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Scanlon B, Brough M, Wyld D, Durham J. Equity across the cancer care continuum for culturally and linguistically diverse migrants living in Australia: a scoping review. Global Health 2021; 17:87. [PMID: 34321015 PMCID: PMC8318324 DOI: 10.1186/s12992-021-00737-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/08/2021] [Indexed: 01/04/2023] Open
Abstract
International evidence suggests migrants experience inequitable access, outcomes and treatment quality across the cancer care continuum. There is currently limited research assessing equity across the cancer care continuum for culturally and linguistically diverse migrants living in Australia. A detailed protocol and search strategy were developed and used to identify all relevant literature, utilising the Joanna Briggs Institute Reviewer’s Manual. Systematic searching was conducted via multiple databases and identified studies were screened against pre-identified inclusion and exclusion criteria. 71 studies met the inclusion criteria for analysis. Most studies examined cancer detection via screening. Very few studies examined cancer prevention, diagnosis, treatment or palliative care. Most studies focused on patient-sided barriers to care and there was a paucity of information regarding institutional barriers to health. Cancer-related outcomes were seldom examined, and most studies were qualitative or behavioral analysis. Results highlighted significant communication issues spanning the cancer care continuum and a context of inadequate support for both patients and clinicians. There is a demonstrable need to examine equity in access and outcomes for culturally and linguistically diverse cancer populations. This requires the identification of cancer-related disparities and an examination of institutional barriers to care. Through addressing this dearth of information, future research and health policy can support the operationalisation of health equity.
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Affiliation(s)
- Brighid Scanlon
- Queensland University of Technology, 149 Victoria Park Road, QLD, 4059, Kelvin Grove, Australia. .,Royal Brisbane and Women's Hospital, Butterfield Street, QLD, 4029, Herston, Australia.
| | - Mark Brough
- Queensland University of Technology, 149 Victoria Park Road, QLD, 4059, Kelvin Grove, Australia
| | - David Wyld
- Queensland University of Technology, 149 Victoria Park Road, QLD, 4059, Kelvin Grove, Australia.,Royal Brisbane and Women's Hospital, Butterfield Street, QLD, 4029, Herston, Australia.,University of Queensland, 20 Weightman Street, QLD, 4006, Herston, Australia
| | - Jo Durham
- Queensland University of Technology, 149 Victoria Park Road, QLD, 4059, Kelvin Grove, Australia
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Alam Z, Shafiee Hanjani L, Dean J, Janda M. Cervical Cancer Screening Among Immigrant Women Residing in Australia: A Systematic Review. Asia Pac J Public Health 2021; 33:816-827. [PMID: 33829888 DOI: 10.1177/10105395211006600] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Since the introduction of systematic population-based cervical cancer screening in Australia in 1991, age-standardized incidence of cervical cancer has halved. Given recent advances in human papillomavirus (HPV) vaccination and screening, cervical cancer may be eliminated nationally within 20 years. However, immigrant women are not equitably reached by screening efforts. This study systematically reviewed evidence on cervical cancer screening practices among immigrant women in Australia. A systematic search of MEDLINE, Embase, PubMed, CINAHL, and PsycINFO and gray literature for English language studies published till March 1, 2019, was conducted. Observational and qualitative studies evaluating cervical cancer screening awareness and participation of immigrant women were screened. Of 125 potentially relevant studies, 25 were eligible: 16 quantitative (4 cohort, 12 cross-sectional), 6 qualitative, and 3 mixed-methods studies. Quantitative studies indicated 1% to 16% lower screening rates among migrant women compared with Australian-born women, with participation of South Asian women being significantly lower (odds ratio = 0.54, 95% confidence interval = 0.48-0.61). Qualitative studies illustrated factors affecting women's willingness to participate in screening, including insufficient knowledge, low-risk perception, and unavailability of a female health professionals being key barriers. Future studies should focus on South Asian women, due to recent increase in their immigration.
