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Ali B, Galbarczyk A, Jasienska G, Ba-Break M, Gül H. Factors related to knowledge, attitudes, and behaviors regarding cervical cancer among Yemeni women. BMC Cancer 2024; 24:695. [PMID: 38844917 PMCID: PMC11157752 DOI: 10.1186/s12885-024-12435-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 05/27/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Cervical cancer (CxCa), although preventable, is still among the most prevalent cancers in women. Mortality from this cancer is high, especially in low-income countries where preventive strategies are often lacking. We studied the knowledge, attitudes, and practices regarding CxCa among Yemeni women. METHODS This cross-sectional study was conducted in 2019 among 399 women in five major hospitals in Sanaa, the capital city of Yemen. Data were collected through face-to-face interviews using structured questionnaires. We used logistic regression models to analyze the likelihood of hearing about CxCa, believing that CxCa is treatable and preventable, awareness of the Pap smear test, and ever having this test, in relation to participant's age, education level, working outside the household, and family history of CxCa. RESULTS Only 66.7% of the women had heard of CxCa. Women with higher education, working outside the household, and with a family history of CxCa were more likely to be aware of CxCa. Working outside the household was the only variable related to a higher likelihood of knowing that CxCa is a treatable and preventable. Furthermore, women with a family history of CxCa were more likely to have knowledge about Pap smear test and were more likely to have Pap smear test in the past. CONCLUSION This study identified a low awareness of CxCa and its prevention among Yemeni women. In order to reduce the burden of CxCa in Yemen and save women's lives, it is necessary to raise women's awareness of this disease, especially among those with lower education and those not involved in work outside their homes.
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Affiliation(s)
- Boshra Ali
- Public Health Department, Institute of Graduate Studies in Health Sciences, Istanbul University, Istanbul, Turkey.
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland.
| | - Andrzej Galbarczyk
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
- Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Grazyna Jasienska
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Maryam Ba-Break
- Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Hülya Gül
- Istanbul Faculty of Medicine, Public Health Department, Istanbul University, Istanbul, Türkiye
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Kabanda R, Kiconco A, Ronald A, Beyer KMM, John SA. Correlates of intention to screen for cervical cancer among adult women in Kyotera District, Central Uganda: a community based cross-sectional study. BMC Womens Health 2024; 24:296. [PMID: 38762723 PMCID: PMC11102156 DOI: 10.1186/s12905-024-03129-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 05/03/2024] [Indexed: 05/20/2024] Open
Abstract
INTRODUCTION Cervical cancer continues to pose a major public health challenge in low-income countries. Cervical cancer screening programs enable early detection and effectively reduce the incidence of cervical cancer as well as late-stage diagnosis and mortality. However, screening uptake remains suboptimal in Uganda. This study assessed correlates of intention to screen for cervical cancer among women in the Kyotera district of Central Uganda. METHODS We analyzed cross-sectional data collected to determine the effectiveness of community audio towers (CATs) as a modality of health communication to support cervical cancer prevention. Women (n = 430) aged 21-60 years without a prior history of cervical cancer screening were surveyed about demographics, sources of health information and cervical cancer screening intentions in 2020. We used generalized linear modelling with modified Poisson regression and backwards variable elimination to identify adjusted prevalence ratios and 95% confidence intervals (CI) to determine factors associated with intention to screen for cervical cancer. RESULTS Half (50.2%) of the participants had intentions to screen for cervical cancer within twelve months and 26.5% had moderate knowledge about cervical cancer. Nearly half (46.0%) considered themselves at risk of cervical cancer. Compared to residents who primarily received their health information from social media and radio, participants who received health information primarily from CATs (aPR:0.64, 95% CI:0.52-0.80, p < 0.001) and TV (aPR:0.52, 95% CI:0.34-0.82, p = 0.005) had a lower prevalence of intention to screen for cervical cancer. The prevalence of intentions to screen for cervical cancer in twelve months was higher among those resided in town councils (aPR:1.44, 95% CI:1.12-1.86, p = 0.004) compared to rural areas, and higher among those who considered themselves to be at risk of cervical cancer (aPR:1.74, 95% CI:1.28-2.36, p < 0.001) compared to those who did not. CONCLUSIONS We found suboptimal prevalence of intentions to screen for cervical cancer among women in central Uganda. Additional research and implementation projects are needed to increase cervical cancer screening. Targeting risk perceptions and behavioral approaches to increase intentions could be effective in future intervention work. Based on urban-rural differences, additional work is needed to support equitable sharing of information to support cancer prevention messaging; CATs and TV may best help reach those with lower intentions to screen based on our research.
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Affiliation(s)
- Richard Kabanda
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, 53226, USA.
| | - Arthur Kiconco
- Uganda Martyrs University, Nkozi, Uganda
- Ministry of Health, Kampala, Uganda
| | - Anguzu Ronald
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Kirsten M M Beyer
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Steven A John
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
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Mantula F, Toefy Y, Sewram V. Barriers to cervical cancer screening in Africa: a systematic review. BMC Public Health 2024; 24:525. [PMID: 38378542 PMCID: PMC10877795 DOI: 10.1186/s12889-024-17842-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/22/2024] [Indexed: 02/22/2024] Open
Abstract
INTRODUCTION Africa has one of the highest burdens of cervical cancer in the world. The unacceptably high incidence and mortality rates could be reduced through implementing a comprehensive approach to its prevention and control that includes screening, which however, is low in most low-and-middle-income countries. Hence, this systematic review aims at exploring factors that prevent women from utilising cervical cancer screening services in the region. METHODS A mixed method systematic review was conducted. A search was performed on PubMed (Medline), EMBASE, CINAHL (EBSCOHOST) and Scopus databases for articles published until May 2019 without time, language or study design limits. Two reviewers critically appraised the included studies independently using the standard quality assessment criteria for evaluating primary research papers. Results of the quantitative and mixed methods studies were transformed into qualitative data and synthesised using thematic analysis. RESULTS From a potential 2 365 studies, 24 from 11 countries met the eligibility criteria and were selected; eight qualitative, 13 quantitative, and three that used the mixed-method approach. The primary barriers were identified as poor access to screening services, lack of awareness and knowledge on cervical cancer and screening, and socio-cultural influences. Service providers perceived lack of skills, screening equipment and supplies, and staff shortages as the major barriers to the provision of screening services. CONCLUSION Barriers to cervical cancer screening in Africa are multifaceted and require a holistic approach that will address them concurrently at the health system, individual, interpersonal, community and structural levels. Political will complimented by stakeholder involvement is required in the development and implementation of strategies that will ensure acceptability, availability, accessibility, and affordability of screening to minimise barriers in accessing the service.
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Affiliation(s)
- Fennie Mantula
- African Cancer Institute, Stellenbosch University, P.O Box 241, Cape Town, 8000, South Africa.
- Department of Nursing and Midwifery, Faculty of Medicine, National University of Science and Technology, P.O. Box A.C. 939, Ascot, Bulawayo, Zimbabwe.
| | - Yoesrie Toefy
- Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, P.O Box 241, Cape Town, 8000, South Africa
| | - Vikash Sewram
- African Cancer Institute, Stellenbosch University, P.O Box 241, Cape Town, 8000, South Africa.
- Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, P.O Box 241, Cape Town, 8000, South Africa.
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Ogunsola OO, Olawepo JO, Ajayi O, Osayi E, Akinro YT, Ifechelobi C, Chigbu C, Okonkwo P, Ezeanolue EE. AVIVA: a telehealth tool to improve cervical cancer screening in resource-constrained settings. BMJ Glob Health 2023; 8:e012311. [PMID: 37433694 DOI: 10.1136/bmjgh-2023-012311] [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: 03/15/2023] [Accepted: 06/17/2023] [Indexed: 07/13/2023] Open
Abstract
Cervical cancer accounts for 21.7% of all cancer deaths in the sub-Saharan Africa with a case fatality rate of 68%. Nigeria's Federal Ministry of Health has adopted cervical cancer screening (CCS) using visual inspection with acetic acid or Lugol's iodine (VIA/VILI) and cryotherapy treatment for precancerous lesions as the preferred screening and treatment strategy. Using the Exploration, Preparation, Implementation and Sustainment Framework, our study documents our experience during the development, piloting and roll-out of the APIN Public Health Initiatives (APIN)-developed VIA Visual Application (AVIVA) for CCS using the VIA method in 86 APIN-supported health facilities across 7 states in Nigeria. Between December 2019 and June 2022, with the aid of 9 gynaecologists and 133 case finders, a total of 29 262 women living with HIV received VIA-based CCS and 1609 of them were VIA-positive, corresponding to VIA positivity rate of 5.5%. Over the 30 months duration and the 5 phases of CCS scale-up, AVIVA development and expansion, a total of 1247 cases were shared via the AVIVA App (3741 pictures), with 1058 of such cases undergoing expert review, corresponding to a reviewer rate of 84.8%. Overall, the use of the AVIVA App improved both the VIA-positive and VIA-negative concordance rates by 16 percentage points each (26%-42% and 80%-96%, respectively) from baseline to the end of the study. We concluded that the AVIVA App is an innovative tool to improve CCS rates and diagnostic precision by connecting health facility staff and expert reviewers in resource-limited settings.
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Affiliation(s)
| | - John Olajide Olawepo
- Center For Translation and Implementation Research, University of Nigeria, Nsukka, Nigeria
- Department of Health Sciences, Northeastern University, Boston, Massachusetts, USA
| | - Oluseye Ajayi
- Prevention and Community Services, APIN Public Health Initiatives, Abuja, Nigeria
| | - Emmanuel Osayi
- Clinical Services, APIN Public Health Initiatives, Abuja, Nigeria
| | | | | | - Chibuike Chigbu
- Center For Translation and Implementation Research, University of Nigeria, Nsukka, Nigeria
- Department of Obstetrics and Gynecology, University of Nigeria, Nsukka, Nigeria
| | | | - Echezona Edozie Ezeanolue
- Center For Translation and Implementation Research, University of Nigeria, Nsukka, Nigeria
- Healthy Sunrise Foundation, Las Vegas, Nevada, USA
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Gao X, Zhang W, Sun J, Adeloye D, Jin H, Rudan I, Song P, Jin M. Lifetime prevalence and adherence rate of cervical cancer screening among women living with HIV: a systematic review and meta-analysis. J Int AIDS Soc 2023; 26:e26090. [PMID: 37247380 DOI: 10.1002/jia2.26090] [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: 06/07/2022] [Accepted: 04/25/2023] [Indexed: 05/31/2023] Open
Abstract
INTRODUCTION Women living with HIV (WLWH) are more likely to develop cervical cancer. Screening and available healthcare can effectively reduce its incidence and mortality rates. We aimed to summarize the lifetime prevalence and adherence rate of cervical cancer screening among WLWH across low- and middle-income countries (LMICs), and high-income countries (HICs). METHODS We systematically searched PubMed, Web of Science and Embase for studies published between database inception and 2 September 2022, without language or geographical restrictions. Those reporting the lifetime prevalence and/or adherence rate of cervical cancer screening among WLWH were included. Pooled estimates across LMICs and HICs were obtained using DerSimonian-Laird random-effects models. When the number of eligible studies was greater than 10, we further conducted stratified analyses by the World Health Organization (WHO) region, setting (rural vs. urban), investigation year, screening method, type of cervical cancer screening programme, age and education level. RESULTS Among the 63 included articles, 26 provided data on lifetime prevalence, 24 on adherence rate and 13 on both. The pooled lifetime prevalence in LMICs was 30.2% (95% confidence interval [CI]: 21.0-41.3), compared to 92.4% in HICs (95% CI: 89.6-94.6). The pooled adherence rate was 20.1% in LMICs (95% CI: 16.4-24.3) and 59.5% in HICs (95% CI: 51.2-67.2). DISCUSSION There was a large gap in cervical cancer screening among WLWH between LMICs and HICs. Further analysis found that those in LMICs had higher lifetime prevalence in subgroups with urban settings, with older age and with higher education levels; and those in HICs had higher adherence in subgroups with younger age and with higher education levels. CONCLUSIONS Cervical cancer screening among WLWH falls considerably short of the WHO's goal. There should be continuous efforts to further increase screening among these women, especially those residing in the rural areas of LMICs and with lower education levels.
