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Makioka D, Inada M, Awano M, Saito E, Shinoda T, Abe S, Yoshimura T, Müller M, Sasagawa T, Ito E. Quantification of HPV16 E7 Oncoproteins in Urine Specimens from Women with Cervical Intraepithelial Neoplasia. Microorganisms 2024; 12:1205. [PMID: 38930587 PMCID: PMC11205804 DOI: 10.3390/microorganisms12061205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/03/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
We present the validity of using an ultrasensitive enzyme-linked immunosorbent assay (ELISA) for quantifying high-risk human papillomavirus (HPV) 16 E7 oncoproteins in urine specimens as a noninvasive method of analyzing the oncogenic activity of HPV. Some reports claim that the oncogenic activity of HPV is a more relevant clinical indicator than the presence of HPV DNA for estimating malignant potential. In the present study, urine containing HPV16 and related types were selected by uniplex E6/E7 polymerase chain reaction and classified according to the pathologic diagnosis of cervical intraepithelial neoplasia (CIN) in cervical biopsy specimens. Our ultrasensitive ELISA was able to detect attomole levels of HPV16 E7 oncoproteins, and it detected HPV16-positive SiHa cells at >500 cells/mL without detecting HPV18-positive cells. Our ELISA results showed E7 oncoproteins in 80% (4/5) of urine specimens from women with HPV16-positive CIN1, 71% (5/7) of urine specimens from CIN2 patients, and 38% (3/8) of urine specimens from CIN3 patients. Some urine specimens with undetectable E7 oncoproteins were thought to be negative for live HPV 16-positive cells or in an inactivated state of infection. These results provide the basis for assessing oncogenic activity by quantifying E7 oncoproteins in patient urine.
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Affiliation(s)
- Daiki Makioka
- Department of Biology, Waseda University, Shinjuku, Tokyo 162-8480, Japan; (D.M.); (M.I.); (M.A.); (E.S.); (T.S.); (S.A.)
| | - Mikio Inada
- Department of Biology, Waseda University, Shinjuku, Tokyo 162-8480, Japan; (D.M.); (M.I.); (M.A.); (E.S.); (T.S.); (S.A.)
| | - Masayuki Awano
- Department of Biology, Waseda University, Shinjuku, Tokyo 162-8480, Japan; (D.M.); (M.I.); (M.A.); (E.S.); (T.S.); (S.A.)
| | - Ema Saito
- Department of Biology, Waseda University, Shinjuku, Tokyo 162-8480, Japan; (D.M.); (M.I.); (M.A.); (E.S.); (T.S.); (S.A.)
| | - Takuya Shinoda
- Department of Biology, Waseda University, Shinjuku, Tokyo 162-8480, Japan; (D.M.); (M.I.); (M.A.); (E.S.); (T.S.); (S.A.)
| | - Satoko Abe
- Department of Biology, Waseda University, Shinjuku, Tokyo 162-8480, Japan; (D.M.); (M.I.); (M.A.); (E.S.); (T.S.); (S.A.)
| | - Teruki Yoshimura
- School of Pharmaceutical Sciences, Health Sciences University of Hokkaido, Tobetsu 061-0293, Hokkaido, Japan;
| | - Martin Müller
- Tumorvirus-Specific Vaccination Strategies, Deutsche Krebsforschungszentrum (DKFZ), 69120 Heidelberg, Germany;
| | - Toshiyuki Sasagawa
- Department of Obstetrics and Gynecology, Kanazawa Medical University, Uchinada 920-0293, Ishikawa, Japan
| | - Etsuro Ito
- Department of Biology, Waseda University, Shinjuku, Tokyo 162-8480, Japan; (D.M.); (M.I.); (M.A.); (E.S.); (T.S.); (S.A.)
- Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
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Stuart G, D'Lima D. Perceived barriers and facilitators to attendance for cervical cancer screening in EU member states: a systematic review and synthesis using the Theoretical Domains Framework. Psychol Health 2021; 37:279-330. [PMID: 34121540 DOI: 10.1080/08870446.2021.1918690] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIMS To identify and synthesise peer-reviewed, published literature reporting perceived barriers and facilitators associated with cervical cancer screening attendance in EU member states with organised population-based screening programmes. METHODS Quantitative and qualitative studies reporting perceived barriers/facilitators to attendance for cervical cancer screening were searched for in databases Embase, HMIC, Medline and PsycInfo. Data were extracted and deductively coded to the Theoretical Domains Framework domains and inductive thematic analysis within domains was employed to identify specific barriers or facilitators to attendance for cervical cancer screening. RESULTS 38 studies were included for data extraction. Five theoretical domains ['Emotion' (89% of the included studies), 'Social influences' (79%), 'Knowledge' (76%), 'Environmental Context and Resources' (74%) and 'Beliefs about Consequences' (68%)] were identified as key domains influencing cervical cancer screening attendance. CONCLUSION Five theoretical domains were identified as prominent influences on cervical cancer screening attendance in EU member states with organised population-based screening programmes. Further research is needed to identify the relative importance of different influences for different sub-populations and to identify the influences that are most appropriate and feasible to address in future interventions.
