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Scott-Williams J, Hosein A, Akpaka P, Adidam Venkata CR. Epidemiology of Cervical Cancer in the Caribbean. Cureus 2023; 15:e48198. [PMID: 38054120 PMCID: PMC10694396 DOI: 10.7759/cureus.48198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2023] [Indexed: 12/07/2023] Open
Abstract
Cervical cancer (CvC) is considered a preventable disease; however, in the Caribbean, it is still one of the fourth most common causes of death in women. Efforts to overcome obstacles to the treatment and control of this preventable disease are being made by several countries within the Caribbean. However, no health issue can be readily managed without first acquiring an understanding of the dynamics relating to its severity of impact reaching the target population, its clinical pathology, and the availability of treatment and/or preventative measures to control or halt its progression. To assess the status of CvC in the Caribbean, a review of the literature was conducted using PubMed. The Caribbean was defined in the review as comprising nations and islands whose coastlines are touched by the Caribbean Sea. This led to an assessment of the available literature on CvC for 33 Caribbean territories. The review showed a lack of published information on CvC and highlights the need for greater research. This also serves as a template for subsequent investigations.
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Affiliation(s)
- Jamie Scott-Williams
- Biomedical Engineering, The University of Trinidad and Tobago, Port of Spain, TTO
| | - Amalia Hosein
- Biomedical Engineering, The University of Trinidad and Tobago, Port of Spain, TTO
| | - Patrick Akpaka
- Pathology/Microbiology, The University of the West Indies, St. Augustine, TTO
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Castaneda-Avila MA, Baek J, Epstein MM, Forrester SN, Ortiz AP, Lapane KL. Association Between Body Mass Index and Cancer Screening Adherence Among Latinas in the United States and Puerto Rico. WOMEN'S HEALTH REPORTS 2022; 3:552-562. [PMID: 37096019 PMCID: PMC10122236 DOI: 10.1089/whr.2021.0153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 11/12/2022]
Abstract
Background Research on the role of body size on cancer screening is mixed with few studies among Latinas in the United States. We evaluated the association between body size and cancer screening adherence among Latinas living in Puerto Rico and the rest of the United States. Methods We conducted a cross-sectional study using 2012-2018 Behavioral Risk Factor Surveillance System data among Latinas 50-64 years of age (n = 16,410). Breast, cervical, and colorectal cancer screening (guideline adherent: yes/no), height and weight were self-reported. Prevalence ratios (PRs) derived from Poisson models were estimated for each cancer screening utilization for Puerto Rico versus rest of the United States by body mass index (BMI) category. Results Nearly a quarter of women lacked adherence with breast and cervical cancer screening and 43.6% were nonadherent to colorectal cancer screening. Latinas with BMI ≥40.0 kg/m2 in both groups were more likely to lack adherence to cervical cancer screening than women with BMI 18.5-24.9 kg/m2. For those with BMI ≥40.0 kg/m2, Latinas in Puerto Rico were more likely to lack adherence to colorectal cancer screening recommendations than Latinas living in the rest of the United States (adjusted PR: 1.38; 95% confidence interval = 1.12-1.70). Conclusions The role of body size in cancer screening utilization among Latinas differs in women living in Puerto Rico versus in the rest of the United States and varies by cancer type. Understanding Latinas' experience can inform culturally adapted interventions to promote cancer screening.
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Affiliation(s)
- Maira A. Castaneda-Avila
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Jonggyu Baek
- Division of Biostatistics and Health Services Research, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Mara M. Epstein
- Meyers Health Care Institute, a Joint Endeavor of the University of Massachusetts Chan Medical School, Fallon Health, and Reliant Medical Group, Worcester, Massachusetts, USA
- Division of Geriatric Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Sarah N. Forrester
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Ana P. Ortiz
- University of Puerto Rico, Comprehensive Cancer Center, San Juan, Puerto Rico
- Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Kate L. Lapane
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
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Claro IB, Lima LDD, Almeida PFD. Cervical cancer guidelines, prevention and screening strategies: experiences from Brazil and Chile. CIENCIA & SAUDE COLETIVA 2021; 26:4497-4509. [PMID: 34730638 DOI: 10.1590/1413-812320212610.11352021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 05/25/2021] [Indexed: 11/22/2022] Open
Abstract
This article analyzes cervical cancer control policies and actions in Brazil and Chile, focusing on prevention and screening. We adopted a comparative approach to identify similarities and differences in guidelines and cervical cancer prevention and screening strategies between the two countries. We used the following data collection techniques: analysis of official documents and secondary data, consultations with experts, government officials and program coordinators, and literature review. The findings show that Chile has a well-structured program with centralized decision-making and a system that permits monitoring of actions. Brazil on the other hand faces ongoing issues with lack of coordination and shortcomings in the follow-up of women with abnormal test results. The following challenges to consolidating cervical cancer screening stand out in Brazil: lack of active tracking of the target population; absence of a test quality assurance system; and inadequate follow-up of women with abnormal test results. Both countries need to increase coverage and implement organized screening.
