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Khalis M, Elbadisy I, Bouaddi O, Luo A, Bendriouich A, Addahri B, Charaka H, Chahboune M, Foucaud J, Badou A, Belyamani L, Huybrechts I. Cluster analysis of cancer knowledge, attitudes and behaviors in the Moroccan population. BMC Cancer 2024; 24:669. [PMID: 38824496 PMCID: PMC11143602 DOI: 10.1186/s12885-024-12226-5] [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: 12/02/2023] [Accepted: 04/03/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND Cancer has become a major health concern due to the increasing morbidity and mortality rates, and its negative social, economic consequences and the heavy financial burden incurred by cancer patients. About 40% of cancers are preventable. The aim of this study was to assess the knowledge, attitudes, and practices regarding cancer prevention, and associated characteristics to inform the development of targeted cancer prevention campaigns and policies. METHODS We conducted a cross-sectional survey of adult patients at Mohamed Sekkat and Sidi Othmane Hospitals in Casablanca, Morocco. Data collection was conducted by two trained interviewers who administered the questionnaire in-person in the local language. An unsupervised clustering approach included 17 candidate variables for the cluster analysis. The variables covered a wide range of characteristics, including demographics, health perceptions and attitudes. Survey answers were calculated to compose qualitative ordinal categories, including a cancer attitude score and knowledge score. RESULTS The cluster-based analysis showed that participants in cluster 1 had the highest mean attitude score (13.9 ± 2.15) and percentage of individuals with a high level of knowledge (50.8%) whereas the lowest mean attitude score (9.48 ± 2.02) and knowledge level (7.5%.) were found in cluster 3. The participants with the lowest cancer attitude scores and knowledge levels were aged 34 to 47 years old (middle age group), predominantly females, living in rural settings, and were least likely to report health professionals as a source of health information. CONCLUSIONS The findings showed that female individuals living in rural settings, belonging to an older age group, who were least likely to use health professionals as an information source had the lowest levels of knowledge and attitudes. These groups are amenable to targeted and tailored interventions aiming to modify their understanding of cancer in order to enhance the outcomes of Morocco's on-going efforts in cancer prevention and control strategies.
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Affiliation(s)
- Mohamed Khalis
- Department of Public Health, Mohammed VI Center for Research and Innovation, Rabat, Morocco.
- Mohammed VI International School of Public Health, Mohammed VI University of Sciences and Health, Casablanca, Morocco.
- Higher Institute of Nursing Professions and Health Techniques, Rabat, Morocco.
- Laboratory of Biostatistics, Clinical, and Epidemiological Research, & Laboratory of Community Health (Public Health, Preventive Medicine and Hygiene), Department of Public Health, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco.
| | - Imad Elbadisy
- Department of Public Health, Mohammed VI Center for Research and Innovation, Rabat, Morocco
- Mohammed VI International School of Public Health, Mohammed VI University of Sciences and Health, Casablanca, Morocco
| | - Oumnia Bouaddi
- Department of Public Health, Mohammed VI Center for Research and Innovation, Rabat, Morocco
- Mohammed VI International School of Public Health, Mohammed VI University of Sciences and Health, Casablanca, Morocco
| | - Amy Luo
- Department of Population, Family and Reproductive Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Amina Bendriouich
- Mohammed VI Faculty of Medicine, Mohammed VI University of Sciences and Health, Casablanca, Morocco
| | - Badr Addahri
- Mohammed VI International School of Public Health, Mohammed VI University of Sciences and Health, Casablanca, Morocco
| | - Hafida Charaka
- Higher Institute of Nursing Professions and Health Techniques, Rabat, Morocco
| | - Mohamed Chahboune
- Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, Settat, Morocco
| | - Jérôme Foucaud
- Institut National du Cancer, Boulogne Billancourt, France
- Laboratory of Education and Health Practice, Sorbonne Paris Nord University, Paris, France
| | - Abdallah Badou
- Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Lahcen Belyamani
- Mohammed VI Faculty of Medicine, Mohammed VI University of Sciences and Health, Casablanca, Morocco
- Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Inge Huybrechts
- Nutrition and Metabolism Branch, International Agency for Research On Cancer, Lyon, France
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Tesfaye D, Weldegebreal F, Ayele F, Dheresa M. Cervical cancer screening uptake and associated factors among Women Living with Human Immunodeficiency Virus in public hospitals, eastern Ethiopia. Front Oncol 2023; 13:1249151. [PMID: 37965474 PMCID: PMC10642187 DOI: 10.3389/fonc.2023.1249151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 10/03/2023] [Indexed: 11/16/2023] Open
