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Individual and intimate-partner factors associated with cervical cancer screening in Central Uganda. PLoS One 2022; 17:e0274602. [PMID: 36108074 PMCID: PMC9477300 DOI: 10.1371/journal.pone.0274602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 08/31/2022] [Indexed: 12/24/2022] Open
Abstract
Intimate-partner factors have a significant effect on the uptake of services that affect maternal reproductive health outcomes. There is limited research on intimate-partner factors associated with cervical cancer screening. Therefore, this article examines the intimate-partner correlates of cervical cancer screening among married women in Central Uganda. We conducted a cross-sectional survey in Wakiso and Nakasongola districts in Central Uganda. A total of 656 married women aged 25–49 participated in the study. Frequency distributions for descriptive statistics and Pearson chi-squared tests were done to identify the association of selected individual explanatory variables and intimate-partner factors with cervical cancer screening. Finally, multivariable complementary log-log regressions were used to estimate intimate-partner factors associated with women’s cervical cancer screening uptake in Central Uganda. About 2 in 10 (20%) of the participants had been screened for cervical cancer. The following characteristics when examined separately in relation to the uptake of cervical cancer screening service and were significant: woman’s age, education attainment, occupation, wealth index, parity, male partner’s age, and male partner’s emotional support. After adjusting for independent factors, cervical cancer screening was significantly associated with women who had; attained secondary (AOR = 2.19; CI 1.18–4.06) compared to none/ primary education, and received partner’s emotional support (AOR = 30.06; CI 13.44–67.20) compared to those who did not receive partner’s emotional support. In Central Uganda, cervical cancer screening among married women was significantly associated with women’s education, and partner’s emotional support. These factors point to the importance of intimate-partner factors. Therefore, more effort should be directed at encouraging men’s participation. This should be supplemented with empowering women through education to increase uptake of screening services.
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Isabirye A, Elwange BC, Singh K, De Allegri M. Individual and community-level determinants of cervical cancer screening in Zimbabwe: a multi-level analyses of a nationwide survey. BMC Womens Health 2022; 22:309. [PMID: 35879710 PMCID: PMC9310401 DOI: 10.1186/s12905-022-01881-0] [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: 02/11/2022] [Accepted: 07/13/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Despite the benefits of cervical cancer (CC) screening to reduce the disease burden, uptake remains limited in developing countries. This study aims to assess the individual and community-level determinants of cervical cancer screening among women of reproductive age in Zimbabwe. METHODS We analyzed data collected from 400 communities from the 2015 Zimbabwe Demographic and Health Survey with a sample size of 9955 women aged 15-49 years. The descriptive statistics and multi-level regression models adjusted for potential covariates were performed to examine the association between individual, household and community-level factors and the uptake of cervical cancer screening in women. RESULTS The mean (SD) age of women in Zimbabwe using cervical cancer screening was 27.9 (9.9) years. A relatively small proportion of women, i.e., only 13.4% had ever screened for cervical cancer, with higher screening rates observed in the following sub-groups: middle aged women 31-49 years (odds ratio (OR) = 2.01; 95% confidence intervals (CI) 1.72-2.34), and currently working (OR = 1.35; 95% CI 1.17-1.55), those with health insurance (OR = 1.95; 95% CI 1.63-2.34), used modern contraceptives (OR = 1.51; 95% CI 1.22-1.86), exposed to multiple media (OR = 1.27; 95% CI 1.03-1.58), those living in communities that had a high predominance of women with favorable attitude towards Intimate Partner Violence (IPV) against women (OR = 1.21; 95% CI 1.04-1.41) and a non-poor wealth index (OR = 1.54; 95% CI 1.14-2.05). CONCLUSIONS Our data shows a significantly low prevalence of cervical cancer screening among reproductive age women in Zimbabwe. To increase the uptake of cervical cancer screening, there is an urgent need both to implement behavioral interventions targeted at women from low socio-economic groups and to advocate for universal health coverage that includes financial risk protection to help all women realize their right to health.