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Affiliation(s)
- Itamar Bento Claro
- Instituto Nacional de Câncer José Alencar Gomes da Silva. Rua Marquês de Pombal 125 7º andar, Centro. 20230-240 Rio de Janeiro RJ Brasil.
| | - Luciana Dias de Lima
- Departamento de Administração e Planejamento em Saúde, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz. Rio de Janeiro RJ Brasil
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Sealy DA, Modeste N, Dyett P. Barriers and facilitators to the HPV vaccine among mothers of adolescent girls: a qualitative study conducted in Trinidad and Tobago. Women Health 2020; 61:235-243. [PMID: 33272144 DOI: 10.1080/03630242.2020.1856295] [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] [Indexed: 10/22/2022]
Abstract
Cervical cancer is a major public health problem in Latin America and the Caribbean and the human papillomavirus (HPV) vaccine may prevent thousands of cases of cervical cancer. The current study explored barriers and facilitators that affected the acceptance of the HPV vaccine by mothers of adolescents. This paper explores the qualitative findings from a larger mixed-methods study. Six focus groups were conducted (N = 33) throughout Trinidad and Tobago with mothers of adolescent girls. Three major themes emerged: a) cervical cancer and vaccine knowledge, b) barriers to uptake, and c) rephrasing the vaccine strategy. Data indicated that no widespread strategies to educate the population about the vaccine had occurred. Barriers to uptake of the vaccine were related to a lack of information on the efficacy and safety of HPV vaccines. Parents were unaware that the HPV caused cervical cancer. It is recommended that physicians and other health professionals be used to deliver targeted messages to parents and adolescents to improve uptake of the vaccine.
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Affiliation(s)
- Diadrey-Anne Sealy
- School of Public Health, Loma Linda University, Loma Linda, California, USA
| | - Naomi Modeste
- School of Public Health, Loma Linda University, Loma Linda, California, USA
| | - Patricia Dyett
- Faculty of Food and Agriculture, The University of the West Indies, St. Augustine, Trinidad and Tobago
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Ferrera A, Valladares W, Cabrera Y, de la Luz Hernandez M, Darragh T, Baena A, Almonte M, Herrero R. Performance of an HPV 16/18 E6 oncoprotein test for detection of cervical precancer and cancer. Int J Cancer 2019; 145:2042-2050. [PMID: 30684396 DOI: 10.1002/ijc.32156] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 11/23/2018] [Accepted: 12/20/2018] [Indexed: 11/06/2022]
Abstract
HPV testing is a better alternative for cervical cancer screening, but additional procedures are required for triage of HPV positive women. HPV encoded oncoproteins E6 and E7, as the main effectors of HPV carcinogenicity represent promising triage alternatives. To evaluate performance of the test, we included 155 women from a screening study and 59 from the same referral population attending colposcopy and with precancerous lesions. All were HPV-tested with HC2 and genotyped with LiPA, and cervical swabs were tested for HPV16/18 E6 oncoproteins. Histologic specimens were reviewed and adjudicated using p16 immunohistochemistry and 55 women had confirmed histologic HSIL, 31 (56.3%) associated with HPV 16/18, 23 with other HPV types and one HPV negative. Sensitivity and specificity were estimated with histologic HSIL/cancer as gold standard. E6 oncoprotein was detectable in all but one HSIL and in all cancers where HPV16/18 DNA was detected, but in none of the cases associated with other HPV types or HPV negatives. Among the few HPV16/18 DNA positive subjects initially without HSIL (n = 4) who were E6 oncoprotein positive, precancer was detected during follow-up in 2 out of 3 with available information. Estimated sensitivity for HPV16/18-related HSIL+ was 96.8% (95%CI = 83.8-99.8) and for all HSIL+ regardless of HPV type it was 56.4% (95%CI = 43.3-68.6). Specificity was 97.5% (95%CI = 93.7-99.0). E6 oncoprotein proved as a highly sensitive and specific marker for detection of HPV16/18-related HSIL lesions in this Honduran population with limited previous screening and may be useful as a triage method in screening programs, particularly in low income countries.