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Affiliation(s)
- Xiangrong Gao
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wanting Zhang
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jingyi Sun
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Davies Adeloye
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Huyi Jin
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Igor Rudan
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Peige Song
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Mingjuan Jin
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Antaon JSS, Essi MJ, Ngo Um Meka E, Mawamba YN, Ndom P, Tebeu PM. [Factors associated with access barriers to cervical cancer screening in Yaoundé]. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2021; Vol. 33:579-589. [PMID: 35485114 DOI: 10.3917/spub.214.0579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Several studies report that only 10% of Cameroonian women at risk have ever been screened for this disease. OBJECTIVE This study aims to analyze the factors explaining the difficulties in accessing screening for cervical cancer in Yaoundé, Cameroon. METHODOLOGY This was an analytical cross-sectional study (participed/not participated), conducted from May 1 to August 10, 2020. The study population was made up of two groups (i.e. women without a history of screening; women who benefited from at least one screening session). Data collection was carried out at the gynecology-obstetrics department in two hospitals in Yaoundé (University hospital center and the obstetrics-gynecology and pediatric hospital). Variables were collected using a pre-tested and validated questionnaire. Data were analyzed using SPSS version 20 software. Simple and multiple logistic regression analysis was performed to assess the influence of different variables on the risk of not participating in screening. A difference was considered significant if P < 5%. RESULTS Out of 300 women interviewed, 150 had never participated in screening (50%). In multivariate analysis, the factors associated with difficulties in accessing cervical cancer screening were, level of primary education (58,33% vs. 41,67%, [AOR: 5.12 (3.42-7.65)]), lack of employment (69,74% vs. 30,26%, [AOR: 5.44 (3.32-8.92)]), insufficient knowledge (78,64% vs. 21,36%; [AOR: 7.11(5.70-8.88)]) and unfavourable attitude (85,71% vs. 14,29%, [AOR: 5.58 (4.41-7.06)]). CONCLUSION There are many factors associated with not being screened. It is therefore necessary to develop strategies to improve access to cervical cancer screening services in Cameroon.
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Yimer NB, Mohammed MA, Solomon K, Tadese M, Grutzmacher S, Meikena HK, Alemnew B, Sharew NT, Habtewold TD. Cervical cancer screening uptake in Sub-Saharan Africa: a systematic review and meta-analysis. Public Health 2021; 195:105-111. [PMID: 34082174 DOI: 10.1016/j.puhe.2021.04.014] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/01/2021] [Accepted: 04/21/2021] [Indexed: 01/07/2023]
Abstract
OBJECTIVES The objective of this study is to estimate the pooled uptake of cervical cancer screening and identify its predictors in Sub-Saharan Africa. STUDY DESIGN Systematic review and meta-analysis. METHODS We searched PubMed, EMBASE, CINAHL, African Journals OnLine, Web of Science and Scopus electronic databases from January 2000 to 2019. All observational studies published in the English language that reported cervical cancer uptake and/or predictors in Sub-Saharan Africa were initially screened. We assessed methodological quality using the Newcastle-Ottawa Scale. An inverse variance-weighted random-effects model meta-analysis was performed to estimate the pooled uptake and odds ratio (OR) of predictors with a 95% confidence interval (CI). The I2 test statistic was used to check between-study heterogeneity, and the Egger's regression statistical test was used to check publication bias. RESULTS We initially screened 3537 citations and subsequently 29 studies were selected for this review, which included a total of 36,374 women. The uptake of cervical cancer screening in Sub-Saharan Africa was 12.87% (95% CI: 10.20, 15.54; I2 = 98.5%). A meta-analysis of seven studies showed that knowledge about cervical cancer increased screening uptake by nearly five times (OR: 4.81; 95% CI: 3.06, 7.54). Other predictors of cervical screening uptake include educational level, age, Human Immune deficiency Virus (HIV) status, contraceptive use, perceived susceptibility and awareness about screening locations. CONCLUSIONS Cervical screening uptake is low in Sub-Saharan Africa as a result of several factors. Health outreach and promotion programmes to target these identified predictors are required.
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Affiliation(s)
- N B Yimer
- Woldia University, College of Health Sciences, School of Midwifery, Woldia, Ethiopia.
| | - M A Mohammed
- Debre Birhan University, Institute of Medicine and Health Sciences, Department of Midwifery, Debre Birhan, Ethiopia
| | - K Solomon
- Addis Ababa University, College of Health Sciences, Department of Preventive Medicine, Addis Ababa, Ethiopia
| | - M Tadese
- Debre Birhan University, Institute of Medicine and Health Sciences, Department of Midwifery, Debre Birhan, Ethiopia
| | - S Grutzmacher
- Oregon State University, College of Public Health and Human Sciences, School of Biological and Population Health Sciences, Corvallis, USA
| | - H K Meikena
- Woldia University, College of Health Sciences, School of Midwifery, Woldia, Ethiopia
| | - B Alemnew
- Woldia University, College of Health Sciences, Department of Medical Laboratory Science, Woldia, Ethiopia
| | - N T Sharew
- Debre Birhan University, Institute of Medicine and Health Sciences, Department of Nursing, Debre Birhan, Ethiopia
| | - T D Habtewold
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands
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Menendez YA, Cambaco O, Mindú C, Nhantumbo H, Uamusse T, Matsinhe G, Matsinhe B, Manjate RM, Bardají A, Menendez C, Sevene E, Munguambe K. Lay knowledge of cervical cancer in Manhiça district, Mozambique: a qualitative study. Reprod Health 2020; 17:130. [PMID: 32831101 PMCID: PMC7444028 DOI: 10.1186/s12978-020-00980-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 08/10/2020] [Indexed: 11/16/2022] Open
Abstract
Background Mozambique has one of the highest cervical cancer incidence rates in the world. Health interventions are still being conceived solely from a non-communicable disease standpoint despite that it is also a sexual and reproductive health problem. The objective of this study was to assess the extent to which lay perceptions of cervical cancer align with biomedical knowledge from the standpoint of sexual and reproductive health. Methods 10 focus group discussions were carried out with 10 target groups in Manhiça. The target groups were diverse in terms of age, sex, educational level and occupation. There were a total of 116 participants. The focus groups discussions were applied to obtain verbal information and trigger debates around beliefs and attitudes about cervical cancer as well as to explore notions of transmission and aetiology of the disease. The discussions were recorded for later transcription and analysis, following a combination of content and thematic analysis. Results Participants were familiar with the biomedical term ‘cervical cancer’ but knowledge of its aetiology and transmission was limited. Cervical cancer was readily associated to sexual transmission and sexually transmitted infections, and conceived as a ‘wound that does not heal’. The term ‘cancer’ caused confusion, as it was perceived to happen only in limbs, understood as hereditary, not transmissible and as an illness of the West. Conclusions Lay perceptions of cervical cancer do, to a large extent, align with biomedical ones, thus, there is common ground to frame future health interventions from a sexual and reproductive health standpoint. Some misperceptions were identified which could be reduced through social behaviour change communication initiatives.
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Affiliation(s)
| | - Olga Cambaco
- Manhiça Health Research Centre (CISM), Rua 12 - Cambeve, Manhiça, Mozambique
| | - Carolina Mindú
- Manhiça Health Research Centre (CISM), Rua 12 - Cambeve, Manhiça, Mozambique
| | - Hoticha Nhantumbo
- Manhiça Health Research Centre (CISM), Rua 12 - Cambeve, Manhiça, Mozambique
| | - Titos Uamusse
- Manhiça Health Research Centre (CISM), Rua 12 - Cambeve, Manhiça, Mozambique
| | - Graça Matsinhe
- Extended Program on Immunization (PAV), Ministry of Health (MISAU), Maputo, Mozambique
| | - Benigna Matsinhe
- National Directorate for Public Health (DNSP), Ministry of Health (MISAU), Maputo, Mozambique
| | - Rosa Marlene Manjate
- National Directorate for Public Health (DNSP), Ministry of Health (MISAU), Maputo, Mozambique
| | - Azucena Bardají
- Manhiça Health Research Centre (CISM), Rua 12 - Cambeve, Manhiça, Mozambique
| | - Clara Menendez
- Manhiça Health Research Centre (CISM), Rua 12 - Cambeve, Manhiça, Mozambique.,Barcelona Institute for Global Health (ISGLOBAL)/Hospital Clinic-Universitat de Barcelona, Barcelona, Spain
| | - Esperança Sevene
- Manhiça Health Research Centre (CISM), Rua 12 - Cambeve, Manhiça, Mozambique.,Faculty of Medicine, Eduardo Mondlane University (UEM), Maputo, Mozambique
| | - Khátia Munguambe
- Manhiça Health Research Centre (CISM), Rua 12 - Cambeve, Manhiça, Mozambique. .,Faculty of Medicine, Eduardo Mondlane University (UEM), Maputo, Mozambique.
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Tekalegn Y, Aman R, Woldeyohannes D, Sahiledengle B, Degno S. Determinants of VIA Positivity Among Women Screened for Cervical Precancerous Lesion in Public Hospitals of Oromia Region, Ethiopia: Unmatched Case-Control Study. Int J Womens Health 2020; 12:587-596. [PMID: 32801936 PMCID: PMC7398741 DOI: 10.2147/ijwh.s256821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/30/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Globally, cervical cancer is the fourth most frequent cancer among women. An estimated 570,000 cases of cervical cancer representing 6.6% of all female cancers were reported in the year 2018. Approximately, 90% of deaths from cervical cancer occurred in low- and middle-income countries. Screening cervical cancer at an early stage and providing access to effective treatment can significantly improve the likelihood of survival. Hence, this study aimed to assess the determinants of visual inspection of cervix with acetic acid (VIA) positivity among women screened in public hospitals of Oromia region, Ethiopia. Methods A hospital-based un-matched case-control study was conducted in Oromia region, Ethiopia. Cases were women who have a positive result for the VIA test, and controls were women with a negative result. An interviewer-administered questionnaire was used to collect the data. Multiple binary logistic regressions were conducted to assess the determinants of VIA positivity. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were reported to describe the strength of associations. Statistical significance was declared at a p-value <0.05. Results A total of 74 cases and 148 controls were included in this study. The mean age of cases and controls was 40.5 ± 13.3 years and 37.1 ± 11.9 years, respectively. Women with parity of four or more children had two times higher odds being positive for VIA test compared to their counterparts (AOR: 2.1, 95% CI: 1.3–4.0). Women with a history of post-coital bleeding had three times higher odds of VIA positivity compared to their counterparts (AOR: 3.3, 95% CI: 1.2–8.0). History of sexually transmitted infection (AOR: 1.9, 95% CI: 1.1–3.5), having multiple sexual partners (AOR: 3.2, 95% CI: 1.2–8.0), and history of smoking (AOR: 8.9, 95% CI: 1.6–48.0) were also found to be determinants of VIA positivity. Conclusion This study found that women with parity greater than four children, post-coital bleeding, history of sexually transmitted infections, having multiple sexual partners, and history of smoking were significantly associated with VIA positivity. Women with the mentioned characteristics should be encouraged to have a close follow-up for the screening. Additionally, awareness creation activities on the identified risk factors are strongly recommended for all women.
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Affiliation(s)
- Yohannes Tekalegn
- School of Health Science, Department of Public Health, Madda Walabu University, Goba Referral Hospital, Goba, Ethiopia
| | - Rameto Aman
- School of Health Science, Department of Public Health, Madda Walabu University, Goba Referral Hospital, Goba, Ethiopia
| | - Demelash Woldeyohannes
- School of Health Science, Department of Public Health, Madda Walabu University, Goba Referral Hospital, Goba, Ethiopia
| | - Biniyam Sahiledengle
- School of Health Science, Department of Public Health, Madda Walabu University, Goba Referral Hospital, Goba, Ethiopia
| | - Sisay Degno
- School of Medicine, Department of Anatomy, Madda Walabu University, Goba Referral Hospital, Goba, Ethiopia
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New-Aaron M, Meza JL, Goedert MH, Kibusi SM, Mkhoi ML, Mayengo CD, Charles J, Shabani S, Musil KM, Cheney A, Sumba S. Cervical Cancer Screening among Women Receiving Antiretroviral Therapy in a Resource-Limited Environment. Asian Pac J Cancer Prev 2020; 21:2035-2045. [PMID: 32711430 PMCID: PMC7573407 DOI: 10.31557/apjcp.2020.21.7.2035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Indexed: 12/31/2022] Open
Abstract
Background: Cervical cancer is among the most prevalent cancer among women worldwide and women living with HIV are at increased risk, especially in a resource-limited environment. Objective: This study aimed to determine levels of awareness, knowledge, uptake, and willingness to screen for cervical cancer among women receiving care in an HIV clinic at Dodoma Regional Referral Hospital (DRRH), Tanzania. Methods: Data were collected for a period of three weeks from July 21 to August 11, 2017 using a mobile phone data collection App. A total of 421 Women aged 18-50 years old were included in the study. Results: Majority of the women interviewed (n=306, 73%) were aware of cervical cancer. Among those who were aware, 84% (n=257) did not recall ever being screened for cervical cancer, and majority had a poor knowledge of cervical cancer. Educational level completed (p=0.01), income per month (p=0.02), age group (p<0.0001), and area of residence (p<0.0001) were all significantly associated to awareness of cervical cancer. Most of the women who have never screened (n=231, 91%) expressed willingness to be screened. Prior uptake of cervical cancer screening was associated with number of live births (p=0.001) and area of residence (p=0.04). And Willingness to screen was significantly associated with age groups (p=0.03) and the number of live births (p=0.03). Moreover, we found that younger age and urban residence was positively associated with awareness and uptake of cervical cancer screening. Willingness was found to decrease as age increased. Conclusion: The study found that despite older women’s higher risk of cervical cancer, those who indicated willingness to screen were younger. Additional education, health promotion, and integration of cervical cancer screening services is needed to improve cervical cancer awareness and screening uptake at the HIV clinic.