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Affiliation(s)
- Alone Isabirye
- Department of Sociology, Anthropology, and Population Studies (Demography), Faculty of Social Sciences, Kyambogo University, Kampala, Uganda.
| | - Bob Charlestine Elwange
- Department of Sociology, Anthropology, and Population Studies (Demography), Faculty of Social Sciences, Kyambogo University, Kampala, Uganda
| | - Kavita Singh
- Heidelberg Institute of Global Health, University Hospital and Faculty of Medicine, University of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.,Public Health Foundation of India, New Delhi, India
| | - Manuela De Allegri
- Heidelberg Institute of Global Health, University Hospital and Faculty of Medicine, University of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
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Isabirye A, Mbonye MK, Kwagala B. Predictors of cervical cancer screening uptake in two districts of Central Uganda. PLoS One 2020; 15:e0243281. [PMID: 33270792 PMCID: PMC7714132 DOI: 10.1371/journal.pone.0243281] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 11/18/2020] [Indexed: 12/24/2022] Open
Abstract
Uganda's cervical cancer age standardized incidence rate is four times the global estimate. Although Uganda's ministry of health recommends screening for women aged 25-49 years, the screening remains low even in the most developed region (Central Uganda) of the country. This study examined the demographic, social, and economic predictors of cervical cancer screening in Central Uganda with the aim of informing targeted interventions to improve screening. The cross-sectional survey was conducted in Wakiso and Nakasongola districts in Central Uganda. A total of 845 women age 25-49 years participated in the study. Data were analyzed at bivariate and multivariate levels to examine the predictors of CC (cervical cancer) screening. Only 1 in 5 women (20.6%) had ever screened for cervical cancer. Our multivariate logistic regression model indicated that wealth index, source of information, and knowledge about CC and CC screening were significantly associated with cervical cancer screening. The odds of cervical cancer screening were higher among rich women compared with poor women [AOR = 1.93 (95%CI: 1.06-3.42), p = 0.031)], receiving information from health providers compared with radios [AOR = 4.14 (95%CI: 2.65-6.48), p<0.001, and being more knowledgeable compared with being less knowledgeable about CC and CC screening [AOR = 2.46 (95%CI: 1.49-3.37), p<0.001)]. Overall cervical cancer screening uptake in central Uganda was found to be low. The findings of the study indicate that women from a wealthy background, who had been sensitized by health workers and with high knowledge about CC and CC screening had higher odds of having ever screened compared with their counterparts. Efforts to increase uptake of screening must address disparities in access to resources and knowledge.
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Affiliation(s)
- Alone Isabirye
- Department of Population Studies, School of Statistics and planning, College of Business and Management Sciences, Makerere University, Kampala, Uganda
- Department of Sociology and Social Administration, Faculty of Arts and Social Sciences, Kyambogo University, Kampala, Uganda
| | - Martin Kayitale Mbonye
- Department of Population Studies, School of Statistics and planning, College of Business and Management Sciences, Makerere University, Kampala, Uganda
| | - Betty Kwagala
- Department of Population Studies, School of Statistics and planning, College of Business and Management Sciences, Makerere University, Kampala, Uganda
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Baezconde-Garbanati L, Agurto I, Gravitt PE, Luciani S, Murphy S, Ochoa C, Gallegos K, Barahona R, Rodríguez Y. Barriers and innovative interventions for early detection of cervical cancer. SALUD PUBLICA DE MEXICO 2020; 61:456-460. [PMID: 31430087 DOI: 10.21149/10425] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 06/19/2019] [Indexed: 11/06/2022] Open
Abstract
Cervical cancer has decreased significantly over the past 30 years in some countries. However, it remains among the leading causes of cancer deaths in low-income, and racial/ethnic minority women. Cervical cancer prevention technologies are not always available. Laboratories are often not well equipped to use them. HPV information has not been widely disseminated. WHO guidelines, and US and Latin American data provide context for strategies on effective interventions to reduce cervical cancer disparities. Systemic, personal and cultural barriers, combined with decision-making guidelines, and impactful messaging can accelerate reductions in cervical cancer health inequities in the Americas.