Abstract
Background Cervical cancer, the second leading cancer in Ethiopia women, is six times higher among women infected with the Human Immune Virus 1-infected women. Its screening provides protective advantages, and is linked to a decrease in the incidence of invasive cervical cancer and mortality. Although cancer screening has great advantages for early treatment and prevention of further complications, cervical cancer screening uptake is low among women in developing countries. Cervical cancer screening uptake among Women Living with Human Immunodeficiency Virus (WLHIV) is not well known in Eastern Ethiopia. Thus, we aimed to assess cervical cancer screening uptake and its associated factors among WLHIV in public hospitals in Harar, eastern Ethiopia. Methods An institution-based cross-sectional study was carried out on 412 randomly selected HIV-positive women from March 20 to April 20, 2022. The results of the study were presented descriptively in percentages and analytically in odds ratio. Bivariate and multivariable logistic regression analyses were used to determine the presence and degree of association between dependent and independent variables. In the multivariable logistic analysis, a p-value of 0.05, and an adjusted odds ratio with a 95% confidence interval were considered to determine independent predictors for the uptake of cervical cancer screening. Results Cervical cancer screening uptake among WLHIV was 57.5% (95% CI: 52.5, 62.9%). The uptake of cervical cancer screening was significantly associated with age between 20-29 years (AOR = 7.33; 95% CI: 1.98, 27.1), 40-49 years (AOR = 4.37; 95% CI: 1.48, 12.89), tertiary level of education (AOR = 0.197; 95% CI: 0.041, 0.946), good knowledge (AOR = 3.591; 95% CI: 2.123, 6.073), and monthly income of 2501(45.52 $) and above Ethiopian Birr (AOR = 0.389; 95% CI: 0.158, 0.959). Conclusions More than half of the participants had undergone cervical cancer screening. Age, marital status, educational status, monthly income, and awareness of cancer screening uptake were all factors related to cervical cancer screening. To maximize uptake, it is necessary to create specific counseling and education programs that target HIV-positive women.
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Affiliation(s)
| | - Fitsum Weldegebreal
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Firayad Ayele
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Merga Dheresa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Arechkik A, lahlou L, Kharbach A, Baba MA, Obtel M, Razine R. Awareness, Knowledge and Attitude Regarding Cervical Cancer among Women Living with HIV in the Souss-Massa Region, Southern Morocco: A Cross-Sectional Study. Asian Pac J Cancer Prev 2023; 24:2875-2884. [PMID: 37642077 PMCID: PMC10685240 DOI: 10.31557/apjcp.2023.24.8.2875] [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: 05/06/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Human immunodeficiency virus- positive women have an increased risk of precancerous lesions and invasive cervical cancer. This study aims to identify the level of awareness/knowledge and attitudes toward cervical cancer among women living with Human immunodeficiency virus in the region of Souss-Massa in southern Morocco. Methods: This is a multicenter cross-sectional study conducted in the Souss-Massa region (southern Morocco) among women attending Human immunodeficiency virus treatment and care centers between March 2022 and September 2022. A questionnaire was used for data collection. The Chi-square test and logistic regression were deployed to identify factors associated with cervical cancer awareness among the target population. RESULTS A total of 494 respondents to the questionnaire, 440 (89.1%) are aware of cervical cancer. Nevertheless, 405 (82.0%) and 369 (74.7%) were unaware of cervical cancer risk factors and symptoms, respectively. Only 125 (25.3%) knew the exact frequency of cervical cancer screening among Human immunodeficiency virus positive women, whereas 221 (44.7%) had ever been tested for cervical cancer. Factors associated with women's awareness of cervical cancer are as follows: level of education (adjusted Odds Ratio = 3.78 with 95% CI, 1.23-11.65), time since diagnosis of Human immunodeficiency virus (adjusted Odds Ratio = 4.31 with 95% CI, 1.12- 16.52), knowledge of women with cervical cancer (adjusted Odds Ratio = 6.30 with 95% CI, 1.87-21.18) and heard the pap- smear/visual inspection with acetic acid (adjusted Odds Ratio = 4.92 with 95% CI, 2.35-10.33). CONCLUSION The general knowledge of seropositive women regarding cervical cancer remains very low, which justifies the integration of cervical cancer prevention services with Human immunodeficiency virus care, and pinpoints the crucial role of patient education.
