affiliation(s)
- F Valent
- Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy.
| | - F Sammartano
- Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - S Degano
- Azienda Regionale di Coordinamento per la Salute, Udine, Italy
| | - C Dellach
- Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | - A Franzo
- Direzione Centrale Salute, Integrazione Sociosanitaria, Politiche Sociali e Famiglia, Regione Autonoma Friuli Venezia Giulia, Udine, Italy; Azienda per l'Assistenza Sanitaria N. 5, "Friuli Occidentale", Pordenone, Italy
| | - D Gerin
- Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | - D Gnesutta
- Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - S Mentil
- Direzione Centrale Salute, Integrazione Sociosanitaria, Politiche Sociali e Famiglia, Regione Autonoma Friuli Venezia Giulia, Udine, Italy; Azienda per l'Assistenza Sanitaria N. 3, "Altro Friuli Collinare Medio Friuli", Gemona del Friuli, Italy
| | - S Stel
- Azienda per l'Assistenza Sanitaria N. 2, "Bassa Friulana Isontina", Palmanova, Italy
| | | | - F Gongolo
- Direzione Centrale Salute, Integrazione Sociosanitaria, Politiche Sociali e Famiglia, Regione Autonoma Friuli Venezia Giulia, Udine, Italy
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Dahiya N, Aggarwal K, Singh MC, Garg S, Kumar R. Knowledge, attitude, and practice regarding the screening of cervical cancer among women in New Delhi, India. Tzu Chi Med J 2019; 31:240-243. [PMID: 31867252 PMCID: PMC6905229 DOI: 10.4103/tcmj.tcmj_145_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 08/21/2018] [Accepted: 10/28/2018] [Indexed: 11/29/2022] Open
Abstract
Objective: Cervical cancer is one of the major concerns of public health importance in today's world. It is a leading cause of mortality in women of reproductive age group worldwide, mainly in developing countries. Reduction in mortality and morbidity due to cervical cancer is possible through early detection and treatment. The major factors influencing the early detection of cervical cancer are knowledge regarding risk factors, screening, Pap smear, and symptoms among women. Materials and Methods: The present cross-sectional study was carried out to assess the knowledge, attitude, and practice of women about the risk factors, symptoms, and prevention of cervical cancer. Data were obtained from 220 women who visited international trade fair using a pretested self-administered questionnaire. Results: Only 75 study women (50.0%) had ever heard of cervical cancer. The knowledge regarding cervical cancer and its various domains was significantly higher in students and unmarried women. The foul-smelling vaginal discharge was the most common early symptom of cervical cancer according to most of the study women (26, 17.3%). Most of the study women (19, 12.7%) reported tobacco and smoking as the most common risk factor associated with cervical cancer. Only 39 women (26%) had ever heard of cervical cancer screening. Only 27 women (18.0%) ever had Pap smear done in the past and 87 women (58.0%) were willing to undergo cervical cancer screening is offered free of cost. Conclusion: The study demonstrates the lack of awareness in women regarding cervical cancer and its screening modalities. This necessitates spreading awareness regarding early symptoms and risk factors associated with cervical cancer for early detection and treatment initiation.
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Affiliation(s)
- Neha Dahiya
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kavita Aggarwal
- Department of Community Medicine, Maulana Azad Medical College, Delhi, India
| | - Megha Chandra Singh
- Department of Community Medicine, Maulana Azad Medical College, Delhi, India
| | - Suneela Garg
- Department of Community Medicine, Maulana Azad Medical College, Delhi, India
| | - Rajesh Kumar
- Department of Community Medicine, Maulana Azad Medical College, Delhi, India
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Barriers to the Uptake of Cervical Cancer Screening and Treatment among Rural Women in Ghana. BIOMED RESEARCH INTERNATIONAL 2019; 2019:6320938. [PMID: 31781631 PMCID: PMC6874950 DOI: 10.1155/2019/6320938] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 09/25/2019] [Indexed: 01/09/2023]
Abstract
Background This study sought to explore the barriers to the uptake of cervical cancer screening and treatment in the North Tongu district of Ghana. Methods Twenty-five in-depth interviews were conducted, while three focus group discussions were held among respondents. The data were analysed with the R package for qualitative data analysis using a thematic analytical approach. Results Low level of knowledge about the disease and screening services, personal or psychological convictions, and cost of screening and treatment coupled with a low level of income were the barriers at the individual level. Perceived health personnel attitude, perceived lack of privacy, and misdiagnosis were the barriers at the institutional level while the sociocultural belief system of the communities about the etiology of the disease was the barrier at the community level. Inadequate education about the disease, lack of funding and access to screening facilities also constrained screening and treatment at the policy level. Conclusions Cervical cancer screening and treatment are constrained at multiple levels in rural Ghana. This study underscores the need to address the low uptake of cervical cancer screening and treatment at the individual, community, institutional, and policy levels simultaneously.
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Gender of Provider-Barrier to Immigrant Women's Obstetrical Care: A Narrative Review. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2019. [PMID: 28625284 DOI: 10.1016/j.jogc.2017.01.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To explore the preference for female obstetrician/gynaecologists among immigrant women, and providers' understandings of these preferences, to identify challenges and potential solutions. METHODS Five databases (Medline, Embase, CINAHL, Global Health, and Scopus) were searched using combinations of search terms related to immigrant, refugee, or Muslim women and obstetrics or gynaecological provider gender preference. STUDY SELECTION Peer reviewed, English-language articles were included if they discussed either patient or provider perspectives of women's preference for female obstetrics or gynaecological care provider among immigrant women in Western and non-western settings. After screening, 54 met inclusion criteria and were reviewed. DATA EXTRACTION Studies were divided first into those specifically focusing on gender of provider, and those in which it was one variable addressed. Each category was then divided into those describing immigrant women, and those conducted in a non-Western settings. The research question, study population, methods, results, and reasons given for preferences in each article were then examined and recorded. CONCLUSION Preference for female obstetricians/gynaecologists was demonstrated. Although many will accept a male provider, psychological stress, delays, or avoidance in seeking care may result. Providers' views were captured in only eight articles, with conflicting perspectives on responding to preferences and the health system impact.
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Devarapalli P, Labani S, Nagarjuna N, Panchal P, Asthana S. Barriers affecting uptake of cervical cancer screening in low and middle income countries: A systematic review. Indian J Cancer 2019; 55:318-326. [PMID: 30829264 DOI: 10.4103/ijc.ijc_253_18] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Cervical cancer is the second-most common cancer among women in the developing world and approximately 500,000 cases are diagnosed each year. In developed countries, cervical cancer (CCa) accounts for only 3.6% of newly diagnosed cancers. OBJECTIVE The present study aims to identify the most effective barriers associated with CCa screening uptake in low and middle-income countries (L and MICs) and aid to adopt effective measures to overcome prevailing barriers to the attainment of CCa uptake in the community. MATERIALS AND METHODS Health sciences electronic databases like MEDLINE, PubMed, Cochrane library, and Google Scholar were searched for studies published until August 2017. Keywords used for the search were ("cervical cancer screening"), ("barriers"), AND ("low income countries" OR "Middle income countries"). Articles were reviewed and data were extracted by using Mendeley Desktop Software (V-1.17.10). Income-level classification of countries was done as per the World Bank 2017 report. Statistical software like SPSS-V.23 and Medical-V.14 were used for the statistical application. RESULTS A total of 31 studies met the inclusion criteria with a total of 25,650 participants. The sample size of the included studies ranged from 97 to 5929 participants. Articles majorly reported data on participants from African region (51.6%) and minimally in the Western Pacific region (3.2%). Sampling methods among studies varied from convenience sampling-12 (39.7%) to consecutive sampling-1 (3.2%). Besides, two studies (6.5%) did not discuss their sampling procedures. It was observed that "Lack of information about CCa and its treatment" (Barrier of lack of knowledge and Awareness); "Embracement or shy" (Psychological Barrier); "Lack of time" (structural Barrier); and "Lack of family support" (Sociocultural and religious barrier) were the most commonly reported among all 22 barriers. CONCLUSION There is a need of policies advancement of CCa screening programs by focusing on aspects of accessibility, affordability, CCa education, and the necessity of screening to improve screening uptake to control the CCa morbidity and mortality rate in L and MIC's.