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Affiliation(s)
- Zufishan Alam
- The University of Queensland, Woolloongabba, Queensland, Australia
| | | | - Judith Dean
- The University of Queensland, Herston, Queensland, Australia
| | - Monika Janda
- The University of Queensland, Woolloongabba, Queensland, Australia
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Parajuli J, Horey D, Avgoulas MI. Perceived barriers to cervical cancer screening among refugee women after resettlement: A qualitative study. Contemp Nurse 2020; 56:363-375. [DOI: 10.1080/10376178.2020.1806089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Jamuna Parajuli
- Public Health, La Trobe University, Health Sciences Building 1, Bundoora, VIC, 3086, Australia
| | - Dell Horey
- Public Health, La Trobe University, College of Science, Health & Engineering, Office PW 228, Bundoora, VIC, 3086, Australia
| | - Maria-Irini Avgoulas
- School of Psychology and Public Health, La Trobe University, College of Science, Health & Engineering, Office HS2, 525, Bundoora, 3086, Australia
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Lovell RC, Botfield JR, Cheng Y, Tilley DM, Fazio A, Estoesta J. Promoting cervical screening among women experiencing homelessness and socio-economic disadvantage in Sydney. Health Promot J Austr 2020; 31:357-368. [PMID: 31978250 DOI: 10.1002/hpja.322] [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: 06/26/2019] [Revised: 01/16/2020] [Accepted: 01/17/2020] [Indexed: 11/07/2022] Open
Abstract
ISSUE ADDRESSED Australia's national cervical screening program has reduced rates of cervical cancer morbidity and mortality. However, these benefits have not been experienced by all women. A Cervical Cancer Screening Project was implemented with lay health educators to address inequitable screening access by women experiencing socio-economic disadvantage. METHODS Resources and a training program were developed and piloted with the specialist homelessness services workforce in Sydney, NSW. Data was collected to inform their development and evaluation through interviews, focus groups, self-administered surveys and analysis of NSW Pap Test Register data. RESULTS Women reported low familiarity with the term 'cervical screening'. They identified a good patient-doctor relationship, and seeing a female practitioner, as screening enablers. While the majority reported having cervical screening before, NSW Pap Test Register data showed only 74% had screened previously and of those, 69% were overdue. Homelessness service workers expressed interest in talking with clients about cervical screening, and reported increased knowledge and confidence following training. CONCLUSION The homelessness sector is an appropriate venue to access women who are disadvantaged and under-screened. However, increasing workforce capacity to discuss screening does not lead to increased screening for women accessing these services. Further efforts are required. SO WHAT?: Access to cervical screening by women experiencing disadvantage remains a challenge. Sustained multi-faceted health promotion efforts are required to increase access. These should be informed by additional research exploring barriers and enablers for this group of women.
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Affiliation(s)
- Renee C Lovell
- Women's Health, Community Health, Sydney Local Health District, Camperdown, NSW, Australia
| | | | - Yan Cheng
- Family Planning NSW, Ashfield, NSW, Australia
| | - Donna M Tilley
- Women's Health, Community Health, Sydney Local Health District, Camperdown, NSW, Australia
| | - Alice Fazio
- Family Planning NSW, Ashfield, NSW, Australia
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Nagendiram A, Bougher H, Banks J, Hall L, Heal C. Australian women’s self‐perceived barriers to participation in cervical cancer screening: A systematic review. Health Promot J Austr 2019; 31:343-353. [DOI: 10.1002/hpja.280] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 06/27/2019] [Accepted: 07/24/2019] [Indexed: 11/06/2022] Open
Affiliation(s)
- Archana Nagendiram
- James Cook University College of Medicine and Dentistry, Mackay Clinical School Mackay QLD Australia
| | - Hannah Bougher
- James Cook University College of Medicine and Dentistry, Mackay Clinical School Mackay QLD Australia
| | - Jennifer Banks
- James Cook University College of Medicine and Dentistry, Mackay Clinical School Mackay QLD Australia
| | - Leanne Hall
- James Cook University College of Medicine and Dentistry, Mackay Clinical School Mackay QLD Australia
| | - Clare Heal
- James Cook University College of Medicine and Dentistry, Mackay Clinical School Mackay QLD Australia