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Affiliation(s)
- Gabriella Stuart
- Centre for Behaviour Change, Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Danielle D'Lima
- Centre for Behaviour Change, Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Australian women's cervical cancer screening attendance as a function of screening barriers and facilitators. Soc Sci Med 2018; 220:396-402. [PMID: 30529797 DOI: 10.1016/j.socscimed.2018.11.038] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 10/16/2018] [Accepted: 11/26/2018] [Indexed: 01/12/2023]
Abstract
RATIONALE Cervical cancer screening registry data indicate that 43% of eligible Australian women did not screen in the latest reporting period (2014-2015). However, few prior empirical studies have examined whether the screening barriers and facilitators experienced by women can affect their screening attendance. Such information is required to inform the development of future tailored health promotion strategies. OBJECTIVE This study examined whether the cervical cancer screening barriers and facilitators identified by women were related to their screening history, from November 2015 and January 2016. At this time, Australian women typically undertook a Pap test every two years. They were deemed overdue for screening if they have not screened in the past 27 months (i.e., overdue by more than three months). METHOD In this study, a large sample (N = 338) of women were asked about their screening history including screening status (i.e., up-to-date vs. overdue) and prior screening (i.e., never screened vs. screened), and the psychological and practical screening barriers or facilitators they had experienced. RESULTS Logistic regression analysis indicated that screening status was related to a greater number of psychological barriers, but not practical barriers or facilitators. In contrast, prior screening was related to more practical and psychological screening barriers and fewer practical facilitators, but not psychological facilitators. Some individual psychological screening barriers (e.g., anxiety, embarrassment), practical barriers (e.g., lack of time) and practical facilitators (e.g., low cost of test) were related to women's screening status and prior screening. CONCLUSIONS Results suggest that addressing practical cervical cancer screening facilitators (e.g., reminder prompts) and psychological screening barriers may help to optimize screening attendance in women who have never screened or are overdue for cervical cancer screening.
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Charlie AM, Gao Y, Heller SL. What Do Patients Want to Know? Questions and Concerns Regarding Mammography Expressed Through Social Media. J Am Coll Radiol 2017; 15:1478-1486. [PMID: 29221997 DOI: 10.1016/j.jacr.2017.09.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 08/17/2017] [Accepted: 09/10/2017] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of this project is to identify questions and concerns patients have regarding breast cancer screening mammography to establish priorities in patient education and health care communication. METHODS A content analysis of posted questions (June 2010 to February 2017) containing the keywords mammogram and mammography was conducted on the social media question and answer website Quora (Quora Inc, Mountainview, California). Question topic, responses, and number of views were recorded. Comparisons were made by respondent type (medical professional or nonmedical professional) for screening recommendations and accompanying evidence. Descriptive statistics were employed to summarize the results. RESULTS Overall, 197,620 views of mammography-related questions were identified, focused on 51 questions and 172 responses (51 of 172 [29.7%] by medical professionals [n = 25]; 121 of 172 [70.3%] by nonmedical professionals [n = 121]). Mammographic efficacy (16 of 51 [31.4%]) and screening guidelines (10 of 51 [19.6%]) were the most frequently queried topics. Overall, the majority of respondents were supportive of screening mammography. Most medical professionals recommended screening mammography starting at age 40, even after revisions in guidelines. Among nonmedical professionals, 4 of 22 (18.2%) were against screening mammography with less consensus regarding appropriate age of initial screen. Health society websites and journal articles were the most commonly referenced sources among medical and nonmedical professionals, respectively. CONCLUSION A considerable interest in screening mammography guidelines and mammographic efficacy exists among users who seek health information on a social media question and answer website. Awareness of such platforms allows a unique opportunity for targeted health education and dissemination of accurate information, which may be able to reach a potentially untapped or hard-to-reach patient population.
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Affiliation(s)
- Abbas M Charlie
- New York University Langone Hospital, Brooklyn, New York; A.T. Still University School of Health Sciences, Mesa, Arizona
| | - Yiming Gao
- Department of Radiology, New York University School of Medicine, New York, New York
| | - Samantha L Heller
- Department of Radiology, New York University School of Medicine, New York, New York.
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Abstract
Studies among health professionals indicate that existing health information programmes directed to the public do not have the desired effect on people’s interest in healthier living. It is unclear to what extent the public’s lack of health knowledge and low awareness of health issues are the result of poor communication skills and difficulties in interpreting the available information. An abundant flow of information alone will not fill this knowledge gap, as knowledge is always both a personal and a mental resource. Therefore, people’s understanding and outlook must be considered in the light of their mental capacity and the characteristics of their learning process. The impact of both socioeconomic and cognitive factors on the convictions, attitudes and behaviours of the intended target groups must be taken into consideration during the planning phase of health information programmes.
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Affiliation(s)
- M. Ginman
- Department of Information Studies, Åbo Akademi University, Tavastgatan 13, 20500 Åbo, Finland,
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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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Christian T, Guell C. Knowledge and Attitudes of Cervical Cancer Screening Among Caribbean Women: A Qualitative Interview Study From Barbados. Women Health 2015; 55:566-79. [PMID: 25833319 DOI: 10.1080/03630242.2015.1022816] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The purpose of this study was to explore Barbadian women's attitudes toward and knowledge of routine cervical cancer screening (Pap tests). We conducted semi-structured individual interviews with fourteen female patients between the ages of 20 and 60 years who attended a selected public clinic in Barbados in May and June 2013. Interviews were audio-recorded with participants' consent. The interviews were then transcribed verbatim and, using thematic content analysis, indexed and coded inductively for emerging similar themes. We identified four themes: (1) women had poor knowledge of the purpose of Pap tests. The most frequently occurring misconception was that the test was for the detection of sexually transmitted infections. (2) The women displayed limited cervical cancer awareness. (3) Health professionals were identified by the women as the main driving force behind women taking up screening. (4) The screening procedure was perceived as painful, but women's overriding attitude was that screening was necessary. These findings suggest that Barbadian women would benefit from focused health education efforts surrounding cervical cancer screening to eradicate the misconception that the purpose of the Pap test is the detection of sexually transmitted diseases.