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Affiliation(s)
- Lourdes Baezconde-Garbanati
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California. Los Angeles, California, USA.,Department of Preventive Medicine, Keck School of Medicine, University of Southern California. Los Angeles, California, USA.,Center for Health Equity in the Americas, Keck School of Medicine, University of Southern California. Los Angeles, California, USA
| | - Irene Agurto
- Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization. Chile
| | - Patti E Gravitt
- Department of Global Health, George Washington University Milken Institute School of Public Health. Washington DC, USA
| | - Silvana Luciani
- Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization. Chile
| | - Sheila Murphy
- Annenberg School for Communication and Journalism, University of Southern California. Los Angeles, California, USA
| | - Carol Ochoa
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California. Los Angeles, California, USA
| | - Katia Gallegos
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California. Los Angeles, California, USA.,Instituto Mexicano de Seguro Social. Mexico City, Mexico
| | - Rosa Barahona
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California. Los Angeles, California, USA.,Department of Preventive Medicine, Keck School of Medicine, University of Southern California. Los Angeles, California, USA.,Center for Health Equity in the Americas, Keck School of Medicine, University of Southern California. Los Angeles, California, USA
| | - Yaneth Rodríguez
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California. Los Angeles, California, USA.,Center for Health Equity in the Americas, Keck School of Medicine, University of Southern California. Los Angeles, California, USA
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Campos NG, Alfaro K, Maza M, Sy S, Melendez M, Masch R, Soler M, Conzuelo-Rodriguez G, Gage JC, Alonzo TA, Castle PE, Felix JC, Cremer M, Kim JJ. The cost-effectiveness of human papillomavirus self-collection among cervical cancer screening non-attenders in El Salvador. Prev Med 2020; 131:105931. [PMID: 31765712 DOI: 10.1016/j.ypmed.2019.105931] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 11/19/2019] [Accepted: 11/21/2019] [Indexed: 01/17/2023]
Abstract
Cervical cancer screening with human papillomavirus (HPV) DNA testing has been incorporated into El Salvador's national guidelines. The feasibility of home-based HPV self-collection among women who do not attend screening at the clinic (i.e., non-attenders) has been demonstrated, but cost-effectiveness has not been evaluated. Using cost and compliance data from El Salvador, we informed a mathematical microsimulation model of HPV infection and cervical carcinogenesis to conduct a cost-effectiveness analysis from the societal perspective. We estimated the reduction in cervical cancer risk, lifetime cost per woman (2017 US$), life expectancy, and incremental cost-effectiveness ratio (ICER, 2017 US$ per year of life saved [YLS]) of a program with home-based self-collection of HPV (facilitated by health promoters) for the 18% of women reluctant to screen at the clinic. The model was calibrated to epidemiologic data from El Salvador. We evaluated health and economic outcomes of the self-collection intervention for women aged 30 to 59 years, alone and in concert with clinic-based HPV provider-collection. Home-based self-collection of HPV was projected to reduce population cervical cancer risk by 14% and cost $1210 per YLS compared to no screening. An integrated program reaching 99% coverage with both provider- and home-based self-collection of HPV reduced cancer risk by 74% (compared to no screening), and cost $1210 per YLS compared to provider-collection alone. Self-collection facilitated by health promoters is a cost-effective strategy for increasing screening uptake in El Salvador.
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Affiliation(s)
- Nicole G Campos
- Center for Health Decision Science, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, 718 Huntington Avenue, Boston, MA, USA.
| | - Karla Alfaro
- Basic Health International, Colonia San Francisco, Avenido Las Camelias 14, San Salvador, El Salvador; Basic Health International, 25 Broadway, 9th Floor, New York, NY 10004, USA
| | - Mauricio Maza
- Basic Health International, Colonia San Francisco, Avenido Las Camelias 14, San Salvador, El Salvador; Basic Health International, 25 Broadway, 9th Floor, New York, NY 10004, USA
| | - Stephen Sy
- Center for Health Decision Science, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, 718 Huntington Avenue, Boston, MA, USA
| | - Mario Melendez
- Basic Health International, Colonia San Francisco, Avenido Las Camelias 14, San Salvador, El Salvador; Basic Health International, 25 Broadway, 9th Floor, New York, NY 10004, USA
| | - Rachel Masch
- Basic Health International, Colonia San Francisco, Avenido Las Camelias 14, San Salvador, El Salvador; Basic Health International, 25 Broadway, 9th Floor, New York, NY 10004, USA
| | - Montserrat Soler
- Obstetrics, Gynecology & Women's Health Institute, Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
| | | | - Julia C Gage
- Department of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, USA
| | - Todd A Alonzo
- University of Southern California, 222 East Huntington Drive, Suite 100, Monrovia, CA 91016, USA
| | | | - Juan C Felix
- Department of Pathology, Medical College of Wisconsin, 9200 W Wisconsin Avenue, Milwaukee, WI, USA
| | - Miriam Cremer
- Basic Health International, Colonia San Francisco, Avenido Las Camelias 14, San Salvador, El Salvador; Basic Health International, 25 Broadway, 9th Floor, New York, NY 10004, USA; Obstetrics, Gynecology & Women's Health Institute, Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
| | - Jane J Kim
- Center for Health Decision Science, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, 718 Huntington Avenue, Boston, MA, USA
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Nilima, Puranik A, Shreenidhi SM, Rai SN. Spatial evaluation of prevalence, pattern and predictors of cervical cancer screening in India. Public Health 2019; 178:124-136. [PMID: 31678693 DOI: 10.1016/j.puhe.2019.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 08/23/2019] [Accepted: 09/10/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To investigate the social determinants of cervical cancer screening and report the locations vulnerable to poor utilization of cervical cancer screening services. STUDY DESIGN An ecological study with the data derived from fourth round of the National Family Health Survey conducted in India in the period 2015-2016. METHODS The study focused on the percentage of women who have never undergone cervical cancer screening across 639 districts in India. Moran's I statistic was used to investigate the overall clustering of location. The Getis-Ord Gi* statistic was used for the detection of significant local clusters. Spatial error, spatial lag, spatial Durbin and spatial Durbin error models were compared, and the model with best fit was reported. ArcGIS, GeoDa and R software were used for the analysis. RESULTS The existence of spatial autocorrelation (Moran's I = 0.61) necessitates the consideration of spatial component while studying the screening data. A significant clustering of districts with poor screening has been observed in the North-Central and North-Eastern regions of India. The geographic arrangement of the percentage of women who have undergone cervical cancer screening was associated with the percentage of women with poor wealth index (P < 0.001), not using a modern method of contraception (P < 0.001), residing in rural areas (P = 0.033) and never heard of sexually transmitted infection (P = 0.014). The range of percentage of women getting cervix screened for cancer was 0.5-68.4%, presenting the heterogeneity among the population elements. CONCLUSION A higher risk of poor cervical cancer screening is observed in the districts where most of the women have poor wealth index, reside in urban area, have never heard of sexually transmitted infection and do not use a modern method of contraception.
