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Kim SH, Park HE. Investigating Factors Influencing the National Cancer Screening Program among Older Individuals in Republic of Korea-Data from the Korea National Health and Nutrition Examination Survey VIII. Healthcare (Basel) 2024; 12:1237. [PMID: 38921351 PMCID: PMC11203246 DOI: 10.3390/healthcare12121237] [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: 05/01/2024] [Revised: 06/07/2024] [Accepted: 06/13/2024] [Indexed: 06/27/2024] Open
Abstract
This study aims to determine the influencing factors of the participation of older individuals aged 65 years and above in South Korea's National Cancer Screening Program (NCSP) using data from the eighth wave (2019-2021) of the Korea National Health and Nutrition Examination Survey (KNHANES VIII), and discuss potential problems and coping strategies. Variables were selected based on Andersen's healthcare utilization model. "Participation in the NSCP" was considered the dependent variable, with independent variables including sociodemographic characteristics (sex, marital status, residence, education level, income level, economic activity, medical coverage type, and private insurance), health conditions (subjective health status, hypertension, and diabetes), and health behaviors (physical activity, monthly alcohol consumption, and current smoking status). The analysis revealed that higher participation rates correlated with being married, having an education level beyond elementary school, being employed, subscribing to private insurance, perceiving oneself as having average or poor health, engaging in physical activity, and not smoking. Sex, residence, income, medical coverage type, hypertension, diabetes, and monthly alcohol consumption were found to be insignificantly correlated. These findings underscore the importance of tailored promotion and health education for older individuals to boost NCSP participation rates, which could ultimately elevate public health standards.
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Affiliation(s)
- Seok Hwan Kim
- Department of Health Information, Dongguk University Wise Campus, 123 Dongdae-ro, Gyeongju-si 38066, Gyeongsangbuk-do, Republic of Korea;
| | - Hyo Eun Park
- Department of Nursing, Suwon Women’s University, 72 Onjeong-ro, Gwonseon-gu, Suwon-si 16632, Gyeonggi-do, Republic of Korea
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Baluwa PC, Moyo RC, Baluwa MA, Nyirenda L. Barriers Associated with Adherence to Cervical Cancer Screening Among Women Living with HIV in Nkhatabay District, Malawi: A Mixed-Methods Study. Int J Womens Health 2024; 16:491-507. [PMID: 38524242 PMCID: PMC10961009 DOI: 10.2147/ijwh.s442522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 03/12/2024] [Indexed: 03/26/2024] Open
Abstract
Background Cervical cancer (CC) incidence among Women Living with HIV (WLHIV) is high compared to the general population of women. As such, the Malawi National CC guideline recommends yearly screening among WLHIV. However, only 15.9% of WLHIV were screened nationally using Visual Inspection with Acetic Acid (VIA) by 2015 and there is no data regarding adherence and barriers to yearly screening. This study assessed adherence levels and associated barriers to yearly Cervical Cancer screening (CCS) among WLHIV. Methods A cross-sectional concurrent mixed-method study was conducted at Nkhatabay District Hospital (NBDH) and Chintheche Rural Hospital (CRH) in Malawi. A sample of 205 WLHIV participated in quantitative strand and in-depth interviews were conducted with 10 health care workers and 10 WLHIV. Quantitative data were analysed using STATA version 16. Pearson's chi-square test and Multivariate logistic regression analysis were performed. P value was set at 0.05. Qualitative data were analysed deductively following six steps of thematic analysis. Results Only 5.4% (n=11) of the participants had been screened as required. Women aged ≥45 had 4 times the odds of being screened for CC compared to ≤30 (OR 4.18, 95% CI 0.65-26.8). WLHIV on ART > 10 years had more than 5 times the odds of being screened (OR 5.9, 95% CI 1.08-33.19) compared with those on ART <3 years. Use of male service providers (p =< 0.001), fear of the VIA procedure (p = <0.001) and lack of interest (p = <0.015) were significant barriers to adherence. Qualitative findings revealed a lack of knowledge regarding CCS protocol and the use of male providers. Conclusion WLHIV face many challenges in accessing CCS and adherence to yearly CCS is very low. There is urgent need for targeted community awareness, scaling up of HPV tests and incorporation of CCS into routine integrated outreach services.
