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Power R, David M, Strnadová I, Touyz L, Basckin C, Loblinzk J, Jolly H, Kennedy E, Ussher J, Sweeney S, Chang EL, Carter A, Bateson D. Cervical screening participation and access facilitators and barriers for people with intellectual disability: a systematic review and meta-analysis. Front Psychiatry 2024; 15:1379497. [PMID: 39132316 PMCID: PMC11310793 DOI: 10.3389/fpsyt.2024.1379497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 06/27/2024] [Indexed: 08/13/2024] Open
Abstract
Background The World Health Organisation's vision of eliminating cervical cancer as a public health problem is achievable, but elimination must be achieved equitably, including for people with intellectual disability. A better understanding of cervical screening within the context of the lives of people with intellectual disability is needed. This study systematically reviewed research on the rates of cervical screening participation among people with intellectual disability, and facilitators and barriers that affect participation. Method Six electronic databases were systematically searched: MEDLINE, CINAHL, Scopus, PsycINFO, Embase and Pro-Quest Central Social Sciences Collection. Empirical studies published between 1986 and 2023, in English language peer-reviewed journals were eligible for inclusion. Further articles were identified through forward and backward citation tracking, and hand-searching the index lists of two key journals. Two authors screened the studies, extracted the data and collated study outcomes using a standardised software program. A meta-analysis was performed using the DerSimonian and Laird method to estimate pooled effect sizes in prevalence rates and odds ratios (ORs). The socio-ecological model (SEM) was used as a framework to thematically analyse facilitators and barriers impacting participation in cervical screening. Results Sixty-three articles met the inclusion criteria. Of these, 42 reported on rates of cervical screening participation and 24 reported on facilitators or barriers to cervical screening for people with intellectual disability. Overall, the studies reported a screening prevalence of 35% (95% CI: 26% to 45%), indicating that just over a third of people with intellectual disability have had cervical screening. The pooled odds ratio of 0.30 (95% CI: 0.23 to 0.41) indicated that people with intellectual disability are significantly less likely to have a cervical screening test compared with people without intellectual disability. Most studies examined individual and interpersonal factors impacting cervical screening. These included: (i) fear and anxiety among people with intellectual disability, (ii) misassumptions preventing screening participation, (iii) the role of support people, (iv) the need for education, (v) accessible information, and time to prepare for screening, (vi) patient-provider communication including challenges obtaining informed consent, and (vii) healthcare provider lack of confidence. Conclusion Future research, policy and practice efforts must address barriers to cervical screening participation among people with intellectual disability and ensure these efforts are co-produced and community-led. This is critical to ensuring equity in global and local efforts to eliminate cervical cancer.
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Affiliation(s)
- Rosalie Power
- Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
| | - Michael David
- The Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
| | - Iva Strnadová
- Faculty of Arts, Design and Architecture, School of Education, University of New South Wales Sydney, Sydney, NSW, Australia
- Disability Innovation Institute, University of New South Wales, Sydney, NSW, Australia
| | - Lauren Touyz
- The Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
| | - Caroline Basckin
- Faculty of Arts, Design and Architecture, School of Education, University of New South Wales Sydney, Sydney, NSW, Australia
| | - Julie Loblinzk
- Faculty of Arts, Design and Architecture, School of Education, University of New South Wales Sydney, Sydney, NSW, Australia
- Self Advocacy Sydney, Sydney, NSW, Australia
| | | | - Elizabeth Kennedy
- The Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
| | - Jane Ussher
- Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
| | | | - Ee-Lin Chang
- Family Planning Australia, Sydney, NSW, Australia
| | - Allison Carter
- Sexual Health and Reproductive Equity Research Group, UNSW Kirby Institute, Sydney, NSW, Australia
| | - Deborah Bateson
- The Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
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Raman Spectroscopy for Early Detection of Cervical Cancer, a Global Women’s Health Issue—A Review. Molecules 2023; 28:molecules28062502. [PMID: 36985474 PMCID: PMC10056388 DOI: 10.3390/molecules28062502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/03/2023] [Accepted: 03/07/2023] [Indexed: 03/11/2023] Open
Abstract
This review focuses on recent advances and future perspectives in the use of Raman spectroscopy for cervical cancer, a global women’s health issue. Cervical cancer is the fourth most common women’s cancer in the world, and unfortunately mainly affects younger women. However, when detected at the early precancer stage, it is highly treatable. High-quality cervical screening programmes and the introduction of the human papillomavirus (HPV) vaccine are reducing the incidence of cervical cancer in many countries, but screening is still essential for all women. Current gold standard methods include HPV testing and cytology for screening, followed by colposcopy and histopathology for diagnosis. However, these methods are limited in terms of sensitivity/specificity, cost, and time. New methods are required to aid clinicians in the early detection of cervical precancer. Over the past 20 years, the potential of Raman spectroscopy together with multivariate statistical analysis has been shown for the detection of cervical cancer. This review discusses the research to date on Raman spectroscopic approaches for cervical cancer using exfoliated cells, biofluid samples, and tissue ex vivo and in vivo.