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Affiliation(s)
- Annabelle Ferrera
- Escuela de Microbiología, Facultad de Ciencias, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Wendy Valladares
- Escuela de Microbiología, Facultad de Ciencias, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Yessy Cabrera
- Escuela de Microbiología, Facultad de Ciencias, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Maria de la Luz Hernandez
- Prevention and Implementation Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Teresa Darragh
- Department of Pathology, UCSF Mt. Zion Medical Center, San Francisco, CA
| | - Armando Baena
- Prevention and Implementation Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Maribel Almonte
- Prevention and Implementation Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Rolando Herrero
- Prevention and Implementation Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
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Liebermann EJ, VanDevanter N, Shirazian T, Frías Gúzman N, Niles M, Healton C, Ompad D. Barriers to Cervical Cancer Screening and Treatment in the Dominican Republic: Perspectives of Focus Group Participants in the Santo Domingo Area. J Transcult Nurs 2019; 31:121-127. [DOI: 10.1177/1043659619846247] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Introduction: Cervical cancer is the second leading cause of cancer death among women in the Dominican Republic, and high rates persist despite existing Pap smear screening programs. The purpose of this study was to explore Dominican women’s knowledge and attitudes regarding human papillomavirus (HPV) and cervical cancer, cervical cancer screening practices, and perceived barriers and facilitators to early detection of cervical cancer. Method: Six focus groups ( N = 64) were conducted in Spanish in urban, suburban, and rural locations, in private and public school settings, community and workplace settings, in or near Santo Domingo, as part of a larger study on barriers and facilitators to HPV vaccine implementation. Audio recordings were transcribed verbatim and translated from Spanish to English. Qualitative data analysis used inductive and deductive approaches. Results: Knowledge regarding HPV and cervical cancer varied across groups, but all agreed there was significant stigma and fear regarding HPV. Most women reported having Pap screening at least yearly. Follow-up of abnormal Pap testing was less consistent, with cost and uncertainty about provider recommendations identified as barriers. Discussion: Broader examination of provider-level and health system barriers and facilitators to cervical cancer prevention in the Dominican Republic is essential, in order to inform interventions to improve the effectiveness of cervical cancer screening and treatment programs and reduce preventable deaths.
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Affiliation(s)
| | | | | | - Natalia Frías Gúzman
- Instituto Nacional de Cáncer Rosa Emilia Sánchez Pérez de Tavares, Santo Domingo, Dominican Republic
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Liebermann EJ, VanDevanter N, Hammer MJ, Fu MR. Social and Cultural Barriers to Women's Participation in Pap Smear Screening Programs in Low- and Middle-Income Latin American and Caribbean Countries: An Integrative Review. J Transcult Nurs 2018; 29:591-602. [PMID: 29366369 DOI: 10.1177/1043659618755424] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
PURPOSE Pap smear screening programs have been ineffective in reducing cervical cancer mortality in most Latin American and Caribbean countries, in part due to low screening rates. The purpose of this review was to analyze recent studies to identify demographic, social, and cultural factors influencing women's participation in Pap screening programs in Latin America and the Caribbean. DESIGN/METHOD For this integrative review, cervical cancer screening in Latin America and the Caribbean was searched using PubMed, CINAHL, EMBASE, and PsycINFO databases. Findings/Results: Demographic barriers to screening were socioeconomic status, education, race/ethnicity, and geography. Social barriers included lack of uniformity in screening guidelines, lack of knowledge regarding cervical cancer, and lack of preventive culture. Cultural barriers were fear/embarrassment and gender roles. CONCLUSIONS There are multilevel barriers to Pap smear utilization among women in Latin America and the Caribbean. IMPLICATIONS FOR PRACTICE Findings highlight a need for health system engagement, promotion of preventive care, and community-generated educational programs and solutions.