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Affiliation(s)
- Moses New-Aaron
- Department of Environmental Health, Occupational Health and Toxicology, University of Nebraska Medical Center, Omaha, Nebraska, USA.,Department of Biostatistics, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Jane L Meza
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Martha H Goedert
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Stephen M Kibusi
- College of Health Sciences, Public Health, The University of Dodoma, Dodoma, Tanzania
| | - Mkhoi L Mkhoi
- University of Dodoma, College of Health Sciences, Department of Microbiology and Immunology, Dodoma, Tanzania
| | - Caroline Damian Mayengo
- Ministry of Health, Community Development, Gender, Elderly & Children, Dodoma, Tanzania.,Dodoma Regional Referral Hospital, Dodoma, Tanzania
| | | | | | - Kelsie M Musil
- Department of Environmental Health, Occupational Health and Toxicology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Anlan Cheney
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
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11
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Ampofo AG, Adumatta AD, Owusu E, Awuviry-Newton K. A cross-sectional study of barriers to cervical cancer screening uptake in Ghana: An application of the health belief model. PLoS One 2020; 15:e0231459. [PMID: 32352983 PMCID: PMC7192489 DOI: 10.1371/journal.pone.0231459] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 03/24/2020] [Indexed: 02/02/2023] Open
Abstract
Background The high incidence (32.9, age-standardized per 100,000) and mortality (23.0, age-standardized per 100,000) of cervical cancer (CC) in Ghana have been largely attributed to low screening uptake (0.8%). Although the low cost (Visual inspection with acetic acid) screening services available at various local health facilities screening uptake is meager. Objective The purpose of the study is to determine the barriers influencing CC screening among women in the Ashanti Region of Ghana using the health belief model. Methods A analytical cross-sectional study design was conducted between January and March 2019 at Kenyase, the Ashanti Region of Ghana. The study employed self-administered questionnaires were used to collect data from 200 women. Descriptive statistics were used to examine the differences in interest and non-interest in participating in CC screening on barriers affecting CC screening. Multivariable logistic regression was used to determine factors affecting CC screening at a significance level of p<0.05. Results Unemployed women were less likely to have an interest in CC screening than those who were employed (adjustes odds ratio (aOR) = 0.005, 95%CI:0.001–0.041, p = 0.005). Women who were highly educated were 122 times very likely to be interested in CC screening than those with no or low formal education (aOR = 121.915 95%CI: 14.096–1054.469, p<0.001) and those who were unmarried were less likely to be interested in CC screening than those with those who were married (aOR = 0.124, 95%CI: 0.024–0.647, p = 0.013). Also, perceived threat, perceived benefits, perceived barriers and cues for action showed significant differences with interest in participating in screening with a P-values <0.003. The association was different for long waiting time, prioritizing early morning and late evening screening which showed no significant difference (P-value > 0.003). Conclusions Married women, unemployed and those with no formal education are less likely to participate in CC screening. The study details significant barriers to cervical cancer screening uptake in Ghana. It is recommended that the Ghana health services should develop appropriate, culturally tailored educational materials to inform individuals with no formal education through health campaigns in schools, churches and communities to enhance CC screening uptake.
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Affiliation(s)
- Ama G. Ampofo
- Department of Nursing, Garden City University College, Kumasi, Ghana
- Health Behaviour Research Collaborative, Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
- * E-mail:
| | - Afia D. Adumatta
- Department of Nursing, Garden City University College, Kumasi, Ghana
| | - Esther Owusu
- Department of Nursing, Garden City University College, Kumasi, Ghana
| | - Kofi Awuviry-Newton
- Priority Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
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Babatunde-Sowole OO, Power T, Davidson PM, DiGiacomo M, Jackson D. Health screening and preventative health care in refugee women: A qualitative analysis. Contemp Nurse 2020; 56:62-79. [PMID: 32141400 DOI: 10.1080/10376178.2020.1739543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Regular health screening provides opportunities for early detection and effective treatment of disease. There is underutilisation of health services by migrants from culturally and linguistically diverse backgrounds, particularly refugees in Australia. Aim: To explore the beliefs, understandings, and use of health and healthcare screening services among African refugee women living in Australia. Design/Method: Qualitative secondary analysis. Method: Oral narratives derived from two primary qualitative datasets of Sub-Saharan women in New South Wales, Australia, underwent secondary thematic analysis. Findings: Twenty-two of the forty-two women had refugee status on migrating to Australia. Thematic findings reflection of misinformation, low health literacy, and health screening as not a priority. Conclusions: There is an urgent need to develop innovative strategies to engage refugee migrant women in health screening by provision of culturally meaningful health information. Relevance to clinical practice: Including refugee women's suggestions for information to be provided by health services may improve attitudes towards screening and preventative health care.
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Affiliation(s)
| | - Tamara Power
- Faculty of Health, University of Technology Sydney, PO Box 123, Broadway, NSW 2007, Australia
| | - Patricia M Davidson
- Faculty of Health, University of Technology Sydney, PO Box 123, Broadway, NSW 2007, Australia
| | - Michelle DiGiacomo
- Faculty of Health, University of Technology Sydney, PO Box 123, Broadway, NSW 2007, Australia
| | - Debra Jackson
- Faculty of Health, University of Technology Sydney, PO Box 123, Broadway, NSW 2007, Australia
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Aina IO, Raul SM, Padilla LA, Mthethwa-Hleta S, Preko PO, Jolly PE. Sociodemographic factors, health seeking behaviors, reproductive history, and knowledge of cervical screening among women in Swaziland. Infect Agent Cancer 2020; 15:16. [PMID: 32165914 PMCID: PMC7059331 DOI: 10.1186/s13027-020-00282-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 02/20/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Cervical cancer is the leading cause of cancer among women in Swaziland; however, a low rate of cervical screening in this population has led to high rates of morbidity and mortality from cervical cancer. OBJECTIVE To identify factors associated with lack of cervical screening among women in Swaziland. METHODS A cross-sectional study was conducted among 300 women aged 18-69 years attending clinics in three regions of Swaziland from May to August of 2014. An investigator-administered questionnaire was used to collect data on socioeconomic factors, health-seeking behaviors, reproductive history, and cervical screening history and knowledge from the women. RESULTS Adjusted multivariable logistic regression analysis revealed that women < 30 years of age were less likely to receive a cervical exam compared to women ≥30 years of age (Odds Ratio 0.06, 95% Confidence Interval 0.01-0.67). Women who had a tertiary education were almost 6 times more likely to receive a cervical screening (OR 5.83, 95% CI 1.11-30.50). Women who said that they did not know when to receive cervical screening were 73% less likely to have a cervical exam (OR 0.27, 95% CI 0.01-0.74). CONCLUSIONS Younger age, lower educational level, and lack of knowledge about when to receive a cervical screening affected whether women obtained a cervical screening. This indicates the need for educating women, particularly younger women, about the importance of cervical examinations. Addressing these barriers to screening should lead to a decrease in cervical lesions and cancer, especially in this high HIV-positive population.
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Affiliation(s)
- Ibironke O. Aina
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, 1655 University Boulevard, Birmingham, AL 35294-0022 USA
| | - Smruti M. Raul
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, 1655 University Boulevard, Birmingham, AL 35294-0022 USA
| | - Luz A. Padilla
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, 1655 University Boulevard, Birmingham, AL 35294-0022 USA
| | - Simangele Mthethwa-Hleta
- Ministry of Health and Social Welfare, 2nd Floor Ministry of Justice & Constitutional Affairs Building, Mhalambanyatsi Road, Mbabane, Swaziland
| | - Peter O. Preko
- Care and Treatment Lead for the President’s Emergency Plan for AIDS Relief (PEPFAR), Jubela Street; Kent Rock, Mbabane, Swaziland
| | - Pauline E. Jolly
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, 1655 University Boulevard, Birmingham, AL 35294-0022 USA
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Leng J, Ntekim AI, Ibraheem A, Anakwenze CP, Golden DW, Olopade OI. Infrastructural Challenges Lead to Delay of Curative Radiotherapy in Nigeria. JCO Glob Oncol 2020; 6:269-276. [PMID: 32083951 PMCID: PMC7051797 DOI: 10.1200/jgo.19.00286] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2020] [Indexed: 11/20/2022] Open
Abstract
PURPOSE In low- and middle-income countries, there has been an exponential increase in cancer incidence. According to the International Atomic Energy Agency, the biggest gap in radiotherapy availability and need is in Nigeria, where each machine serves an estimated 25.7 million people. This study aimed to characterize the barriers to radiotherapy and to identify areas for intervention. METHODS This was a cross-sectional study conducted at the University College Hospital in Ibadan, Nigeria, from June 2017 to August 2017. Demographic, sociocultural, and infrastructural factors relating to radiotherapy were collected through a questionnaire (N = 186). Ordinal logistic regression was used to identify the factors leading to delays in referral and delays in treatment initiation. RESULTS Patients traveled from 20 of Nigeria's 36 states. The median age was 50 years (range, 19-79 years). The most common cancers treated were breast (37.5%), cervical (16.3%), head and neck (11.9%), and prostate (10.9%). In ordinal logistic regression, sociocultural factors, including the inability to pay (odds ratio [OR], 1.99; P = .034), a bad hospital experience (OR, 7.05; P = .001), and travel time (OR, 1.36; P = .001), increased the odds of referral delay to radiotherapy. In contrast, there was no significant relationship between time to treatment initiation and sociocultural factors including age, education, and inability to pay. Infrastructural barriers, including machine breakdown (OR, 2.92; P = .001), worker strikes (OR, 2.64; P = .001), and power outages (OR, 2.81; P = .022), increased the odds of treatment delay. CONCLUSION Although delays caused by patient factors are reported extensively, patients overcame these barriers in the hopes of curative treatment. However, staff and equipment malfunctions prevented patients from receiving timely radiotherapy. Policies aimed at addressing machine maintenance, health care worker satisfaction, and the aging power grid in Nigeria must be implemented in the future to strengthen the health care system to care for patients with cancer.
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Affiliation(s)
- Jim Leng
- University of Chicago Pritzker School of Medicine, Chicago, IL
| | - Atara I. Ntekim
- Department of Radiation Oncology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Chidinma P. Anakwenze
- Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Daniel W. Golden
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL
| | - Olufunmilayo I. Olopade
- Center for Clinical Cancer Genetics & Global Health, Department of Medicine, University of Chicago, Chicago, IL
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Qiu HZ, Huang J, Xiang CC, Li R, Zuo ED, Zhang Y, Shan L, Cheng X. Screening and Discovery of New Potential Biomarkers and Small Molecule Drugs for Cervical Cancer: A Bioinformatics Analysis. Technol Cancer Res Treat 2020; 19:1533033820980112. [PMID: 33302814 PMCID: PMC7734488 DOI: 10.1177/1533033820980112] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 10/09/2020] [Accepted: 11/04/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Cervical cancer (CC) is the second most common type of malignant tumor survival rate is low in advanced stage, metastatic, and recurrent CC patients. This study aimed at identifying potential genes and drugs for CC diagnosis and targeting therapies. METHODS Three GEO mRNA microarray datasets of CC tissues and non-cancerous tissues were analyzed for differentially expressed genes (DEGs) by limma package. GO (Gene Ontologies) and KEGG (Kyoto Encyclopedia of Genes and Genomes) were used to explore the relationships between the DEGs. Protein-protein interaction (PPI) of these genes was established by the STRING database. MCODE was used for screening significant modules in the PPI networks to select hub genes. Biochemical mechanisms of the hub genes were investigated with Metascape. GEPIA database was used for validating the core genes. According to these DEGs, molecular candidates for CC were recognized from the CMAP database. RESULTS We identified 309 overlapping DEGs in the 2 tissue-types. Pathway analysis revealed that the DEGs were involved in cell cycle, DNA replication, and p53 signaling. PPI networks between overlapping DEGs showed 68 high-connectivity DEGs that were chosen as hub genes. The GEPIA database showed that the expression levels of RRM2, CDC45, GINS2, HELLS, KNTC1, MCM2, MYBL2, PCNA, RAD54 L, RFC4, RFC5, TK1, TOP2A, and TYMS in CC tissues were significantly different from those in the healthy tissues and were significantly relevant to the OS of CC. We found 10 small molecules from the CMAP database that could change the trend of gene expression in CC tissues, including piperlongumine and chrysin. CONCLUSIONS The 14 DEGs identified in this study could serve as novel prognosis biomarkers for the detection and forecasting of CC. Small molecule drugs like piperlongumine and chrysin could be potential therapeutic drugs for CC treatment.