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Affiliation(s)
- Pradeep Devarapalli
- Department of Epidemiology and Biostatistics, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, I-7, Sector-39, Noida, Uttar Pradesh, India
| | - Satyanarayana Labani
- Department of Epidemiology and Biostatistics, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, I-7, Sector-39, Noida, Uttar Pradesh, India
| | - Narayanasetti Nagarjuna
- Department of Epidemiology and Biostatistics, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, I-7, Sector-39, Noida, Uttar Pradesh, India
| | - Poonam Panchal
- Department of Epidemiology and Biostatistics, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, I-7, Sector-39, Noida, Uttar Pradesh, India
| | - Smita Asthana
- Department of Epidemiology and Biostatistics, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, I-7, Sector-39, Noida, Uttar Pradesh, India
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15
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O’Donovan J, O’Donovan C, Nagraj S. The role of community health workers in cervical cancer screening in low-income and middle-income countries: a systematic scoping review of the literature. BMJ Glob Health 2019; 4:e001452. [PMID: 31179040 PMCID: PMC6528769 DOI: 10.1136/bmjgh-2019-001452] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 04/22/2019] [Accepted: 04/27/2019] [Indexed: 01/21/2023] Open
Abstract
Introduction Community-based screening for cervical cancer and task sharing to community health workers (CHWs) have been suggested as a potential way to increase screening coverage in low- and middle-income countries (LMICs). The aims of the scoping review were to understand the following: (i) where and how CHWs are currently deployed in screening in LMIC settings; (ii) the methods used to train and support CHWs in screening, and (iii) The evidence on the cost-effectiveness of using CHWs to assist in screening. Methods A scoping literature search of 11 major databases and the grey literature was performed between 1978 and 2018. We included comprehensive search terms for 'CHWs' and 'Cervical Cancer', and used the World Bank criteria to define LMICs. Results Of the 420 articles screened, 15 met the inclusion criteria for review. Studies were located in Africa (n=5), Asia (n=5), and South and Central America (n=5). CHWs played a role in community education and raising awareness (n=14), conducting or assisting in cervical screening (n=5), or follow-up (n=1). 11 studies described CHW training activities. Only one study provided a formal cost analysis. Conclusion The roles of CHWs in cervical cancer screening in LMICs have largely to date focused on education, outreach, and awareness programmes. Community-based approaches to cervical cancer screening are feasible, although the sociocultural context plays an important role in the acceptability of these interventions. Further in-depth contextually grounded studies exploring the acceptability of such interventions are required, as well as studies exploring the cost-effectiveness of involving CHWs in cervical cancer screening activities.
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Affiliation(s)
| | - Charles O’Donovan
- Health Education North West London, North West Thames Foundation School, London, UK
| | - Shobhana Nagraj
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
- The George Institute for Global Health, Oxford, UK
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16
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Mahajan M, Naik N, Jain K, Patira N, Prasad S, Mogri S, Muwonge R, Lucas E, Faruq F, Sankaranarayanan R, Iyer S, Basu P. Study of Knowledge, Attitudes, and Practices Toward Risk Factors and Early Detection of Noncommunicable Diseases Among Rural Women in India. J Glob Oncol 2019; 5:1-10. [PMID: 30998427 PMCID: PMC6528727 DOI: 10.1200/jgo.18.00181] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2019] [Indexed: 01/08/2023] Open
Abstract
PURPOSE In recognition of the growing burden of noncommunicable diseases (NCDs), including cancer, we assessed the knowledge, attitudes, and practices of rural women in low-resourced countries toward common NCDs and the barriers they face in receiving NCD early detection services. PATIENTS AND METHODS The study was conducted in a rural block of India using the Rapid Assessment and Response Evaluation ethnographic assessment, which included in-depth interviews of key health officials; focus group discussions with women, men, teachers, and health workers from the block; and a knowledge, attitudes, and practices questionnaire survey. The home-based survey was conducted among 1,192 women selected from 50 villages of the block using a two-stage randomization process and stratified to 30- to 44-year and 45- to 60-year age-groups. RESULTS Our study revealed low awareness among women with regard to tobacco as a risk factor; hypertension, diabetes, and cancer as major health threats; and the importance of their early detection. Only 4.8% of women reported to have ever consumed tobacco, and many others consumed smokeless tobacco without knowing that the preparations contained tobacco. Only 27.3% and 11.5% of women had any knowledge about breast and cervical cancer, respectively, and only a few could describe at least one common symptom of either cancer. Self-reported diagnosis of hypertension and diabetes was significantly lower than the reported national prevalence. Only 0.9% and 1.3% of women reported having had a breast examination or gynecologic checkup, respectively, in the past 5 years. Low female empowerment and misconceptions were major barriers. CONCLUSION Barriers need to be addressed to improve uptake of NCD early detection services.
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Affiliation(s)
- Manoj Mahajan
- GBH Memorial Cancer Hospital, Udaipur, Rajasthan, India
| | - Navami Naik
- Indo-American Cancer Association, Houston, TX
| | - Kirti Jain
- Indo-American Cancer Association, Houston, TX
| | - Nilesh Patira
- GBH Memorial Cancer Hospital, Udaipur, Rajasthan, India
| | | | - Sushma Mogri
- GBH Memorial Cancer Hospital, Udaipur, Rajasthan, India
| | | | - Eric Lucas
- International Agency for Research on Cancer, Lyon, France
| | | | | | - Swami Iyer
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - Partha Basu
- International Agency for Research on Cancer, Lyon, France
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17
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Mandal R, Basu P. Cancer screening and early diagnosis in low and middle income countries : Current situation and future perspectives. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2018; 61:1505-1512. [PMID: 30353287 DOI: 10.1007/s00103-018-2833-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Limited health system capacities and competing health priorities in low and middle income countries (LMICs) necessitate a pragmatic approach to population-based cancer screening. Thus, the challenges faced by LMICs to implement a 'western' model of screening for common cancers and the possible means to overcome these challenges are presented. Breast cancer is the number one cancer with a rising trend in the majority of LMICs. Implementation of mass-scale mammography-based screening is not feasible and sustainable in most of them. While some LMICs have introduced breast cancer screening based on clinical breast examination (CBE), the programs need to be of appropriate quality. All LMICs should improve the capacity for early diagnosis of breast cancer along with other common cancers through community education, training of frontline health workers, facilitating prompt referrals and improving the infrastructure for cancer diagnosis and treatment. Resources permitting, the LMICs with high burden of cervical cancer may consider human papillomavirus (HPV) detection-based screening; a simple low-cost alternative is visual inspection with acetic acid (VIA). Regardless of the choice, a strong linkage should be established between screening and treatment with implementation of robust quality assurance. The few LMICs with a rising trend of colorectal cancers and adequate resources may implement demonstration projects to screen with fecal immunochemical tests (FIT). Oral cancer screening of habitual tobacco and/or alcohol users using oral visual examination (OVE) may be implemented in countries with high burden of the cancer, but primary prevention (i.e., tobacco/alcohol cessation) should be prioritized. Screenings for other cancers are not recommended for LMICs.
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Affiliation(s)
| | - Partha Basu
- Screening Group, Early Detection and Prevention Section, International Agency for Research on Cancer (WHO), 150 cours Albert Thomas, 69372, Lyon Cedex 08, France.
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18
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Idehen EE, Koponen P, Härkänen T, Kangasniemi M, Pietilä AM, Korhonen T. Disparities in cervical screening participation: a comparison of Russian, Somali and Kurdish immigrants with the general Finnish population. Int J Equity Health 2018; 17:56. [PMID: 29728104 PMCID: PMC5935973 DOI: 10.1186/s12939-018-0768-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 04/26/2018] [Indexed: 11/10/2022] Open
Abstract
Background Cervical cancer is currently ranked as the fourth commonly diagnosed cancer in women globally. A higher incidence has been reported in low- and-middle-income countries, and the disease poses significant public health challenges. Evidence suggests that this disease is preventable by means of regular screening using the Papanicolaou (Pap) test. However, limited knowledge exists about disparities in cervical screening participation among immigrants compared with non-immigrants, in countries with universal cervical screening programmes. We aimed to examine disparities in cervical screening participation among women of Russian, Somali, and Kurdish, origin in Finland, comparing them with the general Finnish population (Finns). We controlled for differences in several socio-demographic and health-related variables as potential confounders. Methods We employed data from the Finnish Migrant Health and Well-being Study 2010–2012 and the National Health 2011 Survey. Data collection involved face-to-face interviews. Data on screening participation in the previous five years from women aged 29–60 were available from 537 immigrants (257 Russians, 113 Somalis, 167 Kurds) and from 436 Finns. For statistical analyses, we used multiple logistic regression. Results Age-adjusted screening participation rates were as follows: Russians 79% (95% CI 72.9–84.4), Somalis 41% (95% CI 31.4–50.1), and Kurds 64% (95% CI 57.2–70.8), compared with 94% (95% CI 91.4–95.9) among Finns. After additionally adjusting for socio-demographic and health-related confounders, all the immigrant groups showed a significantly lower likelihood of screening participation when compared with Finns. The Odds Ratios were as follows: Russians 0.32 (95% CI 0.18–0.58), Somalis 0.10 (95% CI 0.04–0.23), and Kurds 0.17 (95% CI 0.09–0.35). However, when additionally accounting for country of origin-confounder interactions, such differences were attenuated. Conclusions Our results indicate disparities in screening participation among these immigrants and a lower likelihood of screening participation compared with the general Finnish population. To improve equity in cervical cancer screening participation, appropriate culturally tailored intervention programmes for each immigrant group might be beneficial.
