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Jibat N, Ali R, Adissu W, Buruh G, Abdissa A, Goba GK, Garland SM, Mulholland N, Mulholland K, Amenu D. Less known but greatly feared: Cervical cancer in Ethiopia community awareness. Heliyon 2024; 10:e28328. [PMID: 38601557 PMCID: PMC11004701 DOI: 10.1016/j.heliyon.2024.e28328] [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: 05/13/2023] [Revised: 02/26/2024] [Accepted: 03/15/2024] [Indexed: 04/12/2024] Open
Abstract
To improve a community's awareness and attitude towards cervical cancer, strong evidence is needed to inform contextually appropriate policies. This study aims to explore community awareness about cervical cancer from the perspective of women, men and health extension workers (HEWs). The research was conducted from May to July 2021 in Jimma, Ethiopia. A total of 23 in-depth interviews were conducted. The study included married and unmarried women (15-19 and 25-29 years old), men of similar ages (married and unmarried), and HEWs. Furthermore, eight separate focus group discussions (FGDs) were conducted with both men and women. Thematic analysis was used to draw findings from the interviews and FGDs. Community awareness about cervical cancer was very limited. However, people who knew of it believed that cancer is fatal. A few participants were aware of cervical cancer through its symptoms, but most people did not know it by name and had never heard about HPV as the cause of cervical cancer. There was little understanding of HPV risk, transmission factors, prevention, vaccination, screening, or treatment. Participants considered their participation in this study as their first chance to learn about the disease. HEWs had limited knowledge about HPV and cervical cancer. Study participants demonstrated favorable attitudes towards HPV vaccination, cervical screening, and treatment after they received basic information about cervical cancer from the data collectors. Participants and HEWs strongly suggested awareness creation programs for the wider community members, including active involvement of men and HEWs in cervical cancer interventions. There is a critical information gap regarding cervical cancer, its cause and risk factors, HPV transmission, cervical screening, and treatment programs. Limited community awareness leads to poor uptake of cervical screening in the few settings where it is available. Therefore, community awareness programs about HPV, cervical cancer, and available services should improve the community's awareness of cervical cancer and HPV.
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Affiliation(s)
- Nega Jibat
- Department of Sociology, College of Social Science and Humanities Jimma University, Jimma Ethiopia
| | - Rahma Ali
- Department of Population and Family Health, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Wondimagegn Adissu
- School of Medical Laboratory, Faculty of Health Science, Jimma University, Jimma, Ethiopia
| | - Gerezgiher Buruh
- College of Health Science, Mekelle University, Mekelle, Ethiopia
| | | | - Gelila K. Goba
- Department of Obstetrics and Gynecology, University of Illinois, Chicago, USA
| | - Suzanne M. Garland
- Department of Obstetrics and Gynecology, University of Melbourne, Australia
| | - Nigisti Mulholland
- Family & Reproductive Rights Education Program, Royal Women's Hospital, Melbourne, Australia
| | - Kim Mulholland
- Department of Pediatrics, University of Melbourne, Murdoch Children's Research Institute, Australia
- London School of Tropical Medicine, UK
| | - Demisew Amenu
- Department of Gynecology and Obstetrics, Faculty of Medical Science, Jimma University, Jimma, Ethiopia
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Anyolo E, Amakali K, Amukugo HJ. Attitudes of women towards screening, prevention and treatment of cervical cancer in Namibia. Health SA 2024; 29:2433. [PMID: 38445040 PMCID: PMC10913021 DOI: 10.4102/hsag.v29i0.2433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 11/09/2023] [Indexed: 03/07/2024] Open
Abstract
Background Cervical cancer is among the top causes of cancer-related deaths among women globally. Aim The aim of the study was to assess the attitudes of women of reproductive age towards cervical cancer services in the Otjozondjupa region, Namibia. Setting The setting of this study was the Otjozondjupa region, one of the 14 regions of Namibia. Methods A quantitative, cross-sectional, descriptive study was used. The data were collected with a questionnaire from a stratified sample of 381 out of the 37066 study population of women of reproductive age across four districts of the region. Descriptive data analysis was performed using Statistical Package for Social Science version 25. Results The findings revealed that most respondents (83.1%) had an overall neutral attitude towards the screening, prevention, and treatment of cervical cancer; they were not concerned about the risk of cervical cancer and would not practice health-seeking behaviours regarding cervical cancer services. Conclusions The respondents were indifferent with regard to prevention, screening, and management services for cervical cancer, implying that they would not use available cervical cancer services. Contributions Attitudes of women of reproductive age towards cervical cancer services were highlighted. Subsequently, an educational programme for nurses to enhance the utilisation of cervical cancer services among women of reproductive age in the Otjozondjupa region, Namibia, was developed. Guidelines were developed to facilitate the implementation and evaluation of the educational programme activities to enhance the utilisation of cervical cancer screening services among women of reproductive age.
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Affiliation(s)
- Epafras Anyolo
- Department of General Nursing Science, Faculty of Health Science and Veterinary Medicines, University of Namibia, Windhoek, Namibia
| | - Kristofina Amakali
- Department of General Nursing Science, Faculty of Health Science and Veterinary Medicines, University of Namibia, Windhoek, Namibia
| | - Hans J. Amukugo
- Department of General Nursing Science, Faculty of Health Science and Veterinary Medicines, University of Namibia, Windhoek, Namibia
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Aragaw GM, Anteneh TA, Abiy SA, Bewota MA, Aynalem GL. Parents' willingness to vaccinate their daughters with human papillomavirus vaccine and associated factors in Debretabor town, Northwest Ethiopia: A community-based cross-sectional study. Hum Vaccin Immunother 2023; 19:2176082. [PMID: 36794293 PMCID: PMC10026865 DOI: 10.1080/21645515.2023.2176082] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
The Human Papilloma Virus (HPV) is the primary causative agent of cervical cancer. Vaccination against the HPV infection is an effective prevention measure for HPV-related diseases. This study aimed to assess parents' willingness to vaccinate their daughters with Human Papillomavirus vaccine and associated factors in Debre Tabor town. A community-based cross-sectional study was conducted among parents of daughters in Debre Tabor town, and a cluster sampling technique was used to select 738 study participants. A structured and interviewer-administered questionnaire was used to collect the data. Data were entered into EPI data version 4.6 and exported to SPSS version 26 for analysis. Multivariable logistic regression was done and a p-value of ≤ 0.05 was used to declare the level of significance. In this study, parents' willingness for HPV vaccination was found to be 79.10% (95% CI: 76.00, 82.00). Parents having media exposure, had good knowledge of HPV infection, and HPV vaccine, positive attitude, and positive perceived behavioral control toward the HPV vaccine had statistically significant association with willingness for the HPV vaccination of their daughters. Parents' willingness to HPV vaccination for their daughters was higher compared with a previous study done in the setting. Parental knowledge and their beliefs on HPV vaccination, and media exposure play an important role in the HPV vaccination of adolescents. Strengthening community-based education and effective promotion through multimedia on HPV infection and its prevention, addressing parental safety concerns and promoting their positive beliefs about the vaccine are important to increase parents' willingness.
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Affiliation(s)
- Getie Mihret Aragaw
- Department of General Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tazeb Alemu Anteneh
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Saron Abeje Abiy
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mulunesh Abuhay Bewota
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getie Lake Aynalem
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Hall MT, Simms KT, Murray JM, Keane A, Nguyen DTN, Caruana M, Lui G, Kelly H, Eckert LO, Santesso N, de Sanjose S, Swai EE, Rangaraj A, Owiredu MN, Gauvreau C, Demke O, Basu P, Arbyn M, Dalal S, Broutet N, Canfell K. Benefits and harms of cervical screening, triage and treatment strategies in women living with HIV. Nat Med 2023; 29:3059-3066. [PMID: 38087116 PMCID: PMC10719091 DOI: 10.1038/s41591-023-02601-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 09/20/2023] [Indexed: 12/17/2023]
Abstract
To support a strategy to eliminate cervical cancer as a public health problem, the World Health Organisation (WHO) reviewed its guidelines for screening and treatment of cervical pre-cancerous lesions in 2021. Women living with HIV have 6-times the risk of cervical cancer compared to women in the general population, and we harnessed a model platform ('Policy1-Cervix-HIV') to evaluate the benefits and harms of a range of screening strategies for women living with HIV in Tanzania, a country with endemic HIV. Assuming 70% coverage, we found that 3-yearly primary HPV screening without triage would reduce age-standardised cervical cancer mortality rates by 72%, with a number needed to treat (NNT) of 38.7, to prevent a cervical cancer death. Triaging HPV positive women before treatment resulted in minimal loss of effectiveness and had more favorable NNTs (19.7-33.0). Screening using visual inspection with acetic acid (VIA) or cytology was less effective than primary HPV and, in the case of VIA, generated a far higher NNT of 107.5. These findings support the WHO 2021 recommendation that women living with HIV are screened with primary HPV testing in a screen-triage-and-treat approach starting at 25 years, with regular screening every 3-5 years.