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Affiliation(s)
- Hui-Zhu Qiu
- Department of Hematology and Oncology, Soochow University Affiliated Taicang Hospital (The First People’s Hospital of Taicang), Jiangsu, China
| | - Ji Huang
- Department of Pharmacy, Soochow University Affiliated Taicang Hospital (The First People’s Hospital of Taicang), Jiangsu, China
| | - Cheng-Cheng Xiang
- Department of Hematology and Oncology, Soochow University Affiliated Taicang Hospital (The First People’s Hospital of Taicang), Jiangsu, China
| | - Rong Li
- Department of Hematology and Oncology, Soochow University Affiliated Taicang Hospital (The First People’s Hospital of Taicang), Jiangsu, China
| | - Er-Dong Zuo
- Department of Hematology and Oncology, Soochow University Affiliated Taicang Hospital (The First People’s Hospital of Taicang), Jiangsu, China
| | - Yuan Zhang
- Department of Hematology and Oncology, Soochow University Affiliated Taicang Hospital (The First People’s Hospital of Taicang), Jiangsu, China
| | - Li Shan
- Department of Hematology and Oncology, Soochow University Affiliated Taicang Hospital (The First People’s Hospital of Taicang), Jiangsu, China
| | - Xu Cheng
- Department of Hematology and Oncology, Soochow University Affiliated Taicang Hospital (The First People’s Hospital of Taicang), Jiangsu, China
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Tebeu P, Antaon JS, Woromogo S, Tatsipie W, Kibimi C, Njiki R. Knowledges, attitudes, and practices on cervical cancer screening by women in Brazzaville-Congo. JOURNAL OF CANCER RESEARCH AND PRACTICE 2020. [DOI: 10.4103/jcrp.jcrp_7_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Ngwenya D, Huang SL. Knowledge, attitude and practice on cervical cancer and screening: a survey of men and women in Swaziland. J Public Health (Oxf) 2019; 40:e343-e350. [PMID: 29294055 DOI: 10.1093/pubmed/fdx174] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Indexed: 11/14/2022] Open
Abstract
Background Cervical cancer is the most common cancer among females in Swaziland, yet the screening rate remains low. The study intended to explore the knowledge, attitudes and practice on cervical cancer and screening. Methods A cross-sectional questionnaire survey was conducted among 202 men and 213 women aged 30-65 years. The participants were from the Manzini and Shiselweni regions of Swaziland, sampled from both rural (77.8%) and urban areas. Results About half (53.5%) of women and 22.8% of men correctly named at least one symptom of cervical cancer. Many (58.1%) participants had misconceptions on the risk factors of cervical cancer, such as witchcraft, abortion, or birth control. Only 5.2% of the women had been screened. Among women, 40.0% reported that they need to seek their spouses' permission to visit the clinic. Men with less misconceptions on cervical cancer heard of screening and with no preference of the gender of the health care worker were more likely to report that they would allow their partners to be screened. Conclusions Men have less knowledge on cervical cancer yet may make important health related decisions for women. There is a need for comprehensive education on cervical cancer for both women and men.
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Affiliation(s)
- Dumsile Ngwenya
- International Health Program, National Yang Ming University, Taipei, Taiwan
| | - Song-Lih Huang
- Institute of Public Health, National Yang Ming University, 155, Sec. 2, Li-Nong Street, Room 304, Medical Building II, Taipei, Taiwan
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Elewonibi B, BeLue R. The influence of socio-cultural factors on breast cancer screening behaviors in Lagos, Nigeria. ETHNICITY & HEALTH 2019; 24:544-559. [PMID: 28678532 DOI: 10.1080/13557858.2017.1348489] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 06/02/2017] [Indexed: 06/07/2023]
Abstract
Culture has been shown to influence health beliefs and health-related behaviors by influencing the type of health information to which women have been exposed and shapes health and illness perceptions and practices. To increase screening rates, cultural influences should be considered as important correlates of screening behaviors for breast cancer. This study used semi-structured interviews of women attending a cancer screening facility in Lagos, Nigeria guided by the PEN-3 model to describe culturally relevant factors that shape attitudes toward breast cancer and breast cancer screening. Religion was the most prominent theme and was shown to have positive, negative and existential effect on breast cancer perceptions. Other major themes observed were related to family and traditional beliefs. The results from this study could be used to develop and implement culturally relevant cancer prevention interventions, strategies, and recommendations to overcome screening barriers in an effort to increase breast cancer participation and awareness among Nigerian women.
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Affiliation(s)
- Bilikisu Elewonibi
- a Department of Health Policy and Administration and Demography , The Pennsylvania State University , University Park , PA , USA
| | - Rhonda BeLue
- a Department of Health Policy and Administration and Demography , The Pennsylvania State University , University Park , PA , USA
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Devarapalli P, Labani S, Nagarjuna N, Panchal P, Asthana S. Barriers affecting uptake of cervical cancer screening in low and middle income countries: A systematic review. Indian J Cancer 2019; 55:318-326. [PMID: 30829264 DOI: 10.4103/ijc.ijc_253_18] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Cervical cancer is the second-most common cancer among women in the developing world and approximately 500,000 cases are diagnosed each year. In developed countries, cervical cancer (CCa) accounts for only 3.6% of newly diagnosed cancers. OBJECTIVE The present study aims to identify the most effective barriers associated with CCa screening uptake in low and middle-income countries (L and MICs) and aid to adopt effective measures to overcome prevailing barriers to the attainment of CCa uptake in the community. MATERIALS AND METHODS Health sciences electronic databases like MEDLINE, PubMed, Cochrane library, and Google Scholar were searched for studies published until August 2017. Keywords used for the search were ("cervical cancer screening"), ("barriers"), AND ("low income countries" OR "Middle income countries"). Articles were reviewed and data were extracted by using Mendeley Desktop Software (V-1.17.10). Income-level classification of countries was done as per the World Bank 2017 report. Statistical software like SPSS-V.23 and Medical-V.14 were used for the statistical application. RESULTS A total of 31 studies met the inclusion criteria with a total of 25,650 participants. The sample size of the included studies ranged from 97 to 5929 participants. Articles majorly reported data on participants from African region (51.6%) and minimally in the Western Pacific region (3.2%). Sampling methods among studies varied from convenience sampling-12 (39.7%) to consecutive sampling-1 (3.2%). Besides, two studies (6.5%) did not discuss their sampling procedures. It was observed that "Lack of information about CCa and its treatment" (Barrier of lack of knowledge and Awareness); "Embracement or shy" (Psychological Barrier); "Lack of time" (structural Barrier); and "Lack of family support" (Sociocultural and religious barrier) were the most commonly reported among all 22 barriers. CONCLUSION There is a need of policies advancement of CCa screening programs by focusing on aspects of accessibility, affordability, CCa education, and the necessity of screening to improve screening uptake to control the CCa morbidity and mortality rate in L and MIC's.
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Affiliation(s)
- Pradeep Devarapalli
- Department of Epidemiology and Biostatistics, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, I-7, Sector-39, Noida, Uttar Pradesh, India
| | - Satyanarayana Labani
- Department of Epidemiology and Biostatistics, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, I-7, Sector-39, Noida, Uttar Pradesh, India
| | - Narayanasetti Nagarjuna
- Department of Epidemiology and Biostatistics, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, I-7, Sector-39, Noida, Uttar Pradesh, India
| | - Poonam Panchal
- Department of Epidemiology and Biostatistics, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, I-7, Sector-39, Noida, Uttar Pradesh, India
| | - Smita Asthana
- Department of Epidemiology and Biostatistics, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, I-7, Sector-39, Noida, Uttar Pradesh, India
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Re-thinking breast and cervical cancer preventive campaigns in developing countries: the case for interventions at high schools. BMC Public Health 2019; 19:503. [PMID: 31053073 PMCID: PMC6500011 DOI: 10.1186/s12889-019-6890-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 04/24/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The negative impact of cervical and breast cancers in low and lower-middle income countries are worsening, and, along with other non-communicable diseases, occur disproportionately in these resource-limited economies. Most preventive approaches to these cancers require government funding, but few countries with the most at-risk population can afford government-sponsored universal vaccination, screening, diagnostic and treatment programmes, which, along with socioeconomic issues, contribute to the poor outcomes in these mostly developing countries. An urgent need exists, therefore, to find an effective, affordable, cost-effective, culturally-acceptable and sustainable way of reducing these cancers. This paper advocates a re-thinking in the current preventive campaigns. MAIN BODY Using evidence provided by recently-published papers, a case is made for enlightenment campaigns to primarily target teenagers (boys and girls) in high schools of developing countries. Inclusions into the schools' academic curricula are the recommended approach, given that both cancers take hold on populations within that age bracket. This approach, if adopted, may be the only accessible, affordable and realistic approach that gives millions of women in low and lower-middle income countries the chance at survival. Empowering them early instils the self-awareness and confidence necessary for young adults to take charge of their own health. The acquired knowledge, in turn, helps them adopt positive attitudes and preventive behaviours that will, ultimately, prolong their lives. CONCLUSION The recommended approach offers governments and concerned stakeholders an evidence-based option that allows them to deliver cost-effective and sustainable life-saving interventions, while hoping to get around the bottlenecks that limit the large scale implementation of other effective but capital-intensive strategies.
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Dhaher EA. Knowledge, Attitudes and Practices of Women in the Southern
Region of Saudi Arabia Regarding Cervical Cancer and the
Pap Smear Test. Asian Pac J Cancer Prev 2019; 20:1177-1184. [PMID: 31030492 PMCID: PMC6948894 DOI: 10.31557/apjcp.2019.20.4.1177] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: The main barrier for women to receive Papanicolaou (Pap) smear tests and immunization is lack of knowledge about the disease’s signs and symptoms, women’s attitudes toward prevention programs and cultural myths and beliefs. Therefore, the main objective of this study is to measure women’s knowledge, attitudes and practices about cervical cancer and the Pap smear test in the southern region of Saudi Arabia and to assess the findings in relation with women’s demographics. Methods: A cross sectional survey was conducted at the Armed Forces Hospital Southern Region Obstetrics and Gynecology Clinic using a self-administered questionnaire with a sample size of 255 women between the ages of 15 and 65 years. Results: Forty-three percent of the women in this region are aware of cervical cancer, but do not recognize its risk factors, implications, timing or main cause, which is Human papillomavirus (HPV). In fact, the primary source of information was obtained through social media. Only two women conducted Pap smear test and that was based on doctor’s referral, where women’s main reason from not conducting the test was feeling good and no need. Conclusions: There is a need, therefore, to create awareness programs for cervical cancer, its causes and risk factors, as well as its preventive measures for women in the southern region of Saudi Arabia.
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Affiliation(s)
- Enas A Dhaher
- Dean of the Female Nursing Institute, Armed Forces Hospital Southern Region of Saudi Arabia.
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Barchi F, Winter SC, Ketshogile FM, Ramogola-Masire D. Adherence to screening appointments in a cervical cancer clinic serving HIV-positive women in Botswana. BMC Public Health 2019; 19:318. [PMID: 30885175 PMCID: PMC6423763 DOI: 10.1186/s12889-019-6638-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 03/08/2019] [Indexed: 11/24/2022] Open
Abstract
Background The link between human immunodeficiency virus (HIV) and cervical cancer is of particular concern in Botswana, where one in four women at risk for cervical cancer is HIV-positive. In settings where co-occurrence of these diseases is high, adherence to screening appointments is essential to ensure detection and early treatment. Methods This study took place in a cervical cancer-screening program in an HIV clinic in Botswana. Data for this analysis came from 1789 patient records and 257 semi-structured surveys about the screening consent process that were completed by a subset of patients. Results Forty percent of women kept their scheduled follow-up appointments. Findings suggest that women treated at first visit or referred for additional treatment due to the presence of more advanced disease had more than double the odds of adhering to follow-up appointments compared to women with negative screens. Women who completed the 35-min surveys in the embedded consent study were found to have 3.7 times greater odds of adhering to follow-up appointment schedules than women who did not. Factors such as age, education, income and marital status that have been shown elsewhere to be important predictors of adherence were not found to be significant predictors in this study. Conclusions HIV-positive women in Botswana who are symptom free at initial screening may be lost to essential future screening and follow-up care without greater targeted communication regarding cervical cancer and the importance of regular screening. Strategies to reinforce health messages using cell phone reminders, appointment prompts at time of anti-retroviral drug (ARV) refills, and use of trained community workers to review cervical cancer risks may be effective tools in reducing the burden of cervical cancer disease in HIV-positive women in this setting. Electronic supplementary material The online version of this article (10.1186/s12889-019-6638-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Francis Barchi
- Edward J. Bloustein School of Planning & Public Policy, Rutgers, The State University of New Jersey, 33 Livingston Avenue, New Brunswick, NJ, 08901, USA.
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Maju M, Sharma A, Beeram A, Ostrach B. A colonial legacy of HIV/AIDS, NTD, and STI super-syndemics: Eugenicist foreign aid and intertwined health burdens in Nigeria. Glob Public Health 2019; 14:1221-1240. [PMID: 30829113 DOI: 10.1080/17441692.2019.1582683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Syndemics theory has been applied to the structurally shaped, biologically facilitated co-occurrence of HIV/AIDS with Neglected Tropical Diseases (NTDs) and with sexually transmitted infections (STIs). The biological and social pathways of interaction between all three ailments have not yet been analysed together. The effects of these diseases are often exacerbated by structural factors including access to care and socioeconomic status. We explore the interrelated biological pathways and structural factors that have further heightened the risk for HIV/AIDS, NTDs, and STIs. Furthermore, we argue women in rural areas are at an increased risk for all three diseases due to biological and social factors including increased distance to quality care and lower reproductive autonomy. This paper integrates the established syndemics of HIV/NTDs and HIV/STIs within the historical and modern contexts of colonisation and neo-colonisation in Nigeria. We explore the effects of colonisation on women's health by evaluating the influence of foreign aid policies, structural programmes, and shifting gender norms. Applying a syndemic approach, juxtaposed by historical contextualisation, offers important implications for the prevention and treatment of HIV/AIDS, STIs, and NTDs. Our analysis suggests a perspective through which to view health of regions with a history of colonisation.