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Affiliation(s)
- Nilima
- Department of Statistics, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India; Indian Institute of Public Health, Public Health Foundation of India, Gurugram, India; Department of Biostatistics, All India Institute of Medical Sciences, Delhi, India.
| | - A Puranik
- Department of Statistics, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - S M Shreenidhi
- Department of Statistics, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - S N Rai
- Biostatistics and Bioinformatics Facility, James Graham Brown Cancer Center, University of Louisville, Kentucky, USA; Department of Bioinformatics & Biostatistics, School of Public Health & Information Sciences, University of Louisville, Kentucky, USA.
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Mendoza-Almanza G, Ortíz-Sánchez E, Rocha-Zavaleta L, Rivas-Santiago C, Esparza-Ibarra E, Olmos J. Cervical cancer stem cells and other leading factors associated with cervical cancer development. Oncol Lett 2019; 18:3423-3432. [PMID: 31516560 PMCID: PMC6733009 DOI: 10.3892/ol.2019.10718] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 06/06/2019] [Indexed: 02/07/2023] Open
Abstract
Cervical cancer (CC) is one of the leading causes of cancer-associated mortalities in women from developing countries. Similar to other types of cancer, CC is considered to be a multifactorial disease, involving socioeconomic, cultural, immunological and epigenetic factors, as well as persistent human papilloma virus (HPV) infection. It has been well established that cancer stem cells (CSCs) play an important role in defining tumor size, the speed of development and the level of regression following treatment; therefore, CSCs are associated with a poor prognosis. CSCs have been detected in many types of cancer, including leukemia, pancreatic, colon, esophagus, liver, prostate, breast, gastric and lung cancer. In cervical cancer, CSCs have been associated with resistance to normally used drugs such as cisplatin. The present review summarizes the strategies that high-risk HPV viruses (HPV-16 and HPV-18) have developed to transform normal epithelial cells into cancer cells, as well as the cellular pathways and studies associated with the identification of cervical cancer stem cell biomarkers. In this sense, the present review provides state of the art information regarding CC development.
