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Serman F, Favre J, Deken V, Guittet L, Collins C, Rochoy M, Messaadi N, Duhamel A, Launay L, Berkhout C, Raginel T. The association between cervical cancer screening participation and the deprivation index of the location of the family doctor's office. PLoS One 2020; 15:e0232814. [PMID: 32413044 PMCID: PMC7228108 DOI: 10.1371/journal.pone.0232814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 04/21/2020] [Indexed: 11/26/2022] Open
Abstract
Background Cervical cancer screening rates are known to be strongly associated with socioeconomic status. Our objective was to assess whether the rate is also associated with an aggregated deprivation marker, defined by the location of family doctors’ offices. Methods To access this association, we 1) collected data from the claim database of the French Health Insurance Fund about the registered family doctors and their enlisted female patients eligible for cervical screening; 2) carried out a telephone survey with all registered doctors to establish if they were carrying out Pap-smears in their practices; 3) geotracked all the doctors’ offices in the smallest existing blocks of socioeconomic homogenous populations (IRIS census units) that were assigned a census derived marker of deprivation, the European Deprivation Index (EDI), and a binary variable of urbanization; and 4) we used a multivariable linear mixed model with IRIS as a random effect. Results Of 348 eligible doctors, 343 responded to the telephone survey (98.6%) and were included in the analysis, encompassing 88,152 female enlisted patients aged 25–65 years old. In the multivariable analysis (adjusted by the gender of the family doctor, the practice of Pap-smears by the doctor and the urbanization of the office location), the EDI of the doctor’s office was strongly associated with the cervical cancer screening participation rate of eligible patients (p<0.001). Conclusion The EDI linked to the location of the family doctor’s office seems to be a robust marker to predict female patients’ participation in cervical cancer screening.
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Affiliation(s)
- Fanny Serman
- Department of General Medicine, School of Medicine, Lille University, Lille, France
- * E-mail:
| | - Jonathan Favre
- Department of General Medicine, School of Medicine, Lille University, Lille, France
| | - Valérie Deken
- Department of Public Health, University Hospital of Lille, Lille University, Lille, France
| | - Lydia Guittet
- Department of Epidemiological Research and Evaluation, University Hospital Caen, Caen, France
- INSERM U1086 « Anticipe », University Hospital Caen, Normandie University, Caen, France
- Department of General Medicine, Medical School, Normandie University, Caen, France
| | | | - Michaël Rochoy
- Department of General Medicine, School of Medicine, Lille University, Lille, France
| | - Nassir Messaadi
- Department of General Medicine, School of Medicine, Lille University, Lille, France
| | - Alain Duhamel
- Department of Public Health, University Hospital of Lille, Lille University, Lille, France
| | - Ludivine Launay
- Department of Epidemiological Research and Evaluation, University Hospital Caen, Caen, France
- INSERM U1086 « Anticipe », University Hospital Caen, Normandie University, Caen, France
- Department of General Medicine, Medical School, Normandie University, Caen, France
| | - Christophe Berkhout
- Department of General Medicine, School of Medicine, Lille University, Lille, France
| | - Thibaut Raginel
- INSERM U1086 « Anticipe », University Hospital Caen, Normandie University, Caen, France
- Department of General Medicine, Medical School, Normandie University, Caen, France
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Sabol I, Milutin Gašperov N, Matovina M, Božinović K, Grubišić G, Fistonić I, Belci D, Alemany L, Džebro S, Dominis M, Šekerija M, Tous S, de Sanjosé S, Grce M. Cervical HPV type-specific pre-vaccination prevalence and age distribution in Croatia. PLoS One 2017; 12:e0180480. [PMID: 28692681 PMCID: PMC5503252 DOI: 10.1371/journal.pone.0180480] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 06/15/2017] [Indexed: 11/18/2022] Open
Abstract