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Affiliation(s)
- Mehar Maju
- a Department of Community Health Sciences, UCLA Fielding School of Public Health , Los Angeles, CA , USA.,b Department of Anthropology , Boston University , Boston, MA , USA
| | - Andria Sharma
- c Department of Biology , Boston University , Boston, MA , USA.,d Rutgers New Jersey Medical School, School of Medicine, Newark , New Jersey , USA
| | - Archana Beeram
- c Department of Biology , Boston University , Boston, MA , USA.,e Imperial College London, School of Public Health , London , UK
| | - Bayla Ostrach
- f Family Medicine, and Affiliated Faculty, Medical Anthropology , Boston University School of Medicine , Boston, MA.,g Sociology and Anthropology , University of North Carolina Asheville , NC , USA
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24
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Anaman JA, Correa-Velez I, King J. A survey of cervical screening among refugee and non-refugee African immigrant women in Brisbane, Australia. Health Promot J Austr 2019; 28:217-224. [PMID: 27802410 DOI: 10.1071/he16017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 08/31/2016] [Indexed: 11/23/2022] Open
Abstract
Issue addressed To compare the level of cervical screening uptake between refugee and non-refugee African immigrant women living in Brisbane, Australia, and examine factors associated with Pap smear testing. Methods Cross-sectional survey with a convenience sample of 254 women aged 21-62 years from 22 African countries (144 refugees, 110 non-refugees). Chi-square tests were used to compare the demographic and health-related characteristics between refugee and non-refugee women. Bivariate and multiple logistic regression analyses were used to assess the relationship between the outcome variable (Pap smear testing) and the independent variables. Results Two-thirds of women had used Pap smear services in Australia. Chi-square test analysis established that non-refugee women were significantly more likely to have used Pap smear services than refugee women (73.6% vs 61.8% respectively; P=0.047). Immigration status, however, was not a significant predictor of cervical screening uptake in the multiple regression analyses. The significant predictors for screening uptake in these analyses were work arrangement, parity, healthcare visit, knowledge about Pap smear and perceived susceptibility to cervical cancer. Conclusion Most women relied on opportunistic screening after receiving invitation letters to screen or after visiting health professionals for antenatal or postnatal care. So what? The findings suggest that organised cervical screening programs are not reaching most African immigrant women living in Brisbane. It is incumbent on the public health sector, including healthcare professionals and settlement agencies working with African communities, to develop health promotion strategies that meaningfully engage African immigrant women, including those from refugee backgrounds, to enhance their knowledge about cervical cancer and screening practices.
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Affiliation(s)
- Judith A Anaman
- School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia
| | - Ignacio Correa-Velez
- School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia
| | - Julie King
- School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia
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25
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Jradi H, Bawazir A. Knowledge, attitudes, and practices among Saudi women regarding cervical cancer, human papillomavirus (HPV) and corresponding vaccine. Vaccine 2018; 37:530-537. [PMID: 30503079 DOI: 10.1016/j.vaccine.2018.11.065] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 09/13/2018] [Accepted: 11/16/2018] [Indexed: 10/27/2022]
Abstract
AIM To our knowledge there are no studies exploring Saudi women's understanding of the importance of the human papillomavirus (HPV) vaccine. In the present study, we examined the awareness of HPV and women's attitudes toward the HPV vaccine. METHOD Nine focus groups were formed in Riyadh City, Saudi Arabia, including 77 women between the ages of 18 and 45 years old. Face-to-face interviews were conducted in 58 female healthcare providers to examine women's awareness of cervical cancer, HPV, barriers, acceptance, beliefs, and attitudes towards the HPV vaccine. RESULTS Focus group discussions revealed a lack of knowledge and awareness of cervical cancer, HPV, and the HPV vaccine. Cultural concerns regarding screening and vaccinating for a conventionally known sexually transmitted infection were an emerging theme in addition to not perceiving cervical cancer screening as necessary because women with no signs and symptoms considered themselves not at risk for developing cervical cancer. Approximately 30% of healthcare providers other than physicians were unaware of prevention methods, and 63.3% did not practice any screening methods for cervical cancer and attributed the lack of screening to "no specific reasons at all". CONCLUSION Because of the unfavorable knowledge and attitude of HPV infection and the associated vaccine from the women in the present study, emphasis should be directed to educate and promote awareness of women to the risk factors of cervical cancer and to the need for screening programs and the administration of the vaccine.
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Affiliation(s)
- Hoda Jradi
- Public and Environmental Health, College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Amen Bawazir
- Public and Environmental Health, College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, National Guard Health Affairs, Riyadh, Saudi Arabia.
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26
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Mueller JL, Lam CT, Dahl D, Asiedu MN, Krieger MS, Bellido-Fuentes Y, Kellish M, Peters J, Erkanli A, Ortiz EJ, Muasher LC, Taylor PT, Schmitt JW, Venegas G, Ramanujam N. Portable Pocket colposcopy performs comparably to standard-of-care clinical colposcopy using acetic acid and Lugol's iodine as contrast mediators: an investigational study in Peru. BJOG 2018; 125:1321-1329. [PMID: 29893472 DOI: 10.1111/1471-0528.15326] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Our goal was to develop a tele-colposcopy platform for primary-care clinics to improve screening sensitivity and access. Specifically, we developed a low-cost, portable Pocket colposcope and evaluated its performance in a tertiary healthcare centre in Peru. DESIGN AND SETTING Images of the cervix were captured with a standard-of-care and Pocket colposcope at la Liga Contra el Cáncer in Lima, Peru. POPULATION Two hundred Peruvian women with abnormal cytology and/or human papillomavirus positivity were enrolled. METHODS Images were collected using acetic acid and Lugol's iodine as contrast agents. Biopsies were taken as per standard-of-care procedures. MAIN OUTCOME MEASURES After passing quality review, images from 129 women were sent to four physicians who provided a diagnosis for each image. RESULTS Physician interpretation of images from the two colposcopes agreed 83.1% of the time. The average sensitivity and specificity of physician interpretation compared with pathology was similar for the Pocket (sensitivity = 71.2%, specificity = 57.5%) and standard-of-care (sensitivity = 79.8%, specificity = 56.6%) colposcopes. When compared with a previous study where only acetic acid was applied to the cervix, results indicated that adding Lugol's iodine as a secondary contrast agent improved the percent agreement between colposcopes for all pathological categories by up to 8.9% and the sensitivity and specificity of physician interpretation compared with pathology by over 6.0 and 9.0%, respectively. CONCLUSIONS The Pocket colposcope performance was similar to that of a standard-of-care colposcope when used to identify precancerous and cancerous lesions using acetic acid and Lugol's iodine during colposcopy examinations in Peru. TWEETABLE ABSTRACT The Pocket colposcope performance was similar to that of a standard-of-care colposcope when identifying cervical lesions.
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Affiliation(s)
- J L Mueller
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - C T Lam
- Department of Biomedical Engineering, Duke University, Durham, NC, USA.,Duke Global Health Institute, Duke University, Durham, NC, USA
| | - D Dahl
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - M N Asiedu
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - M S Krieger
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | | | - M Kellish
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - J Peters
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - A Erkanli
- Department of Biostatistics and Bioinformatics, Duke University Medical School, Durham, NC, USA
| | - E J Ortiz
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - L C Muasher
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
| | - P T Taylor
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA.,Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - J W Schmitt
- Duke Global Health Institute, Duke University, Durham, NC, USA.,Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
| | - G Venegas
- Liga Contra el Cáncer, Pueblo Libre, Lima, Peru
| | - N Ramanujam
- Department of Biomedical Engineering, Duke University, Durham, NC, USA.,Duke Global Health Institute, Duke University, Durham, NC, USA
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Anaman JA, Correa-Velez I, King J. Knowledge Adequacy on Cervical Cancer Among African Refugee and Non-Refugee Women in Brisbane, Australia. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:716-723. [PMID: 27796876 DOI: 10.1007/s13187-016-1126-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Cervical cancer is a significant public health issue, especially in the developing countries of sub-Saharan Africa. To examine knowledge adequacy on cervical cancer and screening test among African refugee and non-refugee women in Brisbane and further examine whether the level of knowledge vary between refugee and non-refugee women. A cross-sectional survey was conducted among 254 African-born women conveniently sampled from the Brisbane local government area. The outcome measures were knowledge on cervical cancer and Pap smear. In the multivariate logistic regression analysis non-refugees were more likely than refugees to have adequate knowledge about cervical cancer. Also, non-refugee women who were older and educated beyond secondary school, were more likely to have good knowledge about Pap smear test than refugee women. Overall, knowledge level about cervical cancer is limited among the participants and non-refugee women were more likely than refugee women to have good knowledge about cervical cancer and the screening test. These findings may inform the development of health education interventions for the targeted population to improve knowledge and awareness about cervical cancer and the screening guidelines in Australia.
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Affiliation(s)
- Judith A Anaman
- University of Health and Allied Sciences School of Nursing and Midwifery, PMB 31, Ho, Volta Region, Ghana.
- School of Public Health and Social Work, Queensland University of Technology (QUT)-Brisbane, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia.
| | - Ignacio Correa-Velez
- School of Public Health and Social Work, Queensland University of Technology (QUT)-Brisbane, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia
| | - Julie King
- School of Public Health and Social Work, Queensland University of Technology (QUT)-Brisbane, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia
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Ifediora CO, Azuike EC. Knowledge and attitudes about cervical cancer and its prevention among female secondary school students in Nigeria. Trop Med Int Health 2018; 23:714-723. [PMID: 29737004 DOI: 10.1111/tmi.13070] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To ascertain the level of awareness and attitudes towards cervical cancer among secondary school students in Nigeria. METHOD Cross-sectional survey of 432 female senior secondary school students in south-eastern Nigeria. RESULTS A total of 321 (74.3%) responses were valid; 42.7% had heard of cervical cancer, 32.8% of screening, 23.2% of Pap smears and 22.0% of HPV/HPV vaccinations. No widely available reliable source of information exists. General knowledge about Pap smears (41.8%) and HPV (43.1%) was poor, as was specific knowledge about their benefits, timing and frequency, and about HPV vaccinations, but associated attitudes were moderately positive at 60.2% and 65.1%, respectively. Awareness of cervical cancers increases knowledge about when to start screening (OR = 2.30; P = 0.02) and about early symptoms of cervical cancer (OR = 2.56; P = 0.001). CONCLUSION Overall knowledge of cervical cancer is poor, but attitudes are positive. Awareness campaigns are therefore necessary, and are expected to be effective. Campaigns should target teenage females, and commencing teaching in high schools of developing countries, through materials included in their academic curricula, is recommended.
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Affiliation(s)
| | - Emmanuel C Azuike
- Department of Community Medicine, Chukwuemeka Odumegwu Ojukwu University, Awka, Nigeria
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Saei Ghare Naz M, Kariman N, Ebadi A, Ozgoli G, Ghasemi V, Rashidi Fakari F. Educational Interventions for Cervical Cancer Screening Behavior of Women: A Systematic Review. Asian Pac J Cancer Prev 2018; 19:875-884. [PMID: 29693331 PMCID: PMC6031778 DOI: 10.22034/apjcp.2018.19.4.875] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Cervical cancer is the second most common cancer in women worldwide; early detection can play a key role in reducing the associated morbidity. The objective of this study was to systematically assess the effects of educational interventions on cervical cancer screening (CCS) behavior of women. Methods: In this review the Cochrane library, Web of Science, Science Direct, PubMed, Scopus and search engine of Google scholar were searched for all interventional studies (trails, pre- and post-test or quasi-experimental) published in 2000-2017 for a systematic review, The search was based on the following keywords: cervix cancer, uterine cervical neoplasms, screening, prevention and control, Papanicolaou Test, pap test, pap smear, education, intervention, systematic review. Due to the heterogeneity of the data, a qualitative analysis was performed. Results: Thirty seven articles with 15,658 female participants in different parts of world were included in the review. About three quarters of the articles covered behavior change interventions. About one fourth of the articles were based on health education methods. The heath belief model is the most popular used framework for cervical cancer screening interventions. The results of our study showed that different health education methods (such as calls, mailed postcards, mother/daughter education. consultation sessions, picture books, videos, PowerPoint slides, small group discussions, educational brochures, radio broadcast education, lecture presentations, tailored counseling and a fact sheet, Self-learning package, face-to- face interviews and etc) are effective in modifying cervical cancer screening behavior of women. Conclusions: Our results showed that the different interventions and health behavior change frameworks provide an effective base for cervical cancer prevention. Heath providers can chose educational methods based on the particular client situations.