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Affiliation(s)
- Phyllis Chinsamba Baluwa
- School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi
- Nkhatabay District Hospital, Nkhatabay Council, Nkhatabay, Malawi
| | | | | | - Lot Nyirenda
- School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi
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Jolly PE, Junkins A, Aung M. Sociodemographic characteristics, attitudes, and knowledge associated with previous screening for cervical cancer among women in western Jamaica. Infect Agent Cancer 2023; 18:53. [PMID: 37742036 PMCID: PMC10518097 DOI: 10.1186/s13027-023-00537-4] [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: 03/06/2023] [Accepted: 09/19/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND About 90% of new cervical cancer cases and deaths worldwide in 2020 occurred in low- and middle-income countries. This can be attributed to the low rates of cervical cancer screening in these countries. This study was conducted to identify factors associated with lack of cervical cancer screening among women in western Jamaica with the aim to increase screening and decrease cervical cancer risk. METHODS This cross-sectional study assessed associations between previous Pap testing or lack of testing in five years or more, sociodemographic characteristics, attitudes, and knowledge of cervical cancer among women recruited from clinics and community events in the four parishes of western Jamaica. Analyses included chi-square tests, Fisher's exact tests, and logistic regression. RESULTS Of the 223 women included in the study, 109 (48.9%) reported Pap testing five years or more previous to the study. In the multivariate analysis, women from St. James (Odds Ratio [OR]: 3.35, 95% Confidence Interval [CI]: 1.12-9.99), Trelawny (OR: 5.34, 95% CI: 1.23-23.25), and Westmoreland (OR: 3.70, 95% CI: 1.10-12.50) had increased odds of having had Pap test screening compared to women from Hanover. Women ≥ 50 years of age compared to women 18-29 years of age (OR: 6.17, 95% CI: 1.76-21.54), and employed compared to unemployed women (OR: 2.44, 95% CI: 1.15-5.20) had increased odds of Pap test screening. Similarly, women with one (OR: 4.15, 95% CI: 1.06-16.22) or two or more children (OR: 8.43, 95% CI: 2.24-31.63) compared to women with no children had higher odds of screening. Women who were aware, compared to women who were unaware, of the purpose of Pap tests had increased odds of screening (OR: 3.90, 95% CI: 1.55-9.82). Lastly, women who believed Pap tests were painful compared to women who did not, had decreased odds of having had a Pap test (OR: 0.33, 95% CI: 0.16-0.71). CONCLUSIONS Uptake of Pap tests among the women was suboptimal and varied among parishes. Young women and women without children were less likely to have ever been screened. Increased education of the purpose of Pap tests to treat pre-cancer to prevent cancer and minimization of the notion that Pap tests are painful could promote screening among women in this population.
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Affiliation(s)
- Pauline E Jolly
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, 1665 University Blvd, Birmingham, AL, 35233, USA.
| | - Anna Junkins
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, 1665 University Blvd, Birmingham, AL, 35233, USA
| | - Maung Aung
- Epidemiology and Research Unit, Western Regional Health Authority, Montego Bay, Jamaica
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Lulu B, Loha E, Agegnehu A. Factors affecting cervical cancer screening service uptake among clients visiting the ART clinic at Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia: A cross-sectional study. J Cancer Policy 2023; 36:100422. [PMID: 37031920 DOI: 10.1016/j.jcpo.2023.100422] [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: 09/24/2022] [Revised: 02/11/2023] [Accepted: 04/06/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND Annually, around half a million new cases of cervical cancer and 250,000 deaths occur worldwide. It is the second-leading cancerous cause of death after breast cancer among women. Repeated infection and prolonged persistence with human papilloma virus is common among HIV-positive women due to their immune status. A one-visit screen and treat strategy for cervical cancer prevention was instituted in 2010 nationwide in 14 selected hospitals. So, assessing service uptake and associated factors among ART clients is mandatory. METHOD From December 2015 to March 2016 G.C., a cross-sectional study was conducted. An interviewer-administered, semi-structured questionnaire was used to collect data. The data were entered, cleaned, and analyzed using IBM SPSS version 20 software. A statistically significant association of variables was determined based on an adjusted odds ratio with a 95% confidence interval and a p value of 0.05. RESULT Cervical cancer screening service uptake among the 647 interviewed participants was 59%. Study participants accounting for 19% (N = 123) were 18-29 age group, 56.6% (N = 366) were 30-39, and 24.4% (N = 158) were in 40-64 age group. Of 647 participants, 43.7% (N = 283) were illiterate and educated less than secondary level of education, 36.0% (N = 233) had a secondary level of education, and 20.2% (N = 131) had an education above secondary. Being encouraged by others to get screened for cervical cancer (AOR = 1.88, 95% CI: 1.25, 2.82), knowing another woman who got screened, and getting information from the media (AOR = 0.4, 95% CI: 0.27, 0.60) were associated with the uptake of cervical cancer screening. CONCLUSION The uptake of cervical cancer screening among ART clients attending the clinic was not satisfactory. Encouragement to get screened, knowing other screened women, and getting information from the media were important predictors of CCS service uptake. Exploring more information on the attitudes of clients to improve service uptake is mandatory. AVAILABILITY OF DATA AND MATERIAL Raw data supporting this study can be obtained from the corresponding author upon request.