The main etiological factor of precancerous lesion and invasive cervical cancer are oncogenic human papillomaviruses types (HPVs). The objective of this study was to establish the distribution of the most common HPVs in different cervical lesions and cancer prior to the implementation of organized population-based cervical screening and HPV vaccination in Croatia. In this study, 4,432 cervical specimens, collected through a 16-year period, were tested for the presence of HPV-DNA by polymerase chain reaction (PCR) with three sets of broad-spectrum primers and type-specific primers for most common low-risk (LR) types (HPV-6, 11) and the most common high-risk (HR) types (HPV-16, 18, 31, 33, 45, 52, 58). Additional 35 archival formalin-fixed, paraffin embedded tissue of cervical cancer specimens were analyzed using LiPA25 assay. The highest age-specific HPV-prevalence was in the group 18-24 years, which decreased continuously with age (P<0.0001) regardless of the cytological diagnosis. The prevalence of HR-HPV types significantly increased (P<0.0001) with the severity of cervical lesions. HPV-16 was the most common type found with a prevalence (with or without another HPV-type) of 6.9% in normal cytology, 15.5% in atypical squamous cells of undetermined significance, 14.4% in low-grade squamous intraepithelial lesions, 33.3% in high-grade squamous intraepithelial lesions, and 60.9% in cervical cancer specimens (P<0.0001). This study provides comprehensive and extensive data on the distribution of the most common HPV types among Croatian women, which will enable to predict and to monitor the impact of HPV-vaccination and to design effective screening strategies in Croatia.
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Affiliation(s)
- Ivan Sabol
- Department of Molecular Medicine, Ruđer Bošković Institute, Zagreb, Croatia
| | | | - Mihaela Matovina
- Department of Molecular Medicine, Ruđer Bošković Institute, Zagreb, Croatia
| | - Ksenija Božinović
- Department of Molecular Medicine, Ruđer Bošković Institute, Zagreb, Croatia
| | - Goran Grubišić
- University Hospital Sisters of Mercy, Clinic of Obstetrics and Gynaecology, Zagreb, Croatia
| | - Ivan Fistonić
- Obstetrics, Gynecology and Menopause Clinic, Zagreb, Croatia
| | - Dragan Belci
- Department of Gynecology and Obstetrics, General Hospital Pula, Pula, Croatia
| | - Laia Alemany
- Cancer Epidemiology Research Program, Unit of Infections and Cancer, Catalan Institute of Oncology, Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Sonja Džebro
- Department of Pathology and Cytology, University of Zagreb, School of Medicine, University Hospital Merkur, Zagreb, Croatia
| | - Mara Dominis
- Department of Pathology and Cytology, University of Zagreb, School of Medicine, University Hospital Merkur, Zagreb, Croatia
| | - Mario Šekerija
- Croatian National Cancer Registry, Croatian Institute of Public Health, Zagreb, Croatia
- School of Medicine, Andrija Štampar School of Public Health, University of Zagreb, Zagreb, Croatia
| | - Sara Tous
- Cancer Epidemiology Research Program, Unit of Infections and Cancer, Catalan Institute of Oncology, Barcelona, Spain
| | - Silvia de Sanjosé
- Cancer Epidemiology Research Program, Unit of Infections and Cancer, Catalan Institute of Oncology, Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Magdalena Grce
- Department of Molecular Medicine, Ruđer Bošković Institute, Zagreb, Croatia
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Saridi M, Kapogeorgou E, Rekleiti M, Geitona M, Souliotis K. Knowledge and attitudes of women regarding gynaecological cancer prevention in an urban area of Greece in financial crisis. Scand J Caring Sci 2017; 31:710-717. [PMID: 28233331 DOI: 10.1111/scs.12385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 08/17/2016] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Preventive gynaecological examinations (PGEs) are the main means of monitoring gynaecological cancers across the developed world. The purpose of this study was to investigate the perceptions and attitudes of women of a regional municipality of Greece, regarding preventive gynaecological examinations amid economic crisis. MATERIAL AND METHODS The study included 360 women aged 20-70 years, who lived in an urban area of Greece. A specialised, valid and anonymous questionnaire that included questions about perceptions and attitudes regarding preventive gynaecological examinations was used. The data analysis was performed using the statistical package spss 21. RESULTS It was found that women who lived in less developed areas had had lower educational levels and higher abstinence rates from medical examinations. The main source of information about sexually transmitted diseases was their social circle (48%), but the gynaecologist is the one preferred (54.8) to inform about preventive gynaecological examinations. Thirty per cent of the participants had never have a mammogram, while 33.9% of the sample did not show the same result, although considered the Pap test necessary. The main cause of women's abstention of preventive gynaecological examinations is the financial crisis. CONCLUSIONS The current financial crisis has negatively affected the women's ability to afford gynaecological examinations. Therefore, it is necessary to inform the population about the necessity of preventive gynaecological examinations starting from school age and at the same time, health information and promotion campaigns should be launched at a national level.