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Affiliation(s)
- Marzieh Saei Ghare Naz
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. gozgoli@sbmu. ac.ir
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Ebu NI. Facilitators and barriers to cervical cancer screening among HIV-positive women in Ghana. ACTA ACUST UNITED AC 2018. [DOI: 10.12968/ajmw.2018.12.2.93] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Nancy Innocentia Ebu
- Lecturer, University of Cape Coast, School of Nursing and Midwifery, Department of Public Health, Ghana
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Hou SI. Subjective and Objective Cancer Screening Knowledge Among White- and Blue-Collar Chinese Midlife Adults. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:167-173. [PMID: 27565165 DOI: 10.1007/s13187-016-1104-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Cancer is the leading cause of death among Chinese, yet little is known about cancer knowledge among this population. The study described the subjective and objective cancer screening knowledge among white- versus blue-collar Chinese midlife adults. A convenient sample of white-collar adults age 40+ years was recruited from government and academic agencies; and blue-collar adults age 40+ years were recruited from manufactory companies in Taiwan. An eight-item cancer screening knowledge test (CSKT) was used to measure objective knowledge and one five-point Likert scale item for assessing subjective (perceived) cancer screening knowledge. A total of 208 white- and 533 blue-collar workers completed the survey during 2008-2011. Mean ages between groups were comparable (41.1 versus 46.3 years), as well as family cancer history (41.5 %). About 76 % of the white-collar and 43 % of the blue-collar adults had college education. The mean score of the CSKT was lower in the blue-collar versus white-collar workers, 5.4 (SD = 1.76) versus 6.1 (SD = 1.40), indicating on average, 68 versus 76 % of the participants answered the cancer knowledge correctly. The subjective knowledge levels were, however, higher among the blue-collar workers (mean rating of 3.22 versus 2.78). The CSKT showed a good mix of relatively easy and moderately difficult items in both groups. Study showed that overall cancer screening knowledge was low among Chinese midlife adults. Although blue-collar workers scored lower on CSKT, the perceived knowledge level was higher. Results also suggest attention to communicating cancer screening information among Chinese blue-collar midlife workers in particular.
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Affiliation(s)
- Su-I Hou
- Doctoral Program in Public Affairs/Health Management & Informatics, College of Health & Public Affairs, University of Central Florida, HPA I, Room 217, 12805, Orlando, FL, 32816-1600, USA.
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Jassim G, Obeid A, Al Nasheet HA. Knowledge, attitudes, and practices regarding cervical cancer and screening among women visiting primary health care Centres in Bahrain. BMC Public Health 2018; 18:128. [PMID: 29325528 PMCID: PMC5765703 DOI: 10.1186/s12889-018-5023-7] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 01/02/2018] [Indexed: 11/22/2022] Open
Abstract
Background Cervical cancer is one of the most common cancers among women, with 80% of the cases occurring in developing countries. Cervical cancer is largely preventable by effective screening programs. This has not been possible with opportunistic screening and its low use in the Kingdom of Bahrain. The objective of this study was to explore the knowledge, attitudes, and practices of women attending primary care health centres for cervical cancer screening. Methods This was a cross-sectional study of 300 women attending primary health care centres in Bahrain. We used a validated tool comprised of 45 items to collect data through face-to-face interviews between December 2015 and February 2016. Descriptive data are presented for demographic data, and frequency distributions with percentages are presented for each item of the knowledge and attitude questionnaire. Results The mean age ± SD of the participants was 37.24 ± 11.89 years, they were mostly married (221; 73.7%), and had a high school or higher education (261; 87%). Over 64% (194 participants) had never heard of a Pap smear procedure and only 3.7% (11 participants) had heard about the human papillomavirus (HPV) vaccine. Nearly 64% (192 participants) believed that a Pap smear was helpful in detecting pre-cancer and cancer of the cervix, and 44.3% (133 participants) believed that they should have a Pap smear at least every 3 years. Regarding the practice, only 40.7% (122 participants) had a Pap smear in their lifetime. The majority of participants felt embarrassed when examined by a male doctor (250, 83.3%) and few underwent a Pap smear screening if they were never married (69, 23.0%). Conclusions The participants demonstrated a wide range of knowledge and attitudes towards cervical cancer screening. However, the majority demonstrated positive attitudes towards the HPV vaccine.
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Affiliation(s)
- Ghufran Jassim
- Family Medicine Department, Royal College of Surgeons in Ireland -Medical University of Bahrain, Busaiteen Bahrain, Box 15503, Adliya, PO, Bahrain.
| | - Alaaeddin Obeid
- Family Medicine Department, Royal College of Surgeons in Ireland -Medical University of Bahrain, Busaiteen Bahrain, Box 15503, Adliya, PO, Bahrain
| | - Huda A Al Nasheet
- Family Medicine Department, Royal College of Surgeons in Ireland -Medical University of Bahrain, Busaiteen Bahrain, Box 15503, Adliya, PO, Bahrain
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Hou SI, Liu LJ. Objective and Subjective Cancer Knowledge Among Faith-Based Chinese Adults. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2018; 38:47-56. [PMID: 29298633 DOI: 10.1177/0272684x17749567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examined cancer knowledge between church-going younger versus older Chinese adults. Hou's 8-item validated cancer screening knowledge test (CSKT) and a new 14-item cancer warning signs test (CWST) were used to assess objective knowledge. Subjective knowledge was measured by one overall 5-point Likert scale item. A total of 372 Taiwanese and Chinese Americans from nine churches participated. Although there were no significant differences by age on either the CSKT scores (younger = 5.89 vs. older = 5.71; p = .297) or the CWST (younger = 6.27 vs. older = 5.86; p = .245), subjective knowledge was higher among older Chinese adults (younger = 2.44 vs. older = 3.05, p < .001). Older Chinese adults were also more likely to identify cancer warning signs correctly, while younger adults were more likely to identify false warning signs correctly. Results have implication on tailoring cancer knowledge type (subjective vs. objective) and content domain (screening vs. warning signs). Findings can help health educators better understand cancer education needs among Chinese adults.
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Affiliation(s)
- Su-I Hou
- 1 50616 College of Health and Public Affairs, University of Central Florida , Orlando, FL, USA
| | - Ling Jie Liu
- 2 Department of Health Promotion and Behavior, College of Public Health, 1355 University of Georgia , Athens, GA, USA
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Kabalika C, Mulenga D, Mazaba ML, Siziya S. Acceptance of Cervical Cancer Screening and its Correlates Among Women of a Peri-Urban High-Density Residential Area in Ndola, Zambia. Int J MCH AIDS 2018; 7:17-27. [PMID: 30305986 PMCID: PMC6168797 DOI: 10.21106/ijma.223] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Zambia has one of the highest cervical cancer incidence and mortality rates in the world. Cervical cancer screening leads to reduction in the incidence of invasive disease. The objectives of the study were to determine the level of acceptance of cervical cancer screening and its correlates among women of a peri-urban high-density residential area in Ndola, Zambia. METHODS A cross sectional study was conducted. With a population size of 12,000 women in reproductive age and using an expected frequency of 50 + 5% and at 95% confidence interval, the required sample size was 372. A stratified sampling method was used to select participants. Independent factors that were associated with the outcome were established using multi-variate logistic regression. Adjusted odds ratios and their 95% confidence intervals are reported. RESULTS In total, 355 out of 372 questionnaires were administered, achieving a response rate of 95.4%. Out of 355 participants, 9 (2.5%) had ever been screened for cervical cancer. In bivariate analyses, factors associated with screened were knowledge of body part affected, screening as a prevention tool, whether cervical cancer was curable in its early stages or not, awareness of cervical cancer screening, knowledge on frequency of screening and cervical cancer screening causing harm. However, in multivariate analysis, participants who knew that cervical cancer screening prevented cervical cancer were 3.58 (95% CI [1.49, 8.64]) times more likely to have been screened than those who did not have the knowledge. Participants who knew that cervical cancer is curable were 2.76 (95% CI [1.92, 8.31]) times more likely to have been screened than those who did not have the knowledge. CONCLUSION AND GLOBAL HEALTH IMPLICATIONS The uptake of screening was low. Interventions should be designed to increase uptake of screening for cervical cancer by considering factors that have been identified in the current study that are independently associated with cervical cancer screening among this population.
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Affiliation(s)
- Chiluba Kabalika
- Clinical Sciences Department, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola, Zambia
| | - David Mulenga
- Clinical Sciences Department, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola, Zambia
| | - Mazyanga Lucy Mazaba
- The Health Press, Zambia. Institute of Public Health, Ministry of Health, Lusaka, Zambia
| | - Seter Siziya
- Clinical Sciences Department, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola, Zambia
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Erku DA, Netere AK, Mersha AG, Abebe SA, Mekuria AB, Belachew SA. Comprehensive knowledge and uptake of cervical cancer screening is low among women living with HIV/AIDS in Northwest Ethiopia. GYNECOLOGIC ONCOLOGY RESEARCH AND PRACTICE 2017; 4:20. [PMID: 29276611 PMCID: PMC5738137 DOI: 10.1186/s40661-017-0057-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 12/04/2017] [Indexed: 12/02/2022]
Abstract
Background In Ethiopia, cervical cancer is ranked as the second most common type of cancer in women and it is about 8 times more common in HIV infected women. However, data on knowledge of HIV infected women regarding cervical cancer and acceptability of screening is scarce in Ethiopia. Hence, the present study was aimed at assessing the level of knowledge of about cervical cancer and uptake of screening among HIV infected women in Gondar, northwest Ethiopia. Methods A cross sectional, questionnaire based survey was conducted on 302 HIV infected women attending the outpatient clinic of University of Gondar referral and teaching hospital from March 1 to 30, 2017. Descriptive statistics, univariate and multivariate logistic regression analysis were also performed to examine factors associated with uptake of cervical cancer screening service. Results Overall, only 64 (21.2%) of respondent were knowledgeable about cervical cancer and screening and only 71 (23.5%) of respondents were ever screened in their life time. Age between 21 and 29 years old (AOR = 2.78, 95% CI = 1.71–7.29), perceived susceptibility to develop cervical cancer (AOR =2.85, 95% CI = 1.89–6.16) and comprehensive knowledge of cervical cancer (AOR = 3.02, 95% CI = 2.31–7.15) were found to be strong predictors of cervical cancer screening service uptake. Conclusion The knowledge and uptake of cervical cancer screening among HIV infected women was found to be very poor. Taking into consideration the heightened importance of comprehensive knowledge in boosting up the number of participants towards cervical cancer screening services, different stakeholders working on cancer and HIV/AIDS should provide a customized health promotion intervention and awareness creation to HIV-infected women, along with improving accessibility of cervical cancer screening services in rural areas.
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Affiliation(s)
- Daniel Asfaw Erku
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Chechela Street, Lideta Sub city Kebele 16, P.O. Box: 196, Gondar, Ethiopia
| | - Adeladlew Kassie Netere
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Chechela Street, Lideta Sub city Kebele 16, P.O. Box: 196, Gondar, Ethiopia
| | - Amanual Getnet Mersha
- Department of Gynecology and obstetrics, College of Medicine and Health Sciences, University of Gondar, Chechela Street, Lideta Sub city Kebele 16, Gondar, Ethiopia
| | - Sileshi Ayele Abebe
- Department of Gynecology and obstetrics, College of Medicine and Health Sciences, University of Gondar, Chechela Street, Lideta Sub city Kebele 16, Gondar, Ethiopia
| | - Abebe Basazn Mekuria
- Department of Pharmacology, School of Pharmacy, University of Gondar, Chechela Street, Lideta Sub city Kebele 16, Gondar, Ethiopia
| | - Sewunet Admasu Belachew
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Chechela Street, Lideta Sub city Kebele 16, P.O. Box: 196, Gondar, Ethiopia
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Kangmennaang J, Onyango EO, Luginaah I, Elliott SJ. The next Sub Saharan African epidemic? A case study of the determinants of cervical cancer knowledge and screening in Kenya. Soc Sci Med 2017; 197:203-212. [PMID: 29253722 DOI: 10.1016/j.socscimed.2017.12.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 12/04/2017] [Accepted: 12/11/2017] [Indexed: 01/28/2023]
Abstract
Early cervical cancer screening has been shown to be beneficial in reducing cervical cancer related deaths. Despite the benefits of early cervical cancer screening, uptake remains limited, with wide disparities in access and uptake in most developing countries. As part of a larger study, this paper uses a socio-ecological framework to explain the determinants of cervical cancer knowledge and screening among women of reproductive age (15-49 years) in Kenya. We conducted a multilevel analysis of cervical cancer knowledge (n = 11,138) and screening (n = 10,333) using the 2014 Kenya Demographic and Health Survey (KDHS). Results show regional disparities in cancer knowledge and the utilization of cervical cancer screening services; regions with high wealth inequality (OR = 0.70, 95% CI [0.56-0.87]) emerged as vulnerable regions where women were less likely to screen for cervical cancer. Gender equity, health insurance coverage and education level significantly predicted cervical cancer screening rates. Results further revealed regional as well as rural-urban wealth inequalities in cervical cancer screening. We argue that given that Kenyan women are highly exposed to human papilloma virus (HPV) due to the legacy of human immunodeficiency virus (HIV) in the country, cervical cancer may be the next epidemic if integrated measures are not adopted to increase cervical cancer knowledge and overcome the barriers to utilizing early screening services. The paper concludes with policy recommendations and directions for future research.