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Affiliation(s)
| | | | | | - Mei R Fu
- 1 New York University, New York, NY, USA
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Ward JM, Schmalenberg K, Antonishyn NA, Hambleton IR, Blackman EL, Levett PN, Gittens-St.Hilaire MV. Human papillomavirus genotype distribution in cervical samples among vaccine naïve Barbados women. Cancer Causes Control 2017; 28:1323-1332. [DOI: 10.1007/s10552-017-0959-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 09/08/2017] [Indexed: 11/27/2022]
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Rajiah K, Maharajan MK, Fang Num KS, How Koh RC. Knowledge about Human Papillomavirus and Cervical Cancer: Predictors of HPV Vaccination among Dental Students. Asian Pac J Cancer Prev 2017; 18:1573-1579. [PMID: 28669170 PMCID: PMC6373794 DOI: 10.22034/apjcp.2017.18.6.1573] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background: The objective of this study is to determine the influence of dental students’ knowledge and attitude regarding human papillomavirus infection of cervical cancer on willingness to pay for vaccination. Basic research design: A convenience sampling method was used. The minimal sample size of 136 was calculated using the Raosoft calculator with a 5 % margin of error and 95% confidence level. Participants: The study population were all final year dental students from the School of Dentistry. Methods: A self-administered questionnaire was used to measure knowledge levels and attitudes regarding human papillomavirus vaccination. Contingent valuation was conducted for willingness to pay for vaccination. Main outcome measures: The Center for Disease Control and Prevention has stated that human papillomavirus are associated with oropharynx cancer and the American Dental Association insist on expanding public awareness of the oncogenic potential of some HPV infections. Thus, as future dental practitioners, dental students should be aware of human papillomavirus and their links with cancer and the benefits of vaccination. Results: Knowledge on HPV and cervical cancer did not impact on attitudes towards vaccines. However, significant correlation existed between knowledge and willingness to pay for vaccination. Conclusions: Dental students’ knowledge on HPV and cervical cancer has no influence on their attitude towards HPV vaccines. However, their willingness to pay for HPV vaccination is influenced by their knowledge of cervical cancer and HPV vaccination.
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Affiliation(s)
- Kingston Rajiah
- Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur, 57000, Malaysia.
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10
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Eid M, Nahon-Serfaty I. Ethics, Risk, and Media Intervention. Oncology 2017. [DOI: 10.4018/978-1-5225-0549-5.ch023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Breast cancer incidence and mortality rates are of concern among Latin American women, mainly due to the growing prevalence of this disease and the lack of compliance to proper breast cancer screening and treatment. Focusing on Venezuelan women and the challenges and barriers that interact with their health communication, this paper looks into issues surrounding women's breast cancer, such as the challenges and barriers to breast cancer care, the relevant ethics and responsibilities, the right to health, breast cancer risk perception and risk communication, and the media interventions that affect Venezuelan women's perceptions and actions pertaining to this disease. In particular, it describes an action-oriented research project in Venezuela that was conducted over a four-year period of collaborative work among researchers, practitioners, NGOs, patients, journalists, and policymakers. The outcomes include positive indications on more effective interactions between physicians and patients, increasing satisfactions about issues of ethical treatment in providing healthcare services, more sufficient and responsible media coverage of breast cancer healthcare services and information, a widely supported declaration for a national response against breast cancer in Venezuela, and the creation of a code of ethics for the Venezuelan NGO that led the expansion of networking in support of women's breast cancer healthcare.
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Codas M, Pesch B, Adolphs M, Madrazo C, Matthias C, Heinze E, Taeger D, Behrens T, Chaux A, Brüning T. Cancer mortality in Itapúa--A rural province of Paraguay 2003-2012. Cancer Epidemiol 2015; 40:1-6. [PMID: 26599413 DOI: 10.1016/j.canep.2015.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 11/06/2015] [Accepted: 11/09/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Itapúa is a rural department in Paraguay with a population of about 500,000 and a high degree of agro-mechanization for the production of soybean and other crops. So far, only basic health care is provided. Here we analyzed the cancer mortality in this region as a first step towards epidemiological data for cancer prevention. METHODS We calculated the age-adjusted mortality rates according to world standard (AMRWs) for the major cancer sites in both males and females between 2003 and 2012, and estimated the differences between the capital and more central districts of Itapúa vs. remote districts. RESULTS There were about 2000 cancer deaths in the decade studied, with AMRWs for all malignancies of 90.9/100,000 in males from central vs. 49.1/100,000 in remote districts and 69.0/100,000 vs. 45.0/100,000 in women. Cancer was mentioned in 12.4% of all death certificates and outweighed mortality from certain infectious and parasitic diseases (3.6%). Cause of death was ill-defined in 19.6% of all death certificates, especially in remote regions and among the elderly. The part of cancer located in the uterus (47.8%) or cell type of neoplasm of the lymphatic or hematopoietic system (73.1%) were often not specified. The uterus (mainly the cervix) (C53-C55) was the leading cancer site in women with AMRWs of 17.2/100,000 in central and 14.0/100,000 in remote districts, followed by the breast. Lung and prostate were the leading cancer sites among men. The lung cancer mortality rate was 19.3/100,000 in the central region but 9.5/100,000 in remote districts. Although children comprised 36% of the population, only 24 death certificates listed cancer as cause of death in this decade. CONCLUSIONS Analysis of cancer mortality in this rural region of Paraguay, which lacks resources for diagnostics and care, revealed an already large number of cases, with higher rates in the central region than in remote districts. Lung and uterus (primarily the cervix) are common cancer sites and indicate the potential for prevention. However, the quality of the vital statistics needs to be improved. The true cancer burden is most likely underestimated, especially in remote regions and children.
