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Vimpere L, Sami J, Jeannot E. Cervical cancer screening programs for female sex workers: a scoping review. Front Public Health 2023; 11:1226779. [PMID: 37841741 PMCID: PMC10570451 DOI: 10.3389/fpubh.2023.1226779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/11/2023] [Indexed: 10/17/2023] Open
Abstract
Background Cervical cancer (CC) is the fourth most common neoplasia affecting women worldwide. Female sex workers (FSWs) are among those at highest risk of developing and succumbing to CC. Yet, they are often overlooked in CC screening programs and have limited access to CC healthcare globally. The development of CC screening programs for this high-risk target population is necessary to reduce the global burden of this disease and to reach the World Health Organization's objective of accelerating the elimination of CC. Objective This review summarizes findings on CC screening programs for FSWs that have been implemented worldwide, and assesses their effectiveness and sustainability. Methods A scoping review was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). A literature search was performed on PubMed, Swisscovery, and Google Scholar for studies describing and assessing CC screening programs for FSWs. In addition, targeted searching online Non-Governmental and International Organizations websites identified grey literature. A single reviewer screened titles and abstracts, and extracted data from the research findings. Results The search identified 13 articles published from 1989 to 2021. All implemented programs successfully reached FSWs and provided them with CC screening during the study period. The most effective and sustainable strategies were the Screen and Treat approach, introducing CC screening into existing STI services in drop-in or outreach clinics, HPV-DNA self-sampling, and integrating sex-workers-specific services in public health facilities. Follow-up was deemed the main challenge in providing and enhancing CC healthcare to FSWs with rates of loss to follow-up ranging from 35 to 60%. Conclusion FSWs are often omitted in national CC screening programs. The further development and improvement of CC healthcare, including follow-up systems, for this high-priority target population are imperative.
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Affiliation(s)
- Léa Vimpere
- Global Studies Institute, Université de Genève, Geneva, Switzerland
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Jana Sami
- Gynecology Division, Department of Obstetrics and Gynecology, Geneva University Hospitals, Geneva, Switzerland
| | - Emilien Jeannot
- Faculty of Medicine, Institute of Global Health, Geneva, Switzerland
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Bongaerts THG, Ridder M, Vermeer-Mens JCJ, Plukkel JJ, Numans ME, Büchner FL. Cervical Cancer Screening Among Marginalized Women: A Cross-Sectional Intervention Study. Int J Womens Health 2021; 13:549-556. [PMID: 34135643 PMCID: PMC8197586 DOI: 10.2147/ijwh.s302002] [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] [Received: 01/14/2021] [Accepted: 05/04/2021] [Indexed: 11/23/2022] Open
Abstract
Background Many countries organize population-based cervical cancer screening programs (CSP). In the Netherlands, eligible women are invited by mail. Marginalized women living in unstable conditions and homeless women often fail to receive the invitation letter. These women also experience access barriers to regular healthcare. Consequently, despite presumably being at higher risk of developing cervical cancer due to prevalent risk factors, marginalized women are rarely screened for cervical cancer. The aim of the study was to identify the prevalence of (pre)cancerous abnormalities among marginalized women, and subsequently explore invitation approaches to enhance their screening participation. Methods A cross-sectional intervention study was conducted in Rotterdam, the Netherlands. Between February and May 2019, marginalized women aged 20–60 years were invited to participate in cervical screening. A participant was considered screen-positive when they tested positive for high-risk human papilloma virus (HR-HPV) and showed cytological abnormalities. Data of the study population were compared with regional data of the Dutch CSP. Various invitation approaches were used to recruit women. Results Out of 74 included women, 12 participants (16%) were found screen-positive, against 3.4% in women screened by the Dutch CSP. The prevalence ratio for the study population was 4.4 (95% CI 1.9–8.6) compared with women screened by the Dutch CSP. Using a direct, pro-active approach resulted in participation of 92% of the included women. Conclusion Marginalized women have an increased risk of (pre)cancerous cervical abnormalities in screening, compared with women screened by the Dutch CSP. A direct pro-active approach was the most effective to stimulate screening participation. Enhancement of screening uptake for this population needs special effort.
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Affiliation(s)
- Thomas H G Bongaerts
- Leiden University Medical Center LUMC-Campus the Hague, Department of Public Health and Primary Care, The Hague, the Netherlands
| | - Marlieke Ridder
- Leiden University Medical Center LUMC-Campus the Hague, Department of Public Health and Primary Care, The Hague, the Netherlands.,Municipal Health Service Rotterdam-Rijnmond, Rotterdam, the Netherlands
| | | | | | - Mattijs E Numans
- Leiden University Medical Center LUMC-Campus the Hague, Department of Public Health and Primary Care, The Hague, the Netherlands
| | - Frederike L Büchner
- Leiden University Medical Center LUMC-Campus the Hague, Department of Public Health and Primary Care, The Hague, the Netherlands
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Fiala C, Taher J, Diamandis EP. P4 Medicine or O4 Medicine? Hippocrates Provides the Answer. J Appl Lab Med 2019; 4:108-119. [DOI: 10.1373/jalm.2018.028613] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 02/08/2019] [Indexed: 01/12/2023]
Abstract
Abstract
Background
The term P4 medicine (predictive, preventative, personalized, participatory) was coined by Dr. Leroy Hood of the Institute for Systems Biology to demonstrate his framework to detect and prevent disease through extensive biomarker testing, close monitoring, deep statistical analysis, and patient health coaching.
Methods
In 2017, this group published the results of their “100 Person Wellness Project.” They performed whole genome sequencing and 218 clinical laboratory tests, measured 643 metabolites and 262 proteins, quantified 4616 operational taxonomic units in the microbiome, and monitored exercise in 108 participants for 9 months. The study was also interventional, as members were paired with a coach who gave lifestyle and supplement counseling to improve biomarker levels between each sampling period.