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Affiliation(s)
- Joseph Kangmennaang
- Department of Geography and Environmental Management, University of Waterloo, Waterloo, ON, Canada.
| | - Elizabeth O Onyango
- Department of Geography and Environmental Management, University of Waterloo, Waterloo, ON, Canada; Department of Community Health and Management, Masinde Muliro University of Science and Technology, Kakamega, Kenya
| | - Isaac Luginaah
- Department of Geography, Western University, London, ON, Canada
| | - Susan J Elliott
- Department of Geography and Environmental Management, University of Waterloo, Waterloo, ON, Canada
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Toye MA, Okunade KS, Roberts AA, Salako O, Oridota ES, Onajole AT. Knowledge, perceptions and practice of cervical cancer prevention among female public secondary school teachers in Mushin local government area of Lagos State, Nigeria. Pan Afr Med J 2017; 28:221. [PMID: 29629007 PMCID: PMC5881560 DOI: 10.11604/pamj.2017.28.221.13980] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 10/12/2017] [Indexed: 11/11/2022] Open
Abstract
Introduction Cervical cancer is the most common gynecological cancer and a leading cause of cancer death in women in Nigeria. This study was aimed to assess the knowledge, perception, and practice of cervical cancer prevention among female public secondary school teachers in Mushin, Lagos. Methods This was a cross-sectional study carried out among female secondary school teachers in Mushin, Lagos. The participants were selected by a two-stage random sampling method and relevant data were collected with the use a self-administered questionnaire. Data entry and analysis were done using Epi-info version 7.2 statistical software and descriptive statistics were computed for all data. Results The knowledge of cervical cancer and its prevention was 100.0% among the respondents. The most commonly known method of cervical cancer screening identified by the respondents was Papanicolaou smear (91.4%). More than half of the women (67.0%) have had at least one cervical cancer screening done previously. Only 2.2% of the respondents have had HPV vaccine given to their female teenage children in the past despite the acceptance rate for HPV vaccination being 76.2%. Conclusion This study, unlike most previous studies in other regions of Nigeria and most part of sub-Saharan Africa, has demonstrated a relatively high level of awareness about cervical cancer, its cause, risk factors and prevention. However, conversely, the absence of a national health programme means that screening and vaccination centers are not available, accessible or affordable.
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Affiliation(s)
- Mariam Adeola Toye
- Department of Medicine and Surgery, College of Medicine, University of Lagos, Lagos, Nigeria
| | | | - Alero Ann Roberts
- Department of Community Health, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Omolola Salako
- Cancer Information Service, Sebeccly Cancer Care & Support Center, Lagos, Nigeria
| | - Ezekiel Sofela Oridota
- Department of Community Health, College of Medicine, University of Lagos, Lagos, Nigeria
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Islam RM, Billah B, Hossain MN, Oldroyd J. Barriers to Cervical Cancer and Breast Cancer Screening Uptake in Low-Income and Middle-Income Countries: A Systematic Review. Asian Pac J Cancer Prev 2017; 18:1751-1763. [PMID: 28749101 PMCID: PMC5648375 DOI: 10.22034/apjcp.2017.18.7.1751] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: Cervical cancer (CCa) and breast cancer (BCa) are the two leading cancers in women worldwide. Early detection and education to promote early diagnosis and screening of CCa and BCa greatly increases the chances for successful treatment and survival. Screening uptake for CCa and BCa in low and middle - income countries (LMICs) is low, and is consequently failing to prevent these diseases. We conducted a systematic review to identify the key barriers to CCa and BCa screening in women in LMICs. Methods: We performed a systematic literature search using Ovid MEDLINE, EMBASE, PsycINFO, SCOPUS, CINHAL Plus, and Google scholar to retrieve all English language studies from inception to 2015. This review was done in accordance with the PRISMA-P guidelines. Results: 53 eligible studies, 31 CCa screening studies and 22 BCa screening studies, provided information on 81,210 participants. We found fewer studies in low-income and lower - middle - income countries than in upper - middle - income countries. Lack of knowledge about CCa and BCa, and understanding of the role of screening were the key barriers to CCa and BCa screening in LMICs. Factors that are opportunities for knowledge acquisition, such as level of education, urban living, employment outside the home, facilitated CCa and BCa screening uptake in women in LMICs. Conclusions: Improvements to CCa and BCa screening uptake in LMICs must be accompanied by educational interventions which aim to improve knowledge and understanding of CCa and BCa and screening to asymptomatic women. It is imperative for governments and health policy makers in LMICs to implement screening programmes, including educational interventions, to ensure the prevention and early detection of women with CCa and BCa. These programmes and policies will be an integral part of a comprehensive population-based CCa and BCa control framework in LMICs.
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Affiliation(s)
- Rakibul M Islam
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Department of Population Sciences, University of Dhaka, Dhaka, Bangladesh
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Mbachu C, Dim C, Ezeoke U. Effects of peer health education on perception and practice of screening for cervical cancer among urban residential women in south-east Nigeria: a before and after study. BMC WOMENS HEALTH 2017; 17:41. [PMID: 28599635 PMCID: PMC5466744 DOI: 10.1186/s12905-017-0399-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 06/05/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Effective female education on cervical cancer prevention has been shown to increase awareness and uptake of screening. However, sustaining increase in uptake poses a challenge to control efforts. Peer health education has been used as an effective tool for ensuring sustained behavior change. This study was undertaken to assess the effectiveness of peer health education on perception, willingness to screen and uptake of cervical cancer screening by women. METHODS A before and after intervention study was undertaken in 2 urban cities in Enugu state, Nigeria among women of reproductive age attending women's meeting in Anglican churches. Multistage sampling was used to select 300 women. Peer health education was provided once monthly for 3 consecutive sessions over a period of 3 months. Data was collected at baseline and after the intervention using pre-tested questionnaires. Descriptive statistics and tests of significance of observed differences and associations were done at p-value of <0.05. RESULTS Statistical significant difference was observed in participants' individual risk perception for cervical cancer and perception of benefits of early detection through screening. Practice of screening for cervical cancer increased by 6.8% and the observed difference was statistically significant (p = 0.02). This was significantly associated with marital status, level of education, employment status and parity (p < 0.05). CONCLUSION Peer health education is an effective strategy for increasing women's perception of benefits of early detection of cervical cancer through screening. It is also effective for increasing their practice of screening for cervical cancer.
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Affiliation(s)
- Chinyere Mbachu
- Department of Pharmacology and Therapeutics, Health Policy Research Group, College of Medicine, University of Nigeria, Nsukka, Nigeria.
| | - Cyril Dim
- Department of Obstetrics and Gynecology, College of Medicine, University of Nigeria, Nsukka, Nigeria
| | - Uche Ezeoke
- Department of Community Medicine, College of Medicine, University of Nigeria, Nsukka, Nigeria
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Ogbonna FS. Knowledge, attitude, and experience of cervical cancer and screening among Sub-saharan African female students in a UK University. Ann Afr Med 2017; 16:18-23. [PMID: 28300047 PMCID: PMC5452699 DOI: 10.4103/aam.aam_37_16] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Cervical cancer is one of the major diseases that affect women of child bearing age. Its main cause is the human papilloma virus; although, other associated factors have been evidenced to increase its risk. Pap-smear screening and vaccination which has been shown to be successful in reducing the incidence and prevalence of the disease in developed countries, has been neglected in developing countries due to lack of knowledge, misconceptions, and cultural beliefs. MATERIALS AND METHODS A cross-sectional study involving only female Sub-Saharan Africa (SSA) students in a UK university setting. RESULTS One hundred and eighty-six (42%) African female students were recruited from the 442 SSA students attending one of the major Universities in the UK. Seventy-one (38.2%) of the students were aware of cervical screening, but only 20 (10.8%) reported having knowledge of cervical cancer. A small percentage of about 26.9% (50 Students) were already part of this screening program; although, 81 (43.5%) showed willingness to participate in future screening programs. More so, it was evident that student's perception was dependent on their experience of the disease (P = 000) just as their participation in screening program was dependent on their awareness level (P ≤ 0.01). CONCLUSION Female African students from the SSA region have poor knowledge of the disease which influenced their attitude toward screening. More needs to be carried out to increase awareness and uptake of screening within the school environment as university setting provides a viable platform to promote healthy behavior. Résumé Contexte: Le cancer du col de l'utérus est l'une des principales maladies qui touchent les femmes en âge de procréer. Sa principale cause est le virus du papillome humain; Bien que, d'autres facteurs associés ont été mis en évidence pour augmenter son risque. Le dépistage du Pap et la vaccination, qui s'est avéré efficace pour réduire l'incidence et la prévalence de la maladie dans les pays développés, a été négligé dans les pays en développement en raison du manque de connaissances, d'idées fausses et de croyances culturelles. Matériel et Méthodes: Une étude transversale impliquant seulement des étudiantes d'Afrique subsaharienne (SSA) dans un université britannique. Résultats: Cent quatre-vingt-six (42%) étudiantes africaines ont été recrutées parmi les 442 étudiants SSA fréquentant l'une des plus grandes universités du Royaume-Uni. Soixante et onze (38,2%) des étudiants étaient au courant du dépistage du cancer du col, mais seulement 20 (10,8%) ont déclaré avoir une connaissance du cancer du col de l'utérus. Un faible pourcentage d'environ 26,9% (50 étudiants)Font déjà partie de ce programme de dépistage; 81 (43,5%) se sont montrés disposés à participer à de futurs programmes de dépistage. De plus, il était évident que la perception des étudiants dépendait de leur expérience de la maladie (P = 000), tout comme leur participation au programme de dépistage dépendait de leur niveau de sensibilisation (P ≤ 0,01). CONCLUSION Les étudiantes africaines de la région de l'Afrique subsaharienne connaissent mal la maladie et ont influencé leur attitude envers le dépistage. Davantage de mesures doivent être prises pour accroître la sensibilisation et l'adoption du dépistage dans l'environnement scolaire, car le cadre universitaire constitue une plate-forme viable pour promouvoir un comportement sain.
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Affiliation(s)
- Faith Sopuruchukwu Ogbonna
- Department of Allied and Public Health, Faculty of Medical Science, Anglia Ruskin University, Cambridge, England
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Compaore S, Ouedraogo CMR, Koanda S, Haynatzki G, Chamberlain RM, Soliman AS. Barriers to Cervical Cancer Screening in Burkina Faso: Needs for Patient and Professional Education. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2016; 31:760-766. [PMID: 26336956 PMCID: PMC4779069 DOI: 10.1007/s13187-015-0898-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Cervical cancer is among the leading causes of cancer deaths for women in low-income African countries, such as Burkina Faso. Given that cervical cancer is a preventable disease through early detection and vaccination, this study aimed at understanding the barriers to cervical cancer early detection in Ouagadougou, the capital city of Burkina Faso. Women seeking screening and treatment for cervical cancer (n = 351) during the period of May-August 2014, at the Yalgado Ouedraogo University Hospital, were interviewed about their knowledge, attitudes, and practices toward cervical cancer. Interview questions elicited information about sociodemographic of participants, history of screening, knowledge of cervical cancer, and attitudes toward cervical screening. Scores were assigned to responses of questions and knowledge, and tertitles of distributions were used for comparison. A multivariate logistic regression was performed to predict cervical screening. Study participants were relatively young (37.5 ± 10.7 years) and predominately resident of urban areas (83.8 %), and over half had no or less than high school education. Over 90 % of participants had heard about cervical cancer, and about 55 % of them had intermediate-level knowledge of the disease, its screening, and/or risk factors. Knowledge level was lower among rural than urban residents. Predictors of screening included higher level of education (odds ratio (OR) = 2.2; 95 % confidence interval (CI) 1.48-3.23), older age (OR = 1.1; 95 % CI 1.06-1.12), higher socioeconomic standard (SES) (OR = 1.5; 95 % CI 1-2.37), urban residence (OR = 2.0; 95 % CI 1.19-3.25), encouragement for screening by a health care worker (1.98; 95 % CI 1.06-3.69), and employment (OR = 1.9; 95 % CI 1.13-3.11). Low awareness and socioeconomic barriers lead to underutilization of screening services of women. Motivation and education by healthcare workers are important factors for increasing screening rates. Organized patient and professional education programs in gynecologic services are warranted for improving screening in Burkina Faso and other low-resource countries in Africa.
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Affiliation(s)
- Salomon Compaore
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Charlemagne M R Ouedraogo
- Centre Hospitalier Universitaire Yalgado Ouedraogo de Ouagadougou (CHU/YO), Ouagadougou, Burkina Faso
| | - Seni Koanda
- Institut de Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso
- Institut Africain de Sante Publique, Ouagadougou, Burkina Faso
| | - Gleb Haynatzki
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Robert M Chamberlain
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198, USA
- Department of Epidemiology, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Amr S Soliman
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198, USA.