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Affiliation(s)
- Trudy Christian
- a Public Health Group, Faculty of Medical Sciences , University of the West Indies , Cave Hill Campus, Bridgetown , Barbados
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Labeit A, Peinemann F, Kedir A. Cervical cancer screening service utilisation in UK. Sci Rep 2014; 3:2362. [PMID: 23917486 PMCID: PMC3734438 DOI: 10.1038/srep02362] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 07/08/2013] [Indexed: 11/10/2022] Open
Abstract
This study investigates empirically how past screening behaviour, individual and household characteristics affect the current uptake of cervical cancer screening in UK. For the conceptual framework, we use a modified Grossman model which is extended for non-economic factors. A dynamic version of a random effects panel probit model with initial conditions is estimated on the balanced sub-sample of the data. The analysis sample is restricted to women of age 16 and older and grouped into different age categories with respect to the NHS Cervical Screening Programme (NHSCSP). As dataset a balanced panel data of 857 women with 11,998 observations from the British Household Panel Study (BHPS) for the period from 1992 to 2008 is used for the analysis. Results suggest show that previous screening uptake, age, partner status, employment status and a previous GP visit have a significant influence on the likelihood of the uptake of cervical cancer screening.
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Affiliation(s)
- Alexander Labeit
- Department of Health Sciences, University of Leicester, Leicester, UK.
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Sadler L, Albrow R, Shelton R, Kitchener H, Brabin L. Development of a pre-notification leaflet to encourage uptake of cervical screening at first invitation: a qualitative study. HEALTH EDUCATION RESEARCH 2013; 28:793-802. [PMID: 23111151 DOI: 10.1093/her/cys103] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Cervical screening attendance among women aged 25-29 years in England is lower than at older ages. There is some evidence that pre-notification leaflets motivate women who have not yet considered their response to a health intervention. We aimed to identify key information to motivate young women at their first cervical screening invitation. Six focus groups were conducted, five with young women aged 17-25 registered with a General Practice in Manchester, UK, and one with Practice nurses. Some women took part in two further groups to discuss leaflet design. There was low awareness of the purpose or procedures of cervical screening, and most women were de-motivated by reports of bad experiences. Some intended to be screened, but not immediately after invitation. Screening was viewed as a test for a cancer that affected older women. Since none of the participants believed that they had cervical cancer, screening seemed unnecessary. We conclude that the perception that screening is unimportant when you are young needs to be challenged. Women also need to be better informed of screening procedures. A pre-notification leaflet incorporating key information was designed and will be tested in a randomized trial of complex interventions within the routine cervical screening programme.
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Affiliation(s)
- Laura Sadler
- Academic Unit of Obstetrics and Gynaecology, School of Cancer and Enabling Sciences, University of Manchester, Manchester M13 9WL, UK and Robert Darbishire General Practice, Rusholme, Manchester M14 5NP, UK
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Armstrong N, James V, Dixon-Woods M. The role of primary care professionals in women's experiences of cervical cancer screening: a qualitative study. Fam Pract 2012; 29:462-6. [PMID: 22090193 DOI: 10.1093/fampra/cmr105] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The UK Cervical Screening Programme, delivered mostly through primary care, commands impressive levels of public support. However, considerable evidence suggests that women find the experience of screening problematic. OBJECTIVE To investigate this tension using women's accounts of cervical screening, with a view to informing practice to better meet their needs. METHODS A qualitative interview study with 34 participants focussed on their experiences and understandings of cervical cancer screening in the UK. Analysis was based on the constant comparative method. RESULTS The highly intimate and personal nature of the test is challenging, and many women report unsatisfactory experiences. Problematic issues include: embarrassment and discomfort (sometimes severe) in exposing an intimate and personal part of their body; surrendering control and finding the test painful, uncomfortable and personally threatening. Though there is an important role for primary health care professionals in easing discomfort and facilitating positive experiences, women often report feeling disappointed with how the procedure is conducted. Women suggest that practitioners' attempts to normalize the interaction and maintain a degree of detachment could have the perverse effect of making them feel more uncomfortable and that more personalization would be welcome. CONCLUSIONS This work identifies the ways in which women may find personal engagement with cervical screening difficult and demonstrates the important role of primary care practitioners in contributing to women's experiences of the encounter. We draw on Erving Goffman's work on the 'interaction order' to explain some of the problems reported by women and to help inform good practice in primary care.
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Affiliation(s)
- Natalie Armstrong
- Department of Health Sciences, University of Leicester, Leicester, UK.
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Tribe C, Webb J. Avoiding piecemeal research on participation in cervical cancer screening: the advantages of a social identity framework. Health Expect 2012; 17:453-65. [PMID: 22646802 DOI: 10.1111/j.1369-7625.2012.00779.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Cervical cancer screening research has predominantly focused on one type of participation, namely compliance with medical recommendations, and has largely ignored other types of participation. While there is some research that has taken a different approach, findings in this research area are not well integrated under a theoretical framework. OBJECTIVE The aim of this study is to show how consideration of a broader definition of participation and better integration of the theoretical conceptualization of participation in cervical cancer screening are both possible and desirable to enable a better understanding of women's experiences of cervical cancer screening specifically and to improve women's health generally. MAIN CONCLUSION It is suggested that alternative types of participation in cervical cancer screening warrant further investigation and that a social identity theoretical approach offers one way of integrating such conceptualizations of participation. The paper also argues for more explicit consideration of the role of social processes and of the variables, such as power, social identity and relational justice, which are involved in participation in cervical cancer screening.