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Affiliation(s)
- Abderrahman Arechkik
- Laboratory of Biostatistics, Clinical Research, and Epidemiology (LBRCE), Faculty of Medicine and Pharmacy of Rabat, MOHAMMED V University of Rabat, 10100 Morocco.
| | - laila lahlou
- Laboratory of Community Medicine, Preventive Medicine, Public Health and Hygiene, Faculty of Medicine and Pharmacy of Agadir, Ibn Zohr University, Agadir 80060, Morocco.
| | - Ahmed Kharbach
- Higher Institute of Nursing Professions and Technical Health, Guelmim, Morocco.
| | - Mohamed Amine Baba
- Laboratory of Health Sciences Research, Ibn Zohr University, 80000 Agadir, Morocco.
- Faculty of Medicine and Pharmacy of Agadir, Ibn Zohr University, 80000 Agadir, Morocco.
| | - Majdouline Obtel
- Laboratory of Biostatistics, Clinical Research, and Epidemiology (LBRCE), Faculty of Medicine and Pharmacy of Rabat, MOHAMMED V University of Rabat, 10100 Morocco.
- Laboratory of Social Medicine (Public Health, Hygiene, and Preventive Medicine), Morocco.
| | - Rachid Razine
- Laboratory of Community Health, Preventive Medicine and Hygiene, Department of Public Health, Faculty of Medicine and Pharmacy, University Mohammed V in Rabat, Morocco.
- Epidemiology and Clinical Research, Department of Public Health, Morocco.
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Mohamed ZK, Amare YW, Getahun MS, Negussie YM, Gurara AM. Cervical Cancer Screening Service Utilization and Associated Factors Among Women Living With HIV Receiving Anti-Retroviral Therapy at Adama Hospital Medical College, Ethiopia. SAGE Open Nurs 2023; 9:23779608231152072. [PMID: 36726790 PMCID: PMC9885028 DOI: 10.1177/23779608231152072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/27/2022] [Accepted: 01/03/2023] [Indexed: 01/26/2023] Open
Abstract
Introduction Cervical cancer is the second highest cause of cancer-related mortality in the world, and it is one of the top 20 causes of mortality in Ethiopia. Even though cervical cancer is more common among women living with HIV, the utilization of cervical cancer screening services remains low in Ethiopia. Objectives This study aimed to assess cervical cancer screening service utilization and associated factors among women living with HIV receiving anti-retroviral therapy at Adama Hospital Medical College, Ethiopia. Methods An institution-based cross-sectional study was conducted among a sample of 304 women living with HIV from 1st-30th June 2022. Data were collected using an interviewer-administered questionnaire. The data were entered into Epi info version 7 and exported to SPSS version 25 for analysis. Bi-variable logistic regression analysis was used to identify candidate variables at p < .25. Finally, multivariable logistic regression analysis was used to identify the independent predictors of cervical cancer screening service utilization at p < .05 with 95% confidence intervals. Results The magnitude of cervical cancer screening service utilization was 26.9% (95% CI: 22.0, 32.6). Being a government employee (AOR: 8.09, 95% CI: 1.5, 41.19), having a family history of cervical cancer (AOR: 3.4, 95% CI: 1.02, 11.9), being aware of cervical cancer screening (AOR: 3.75, 95% CI: 2.11, 14.7), having a history of sexually transmitted infection (AOR: 3.14, 95% CI: 1.95, 10.2), and heard about cervical cancer (AOR: 2.6, 95% CI: 1.05, 6.41) were associated with cervical cancer screening service utilization. Conclusion The magnitude of cervical cancer screening service utilization was low. It was associated with occupation status, family history of cervical cancer, awareness about cervical cancer screening, history of STI, and ever heard about cervical cancer. Thus, to maximize utilization, health education programs and other multidisciplinary strategies had to be implemented.
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Affiliation(s)
| | | | - Mihiret Shawel Getahun
- Department of Nursing, Adama General Hospital and Medical
College, Adama, Ethiopia,Mihiret Shawel Getahun, Department of
Nursing, Adama General Hospital and Medical College, Adama, Ethiopia.