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Affiliation(s)
- Gretel Mendoza-Almanza
- National Council for Science and Technology, Autonomous University of Zacatecas, Zacatecas 98060, Mexico
| | | | - Leticia Rocha-Zavaleta
- Institute of Biomedical Research, National Autonomous University of Mexico, Mexico City 04510, Mexico
| | - César Rivas-Santiago
- National Council for Science and Technology, Autonomous University of Zacatecas, Zacatecas 98060, Mexico
| | - Edgar Esparza-Ibarra
- Academic Unit of Biological Sciences, Autonomous University of Zacatecas, Zacatecas 98060, Mexico
| | - Jorge Olmos
- Department of Marine Biotechnology, Center for Scientific Research and Higher Education, Ensenada 22860, Mexico
- Correspondence to: Dr Jorge Olmos, Department of Marine Biotechnology, Center for Scientific Research and Higher Education, 3918 Carretera Ensenada-Tijuana, Ensenada 22860, Mexico, E-mail:
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Devarapalli P, Labani S, Nagarjuna N, Panchal P, Asthana S. Barriers affecting uptake of cervical cancer screening in low and middle income countries: A systematic review. Indian J Cancer 2019; 55:318-326. [PMID: 30829264 DOI: 10.4103/ijc.ijc_253_18] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Cervical cancer is the second-most common cancer among women in the developing world and approximately 500,000 cases are diagnosed each year. In developed countries, cervical cancer (CCa) accounts for only 3.6% of newly diagnosed cancers. OBJECTIVE The present study aims to identify the most effective barriers associated with CCa screening uptake in low and middle-income countries (L and MICs) and aid to adopt effective measures to overcome prevailing barriers to the attainment of CCa uptake in the community. MATERIALS AND METHODS Health sciences electronic databases like MEDLINE, PubMed, Cochrane library, and Google Scholar were searched for studies published until August 2017. Keywords used for the search were ("cervical cancer screening"), ("barriers"), AND ("low income countries" OR "Middle income countries"). Articles were reviewed and data were extracted by using Mendeley Desktop Software (V-1.17.10). Income-level classification of countries was done as per the World Bank 2017 report. Statistical software like SPSS-V.23 and Medical-V.14 were used for the statistical application. RESULTS A total of 31 studies met the inclusion criteria with a total of 25,650 participants. The sample size of the included studies ranged from 97 to 5929 participants. Articles majorly reported data on participants from African region (51.6%) and minimally in the Western Pacific region (3.2%). Sampling methods among studies varied from convenience sampling-12 (39.7%) to consecutive sampling-1 (3.2%). Besides, two studies (6.5%) did not discuss their sampling procedures. It was observed that "Lack of information about CCa and its treatment" (Barrier of lack of knowledge and Awareness); "Embracement or shy" (Psychological Barrier); "Lack of time" (structural Barrier); and "Lack of family support" (Sociocultural and religious barrier) were the most commonly reported among all 22 barriers. CONCLUSION There is a need of policies advancement of CCa screening programs by focusing on aspects of accessibility, affordability, CCa education, and the necessity of screening to improve screening uptake to control the CCa morbidity and mortality rate in L and MIC's.
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Affiliation(s)
- Pradeep Devarapalli
- Department of Epidemiology and Biostatistics, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, I-7, Sector-39, Noida, Uttar Pradesh, India
| | - Satyanarayana Labani
- Department of Epidemiology and Biostatistics, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, I-7, Sector-39, Noida, Uttar Pradesh, India
| | - Narayanasetti Nagarjuna
- Department of Epidemiology and Biostatistics, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, I-7, Sector-39, Noida, Uttar Pradesh, India
| | - Poonam Panchal
- Department of Epidemiology and Biostatistics, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, I-7, Sector-39, Noida, Uttar Pradesh, India
| | - Smita Asthana
- Department of Epidemiology and Biostatistics, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, I-7, Sector-39, Noida, Uttar Pradesh, India
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9
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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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10
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Tatar O, Thompson E, Naz A, Perez S, Shapiro GK, Wade K, Zimet G, Gilca V, Janda M, Kahn J, Daley E, Rosberger Z. Factors associated with human papillomavirus (HPV) test acceptability in primary screening for cervical cancer: A mixed methods research synthesis. Prev Med 2018; 116:40-50. [PMID: 30172799 DOI: 10.1016/j.ypmed.2018.08.034] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 07/27/2018] [Accepted: 08/27/2018] [Indexed: 01/14/2023]
Abstract
Primary screening for cervical cancer is transitioning from the longstanding Pap smear towards implementation of an HPV-DNA test, which is more sensitive than Pap cytology in detecting high-risk lesions and offers greater protection against invasive cervical carcinomas. Based on these results, many countries are recommending and implementing HPV testing-based screening programs. Understanding what factors (e.g., knowledge, attitudes) will impact on HPV test acceptability by women is crucial for ensuring adequate public health practices to optimize cervical screening uptake. We used mixed methods research synthesis to provide a categorization of the relevant factors related to HPV primary screening for cervical cancer and describe their influence on women's acceptability of HPV testing. We searched Medline, Embase, PsycINFO, CINAHL, Global Health and Web of Science for journal articles between January 1, 1980 and October 31, 2017 and retained 22 empirical articles. Our results show that while most factors associated with HPV test acceptability are included in the Health Belief Model and/or Theory of Planned Behavior (e.g., attitudes, knowledge), other important factors are not encompassed by these theoretical frameworks (e.g., health behaviors, negative emotional reactions related to HPV testing). The direction of influence of psychosocial factors on HPV test acceptability was synthesized based on 14 quantitative studies as: facilitators (e.g., high perceived HPV test benefits), barriers (e.g., negative attitudes towards increased screening intervals), contradictory evidence (e.g., sexual history) and no impact (e.g., high perceived severity of HPV infection). Further population-based studies are needed to confirm the impact of these factors on HPV-based screening acceptability.