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Affiliation(s)
- Michaela T Hall
- Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia.
| | - Kate T Simms
- Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - John M Murray
- School of Mathematics and Statistics, University of New South Wales, Sydney, NSW, Australia
| | - Adam Keane
- Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Diep T N Nguyen
- Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Michael Caruana
- Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Gigi Lui
- Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Helen Kelly
- London School of Hygiene and Tropical Medicine, University of London, London, UK
| | - Linda O Eckert
- Department of Global Health and the Department of Obstetrics & Gynecology, University of Washington, Seattle, WA, USA
| | - Nancy Santesso
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Silvia de Sanjose
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
- ISGlobal, Barcelona, Spain
| | - Edwin E Swai
- Universal Health Coverage and Life Course Cluster, World Health Organization, Dar es Salaam, Tanzania
| | - Ajay Rangaraj
- Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Morkor Newman Owiredu
- Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Cindy Gauvreau
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- SUCCESS Project, Expertise France, Paris, France
| | - Owen Demke
- Global Diagnostics, Clinton Health Access Initiative, Kigali, Rwanda
| | - Partha Basu
- Early Detection Prevention and Infections, International Agency for Research on Cancer, Lyon, France
| | - Marc Arbyn
- Cancer Epidemiology Unit, Belgian Cancer Centre, Sciensano, Brussels, Belgium
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Shona Dalal
- Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Nathalie Broutet
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Karen Canfell
- Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
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Misgun T, Demissie DB. Knowledge, practice of cervical cancer screening and associated factors among women police members of Addis Ababa police commission Ethiopia. BMC Cancer 2023; 23:961. [PMID: 37817082 PMCID: PMC10566075 DOI: 10.1186/s12885-023-11478-x] [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: 02/23/2023] [Accepted: 10/04/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Cervical cancer is a public health problem. It is one of the leading causes of death in women worldwide and the second leading cause of female cancer-related deaths. Cervical cancer screening enables the detection of abnormal cervical cells, including precancerous cervical lesions, as well as early-stage cervical cancer. Routine cervical screening has been shown to reduce both the incidence and mortality of the disease. OBJECTIVE The aim of this study was to assess knowledge, practice of cervical cancer screening and associated factors among women police members at Addis Ababa police commission Ethiopia 2022. METHOD An institutional-based cross-sectional study was conducted at the Addis Ababa police commission in the Lidet Sub-city police department from December 1st to January 30th, 2022. The data were collected through a structured, self-administered questionnaire from 361 randomly selected police officers. The collected data were analyzed using SPSS version 26 software in descriptive statistics, binary, and multivariable logistic regression analysis to identify factors associated with the outcome variable at PV = 0.05 with an AOR and 95% CI. RESULTS The complete response rate was 97.57% (361/371). This found that 59.5% of the total study participants were aged between 18 and 29 years old, and 47.3% were married in marital status. This study determined knowledge status of police commission towards cervical cancer screening revealed that 183(49.5%) had good knowledge, with identified factors which increases likelihood of good knowledge were attitude [AOR = 2.03, 95%CI;( 1.25-3.3)] and cervical cancer screening practice [AOR = 2.0, 95%CI (1.15-3.53)] respectively. This is determined the prevalence of cervical cancer screening practice was 68(18.4%)with 95% CI(14.3-22.4) with identified factors which increases likelihood of cervical cancer screening practice were age, [AOR = 3.24, 95% CI;( 1.08-9.75)], marital status [AOR = 3.88,95%CI,(1.55-9.73)] monthly income [AOR = 4.82,95%CI;(1.44-16.12)],religion[AOR = 8.65,95%CI,( 1.65-45.46)] and knowledge [AOR = 2.35,95%CI;( 1.22-4.52)] respectively. The main reason reported for not practice of cervical cancer screening was feeling healthy. CONCLUSION AND RECOMMENDATION This study identified that the knowledge status of female police commissioners were poor and practice of cervical cancer screening were found to be very low. Some of the factors associated with the cervical cancer screening practice were age, marital status, monthly income and knowledge of the women. In addition, feeling being health was associated poor practice of cervical cancer screening. To alleviate this problem the health authorities at different level of the health system should take massive awareness creation activities through various communication channels about screening service prepare screening campaign.
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Affiliation(s)
- Tangut Misgun
- Santé Medical College School of Public Health Department of Reproductive Health, Addis Ababa, Ethiopia
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He C, Pei C, Ma J. Developing an evaluation indicators of health literacy for cervical cancer among Chinese women: a modified Delphi method study. BMC Cancer 2023; 23:863. [PMID: 37700262 PMCID: PMC10498636 DOI: 10.1186/s12885-023-11208-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/22/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Increasing women's health literacy is the key to preventing cervical cancer, and various tools have been developed to assess women's cancer health literacy. However, many of these tools come from other countries and have not been adapted to Chinese requirements. Furthermore, a system for evaluating cervical cancer health literacy among Chinese women has not been developed. Therefore, we sought to establish an evaluation index system for cervical cancer health literacy among Chinese women and to provide an effective evaluation tool for tertiary prevention of cervical cancer in China. METHODS We invited 20 recognized experts to participate in two rounds of Delphi expert consultation, and the modified Delphi process with percentage weighting and multiplication was used. A literature review identified 67 potential indicators. Subsequent discussions within our research team led to the retention of 48 indicators following a rigorous screening process. On this basis, two rounds of Delphi expert consultation were conducted to rate and screen the indexes. Percentage weighting and multiplication were used to determine index weights. RESULTS Twenty experts participated in the first-round Delphi consultations (95.23% recovery rate). In the second-round Delphi consultations, 20 questionnaires were returned (100%), and the expert authority coefficient was 0.93 ± 0.02. After both rounds of Delphi consultation, 4 first-level indicators, 9 second-level indicators, and 32 third-level indicators were identified for cervical cancer literacy among Chinese women. On a five-point scale, importance ratings ranged from 3.76 to 4.95 points, with variation coefficients ranging from 0.06 to 0.25, while sensitivity ratings ranged from 3.71 to 4.83 points, with variation coefficients ranging from 0.08 to 0.24. Across both rounds, Kendall's W coefficients ranged from 0.168 to 0.248. The weights of first-level indicators of basic knowledge and attitudes about cervical cancer, primary prevention of cervical cancer literacy, secondary prevention of cervical cancer literacy, and tertiary prevention of cervical cancer literacy were 0.257, 0.249, 0.251, and 0.243, respectively. CONCLUSIONS We have developed the first tertiary prevention-based, comprehensive evaluation index system for cervical cancer literacy among Chinese women, which will provide theoretical support for cervical cancer prevention and health education programs.
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Affiliation(s)
- Chanchan He
- Institute for Hospital Management of Tsinghua University, Shenzhen, 518055, China
| | - Chenyang Pei
- School of Health Policy Management, Peking Union Medical College, Beijing, 100730, China
| | - Jing Ma
- Institute for Hospital Management of Tsinghua University, Shenzhen, 518055, China.
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Azzani M, Ba-Alawi E, Atroosh WM, Yadav H. Awareness of cervical cancer and its associated socio-demographic factors among Yemeni immigrant women in Malaysia. BMC Womens Health 2023; 23:19. [PMID: 36647066 PMCID: PMC9841630 DOI: 10.1186/s12905-023-02172-y] [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: 10/21/2022] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Studies have revealed that a higher proportion of women affected by cervical cancer are from some minority groups of immigrant women. Hence, this study was conducted to assess Yemeni immigrant women's awareness of cervical cancer and its associated socio-demographic factors. METHODS A cross-sectional study was conducted among 370 Yemeni women in Selangor and Kuala Lumpur, Malaysia. Data on the awareness of symptoms/signs, risk factors, and screening programme were collected using Cervical Cancer Awareness Measurement (Cervical CAM) questionnaire. RESULTS More than 74% of the study participants were unable to recall any warning symptoms/signs, and 73% were unable to recall any risk factors. The factors associated with the awareness of symptoms and risk factors were age (95% CI 4.22-5.22, p = 0.039), marital status (95% CI 4.05-7.87, p = 0.021), employment (95% CI 3.89-5.77, p = 0.046) and the number of children (95% CI 5.33-6.54, p = 0.041). CONCLUSION The findings underline the need for public awareness campaigns to improve public awareness of cancer symptoms and risk factors among underserved communities.
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Affiliation(s)
- Meram Azzani
- grid.412259.90000 0001 2161 1343Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, 47000 Sungai Buloh, Selangor Malaysia
| | - Eshrak Ba-Alawi
- grid.459705.a0000 0004 0366 8575Department of Community Medicine, Faculty of Medicine, MAHSA University, Saujana Putra Campus, 42610 Jenjarum, Selangor Malaysia
| | - Wahib Mohammed Atroosh
- grid.10347.310000 0001 2308 5949Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Hematram Yadav
- grid.459705.a0000 0004 0366 8575Department of Community Medicine, Faculty of Medicine, MAHSA University, Saujana Putra Campus, 42610 Jenjarum, Selangor Malaysia
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Gadiraju P, Dehury RK, Singh P, Vanlalhruaii C, Dehury P, Devaraju K, Behera S. Behavioral interventions towards knowledge and awareness of reproductive cancer care: A study on select Indians using an online survey. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:371. [PMID: 36618477 PMCID: PMC9818615 DOI: 10.4103/jehp.jehp_453_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/30/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The behavioral aspects of human beings influence the incidences of cancer cases directly and indirectly. The factors like positive thinking and motivation were found to change the behavior toward knowledge and awareness of cancer. The main objective of the study is to assess the knowledge and awareness of select Indians about reproductive cancer. MATERIALS AND METHODS The online survey method assessed various components of knowledge and awareness about reproductive cancer. A Google Form has been distributed through social media platforms such as e-mail, Instagram, Facebook, and WhatsApp. The coded data has been computed in SPSS (version 25) by IBM (USA) for the analysis. Univariate and bivariate data analysis has been drawn to justify the objective. RESULTS Nearly 68 percent of the respondents were aware of reproductive cancer. Among them, 17 percent know about cervical cancer, and 12.5 percent have awareness about breast cancer. Electronic and print media (41.2 percent) were major sources of information about reproductive cancer. Nearly 48 percent of respondents reported that multiple sexual partners and poor sexual hygiene were risk factors for reproductive cancer. Around 57 percent of respondents reported reproductive cancer is preventable, 59 percent knew about cancer screening, and 63.5 percent knew the treatment process. The gender of the respondents was associated (p-value = 0.002) with awareness of reproductive cancer. It has been found that there is a significant association between knowledge of screening tests and the treatment process of reproductive cancer. The marital status of respondents is strongly associated (p-value = 0.000) with the awareness of reproductive cancer. CONCLUSION The factors like knowledge of reproductive cancer and awareness proceed as an important role in cancer prevention. A gender-neutral cancer awareness program is needed to increase cancer awareness irrespective of marital status.