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Arechkik A, Lahlou L, Obtel M, Kharbach A, Razine R. Cervical cancer in Morocco: A systematic review. Rev Epidemiol Sante Publique 2022; 70:230-242. [DOI: 10.1016/j.respe.2022.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/13/2022] [Accepted: 05/30/2022] [Indexed: 12/24/2022] Open
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Bogale AL, Teklehaymanot T, Haidar Ali J, Kassie GM. Knowledge, attitude and practice of cervical cancer screening among women infected with HIV in Africa: Systematic review and meta-analysis. PLoS One 2021; 16:e0249960. [PMID: 33831128 PMCID: PMC8031808 DOI: 10.1371/journal.pone.0249960] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 03/27/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND To establish successful strategies and increasing the utilization of preventive services, there is a need to explore the extent to which the general female population is aware and use the service for cervical cancer-screening among women infected with HIV in Africa. Available evidences in this regard are controversial and non-conclusive on this potential issue and therefore, we estimated the pooled effect of the proportion of knowledge, attitude and practice of HIV infected African women towards cervical cancer screening to generate evidence for improved prevention strategies. METHODS We applied a systematic review and meta-analysis of studies conducted in Africa and reported the proportion of knowledge, attitude and practice towards cervical cancer screening. We searched electronic databases: PubMed/Medline, SCOPUS, ScienceDirect, Web of science, Cumulative Index of Nursing and allied Health Sciences (CINAHL) and Google scholar databases to retrieve papers published in English language till August 2020. We used random-effects model to estimate the pooled effect, and funnel plot to assess publication bias. The registration number of this review study protocol is CRD42020210879. RESULTS In this review, we included eight published papers comprising 2,186 participants. The estimated pooled proportion of knowledge of the participants was 43.0% (95%CI:23.0-64.0) while the pooled estimates of attitudes and practices were 38.0% (95%CI: 1.0-77.0) and 41.0% (95%CI: 4.0-77.0), respectively. The proportion of the outcome variables were extremely heterogeneous across the studies with I2> 98%). CONCLUSION The pooled estimates of knowledge, attitude and practice were lower than other middle income countries calls for further activities to enhance the uptake of the services and establish successful strategies.
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Affiliation(s)
- Agajie Likie Bogale
- Ethiopian Public Health Institute, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tilahun Teklehaymanot
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Program of Tropical and Infectious Diseases, Addis Ababa, Ethiopia
| | - Jemal Haidar Ali
- Addis Ababa University, College of Health Sciences, School of Public Health, Addis Ababa, Ethiopia
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Oduguwa E, Dongarwar D, Salihu HM. Trends in Premature Deaths among Women Living with HIV/AIDS and Cervical Cancer. South Med J 2021; 113:651-658. [PMID: 33263137 DOI: 10.14423/smj.0000000000001184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES There is a lack of updated information on premature death and years of potential life lost (YPLL) among human immunodeficiency (HIV)-positive women with cervical cancer. We hypothesize that increased access to preventive resources such as antiretroviral therapy, preexposure prophylaxis, and human papillomavirus vaccines has reduced premature mortality and YPLL in these women in the previous decades. METHODS We used data from the National Inpatient Sample database from 2003 to the third quarter of 2015, and restricted the analysis to HIV-positive women with or without cervical cancer. Joinpoint regression models were run to identify trends in the rates of HIV and cervical cancer. Overall and age-stratified YPLL were calculated for HIV-positive women with cervical cancer. Adjusted survey logistic regression models were built to determine the predictive factors of in-hospital mortality among women living with HIV. RESULTS Among hospitalized women, low-income, non-Hispanic Blacks, and patients aged 40 to 59 years experienced greater frequencies of HIV/cervical cancer comorbidity. The prevalence of HIV hospitalizations increased by an average annual percentage of 0.9% (95% confidence interval 0.3-1.6). YPLL decreased in HIV-positive women living with and without cervical cancer by 4.9% and 4.3%, respectively. The trajectory for YPLL was not uniform across age groups. YPLL decreased substantially in women aged 20 to 29 years with HIV/cervical cancer comorbidity. Cervical cancer remained a significant predictor of mortality among HIV-positive women when adjusted for age, race, and insurance coverage. CONCLUSIONS Within a large, national sample from 2003 to 2015, we found an overall declining trend in YPLL in women living with HIV/cervical cancer comorbidity. In-hospital mortality among HIV-positive women was associated with cervical cancer, age, race, and insurance coverage. We recommend further investigation into the quality of HIV and cervical cancer treatment and prevention services for the sociodemographic groups described.