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Affiliation(s)
- Ovidiu Tatar
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste-Catherine Road, Montreal, Quebec H3T1E4, Canada.
| | - Erika Thompson
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie, Blvd., EAD 709M, Fort Worth, TX 76107-2699, USA.
| | - Anila Naz
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste-Catherine Road, Montreal, Quebec H3T1E4, Canada.
| | - Samara Perez
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste-Catherine Road, Montreal, Quebec H3T1E4, Canada; Department of Psychology, McGill University, 2001 McGill College Avenue, Montreal, Quebec, Canada.
| | - Gilla K Shapiro
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste-Catherine Road, Montreal, Quebec H3T1E4, Canada; Department of Psychology, McGill University, 2001 McGill College Avenue, Montreal, Quebec, Canada.
| | - Kristina Wade
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste-Catherine Road, Montreal, Quebec H3T1E4, Canada.
| | - Gregory Zimet
- Indiana University School of Medicine, Section of Adolescent Medicine, 410 West 10th Street, HS 1001, Indianapolis, IN 46202, USA.
| | - Vladimir Gilca
- Institut National de Santé Publique du Québec, 945 Wolfe Avenue, Québec, Quebec G1V 5B3, Canada.
| | - Monika Janda
- Queensland University of Technology, Faculty of Health, Brisbane, Australia.
| | - Jessica Kahn
- University of Cincinnati (Ohio), Division of Adolescent and Transition Medicine, MLC 4000, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA.
| | - Ellen Daley
- University of South Florida, Department of Community and Family Health, 13201 Bruce B. Downs Blvd, MDC 56, Tampa, FL 33612, USA.
| | - Zeev Rosberger
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste-Catherine Road, Montreal, Quebec H3T1E4, Canada; Department of Psychology, McGill University, 2001 McGill College Avenue, Montreal, Quebec, Canada.
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11
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Maza M, Melendez M, Masch R, Alfaro K, Chacon A, Gonzalez E, Soler M, Conzuelo-Rodriguez G, Gage JC, Alonzo TA, Castle PE, Felix JC, Cremer M. Acceptability of self-sampling and human papillomavirus testing among non-attenders of cervical cancer screening programs in El Salvador. Prev Med 2018; 114:149-155. [PMID: 29958860 DOI: 10.1016/j.ypmed.2018.06.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/21/2018] [Accepted: 06/25/2018] [Indexed: 10/28/2022]
Abstract
In a cross-sectional study carried out in El Salvador between February 2016 and July 2017, self-sampling and human papillomavirus (HPV) testing was found to be highly acceptable among 2019 women who had not attended a cervical cancer screening in at least 3 years. Within this population, HPV positivity rates differed according to age, marital status, number of children, and lifetime sexual partners. The proportion of women who tested HPV positive or who were diagnosed with cervical intraepithelial neoplasia grade 2 (CIN2) or more severe diagnoses (CIN2+) was similar to the general population of the area. Among the reasons for failing to participate in previous screening programs, non-attending women described logistic concerns, but also erroneous beliefs regarding HPV and cervical cancer, misconceptions regarding the screening procedure, discomfort with male providers, and confidentiality fears. The aim of this study was to identify opportunities and challenges that emerged from the use of self-sampling and HPV testing as part of a public cervical cancer control effort in a low-resource setting.
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Affiliation(s)
- M Maza
- Basic Health International, Colonia San Francisco, Avenida Las Camelias 14, San Salvador, El Salvador; Basic Health International, 25 Broadway, 9th Floor, New York, NY 10004, United States of America.
| | - M Melendez
- Basic Health International, Colonia San Francisco, Avenida Las Camelias 14, San Salvador, El Salvador; Basic Health International, 25 Broadway, 9th Floor, New York, NY 10004, United States of America.
| | - R Masch
- Basic Health International, Colonia San Francisco, Avenida Las Camelias 14, San Salvador, El Salvador; Basic Health International, 25 Broadway, 9th Floor, New York, NY 10004, United States of America.
| | - K Alfaro
- Basic Health International, Colonia San Francisco, Avenida Las Camelias 14, San Salvador, El Salvador; Basic Health International, 25 Broadway, 9th Floor, New York, NY 10004, United States of America.
| | - A Chacon
- Ministry of Health, San Salvador, El Salvador, Calle Arce 827, San Salvador, El Salvador
| | - E Gonzalez
- Ministry of Health, San Salvador, El Salvador, Calle Arce 827, San Salvador, El Salvador
| | - M Soler
- Basic Health International, Colonia San Francisco, Avenida Las Camelias 14, San Salvador, El Salvador; Basic Health International, 25 Broadway, 9th Floor, New York, NY 10004, United States of America.