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Affiliation(s)
- Padmaja Gadiraju
- Centre for Health Psychology, School of Medical Sciences, University of Hyderabad, Telangana, India
| | | | - Punam Singh
- School of Management Studies, University of Hyderabad, Telangana, India
| | - C. Vanlalhruaii
- Centre for Health Psychology, School of Medical Sciences, University of Hyderabad, Telangana, India
| | - Parthsarathi Dehury
- Centre for Health Psychology, School of Medical Sciences, University of Hyderabad, Telangana, India
- Tata Institute of Social Sciences, Mumbai, Maharastra, India
| | - Kadari Devaraju
- Centre for Health Psychology, School of Medical Sciences, University of Hyderabad, Telangana, India
- Department of Psychology, Osmania University, Telangana, India
| | - Sangita Behera
- Centre for Health Psychology, School of Medical Sciences, University of Hyderabad, Telangana, India
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Hauwa I, Oluwasanu MM, John-Akinola Y, Oyewole OE. Knowledge of cervical cancer and barriers to screening among women in a city in Northern Nigeria. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-021-01593-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Adewumi K, Nishimura H, Oketch SY, Adsul P, Huchko M. Barriers and Facilitators to Cervical Cancer Screening in Western Kenya: a Qualitative Study. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1122-1128. [PMID: 33411253 PMCID: PMC9257902 DOI: 10.1007/s13187-020-01928-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/22/2020] [Indexed: 06/12/2023]
Abstract
About nine out of 10 cervical cancer deaths occur in low-resource countries, with a particularly high burden in sub-Saharan Africa. The objectives of this study were to assess barriers and facilitators to cervical cancer screening in western Kenya from the perspectives of community members and healthcare providers. We conducted two focus groups with female community members (n = 24) and one with providers (n = 12) in Migori County, Kenya. Discussion guides queried about knowledge and awareness of cervical cancer prevention; structural, social, and personal barriers; and facilitators towards cervical cancer screening uptake. Group discussions were recorded, transcribed, and analyzed for emerging themes. Participants in both groups reported low awareness of HPV and cervical cancer screening in the community, and identified that as a main barrier to screening. Community members reported fear of pain and embarrassment as significant barriers to a screening pelvic exam. They also reported that providers' lack of knowledge and discomfort with a sensitive subject were significant barriers. A personal connection to cervical cancer and/or screening was associated with willingness to screen and awareness. Providers reported workload and lack of supplies and trained staff as significant barriers to offering services. Based on these findings, we identified three intervention components to address these facilitators and barriers to screening. They include utilizing existing social networks to expand awareness of cervical cancer risk and screening, training non-physician health workers to meet the demand for screening, and employing female-driven screening techniques such as self-collection of specimens for HPV testing. Cervical cancer prevention programs must take into account the local realities in which they occur. In low-resource areas in particular, identifying low-cost, effective, and culturally appropriate strategies for addressing poor screening uptake is important given limited funding. This study took a formative approach to identify facilitators and barriers to cervical cancer screening based on focus groups and interviews with community members and healthcare providers.
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Affiliation(s)
- Konyin Adewumi
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27710, USA.
| | - Holly Nishimura
- School of Public Health, University of California at Berkeley, Berkeley, CA, USA
| | - Sandra Y Oketch
- Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Prajakta Adsul
- National Cancer Institute/National Institutes of Health, Bethesda, MD, USA
| | - Megan Huchko
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27710, USA
- Department of Obstetrics and Gynecology, Duke University, Durham, NC, USA
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Dalla V, Panagiotopoulou EK, Deltsidou A, Kalogeropoulou M, Kostagiolas P, Niakas D, Labiris G. Level of Awareness Regarding Cervical Cancer Among Female Syrian Refugees in Greece. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:717-727. [PMID: 32959214 DOI: 10.1007/s13187-020-01873-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/09/2020] [Indexed: 06/11/2023]
Abstract
Nowadays, prevention, control and treatment of cervical cancer are a worldwide public health priority. Primary objective of this study was to evaluate the level of awareness of female Syrian refugees who have recently settled in Greece regarding the warning signs and the risk factors of cervical cancer. This is a descriptive, cross-sectional study that was conducted in two facilities of the Hellenic Red Cross. The Cervical Cancer Awareness Measure questionnaire was addressed to 176 female Syrian refugees, aged between 18 and 50. Syrian women presented low awareness both for risk factors and warning signs. The most frequently identified warning signs were vaginal bleeding after menopause (44.3%), vaginal bleeding between menstruation (34.1%) and unexplained weight loss (32.4%). Regarding the risk factors' recognition rates, 74.5% considered the existence of many sexual partners as a risk factor and 61.3% the existence of a sexual partner with many previous sexual partners. Older age, a higher level of education and confidence that any potential symptom would be identified were associated with increased awareness. Our findings confirm former published reports that indicate poor awareness regarding cervical cancer among refugee populations. Full compliance with the guidelines of the World Health Organization for a national cervical cancer screening programme is highly advised in Greece and should address the needs of both native and refugee populations. This research is the first one that underlines the need for raising awareness of cervical cancer among female Syrian refugees in Greece by developing health promotion strategies adjusted to their unique cultural needs.
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Affiliation(s)
- Vasiliki Dalla
- Faculty of Social Sciences, Hellenic Open University, Patras, Greece.
| | | | - Anna Deltsidou
- Faculty of Social Sciences, Hellenic Open University, Patras, Greece
- Department of Midwifery, University of West Attica, Athens, Greece
| | | | - Petros Kostagiolas
- Faculty of Social Sciences, Hellenic Open University, Patras, Greece
- Department of Archives, Library Science and Museology, School of Information Science and Informatics, Ionian University, Corfu, Greece
| | - Dimitris Niakas
- Faculty of Social Sciences, Hellenic Open University, Patras, Greece
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Labiris
- Faculty of Social Sciences, Hellenic Open University, Patras, Greece
- Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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Gerstl S, Lee L, Nesbitt RC, Mambula C, Sugianto H, Phiri T, Kachingwe J, Llosa AE. Cervical cancer screening coverage and its related knowledge in southern Malawi. BMC Public Health 2022; 22:295. [PMID: 35164716 PMCID: PMC8842862 DOI: 10.1186/s12889-022-12547-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 01/03/2022] [Indexed: 12/24/2022] Open
Abstract
Background Cervical cancer (CC) is the fourth most common cancer among women worldwide and Malawi has the world’s highest rate of cervical cancer related mortality. Since 2016 the National CC Control Strategy has set a screening coverage target at 80% of 25-49-year-old women. The Ministry of Health and Médecins Sans Frontières (MSF) set up a CC program in Blantyre City, as a model for urban areas, and Chiradzulu District, as a model for rural areas. This population-based survey aimed to estimate CC screening coverage and to understand why women were or were not screened. Methods A population-based survey was conducted in 2019. All resident consenting eligible women aged 25-49 years were interviewed (n = 1850) at households selected by two-stage cluster sampling. Screening and treatment coverage and facilitators and barriers to screening were calculated stratified by age, weighted for survey design. Chi square and design-based F tests were used to assess relationship between participant characteristics and screening status. Results The percentage of women ever screened for CC was highest in Blantyre at 40.2% (95% CI 35.1-45.5), 38.9% (95% CI 32.8-45.4) in Chiradzulu with supported CC screening services, and lowest in Chiradzulu without supported CC screening services at 25.4% (95% CI 19.9-31.8). Among 623 women screened, 49.9% (95% CI 44.0-55.7) reported that recommendation in the health facility was the main reason they were screened and 98.5% (95% CI 96.3-99.4) recommended CC screening to others. Among 1227 women not screened, main barriers were lack of time (26.0%, 95% CI 21.9-30.6), and lack of motivation (18.3%, 95% CI 14.1-23.3). Overall, 95.6% (95% CI 93.6-97.0) of women reported that they had some knowledge about CC. Knowledge of CC symptoms was low at 34.4% (95% CI 31.0-37.9) and 55.1% (95% CI 51.0-59.1) of participants believed themselves to be at risk of CC. Conclusion Most of the survey population had heard about CC. Despite this knowledge, fewer than half of eligible women had been screened for CC. Reasons given for not attending screening can be addressed by programs. To significantly reduce mortality due to CC in Malawi requires a comprehensive health strategy that focuses on prevention, screening and treatment.