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Affiliation(s)
- Esther E Idehen
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Yliopistoranta 1, P. O. Box 1627, 70211, Kuopio, Finland.
| | - Päivikki Koponen
- Department of Public Health Solutions, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Tommi Härkänen
- Department of Public Health Solutions, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Mari Kangasniemi
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Anna-Maija Pietilä
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Tellervo Korhonen
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Yliopistoranta 1, P. O. Box 1627, 70211, Kuopio, Finland.,Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Basu P, Mittal S, Bhadra Vale D, Chami Kharaji Y. Secondary prevention of cervical cancer. Best Pract Res Clin Obstet Gynaecol 2018; 47:73-85. [PMID: 28988647 DOI: 10.1016/j.bpobgyn.2017.08.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 08/27/2017] [Indexed: 01/04/2023]
Abstract
Cervical cancer affects women in their reproductive ages. Screening is an important secondary prevention strategy. The long process of carcinogenic transformation from human papillomavirus (HPV) infection to invasive cancer provides ample opportunities to detect the disease at a stage when treatment is highly effective. Suitable screening tests are cytology, visual inspection after acetic acid application and HPV detection tests. Evidence of effectiveness of the tests to reduce cervical cancer mortality and the cost-effectiveness of screening programs have been demonstrated. Cervical intraepithelial neoplasia grade 2 and grade 3 are the high-grade cervical cancer precursors and need to be treated. Treatment is safe and effective with ablative or excisional techniques. The World Health Organization recommends screening women at least once in a lifetime between 30 and 49 years of age and ensuring effective treatment of the detected abnormalities. Combination of HPV vaccination and population-based screening will be instrumental in eliminating cervical cancer.
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Affiliation(s)
- Partha Basu
- Screening Group, International Agency for Research on Cancer, Lyon, France.
| | - Srabani Mittal
- Chittaranjan National Cancer Institute, Kolkata, West Bengal, India
| | - Diama Bhadra Vale
- Departamento de Tocoginecologia, Divisão de Oncologia, Universidade Estadual de Campinas, Brazil
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20
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Kabalika C, Mulenga D, Mazaba ML, Siziya S. Acceptance of Cervical Cancer Screening and its Correlates Among Women of a Peri-Urban High-Density Residential Area in Ndola, Zambia. Int J MCH AIDS 2018; 7:17-27. [PMID: 30305986 PMCID: PMC6168797 DOI: 10.21106/ijma.223] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Zambia has one of the highest cervical cancer incidence and mortality rates in the world. Cervical cancer screening leads to reduction in the incidence of invasive disease. The objectives of the study were to determine the level of acceptance of cervical cancer screening and its correlates among women of a peri-urban high-density residential area in Ndola, Zambia. METHODS A cross sectional study was conducted. With a population size of 12,000 women in reproductive age and using an expected frequency of 50 + 5% and at 95% confidence interval, the required sample size was 372. A stratified sampling method was used to select participants. Independent factors that were associated with the outcome were established using multi-variate logistic regression. Adjusted odds ratios and their 95% confidence intervals are reported. RESULTS In total, 355 out of 372 questionnaires were administered, achieving a response rate of 95.4%. Out of 355 participants, 9 (2.5%) had ever been screened for cervical cancer. In bivariate analyses, factors associated with screened were knowledge of body part affected, screening as a prevention tool, whether cervical cancer was curable in its early stages or not, awareness of cervical cancer screening, knowledge on frequency of screening and cervical cancer screening causing harm. However, in multivariate analysis, participants who knew that cervical cancer screening prevented cervical cancer were 3.58 (95% CI [1.49, 8.64]) times more likely to have been screened than those who did not have the knowledge. Participants who knew that cervical cancer is curable were 2.76 (95% CI [1.92, 8.31]) times more likely to have been screened than those who did not have the knowledge. CONCLUSION AND GLOBAL HEALTH IMPLICATIONS The uptake of screening was low. Interventions should be designed to increase uptake of screening for cervical cancer by considering factors that have been identified in the current study that are independently associated with cervical cancer screening among this population.
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Affiliation(s)
- Chiluba Kabalika
- Clinical Sciences Department, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola, Zambia
| | - David Mulenga
- Clinical Sciences Department, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola, Zambia
| | - Mazyanga Lucy Mazaba
- The Health Press, Zambia. Institute of Public Health, Ministry of Health, Lusaka, Zambia
| | - Seter Siziya
- Clinical Sciences Department, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola, Zambia
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21
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Detection and genotyping of HPV in urine samples from Chilean women attending primary health care centers. Med Microbiol Immunol 2017; 207:95-103. [PMID: 29238853 DOI: 10.1007/s00430-017-0530-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 12/09/2017] [Indexed: 12/22/2022]
Abstract
Cervical cancer is the second most common malignant neoplasm in women worldwide representing approximately 10% of all types of cancers. Triage of women through cervical cytology has been an important strategy for the surveillance and control of new cases of cervical cancer. However, in many regions around the world cervical cytology has a low coverage compared to developed countries. The molecular detection of HPV is the most effective method to increase the screening sensitivity of women at risk of developing cervical cancer. There are very few studies about the efficacy of urine testing for detection of HPV in women followed up in primary health care centers. Consequently, the efficacy of using urine HPV screening in these populations has not been addressed yet. Here, we compared the detection of HPV in simultaneous urine and cervical samples of women followed up in primary health care centers. Urine and cervical samples were analyzed in 543 women attending at primary health care centers. HPV was detected by real time PCR, and HPV typing performed by PCR-RLB. A general HPV concordance of 86.2% (κ = 0.72) was determined between urine and cervical samples. The concordance for HPV-16 and 18 was almost perfect (κ = 0.82) and strong (κ = 0.77), respectively. The sensitivity and specificity for all HPV genotypes in urine using cervical samples as reference were 82.1 and 93.7%, respectively. The results showed that urine is a good alternative as clinical sample for HPV screening in women attending primary health care centers. Therefore, urine should be used as an alternative sample for increasing triage coverage either in refractory women participating in Pap surveillance programs or when cervical samples are not available.
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22
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Islam RM, Billah B, Hossain MN, Oldroyd J. Barriers to Cervical Cancer and Breast Cancer Screening Uptake in Low-Income and Middle-Income Countries: A Systematic Review. Asian Pac J Cancer Prev 2017; 18:1751-1763. [PMID: 28749101 PMCID: PMC5648375 DOI: 10.22034/apjcp.2017.18.7.1751] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: Cervical cancer (CCa) and breast cancer (BCa) are the two leading cancers in women worldwide. Early detection and education to promote early diagnosis and screening of CCa and BCa greatly increases the chances for successful treatment and survival. Screening uptake for CCa and BCa in low and middle - income countries (LMICs) is low, and is consequently failing to prevent these diseases. We conducted a systematic review to identify the key barriers to CCa and BCa screening in women in LMICs. Methods: We performed a systematic literature search using Ovid MEDLINE, EMBASE, PsycINFO, SCOPUS, CINHAL Plus, and Google scholar to retrieve all English language studies from inception to 2015. This review was done in accordance with the PRISMA-P guidelines. Results: 53 eligible studies, 31 CCa screening studies and 22 BCa screening studies, provided information on 81,210 participants. We found fewer studies in low-income and lower - middle - income countries than in upper - middle - income countries. Lack of knowledge about CCa and BCa, and understanding of the role of screening were the key barriers to CCa and BCa screening in LMICs. Factors that are opportunities for knowledge acquisition, such as level of education, urban living, employment outside the home, facilitated CCa and BCa screening uptake in women in LMICs. Conclusions: Improvements to CCa and BCa screening uptake in LMICs must be accompanied by educational interventions which aim to improve knowledge and understanding of CCa and BCa and screening to asymptomatic women. It is imperative for governments and health policy makers in LMICs to implement screening programmes, including educational interventions, to ensure the prevention and early detection of women with CCa and BCa. These programmes and policies will be an integral part of a comprehensive population-based CCa and BCa control framework in LMICs.
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Affiliation(s)
- Rakibul M Islam
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Department of Population Sciences, University of Dhaka, Dhaka, Bangladesh
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Basu P, Meheus F, Chami Y, Hariprasad R, Zhao F, Sankaranarayanan R. Management algorithms for cervical cancer screening and precancer treatment for resource-limited settings. Int J Gynaecol Obstet 2017; 138 Suppl 1:26-32. [PMID: 28691336 DOI: 10.1002/ijgo.12183] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Management algorithms for screen-positive women in cervical cancer prevention programs have undergone substantial changes in recent years. The WHO strongly recommends human papillomavirus (HPV) testing for primary screening, if affordable, or if not, then visual inspection with acetic acid (VIA), and promotes treatment directly following screening through the screen-and-treat approach (one or two clinic visits). While VIA-positive women can be offered immediate ablative treatment based on certain eligibility criteria, HPV-positive women need to undergo subsequent VIA to determine their eligibility. Simpler ablative methods of treatment such as cryotherapy and thermal coagulation have been demonstrated to be effective and to have excellent safety profiles, and these have become integral parts of new management algorithms. The challenges faced by low-resource countries are many and include, from the management perspective, identifying an affordable point-of-care HPV detection test, minimizing over-treatment, and installing an effective information system to ensure high compliance to treatment and follow-up.