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Affiliation(s)
- Birhanu Lulu
- School of Medical Laboratory Science, College of Medicine and Health Sciences, Hawassa University, Ethiopia.
| | - Eskindir Loha
- School of Public and Environmental Health, College of Medicine and Health Sciences, Hawassa University, Ethiopia.
| | - Asnakech Agegnehu
- Hawassa University Comprehensive Specialized Hospital: Microbiology Unit.
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Choi S, Ismail A, Pappas-Gogos G, Boussios S. HPV and Cervical Cancer: A Review of Epidemiology and Screening Uptake in the UK. Pathogens 2023; 12:pathogens12020298. [PMID: 36839570 PMCID: PMC9960303 DOI: 10.3390/pathogens12020298] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 01/31/2023] [Accepted: 02/09/2023] [Indexed: 02/15/2023] Open
Abstract
Cervical cancer is the fourth most common malignancy in females worldwide, and a leading cause of death in the United Kingdom (UK). The human papillomavirus (HPV) is the strongest risk factor for developing cervical intraepithelial neoplasia and cancer. Across the UK, the national HPV immunisation programme, introduced in 2008, has been successful in protecting against HPV-related infections. Furthermore, the National Health Service (NHS) implemented the cytology-based cervical cancer screening service to all females aged 25 to 64, which has observed a decline in cervical cancer incidence. In the UK, there has been an overall decline in age-appropriate coverage since April 2010. In 2019, the COVID-19 pandemic disrupted NHS cancer screening and immunisation programmes, leading to a 6.8% decreased uptake of cervical cancer screening from the previous year. Engagement with screening has also been associated with social deprivation. In England, incidence rates of cervical cancer were reported to be 65% higher in the most deprived areas compared to the least, with lifestyle factors such as cigarette consumption contributing to 21% of cervical cancer cases. In this article, we provide an update on the epidemiology of cervical cancer, and HPV pathogenesis and transmission, along with the current prevention programmes within the NHS.
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Affiliation(s)
- Sunyoung Choi
- GKT School of Medicine, King’s College London, London SE1 9RT, UK
| | - Ayden Ismail
- GKT School of Medicine, King’s College London, London SE1 9RT, UK
| | - George Pappas-Gogos
- Department of General Surgery, University Hospital of Alexandroupolis, School of Medicine, Democritus University of Thrace, 6th Kilometer, 68100 Alexandroupolis, Greece
| | - Stergios Boussios
- Department of Medical Oncology, Medway NHS Foundation Trust, Windmill Road, Kent, Gillingham ME7 5NY, UK
- Faculty of Life Sciences & Medicine, School of Cancer & Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK
- Kent Medway Medical School, University of Kent, Kent, Canterbury CT2 7LX, UK
- AELIA Organization, 9th Km Thessaloniki—Thermi, 57001 Thessaloniki, Greece
- Correspondence: or or or
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Uchendu I, Hewitt-Taylor J, Turner-Wilson A, Nwakasi C. Knowledge, attitudes, and perceptions about cervical cancer, and the uptake of cervical cancer screening in Nigeria: An integrative review. SCIENTIFIC AFRICAN 2021. [DOI: 10.1016/j.sciaf.2021.e01013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Liegise H, Barmon D, Baruah U, Begum D, Kataki A, Chhangte Z. Reason for improper simple hysterectomy in invasive cervical cancer in Northeast India. J Cancer Res Ther 2021; 18:1564-1568. [DOI: 10.4103/jcrt.jcrt_1005_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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Bhatla N, Singhal S, Saraiya U, Srivastava S, Bhalerao S, Shamsunder S, Chavan N, Basu P, Purandare CN. Screening and management of preinvasive lesions of the cervix: Good clinical practice recommendations from the Federation of Obstetrics and Gynaecologic Societies of India (FOGSI). J Obstet Gynaecol Res 2020; 46:201-214. [PMID: 31814222 DOI: 10.1111/jog.14168] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 11/13/2019] [Indexed: 01/31/2023]
Abstract