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Affiliation(s)
- Sibylle Gerstl
- Epicentre / Médecins Sans Frontières (MSF), Paris, France.
| | - Lawrence Lee
- Epicentre / Médecins Sans Frontières (MSF), Paris, France
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Gebisa T, Bala ET, Deriba BS. Knowledge, Attitude, and Practice Toward Cervical Cancer Screening Among Women Attending Health Facilities in Central Ethiopia. Cancer Control 2022; 29:10732748221076680. [PMID: 35315704 PMCID: PMC8943579 DOI: 10.1177/10732748221076680] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background In Ethiopia, cervical cancer ranked as the second leading cause of female
cancer and also stands as the most common cancer among women aged from 15 to
44 years old. Hence, this study aimed to assess knowledge, attitude, and
practice toward cervical cancer screening among women attending health
facilities in central Ethiopia. Methods Institutional-based cross-sectional study was conducted among 420 study
participants. Data were collected using an interviewer-administered
questionnaire. The collected data were entered into EPI data 3.1 and
exported to SPSS version 23 for analysis. Binary and multivariate logistic
regressions were used to identify factors associated with knowledge,
attitude, and practice of cervical cancer screening. Odds ratio (OR) with
95% CI and a P-value < .05 were used to declare
statistical significance. Results Half, 50.7% of study participants had good knowledge. Less than half, 46.1%
had a positive attitude toward cervical cancer screening. Only 6.3% of women
have been screened for cervical cancer. Diploma and above education (AOR:
2.22, 95% CI: 1.32, 6.157), no idea about cervical cancer curable at an
early stage (AOR: 6.23, 95% CI: 6.23 (2.77, 15.13) were significantly
associated with knowledge of cervical cancer screening. Diploma and above
education (AOR: 0.37, 95% CI: 0.19, 0.74) and multiple sexual partners (AOR:
0.18, 95% CI: 0.05, 0.62) were factors associated with a negative attitude
toward cervical cancer screening. Positive attitude about cervical cancer
screening (AOR: 2.37, 95% CI: 1.91, 6.20) was significantly associated with
the practice of being screened. Conclusions Cervical cancer screening knowledge and attitudes were moderate, but practice
was low. Educational status, considering cervical cancer is not curable at
an early stage and not having an idea about its curability at an early
stage, was significantly associated with knowledge of cervical cancer
screening. Sexual partner status and educational status showed significant
association with an attitude toward cervical cancer screening and having a
positive attitude toward cervical cancer screening were significantly
associated with the practice of cervical cancer screening. Health
professionals need to disseminate cervical cancer screening information and
offer cervical cancer treatment during health-care appointments.
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Affiliation(s)
- Tulu Gebisa
- Department of Public Health, Oromia Regional Health Bureau West Shewa Zonal Health Office, Ambo, Ethiopia
| | - Elias Teferi Bala
- Department of Public Health, 361570Ambo University College of Medicine and Health Sciences, Ambo, Ethiopia
| | - Berhanu Senbeta Deriba
- Department of Public Health, 576981Salale University College of Health Sciences, Fitche, Ethiopia
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Wang Y, Xie Y, Sun B, Guo Y, Song L, Mohammednur DE, Zhao C. The degradation of Rap1GAP via E6AP-mediated ubiquitin-proteasome pathway is associated with HPV16/18-infection in cervical cancer cells. Infect Agent Cancer 2021; 16:71. [PMID: 34952616 PMCID: PMC8710002 DOI: 10.1186/s13027-021-00409-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cervical cancers are closely associated with persistent high-risk human papillomaviruses (HR HPV) infection. The main mechanism involves the targeting of tumor suppressors, such as p53 and pRB, for degradation by HR HPV-encoded oncoproteins, thereby leading to tumorigenesis. Rap1GAP, a tumor suppressor gene, is down-regulated in many cancers. Previous studies have revealed that down-regulation of Rap1GAP is correlated with HPV16/18 infection in cervical cancer. However, the molecular mechanism remains unclear. In this study, we aimed to address the degradation pathway of Rap1GAP in HPV-positive cervical cancer cells. METHODS HPV-positive (HeLa and SiHa) and negative (C33A) cervical cancer cells were used to analyze the pathways of Rap1GAP degradation. MG132 (carbobenzoxy-leucyl-leucyl-leucine) was used to inhibit protein degradation by proteasome. Co-immunoprecipitation (co-IP) was used to detect the interaction between Rap1GAP and E6AP. siRNA for E6AP was used to silence the expression of E6AP. Rapamycin was used to induce cell autophagy. Western blotting was used to check the levels of proteins. RESULTS Following treatment with MG132, the levels of Rap1GAP were increased in the HR HPV-positive HeLa and SiHa cells, but not in the HPV-negative C33A cells. Co-immunoprecipitation assay revealed ubiquitinated Rap1GAP protein in HeLa and SiHa cells, but not in C33A cells. E6-associated protein (E6AP) mediated the ubiquitination of Rap1GAP by binding to it in HeLa and SiHa cells, but not in C33A cells. However, the levels of Rap1GAP were decreased in HeLa and SiHa cells after knocking down E6AP by siRNA. Silencing of E6AP did not affect the levels of Rap1GAP in C33A cells. Autophagy marker p62 was decreased and LC3 II/LC3 I was increased after knocking down E6AP in HeLa cells, but not in C33A cells. The levels of Rap1GAP were decreased after treating the cells with rapamycin to induce cell autophagy in HeLa and C33A cells. CONCLUSION Rap1GAP may be degraded by autophagy in cervical cancer cells, but HPV infection can switch the degradation pathway from autophagy to E6AP-mediated ubiquitin-proteasome degradation. E6AP may be a key component of the switch.
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Affiliation(s)
- Yinghui Wang
- College of Laboratory Medicine, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning, China
- Liaoning Provincial Center for Disease Control and Prevention, Shenyang, China
| | - Yihang Xie
- College of Laboratory Medicine, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning, China
| | - Boxuan Sun
- College of Laboratory Medicine, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning, China
| | - Yuwei Guo
- College of Laboratory Medicine, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning, China
| | - Ling Song
- College of Laboratory Medicine, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning, China
- Foruth Teaching Hospital, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Dawit Eman Mohammednur
- College of Laboratory Medicine, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning, China
| | - Chunyan Zhao
- College of Laboratory Medicine, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning, China.
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Aredo MA, Sendo EG, Deressa JT. Knowledge of cervical cancer screening and associated factors among women attending maternal health services at Aira Hospital, West Wollega, Ethiopia. SAGE Open Med 2021; 9:20503121211047063. [PMID: 34603728 PMCID: PMC8481706 DOI: 10.1177/20503121211047063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 08/31/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Cervical cancer is one of the major noncommunicable public health problems among women globally. About 500,000 women develop cervical cancer each year, with an estimated 85% or more occurring in developing countries, including Ethiopia. OBJECTIVE The main objective of the study was to assess the knowledge of cervical cancer screening and its associated factors among women attending maternal health services at Aira hospital, West Wollega, Ethiopia. METHODS An institutional-based cross-sectional study design was conducted among 421 reproductive-age women. A systematic sampling method was used for the study. Data were collected using a pretested and structured questionnaire. Data analysis included descriptive statistics and the statistical association between the outcome variable and the explanatory variables tested by the binary logistic regression. Multivariable logistic regression was used to control confounding factors, the magnitude of the association between the different independent and dependent variable was measured using 95% confidence interval, and p values below 0.05 were considered as statistically significant. RESULTS A total of 421 women were responded with 100% response rate and with the mean age of 26.0 ± 5.15 (M ± SD) years. About 95.0% of the respondents ever heard of cervical cancer and 46.8% of the respondents had good knowledge about cervical cancer screening. Age, occupation, educational level, and monthly income were predictors associated with knowledge about cervical cancer screening. CONCLUSION The study revealed 46.8% of study participants had knowledge about cervical cancer screening. The age of the participant, occupation, level of education, and monthly income were determinants of knowledge about cervical cancer screening. Prevention programs should focus on cervical cancer screening according to identified factors in the study.