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Affiliation(s)
- Partha Basu
- Screening Group, Early Detection and Prevention Section, International Agency for Research on Cancer, Lyon, France
| | - Filip Meheus
- Prevention and Implementation Group, Early Detection and Prevention Section, International Agency for Research on Cancer, Lyon, France
| | - Youssef Chami
- Lalla Salma Foundation for Cancer Prevention and Treatment, Rabat, Morocco
| | - Roopa Hariprasad
- Division of Clinical Oncology, National Institute of Cancer Prevention and Research (ICMR), Noida, India
| | - Fanghui Zhao
- Department of Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rengaswamy Sankaranarayanan
- Screening Group, Early Detection and Prevention Section, International Agency for Research on Cancer, Lyon, France
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24
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Mittal S, Basu P, Muwonge R, Banerjee D, Ghosh I, Sengupta MM, Das P, Dey P, Mandal R, Panda C, Biswas J, Sankaranarayanan R. Risk of high-grade precancerous lesions and invasive cancers in high-risk HPV-positive women with normal cervix or CIN 1 at baseline-A population-based cohort study. Int J Cancer 2017; 140:1850-1859. [PMID: 28108997 DOI: 10.1002/ijc.30609] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 12/19/2016] [Accepted: 01/03/2017] [Indexed: 11/11/2022]
Abstract
Infection with high-risk human papillomavirus (HR-HPV) is transient and clears on its own in majority of the women. Only a few women who have persistent infection may finally develop cervical intraepithelial neoplasia (CIN) or cervical cancer in later years. The risk of progression in the HR-HPV-positive women with normal cervix or low-grade lesion on colposcopy and histopathology at baseline is less studied. We performed a longitudinal study on 650 HR-HPV-positive women with colposcopy and/or histopathology-proved normal or CIN1 diagnosis at baseline to assess the cumulative risk of development of high-grade CIN. After a mean follow-up of 2.1 person years of observation (PYO) (range 0.1-5.1), the cumulative incidence of CIN2+ (6.4%; 3.0/100 PYO) was significantly higher in women who had persistent HR-HPV infection compared to those who cleared the infection (adjusted HR 6.28; 95% CI 2.87-13.73). The risk of viral persistence in women aged 50-60 years was two times higher compared to women aged 40-49 years and three times higher compared to women aged 30-39 years. The probability of having persistent infection increased progressively with higher viral load at baseline (adjusted HR 3.29, 95% CI 2.21-4.90 for RLU ≥100; adjusted HR 2.69, 95% CI 1.71-4.22 for RLU 10-100). Women with increasing viral load at follow-up had four times higher risk of developing CIN2 or worse lesions as compared to those with decreasing load (20.9% vs 4.8%; p < 0.001). In the context of developing countries where cytology or genotyping triaging is not feasible, colposcopy referral of HR-HPV-positive women with advancing age, viral persistence, and increasing viral load may be considered.
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Affiliation(s)
- Srabani Mittal
- Chittaranjan National Cancer Institute, Kolkata, West Bengal, India
| | - Partha Basu
- Screening Group, Early Detection and Prevention Section, International Agency for Research on Cancer, Lyon, France
| | - Richard Muwonge
- Screening Group, Early Detection and Prevention Section, International Agency for Research on Cancer, Lyon, France
| | | | - Ishita Ghosh
- Chittaranjan National Cancer Institute, Kolkata, West Bengal, India
| | | | - Pradip Das
- Chittaranjan National Cancer Institute, Kolkata, West Bengal, India
| | - Priatosh Dey
- Chittaranjan National Cancer Institute, Kolkata, West Bengal, India
| | - Ranajit Mandal
- Chittaranjan National Cancer Institute, Kolkata, West Bengal, India
| | - Chinmay Panda
- Chittaranjan National Cancer Institute, Kolkata, West Bengal, India
| | - Jaydip Biswas
- Chittaranjan National Cancer Institute, Kolkata, West Bengal, India
| | - Rengaswamy Sankaranarayanan
- Screening Group, Early Detection and Prevention Section, International Agency for Research on Cancer, Lyon, France
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25
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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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Olson B, Gribble B, Dias J, Curryer C, Vo K, Kowal P, Byles J. Cervical cancer screening programs and guidelines in low- and middle-income countries. Int J Gynaecol Obstet 2016; 134:239-46. [DOI: 10.1016/j.ijgo.2016.03.011] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 03/04/2016] [Accepted: 05/17/2016] [Indexed: 01/23/2023]
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Urrutia MT, Araya A, Jaque MF. Why Do Chilean Women Choose to Have or Not Have Pap Tests? J Obstet Gynecol Neonatal Nurs 2016; 46:e3-e12. [PMID: 27886949 DOI: 10.1016/j.jogn.2016.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2016] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To describe the perceptions of Chilean women about why women choose to have or not have Pap test screening. DESIGN Qualitative research using content analysis according to Krippendorf. SETTING Four urban health clinics in Santiago, Chile. PARTICIPANTS Fifty-seven Chilean women. METHODS Audiotaped focus groups. RESULTS Six themes emerged: Reasons that make it difficult for women to schedule appointments, Characteristics of health professionals that make it difficult to have a Pap test, Characteristics of the test that are barriers to having a Pap test, The relationship of the test with cancer, Family context, and Each woman's personal characteristics. CONCLUSION Primary health care providers play an important role in promoting adherence to cervical cancer screening. Nurses should proactively address women's perceptions and knowledge about screening and openly and uniformly discuss the importance and benefits of Pap test screening.
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Pun CB, Pradhananga KK, Siwakoti B, Subedi K, Moore MA. Malignant Neoplasm Burden in Nepal - Data from the Seven Major Cancer Service Hospitals for 2012. Asian Pac J Cancer Prev 2016; 16:8659-63. [PMID: 26745133 DOI: 10.7314/apjcp.2015.16.18.8659] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
In Nepal, while no population based cancer registry program exists to assess the incidence, prevalence, morbidity and mortality of cancer, at the national level a number of hospital based cancer registries are cooperating to provide relevant data. Seven major cancer diagnosis and treatment hospitals are involved, including the BP Koirala Memorial Cancer hospital, supported by WHO-Nepal since 2003. The present retrospective analysis of cancer patients of all age groups was conducted to assess the frequencies of different types of cancer presenting from January 1st to December 31st 2012. A total of 7,212 cancer cases were registered, the mean age of the patients being 51.9 years. The most prevalent age group in males was 60-64 yrs (13.6%), while in females it was 50-54 yrs (12.8%). The commonest forms of cancer in males were bronchus and lung (17.6%) followed by stomach (7.3%), larynx (5.2%) and non Hodgkins lymphoma (4.5%). In females, cervix uteri (19.1%) and breast (16.3%), were the top ranking cancer sites followed by bronchus and lung (10.2%), ovary (6.1%) and stomach (3.8%). The present data provide an update of the cancer burden in Nepal and highlight the relatively young age of breast and cervical cancer patients.
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Affiliation(s)
- Chin Bahadur Pun
- Executive Director, BP Koirala Memorial Cancer Hospital, Bharatpur, Nepal E-mail :
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Subramanian S, Sankaranarayanan R, Esmy PO, Thulaseedharan JV, Swaminathan R, Thomas S. Clinical trial to implementation: Cost and effectiveness considerations for scaling up cervical cancer screening in low- and middle-income countries. J Cancer Policy 2016. [DOI: 10.1016/j.jcpo.2015.12.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Das LT, Wagner CD, Bigatti SM. Illness representations of cancer among healthy residents of Kolkata, India. Asian Pac J Cancer Prev 2015; 16:845-52. [PMID: 25684536 DOI: 10.7314/apjcp.2015.16.2.845] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Cancer illness representations and screening history among residents of Kolkata, India, were investigated along with socio-demographic characteristics in an effort to understand possible motivations for health behavior. A total of 106 participants were recruited from community locations in Kolkata, India and completed surveys including demographics, the illness perception questionnaire-revised (IPQ-R), and previous experience with cancer and screening practices. Participants were 51.5% college educated, 57% female, 51.5% full-time employed with average age of 32.7 years (R: 18-60 years). Descriptive statistics were generated for the subscales of the IPQ-R, cancer-screening practices and cancer experience. Correlation analyses were conducted to investigate associations between cancer representations and socio-demographic variables. Univariate ANOVAs were calculated to determine gender differences in IPQ-R subscales and differences between participants who knew someone diagnosed with cancer versus those who did not. While 76% of participants knew someone with cancer, only 5% of the sample engaged in cancer screening. Participants perceived cancer as a serious illness with negative emotional valence. Younger age (r(100)=-.36, p<0.001) and male gender (F(1, 98)=5.22, p=0.01, η2=0.05) were associated with better illness coherence. Males also reported greater personal control (F(1, 98)=5.34, p=0.02, η2=0.05) were associated with better illness coherence. Low screening rates precluded analyses of the relationship between illness representations and cancer screening. Cancer was viewed as a threatening and uncontrollable disease among this sample of educated, middle class Kolkata residents. This view may act as a barrier to seeking cancer screening. Public awareness campaigns aimed at improving understanding of the causes, symptoms and consequences of cancer might reduce misunderstandings and fear, especially among women and older populations, who report less comprehension of cancer.