| | - G Conzuelo-Rodriguez
- Basic Health International, Colonia San Francisco, Avenida Las Camelias 14, San Salvador, El Salvador; Basic Health International, 25 Broadway, 9th Floor, New York, NY 10004, United States of America.
| | - J C Gage
- National Cancer Institute, 9000 Rockville Pike, Bethesda, MD 20892, United States of America.
| | - T A Alonzo
- University of Southern California, 222 East Huntington Drive, Suite 100, Monrovia, CA 91016, United States of America.
| | - P E Castle
- Albert Einstein College of Medicine, 300 Morris Park Avenue, Bronx, NY 10461, United States of America
| | - J C Felix
- Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, United States of America.
| | - M Cremer
- Basic Health International, Colonia San Francisco, Avenida Las Camelias 14, San Salvador, El Salvador; Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States of America; Basic Health International, 25 Broadway, 9th Floor, New York, NY 10004, United States of America.
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12
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Piñeros M, Frech S, Frazier L, Laversanne M, Barnoya J, Garrido C, Gharzouzi E, Chacón A, Fuentes Alabi S, Ruiz de Campos L, Figueroa J, Dominguez R, Rojas O, Pereira R, Rivera C, Morgan DR. Advancing Reliable Data for Cancer Control in the Central America Four Region. J Glob Oncol 2018; 4:1-11. [PMID: 30241165 PMCID: PMC6180802 DOI: 10.1200/jgo.2016.008227] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The Central America Four (CA-4) region, comprising Guatemala, Honduras, El Salvador, and Nicaragua, is the largest low- and middle-income country region in the Western Hemisphere, with over 36 million inhabitants. The CA-4 nations share a common geography, history, language, and development indices, and unified with open borders in 2006. The growing CA-4 cancer burden among the noncommunicable diseases is expected to increase 73% by 2030, which argues for a regional approach to cancer control. This has driven efforts to establish population-based cancer registries as a central component of the cancer control plans. The involvement of international and academic partners in an array of initiatives to improve cancer information and control in the CA-4 has accelerated over the past several years. Existing data underscore that the infectious cancers (cervical, stomach, and liver) are a particular burden. All four countries have committed to establishing regional population-based cancer registries and have advanced significantly in pediatric cancer registration. The challenges common to each nation include the lack of national cancer control plans and departments, competing health priorities, lack of trained personnel, and sustainability strategies. General recommendations to address these challenges are outlined. The ongoing regional, international, and academic cooperation has proven helpful and is expected to continue to be a powerful instrument to contribute to the design and implementation of long-term national cancer control plans.
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Affiliation(s)
- Marion Piñeros
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Silvina Frech
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Lindsay Frazier
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Mathieu Laversanne
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Joaquin Barnoya
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Claudia Garrido
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Eduardo Gharzouzi
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Andrea Chacón
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Soad Fuentes Alabi
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Lisseth Ruiz de Campos
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Jacqueline Figueroa
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Ricardo Dominguez
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Ofelia Rojas
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Rosario Pereira
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Carla Rivera
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
| | - Douglas R. Morgan
- Marion Piñeros and Mathieu Laversanne,
International Agency for Research on Cancer, Lyon, France; Silvina
Frech, US National Cancer Institute, Bethesda, MD; Lindsay
Frazier, Dana-Farber/Children’s Cancer Center, Boston MA;
Joaquin Barnoya and Eduardo Gharzouzi, Instituto
de Cancerologia; Claudia Garrido, Unidad Nacional Oncología
Pediátrica, Guatemala City, Guatemala; Joaquin Barnoya,
Washington University in St. Louis, St. Louis, MO; Andrea
Chacón, Unidad Nacional para la Prevención y control del
Cáncer, Ministerio de Salud; Soad Fuentes Alabi, Hospital
Benjamín Bloom, Ministerio de Salud; Lisseth Ruiz de Campos,
Asociación Salvadoreña para la Prevención del Cáncer, San
Salvador, El Salvador; Jacqueline Figueroa, Unidad de Registro de
Cáncer, Secretaria de Salud, Tegucigalpa; Ricardo Dominguez,
Hospital de Occidente, Secretaria de Salud, Copán, Honduras; Ofelia
Rojas, Rosario Pereira, and Carla Rivera,
Universidad Nacional Autónoma de Nicaragua, León, Nicaragua; and