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Affiliation(s)
- Candice Tribe
- School of Psychology, Deakin University, Melbourne, Vic., Australia
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Bang JY, Yadegarfar G, Soljak M, Majeed A. Primary care factors associated with cervical screening coverage in England. J Public Health (Oxf) 2012; 34:532-8. [PMID: 22518028 DOI: 10.1093/pubmed/fds019] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The National Health Service Cervical Screening Programme was established to decrease the incidence and mortality of cervical cancer in England. METHODS To identify socioeconomic and general practice factors associated with cervical screening coverage in England, a national cross-sectional study was conducted using data on 26 497 476 female patients registered with 7970 practices in 152 English primary care trusts (PCTs). The 2008-09 data on cervical screening coverage rates from the quality and outcomes framework (QOF) database were used with data on QOF indicators, staffing levels and socioeconomic status. RESULTS The mean cervical screening coverage rate was 78.5% at the PCT level and 83.5% at the practice level. At both levels, cervical screening coverage was significantly negatively associated with the index of multiple deprivation score, percentage of female patients aged 25-49 years and percentage of ethnic minority patients. Also, at the practice level, the percentage of female patients aged 50-64 years, overall QOF score and records and information score were significantly positively associated with cervical screening coverage. CONCLUSIONS Cervical screening coverage was significantly lower in PCTs and practices serving higher percentages of younger-aged women, non-Caucasian individuals and those living in socioeconomic deprivation. It is therefore important to adopt strategies to improve cervical screening coverage in these groups.
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Affiliation(s)
- Ji Young Bang
- Department of Primary Care & Public Health, Imperial College London, London W6 8RP, UK.
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Mather T, McCaffery K, Juraskova I. Does HPV vaccination affect women's attitudes to cervical cancer screening and safe sexual behaviour? Vaccine 2012; 30:3196-201. [PMID: 22425789 DOI: 10.1016/j.vaccine.2012.02.081] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Revised: 02/23/2012] [Accepted: 02/29/2012] [Indexed: 10/28/2022]
Abstract
The Human Papillomavirus (HPV) vaccine has the potential to greatly reduce the incidence of cervical cancer by protecting against HPV infections responsible for 70% of cervical cancer diagnoses. However, preliminary research has indicated that women vaccinated against HPV may be less likely to undergo cervical cancer screening and engage in safe sexual behaviour. The aim of the current study was to investigate whether vaccinated and unvaccinated women differ in their (i) knowledge of cervical screening guidelines, (ii) perceived vulnerability to cervical cancer, (iii) cervical screening intentions and uptake, and (iv) attitudes to and engagement in safe sexual behaviour. Participants were 193 female university students (119 vaccine recipients and 74 vaccine non-recipients) who completed online self-report questionnaires. Of all the assessed outcomes, attitudes to safe sexual behaviour were the only significant findings related to vaccination status (p<.001), such that vaccinated women held more positive attitudes to practicing safe sexual behaviour. Less than 5% of participants correctly identified screening guidelines. These findings do not support previous research concluding vaccination could have a detrimental impact on screening and sexual behaviour. Importantly, results highlight poor awareness of screening guidelines, poor levels of consistent condom use (50%) amongst those sexually active, and low uptake of screening (42%) amongst those eligible to be screened. Further research needs to specifically address young women's gaps in knowledge by developing initiatives promoting cervical screening.
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Affiliation(s)
- Tanya Mather
- Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, The University of Sydney, NSW, Australia
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Armstrong N, Eborall H. The sociology of medical screening: past, present and future. SOCIOLOGY OF HEALTH & ILLNESS 2012; 34:161-176. [PMID: 22369578 DOI: 10.1111/j.1467-9566.2011.01441.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Medical screening raises fundamental issues for sociological inquiry, but at present a well-developed sociology of medical screening is lacking. This special issue on the sociology of screening brings together an exciting collection of new work that tackles medical screening from a variety of theoretical and methodological approaches. In this opening paper, we begin by explaining what we mean by screening, and why we believe screening merits sociological attention. Secondly, we reflect on the sociology of screening to date and provide an introduction for those new to this area. We then provide an overview of the papers in this collection, highlighting links and contrasts between papers. We conclude by reflecting on sociology's potential contribution to wider debates about screening, and propose future research directions.
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Affiliation(s)
- Natalie Armstrong
- Department of Health Sciences, University of Leicester, Leicester, LE1 7RH, UK.
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Juraskova I, Butow P, Bonner C, Robertson R, Sharpe L. Sexual adjustment following early stage cervical and endometrial cancer: prospective controlled multi-centre study. Psychooncology 2011; 22:153-9. [PMID: 21971959 DOI: 10.1002/pon.2066] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2010] [Revised: 08/08/2011] [Accepted: 08/08/2011] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The primary aim of this study was to investigate objective and subjective aspects of sexual adjustment for women with early stage cervical and endometrial cancer during the first 6 months post-treatment, compared to women with benign and pre-invasive gynaecological conditions. 'Objective' aspects of sexual function were operationalised as the frequency of sexual activity and 'subjective' aspects as the perceived quality of sexual interactions. METHOD This multi-centre controlled study compared sexual outcomes of women treated for early stage cervical and endometrial cancer (n = 53) with (i) benign gynaecological patients (n = 60), as a comparison group for the physical effects of major pelvic surgery, and (ii) pre-invasive cancer patients (n = 52), as a comparison group for the emotional effect of the perceived threat of cancer. All patients were assessed at baseline and at 6 months follow-up using standardised measures of objective and subjective aspects of sexual function, overall satisfaction with sexual life, relationship satisfaction and psychological distress. RESULTS Despite experiencing treatment-related physical changes, women with early stage cervical and endometrial cancer did not report more severe or longer-lasting sexual sequelae than the benign or pre-invasive groups. There were no significant differences between the three groups or changes over time for the objective, subjective or overall measures of sexual function, controlling for age, psychological distress and relationship satisfaction. CONCLUSION The current findings suggest that early stage cervical and endometrial cancer patients fare as well as benign and pre-invasive cancer groups in terms of sexual adjustment over the 6 months post-treatment.
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Affiliation(s)
- Ilona Juraskova
- Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, University of Sydney, NSW, Australia.