In India, there are marked variations in resources for cervical cancer screening. For the first time, resource-stratified screening guidelines have been developed that will be suitable for low middle-income countries with similar diversities. The current article describes the process and outcomes of these resource stratified guidelines for screening and treatment of preinvasive lesions of cervix. Evidence from literature was collated and various guidelines were reviewed by an expert panel. Based on the level of evidence, guidelines were developed for screening by human papillomavirus (HPV) testing, cytology and visual inspection after application of acetic acid (VIA), and management of screen positive lesions in different resource settings. Expert opinion was used for certain country-specific situations. The healthcare system was stratified into two resource settings - good or limited. The mode of screening and treatment for each was described. HPV testing is the preferred method for cervical cancer screening. VIA by trained providers is especially suitable for low resource settings until an affordable HPV test becomes available. Healthcare providers can choose the most appropriate screening and treatment modality. A single visit approach is encouraged and treatment may be offered based on colposcopy diagnosis ('see and treat') or even on the basis of HPV test or VIA results ('screen and treat'), if compliance cannot be ensured. The Federation of Obsterician and Gynaecologists of India Good Clinical Practice Recommendations (FOGSI) GCPR are appropriately designed for countries with varied resource situations to ensure an acceptable cervical cancer prevention strategy.
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Affiliation(s)
- Neerja Bhatla
- All India Institute of Medical Sciences, New Delhi, India
| | - Seema Singhal
- All India Institute of Medical Sciences, New Delhi, India
| | - Usha Saraiya
- Breach Candy, Saifee, Elizabeth & Cumballa Hill Hospitals, Mumbai, India
| | | | | | - Saritha Shamsunder
- Vardhmaan Mahaveer Medical College & Safdarjung Hospital, New Delhi, India
| | | | - Partha Basu
- Early Detection and Prevention Section (EDP)/Screening Group (SCR) International Agency for Research on Cancer, World Health Organization, Lyon, France
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Açucena Vieira Alves S, Schiaveto de Souza A, Weller M, Pires Batiston A. Differential Impact of Education Level, Occupation and
Marital Status on Performance of the Papanicolaou Test among
Women from Various Regions in Brazil. Asian Pac J Cancer Prev 2019; 20:1037-1044. [PMID: 31030471 PMCID: PMC6948916 DOI: 10.31557/apjcp.2019.20.4.1037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 04/01/2019] [Indexed: 11/25/2022] Open
Abstract
Background: In Brazil, little is known regarding the underlying causes of differences among populations regarding socio-economic variables that affect women’s cervical cancer screening behavior. The present study focused on socio-economic variables that affect women’s performance of the Papanicolaou test, comparing two distinct Brazilian populations. Methods: We collected data regarding performance of the Papanicolaou test and socio-economic variables from 559 women in Mato Grosso do Sul (MS), in the Central East region, and 338 women in Paraíba (PB), in the Northeast region of Brazil. Nominal logistic regression modeling was performed to identify independent variables for both groups of data. Results: Of the women interviewed from MS and PB, 116 out of 599 (19.37%) and 94 out of 338 (27.81%), respectively, had not performed the Papanicolaou test within the last three years (p = 0.025). Low educational level characterized 570 (95.16%) and 203 (60.06%) of women from MS and PB, respectively (p = 0.000). Women in PB who had a low educational level and were unemployed had a 2.96-fold (OR = 0.338; 95% CI: 0.121 - 0.939) and 2.40-fold (OR = 0.416; 95% CI: 0.199 - 0.869) lower chance, respectively, to have performed the Papanicolaou test ≥ three times, or once within the last three years (p = 0.029; p = 0.014). The chance of women in MS who did not live in a stable relationship to have performed the test ≥ three times was 1.79-fold (OR = 0.560; 95% CI: 0.348 – 0.901) lower compared to women who reported a stable relationship (p = 0.039). Conclusions: High educational level, employment, and having a stable interpersonal relationship positively associated with performance of the Papanicolaou test among women in PB and MS. Despite having predominantly a low educational level, women in MS performed the Papanicolaou test more frequently than those in PB.