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Sidorkiewicz I, Zbucka-Krętowska M, Zaręba K, Lubowicka E, Zajkowska M, Szmitkowski M, Gacuta E, Ławicki S. Plasma levels of M-CSF and VEGF in laboratory diagnostics and differentiation of selected histological types of cervical cancers. BMC Cancer 2019; 19:398. [PMID: 31035945 PMCID: PMC6489352 DOI: 10.1186/s12885-019-5558-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 03/31/2019] [Indexed: 12/14/2022] Open
Abstract
Background The search of useful serum biomarkers for the early detection of cervical cancers has been of a high priority. The activation of Macrophage-Colony Stimulating Factor (M-CSF) and Vascular Endothelial Growth Factor (VEGF) is likely involved in the pathogenesis and spread of cancer. We compared the plasma levels of M-CSF and VEGF to the ones of commonly accepted tumor markers CA 125and SCC-Ag in three groups of patients: 1. the cervical cancer group (patients with either squamous cell carcinoma or adenocarcinoma); 2. the cervical dysplasia group; 3. the control group. Methods This cohort study included 100 patients with cervical cancer and 55 patients with cervical dysplasia. The control group consisted of 50 healthy volunteers. The plasma levels of VEGF and M-CSF were determined using ELISA, while CA 125 and SCC-Ag concentrations were obtained by the chemiluminescent microparticle immunoassay (CMIA). Results The median levels of M-CSF and VEGF as well as CA 125 and SCC-Ag in the entire group of cervical cancer patients, were significantly different compared to the healthy women group. In case of both the squamous cell carcinoma and the adenocarcinoma groups, plasma levels of M-CSF and VEGF were higher compared to the control group. No significant differences in the studied parameters between the squamous cell carcinoma and the adenocarcinoma group were observed. The highest sensitivity and specificity were obtained for VEGF (81.18 and 76.00%, respectively) and SCC-Ag (81.18%; 74.00%) in the squamous cell carcinoma group and for VEGF (86.67%; 76.00%) in the adenocarcinoma group. The area under the ROC curve for VEGF was the largest in the adenocarcinoma group followed by the squamous cell carcinoma group (0.9082 and 0.8566 respectively). Conclusions Obtained results indicate a possible clinical applicability and a high diagnostic power for the combination of MSC-F, VEGF, CA 125 and SCC-Ag in the diagnosis of both studied types of cervical cancer.
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Affiliation(s)
- Iwona Sidorkiewicz
- Department of Reproduction and Gynecological Endocrinology, Medical University of Bialystok, 15-276, Bialystok, Poland. .,Present address: Clinical Research Centre, Medical University of Bialystok, 15-276, Bialystok, Poland.
| | - Monika Zbucka-Krętowska
- Department of Reproduction and Gynecological Endocrinology, Medical University of Bialystok, 15-276, Bialystok, Poland
| | - Kamil Zaręba
- Department of Gynecology and Gynecologic Oncology, Medical University of Białystok, 15-276, Bialystok, Poland
| | - Emilia Lubowicka
- Department of Esthetic Medicine, Medical University of Bialystok, 15-089, Bialystok, Poland
| | - Monika Zajkowska
- Department of Biochemical Diagnostics, Medical University of Bialystok, 15-269, Bialystok, Poland
| | - Maciej Szmitkowski
- Department of Biochemical Diagnostics, Medical University of Bialystok, 15-269, Bialystok, Poland
| | - Ewa Gacuta
- Department of Perinatology, Medical University of Bialystok, 15-276, Bialystok, Poland
| | - Sławomir Ławicki
- Department of Population Medicine and Civilization Diseases Prevention, Medical University of Bialystok, 15-269, Bialystok, Poland
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Visioli CB, Crocetti E, Zappa M, Iossa A, Andersson KL, Bulgaresi P, Alfieri A, Amunni G. Participation and risk of high grade cytological lesions among immigrants and Italian-born women in an organized cervical cancer screening program in Central Italy. J Immigr Minor Health 2016; 17:670-8. [PMID: 24917238 DOI: 10.1007/s10903-014-0050-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Few studies analyzed the risk for high-grade squamous intraepithelial lesions or worse (HSIL+) among immigrants and natives attending organized cervical cancer (CC) screening programs (SP). We evaluated participation and diagnosis of HSIL+ by country of birth with logistic models. Overall 540,779 invitation letters were delivered to target women of Florence SP in three screening rounds (years 2000-2002, 2003-2005, 2006-2008). The probability of attending screening was lower for immigrants than natives, but the difference decreased from 35% (1st round) to 20% (2nd-3rd round) for women born in high migration pressure (HMP) countries. The risk of HSIL+ was double than natives for HMP-born women from countries with high prevalence of human papillomavirus, even adjusting for age and previous history of Pap test. This is an important public health problem due to an increasing proportion over time of immigrant women with a lower attendance and greater risk for CC.