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Affiliation(s)
- Emmanuella Oduguwa
- From the Center of Excellence in Health Equity, Training, and Research, Baylor College of Medicine, Houston, Texas
| | - Deepa Dongarwar
- From the Center of Excellence in Health Equity, Training, and Research, Baylor College of Medicine, Houston, Texas
| | - Hamisu M Salihu
- From the Center of Excellence in Health Equity, Training, and Research, Baylor College of Medicine, Houston, Texas
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Barriers to Cervical Cancer Screening Among Women Living With HIV in Low- and Middle-Income Countries: A Systematic Review. J Assoc Nurses AIDS Care 2021; 31:497-516. [PMID: 32675646 DOI: 10.1097/jnc.0000000000000194] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Women living with HIV in low-and-middle-income countries (LMICs) are at high risk of developing cervical cancer due to their immunocompromised status. Screening is an imperative prevention measure for early detection and for ultimately reducing high rates of cervical cancer; however, cervical cancer screening uptake among this group remains low. This systematic review aimed to identify barriers to cervical cancer screening among women living with HIV in LMIC. A comprehensive literature search was undertaken, and an analysis of included studies was completed to abstract major themes related to cervical cancer screening barriers for women living with HIV in LMIC. Lack of cervical cancer and cervical cancer screening knowledge among patients was found to be the most prevalent barrier to cervical cancer screening. Our findings highlight a dire need for interventions to increase knowledge and awareness of cervical cancer screening among women living with HIV in LMIC, along with addressing barriers within health care systems.
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Labisso WL, Leka Y, Leka Y, Haileselassie W. A Descriptive Cross-Sectional Study on Awareness and Belief of People About Cancer in Southern Ethiopia: Special Focus on Breast and Cervical Cancers. Risk Manag Healthc Policy 2020; 13:2655-2668. [PMID: 33239927 PMCID: PMC7682616 DOI: 10.2147/rmhp.s267207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 10/14/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The general population's lack of awareness, limited knowledge, myths and misconceptions about breast and cervical cancers (CCs) is considered as a serious public health problem. OBJECTIVE This study was intended to assess the status of awareness and beliefs of people about cancer and breast and CCs in particular. METHODS A descriptive community-based cross-sectional survey was conducted on 345 study participants in Southern Ethiopia. A pretested, structured questionnaire that contained demographics and questions on the variables of exposure to biological and chemical carcinogenic agents, lifestyle and personal behavior was administered. Frequency distribution and proportions were used to describe the study population in relation to major variables. RESULTS The mean age of study participants was 25.19 (Range 15-58). More than a third of the study participants heard about cancer from Mass Media followed by schools (28.5%) and treating physicians (6.7%). The proportion of study participants that knew about the association between smoking, alcohol intake and cancer development was 38.6% and 51.5%, respectively. Only 48% and 24.2% of the study participants heard about breast and CCs, respectively. The fact that 69.4% of the study participants had limited knowledge about the mode of transmission of the causative agents of CCs indicates that the study groups are at risk of acquiring the agent. Additionally, only 4.7% of the study participants were screened for CC and have poor breast self-examination experiences, indicating poor awareness and knowledge about the importance of screening programs. CONCLUSION Comprehensive awareness and knowledge about cancer in general and breast and CCs in particular is lacking in southern Ethiopia. Early sexual debut, limited knowledge about the diseases and unfavorable lifestyle are the risk factors to be addressed in public health education.
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Affiliation(s)
- Wajana Lako Labisso
- Department of Pathology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yishak Leka
- Department of Pathology, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Yohannes Leka
- Department of Medical Microbiology, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Werissaw Haileselassie
- Department of Reproductive Health and Health Service Management, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Experiences of cervical cancer survivors in Chitwan, Nepal: A qualitative study. PLoS One 2020; 15:e0234834. [PMID: 33151965 PMCID: PMC7644025 DOI: 10.1371/journal.pone.0234834] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 10/21/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction Cervical cancer is a global leading cause of morbidity and mortality. The majority of cervical cancer deaths occur in developing countries including Nepal. Though knowledge of cervical cancer is an important determinant of women’s participation in prevention and screening for cervical cancer, little is known about this topic in Nepal. This study explores the experiences of cervical cancer survivors and assesses the attitude of family and community towards it and stigma related to this disease in Bharatpur, Nepal. Methods The study design was qualitative methods involving two focus-group discussions. A total of 17 cervical cancer survivors, who have completed two years of cancer treatment were selected purposively from Chitwan. All qualitative data were transcribed and translated into English and were thematically analyzed. Results The majority of the participants had scant knowledge about cervical cancer, its causative agent, showed less cervical cancer screening, delayed healthcare-seeking behavior despite having persistent symptoms before the diagnosis. The main reasons identified for not uptaking the cervical screening methods were an embarrassment and having no symptoms at all. Most of them endured social stigma related to cervical cancer in the form of physical isolation and verbal abuse. Conclusions There is an urgent need for interventions to make women and the public aware of cervical cancer and launch effective health education campaigns, policies for cervical cancer prevention programs. This implementation can save the lives of hundreds of women and help them avoid going through all the negative experiences related to cervical cancer. More studies are required to gain the perspectives, knowledge, experiences, and attitudes of cervical cancer survivors to add to the research.