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Affiliation(s)
- Manuel Codas
- Regional Hospital of Encarnación, National Itapúa University, Jorge Memmel/Independencia Nacional, Encarnación, Paraguay.
| | - Beate Pesch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of Ruhr University Bochum (IPA), Buerkle-de-la-Camp-Platz 1, 44789 Bochum, Germany.
| | - Madita Adolphs
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of Ruhr University Bochum (IPA), Buerkle-de-la-Camp-Platz 1, 44789 Bochum, Germany.
| | - Carolina Madrazo
- Regional Hospital of Encarnación, National Itapúa University, Jorge Memmel/Independencia Nacional, Encarnación, Paraguay.
| | - Cristian Matthias
- Regional Hospital of Encarnación, National Itapúa University, Jorge Memmel/Independencia Nacional, Encarnación, Paraguay.
| | - Evelyn Heinze
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of Ruhr University Bochum (IPA), Buerkle-de-la-Camp-Platz 1, 44789 Bochum, Germany.
| | - Dirk Taeger
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of Ruhr University Bochum (IPA), Buerkle-de-la-Camp-Platz 1, 44789 Bochum, Germany.
| | - Thomas Behrens
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of Ruhr University Bochum (IPA), Buerkle-de-la-Camp-Platz 1, 44789 Bochum, Germany.
| | - Alcides Chaux
- Universidad del Norte, Gral. Santos e/25 de Mayo, Asunción, Paraguay.
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of Ruhr University Bochum (IPA), Buerkle-de-la-Camp-Platz 1, 44789 Bochum, Germany.
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Eid M, Nahon-Serfaty I. Ethics, Risk, and Media Intervention: Women's Breast Cancer in Venezuela. INTERNATIONAL JOURNAL OF RISK AND CONTINGENCY MANAGEMENT 2015; 4:49-69. [PMID: 27867750 DOI: 10.4018/ijrcm.2015070104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Breast cancer incidence and mortality rates are of concern among Latin American women, mainly due to the growing prevalence of this disease and the lack of compliance to proper breast cancer screening and treatment. Focusing on Venezuelan women and the challenges and barriers that interact with their health communication, this paper looks into issues surrounding women's breast cancer, such as the challenges and barriers to breast cancer care, the relevant ethics and responsibilities, the right to health, breast cancer risk perception and risk communication, and the media interventions that affect Venezuelan women's perceptions and actions pertaining to this disease. In particular, it describes an action-oriented research project in Venezuela that was conducted over a four-year period of collaborative work among researchers, practitioners, NGOs, patients, journalists, and policymakers. The outcomes include positive indications on more effective interactions between physicians and patients, increasing satisfactions about issues of ethical treatment in providing healthcare services, more sufficient and responsible media coverage of breast cancer healthcare services and information, a widely supported declaration for a national response against breast cancer in Venezuela, and the creation of a code of ethics for the Venezuelan NGO that led the expansion of networking in support of women's breast cancer healthcare.