Douglas R. Morgan, Vanderbilt University, Nashville, TN
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13
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Yao X, Tang H, Ren Q, Zhao X, Zuo H, Li Z. Inhibited effects of CAPE- pNO 2 on cervical carcinoma in vivo and in vitro and its detected metabolites. Oncotarget 2017; 8:94197-94209. [PMID: 29212221 PMCID: PMC5706867 DOI: 10.18632/oncotarget.21617] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 08/27/2017] [Indexed: 12/28/2022] Open
Abstract
The development of advanced cervical cancer therapies is a particularly urgent need due to the strong side effects and toxicities of current treatments. Caffeic acid phenethyl ester (CAPE) exhibits broad-spectrum antitumor activities and little toxicity or side effects. In our previous study, caffeic acid para-nitro phenethyl ester (CAPE-pNO2) significantly improved the effect of anti-platelet aggregation and attenuated myocardial ischemia. Based on this finding, we aimed to further explore the antitumor activity of CAPE-pNO2 in cervical cancer cells and tumor xenografts. In addition, we assessed the biotransformation of CAPE-pNO2 in cervical cancer cells. Our study demonstrated that both CAPE and CAPE-pNO2 can inhibit cell proliferation via the induction of G2/M cell cycle arrest. More importantly, CAPE-pNO2 dramatically induced cell apoptosis via significant down-regulation of pro-caspase-3, pro-caspase-9, Bcl-2, Cyclin B1 and Cdc2 and up-regulation of cleaved-caspase-3, Bax, CytoC and P21Cip1. Moreover, CAPE and CAPE-pNO2 significantly suppressed the growth and angiogenesis of nude mice xenografts. CAPE and CAPE-pNO2 were found to degrade into four and six metabolites, respectively. The metabolites of CAPE and CAPE-pNO2 were different, and the major metabolic pathway may be phase II reactions. These results suggest that CAPE-pNO2 induced cell apoptosis and cell cycle arrest via a strong regulatory effect on relevant apoptotic proteins. Therefore, CAPE-pNO2 should be further studied as a potent anti-cancer agent.
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Affiliation(s)
- Xiaofang Yao
- College of Pharmaceutical Sciences, Southwest University, Chongqing 400716, China.,International Academy of Targeted Therapeutics and Innovation, Chongqing University of Arts and Sciences, Chongqing 402160, China
| | - Hao Tang
- College of Pharmaceutical Sciences, Southwest University, Chongqing 400716, China
| | - Qiao Ren
- College of Pharmaceutical Sciences, Southwest University, Chongqing 400716, China
| | - Xiaoyan Zhao
- College of Pharmaceutical Sciences, Southwest University, Chongqing 400716, China
| | - Hua Zuo
- College of Pharmaceutical Sciences, Southwest University, Chongqing 400716, China
| | - Zhubo Li
- College of Pharmaceutical Sciences, Southwest University, Chongqing 400716, China
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Laskow B, Figueroa R, Alfaro KM, Scarinci IC, Conlisk E, Maza M, Chang JC, Cremer M. A pilot study of community-based self-sampling for HPV testing among non-attenders of cervical cancer screening programs in El Salvador. Int J Gynaecol Obstet 2017; 138:194-200. [PMID: 28589548 DOI: 10.1002/ijgo.12204] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 03/13/2017] [Accepted: 05/05/2017] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To establish the feasibility and acceptability of home-based HPV self-sampling among women who did not attend screening appointments in rural El Salvador. METHODS In a cross-sectional study, data were collected from May 2015 to January 2016 among 60 women aged 30-59 years who were not pregnant, provided informed consent, had not been screened in 2 years, had no history of pre-cancer treatment, and did not attend a scheduled HPV screening. Participants completed questionnaires and received educational information before being given an opportunity to self-sample with the Hybrid Capture 2 High Risk HPV DNA Test. RESULTS Self-sampling was accepted by 41 (68%) participants. Almost all women chose to self-sample because the process was easy (40/41, 98%), could be performed at home (40/41, 98%), and saved time (38/41, 93%), and because they felt less embarrassed (33/41, 80%). The most common reason for declining the test was not wanting to be screened (8/19, 42%). The prevalence of high-risk HPV types among women who accepted self-sampling was 17% (7/41). CONCLUSION For most women, community-based self-sampling was an acceptable way to participate in a cervical cancer screening program. In low-resource countries, incorporating community-based self-sampling into screening programs might improve coverage of high-risk women.
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Affiliation(s)
- Bari Laskow
- Basic Health International, San Salvador, El Salvador
| | | | | | - Isabel C Scarinci
- University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | | | - Mauricio Maza
- Basic Health International, San Salvador, El Salvador
| | - Judy C Chang
- Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Miriam Cremer
- Department of Obstetrics and Gynecology, Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
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