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Cervical Cancer Screening Uptake and Associated Factors among HIV-Positive Women in Ethiopia: A Systematic Review and Meta-Analysis. Adv Prev Med 2020; 2020:7071925. [PMID: 32879739 PMCID: PMC7448202 DOI: 10.1155/2020/7071925] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/17/2020] [Accepted: 07/26/2020] [Indexed: 02/08/2023] Open
Abstract
Background Women living with human immunodeficiency virus (HIV) are more likely to develop an increased risk of invasive cervical cancer. Morbidity and mortality due to cervical cancer could be reduced with early detection through cervical screening. Though uptake of cervical screening was investigated in Ethiopia, inconsistent findings were reported. Therefore, this systematic review and meta-analysis was designed to estimate the pooled prevalence of cervical cancer screening uptake among HIV-positive women and its associated factors in Ethiopia. Methods A comprehensive search of PubMed/MEDLINE, Scopus, EMBASE, CINAHL, Google Scholar, Science Direct, and Cochrane Library was conducted. The data were extracted using a standardized data extraction format. Statistical analysis was done using the STATA, version 14, software. The heterogeneity of the studies was assessed using the I2 test. Funnel plots and Egger's test were used to check publication bias. A random effects model was computed to estimate the pooled prevalence of cervical cancer screening uptake. Moreover, pooled odds ratios with 95% confidence intervals were used to determine the association of identified determinant factors with cervical cancer screening uptake. Results A total of 10358 studies were retrieved, and 7 studies were included in the meta-analysis. The pooled prevalence of cervical cancer screening uptake among HIV-positive women in Ethiopia was 18.17% (95% CI : 11.23, 25.10) with exhibited heterogeneity (I2 = 96.6%; p < 0.001). Educational status of women (AOR = 3.50; 95% CI : 1.85, 6.07), knowledge of women on cervical cancer (AOR = 3.26; 95% CI : 2.50, 4.43), and perceived susceptibility (AOR = 3.26; 95% CI : 2.26, 4.26) were significantly associated with cervical cancer screening uptake among HIV-positive women. Conclusion The uptake of cervical cancer screening among HIV-positive women in Ethiopia was low. The findings of this study suggest the need to improve the existing national strategies of cervical cancer screening so as to strengthen reproductive health education and promotion, in addition to providing screening services. Furthermore, cervical screening service should be integrated to the routine care and treatment, so that HIV-positive women can get counseling services in every clinical contact.
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Kasraeian M, Hessami K, Vafaei H, Asadi N, Foroughinia L, Roozmeh S, Bazrfashan K. Patients' self-reported factors influencing cervical cancer screening uptake among HIV-positive women in low- and middle-income countries: An integrative review. Gynecol Oncol Rep 2020; 33:100596. [PMID: 32551354 PMCID: PMC7292910 DOI: 10.1016/j.gore.2020.100596] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 04/30/2020] [Accepted: 05/29/2020] [Indexed: 01/10/2023] Open
Abstract
This review reveals barriers of cervical cancer screening among HIV-positive women. The uptake of cervical cancer screening among HIV-positive women is very low. We reported personal, social and structural barriers of cervical cancer screening.