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Affiliation(s)
- Mahmoud Eid
- Department of Communication, University of Ottawa, Ottawa, Ontario, Canada
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Vamos CA, Calvo AE, Daley EM, Giuliano AR, López Castillo H. Knowledge, Behavioral, and Sociocultural Factors Related to Human Papillomavirus Infection and Cervical Cancer Screening Among Inner-City Women in Panama. J Community Health 2015; 40:1047-56. [DOI: 10.1007/s10900-015-0030-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Murphy ST, Frank LB, Chatterjee JS, Moran MB, Zhao N, Amezola de Herrera P, Baezconde-Garbanati LA. Comparing the Relative Efficacy of Narrative vs Nonnarrative Health Messages in Reducing Health Disparities Using a Randomized Trial. Am J Public Health 2015; 105:2117-23. [PMID: 25905845 DOI: 10.2105/ajph.2014.302332] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We compared the relative efficacy of a fictional narrative film to a more traditional nonnarrative film in conveying the same health information. METHODS We used a random digit dial procedure to survey the cervical cancer-related knowledge, attitudes, and behavior of non-Hispanic White, Mexican American, and African American women, aged 25 to 45 years, living in Los Angeles, California, from 2011 to 2012. Participants (n = 704) were randomly assigned to view either a narrative or nonnarrative film containing the same information about how cervical cancer could be prevented or detected, and they were re-contacted 2 weeks and 6 months later. RESULTS At 2 weeks, both films produced a significant increase in cervical cancer-related knowledge and attitudes, but these effects were significantly higher for the narrative film. At 6 months, viewers of both films retained greater than baseline knowledge and more positive attitudes toward Papanicolaou (Pap) tests, but women who saw the narrative were significantly more likely to have had or scheduled a Pap test. The narrative was particularly effective for Mexican American women, eliminating cervical cancer screening disparities found at baseline. CONCLUSIONS Narratives might prove to be a useful tool for reducing health disparities.
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Affiliation(s)
- Sheila T Murphy
- Sheila T. Murphy, Joyee S. Chatterjee, Nan Zhao, and Paula Amezola de Herrera are with the Annenberg School for Communication and Journalism, University of Southern California, Los Angeles. Lauren B. Frank is with the Department of Communication, Portland State University, Portland, OR. Meghan B. Moran is with the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Lourdes A. Baezconde-Garbanati is with the Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Lauren B Frank
- Sheila T. Murphy, Joyee S. Chatterjee, Nan Zhao, and Paula Amezola de Herrera are with the Annenberg School for Communication and Journalism, University of Southern California, Los Angeles. Lauren B. Frank is with the Department of Communication, Portland State University, Portland, OR. Meghan B. Moran is with the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Lourdes A. Baezconde-Garbanati is with the Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Joyee S Chatterjee
- Sheila T. Murphy, Joyee S. Chatterjee, Nan Zhao, and Paula Amezola de Herrera are with the Annenberg School for Communication and Journalism, University of Southern California, Los Angeles. Lauren B. Frank is with the Department of Communication, Portland State University, Portland, OR. Meghan B. Moran is with the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Lourdes A. Baezconde-Garbanati is with the Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Meghan B Moran
- Sheila T. Murphy, Joyee S. Chatterjee, Nan Zhao, and Paula Amezola de Herrera are with the Annenberg School for Communication and Journalism, University of Southern California, Los Angeles. Lauren B. Frank is with the Department of Communication, Portland State University, Portland, OR. Meghan B. Moran is with the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Lourdes A. Baezconde-Garbanati is with the Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Nan Zhao
- Sheila T. Murphy, Joyee S. Chatterjee, Nan Zhao, and Paula Amezola de Herrera are with the Annenberg School for Communication and Journalism, University of Southern California, Los Angeles. Lauren B. Frank is with the Department of Communication, Portland State University, Portland, OR. Meghan B. Moran is with the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Lourdes A. Baezconde-Garbanati is with the Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Paula Amezola de Herrera
- Sheila T. Murphy, Joyee S. Chatterjee, Nan Zhao, and Paula Amezola de Herrera are with the Annenberg School for Communication and Journalism, University of Southern California, Los Angeles. Lauren B. Frank is with the Department of Communication, Portland State University, Portland, OR. Meghan B. Moran is with the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Lourdes A. Baezconde-Garbanati is with the Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Lourdes A Baezconde-Garbanati
- Sheila T. Murphy, Joyee S. Chatterjee, Nan Zhao, and Paula Amezola de Herrera are with the Annenberg School for Communication and Journalism, University of Southern California, Los Angeles. Lauren B. Frank is with the Department of Communication, Portland State University, Portland, OR. Meghan B. Moran is with the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Lourdes A. Baezconde-Garbanati is with the Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California
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Ncube B, Bey A, Knight J, Bessler P, Jolly PE. Factors associated with the uptake of cervical cancer screening among women in portland, Jamaica. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2015; 7:104-13. [PMID: 25839002 PMCID: PMC4382764 DOI: 10.4103/1947-2714.153922] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Cervical cancer is the second most common cancer among women worldwide and is the leading cause of deaths in developing countries. Despite the strong evidence that cervical cancer screening results in decreased mortality from this disease, the uptake for cervical screening among Jamaican women remains low. AIMS This study was carried out to identify factors associated with Jamaican women's decisions to screen for cervical cancer. MATERIALS AND METHODS Cross-sectional descriptive study of 403 women aged 19 years and older from Portland, Jamaica. An interviewer-administered questionnaire assessed the women's cervical cancer screening history, as well as their knowledge, attitudes, and practices regarding the disease and screening. RESULTS Of the 403 women interviewed, 66% had a Papanicolaou (Pap) smear and only 16% had a Pap test within the past year. Significant predicators of uptake of screening were being married, age, parity, discussing cancer with health provider, perception of consequences of not having a Pap smear, and knowing a person with cervical cancer. Women who did not know where to go for a Pap smear were 85% less likely to have been screened (prevalence odds ratio (POR): 0.15, 95% confidence interval (CI): 0.04, 0.52). CONCLUSIONS This study showed suboptimal uptake of cervical cancer screening among Jamaican women. Multipronged approaches are needed to address barriers to screening, as well as identify and support conditions that encourage women's use of reproductive health services, thereby reducing incidence and mortality rates from cervical cancer.