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Affiliation(s)
- Lala Tanmoy Das
- Center for Health Informatics and Policy Weill Cornell Graduate School of Medical Sciences Greenberg Division of Cardiology Weill Cornell Medical College New York, New York, USAE-mail :
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Alfaro KM, Gage JC, Rosenbaum AJ, Ditzian LR, Maza M, Scarinci IC, Miranda E, Villalta S, Felix JC, Castle PE, Cremer ML. Factors affecting attendance to cervical cancer screening among women in the Paracentral Region of El Salvador: a nested study within the CAPE HPV screening program. BMC Public Health 2015; 15:1058. [PMID: 26474762 PMCID: PMC4609068 DOI: 10.1186/s12889-015-2360-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 09/28/2015] [Indexed: 11/13/2022] Open
Abstract
Background Cervical cancer is the third most commonly occurring cancer among women and the fourth leading cause of cancer-related deaths in women worldwide, with more than 85 % of these cases occurring in developing countries. These global disparities reflect the differences in cervical cancer screening rates between high-income and medium- and low-income countries. At 19 %, El Salvador has the lowest reported screening coverage of all Latin American countries. The purpose of this study is to identify factors affecting public sector HPV DNA-based cervical cancer screening participation in El Salvador. Methods This study was nested within a public sector screening program where health promoters used door-to-door outreach to recruit women aged 30–49 years to attend educational sessions about HPV screening. A subgroup of these participants was chosen randomly and questioned about demographic factors, healthcare utilization, previous cervical cancer screening, and HPV knowledge. Women then scheduled screening appointments at their public health clinics. Screening participants were adherent if they attended their scheduled appointment or rescheduled and were screened within 6 months. The association between non-adherence and demographic variables, medical history, history of cancer, sexual history, birth control methods, and screening barriers was assessed using Chi-square tests of significance and logistic regression. Results All women (n = 409) enrolled in the study scheduled HPV screening appointments, and 88 % attended. Non-adherence was associated with a higher number of lifetime partners and being under-screened—defined as not having participated in cervical cancer screening within the previous 3 years (p = 0.03 and p = 0.04, respectively); 22.8 % of participants in this study were under-screened. Conclusions Adherence to cervical cancer screening after educational sessions was higher than expected, in part due to interactions with the community-based health promoters as well as the educational session itself. More effective recruitment methods targeted toward under-screened women are required.
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Affiliation(s)
- Karla M Alfaro
- Basic Health International, Colonia las Mercedes, Avenida los Espliegos #5, San Salvador, El Salvador.
| | - Julia C Gage
- Division of Cancer Epidemiology and Genetic, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA.
| | - Alan J Rosenbaum
- Department of Obstetrics and Gynecology, University of Pittsburgh School of Medicine, 300 Halket Street, Pittsburgh, PA, 15213, USA. .,Fulbright U.S. Student Program, U.S. Department of State, 1400 K Street NW, Suite 700, Washington, DC, 20005, USA. .,Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, 395 W. 12th Ave., Columbus, OH, 43210, USA.
| | - Lauren R Ditzian
- Basic Health International, Colonia las Mercedes, Avenida los Espliegos #5, San Salvador, El Salvador.
| | - Mauricio Maza
- Basic Health International, Colonia las Mercedes, Avenida los Espliegos #5, San Salvador, El Salvador.
| | - Isabel C Scarinci
- Division of Preventive Medicine, University of Alabama at Birmingham, Medical Towers 621, 1717 11th Avenue South, Birmingham, AL, 35205, USA.
| | - Esmeralda Miranda
- Ministry of Health of El Salvador, Calle Arce, 827, San Salvador, El Salvador.
| | - Sofia Villalta
- Ministry of Health of El Salvador, Calle Arce, 827, San Salvador, El Salvador.
| | - Juan C Felix
- Department of Pathology, University of Southern California, 2011 Zonal Ave., Los Angeles, CA, 90033, USA.
| | - Philip E Castle
- Global Cancer Initiative, 100 Radcliffe Drive, Chestertown, MD, 21620, USA.
| | - Miriam L Cremer
- OB/GYN & Women's Health Institute, Cleveland Clinic 9500 Euclid Ave., Cleveland, OH, 44195, USA.
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Krishnan S, Dhillon PK, Bhadelia A, Schurmann A, Basu P, Bhatla N, Birur P, Colaco R, Dey S, Grover S, Gupta H, Gupta R, Gupta V, Lewis MA, Mehrotra R, McMikel A, Mukherji A, Naik N, Nyblade L, Pati S, Pillai MR, Rajaraman P, Ramesh C, Rath GK, Reithinger R, Sankaranarayanan R, Selvam J, Shanmugam MS, Shridhar K, Siddiqi M, Squiers L, Subramanian S, Travasso SM, Verma Y, Vijayakumar M, Weiner BJ, Reddy KS, Knaul FM. Report from a symposium on catalyzing primary and secondary prevention of cancer in India. Cancer Causes Control 2015; 26:1671-84. [PMID: 26335262 PMCID: PMC4596898 DOI: 10.1007/s10552-015-0637-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 07/16/2015] [Indexed: 12/25/2022]
Abstract
Purpose Oral, breast, and cervical cancers are amenable to early detection and account for a third of India’s cancer burden. We convened a symposium of diverse stakeholders to identify gaps in evidence, policy, and advocacy for the primary and secondary prevention of these cancers and recommendations to accelerate these efforts.
Methods Indian and global experts from government, academia, private sector (health care, media), donor organizations, and civil society (including cancer survivors and patient advocates) presented and discussed challenges and solutions related to strategic communication and implementation of prevention, early detection, and treatment linkages. Results Innovative approaches to implementing and scaling up primary and secondary prevention were discussed using examples from India and elsewhere in the world. Participants also reflected on existing global guidelines and national cancer prevention policies and experiences. Conclusions Symposium participants proposed implementation-focused research, advocacy, and policy/program priorities to strengthen primary and secondary prevention efforts in India to address the burden of oral, breast, and cervical cancers and improve survival.
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Affiliation(s)
- Suneeta Krishnan
- Research Triangle Institute Global India Pvt. Ltd, Suite 405, Paharpur Business Center, 21 Nehru Place, New Delhi, 110019, India.
| | - Preet K Dhillon
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Sector 44, Gurgaon, 122002, India.
| | - Afsan Bhadelia
- Harvard Global Equity Initiative, Harvard University, 651 Huntington Avenue, Room 632, Boston, MA, 02115, USA
| | - Anna Schurmann
- Independent Public Health Consultant, 2C Alsa Terraces, 26 Langford Gardens, Bangalore, 560025, India
| | - Partha Basu
- Chittaranjan National Cancer Institute, 37, S. P. Mukherjee Road, Kolkata, 700026, India
| | - Neerja Bhatla
- Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Praveen Birur
- Biocon Foundation, 20th KM Hosur Road, Electronic City, Bangalore, 560100, India
| | - Rajeev Colaco
- RTI International, 701 13th St NW #750, Washington, DC, 20005, USA
| | - Subhojit Dey
- Indian Institute of Public Health-Delhi, Public Health Foundation of India, Plot 47, Sector 44, Gurgaon, 122002, India
| | - Surbhi Grover
- University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - Harmala Gupta
- CanSupport, KanakDurgaBastiVikasKendra, Sector 12 R. K. Puram, Near New CGHS Dispensary, New Delhi, 110022, India
| | - Rakesh Gupta
- Rajasthan Cancer Foundation, B-113, 10 B Scheme, Gopalpura Bypass, Jaipur, 302018, India
| | - Vandana Gupta
- V Care Foundation, A102, Om Residency, J W Road, Near Tata Memorial Hospital, Parel (East), Mumbai, 400012, India
| | - Megan A Lewis
- RTI International, 3040 Cornwallis Rd., PO Box 12194, Research Triangle Park, NC, 27709-2194, USA
| | - Ravi Mehrotra
- Institute of Cytology and Preventive Oncology (ICMR), I-7, Sector-39, Noida, 201301, India
| | - Ann McMikel
- American Cancer Society, Inc., 250 Williams Street NW, Atlanta, GA, 30303, USA
| | - Arnab Mukherji
- Center for Public Policy, IIM Bangalore, Bannerghatta Road, Bangalore, 560076, India
| | - Navami Naik
- American Cancer Society, Inc., 250 Williams Street NW, Atlanta, GA, 30303, USA
| | - Laura Nyblade
- RTI International, 701 13th St NW #750, Washington, DC, 20005, USA
| | - Sanghamitra Pati
- Indian Institute of Public Health Bhubaneswar, Public Health Foundation of India, Infocity Road, Patia, Bhubaneswar, 751024, India
| | - M Radhakrishna Pillai
- Rajiv Gandhi Centre for Biotechnology (Government of India, Ministry for Science and Technology), Millennium Avenue, Jagathy, Thiruvananthapuram, 695014, India
| | - Preetha Rajaraman
- Center for Global Health, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20892-9760, USA
| | | | - G K Rath
- All India Institute of Medical Science, Gautam Nagar, Ansari Nagar East, New Delhi, 110029, India
| | | | - Rengaswamy Sankaranarayanan
- International Agency for Research on Cancer (WHO-IARC), 150 Cours Albert Thomas, 69372, Lyon Cedex 08, France
| | - Jerard Selvam
- Tamil Nadu Health Systems Project, 3rd Floor, DMS Annex New Building 259 Anna Salai, Teynampet, Chennai, 600006, India
| | - M S Shanmugam
- Tamil Nadu Health Systems Project, 3rd Floor, DMS Annex New Building 259 Anna Salai, Teynampet, Chennai, 600006, India
| | - Krithiga Shridhar
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Sector 44, Gurgaon, 122002, India
| | - Maqsood Siddiqi
- Cancer Foundation of India, 47/2D, Selimpur Road, Kolkata, 700031, India
| | - Linda Squiers
- RTI International, 701 13th St NW #750, Washington, DC, 20005, USA
| | - Sujha Subramanian
- RTI International, 1440 Main Street, Suite 310, Waltham, MA, 02451-1623, USA
| | - Sandra M Travasso
- St. Johns Research Institute, 100 Feet Road, Koramangala, Bangalore, 560034, India
| | - Yogesh Verma
- S.T.N.M Hospital, NH 31A, Gangtok, Sikkim, 737101, India
| | - M Vijayakumar
- Kidwai Memorial Institute of Oncology, Dr. M.H Marigowda Road, Bangalore, 560029, India
| | - Bryan J Weiner