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LOGAN L, MCILFATRICK S. Exploring women's knowledge, experiences and perceptions of cervical cancer screening in an area of social deprivation. Eur J Cancer Care (Engl) 2011; 20:720-7. [DOI: 10.1111/j.1365-2354.2011.01254.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Flanagan SM, Wilson S, Luesley D, Damery SL, Greenfield SM. Adverse outcomes after colposcopy. BMC Womens Health 2011; 11:2. [PMID: 21251278 PMCID: PMC3034683 DOI: 10.1186/1472-6874-11-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Accepted: 01/20/2011] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Colposcopy is an essential part of the National Health Service Cervical Screening Programme (NHSCSP). It is used for both diagnosis and treatment of pre-cancerous cells of the cervix. Despite colposcopy being a commonly performed and relatively invasive procedure, very little research has explored the potential long-term impacts of colposcopic examination upon patient quality of life.The aim of this study is to investigate and quantify any potential reduction in women's quality of life following a colposcopy procedure. More specifically, the degree of female sexual dysfunction and the excess risk of adverse events in those undergoing colposcopy will be explored. If such risks are identified, these can be communicated to women before undergoing colposcopy. It will also assist in identifying whether there are particular sub-groups at greater risk and if so, this may lead to a re-evaluation of current recommendations concerning colposcopically directed treatments. METHODS/DESIGN Cohort study using postal surveys to assess sexual function and quality of life in women who have attended for colposcopy (cases), compared with those who have not attended colposcopy (controls). The prevalence and excess risk of female sexual dysfunction will be determined. Logistic regression will identify the predictors of adverse outcomes. DISCUSSION There are more than 400,000 colposcopy appointments each year in England, of which 134,000 are new referrals. There is some evidence that there may be long-term implications for women treated under colposcopy with respect to adverse obstetric outcomes, persisting anxiety, increased rates of sexual dysfunction and reduced quality of life. Reliably establishing whether such adverse outcomes exist and the excess risk of adverse events will facilitate informed decision-making and patient choice.
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Affiliation(s)
- Sarah M Flanagan
- Department of Primary Care Clinical Sciences, The University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Sue Wilson
- Department of Primary Care Clinical Sciences, The University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - David Luesley
- Department of Primary Care Clinical Sciences, The University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Sarah L Damery
- Department of Primary Care Clinical Sciences, The University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Sheila M Greenfield
- Department of Primary Care Clinical Sciences, The University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
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Waller J, Bartoszek M, Marlow L, Wardle J. Barriers to cervical cancer screening attendance in England: a population-based survey. J Med Screen 2009; 16:199-204. [DOI: 10.1258/jms.2009.009073] [Citation(s) in RCA: 173] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objectives To explore barriers to cervical screening attendance in a population-based sample, and to compare barriers endorsed by women who were up-to-date with screening versus those who were overdue. We also tested the hypothesis that women who were overdue for screening would be more generally disillusioned with public services, as indexed by reported voting behaviour in elections. Setting A population-based survey of women in England. Methods Face-to-face interviews were carried out with 580 women aged 26–64 years, and recruited using stratified random probability sampling as part of an omnibus survey. Questions assessed self-reported cervical screening attendance, barriers to screening, voting behaviour and demographic characteristics. Results Eighty-five per cent of women were up-to-date with screening and 15% were overdue, including 2.6% who had never had a smear test. The most commonly endorsed barriers were embarrassment (29%), intending to go but not getting round to it (21%), fear of pain (14%) and worry about what the test might find (12%). Only four barriers showed significant independent associations with screening status: difficulty making an appointment, not getting round to going, not being sexually active and not trusting the test. We found support for our hypothesis that women who do not attend for screening are less likely to vote in elections, even when controlling for barrier endorsement and demographic factors. Conclusions Practical barriers were more predictive of screening uptake than emotional factors such as embarrassment. This has clear implications for service provision and future interventions to increase uptake. The association between voting behaviour and screening uptake lends support to the hypothesis that falling screening coverage may be indicative of a broader phenomenon of disillusionment, and further research in this area is warranted.
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Affiliation(s)
- Jo Waller
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, UCL, London, UK
| | - Marta Bartoszek
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, UCL, London, UK
| | - Laura Marlow
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, UCL, London, UK
| | - Jane Wardle
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, UCL, London, UK
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Armstrong N, Murphy E. Weaving meaning? An exploration of the interplay between lay and professional understandings of cervical cancer risk. Soc Sci Med 2008; 67:1074-82. [PMID: 18640758 DOI: 10.1016/j.socscimed.2008.06.022] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2007] [Indexed: 10/21/2022]
Abstract
In line with the increasing emphasis on informed choice, women invited for cervical cancer screening in England receive a leaflet containing information on the risk factors and causation of the condition. However, data from a qualitative interview study with 35 women suggest that the ways in which women make sense of this information can vary and frequently do not correspond to the causal pathways and explanations which characterise contemporary professional medical explanations. This paper examines the complex interplay between lay and professional understandings that takes place as women attempt to weave the information they receive, their prior understandings and contextual factors together into some kind of coherent framework, in which each piece of information makes sense in relation to everything else. We conclude by arguing that, while presenting full and accurate information about orthodox medical understandings of cervical cancer causation in an accessible way maybe challenging, partial presentation of 'the facts' is likely to be ineffective.
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Affiliation(s)
- Natalie Armstrong
- Health Sciences, University of Leicester, 2nd Floor Adrian Building, University Road, Leicester, UK.
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20
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Martin JT. Do women comply with recommendations for Papanicolaou smears following colposcopy? A retrospective study. J Midwifery Womens Health 2008; 53:138-42. [PMID: 18308263 DOI: 10.1016/j.jmwh.2007.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The objective of this study was to determine compliance with follow-up serial Papanicolaou smears after the completion of colposcopic examination and treatment as required in women with abnormal Papanicolaou smears. Following a retrospective chart review, data were selected from 103 charts of women who had undergone colposcopy. Patient compliance with the treatment plan was tracked for 18 months. Compliance was defined as having at least two cervical cancer screenings performed in the year and a half following colposcopy. Thirty-two percent of the study population complied with the plan of care. Eighty-six percent of those patients who had at least one Papanicolaou smear in the 18 months following colposcopy had no progression of dysplasia. Less than one-third of the patients in this study population followed the recommendations given to them after their colposcopic examination and treatment. Health care providers will be aware of the low percentage of patient follow-up as well as the importance of educating patients about prevention of cervical cancer and reducing risk of cervical dysplasia.