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Affiliation(s)
| | - Albert Schiaveto de Souza
- Institute of Biosciences, Federal University of Mato Grosso do Sul (UFMS), Campo Grande- Mato Grosso do Sul, Brazil
| | - Mathias Weller
- Postgraduate Program in Public Health, State University of Paraíba (UEPB), Campina Grande, Paraíba, Brazil.
| | - Adriane Pires Batiston
- Instituto Integrado de Saúde, Federal University of Mato Grosso do Sul (UFMS), Campo Grande- Mato Grosso do Sul, Brazil
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Musa J, Achenbach CJ, Evans CT, Jordan N, Daru PH, Hou L, Murphy RL, Adewole IF, Simon MA. Association between patient-reported HIV status and provider recommendation for screening in an opportunistic cervical Cancer screening setting in Jos, Nigeria. BMC Health Serv Res 2018; 18:885. [PMID: 30466437 PMCID: PMC6251217 DOI: 10.1186/s12913-018-3700-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 11/08/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Cervical cancer screening (CCS) is an important health service intervention for prevention of morbidity and mortality from invasive cervical cancer. The role of provider recommendation and referral is critical in utilization of this services particularly in settings where screening is largely opportunistic. We sought to understand how patient-reported human immunodeficiency virus (HIV) infection status is associated with provider referral in an opportunistic screening setting. METHODS We performed a cross-sectional analysis of data on a sample of women who had received a CCS at the "Operation Stop" cervical cancer (OSCC) screening service in Jos, Nigeria over a 10-year time period (2006-2016). We used the de-identified records of women who had their first CCS to analyze the association between patient-reported HIV and likelihood of provider-referral at first CCS. We performed descriptive statistics with relevant test of association using Student t-test (t-test) for continuous variables and Pearson chi square or Fisher exact test where applicable for categorical variables. We also used a bivariable and multivariable logistic regression models to estimate the independent association of patient-reported HIV on provider referral. All statistical tests were performed using STATA version 14.1, College Station, Texas, USA. Level of statistical significance was set at 0.05. RESULTS During the 10-year period, 14,088 women had their first CCS. The reported HIV prevalence in the population was 5.0%; 95% CI: 4.6, 5.4 (703/14,088). The median age of women who were screened was 37 years (IQR; 30-45). Women who were HIV infected received more referrals from providers compared to women who were HIV uninfected (68.7% versus 49.2%), p-value < 0.001. Similarly, we found an independent effect of patient-reported HIV infection on the likelihood for provider-referral in the screened sample (aOR = 2.35; 95% CI: 1.95, 2.82). CONCLUSION Our analysis supports the design of health systems that facilitates providers' engagement and provision of necessary counseling for CCS in the course of routine clinical care. The practice of offering recommendation and referrals for CCS to women at high risk of cervical cancer, such as HIV infected women should be supported.
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Affiliation(s)
- Jonah Musa
- Health Sciences Integrated PhD Program, Center for Healthcare Studies, Institute of Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA. .,Center for Global Health, Institute of Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA. .,Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Jos, Plateau State, Nigeria.