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-7411, USA
| | - K Srinath Reddy
- Public Health Foundation of India, Delhi NCR, Plot No. 47, Sector 44, Gurgaon, Haryana, 122 003, India
| | - Felicia M Knaul
- Harvard Global Equity Initiative, Harvard University, 651 Huntington Avenue, Room 632, Boston, MA, 02115, USA
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Curmi C, Peters K, Salamonson Y. Barriers to cervical cancer screening experienced by lesbian women: a qualitative study. J Clin Nurs 2015; 25:3643-3651. [DOI: 10.1111/jocn.12947] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Claire Curmi
- School of Nursing & Midwifery; University of Western Sydney; Penrith NSW Australia
| | - Kath Peters
- School of Nursing & Midwifery; University of Western Sydney; Penrith NSW Australia
| | - Yenna Salamonson
- School of Nursing & Midwifery; University of Western Sydney; Penrith NSW Australia
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Basu P, Hassan S, Fileeshia F, Mohamed S, Nahoodha A, Shiuna A, Sulaiman AI, Najeeb N, Saleem FJ. Knowledge, attitude and practices of women in maldives related to the risk factors, prevention and early detection of cervical cancer. Asian Pac J Cancer Prev 2015; 15:6691-5. [PMID: 25169510 DOI: 10.7314/apjcp.2014.15.16.6691] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A population-based cervical cancer screening program using visual inspection with acetic acid was launched in Maldives in 2014. Our study aimed to assess the knowledge, attitude and practices of women in relation to risk factors of cervical cancer, early detection of the disease and its prevention. MATERIALS AND METHODS The questionnaire based survey was conducted among 20 to 50 year old women, systematically sampled to represent three regions of Maldives. Trained investigators interviewed a total of 2,845 women at home. RESULTS The prevalence of the risk factors of cervical cancer like early age at marriage and childbirth, multiple marriages, multiple marriages of the husbands, and multiple pregnancies was high. More women knew about breast cancer than cervical cancer. Even among the small number of women who knew of cervical cancer, only 34.6% had the knowledge of at least one early symptom. Very few women knew that the cancer could be prevented by any test. Only 6.2% of the women reported having ever undergone a Pap smear. Many women had the misconception that cervical cancer was infectious. In Maldives the younger women have high literacy rate due to the policy of universal free education and those with higher levels of education had improved knowledge of cervical cancer and its risk factors. The prevalence of risk factors also reduced with improved literacy. CONCLUSIONS Awareness about risk factors and prevention of cervical cancer is limited among Maldivian women in spite of having high exposure to some of the risk factors. A universal literacy program in the country has helped to improve the knowledge of cervical cancer prevention and to reduce the exposure to various risk factors in the younger population.
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Affiliation(s)
- Partha Basu
- Department of Gynecological Oncology, Chittaranjan National Cancer Institute, Kolkata, India E-mail :
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Bahri N, Jajvandian R, Bolandhemmat M, Mirzaiinajmabadi K. Knowledge, attitudes and practice about pap smear test among women living in Bojnourd, North East of Iran: a population-based study. Asian Pac J Cancer Prev 2015; 16:2013-8. [PMID: 25773804 DOI: 10.7314/apjcp.2015.16.5.2013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of the study was to assess the extent of knowledge, attitudes and practical behavior of women in Bojnourd conerning the Pap smear test. MATERIALS AND METHODS This cross-sectional and population-based study was conducted with 1000 Iranian women aged 15-60 years old in Bojnourd city. In order to collect the data, a validated questionnaire was provided in four sections covering demographic information and questions about knowledge, attitude and practice about the Pap smear. Statistical analysis was performed with the Statistical Package for Social Sciences (version 17.0) applying a 0.05 significance level. RESULTS Evaluation of knowledge showed that 146 women (14.6%) had very weak, and 594 women (59.4%) had weak knowledge. In contrast, most of the women studied, 873 (87.3%), had a positive attitude toward the Pap smear test. According to the findings, 375 women (37.6%) had done this test so far. Findings indicated that the extent of knowledge had a meaningful relationship with the attitude status (p<0.0001). Also, there was a meaningful relationship between knowledge and practice, so that the weakest practice was seen in women who had weak knowledge (61.1%), (p<0.0001). CONCLUSIONS According to findings of this research, most women do not have an appropriate knowledge about the necessity of having the Pap smear test, so that only a low percentage of women had undergone this test.
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Affiliation(s)
- Narjes Bahri
- Department of Midwifery, School of Nursing and Midwifery, Gonabad University of Medical Sciences, Gonabad, Iran E-mail : ,
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Cunningham MS, Skrastins E, Fitzpatrick R, Jindal P, Oneko O, Yeates K, Booth CM, Carpenter J, Aronson KJ. Cervical cancer screening and HPV vaccine acceptability among rural and urban women in Kilimanjaro Region, Tanzania. BMJ Open 2015; 5:e005828. [PMID: 25757944 PMCID: PMC4360576 DOI: 10.1136/bmjopen-2014-005828] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To determine cervical cancer screening coverage and the knowledge, attitudes and barriers toward screening tests among women in rural and urban areas of Tanzania, as well as explore how they view the acceptability of the HPV vaccine and potential barriers to vaccination. SETTING A cross-sectional study using interview-administered questionnaires was conducted using multistage random sampling within urban and rural areas in Kilimanjaro Region, Tanzania. PARTICIPANTS Women aged 18-55 were asked to participate in the survey. The overall response rate was 97.5%, with a final sample of 303 rural and 272 urban dwelling women. PRIMARY AND SECONDARY OUTCOME MEASURES Descriptive and simple test statistics were used to compare across rural and urban strata. Multivariate logistic regression models were used to estimate ORs and 95% CIs. RESULTS Most women (82%) reported they had heard of cervical cancer, while self-reported cervical cancer screening among women was very low (6%). In urban areas, factors associated with screening were: older age (OR=4.14, 95% CI 1.86 to 9.24 for ages 40-49, and OR=8.38, 95% CI 2.10 to 33.4 for >50 years), having health insurance (OR=4.15, 95% CI 1.52 to 11.4), and having knowledge about cervical cancer (OR=5.81, 95% CI 1.58 to 21.4). In contrast, among women residing in rural areas, only condom use (OR=6.44, 95% CI 1.12 to 37.1) was associated with screening. Women from both rural and urban areas had low vaccine-related knowledge; however, most indicated they would be highly accepting if it were readily available (93%). CONCLUSIONS The current proportion of women screened for cervical cancer is very low in Kilimanjaro Region, and our study has identified several modifiable factors that could be addressed to increase screening rates. Although best implemented concurrently, the availability of prophylactic vaccination for girls may provide an effective means of prevention if they are unable to access screening in the future.
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Affiliation(s)
- Melissa S Cunningham
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Emily Skrastins
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Ryan Fitzpatrick
- Faculty of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Priya Jindal
- Faculty of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Olola Oneko
- Kilimanjaro Christian Medical Center, Moshi, Tanzania, Africa
| | - Karen Yeates
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
- Faculty of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Christopher M Booth
- Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University, Kingston, Canada
| | - Jennifer Carpenter
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
- Faculty of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Kristan J Aronson
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
- Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University, Kingston, Canada
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Montgomery MP, Dune T, Shetty PK, Shetty AK. Knowledge and acceptability of human papillomavirus vaccination and cervical cancer screening among women in Karnataka, India. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2015; 30:130-137. [PMID: 25355525 DOI: 10.1007/s13187-014-0745-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Cervical cancer is the leading cause of cancer-related mortality among women in India; however, participation in prevention and screening is low and the reasons for this are not well understood. In a cross-sectional survey in August 2008, 202 healthy women in Karnataka, India completed a questionnaire regarding knowledge, attitudes, and practices related to human papillomavirus (HPV) and cervical cancer. Factors associated with vaccination and Papanicolau (Pap) smear screening acceptance were explored. Thirty-six percent of women had heard of HPV while 15% had heard of cervical cancer. Five percent of women reported ever having a Pap smear, and 4% of women felt at risk of HPV infection. Forty-six percent of women were accepting of vaccination, but fewer (21%) were willing to have a Pap smear. Overall, knowledge related to HPV and cervical cancer topics was low. Women with negative attitudes toward HPV infection were 5.3 (95% confidence interval (CI) 2.8-10) times more likely to accept vaccination but were not significantly more likely to accept Pap smear (odds ratio 1.5, 95% CI 0.7-3.0). Cost and a low level of perceived risk were the most frequent factors cited as potential barriers. Improving awareness of HPV and cervical cancer through health care providers in addition to increasing access to vaccination and screening through government-sponsored programs may be feasible and effective methods to reduce cervical cancer burden in India.