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Abstract
Cervical cancer is the leading cause of death among women in Thailand. A significant number of Thai women have never received cervical cancer screening. This study examined the perceived susceptibility, benefits, and barriers that influence Papanicolaou testing and examined the relationships between socioeconomic factors and obtaining a Papanicolaou test among women working in 1 government agency and 3 private sector companies in Bangkok, Thailand. The Health Belief Model was used to guide the cross-sectional design of the study. The Susceptibility, Benefits, and Barriers Scale was mailed to 300 working women. The response rate to the survey was 63% (N = 189). Logistic regression analysis showed that perceived barriers were significant predictors of Papanicolaou testing (beta = -.13, P < .001). Women who reported barriers were significantly less likely to obtain a Papanicolaou test (odds ratio, 0.88; P < .001). The specific barriers to engaging in Papanicolaou testing were embarrassment, fear, time constraints, knowledge deficits, and cost. Marital status, age, education, and family income were other factors related to Papanicolaou testing. Findings suggest that screening rates may be improved by addressing a combination of research, health policy, and cultural factors in these women through a nationwide campaign.
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Affiliation(s)
- Chayanin Boonpongmanee
- Intercollegiate College of Nursing, Washington State University Tri-Cities, Richland, Wash 99352-1671, USA.
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22
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Olowokure B, Caswell M, Duggal HV. What women want: convenient appointment times for cervical screening tests. Eur J Cancer Care (Engl) 2007; 15:489-92. [PMID: 17177908 DOI: 10.1111/j.1365-2354.2006.00703.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Little is known about women's preferred appointment times for cervical screening tests. Data from a postal questionnaire survey were used to compare preferred appointment times with those given. Although 33.4%[95% confidence intervals (CI) 31.8%-35.0%] of respondents received appointments between 10h00 and 11h55, only 17.0% (95% CI 15.3%-18.7%) wanted an appointment at that time. Nineteen per cent (95% CI 17.4%-21.0%) of respondents wanted appointments between 18h00 and 20h00, but only 4.4% (95% CI 3.7%-5.1%) received them. Saturday appointments for cervical screening are not given; however, overall approximately 13% of those surveyed would have preferred a Saturday appointment. Preferred times also varied significantly with age and deprivation category. Further research is required to determine whether appointment times for cervical screening can be tailored to meet these expressed needs, and the impact this has on service provision and uptake.
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Affiliation(s)
- B Olowokure
- Health Protection Agency, Regional Surveillance Unit, West Midlands, Birmingham, UK.
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Abstract
The official discourse on cervical screening, disseminated to women through the information material they receive when called to attend, is important for the ways in which it presents screening to women and encourages them to think about it. However, because this material is nationally produced it is designed to address a large number of women and, as a result, is necessarily general and uniform in nature. This article uses qualitative interview data to explore how individual women interpret, negotiate and make sense of this discourse in the context of their personal circumstances, experiences and characteristics; therefore producing alternative conceptualizations of, and discourses upon, cervical screening. Foucault's work on 'technologies of the self' is employed in order to suggest that these practices of individualization can be seen as the means through which a space is opened up between discourse and the individual. Within such a space the working out of individual subject positions is possible.
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Affiliation(s)
- Natalie Armstrong
- Health Sciences Research Institute, Warwick Medical School, University of Warwick, UK.
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24
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Whynes DK, Philips Z, Avis M. Why do women participate in the English cervical cancer screening programme? JOURNAL OF HEALTH ECONOMICS 2007; 26:306-25. [PMID: 17010459 DOI: 10.1016/j.jhealeco.2006.08.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2004] [Revised: 06/08/2006] [Accepted: 08/25/2006] [Indexed: 05/12/2023]
Abstract
The vast majority of women in England attend for cervical cancer screening. Conventional economic theorising fails to explain why and its predictions are inconsistent with the evidence. Using questionnaire data, we analyse directly motivations for screening attendance. We conclude that regular attendance at screening is driven primarily by a search for reassurance, a sense of duty and herd signalling. It is evident that recognisable sub-groups of attenders exist, in which the configurations of motivational factors differ. Being motivated to attend by physicians is less significant that is widely supposed and is more frequently associated with irregular attendance.
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Affiliation(s)
- David K Whynes
- School of Economics, University of Nottingham, Nottingham NG7 2RD, United Kingdom.
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25
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Juraskova I, Butow P, Sharpe L, Campion M. ‘What does it mean?’ uncertainty, trust and communication following treatment for pre-cancerous cervical abnormalities. Psychooncology 2007; 16:525-33. [PMID: 16988948 DOI: 10.1002/pon.1104] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The early detection of pre-cancerous cervical conditions has risen dramatically, prompting more in-depth investigations regarding psychological implications inherent within the diagnosis and treatment of this condition. This study aimed to identify factors that influence women's experience of diagnosis and treatment of cervical abnormalities and factors that facilitate positive adjustment. Using a semi-structured telephone interview, we interviewed 21 women (age 24-54) treated at a colposcopy clinic. Systematic recruitment of women with varying degrees of cervical abnormality (CIN 1-3) and time since treatment was undertaken to ensure representation of all relevant experiences and allow the identification of long-term factors. Coding of audio-taped, transcribed interviews and searching for themes was achieved by using NUD*IST software. The results identified uncertainty, trust and communication as the key factors for women following diagnosis and treatment. The primary concern following diagnosis was related to cancer but changed to a more prominent concern with future reproductive issues in the post-treatment period. The majority of women acknowledged the importance of the doctor's empathic communication style. These findings have important implications for future studies and clinical practice.