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Affiliation(s)
- Butho Ncube
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Amita Bey
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | - Patricia Bessler
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Pauline E. Jolly
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Luciani S, Cabanes A, Prieto-Lara E, Gawryszewski V. Cervical and female breast cancers in the Americas: current situation and opportunities for action. Bull World Health Organ 2014; 91:640-9. [PMID: 24101780 DOI: 10.2471/blt.12.116699] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 05/21/2013] [Accepted: 05/27/2013] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To understand better the current regional situation and public health response to cervical cancer and female breast cancer in the Americas. METHODS Data on cervical cancer and female breast cancers in 33 countries, for the period from 2000 to the last year with available data, were extracted from the Pan American Health Organization (PAHO) Regional Mortality Database and analysed. Changes in mortality rates over the study period - in all countries except those with small populations and large fluctuations in time-series mortality data - were calculated using Poisson regression models. Information from the PAHO Country Capacity Survey on noncommunicable diseases was also analysed. FINDINGS The Bahamas, Trinidad and Tobago and Uruguay showed relatively high rates of death from breast cancer, whereas the three highest rates of death from cervical cancer were observed in El Salvador, Nicaragua and Paraguay. Several countries - particularly Paraguay and Venezuela - have high rates of death from both types of cancer. Although mortality from cervical cancer has generally been decreasing in the Americas, decreases in mortality from breast cancer have only been observed in a few countries in the Region of the Americas. All but one of the 25 countries in the Americas included in the PAHO Country Capacity Survey reported having public health services for the screening and treatment of breast and cervical cancers. CONCLUSION Most countries in the Americas have the public health capacity needed to screen for - and treat - breast and cervical cancers and, therefore, the potential to reduce the burden posed by these cancers.
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Affiliation(s)
- Silvana Luciani
- Pan American Health Organization, 525 23rd Street NW, Washington, DC 20037, United States of America
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Baezconde-Garbanati LA, Chatterjee JS, Frank LB, Murphy ST, Moran MB, Werth LN, Zhao N, Amezola de Herrera P, Mayer D, Kagan J, O'Brien D. Tamale Lesson: A case study of a narrative health communication intervention. ACTA ACUST UNITED AC 2014. [DOI: 10.1179/1753807614y.0000000055] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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18
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Moore SP, Forman D, Piñeros M, Fernández SM, de Oliveira Santos M, Bray F. Cancer in indigenous people in Latin America and the Caribbean: a review. Cancer Med 2014; 3:70-80. [PMID: 24403278 PMCID: PMC3930391 DOI: 10.1002/cam4.134] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 07/20/2013] [Accepted: 08/17/2013] [Indexed: 12/29/2022] Open
Abstract
Cancer is a leading cause of death in Latin America but there have been few assessments of the cancer burden for the 10% of the population who are indigenous. Evidence from other world regions suggests cancer survival is poorer for indigenous people than for others due to a greater incidence of case-fatal cancers, later stage at diagnosis, and less cancer treatment. A status report on the cancer profile of indigenous people in Latin America and the Caribbean (LAC) is therefore clearly warranted. We undertook a systematic review of the peer-reviewed literature in academic databases, and considered evidence from cancer registries from 1980, to assess cancer epidemiology among indigenous people in LAC. We identified 35 peer-reviewed articles pertaining to cancer in indigenous people. Rates of cervical cancer in parts of Brazil, Ecuador, and Guyana, stomach cancer rates in regions of Chile and gallbladder rates in Chile and Bolivia, were higher for indigenous compared to others. Breast cancer rates were lower in Ecuador, Brazil, and Chile. Six cancer registries in Brazil provided incidence data but no other reports of incidence, mortality, or survival were identified. There was a paucity of data surrounding the cancer burden of indigenous people in LAC. In view of predicted increases in cancer rates in ensuing decades, and the disparities in burden already experienced by indigenous people in the region, it is imperative that cancer profiles are obtained and cancer control measures identified and prioritized.