| | - Chad J Achenbach
- Center for Global Health, Institute of Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA.,Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Charlesnika T Evans
- Department of Preventive Medicine, Center for Health Care Studies, Global Health, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, IL, USA
| | - Neil Jordan
- Health Sciences Integrated PhD Program, Center for Healthcare Studies, Institute of Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA.,Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, IL, USA.,Department of Psychiatry & Behavioral Science, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Patrick H Daru
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Jos, Plateau State, Nigeria
| | - Lifang Hou
- Center for Global Health, Institute of Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA.,Center for Population Epigenetics, Robert H. Lurie Comprehensive Cancer Center and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Robert L Murphy
- Center for Global Health, Institute of Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA.,Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Isaac F Adewole
- Federal Ministry of Health, Federal Secretariat Complex, Central Business District, Federal Capital, Abuja, Nigeria
| | - Melissa A Simon
- Department of Obstetrics and Gynecology, Preventive Medicine and Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, USA
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Refaei M, Dehghan Nayeri N, Khakbazan Z, Yazdkhasti M, Shayan A. Exploring Effective Contextual Factors for Regular Cervical
Cancer Screening in Iranian Women: A Qualitative Study. Asian Pac J Cancer Prev 2018; 19:533-539. [PMID: 29480997 PMCID: PMC5980946 DOI: 10.22034/apjcp.2018.19.2.533] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background: Adherence to regular screening programs for cervical cancer in Iranian women is not common. The aim of this study was to explore contextual factors influencing behavior and compliance with guidelines. Methods: This qualitative content analysis study was conducted in 2016-2017 in Hamadan city, Iran. Semi-structured in-depth interviews were conducted with 31 participants who were selected purposefully on referring to health centers. Twenty-three were women with various experiences of cervical cancer screening and 8 were health care providers (4 midwives, 1 gynecologist, 1 general practitioner and 1 family health expert). Guba and Lincoln criteria were used for tustworthiness. MAXQDA10 software was employed for data analysis. Results: Four themes were extracted from the data: an opportunity maker system, opportunities to become acquainted, concerns for healthy living, and perception of cancer. Conclusion: The results showed sensitivity of health care providers and their appropriate performance in relation to regular screening behavior of women is very important. Women’s perception of cancer and its curability is another factor with a major effect on screening behavior. Opportunities for people to become acquainted with the Pap smear in a variety of ways and concern for healthy living and the need to have a healthy life to ensure quality of life were also found to be important.
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Affiliation(s)
- Mansoureh Refaei
- Department of Midwifery, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
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Labeit A, Kedir A, Peinemann F. Blood pressure and cholesterol level checks as dynamic interrelated screening examinations. Sci Rep 2017; 7:13235. [PMID: 29038602 PMCID: PMC5643389 DOI: 10.1038/s41598-017-12904-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 09/11/2017] [Indexed: 12/28/2022] Open
Abstract
This study analysed the determinants of screening uptake for blood pressure and cholesterol level checks. Furthermore, it investigated the presence of possible spillover effects from one type of cardiovascular screening to another type of cardiovascular screening. A dynamic random effects bivariate panel probit model with initial conditions (Wooldridge-type estimator) was adopted for the estimation. The outcome variables were the participation in blood pressure and cholesterol level checks by individuals in a given year. The balanced panel sample of 21,138 observations was constructed from 1,626 individuals from the British Household Panel Survey (BHPS) between 1996 and 2008. The analysis showed the significance of past screening behaviour for both cardiovascular screening examinations. For both cardiovascular screening examinations state dependence exist. The study also shows a significant spillover effect of the cholesterol level check on the blood pressure check and vice versa. Also a poorer health status led to a higher uptake for both types of screening examinations. Changes in recommendations have to consider the fact that taking part in one type of cardiovascular screening examination can influence the decision to take part in the other type of cardiovascular screening examination.
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Affiliation(s)
- Alexander Labeit
- School of Health and Related Sciences, University of Sheffield, Sheffield, UK.
- Centre for Applied Health Economics, School of Medicine, Griffith University, Nathan Campus, Australia.
- Menzies Health Institute Queensland, Griffith University, Nathan Campus, Australia.
| | - Abbi Kedir
- Management School, University of Sheffield, Sheffield, UK
| | - Frank Peinemann
- FOM University of Applied Science for Economics & Management, Essen, Germany
- Children's Hospital, University Hospital of Cologne, Cologne, Germany
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Labeit AM, Peinemann F. Determinants of a GP visit and cervical cancer screening examination in Great Britain. PLoS One 2017; 12:e0174363. [PMID: 28379990 PMCID: PMC5381856 DOI: 10.1371/journal.pone.0174363] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 03/08/2017] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE In the UK, women are requested to attend a cervical cancer test every 3 years as part of the NHS Cervical Screening Programme. This analysis compares the determinants of a cervical cancer screening examination with the determinants of a GP visit in the same year and investigates if cervical cancer screening participation is more likely for women who visit their GP. METHODS A recursive probit model was used to analyse the determinants of GP visits and cervical cancer screening examinations. GP visits were considered to be endogenous in the cervical cancer screening examination. The analysed sample consisted of 52,551 observations from 8,386 women of the British Household Panel Survey. RESULTS The analysis showed that a higher education level and a worsening self-perceived health status increased the probability of a GP visit, whereas smoking decreased the probability of a GP visit. GP visits enhanced the uptake of a cervical cancer screening examination in the same period. The only variables which had the same positive effect on both dependent variables were higher education and living with a partner. The probability of a cervical cancer screening examination increased also with previous cervical cancer screening examinations and being in the recommended age groups. All other variables had different results for the uptake of a GP visit or a cervical cancer screening examination. CONCLUSIONS Most of the determinants of visiting a GP and cervical cancer screening examination differ from each other and a GP visit enhances the uptake of a smear test.