Results
Using this study as a basis, we here analyze the Hippocratic roots and the advantages and disadvantages of P4 medicine. We introduce O4 medicine (overtesting, overdiagnosis, overtreatment, overcharging) as a counterpoint to P4 medicine to highlight the drawbacks, including possible harms and cost.
Conclusions
We hope this analysis will contribute to the discussion about the best use of limited health-care resources to produce maximum benefit for all patients.
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Affiliation(s)
- Clare Fiala
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Jennifer Taher
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Department of Clinical Biochemistry, University Health Network, Toronto, Ontario, Canada
| | - Eleftherios P Diamandis
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Department of Clinical Biochemistry, University Health Network, Toronto, Ontario, Canada
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Tricco AC, Lillie E, Zarin W, O'Brien K, Colquhoun H, Kastner M, Levac D, Ng C, Sharpe JP, Wilson K, Kenny M, Warren R, Wilson C, Stelfox HT, Straus SE. A scoping review on the conduct and reporting of scoping reviews. BMC Med Res Methodol 2016; 16:15. [PMID: 26857112 PMCID: PMC4746911 DOI: 10.1186/s12874-016-0116-4] [Citation(s) in RCA: 803] [Impact Index Per Article: 100.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 01/26/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Scoping reviews are used to identify knowledge gaps, set research agendas, and identify implications for decision-making. The conduct and reporting of scoping reviews is inconsistent in the literature. We conducted a scoping review to identify: papers that utilized and/or described scoping review methods; guidelines for reporting scoping reviews; and studies that assessed the quality of reporting of scoping reviews. METHODS We searched nine electronic databases for published and unpublished literature scoping review papers, scoping review methodology, and reporting guidance for scoping reviews. Two independent reviewers screened citations for inclusion. Data abstraction was performed by one reviewer and verified by a second reviewer. Quantitative (e.g. frequencies of methods) and qualitative (i.e. content analysis of the methods) syntheses were conducted. RESULTS After searching 1525 citations and 874 full-text papers, 516 articles were included, of which 494 were scoping reviews. The 494 scoping reviews were disseminated between 1999 and 2014, with 45% published after 2012. Most of the scoping reviews were conducted in North America (53%) or Europe (38%), and reported a public source of funding (64%). The number of studies included in the scoping reviews ranged from 1 to 2600 (mean of 118). Using the Joanna Briggs Institute methodology guidance for scoping reviews, only 13% of the scoping reviews reported the use of a protocol, 36% used two reviewers for selecting citations for inclusion, 29% used two reviewers for full-text screening, 30% used two reviewers for data charting, and 43% used a pre-defined charting form. In most cases, the results of the scoping review were used to identify evidence gaps (85%), provide recommendations for future research (84%), or identify strengths and limitations (69%). We did not identify any guidelines for reporting scoping reviews or studies that assessed the quality of scoping review reporting. CONCLUSION The number of scoping reviews conducted per year has steadily increased since 2012. Scoping reviews are used to inform research agendas and identify implications for policy or practice. As such, improvements in reporting and conduct are imperative. Further research on scoping review methodology is warranted, and in particular, there is need for a guideline to standardize reporting.
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Affiliation(s)
- Andrea C Tricco
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, 209 Victoria Street, Toronto, ON, M5B 1 W8, Canada. .,Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 6th floor, 155 College St, Toronto, ON, M5T 3 M7, Canada.
| | - Erin Lillie
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, 209 Victoria Street, Toronto, ON, M5B 1 W8, Canada.
| | - Wasifa Zarin
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, 209 Victoria Street, Toronto, ON, M5B 1 W8, Canada.
| | - Kelly O'Brien
- Department of Physical Therapy, University of Toronto, 500 University Avenue, Room 160, Toronto, ON, M5G 1 V7, Canada. .,Institute of Health Policy, Management and Evaluation, University of Toronto, 4th Floor, 155 College St, Toronto, ON, M5T 3 M6, Canada.
| | - Heather Colquhoun
- Department of Occupational Science & Occupational Therapy, University of Toronto, 160-500 University Avenue, Toronto, ON, M5G 1 V7, Canada.
| | - Monika Kastner
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, 209 Victoria Street, Toronto, ON, M5B 1 W8, Canada. .,Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 6th floor, 155 College St, Toronto, ON, M5T 3 M7, Canada.
| | - Danielle Levac
- School of Rehabilitation Science, University of Ottawa, 200 Lees Avenue, Room A120, Ottawa, ON, K1N 6 N5, Canada.
| | - Carmen Ng
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, 209 Victoria Street, Toronto, ON, M5B 1 W8, Canada.
| | - Jane Pearson Sharpe
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, 209 Victoria Street, Toronto, ON, M5B 1 W8, Canada.
| | - Katherine Wilson
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, 209 Victoria Street, Toronto, ON, M5B 1 W8, Canada.
| | - Meghan Kenny
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, 209 Victoria Street, Toronto, ON, M5B 1 W8, Canada.
| | - Rachel Warren
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, 209 Victoria Street, Toronto, ON, M5B 1 W8, Canada.
| | - Charlotte Wilson
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, 209 Victoria Street, Toronto, ON, M5B 1 W8, Canada.
| | - Henry T Stelfox
- Department of Critical Care Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 2 T9, Canada.
| | - Sharon E Straus
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, 209 Victoria Street, Toronto, ON, M5B 1 W8, Canada. .,Department of Medicine, Faculty of Medicine, University of Toronto, 27 Kings College Circle, Toronto, ON, M5S 1A1, Canada.
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