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Martínez-Mesa J, Werutsky G, Campani RB, Wehrmeister FC, Barrios CH. Inequalities in Pap smear screening for cervical cancer in Brazil. Prev Med 2013; 57:366-71. [PMID: 23827721 DOI: 10.1016/j.ypmed.2013.06.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 05/29/2013] [Accepted: 06/17/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To examine the risk factors associated with never being screened for cervical cancer (CC) in Brazil. METHODS Using the National Household Sample Survey 2008 (PNAD), we analyzed data from 102,108 Brazilian women ages 25-64years. The patients were analyzed as having been or never having been screened with a Pap smear (Yes/No). Age-adjusted prevalence of never-screening was analyzed using a Chi-squared test. Crude and adjusted models using Poisson regression were performed. RESULTS The prevalence of never-screened women for CC was 12.9%, 11.5% and 22.2% in Brazil in general, urban and rural areas, respectively. The Brazilian region with the highest prevalence of never-screening was the North (17.4%, 14.7% and 27.3% in general, urban and rural areas, respectively). The factors associated with a higher risk for never being screened were the following: poverty, younger age, lower educational level, non-white skin color, a greater number of children, no supplemental health insurance and not having visited a doctor in the past 12months. CONCLUSION Socioeconomic and demographic conditions lead to inequalities in access to Pap smear screening in Brazil. Public health policy addressing these risk groups is necessary.
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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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Price J, Asgary R. Women's Health Disparities in Honduras: Indicators and Determinants. J Womens Health (Larchmt) 2011; 20:1931-7. [DOI: 10.1089/jwh.2010.2615] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Joan Price
- Global Health Center, WHO Collaborating Centre in Children's Environmental Health, Mount Sinai School of Medicine, New York, New York
| | - Ramin Asgary
- Global Health Center, WHO Collaborating Centre in Children's Environmental Health, Mount Sinai School of Medicine, New York, New York
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Pimentel AV, Panobianco MS, Almeida AMD, Oliveira ISB. Percepção da vulnerabilidade entre mulheres com diagnóstico avançado do câncer do colo do útero. TEXTO & CONTEXTO ENFERMAGEM 2011. [DOI: 10.1590/s0104-07072011000200006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Estudo descritivo, de abordagem qualitativa, que objetivou compreender a percepção da vulnerabilidade à doença, entre mulheres com diagnóstico avançado do câncer do colo do útero, tendo como referencial, a vulnerabilidade. Participaram doze mulheres que estavam em atendimento ambulatorial hospitalar, para tratamento do câncer cérvico-uterino avançado. Os dados foram coletados por entrevistas e analisados por Análise de Conteúdo. Dos resultados emergiram duas categorias temáticas: Percebendo-se vulnerável na descoberta da doença e Percebendo-se vulnerável na realização do tratamento. Fatores relacionados à cliente, profissionais, serviços, entre outros, tornaram a mulher suscetível aos problemas e danos de saúde, relativos ao câncer cérvico-uterino, exacerbando sua vulnerabilidade à doença. É necessário superar deficiências no modelo de assistência e humanização do atendimento, no grau de compromisso e qualidade das instituições, dos recursos, gerenciamento e monitoramento dos programas de prevenção e detecção do câncer do colo do útero, nos diferentes níveis de atenção.
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Luciani S, Prieto-Lara E, Vicari A. Providing Vaccines Against Human Papillomavirus To Adolescent Girls In The Americas: Battling Cervical Cancer, Improving Overall Health. Health Aff (Millwood) 2011; 30:1089-95. [DOI: 10.1377/hlthaff.2011.0315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Silvana Luciani
- Silvana Luciani ( ) is an adviser on chronic disease prevention and control at the Pan American Health Organization (PAHO), in Washington, D.C
| | | | - Andrea Vicari
- Andrea Vicari is an adviser on immunization in the Comprehensive Family Immunization Project at PAHO
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Suárez Pacheco E. Detección precoz del cáncer de cuello uterino. Nuevas tecnologías: ¿promesas o mejores resultados? Medwave 2010. [DOI: 10.5867/medwave.2010.06.4596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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