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Affiliation(s)
- Ilona Juraskova
- Medical Psychology Research Unit, School of Psychology, University of Sydney, NSW 2006, Australia.
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26
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Rydström C, Törnberg S. Cervical cancer incidence and mortality in the best and worst of worlds. Scand J Public Health 2006; 34:295-303. [PMID: 16754588 DOI: 10.1080/14034940500241979] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Globally speaking, cervical cancer is a common cause of death. The cancer is caused by a human papillomavirus (HPV) infection, and hence is preventable. Pap smear screening allows for the early detection of precancerous lesions that are easily treated in a pre-invasive phase of the disease. New tests and treatment methods have the overall aim of lowering cervix cancer incidence and death. However, whether a woman will or will not develop cervix cancer depends on a complex number of interacting variables. AIM The aim of the present study was to identify factors that might have an impact on cervix cancer incidence and mortality, and rank them according to the weight of their relative influence. METHODS By using a forecasting model called the scenario method, factors were identified that could have an impact on cervix cancer development, and their relative importance was ranked by using a special matrix. The figures given for each factor were summed and presented in a System Grid, which made it possible to determine the most important variable. RESULTS The cultural structure of the female population, as well as women's habits and behaviour, all seem to be more important factors than the Pap smear test or the treatment in relation to cervical cancer incidence and mortality. CONCLUSION In the endeavour to prevent cervical cancer one must consider the whole chain of events, i.e. population-tests-treatment-outcome. New and improved test methods and treatment procedures are of little use if women refrain from coming for a test when called.
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Affiliation(s)
- Catrine Rydström
- Division of Social Medicine, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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27
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Philips Z, Whynes DK, Avis M. Testing the construct validity of willingness to pay valuations using objective information about risk and health benefit. HEALTH ECONOMICS 2006; 15:195-204. [PMID: 16229053 DOI: 10.1002/hec.1054] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
This paper describes an experiment to test the construct validity of contingent valuation, by eliciting women's valuations for the NHS cervical cancer screening programme. It is known that, owing to low levels of knowledge of cancer and screening in the general population, women both over-estimate the risk of disease and the efficacy of screening. The study is constructed as a randomised experiment, in which one group is provided with accurate information about cervical cancer screening, whilst the other is not. The first hypothesis supporting construct validity, that controls who perceive greater benefits from screening will offer higher valuations, is substantiated. Both groups are then provided with objective information on an improvement to the screening programme, and are asked to value the improvement as an increment to their original valuations. The second hypothesis supporting construct validity, that controls who perceive the benefits of the programme to be high already will offer lower incremental valuations, is also substantiated.
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Affiliation(s)
- Zoë Philips
- School of Economics, University of Nottingham, UK.
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28
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Women's perceptions and social barriers determine compliance to cervical screening: Results from a population based study in India. ACTA ACUST UNITED AC 2006; 30:369-74. [DOI: 10.1016/j.cdp.2006.07.004] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2006] [Indexed: 11/19/2022]
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29
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Miles A, Cockburn J, Smith RA, Wardle J. A perspective from countries using organized screening programs. Cancer 2004; 101:1201-13. [PMID: 15316915 DOI: 10.1002/cncr.20505] [Citation(s) in RCA: 145] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Cancer screening may be offered to a population opportunistically, as part of an organized program, or as some combination of the preceding two options. Organized screening is distinguished from opportunistic screening primarily on the basis of how invitations to screening are extended. In organized screening, invitations are issued from centralized population registers. In opportunistic screening, however, due to the lack of central registers, invitations to screening depend on the individual's decision or on encounters with health care providers. The current article outlines key differences between organized and opportunistic screening. In the current study, literature searches were performed using PubMed and MEDLINE. Additional data were assembled from interviews with health officials in the five countries investigated and from the authors' personal files. Opportunistic screening was found to be distinguishable from organized screening on the basis of whether screening invitations were issued from centralized population registers. Organized screening programs also assumed centralized responsibility for other key elements of screening, such as eligibility requirements, quality assurance, follow-up, and evaluation. Organized programs focused on reducing mortality and morbidity at the level of the population rather than at the level of the individual. Thus, programs did not necessarily offer the most sensitive screening test for a particular cancer, and tests sometimes were offered at suboptimal intervals with respect to individual-level protection. Nonetheless, organized systems paid greater attention to the quality of screening, as measured by factors such as cancer detection rates, tumor characteristics, and false-positive biopsy rates. As a result, participants in organized screening programs received greater protection from the harmful effects associated with screening. In addition, organized programs worked more systematically toward providing value for money in an inevitably resource-limited environment. Although organized and opportunistic models of screening can yield similar uptake rates, organized programs exhibited greater potential ability to reduce cancer incidence and mortality, because of the higher levels of population coverage and centralized commitment to quality and monitoring; were more likely to be cost-effective; and offered greater protection against the harmful effects associated with poor quality or overly frequent screening.