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Affiliation(s)
- Maria Saridi
- Faculty of Social and Political Sciences, University of Peloponnese, Korinthos, Greece
| | - Eleni Kapogeorgou
- Faculty of Social and Political Sciences, University of Peloponnese, Korinthos, Greece
| | - Maria Rekleiti
- Faculty of Social and Political Sciences, University of Peloponnese, Korinthos, Greece.,Department of Nursing, University of Peloponnese, Sparta, Greece
| | - Maria Geitona
- Faculty of Social and Political Sciences, University of Peloponnese, Korinthos, Greece
| | - Kyriakos Souliotis
- Faculty of Social and Political Sciences, University of Peloponnese, Korinthos, Greece
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Marín HM, Torres C, Deluca GD, Mbayed VA. Human papillomavirus detection in Corrientes, Argentina: High prevalence of type 58 and its phylodynamics. Rev Argent Microbiol 2015; 47:302-11. [DOI: 10.1016/j.ram.2015.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 09/04/2015] [Accepted: 09/09/2015] [Indexed: 10/22/2022] Open
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Kamzol W, Jaglarz K, Tomaszewski KA, Puskulluoglu M, Krzemieniecki K. Assessment of knowledge about cervical cancer and its prevention among female students aged 17-26 years. Eur J Obstet Gynecol Reprod Biol 2012; 166:196-203. [PMID: 23141797 DOI: 10.1016/j.ejogrb.2012.10.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Revised: 07/12/2012] [Accepted: 10/12/2012] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To assess knowledge about cervical cancer and its primary and secondary prevention, and identify the sources of information about the disease among female high school and university students in Krakow, Poland. STUDY DESIGN This study was based on a questionnaire consisting of 64 questions, divided into six parts: personal data, general knowledge about cervical cancer, estimation of risk factors, knowledge about primary prevention, knowledge about secondary prevention, and information sources. Data were collected from students aged 17-26 years over a 3-month period in 2011 and 2012. RESULTS Four hundred women living in Krakow or its vicinity were included in the study. Nearly all respondents (98.5%) had heard of cervical cancer, 89.4% were aware of the risk of death associated with cervical cancer, and 44.8% believed that the disease could affect them in the future. The interviewees considered genetics and family history to be the most important risk factors, followed by infection with human papillomavirus (HPV) and having multiple sex partners. Most (91.5%) respondents had not been vaccinated against HPV, 47.9% did not know where to go to get vaccinated, and 30.1% were unaware of vaccination as a prevention method. Most (91.5%) respondents were aware of cytological screening, and 86.5% thought that they should have it done in the future. Women who had not heard of cytological screening were more likely to be unaware of cervical cancer than women who had heard about cytological screening (odds ratio 0.24, 95% confidence interval 0.11-0.49, p=0.0001). The Internet, television and newspapers were reported to be the main sources of information about the disease. CONCLUSIONS General awareness of cervical cancer among young women in Poland is insufficient. HPV infection is not considered to be the major aetiological factor. A relatively high percentage of women in this study had never heard of the HPV vaccine as a way of preventing cervical cancer. Knowledge about cytological screening, however, appears to be much better.
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Affiliation(s)
- Wojciech Kamzol
- Department of Clinical Oncology, Krakow University Hospital, Krakow, Poland
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