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Bezabih M, Tessema F, Sengi H, Deribew A. Risk Factors Associated with Invasive Cervical Carcinoma among Women Attending Jimma University Specialized Hospital, Southwest Ethiopia: A Case Control Study. Ethiop J Health Sci 2016; 25:345-52. [PMID: 26949299 PMCID: PMC4762973 DOI: 10.4314/ejhs.v25i4.8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Cervical cancer is a more serious public health problem than other cancers in women in Sub-Saharan Africa in general and in Ethiopia in particular. Thus, this study assessed risk factors related to invasive cervical carcinomas in southwestern Ethiopia. Methods Unmatched case control study was conducted in Jimma University Specialized Hospital from April 1 to September 30, 2010. The study consisted of 60 cases (women who had cervical cancers based on histopathologic examination) and 120 controls (women with no cervical cancers). Semi-structured questionnaire was utilized for data collection. Vaginal examinations often visualized with speculum insertions were done for both cases and controls. Punch cervical biopsies were then performed for the suspected cases at Jimma University Hospital that serves about 15 million people in a catchment radius of 250 kms. Data were analyzed using SPSS version 13.0 software. Univariate and multivariate analyes were done to describe and identify independent predictors of cervical cancer. Results The mean ages of cases and controls were 47.7 (SD=10.8) and 35.5 (SD =10.5) years respectively. Older women (40–59 years), (OR= 4.7; 95%CI= 2.3–9.6), more than one husband (OR= 2.0; 95%CI=1.0–3.9), as well as more than one wife in lifetime, (OR= 3.0; 95% CI= 1.5–5.9), women who had more than 4 children, (OR =10.3, 95% CI= 3.6–29.0), and age greater than 25 years at first full term delivery, (OR= 8.8; 95% CI= 3.5–22.0) were statistically significant and the latter two were independently associated with invasive cervical cancer. Only 7(11.7 %) of cases and 58(48.3%) of controls ever heard of cervical cancers; however, 2(3.3%) of cases and 7(5.8%) of controls had ever had history of papaneocolous (pap) smear tests done. Conclusion Poor knowledge on cervical cancer was observed that required more work to be done to increase knowledge of mothers on cervical cancer and on associated risk factors. Behavioral communication activities and establishment of cervical cancer screening programs for the young could help reduce the advancement of cervical cancer particularly among the less knowledgeable, older and grand multiparous women in our parts of the world.
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Affiliation(s)
- Mesele Bezabih
- Department of Medical laboratory Sciences and Pathology, Jimma University, Ethiopia
| | - Fasil Tessema
- Department of Epidemiology and Biostatistics, Jimma University, Ethiopia
| | | | - Amare Deribew
- Department of Epidemiology and Biostatistics, Jimma University, Ethiopia
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Knowledge and Awareness of Cervical Cancer among HIV-Infected Women in Ethiopia. Obstet Gynecol Int 2016; 2016:1274734. [PMID: 27867397 PMCID: PMC5102747 DOI: 10.1155/2016/1274734] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 09/14/2016] [Indexed: 11/30/2022] Open
Abstract
Introduction. Cervical cancer is one of the leading causes of cancer death among Ethiopian women. Low awareness of cervical cancer, in combination with low health care seeking behavior, is a key challenge for cervical cancer prevention. This study assessed the knowledge of cervical cancer among HIV-infected women in Ethiopia. Methods. A facility-based cross-sectional survey was conducted from August to September 2012 among HIV-infected women between 21 and 49 years of age. Basic descriptive statistics were performed using SPSS. Results. A total of 432 HIV-infected women participated in this study. About 71% of participants had ever heard of cervical cancer. Among women who had ever heard of cervical cancer, 49% did not know the cause while 74% were able to identify at least one risk factor for cervical cancer. Only 33% of women were able to correctly address when women should seek care and 33% identified at least one treatment option for cervical cancer. Conclusion. This study revealed that knowledge about cervical cancer was generally low, in particular for health care seeking behavior and treatment of cervical cancer. Health awareness programs should be strengthened at both community and health facility levels with emphasis highlighting the causes, risk factors, care seeking behaviors, and treatment options for cervical cancer.
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The effect of quercetin nanoparticle on cervical cancer progression by inducing apoptosis, autophagy and anti-proliferation via JAK2 suppression. Biomed Pharmacother 2016; 82:595-605. [PMID: 27470402 DOI: 10.1016/j.biopha.2016.05.029] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 05/19/2016] [Accepted: 05/19/2016] [Indexed: 12/31/2022] Open
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Ramathuba DU, Ngambi D, Khoza LB, Ramakuela NJ. Knowledge, attitudes and practices regarding cervical cancer prevention at Thulamela Municipality of Vhembe District in Limpopo Province. Afr J Prim Health Care Fam Med 2016; 8:e1-7. [PMID: 27380857 PMCID: PMC4926715 DOI: 10.4102/phcfm.v8i2.1002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 04/07/2016] [Accepted: 04/13/2016] [Indexed: 12/03/2022] Open
Abstract
Background Cervical cancer is a widespread and often fatal disease that affected 1 million women globally in 2005. Not only is it the second most common cancer in women but it was also the second leading cause of cancer deaths, accounting for over 250 000 in 2006. Purpose The purpose of the study was to assess the knowledge, attitudes and practices regarding cervical cancer prevention among rural women in Vhembe District in Limpopo Province. Methodology A quantitative descriptive approach was adopted. The quantitative design enabled the discovery of more information by means of direct questioning of a sample of women aged 30 years and older. A convenience sampling was used to select the respondents. Data were analysed using the Statistical Package for Social Sciences. Measures to ensure ethical issues were adhered to. Results The findings revealed that women lacked knowledge about cervical cancer and preventive methods, and displayed positive attitudes to the use of services if made available as health workers did not adequately inform them about the availability of the services. Conclusion The awareness of cervical cancer among women in Vhembe District is limited. There is a need to educate and promote awareness of cervical cancer among women to reduce the burden of morbidity and mortality.
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Finocchario-Kessler S, Wexler C, Maloba M, Mabachi N, Ndikum-Moffor F, Bukusi E. Cervical cancer prevention and treatment research in Africa: a systematic review from a public health perspective. BMC Womens Health 2016; 16:29. [PMID: 27259656 PMCID: PMC4893293 DOI: 10.1186/s12905-016-0306-6] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Accepted: 05/21/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Women living in Africa experience the highest burden of cervical cancer. Research and investment to improve vaccination, screening, and treatment efforts are critically needed. We systematically reviewed and characterized recent research within a broader public health framework to organize and assess the range of cervical cancer research in Africa. METHODS We searched online databases and the Internet for published articles and cervical cancer reports in African countries. Inclusion criteria included publication between 2004 and 2014, cervical cancer-related content pertinent to one of the four public health categories (primary, secondary, tertiary prevention or quality of life), and conducted in or specifically relevant to countries or regions within the African continent. The study design, geographic region/country, focus of research, and key findings were documented for each eligible article and summarized to illustrate the weight and research coverage in each area. Publications with more than one focus (e.g. secondary and tertiary prevention) were categorized by the primary emphasis of the paper. Research specific to HIV-infected women or focused on feasibility issues was delineated within each of the four public health categories. RESULTS A total of 380 research articles/reports were included. The majority (54.6 %) of cervical cancer research in Africa focused on secondary prevention (i.e., screening). The number of publication focusing on primary prevention (23.4 %), particularly HPV vaccination, increased significantly in the past decade. Research regarding the treatment of precancerous lesions and invasive cervical cancer is emerging (17.6 %), but infrastructure and feasibility challenges in many countries have impeded efforts to provide and evaluate treatment. Studies assessing aspects of quality of life among women living with cervical cancer are severely limited (4.1 %). Across all categories, 11.3 % of publications focused on cervical cancer among HIV-infected women, while 17.1 % focused on aspects of feasibility for cervical cancer control efforts. CONCLUSIONS Cervical cancer research in African countries has increased steadily over the past decade, but more is needed. Tertiary prevention (i.e. treatment of disease with effective medicine) and quality of life of cervical cancer survivors are two severely under-researched areas. Similarly, there are several countries in Africa with little to no research ever conducted on cervical cancer.
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Affiliation(s)
| | - Catherine Wexler
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, USA
| | - May Maloba
- Family AIDS Care and Education Services, Kenya Medical Research Institute, Kisumu, Kenya
| | - Natabhona Mabachi
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, USA
| | - Florence Ndikum-Moffor
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, USA
| | - Elizabeth Bukusi
- Family AIDS Care and Education Services, Kenya Medical Research Institute, Kisumu, Kenya
- Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
- Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya
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47
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Adedimeji AA, Lounsbury D, Popoola O, Asuzu C, Lawal A, Oladoyin V, Crifase C, Agalliu I, Shankar V, Adebiyi A. Improving outcomes in cancer diagnosis, prevention and control: barriers, facilitators and the need for health literacy in Ibadan Nigeria. Psychooncology 2016; 26:1455-1462. [PMID: 27218238 DOI: 10.1002/pon.4158] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 03/02/2016] [Accepted: 04/17/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND Cancers constitute a significant public health problem in Nigeria. Breast, cervix and prostate cancers are leading causes of cancer-related deaths. Changing diets, lifestyles, HIV/AIDS and macro-structural factors contribute to cancer morbidity and mortality. Poor health information linking cancer risk to individual behaviors, environmental pollutants and structural barriers undermine prevention/control efforts. Studies suggest increasing health literacy and empowering individuals to take preventive action will improve outcomes and mitigate impact on a weak health system. METHODS We obtained qualitative data from 80 men, women, and young adults in 11 focus groups to assess beliefs, risk-perceptions, preventive behaviors and perceptions of barriers and facilitators to cancer control in Ibadan, Nigeria and conducted thematic analysis. RESULTS Participants demonstrated awareness of cancers and mentioned several risk factors related to individual behaviors and the environment. Nonetheless, myths and misconceptions as well as micro, meso and macro level barriers impede prevention and control efforts. CONCLUSION Developing and implementing comprehensive context-relevant health literacy interventions in community settings are urgently needed.Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Adebola A Adedimeji
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA
| | - David Lounsbury
- Albert Einstein College of Medicine, Epidemiology and Population Health, USA
| | - Oluwafemi Popoola
- College of Medicine, University of Ibadan, Community Medicine, Nigeria
| | - Chioma Asuzu
- University of Ibadan, Department of Guidance and Counselling, Nigeria.,University College Hospital, LMPC, Department of Radiotherapy, Nigeria
| | | | - V Oladoyin
- College of Medicine, University of Ibadan, Community Medicine, Nigeria
| | | | - Ilir Agalliu
- Albert Einstein College of Medicine, Epidemiology and Population Health, USA
| | - Viswanathan Shankar
- Albert Einstein College of Medicine, Epidemiology and Population Health, USA
| | - Akindele Adebiyi
- College of Medicine, University of Ibadan, Community Medicine, Nigeria
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Rosser JI, Hamisi S, Njoroge B, Huchko MJ. Barriers to Cervical Cancer Screening in Rural Kenya: Perspectives from a Provider Survey. J Community Health 2016; 40:756-61. [PMID: 25677728 DOI: 10.1007/s10900-015-9996-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Although cervical cancer is highly preventable through screening, it remains the number one cause of cancer-related death in Kenyan women due to lack of funding and infrastructure for prevention programs. In 2012, Family AIDS Care and Education Services in partnership with the Kenya Ministry of Health began offering free screening at eleven rural health facilities. We sought to explore why screening coverage remains low at some sites. We examined the barriers to screening through a survey of 106 healthcare staff. The most frequently cited barriers to service delivery included staffing shortages, lack of trained staff, insufficient space, and supply issues. The patient barriers commonly perceived by the staff included inadequate knowledge, wait time, discomfort with male providers, and fear of pain with the speculum exam. Despite multilateral efforts to implement cervical cancer screening, staff face significant challenges to service provision and increased education is needed for both providers and patients.
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Affiliation(s)
- Joelle I Rosser
- Department of Internal Medicine, University of Washington, 1959 NE Pacific Street, 356421, Seattle, WA, 98195-6421, USA,
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Lim J, Ojo A. Barriers to utilisation of cervical cancer screening in Sub Sahara Africa: a systematic review. Eur J Cancer Care (Engl) 2016; 26. [DOI: 10.1111/ecc.12444] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2015] [Indexed: 11/30/2022]
Affiliation(s)
- J.N.W. Lim
- Faculty of Medical Science; Anglia Ruskin University; Cambridge Campus UK
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50
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Increasing Cervical Cancer Awareness and Screening in Jamaica: Effectiveness of a Theory-Based Educational Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 13:ijerph13010053. [PMID: 26703641 PMCID: PMC4730444 DOI: 10.3390/ijerph13010053] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 11/23/2015] [Accepted: 12/01/2015] [Indexed: 11/17/2022]
Abstract
Despite declines in cervical cancer mortality in developed countries, cervical cancer incidence and mortality rates remain high in Jamaica due to low levels of screening. Effective interventions are needed to decrease barriers to preventive behaviors and increase adoption of behaviors and services to improve prospects of survival. We enrolled 225 women attending health facilities in an intervention consisting of a pre-test, educational presentation and post-test. The questionnaires assessed attitudes, knowledge, risk factors, and symptoms of cervical cancer among women. Changes in knowledge and intention to screen were assessed using paired t-tests and tests for correlated proportions. Participants were followed approximately six months post-intervention to determine cervical cancer screening rates. We found statistically significant increases from pre-test to post-test in the percentage of questions correctly answered and in participants’ intention to screen for cervical cancer. The greatest improvements were observed in responses to questions on knowledge, symptoms and prevention, with some items increasing up to 62% from pre-test to post-test. Of the 123 women reached for follow-up, 50 (40.7%) screened for cervical cancer. This theory-based education intervention significantly increased knowledge of and intention to screen for cervical cancer, and may be replicated in similar settings to promote awareness and increase screening rates.
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