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Del Mistro A, Battagello J, Weis L, Bressan V, Selle V, Ramigni M, Dal Zotto A, Maggiolo A, Gori S, Frayle H, Zappa M, Zorzi M. A Retrospective Cohort Study of Young Women Spontaneously Choosing to Be Vaccinated against HPV: Outcomes from Their First Cervical Cancer Screening Test. Viruses 2021; 13:v13030486. [PMID: 33809436 PMCID: PMC7999740 DOI: 10.3390/v13030486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/08/2021] [Accepted: 03/12/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Efficacy for cervical cancer prevention of opportunistic HPV vaccination in post-pubertal girls is lower than in 11-year-olds. Methods: Women born between 1986 and 1992 vaccinated at 15–25 years of age (at least one dose of 4-valent HPV vaccine) and screened at 24–27 years of age were included. Frequency of opportunistic vaccination, overall and by birth cohort, was calculated; screening outcomes were compared between vaccinated and unvaccinated women. Results: Overall, 4718 (4.9%) HPV-vaccinated, and 91,512 unvaccinated, women were studied. The frequency of vaccination increased by birth cohort, ranging between 1.8% and 9.8%; age at vaccination decreased progressively by birth cohort (p < 0.0001). Participation in screening was 60.8% among vaccinated, and 56.6% among unvaccinated, women (p < 0.0001). Detection rates (DR) for high-grade lesions were lower in vaccinated women (2.11‰ vs. 3.85‰ in unvaccinated, for CIN3+, p = 0.24; 0.0‰ vs. 0.22‰ for cancer). The DR of CIN3+ increased with age at vaccination, scoring respectively 0.0‰, 0.83‰, and 4.68‰ for women vaccinated when they were 15–16, 17–20, and 21–25 years old (p = 0.17). Conclusions: In comparison to unvaccinated women, higher compliance with cervical cancer screening invitation and lower CIN3+ DR among vaccinated women was observed. Age at vaccination was inversely correlated to vaccination efficacy.
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Affiliation(s)
- Annarosa Del Mistro
- Immunologia e Diagnostica Molecolare Oncologica, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata, 64, 35128 Padua, Italy; (L.W.); (S.G.); (H.F.)
- Correspondence:
| | - Jessica Battagello
- Veneto Tumour Registry, Azienda Zero, 35131 Padua, Italy; (J.B.); (M.Z.)
| | - Luca Weis
- Immunologia e Diagnostica Molecolare Oncologica, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata, 64, 35128 Padua, Italy; (L.W.); (S.G.); (H.F.)
- Department of Neuroscience (DNS), University of Padua, 35131 Padua, Italy
| | | | | | - Mauro Ramigni
- Local Health Unit Marca Trevigiana, 31100 Treviso, Italy;
| | | | | | - Silvia Gori
- Immunologia e Diagnostica Molecolare Oncologica, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata, 64, 35128 Padua, Italy; (L.W.); (S.G.); (H.F.)
| | - Helena Frayle
- Immunologia e Diagnostica Molecolare Oncologica, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata, 64, 35128 Padua, Italy; (L.W.); (S.G.); (H.F.)
| | - Marco Zappa
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy;
| | - Manuel Zorzi
- Veneto Tumour Registry, Azienda Zero, 35131 Padua, Italy; (J.B.); (M.Z.)
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