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Affiliation(s)
| | - Endalew Gemechu Sendo
- Department of Midwifery, School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Jembere Tesfaye Deressa
- Department of Midwifery, School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Niyonsenga G, Gishoma D, Sego R, Uwayezu MG, Nikuze B, Fitch M, Igiraneza PC. Connaissances, utilisation et obstacles liés au dépistage du cancer du col utérin dans des hôpitaux de district de Kigali, au Rwanda. Can Oncol Nurs J 2021; 31:275-284. [PMID: 34395830 DOI: 10.5737/23688076313275284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Contexte Dans le monde, le cancer du col utérin arrive au troisième rang des cancers les plus fréquents chez les femmes, mais il passe au deuxième rang en Afrique orientale, où se trouve le Rwanda. Le dépistage périodique est un moyen de prévention efficace. Malgré cela, en Afrique, on estime que le taux de dépistage de ce cancer se situe entre 10 et 70 %. Plusieurs facteurs entravent le dépistage, surtout en Afrique subsaharienne. Au Rwanda, on recense peu d'écrits sur l'utilisation des services de dépistage et les facteurs nuisant au dépistage du cancer du col utérin. Objectif Évaluer les connaissances sur le dépistage du cancer du col utérin qu'ont les femmes fréquentant les hôpitaux de district de Kigali (au Rwanda), recenser l'utilisation de ce service et déterminer les obstacles qui empêchent d'y recourir. Méthodologie Une étude transversale descriptive a été menée, et les données ont été collectées au moyen d'un questionnaire structuré. Des questions nominales de type « oui ou non » ont mis en lumière les connaissances des femmes sur le cancer du col utérin et l'utilisation des services de dépistage. Pour cerner les obstacles au dépistage, nous avons utilisé des questions de type « échelle de Likert ». Ces données ont ensuite fait l'objet d'une analyse statistique descriptive et déductive. La sélection des répondantes s'est faite par échantillonnage aléatoire systématique depuis la base de données des patientes fréquentant les services gynécologiques de trois hôpitaux de district de Kigali (Rwanda). Résultats Au total, 329 femmes ont répondu au sondage. La moitié d'entre elles (n = 165) connaissaient bien le dépistage du cancer du col utérin. Le pourcentage de dépistage se situe à 28,3 %. Nous avons décelé un lien entre l'utilisation du dépistage et une bonne connaissance du sujet (P = 0,000, r = -0,392) ainsi que certains facteurs démographiques (P = 0,000). Parmi les obstacles qui concourent à restreindre l'accès au dépistage, nous avons relevé des obstacles individuels (méconnaissance de l'existence des services de dépistage), géographiques (milieu rural) et liés au système de santé et aux prestataires de soins (campagnes de sensibilisation déficientes, attitudes négatives des prestataires de soins envers les patientes et longs délais d'attente). Conclusion Dans les hôpitaux de district étudiés de Kigali (Rwanda), on constate un faible pourcentage de dépistage du cancer du col utérin causé par plusieurs obstacles. Il est donc fortement recommandé d'engager une campagne d'information permanente sur ce cancer et son dépistage. Enfin, il est crucial que les prestataires de soins qualifiés encouragent les femmes à se soumettre au dépistage, et qu'ils s'efforcent de réduire les obstacles qui s'y rattachent.
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Affiliation(s)
| | - Darius Gishoma
- École de sciences infirmières et pratique sagefemme, Université du Rwanda, Collège de médecine et de sciences de la santé, Kigali, Rwanda
| | - Ruth Sego
- Collège des sciences infirmières Rory Meyers, Université de New York, New York, États-Unis et Faculté des sciences infirmières Bloomberg, Université de Toronto, Canada
| | - Marie Goretti Uwayezu
- École de sciences infirmières et pratique sage-femme, Université du Rwanda, Collège de médecine et de sciences de la santé, Kigali, Rwanda
| | - Bellancille Nikuze
- École de sciences infirmières et pratique sagefemme, Université du Rwanda, Collège de médecine et de sciences de la santé, Kigali, Rwanda
| | - Margaret Fitch
- École de sciences infirmières et pratique sagefemme, Université du Rwanda, Collège de médecine et de sciences de la santé, Kigali, Rwanda
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Pak LM, Purad CC, Nadipally S, Rao MP, Mukherjee S, Hegde SKB, Golshan M. Cancer Awareness and Stigma in Rural Assam India: Baseline Survey of the Detect Early and Save Her/Him (DESH) Program. Ann Surg Oncol 2021; 28:7006-7013. [PMID: 34215953 DOI: 10.1245/s10434-021-10366-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 05/28/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND India has an estimated incidence of more than one million cancers annually. Breast, oral, and cervical cancers account for over one-third of newly diagnosed cases. With the introduction of pilot cancer screening programs in India, little is known about current sociocultural barriers that may hinder acceptance of screening and treatment. We sought to identify knowledge gaps, misconceptions, and stigmas surrounding cancer diagnosis. PATIENTS AND METHODS A baseline survey was conducted in Assam, India, as part of the Detect Early and Save Her/Him program, a mobile screening program for breast, oral, and cervical cancer. Data were collected on participants' cancer knowledge, and attitudes towards screening, diagnosis, and treatment. RESULTS Of the 923 residents who participated, a large majority (92.9%; n = 858) were neither aware of cancer screening availability nor had prior screening. Low-medium awareness was demonstrated regarding the carcinogenic effects of betel nuts (n = 433, 47%). Only one-third of participants recognized oral ulcers and dysphagia as cancer symptoms. Approximately 10% of respondents had misconceptions about cancer etiologies, and 42-57% endorsed statements reflecting a negative stigma towards cancer, including its long-term detrimental effects on personal, occupational, and familial life. However, the majority (68-96%) agreed with statements endorsing positive community support and medical care for cancer patients. CONCLUSIONS This study identifies actionable targets for intervention in cancer education and awareness within a large rural Indian population. Education to address preventable causes of cancer and to correct misconceptions and stigma is a critical component in ensuring the successful implementation of cancer screening programs.
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Affiliation(s)
- Linda M Pak
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Chetan C Purad
- Piramal Swasthya Management and Research Institute, Hyderabad, India
| | - Sudheer Nadipally
- Piramal Swasthya Management and Research Institute, Hyderabad, India
| | | | | | | | - Mehra Golshan
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Dana Farber/Brigham and Women's Cancer Center Boston, Boston, MA, USA.,Yale New Haven Hospital, New Haven, CT, USA
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18
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Niyonsenga G, Gishoma D, Sego R, Uwayezu MG, Nikuze B, Fitch M, Igiraneza PC. Knowledge, utilization and barriers of cervical cancer screening among women attending selected district hospitals in Kigali - Rwanda. Can Oncol Nurs J 2021; 31:266-274. [PMID: 34395829 DOI: 10.5737/23688076313266274] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background Cervical cancer is the third most common cancer attacking women globally, and the second in Eastern Africa where Rwanda is located. Regular screening is an effective prevention approach for cervical cancer. Despite that, the screening rate for cervical cancer in Africa is estimated between 10% and 70%, with a number of barriers. This is especially the case in sub-Saharan Africa. In Rwanda, there is limited literature on the rate of use of screening services or the barriers to cervical screening. Objective To assess knowledge, utilization, and barriers of cervical cancer screening among women attending selected district hospitals in Kigali, Rwanda. Methods A descriptive cross-sectional study with a structured questionnaire was used to collect data. Nominal 'yes' or 'no' questions were used to gather data on knowledge and utilisation of cervical cancer and its screening. Likert-type scale questions were used to identify different barriers to screening services. Data were analysed using descriptive and inferential statistics. Respondents were selected by systematic random sampling from the database of women attending gynaecology services at three district hospitals in Kigali, Rwanda. Results Three hundred and twenty-nine women responded to the survey. Half of the respondents (n = 165) had high knowledge level scores on cervical cancer screening. The cervical cancer screening rate was 28.3%. Utilization of screening was associated with knowledge (P = 0.000, r = -0.392) and selected demographic factors (P = 0.000). Individual barriers included poor knowledge on availability of screening services, community barriers included living in a rural area, and health provider and systems barriers included lack of awareness campaigns, negative attitudes of healthcare providers toward clients, and long waiting times; all barriers limit the access to screening services. Conclusion A low rate of cervical cancer screening was identified for women attending selected district hospitals in Kigali-Rwanda due to various barriers. On-going education on cervical cancer and its screening is highly recommended. It is important that trained health providers encourage their clients to have cervical cancer screening and work to reduce related barriers.
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Affiliation(s)
| | - Darius Gishoma
- School of Nursing and Midwifery, University of Rwanda, College of Medicine and Health Sciences, Kigali, Rwanda
| | - Ruth Sego
- Rory Meyer's College of Nursing, New York University, New York, USA and the Bloomberg Faculty of Nursing, University of Toronto, Canada
| | - Marie Goretti Uwayezu
- School of Nursing and Midwifery, University of Rwanda, College of Medicine and Health Sciences, Kigali, Rwanda
| | - Bellancille Nikuze
- School of Nursing and Midwifery, University of Rwanda, College of Medicine and Health Sciences, Kigali, Rwanda
| | - Margaret Fitch
- School of Nursing and Midwifery, University of Rwanda, College of Medicine and Health Sciences, Kigali, Rwanda
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Henke A, Kluge U, Borde T, Mchome B, Serventi F, Henke O. Tanzanian women´s knowledge about Cervical Cancer and HPV and their prevalence of positive VIA cervical screening results. Data from a Prevention and Awareness Campaign in Northern Tanzania, 2017 - 2019. Glob Health Action 2021; 14:1852780. [PMID: 33371824 PMCID: PMC7782163 DOI: 10.1080/16549716.2020.1852780] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: 14.9 million women (≥15 years) in Tanzania are at risk of developing cervical cancer. Limited cancer care facilities, prevention programs and sparse knowledge among community members and healthcare workers contribute to late-stage presentation leading to a high mortality rate. Objective: This study aims to scientifically accompany prevention and awareness campaigns (PrevACamp) in northern Tanzania in its real-world settings to obtain (1) a better understanding about cervical cancer and HPV knowledge amongst female PrevACamp participants and (2) to determine the prevalence of pre-cancerous lesions among women undergoing cervical cancer VIA screening. Method: Cross-sectional survey among PrevACamp attendees in two regions in Northern Tanzania. Two data collections tools were used: Questionnaires and clinical data from VIA screening. Data were collected from October 2017 to March 2019. Results: 2,192 PrevACamp attendees were interviewed and 2,224 received VIA screening. There was significant nescience on cervical cancer regardless of education level, resident status, or number of children as well as nescience on HPV in all age groups, especially in urban areas and misconceptions about cancer. Screening revealed VIA positivity rate of 3.1%. Conclusion: There is an alarming lack of knowledge about cervical cancer and, to a lesser Extent, about HPV among the study participants. Having health insurance influenced the level of knowledge significantly. Outreach programs in rural areas appear to target the population in need of health education. Low positive VIA screening results are paralleled with lower HIV rates among the women. We assume that the high density of primary health care coverage in northern Tanzania contributes to these findings..