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Affiliation(s)
| | - Frank Peinemann
- FOM University of Applied Science for Economics & Management, Essen, Germany
- Children's Hospital, University Hospital of Cologne, Cologne, Germany
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Labeit A, Peinemann F. Breast and cervical cancer screening in Great Britain: Dynamic interrelated processes. HEALTH ECONOMICS REVIEW 2015; 5:32. [PMID: 26487452 PMCID: PMC4615931 DOI: 10.1186/s13561-015-0065-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 10/07/2015] [Indexed: 06/05/2023]
Abstract
No previous analysis has investigated the determinants of screening uptake for breast and cervical cancer screening for possible spillover effects from one type of screening examination to the other type of screening examination with a dynamic bivariate panel probit model. For our analysis, we used a dynamic random effects bivariate panel probit model with initial conditions (Wooldridge-type estimator) and dependent variables were the participation of breast and cervical cancer screening in the recent year. The balanced panel sample consisted of 844 women from the British Household Panel Survey (BHPS) from the time period 1992 to 2008. Our analysis showed the high relevance of past screening behaviour and the importance of state dependency for the same and the other type of cancer screening examinations even after controlling for covariates and unobserved heterogeneity. The uptake for breast and cervical cancer screening was higher when the same screening examination was done one or three years earlier. This result is in accordance with the medical screening programmes in Great Britain. With regard to breast and cervical cancer screening positive spillover effects existed between screening examinations in the third order lags. Women with a previous visit to a general practitioner and individuals in the recommended age groups had a higher uptake for breast and cervical cancer screening. Other socioeconomic and health related variables had non-uniform results in both screening examinations. Promoting the uptake of one female prevention activity could also enhance the uptake of the other prevention activity.
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Affiliation(s)
- Alexander Labeit
- School of Health and Related Sciences, Regent Court, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, UK.
| | - Frank Peinemann
- FOM University of Applied Science for Economics & Management, Leimkugelstr. 6, 45141, Essen, Germany.
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Tay K, Tay SK, Tesalona KC, Rashid NMR, Tai EYS, Najib SJM. Factors affecting the uptake of cervical cancer screening among nurses in Singapore. Int J Gynaecol Obstet 2015; 130:230-4. [PMID: 26032624 DOI: 10.1016/j.ijgo.2015.03.037] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Revised: 03/03/2015] [Accepted: 05/11/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To identify factors other than socioeconomic status that influence participation in cervical cancer screening. METHODS A prospective, questionnaire-based, cross-sectional study was conducted among all female nurses working at Singapore General Hospital, Singapore, between November 1 and December 15, 2013. Characteristics assessed included age, knowledge score (0-10, on the basis of 10 true-or-false statements), perceived risk of cervical cancer, and health facility use. RESULTS Among 2000 nurses, 1622 (81.1%) responded. The mean knowledge score was 4.70±1.76. Among 1593 nurses who reported on self-perception of risk, 97 (6.1%) reported high risk, 675 (42.4%) reported low risk, and 821 (51.5%) reported uncertainty. Of the 815 nurses reporting on their history of screening, 344 (42.2%) were screened regularly, 103 (12.6%) underwent opportunistic screening, and 368 (45.2%) had never undergone screening. The likelihood of screening was increased among women aged 35-4years, those who had recent experience of medical screening, those who had recently had a specialist consultation, or those who had recently had a consultation with a gynecologist (P<0.001 for all). Nurses undergoing regular screening reported positive effects of a doctor's recommendation, husband's encouragement, people talking about screening, and people close to the respondent undergoing screening. CONCLUSION Advocacy and herd signaling positively influenced the cervical cancer screening rate.