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Affiliation(s)
- Martha P Montgomery
- Department of Pediatrics, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA
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Czerninski R, Zadik Y, Vered M, Becker T, Yahalom R, Derazne E, Aframian DJ, Almoznino G. Demographic and clinical factors associated with referrals and compliance to biopsy of oral and maxillofacial lesions. J Oral Pathol Med 2015; 43:364-70. [PMID: 24877225 DOI: 10.1111/jop.12139] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The gold standard for diagnosing oral disease is tissue biopsy. Data regarding compliance with advised oral and maxillofacial (OMF) biopsy are scarce. PURPOSE To quantify compliance and evaluate the demographics and clinical factors associated with referrals and compliance with OMF biopsy procedures. METHODS Medical records of military personnel referred for a biopsy (RB; N = 669) of OMF lesions over a 4-year period were studied retrospectively. These patients were divided into performed the biopsy (PB; N = 386) and not perform biopsy (NPB; N = 283) groups. Demographic and clinical features were analyzed, and demographics were compared to a control group of general military personnel (N > 100,000). RESULTS The RB group differed from the control group regarding age >21 (OR = 1.681, P < 0.001) and education >12 years of schooling (OR = 1.545, P < 0.001). Differences between the PB and NPB groups related to the clinical features of the lesion but not to demographic parameters. Exophytic and suspected potentially malignant/malignant lesions were positively associated with higher compliance to biopsy (OR = 1.75, P = 0.004 and OR = 2.18, P = 0.017, respectively). CONCLUSION Referrals to biopsy of OMF lesions are significantly influenced by age and education, whereas compliance is influenced by clinical features or suspected malignancy. Clinicians and health authorities should be aware of non-compliance, enhance awareness to biopsy as the gold standard in the diagnostic workup of OMF lesions, and closely monitor compliance patterns of patients with clinical and demographic risk factors.
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Senthil Kumar M, Shanmugapriya PC, Kaur P. Acceptance of cervical and breast cancer screening and cancer awareness among women in Villupuram, Tamil Nadu, India: A cross sectional survey. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2015. [DOI: 10.1016/j.cegh.2015.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Sami N, Ali TS, Osama M. Quality of life among women with symptoms of gynecological morbidities: results of a cross-sectional study in Karachi, Pakistan. J Obstet Gynaecol Res 2014; 41:608-14. [PMID: 25492624 DOI: 10.1111/jog.12614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 09/01/2014] [Indexed: 11/30/2022]
Abstract
AIMS A population-based cross-sectional study design was used to study the effects of symptoms of various gynecological morbidities (GM) on health-related quality of life (HRQoL) of women, residents of squatter settlements of Karachi, Pakistan. MATERIAL AND METHODS This cross-sectional study was conducted in squatter settlements of Karachi from September 2012 to August 2013, with 1002 married, non-pregnant women. After obtaining written informed consent from every participant, a structured questionnaire was used to collect information about symptoms of GM and their effect on four domains of HRQoL (physical, social, functional and financial domains). RESULTS Of 1002 women who participated in the study, 578 reported suffering from one or more symptoms of GM. The most commonly reported symptoms were foul-smelling vaginal discharge, dysmenorrhea and uterovaginal prolapse while the least reported symptom was post-coital bleeding. Symptoms of GM were found to have a negative impact on HRQoL. Approximately one-third of women with the symptoms of GM reported having negative influences on the physical, financial and functional domains of HRQoL with social domain being comparatively less affected. Compared to other symptoms, dysmenorrhea and uterovaginal prolapse were reported to be mostly associated with poor HRQoL of women. CONCLUSION The concept of HRQoL has been kept marginal and inconspicuous by clinicians. In order to achieve the psychosocial satisfaction of the patient, the focus needs to be diverted to all domains of HRQoL.
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Harsha Kumar H, Tanya S. A Study on Knowledge and Screening for Cervical Cancer among Women in Mangalore City. Ann Med Health Sci Res 2014; 4:751-6. [PMID: 25328788 PMCID: PMC4199169 DOI: 10.4103/2141-9248.141547] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: Most of the cervical cancer cases are diagnosed late leading to poor outcomes. Very few studies have explored the role of doctor and source of information for awareness of women about cervical cancer in India. Aim: Hence, this study was conducted with the objective of knowing the knowledge of women about cervical cancer, its screening, role of doctor, source of information, and reasons for not undergoing screening if the women had not undergone testing for cervical cancer. Subjects and Methods: This was a questionnaire based cross-sectional study conducted among the women attending the outpatient departments of teaching hospitals attached to Kasturba Medical College. A sample size of 83 was calculated. A semi-structured questionnaire was developed. After obtaining permission from Institutional Ethics Committee, the questionnaire was administered to the women in the language of their preference. Women were educated after the data collection and a hand-out was provided. Data was analyzed using SPSS Version 10. Student's independent ‘t’ test was used to compare mean knowledge scores across sociodemographic groups. Results: Majority of the women have poor knowledge about cervical cancer (81.9% [68/83]) and it's screening (85.5% [71/83]). Only 6 out of 83 women had undergone screening. Though women had come into contact with doctors earlier, they were neither educated about cervical cancer nor were they told about the screening. Whatever little knowledge the women had was obtained from mass media. Conclusions: Majority of women had poor knowledge. Mass media could be used to educate the women. There is a need to conduct community based study to know the practices of doctors and assess if they are educating and offering suggestions for screening.
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Affiliation(s)
- Hn Harsha Kumar
- Department of Community Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
| | - Shubham Tanya
- Department of Community Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
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Goss PE, Strasser-Weippl K, Lee-Bychkovsky BL, Fan L, Li J, Chavarri-Guerra Y, Liedke PER, Pramesh CS, Badovinac-Crnjevic T, Sheikine Y, Chen Z, Qiao YL, Shao Z, Wu YL, Fan D, Chow LWC, Wang J, Zhang Q, Yu S, Shen G, He J, Purushotham A, Sullivan R, Badwe R, Banavali SD, Nair R, Kumar L, Parikh P, Subramanian S, Chaturvedi P, Iyer S, Shastri SS, Digumarti R, Soto-Perez-de-Celis E, Adilbay D, Semiglazov V, Orlov S, Kaidarova D, Tsimafeyeu I, Tatishchev S, Danishevskiy KD, Hurlbert M, Vail C, St Louis J, Chan A. Challenges to effective cancer control in China, India, and Russia. Lancet Oncol 2014; 15:489-538. [PMID: 24731404 DOI: 10.1016/s1470-2045(14)70029-4] [Citation(s) in RCA: 312] [Impact Index Per Article: 31.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Cancer is one of the major non-communicable diseases posing a threat to world health. Unfortunately, improvements in socioeconomic conditions are usually associated with increased cancer incidence. In this Commission, we focus on China, India, and Russia, which share rapidly rising cancer incidence and have cancer mortality rates that are nearly twice as high as in the UK or the USA, vast geographies, growing economies, ageing populations, increasingly westernised lifestyles, relatively disenfranchised subpopulations, serious contamination of the environment, and uncontrolled cancer-causing communicable infections. We describe the overall state of health and cancer control in each country and additional specific issues for consideration: for China, access to care, contamination of the environment, and cancer fatalism and traditional medicine; for India, affordability of care, provision of adequate health personnel, and sociocultural barriers to cancer control; and for Russia, monitoring of the burden of cancer, societal attitudes towards cancer prevention, effects of inequitable treatment and access to medicine, and a need for improved international engagement.
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Affiliation(s)
- Paul E Goss
- Harvard Medical School, Boston, MA, USA; Avon Breast Cancer Center of Excellence, Massachusetts General Hospital, Boston, MA, USA.