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Affiliation(s)
- Anne Miles
- Cancer Research UK Health Behaviour Unit, Department of Epidemiology and Public Health, University College London, London, United Kingdom
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30
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Olowokure B, Caswell M, Duggal HV. Response patterns to a postal survey using a cervical screening register as the sampling frame. Public Health 2004; 118:508-12. [PMID: 15351224 DOI: 10.1016/j.puhe.2003.12.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2002] [Revised: 10/16/2003] [Accepted: 12/06/2003] [Indexed: 11/29/2022]
Abstract
This study compared different types of respondent to a postal survey. A random sample of women aged 20-64 years (n = 4057) was selected from a population-based cervical screening register to examine their information experience during the screening programme. The initial response rate was 57%, and this increased to 81% after one reminder. Respondents were older (P < 0.0001) than non-respondents, but both groups were comparable with regard to attendance history for cervical screening (respondents 89.3%; non-respondents 89.1%) and normal smear test results (respondents 84.0%; non-respondents 81.4%). Early and late respondents were similar in age. Compared with late respondents, early respondents were more likely to live in highly affluent (P < 0.0001) and rural areas (P = 0.026). They were also more likely to be non-attenders (P < 0.0001), but they were less likely to have had inadequate smear results (P = 0.030) than late respondents. These results suggest that consideration should be given to factors other than sociodemographic differences when examining response patterns to postal surveys.
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Affiliation(s)
- B Olowokure
- Department of Public Health and Health Strategy, South Staffordshire Health Authority, Stafford, PHLS CDSC West Midlands, 2nd Floor Lincoln House, Heartlands Hospital, Birmingham B9 5SS, UK.
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31
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Hou SI, Fernandez ME, Parcel GS. Development of a cervical cancer educational program for Chinese women using intervention mapping. Health Promot Pract 2004; 5:80-7. [PMID: 14965438 DOI: 10.1177/1524839903257311] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article describes the development of a program to increase Pap screening behavior among women in Taiwan. Intervention mapping, an innovative process of intervention design, guided the development of this program. The development process included a needs assessment identifying factors influencing Pap screening behavior relevant to Chinese women. The program used methods such as information transmission, modeling, persuasion, and facilitation. Strategies included direct mail communication, role-model stories and testimonials, and a telephone-counseling component. The delineation of specific plans for implementation and evaluation are also described.
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Affiliation(s)
- Su-I Hou
- Health Promotion and Behavior, University of Georgia, Athens, GA, USA
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32
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Richardson JC, Hassell AB, Hay EM, Thomas E. "I'd rather go and know": women's understanding and experience of DEXA scanning for osteoporosis. Health Expect 2002; 5:114-26. [PMID: 12031052 PMCID: PMC5060141 DOI: 10.1046/j.1369-6513.2002.00173.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To explore women's knowledge and understanding of osteoporosis and of dual energy x-ray absorptiometer (DEXA) scans; the factors influencing their decision to have a scan and their experience of undergoing a DEXA scan. DESIGN In-depth interviews (using a topic guide) were carried out with 12 women [before a DEXA scan and after they had discussed the results with their general practitioner (GP)] and with three women who chose not to have a scan. SETTING Stoke-on-Trent, Staffordshire, UK. PARTICIPANTS Women who responded to a primary-care based questionnaire were purposively selected for interview. RESULTS The women interviewed had varied levels of understanding of osteoporosis. For the majority of participants the scan was an overwhelmingly positive experience, despite some women's negative expectations. Findings are also explored in terms of the influences on women's decision-making about whether to have a scan and the concept of "knowing" one's risk status. CONCLUSIONS The main implication for primary care is how to improve women's understanding of osteoporosis and DEXA scans in order to promote the strategy of scanning high-risk women.
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Affiliation(s)
- Jane C Richardson
- Primary Care Sciences Research Centre, Hornbeam Building, Keele University, Keele, Staffordshire ST5 5BG, UK.
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Abstract
This paper explores the importance of cervical screening discourses in framing women's perceptions of femininity. In-depth interviews with 35 women -- which focused on experiences of, and feelings about, cervical screening -- highlighted how medical discourses embedded within the cervical screening programme shape the feelings of normalcy and sense of obligation associated with having smear tests. With the introduction of the invitation based call and re-call programme in the UK, cervical screening has moved from an ad hoc system to a programme of mass surveillance and regulation of women's bodies. The paper highlights the ways in which cervical screening discourses were negotiated, accepted and resisted by the women interviewed. Possible theoretical explanations as to why cervical screening discourses have become important in framing femininity are discussed. The paper concludes by suggesting that the meaning and objective of mass screening programmes must be brought into question and reconsidered by feminists and those involved with the planning, implementation, research and use of screening services.
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Affiliation(s)
- J Bush
- Department of Epidemiology and Public Health, School of Health Sciences, The Medical School, University of Newcastle, Newcastle Upon Tyne, UK.
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Peate I. Cervical cancer. 2: Colposcopy, treatment and patient education. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 1999; 8:805-9. [PMID: 10670298 DOI: 10.12968/bjon.1999.8.12.6576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In the first article in this two-part series (Vol 8(11): 730-34) the issue of cervical screening and the cervical smear test was described and discussed. This article looks at colposcopy. When a woman receives an abnormal smear test result, she will often require further examination of the cervix in order to identify the degree and area of dyskaryosis. Colposcopy can often provoke feelings of fear and anxiety in women and the nurse must help to alleviate these fears and anxieties. Colposcopy and cervical intraepithelial neoplasia are discussed and the treatment (if any) is outlined.
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Affiliation(s)
- I Peate
- Faculty of Health and Human Sciences, Department of Adult Nursing and Health Care, University of Hertfordshire
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35
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Peate I. Cervical cancer. 1: Role of nurses in the primary healthcare setting. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 1999; 8:730-4. [PMID: 10624210 DOI: 10.12968/bjon.1999.8.11.6590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This two-part series examines the nurse's role when caring for women with cervical cancer. The incidence of cervical cancer, survival rates and trends of the disease are discussed, and the role of the nurse and his/her contribution to providing a quality cervical screening service to women is outlined. The nurse in primary healthcare settings takes the majority of smears. In order to detect cancer of the cervix at an early stage, it is important that the nurse provides women with sound and up-to-date information in a way that they understand.
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Affiliation(s)
- I Peate
- Faculty of Health and Human Sciences, Department of Adult Nursing and Health Care, University of Hertfordshire
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