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Affiliation(s)
- Kaijun Tay
- Department of Obstetrics and Gynecology, Singapore General Hospital, Singapore
| | - Sun K Tay
- Department of Obstetrics and Gynecology, Singapore General Hospital, Singapore.
| | | | - Nadia M R Rashid
- Department of Obstetrics and Gynecology, Singapore General Hospital, Singapore
| | - Esther Y S Tai
- Department of Obstetrics and Gynecology, Singapore General Hospital, Singapore
| | - Sitti J M Najib
- Department of Obstetrics and Gynecology, Singapore General Hospital, Singapore
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Antic LG, Vukovic DS, Vasiljevic MD, Antic DZ, Aleksopulos HG. Differences in risk factors for cervical dysplasia with the applied diagnostic method in Serbia. Asian Pac J Cancer Prev 2014; 15:6697-701. [PMID: 25169511 DOI: 10.7314/apjcp.2014.15.16.6697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the etiology of cervical cancer not only HPV infection is important, but also other factors such as demographic influences and sexual and reproductive health attitudes, as well as others related to preventive measure usage (or non usage). The aim of this study was to examine factors associated with cervical dysplasia in asymptomatic women who were examined by routine cytology and cervical biopsy for early detection of cervical cancer. MATERIALS AND METHODS Socio-demographic and other characteristics were obtained from medical files of 85 examinees with pathologic cytologic findings (Pap test) and histopathologic (HP) findings after biopsy. RESULTS According to the Pap test result, a greater probability for development of cervical dysplasia was noted with examinees having a larger number of sexual partners (OR= 5.01, 95% CI 1.04-24.10), and those who are afraid of the Pap finding. Risk factors for development of cervical dysplasia according to the bioptic finding were early beginning with sexual activities, presence of any STD in personal medical history and fear of the Pap test finding. CONCLUSIONS The only risk factor found to be important for both methods was fear of the Pap testing finding.
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Affiliation(s)
- Ljiljana Gojko Antic
- Department for Medical Nurses-Midwives, College of Health Studies in Cuprija, Cuprija, Serbia E-mail :
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Labeit A, Peinemann F, Baker R. Utilisation of preventative health check-ups in the UK: findings from individual-level repeated cross-sectional data from 1992 to 2008. BMJ Open 2013; 3:e003387. [PMID: 24366576 PMCID: PMC3884617 DOI: 10.1136/bmjopen-2013-003387] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 11/06/2013] [Accepted: 11/07/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To analyse and compare the determinants of screening uptake for different National Health Service (NHS) health check-ups in the UK. DESIGN Individual-level analysis of repeated cross-sectional surveys with balanced panel data. SETTING The UK. PARTICIPANTS Individuals taking part in the British Household Panel Survey (BHPS), 1992-2008. OUTCOME MEASURE Uptake of NHS health check-ups for cervical cancer screening, breast cancer screening, blood pressure checks, cholesterol tests, dental screening and eyesight tests. METHODS Dynamic panel data models (random effects panel probit with initial conditions). RESULTS Having had a health check-up 1 year before, and previously in accordance with the recommended schedule, was associated with higher uptake of health check-ups. Individuals who visited a general practitioner (GP) had a significantly higher uptake in 5 of the 6 health check-ups. Uptake was highest in the recommended age group for breast and cervical cancer screening. For all health check-ups, age had a non-linear relationship. Lower self-rated health status was associated with increased uptake of blood pressure checks and cholesterol tests; smoking was associated with decreased uptake of 4 health check-ups. The effects of socioeconomic variables differed for the different health check-ups. Ethnicity did not have a significant influence on any health check-up. Permanent household income had an influence only on eyesight tests and dental screening. CONCLUSIONS Common determinants for having health check-ups are age, screening history and a GP visit. Policy interventions to increase uptake should consider the central role of the GP in promoting screening examinations and in preserving a high level of uptake. Possible economic barriers to access for prevention exist for dental screening and eyesight tests, and could be a target for policy intervention. TRIAL REGISTRATION This observational study was not registered.
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Affiliation(s)
- Alexander Labeit
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Frank Peinemann
- Children's Hospital, University of Cologne, Cologne, Germany
| | - Richard Baker
- Department of Health Sciences, University of Leicester, Leicester, UK
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