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Affiliation(s)
- Antje Henke
- Kilimanjaro Christian Medical Centre, Cancer Care Centre , Moshi, Tanzania
| | - Ulrike Kluge
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin , Berlin, Germany
| | - Theda Borde
- Alice Salomon Hochschule Berlin, University of Applied Sciences , Berlin, Germany
| | - Bariki Mchome
- Department of Gynaecology, Kilimanjaro Christian Medical Centre , Moshi, Tanzania
| | - Furaha Serventi
- Kilimanjaro Christian Medical Centre, Cancer Care Centre , Moshi, Tanzania
| | - Oliver Henke
- Kilimanjaro Christian Medical Centre, Cancer Care Centre , Moshi, Tanzania
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John-Akinola YO, Oluwasanu MM, Oladepo O. Urban Poor Community Settings' Knowledge and Screening Practices for Cervical Cancer in Ibadan, Nigeria. JCO Glob Oncol 2021; 7:1024-1031. [PMID: 34185548 PMCID: PMC8457819 DOI: 10.1200/go.20.00619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 04/16/2021] [Accepted: 05/25/2021] [Indexed: 12/24/2022] Open
Abstract
PURPOSE This study investigated knowledge and screening practices for cervical cancer among two urban poor community settings in Ibadan, Nigeria. METHODS A cross-sectional design was used. ODK tool was used to collect quantitative data among a sample size of 500 respondents. Data were analyzed using IBM SPSS version 21 for descriptive and inferential statistics. Scores for knowledge were on a scale of 0-39 points (0-18 low, 19-23 fair, and 24-39 high knowledge). RESULTS A majority of respondents (77.2%) had low knowledge of cervical cancer and were not aware (93.6%) of the Papanicolaou test (Pap smear test) or cervical cancer screening (91.2%). Very few women (10%) were aware of the human papillomavirus vaccine for the prevention of cervical cancer, 4% had been screened with the Papanicolaou test, and one woman (0.3%) with visual inspection with acetic acid. Four (1.1%) women had taken human papillomavirus vaccine before. CONCLUSION The findings of this study have underscored a necessity for increased awareness creation through health promotion interventions and strategies to alleviate low knowledge, prevention, and screening practices for cervical cancer in poor community settings in Nigeria.
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Affiliation(s)
- Yetunde O. John-Akinola
- Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Mojisola M. Oluwasanu
- Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oladimeji Oladepo
- Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Ararsa T, Tadele N, Ayalew Y, Gela D. Knowledge towards cervical cancer screening and associated factors among urban health extension workers at Addis Ababa, Ethiopia: facility based cross-sectional survey. BMC Cancer 2021; 21:224. [PMID: 33663412 PMCID: PMC7934429 DOI: 10.1186/s12885-021-07952-z] [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: 12/07/2020] [Accepted: 02/22/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cervical cancer is preventable and remains a leading cause of avoidable death among women in the world. In a developing country, the knowledge of screening for cervical cancer behavior still very low. However, little is known about the knowledge towards cervical cancer screening of urban health extension workers in Ethiopia. This study aimed to assess knowledge towards cervical cancer screening and associated factors among urban health extension workers in Addis Ababa, Ethiopia, 2020. METHODS In this cross-sectional study, 312 urban health extension workers completed the survey in the Amharic language. Data collected using a structured questionnaire in a face-to-face interview. Descriptive and logistic regression analyses were conducted using SPSS version 26. RESULTS The mean age of the urban health extension workers was 20.41 ± 3.73 years and 55.1% were married. The majority of the participants (75.6%) had diploma educational level, and 38.1% of them had 1-2 years of work experience. More than half (51.6%) of the participants had poor knowledge about cervical cancer screening. Participants with work experience of 5-6 years (AOR = 4.32: 95% CI = 1.71,10.94) and those who had a monthly income of 5000-10,000 ETB (AOR = 3.75: 95% CI = 1.49,9.41) and greater than > 10,000 ETB (AOR = 3.08: 95% CI =1.06, 8.98) were positively associated with knowledge towards cervical cancer screening among urban health extension workers, p-value< 0.05. CONCLUSION This study indicated that the knowledge towards cervical cancer screening of urban health extension workers was inadequate. Urban health extension workers' work experiences and monthly income were found to be independent predictors of the knowledge towards cervical cancer screening of respondents. Therefore, urban health extension workers with low work experiences and those with small monthly income could be targeted for cervical cancer screening information and training interventions.
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Affiliation(s)
- Tiruneh Ararsa
- Oncology Nurse, Black Lion Specialized Hospital, College of Health Science, Addis Ababa University, P.O. Box: 5657, Addis Ababa, Ethiopia
| | - Niguse Tadele
- School of Nursing & Midwifery, College of Health Science, Addis Ababa University, P.O. Box: 100686, Addis Ababa, Ethiopia
| | - Yohannes Ayalew
- School of Nursing & Midwifery, College of Health Science, Addis Ababa University, P.O. Box: 4412, Addis Ababa, Ethiopia
| | - Debela Gela
- School of Nursing & Midwifery, College of Health Science, Addis Ababa University, P.O. Box: 4412, Addis Ababa, Ethiopia.
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22
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Antinyan A, Bertoni M, Corazzini L. Cervical cancer screening invitations in low and middle income countries: Evidence from Armenia. Soc Sci Med 2021; 273:113739. [PMID: 33609965 DOI: 10.1016/j.socscimed.2021.113739] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/27/2021] [Accepted: 01/30/2021] [Indexed: 11/16/2022]
Abstract
Roughly 90 percent of cervical cancer deaths occur in low- and middle-income countries (LMICs), where the lack of adequate infrastructures hampers screening, while informational, cultural, and socio-economic barriers limit participation in the few programs that do exist. We conducted a field experiment with the Armenian cervical cancer screening program to determine whether, despite these barriers, the simple, economical invitation strategies adopted in high-income countries could enhance screening take-up in LMICs. We find that letters of invitation increase screening take-up, especially when there are follow-up reminders. Different ways of framing messages appear to have no impact. Finally, women in rural areas are more likely to respond to invitation by letter, helping to narrow the urban-rural screening gap.
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Affiliation(s)
- Armenak Antinyan
- Wenlan School of Business, Zhongnan University of Economics and Law, Nanhu Avenue 182, 430073, Wuhan, PR China.
| | - Marco Bertoni
- Department of Economics and Management "Marco Fanno", University of Padova, Via Del Santo 33, 35123, Padova, Italy
| | - Luca Corazzini
- Department of Economics, University of Venezia "Ca' Foscari,", Cannaregio, 821, 30121, Venice, Italy
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23
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Cooper EC, Maher JA, Naaseh A, Crawford EW, Chinn JO, Runge AS, Lucas AN, Zezoff DC, Bera KR, Dinicu AI, White KM, Tewari SE, Hari A, Bernstein M, Chang J, Ziogas A, Pearre DC, Tewari KS. Implementation of human papillomavirus video education for women participating in mass cervical cancer screening in Tanzania. Am J Obstet Gynecol 2021; 224:105.e1-105.e9. [PMID: 32682861 DOI: 10.1016/j.ajog.2020.07.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/30/2020] [Accepted: 07/14/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Because the global disease burden of cervical cancer is greatest in Africa, the World Health Organization has endorsed visual inspection with acetic acid screening with cryotherapy triage for the screen-and-treat approach. With the lowest doctor-to-patient ratio worldwide (1:50,000), Tanzania has nearly 10,000 new cases of cervical cancer and 7000 deaths annually. OBJECTIVE We report on the feasibility of visual inspection with acetic acid in the severely resource-limited Mwanza district and on the impact of intervening education on baseline human papillomavirus and cervical cancer knowledge. STUDY DESIGN Two 5-day free visual inspection with acetic acid (VIA) clinics in urban Buzuruga and rural Sangabuye on the shores of Lake Victoria were approved by our university institutional review board and local Tanzanian health authorities. Participants completed a demographic survey and a 6-question (1 point per question) multiple choice test written in Kiswahili to assess baseline knowledge. A 15-minute educational video in Kiswahili (MedicalAidFilms: Understanding screening, treatment, and prevention of cervical cancer) was followed by repeated assessment using the same test, visual inspection with acetic acid screening, and optional HIV testing. Pre- and postvideo scores and change of score were analyzed via t test, analysis of variance, and multivariate regression. Significance was considered at P<.05. RESULTS From July 2, 2018 to July 6, 2018, 825 women were screened, and 207 women (25.1%) were VIA positive (VIA+). One hundred forty-seven VIA+ nonpregnant women received same-day cryotherapy. Seven hundred sixty women participated in an educational intervention-61.6% of whom were from an urban site and 38.2% from a rural site. The mean age was 36.4 (standard deviation, 11.1). Primary languages were Kiswahili (62.2%) and Kisukuma (30.6%). Literacy was approximately 73%, and average education level was equivalent to the seventh grade (United States). Less than 20% of urban and rural women reported access to healthcare providers. Mean score of the participants before watching the video was 2.22 (standard deviation, 1.76) and was not different between VIA+ and VIA negative groups. Mean score of the participants after watching the video was 3.86 (standard deviation, 1.78). Postvideo scores significantly improved regardless of age group, clinic site, primary language, education level, literacy, or access to healthcare provider (P<.0001). Change of score after watching the video was significantly greater in participants from urban areas (1.99±2.07) than in those from rural areas (1.07±1.95) (P<.0001). Multivariate analysis identified urban site as an independent factor in change of score (P=.0211). CONCLUSION Visual inspection with acetic acid screening for cervical cancer is feasible and accepted in northern Tanzania. Short video-based educational intervention improved baseline knowledge on the consequences of human papillomavirus infection in the studied populations. The impact was greater in the urban setting than in the rural setting.