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Affiliation(s)
- Carmen Beatriz Visioli
- Clinical and Descriptive Epidemiology Unit, ISPO - Istituto per lo Studio e la Prevenzione Oncologica, Via delle Oblate 2, 50144, Florence, Italy,
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Al-Ayoubi AM, Flores RM. Lung cancer screening: did we really need a randomized controlled trial? Eur J Cardiothorac Surg 2016; 50:29-33. [DOI: 10.1093/ejcts/ezw043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Cullerton K, Gallegos D, Ashley E, Do H, Voloschenko A, Fleming M, Ramsey R, Gould T. Cancer screening education: can it change knowledge and attitudes among culturally and linguistically diverse communities in Queensland, Australia? Health Promot J Austr 2016; 27:140-147. [PMID: 27376437 DOI: 10.1071/he15116] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 04/11/2016] [Indexed: 11/23/2022] Open
Abstract
Issue addressed: Screening for cancer of the cervix, breast and bowel can reduce morbidity and mortality. Low participation rates in cancer screening have been identified among migrant communities internationally. Attempting to improve low rates of cancer screening, the Ethnic Communities Council of Queensland developed a pilot Cancer Screening Education Program for breast, bowel and cervical cancer. This study determines the impact of education sessions on knowledge, attitudes and intentions to participate in screening for culturally and linguistically diverse (CALD) communities living in Brisbane, Queensland.Methods: Seven CALD groups (Arabic-speaking, Bosnian, South Asian (including Indian and Bhutanese), Samoan and Pacific Island, Spanish-speaking, Sudanese and Vietnamese) participated in a culturally-tailored cancer screening education pilot program that was developed using the Health Belief Model. A pre- and post-education evaluation session measured changes in knowledge, attitudes and intention related to breast, bowel and cervical cancer and screening. The evaluation focussed on perceived susceptibility, perceived seriousness and the target population's beliefs about reducing risk by cancer screening.Results: There were 159 participants in the three cancer screening education sessions. Overall participants' knowledge increased, some attitudes toward participation in cancer screening became more positive and intent to participate in future screening increased (n=146).Conclusion: These results indicate the importance of developing screening approaches that address the barriers to participation among CALD communities and that a culturally-tailored education program is effective in improving knowledge, attitudes about and intentions to participate in cancer screening.So what?: It is important that culturally-tailored programs are developed in conjunction with communities to improve health outcomes.
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Affiliation(s)
- Katherine Cullerton
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia
| | - Danielle Gallegos
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia
| | - Ella Ashley
- Ethnic Communities Council of Queensland, 253 Boundary Street, West End, Qld 4101, Australia
| | - Hong Do
- Ethnic Communities Council of Queensland, 253 Boundary Street, West End, Qld 4101, Australia
| | - Anna Voloschenko
- Ethnic Communities Council of Queensland, 253 Boundary Street, West End, Qld 4101, Australia
| | - MaryLou Fleming
- School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia
| | - Rebecca Ramsey
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia
| | - Trish Gould
- School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia
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Ncube B, Bey A, Knight J, Bessler P, Jolly PE. Factors associated with the uptake of cervical cancer screening among women in portland, Jamaica. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2015; 7:104-13. [PMID: 25839002 PMCID: PMC4382764 DOI: 10.4103/1947-2714.153922] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Cervical cancer is the second most common cancer among women worldwide and is the leading cause of deaths in developing countries. Despite the strong evidence that cervical cancer screening results in decreased mortality from this disease, the uptake for cervical screening among Jamaican women remains low. AIMS This study was carried out to identify factors associated with Jamaican women's decisions to screen for cervical cancer. MATERIALS AND METHODS Cross-sectional descriptive study of 403 women aged 19 years and older from Portland, Jamaica. An interviewer-administered questionnaire assessed the women's cervical cancer screening history, as well as their knowledge, attitudes, and practices regarding the disease and screening. RESULTS Of the 403 women interviewed, 66% had a Papanicolaou (Pap) smear and only 16% had a Pap test within the past year. Significant predicators of uptake of screening were being married, age, parity, discussing cancer with health provider, perception of consequences of not having a Pap smear, and knowing a person with cervical cancer. Women who did not know where to go for a Pap smear were 85% less likely to have been screened (prevalence odds ratio (POR): 0.15, 95% confidence interval (CI): 0.04, 0.52). CONCLUSIONS This study showed suboptimal uptake of cervical cancer screening among Jamaican women. Multipronged approaches are needed to address barriers to screening, as well as identify and support conditions that encourage women's use of reproductive health services, thereby reducing incidence and mortality rates from cervical cancer.
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Affiliation(s)
- Butho Ncube
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Amita Bey
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | - Patricia Bessler
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Pauline E. Jolly
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Armstrong BK. Time trends in cancer incidence and mortality. Med J Aust 2013; 199:570-1. [PMID: 24182207 DOI: 10.5694/mja13.11247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Accepted: 10/09/2013] [Indexed: 01/01/2023]
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