Cervical cancer is among the most common causes of cancer-related deaths in low- and middle-income countries (LMICs). Despite the strong evidence regarding cervical cancer screening cost-effectiveness, its utilization remains low especially in high risk populations such as HIV-positive women. The aim of this review was to provide an overview on the patient-reported factors influencing cervical cancer screening uptake among HIV-positive women living in LMICs. We systematically searched EMBASE, PUBMED/MEDLINE and Web of Science databases to identify all quantitative and qualitative studies investigating the patient-reported barriers or facilitators to cervical cancer screening uptake among HIV-positive population from LMICs. A total of 32 studies met the inclusion criteria. A large number of barriers/facilitators were identified and then grouped into three categories of personal, social and structural variables. However, the most common influential factors include knowledge and attitude toward cervical cancer or its screening, embarrassment, fear of cervical cancer screening and test results, patient-healthcare provider relationship, social support, screening costs and time constraints. This review’s findings highlighted the need for multi-level participation of policy makers, health professionals, patients and their families in order to overcome the barriers to uptake of cervical cancer screening among HIV-positive women, who are of special concern in LMICs.
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Affiliation(s)
- Maryam Kasraeian
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran Hessami
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Homeira Vafaei
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nasrin Asadi
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Shohreh Roozmeh
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Khadije Bazrfashan
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Favela-Bueno J, Pérez-Morales R, Ramirez-Torres J, Hernandez-Arteaga L, Anguiano-Vega GA. Identification of Multiple High-Risk Human Papillomavirus Infections in a Rural Population of Canatlan, Durango, Mexico. Genet Test Mol Biomarkers 2020; 24:370-374. [DOI: 10.1089/gtmb.2019.0189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jesús Favela-Bueno
- Laboratorio de Biomedicina Molecular, Facultad de Ciencias Químicas, Universidad Juárez del Estado de Durango, Durango, Durango, México
| | - Rebeca Pérez-Morales
- Laboratorio de Biología Celular y Molecular, Facultad de Ciencias Químicas, Universidad Juárez del Estado de Durango, Durango, México
| | - José Ramirez-Torres
- Laboratorio de Biomedicina Molecular, Facultad de Ciencias Químicas, Universidad Juárez del Estado de Durango, Durango, Durango, México
| | - Luisa Hernandez-Arteaga
- Laboratorio de Virología, Facultad de Agronomía y Veterinaria, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
| | - Gerardo Alfonso Anguiano-Vega
- Laboratorio de Biomedicina Molecular, Facultad de Ciencias Químicas, Universidad Juárez del Estado de Durango, Durango, Durango, México
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Yuan G. Correlation between ER, PR, P53, Ki67 expression, and high-risk HPV infection in patients with different levels of cervical intraepithelial neoplasia. EUR J INFLAMM 2020. [DOI: 10.1177/2058739220933084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study was designed to investigate the correlation between high-risk human papillomavirus (HPV) infection and the expression of IHC markers (ER, PR, p53, Ki67) in patients with different grades of cervical intraepithelial neoplasia (CIN). It was a retrospective study, which was conducted from June 2016 to June 2018. 140 specimens of CIN were collected from the pathology department of a certain hospital that included 40 specimens of CIN1, 50 specimens of CIN2 and 50 specimens of CIN3. The expression of ER, PR, P53 and Ki67 were determined by immunohistochemistry. The high-risk HPV infections were detected by PCR fluorescence quantification and were given the correlation analysis. In the 140 specimens, the positive rates of HPV16 and HPV18 in CIN1 specimens were 27.5% and 25.0% respectively, and in CIN2 specimens were 64.0% and 60.0% respectively, and in CIN3 specimens were 90.0% and 92.0% respectively, the difference were statistically significant (p<0.05). There were no significant correlation (p<0.05) between HPV16 and HPV18 positive rate and patient age, tissue differentiation, and tumor size. With the increased of CIN grade, the positive rate of ER, PR, P53 and Ki67 expression in specimen were also increased significantly, and the difference were statistically significant (p<0.05). Pearson correlation analysis showed there were positive correlation (p<0.05) between the positive rates of HPV16 and HPV18 and the positive rates of ER, PR, P53 and Ki67. With the increase of CIN level, the positive rates of high-risk HPV infection as well as ER, PR, P53 and Ki67 are increased, and they have positive correlation.