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Affiliation(s)
- Emma C Cooper
- Department of Medical Education, University of California, Irvine College of Medicine, Irvine, CA.
| | - Justine A Maher
- Department of Medical Education, University of California, Irvine College of Medicine, Irvine, CA
| | - Ariana Naaseh
- Department of Medical Education, University of California, Irvine College of Medicine, Irvine, CA
| | - Elizabeth W Crawford
- Department of Medical Education, University of California, Irvine College of Medicine, Irvine, CA
| | - Justine O Chinn
- Department of Medical Education, University of California, Irvine College of Medicine, Irvine, CA
| | - Ava S Runge
- Department of Medical Education, University of California, Irvine College of Medicine, Irvine, CA
| | - Alexa N Lucas
- Department of Medical Education, University of California, Irvine College of Medicine, Irvine, CA
| | - Danielle C Zezoff
- Department of Medical Education, University of California, Irvine College of Medicine, Irvine, CA
| | - Kevin R Bera
- Department of Medical Education, University of California, Irvine College of Medicine, Irvine, CA
| | - Andreea I Dinicu
- Department of Medical Education, University of California, Irvine College of Medicine, Irvine, CA
| | - Kayla M White
- Department of Medical Education, University of California, Irvine College of Medicine, Irvine, CA
| | | | - Anjali Hari
- Department of Obstetrics & Gynecology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA
| | - Megan Bernstein
- Department of Obstetrics & Gynecology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA
| | - Jenny Chang
- Department of Epidemiology, University of California, Irvine College of Medicine, Irvine, CA
| | - Argyrios Ziogas
- Department of Epidemiology, University of California, Irvine College of Medicine, Irvine, CA
| | - Diana C Pearre
- Division of Gynecologic Oncology, University of California Irvine Medical Center, Orange, CA
| | - Krishnansu S Tewari
- Bowdoin College, Brunswick, ME; Division of Gynecologic Oncology, University of California Irvine Medical Center, Orange, CA
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24
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Mboineki JF, Wang P, Dhakal K, Getu MA, Millanzi WC, Chen C. Predictors of uptake of cervical cancer screening among women in Urban Tanzania: community-based cross-sectional study. Int J Public Health 2020; 65:1593-1602. [PMID: 33130908 DOI: 10.1007/s00038-020-01515-y] [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] [Received: 03/14/2020] [Revised: 10/14/2020] [Accepted: 10/19/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES The proportion of women screened for cervical cancer in Tanzania remains small at 6-21%. Even though some studies have been conducted to address barriers, the screening uptake remains low, which denotes the presence of unidentified barriers. The main objective of this study is to assess the predictors in the uptake of cervical cancer screening (CCS) among women in Tanzania. METHODS This is a community-based cross-sectional study conducted to obtain quantitative data through validated questionnaires to assess predictors of CCS. RESULTS 1013 (91.8%) of the respondents had not been screened for cervical cancer. Three predictors of CCS were identified in this study; screening intention, health beliefs, and knowledge level. 600 (54.4%) of respondents had no screening intention. 552 (50%) had negative health beliefs, and 585 (53%) had inadequate knowledge of cervical cancer and CCS. Respondents who had no intention to screen were 0.482 (AOR) times less likely to uptake CCS (P = 0.002; 95% CI: 0.305, 0.761). CONCLUSIONS The ongoing community-awareness raising campaigns should be coupled with community knowledge-raising campaign, and there should be an establishing of peer-supporting screening programs in communities.
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Affiliation(s)
- Joanes Faustine Mboineki
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China.,Department of Nursing and Midwifery, College of Health Sciences, The University of Dodoma, Dodoma, Tanzania
| | - Panpan Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Kamala Dhakal
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | | | - Walter Cleophance Millanzi
- Department of Nursing and Midwifery, College of Health Sciences, The University of Dodoma, Dodoma, Tanzania
| | - Changying Chen
- The first affiliated hospital of Zhengzhou University, Jianshe Dong Lu, Zhengzhou, 450000, Henan province, China.
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25
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Yim ET, Rogers TB, Msami K, Calixte R, Kahesa C, Mwaiselage JD, Dorn J, Soliman AS. Factors related to completion of referral among women with suspected cervical cancer and dysplasia in Tanzania. Int J Gynaecol Obstet 2020; 152:88-95. [PMID: 33025590 DOI: 10.1002/ijgo.13412] [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] [Received: 02/21/2020] [Revised: 07/13/2020] [Accepted: 10/02/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To investigate completion of referral among women with suspected cervical cancer in Tanzania. METHODS Retrospective cohort study of 196 women referred from two healthcare clinics to Ocean Road Cancer Institute, Dar es Salaam, between March 2016 and June 2018. Women with precancerous lesions or suspected cancer were interviewed about their knowledge and perception of cervical cancer and referred for follow-up. RESULTS Most participants were unable to name symptoms (55.1%), prevention methods (88.3%), or treatments (59.0%), although 79.1% rated the disease as severe. Women who came for routine early detection were less likely to complete referral than those who did not (odds ratio [OR], 0.18; 95% confidence interval [CI], 0.05-0.70). Women who knew someone who died from cervical cancer were 5.40 times more likely to complete referral than those who did not. Knowing someone with cervical cancer was a predictor of referral completion in three multivariate models: OR, 5.62 (95% CI, 2.20-14.38); 4.34 (1.64-11.47); and 4.61 (1.72-12.36). Having severe symptoms was a predictor of non-completion in two models: 0.30 (0.12-0.75) and 0.35 (0.14-0.87). CONCLUSION Patient-directed interventions should include education involving survivors of cancer and dysplasia, whereas system-directed interventions should utilize reminders to increase referral completion.
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Affiliation(s)
| | | | - Khadija Msami
- Ocean Road Cancer Institute, Dar es Salaam, Tanzania
| | | | | | | | - Joan Dorn
- CUNY School of Medicine, New York, NY, USA
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26
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Weng Q, Jiang J, Haji FM, Nondo LH, Zhou H. Women's knowledge of and attitudes toward cervical cancer and cervical cancer screening in Zanzibar, Tanzania: a cross-sectional study. BMC Cancer 2020; 20:63. [PMID: 31992250 PMCID: PMC6988189 DOI: 10.1186/s12885-020-6528-x] [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] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 01/09/2020] [Indexed: 12/09/2022] Open
Abstract
Background Cervical cancer is the most common cancer and the leading cause of cancer death among women in Tanzania. Knowledge of and willingness to receive a cervical cancer screening are important determinants of prevention. This study aimed to describe women’s awareness of cervical cancer and to explore the attitudes toward, acceptability of and barriers to cervical cancer screening (CCS) in Zanzibar. Methods A cross-sectional study was conducted from March to June 2018 involving 1483 women from 10 districts in Zanzibar who responded to questionnaires concerning their general demo-graphic characteristics, screening willingness and awareness of cervical cancer. Chi-square tests, analysis of variance (ANOVA) and stepwise multiple regression were conducted using STATA 15.1 software. Results The average total knowledge score (TKS) was 7.84 ± 5.32 on a 23-point scale. Educational level and family income were positively correlated with the TKS. Previous schistosomiasis history and family genetic disease history were strong predictors of screening willingness. Women were less likely to be screened freely if they had 7 or more deliveries and were unaware of any previous family tumor history. Age and educational level were negatively associated non-free screening willingness, while family income was positively associated; being divorced/widowed or single and being unaware of any previous family tumor history were predictors of screening reluctance, while previous disease history was a strong predictor of non-free screening willingness. Fear of screening and inconvenience were the primary concerns among the Zanzibari interviewees. Compared to the 20–49 age group, more women in the less than 20 and 50 or more age groups thought cervical cancer screening was not necessary. The highest rate of cognitive accuracy in regard to cervical cancer warning signs and risk factors was only 37.76%. Conclusions The findings revealed that knowledge of cervical cancer was poor. Educational level, family income and awareness of previous disease history were significant influencing factors of screening uptake. Specific awareness programs to increase knowledge of cervical cancer and screening willingness should be designed and implemented in the public without delay, especially for younger and elderly women.
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Affiliation(s)
- Qiao Weng
- Department of Obstetrics & Gynecology, Nanjing Drum Tower Hospital, Affiliated to Nanjing University Medical College, Nanjing, 210008, China.,Department of Obstetrics & Gynecology, Drum Tower Clinical Medical College, Nanjing Medical University, Nanjing, 210008, China
| | - Jie Jiang
- Jiangsu Province Center for Disease Prevention and Control, Nanjing, China
| | - Fatma Mrisho Haji
- Department of Obstetrics & Gynecology, Mnazi Mmoja Hospital, Zanzibar, Tanzania
| | - Lamlet Hassan Nondo
- Department of Obstetrics & Gynecology, Mnazi Mmoja Hospital, Zanzibar, Tanzania
| | - Huaijun Zhou
- Department of Obstetrics & Gynecology, Nanjing Drum Tower Hospital, Affiliated to Nanjing University Medical College, Nanjing, 210008, China. .,Department of Obstetrics & Gynecology, Drum Tower Clinical Medical College, Nanjing Medical University, Nanjing, 210008, China.