| | | | - Brittany L Lee-Bychkovsky
- Harvard Medical School, Boston, MA, USA; Department of Hematology-Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA; International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Lei Fan
- International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA; Cancer Center and Cancer Institute, Shanghai Medical College, Fudan University, Breast Surgery Department, Shanghai, China
| | - Junjie Li
- International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA; Cancer Center and Cancer Institute, Shanghai Medical College, Fudan University, Breast Surgery Department, Shanghai, China
| | - Yanin Chavarri-Guerra
- International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA; Hemato-Oncology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Pedro E R Liedke
- International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA; Oncologia Hospital de Clínicas de Porto Alegre and Instituto do Cancer Mãe de Deus, Porto Alegre, Rio Grande do Sul, Brazil
| | - C S Pramesh
- Department of Surgical Oncology/Clinical Research, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India
| | - Tanja Badovinac-Crnjevic
- International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA; University Hospital Zagreb, Department of Oncology, Zagreb, Croatia
| | - Yuri Sheikine
- Harvard Medical School, Boston, MA, USA; Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Zhu Chen
- State Key Lab of Medical Genomics, Shanghai Institute of Hematology, Rui-Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - You-lin Qiao
- Department of Cancer Epidemiology, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhiming Shao
- Cancer Center and Cancer Institute, Shanghai Medical College, Fudan University, Breast Surgery Department, Shanghai, China
| | - Yi-Long Wu
- Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Daiming Fan
- Fourth Military Medical University, State Key Laboratory of Cancer Biology & Xijing Hospital of Digestive Diseases, Xi'an, Shaanxi Province, China
| | - Louis W C Chow
- Organisation for Oncology and Translational Research, Hong Kong, China; UNIMED Medical Institute, Comprehensive Centre for Breast Diseases, Hong Kong, China
| | - Jun Wang
- Institute of Public Health Economics and Management, Central University of Finance and Economics, Beijing, China
| | - Qiong Zhang
- Department of Economics, School of Economics, Central University of Finance and Economics, Beijing, China
| | - Shiying Yu
- Cancer Center of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gordon Shen
- University of California, Berkeley, CA, USA; Cancer Institute & Hospital Chinese Academy of Medical Sciences, Beijing, China
| | - Jie He
- Department of Thoracic Surgery, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Arnie Purushotham
- King's Health Partners Cancer Centre, King's College London, Guy's Hospital, London, UK
| | - Richard Sullivan
- King's Health Partners Cancer Centre, King's College London, Guy's Hospital, London, UK; Institute of Cancer Policy, King's College London, Guy's Hospital, London, UK
| | - Rajendra Badwe
- Administration, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India
| | - Shripad D Banavali
- Department of Medical and Pediatric Oncology, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India
| | - Reena Nair
- Department of Clinical Hematology, Tata Medical Center, Kolkata, West Bengal, India
| | - Lalit Kumar
- Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Purvish Parikh
- Clinical Research and Education, BSES GH Municipal Hospital, Mumbai, India
| | | | - Pankaj Chaturvedi
- Department of Head and Neck Surgery, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India
| | - Subramania Iyer
- Amrita Institute of Medical Sciences & Research Centre, Head & Neck/Plastic & Reconstructive Surgery, Kochi, Kerala, India
| | | | | | - Enrique Soto-Perez-de-Celis
- Hemato-Oncology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Dauren Adilbay
- Astana Oncology Center, Head and Neck Oncology, Astana, Kazakhstan
| | - Vladimir Semiglazov
- Reproductive System Tumors Department, NN Petrov Research Institute of Oncology, St Petersburg, Russia
| | - Sergey Orlov
- Department of Thoracic Oncology, Saint Petersburg Medical University, Saint Petersburg, Russia
| | | | - Ilya Tsimafeyeu
- Russian Society of Clinical Oncology, Kidney Cancer Research Bureau, Moscow, Russia
| | - Sergei Tatishchev
- Pathology and Laboratory Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA
| | | | - Marc Hurlbert
- Avon Foundation Breast Cancer Crusade, New York, NY, USA
| | - Caroline Vail
- International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Jessica St Louis
- International Cancer Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Arlene Chan
- Breast Cancer Research Centre-Western Australia and Curtin University, Perth, WA, Australia
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Donta B, Begum S, Nair S, Naik DD, Mali BN, Bandiwadekar A. Awareness of cervical cancer among couples in a slum area of Mumbai. Asian Pac J Cancer Prev 2013; 13:4901-3. [PMID: 23244078 DOI: 10.7314/apjcp.2012.13.10.4901] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
To assess the awareness of cervical cancer among couples, data were collected from two urban slums community in Mumbai. A total of 1958 married women aged from 18 to 49 and their husbands were selected using simple random sampling. Women (37.7%) were significantly more aware of cervical cancer than husbands (8.7%). A slight agreement (kappa statistics=0.16) was observed between husbands and wives on awareness of cervical cancer. Significantly higher percentages of wives were aware of pap smear test than husbands. Overall, awareness of cervical cancer and pap smear test among couples is low. There is need to educate and motivate both of them to participate in cervical cancer screening program.
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Affiliation(s)
- Balaiah Donta
- Department of Biostatistics, National Institute for Research in Reproductive Health, (ICMR), JM Street, Parel, India.
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Paul P, Tanner AE, Gravitt PE, Vijayaraghavan K, Shah KV, Zimet GD, Study Group C. Acceptability of HPV vaccine implementation among parents in India. Health Care Women Int 2013; 35:1148-61. [PMID: 23611111 DOI: 10.1080/07399332.2012.740115] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Due to high cervical cancer rates and limited research on human papillomavirus (HPV) vaccine acceptability in India, the research team examined parental attitudes toward HPV vaccines. Thirty-six interviews with parents were conducted to assess sexually transmitted infection (STI)-related knowledge and HPV-specific vaccine awareness and acceptability. Despite limited knowledge, parents had positive views toward HPV vaccines. Common barriers included concerns about side effects, vaccine cost, and missing work to receive the vaccine. Parents were strongly influenced by health care providers' recommendations. Our findings suggest that addressing parental concerns, health worker training and polices, and efforts to minimize cost will be central to successful HPV vaccine implementation.
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Affiliation(s)
- Proma Paul
- a Department of Epidemiology, Graduate School of Public Health , University of Pittsburgh , Pittsburgh , Pennsylvania ; and Johns Hopkins University Bloomberg School of Public Health , Baltimore , Maryland , USA
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Lobb R, Pinto AD, Lofters A. Using concept mapping in the knowledge-to-action process to compare stakeholder opinions on barriers to use of cancer screening among South Asians. Implement Sci 2013; 8:37. [PMID: 23522447 PMCID: PMC3617025 DOI: 10.1186/1748-5908-8-37] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 03/14/2013] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Using the knowledge-to-action (KTA) process, this study examined barriers to use of evidence-based interventions to improve early detection of cancer among South Asians from the perspective of multiple stakeholders. METHODS In 2011, we used concept mapping with South Asian residents, and representatives from health service and community service organizations in the region of Peel Ontario. As part of concept mapping procedures, brainstorming sessions were conducted with stakeholders (n = 53) to identify barriers to cancer screening among South Asians. Participants (n = 46) sorted barriers into groups, and rated barriers from lowest (1) to highest (6) in terms of importance for use of mammograms, Pap tests and fecal occult blood tests, and how feasible it would be to address them. Multi-dimensional scaling, cluster analysis, and descriptive statistics were used to analyze the data. RESULTS A total of 45 unique barriers to use of mammograms, Pap tests, and fecal occult blood tests among South Asians were classified into seven clusters using concept mapping procedures: patient's beliefs, fears, lack of social support; health system; limited knowledge among residents; limited knowledge among physicians; health education programs; ethno-cultural discordance with the health system; and cost. Overall, the top three ranked clusters of barriers were 'limited knowledge among residents,' 'ethno-cultural discordance,' and 'health education programs' across surveys. Only residents ranked 'cost' second in importance for fecal occult blood testing, and stakeholders from health service organizations ranked 'limited knowledge among physicians' third for the feasibility survey. Stakeholders from health services organizations ranked 'limited knowledge among physicians' fourth for all other surveys, but this cluster consistently ranked lowest among residents. CONCLUSION The limited reach of cancer control programs to racial and ethnic minority groups is a critical implementation issue that requires attention. Opinions of community service and health service organizations on why this deficit in implementation occurs are fundamental to understanding the solutions because these are the settings in which evidence-based interventions are implemented. Using concept mapping within a KTA process can facilitate the engagement of multiple stakeholders in the utilization of study results and in identifying next steps for action.
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Affiliation(s)
- Rebecca Lobb
- Centre for Research on Inner City Health, Keenan Research Centre, Li Ka Shing Knowledge Institute, St, Michael's Hospital, Toronto, ON, USA.
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Grosse Frie K, Ramadas K, Anju GA, Mathew BS, Muwonge R, Sauvaget CS, Thara ST, Sankaranarayanan R. Determinants of participation in a breast cancer screening trial in trivandrum district, India. Asian Pac J Cancer Prev 2013; 14:7301-7. [PMID: 24460292 DOI: 10.7314/apjcp.2013.14.12.7301] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Conspicuous differences in participation rates for breast self-examination (BSE), clinical breast examination (CBE), and referral for further investigations have been observed indicating involvement of a number of different factors. This study analysed determinants for participation in different levels of the breast cancer screening process in Indian females. MATERIALS AND METHODS An intervention group of 52,011 women was interviewed in a breast cancer screening trial in Trivandrum district, India. In order to assess demographic, socio-economic, reproductive, and cancer-related determinants of participation in BSE, CBE, and referral, uni- and multi-variate logistic regression was employed. RESULTS Of the interviewed women, 23.2% reported practicing BSE, 96.8% had attended CBE, and 49.1% of 2,880 screen-positives attended referral. Results showed an influence of various determinants on participation; women who were currently not married or who had no family history of cancer were significantly less likely to attend the screening process at any level. CONCLUSIONS Increasing awareness about breast cancer, early detection methods, and the advantages of early diagnoses among women, and their families, as well as health care workers offering social support, could help to increase participation over the entire screening process in India.
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Affiliation(s)
- Kirstin Grosse Frie
- Early Detection and Prevention, International Agency for Research on Cancer, Lyon, France E-mail :
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Williams-Brennan L, Gastaldo D, Cole DC, Paszat L. Social determinants of health associated with cervical cancer screening among women living in developing countries: a scoping review. Arch Gynecol Obstet 2012; 286:1487-505. [DOI: 10.1007/s00404-012-2575-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 09/13/2012] [Indexed: 12/01/2022]
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Basu P, Mittal S, Bhaumik S, Mandal SS, Samaddar A, Ray C, Siddiqi M, Biswas J, Sankaranarayanan R. Prevalence of high-risk human papillomavirus and cervical intraepithelial neoplasias in a previously unscreened population-A pooled analysis from three studies. Int J Cancer 2012; 132:1693-9. [DOI: 10.1002/ijc.27793] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 07/25/2012] [Indexed: 11/09/2022]
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