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Affiliation(s)
- Gao Yuan
- Department of Gynecologic Oncology, Tianjin Central Hospital of Gynecology Obstetrics, Tianjin, P.R. China
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Assefa AA, Astawesegn FH, Eshetu B. Cervical cancer screening service utilization and associated factors among HIV positive women attending adult ART clinic in public health facilities, Hawassa town, Ethiopia: a cross-sectional study. BMC Health Serv Res 2019; 19:847. [PMID: 31744548 PMCID: PMC6862783 DOI: 10.1186/s12913-019-4718-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 11/06/2019] [Indexed: 01/15/2023] Open
Abstract
Background In Ethiopia, cervical cancer is a public health concern, as it is the second most cause of cancer deaths among reproductive age women and it affects the country’s most vulnerable groups like; rural, poor, and HIV-positive women. Despite the strong evidence that cervical cancer screening results in decreased mortality from this disease, its utilization remains low. Methods An institution-based cross-sectional study was conducted from March 2 to April 1/2019 to assess the level and factors affecting utilization of cervical cancer screening among HIV positive women in Hawassa town. Quantitative data collection methods were used. Data were gathered using a structured and pretested questionnaire. Epi-Info version 7 and SPSS version 23 were used for data entry and analysis respectively. Statistically significant association of variables was determined based on Adjusted Odds ratio with its 95% confidence interval and p-value of ≤0.05. Results Of the 342 women interviewed, 40.1% (95% CI: 35.00, 45.33%) of them were screened. Having a post primary education (AOR = 5.1, 95% CI: 1.8, 14.5), less than 500 cell/mm3 CD4 count (AOR = 2.7, 95% CI: 1.2, 5.9); duration since HIV diagnosis (AOR = 4.2, 95% CI: 2.1, 8.5), partner support (AOR = 4.7, 95% CI: 2.3, 9.4), having knowledge about risk factors (AOR = 2.9 (95% CI: 1.2, 6.9) and having favorable attitude towards cervical cancer and its screening (AOR = 3.7 (95% CI: 1.8, 7.5) were associated with cervical cancer screening utilization. Conclusions The study revealed utilization of cervical cancer screening service was low among HIV positive women. Educational status, duration of HIV diagnosis, partner support, knowledge status about risk factor, CD4 count and attitude towards cervical cancer and its screening were associated with cervical cancer screening utilization. Health care workers need to provide intensive counseling services for all ART care attendants to increase utilization.
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Affiliation(s)
- Abiyu Ayalew Assefa
- Department of public health, Hawassa college of health science, P.O.Box: 84, Hawassa, Ethiopia.
| | | | - Bethlehem Eshetu
- School of public health, College of medicine and health sciences, Hawassa University, Hawassa, Ethiopia
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Belglaiaa E, Mougin C. [Cervical cancer: Current situation and management in Morocco]. Bull Cancer 2019; 106:1008-1022. [PMID: 31606139 DOI: 10.1016/j.bulcan.2019.08.020] [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: 04/09/2019] [Revised: 07/09/2019] [Accepted: 08/27/2019] [Indexed: 12/24/2022]
Abstract
With more than 3300 new cases and almost 2500 deaths each year, cervical cancer (CC) ranks second among female cancers in Moroccan women. The majority of cases occurs in women aged 50 and over. In absence of a national cancer registry, data published in Morocco are limited to the number of cases recorded in some oncology centers, so the incidence of this cancer is likely much higher than estimated. A Moroccan national program against CC based on the practice of visual inspection after application of acetic acid was set up in 2010, allowing both screening and possibly immediate treatment of (pre)cancerous lesions. However, this program has not been implemented in all regions of the country. The CC develops slowly and most often without any symptoms, and so it is diagnosed at an advanced stage of the disease. Virtually, all CC are associated with persistent infection of high risk human papillomavirus (HPV), particularly HPV16 and 18. For more than ten years, two prophylactic vaccines targeting these two HPV genotypes have been marketed. They have proved their excellent immunogenicity and efficacy and they are well tolerated. However, HPV vaccine is not yet recommended by health authorities in Morocco. In this literature review, we focused on the current situation of CC, the prevalence of HPV infection and the prevention strategies against CC in Morocco.
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Affiliation(s)
- Essaada Belglaiaa
- Institut supérieur des professions infirmières et techniques de santé, département des soins infirmiers, Laâyoune, Maroc; Université de Bourgogne Franche-Comté, EA 3181, LabExLipSTIC ANR-11-LABX-0021, 25000 Besançon, France
| | - Christiane Mougin
- Université de Bourgogne Franche-Comté, EA 3181, LabExLipSTIC ANR-11-LABX-0021, 25000 Besançon, France; CHU, centre national de référence des papillomavirus (CNRP), 25000 Besançon, France.
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