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27
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Nigussie T, Asefa A, Nigusse A, Admassu B. Knowledge Toward Cervical Cancer and Its Determinants Among Women Aged 30-49 in Jimma Town, Southwest Ethiopia. Cancer Control 2020; 27:1073274820983027. [PMID: 33353383 PMCID: PMC8642062 DOI: 10.1177/1073274820983027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 10/26/2020] [Accepted: 11/30/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Cervical cancer is one of the common causes of premature death and disability in women worldwide. It is preventable through vaccination, and screening for precancerous lesions and early treatment. However, screening service uptake and treatment for cervical cancer face significant challenges in low-income countries due to poor information systems. The aim of this study was to assess knowledge of cervical cancer and its determinants among women aged 30-49 years living in Jimma Town, Southwest Ethiopia. METHODS A community-based cross-sectional study was undertaken from March 20 to April 15, 2017. The data were collected using a structured interviewer-administered questionnaire and analyzed by SPSS version 21. Multivariable logistic regression anaysis was done and variables with a p-value < 0.05 were considered statistically significant. RESULTS Of the interviewed women, only 321(43.6%) had adequate knowledge about cervical cancer and screening. Attending secondary school or above (AOR = 2.42, 95% CI: 1.24-4.74), using modern contraceptives (AOR = 6.31, 95% CI: 2.86-13.89), knowing somebody with cervical cancer (AOR = 2.24, 95% CI: 1.35-3.71) and knowing someone screened for cervical cancer (AOR = 2.23, 95% CI: 1.30-3.80) were associated with knowledge of cervical cancer. CONCLUSION Knowledge of cervical cancer is low in the current study area even if appropriate knowledge regarding the disease is important in decreasing the incidence and prevalence of cervical cancer through screening and human pappiloma virus vaccination. Increasing awereness regarding the disease and prevention strategies are the key issue.
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Affiliation(s)
- Tadesse Nigussie
- Department of Public Health, Mizan-Tepi University College of Health
Science, Mizan Aman, Ethiopia
| | - Adane Asefa
- Department of Public Health, Mizan-Tepi University College of Health
Science, Mizan Aman, Ethiopia
| | - Aderajew Nigusse
- Department of Population and Family Health, Faculty of Public
Health, Jimma University Institution of Health Science, Ethiopia
| | - Bitiya Admassu
- Department of Population and Family Health, Faculty of Public
Health, Jimma University Institution of Health Science, Ethiopia
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He FX, Zhang LL, Jin PF, Liu DD, Li AH. DPY30 regulates cervical squamous cell carcinoma by mediating epithelial-mesenchymal transition (EMT). Onco Targets Ther 2019; 12:7139-7147. [PMID: 31564898 PMCID: PMC6730605 DOI: 10.2147/ott.s209315] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 07/01/2019] [Indexed: 12/29/2022] Open
Abstract
Introduction Set1/MLL complexes are the main histone H3K4 methyltransferases and are crucial regulators of tumor pathogenesis. DPY30 is a fairly uncharacterized protein in the Set1/MLL complex, but it has been reported to regulate tumor growth. However, the exact mechanism by which DPY30 mediates the progression of cervical squamous cell carcinoma (CSCC) remains unknown. In the present study, we investigated the role of DPY30 in CSCC at a molecular level. Methods We obtained normal cervical and cervical cancer tissue samples from patients. We used immunohistochemistry and real-time polymerase chain reaction (PCR) to detect DPY30 expression in CSCC tissues. In addition, we used the human cervical cancer cell line to evaluate expression levels of DPY30 and epithelial–mesenchymal transition (EMT) markers in vitro. Results Immunohistochemical and real-time PCR analyses showed that DPY30 expression was upregulated in tissue samples from patients with CSCC and that DPY30 levels were associated with EMT markers such as E-cadherin. Furthermore, knock-down of DPY30 by siRNA resulted in a decrease in the proliferation, migration, and invasion of CSCC cells. We also found that DPY30-induced EMT is mediated by the Wnt/β-catenin signaling pathway. Conclusion Our results suggest that elevated DPY30 levels may contribute to EMT by activating Wnt/β-catenin signaling in the progression of CSCC.
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Affiliation(s)
- Feng-Xi He
- Department of Obstetrics and Gynecology, Liaocheng People's Hospital Affiliated to Shandong First Medical University, Liaocheng 252000, People's Republic of China
| | - Li-Li Zhang
- Department of Obstetrics and Gynecology, Liaocheng People's Hospital Affiliated to Shandong First Medical University, Liaocheng 252000, People's Republic of China
| | - Peng-Fei Jin
- Department of Obstetrics and Gynecology, Liaocheng People's Hospital Affiliated to Shandong First Medical University, Liaocheng 252000, People's Republic of China
| | - Dan-Dan Liu
- Shandong First Medical University, Taian 271016, People's Republic of China
| | - Ai-Hua Li
- Department of Obstetrics and Gynecology, Liaocheng People's Hospital Affiliated to Shandong First Medical University, Liaocheng 252000, People's Republic of China
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Runge AS, Bernstein ME, Lucas AN, Tewari KS. Cervical cancer in Tanzania: A systematic review of current challenges in six domains. Gynecol Oncol Rep 2019; 29:40-47. [PMID: 31309135 PMCID: PMC6606891 DOI: 10.1016/j.gore.2019.05.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/14/2019] [Accepted: 05/16/2019] [Indexed: 01/29/2023] Open
Abstract
Cervical cancer is the most common cancer in Tanzania. After excluding human immunodeficiency virus, lower respiratory infections, malaria, diarrheal diseases, and tuberculosis, cervical cancer kills more women than any other form of illness in the country. Unfortunately, Tanzania has a low doctor-to-patient ratio (1:50,000) and nearly 7000 women die each year from this disease. The clinical problem is further magnified by the country's lack of resources and prevailing poverty, sporadic cervical cancer screening, prevalence of high-risk oncogenic human papillomavirus subtypes, and relatively high rates of human immunodeficiency virus co-infection. In recent years, addressing the cervical cancer problem has become a priority for the Tanzanian government. In this systematic review of 39 peer-reviewed publications that appeared in the PubMed/MEDLINE (NCBI) database from 2013 to 2018, we synthesize the growing body of literature to capture current trends in Tanzania's evolving cervical cancer landscape. Six domains were identified, including risk factors, primary prevention, barriers to screening, treatment, healthcare worker education, and sustainability. In addition to traditional risk factors associated with sexual behavior, acetowhite changes observed during visual inspection of the cervix with acetic acid, lower education, rural setting, and HIV positivity also have a noteworthy clinical impact.
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Affiliation(s)
- Ava S. Runge
- Department of Medical Education, University of California, Irvine School of Medicine, Irvine, CA, USA
| | - Megan E. Bernstein
- Department of Medical Education, University of California, Irvine School of Medicine, Irvine, CA, USA
| | - Alexa N. Lucas
- Department of Medical Education, University of California, Irvine School of Medicine, Irvine, CA, USA
| | - Krishnansu S. Tewari
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of California, Irvine Medical Center, Orange, CA, USA
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30
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O’Donovan J, O’Donovan C, Nagraj S. The role of community health workers in cervical cancer screening in low-income and middle-income countries: a systematic scoping review of the literature. BMJ Glob Health 2019; 4:e001452. [PMID: 31179040 PMCID: PMC6528769 DOI: 10.1136/bmjgh-2019-001452] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 04/22/2019] [Accepted: 04/27/2019] [Indexed: 01/21/2023] Open
Abstract
Introduction Community-based screening for cervical cancer and task sharing to community health workers (CHWs) have been suggested as a potential way to increase screening coverage in low- and middle-income countries (LMICs). The aims of the scoping review were to understand the following: (i) where and how CHWs are currently deployed in screening in LMIC settings; (ii) the methods used to train and support CHWs in screening, and (iii) The evidence on the cost-effectiveness of using CHWs to assist in screening. Methods A scoping literature search of 11 major databases and the grey literature was performed between 1978 and 2018. We included comprehensive search terms for 'CHWs' and 'Cervical Cancer', and used the World Bank criteria to define LMICs. Results Of the 420 articles screened, 15 met the inclusion criteria for review. Studies were located in Africa (n=5), Asia (n=5), and South and Central America (n=5). CHWs played a role in community education and raising awareness (n=14), conducting or assisting in cervical screening (n=5), or follow-up (n=1). 11 studies described CHW training activities. Only one study provided a formal cost analysis. Conclusion The roles of CHWs in cervical cancer screening in LMICs have largely to date focused on education, outreach, and awareness programmes. Community-based approaches to cervical cancer screening are feasible, although the sociocultural context plays an important role in the acceptability of these interventions. Further in-depth contextually grounded studies exploring the acceptability of such interventions are required, as well as studies exploring the cost-effectiveness of involving CHWs in cervical cancer screening activities.
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Affiliation(s)
| | - Charles O’Donovan
- Health Education North West London, North West Thames Foundation School, London, UK
| | - Shobhana Nagraj
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
- The George Institute for Global Health, Oxford, UK
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