1
|
Kulothungan V, Mascarenhas L, Das P, Mathur P. District-level epidemiology and sociodemographic determinants of noncommunicable diseases - results the National Family Health Survey -5 (2019-21). Diabetes Metab Syndr 2024; 18:103085. [PMID: 39084053 DOI: 10.1016/j.dsx.2024.103085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 07/12/2024] [Accepted: 07/19/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND Noncommunicable diseases (NCDs) are the leading cause of adult mortality in India. However, the data regarding the prevalence of NCD risk factors at district level is scarce. This study aims to analyse and map NCD risk factors at the state and district levels, exploring sociodemographic influences on these risks in Indian males and females. METHODS We analyzed National Family Health Survey-5 database and used the prevalence estimates to create choropleth maps, enabling us to examine the geographical variations in NCD risk factors at the district level in India. RESULTS Districts in the Satluj-Yamuna plains, western Rajasthan, and the northeastern regions exhibited clusters with a prevalence of high blood pressure exceeding 30.1 %. Northeastern districts showed over 40 % prevalence of current tobacco use, while high alcohol consumption clusters were observed in the northeastern and Telangana districts. Southern districts showed clusters of both obesity (as measured by BMI) and highest rates of oral, breast, and cervical cancer screening, moreover districts in Tamil Nadu exhibited notable clusters of raised blood glucose prevalence. CONCLUSION Our analysis revealed variations in the prevalence of NCD risk factors at both the state and district levels. Accordingly, this study ranks districts based on the NCD burden, offering valuable insights to state and district teams to devise targeted measures for the prevention and control of NCDs, particularly in the most heavily affected districts.
Collapse
Affiliation(s)
- Vaitheeswaran Kulothungan
- Indian Council of Medical Research - National Centre for Disease Informatics and Research, Nirmal Bhawan-ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562 110, India.
| | - Leena Mascarenhas
- Indian Council of Medical Research - National Centre for Disease Informatics and Research, Nirmal Bhawan-ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562 110, India
| | - Priyanka Das
- Indian Council of Medical Research - National Centre for Disease Informatics and Research, Nirmal Bhawan-ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562 110, India
| | - Prashant Mathur
- Indian Council of Medical Research - National Centre for Disease Informatics and Research, Nirmal Bhawan-ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562 110, India.
| |
Collapse
|
2
|
Kulothungan V, Ramamoorthy T, Sathishkumar K, Mohan R, Tomy N, Miller GJ, Mathur P. Burden of female breast cancer in India: estimates of YLDs, YLLs, and DALYs at national and subnational levels based on the national cancer registry programme. Breast Cancer Res Treat 2024; 205:323-332. [PMID: 38433127 PMCID: PMC11101532 DOI: 10.1007/s10549-024-07264-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 01/19/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE Female breast cancer (BC) is the leading cause of cancer incidence and mortality in India, and accounted for 13.5% of new cancer cases and 10% of cancer-related deaths in 2020. This study aims to estimate and report the female BC burden in India at state level from 2012 to 2016 in terms of years of life lost, years lived with disability, and disability-adjusted life years (DALYs), and to project the burden for the year 2025. METHODS The cancer incidence and mortality data from 28 population-based cancer registries were analysed. The mean mortality to incidence ratio was estimated, and mortality figures were adjusted for underreporting. The burden of female BC was estimated at national and subnational levels using Census data, World Health Organisation's lifetables, disability weights, and the DisMod-II tool. A negative binomial regression is employed to project burden for 2025. RESULTS The burden of BC among Indian women in 2016 was estimated to be 515.4 DALYs per 100,000 women after age standardization. The burden metrics at state level exhibited substantial heterogeneity. Notably, Tamil Nadu, Telangana, Karnataka, and Delhi had a higher burden of BC than states in the eastern and north-eastern regions. The projection for 2025 indicates to a substantial increase, reaching 5.6 million DALYs. CONCLUSION The female BC burden in India was significantly high in 2016 and is expected to substantially increase. Undertaking a multidisciplinary, context-specific approach for its prevention and control can address this rising burden.
Collapse
Affiliation(s)
- Vaitheeswaran Kulothungan
- Indian Council of Medical Research (ICMR) - National Centre for Disease Informatics and Research (NCDIR), Nirmal Bhawan - ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562 110, India
| | - Thilagavathi Ramamoorthy
- Indian Council of Medical Research (ICMR) - National Centre for Disease Informatics and Research (NCDIR), Nirmal Bhawan - ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562 110, India
| | - Krishnan Sathishkumar
- Indian Council of Medical Research (ICMR) - National Centre for Disease Informatics and Research (NCDIR), Nirmal Bhawan - ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562 110, India
| | - Rohith Mohan
- Indian Council of Medical Research (ICMR) - National Centre for Disease Informatics and Research (NCDIR), Nirmal Bhawan - ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562 110, India
| | - Nifty Tomy
- Indian Council of Medical Research (ICMR) - National Centre for Disease Informatics and Research (NCDIR), Nirmal Bhawan - ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562 110, India
| | - G J Miller
- Indian Council of Medical Research (ICMR) - National Centre for Disease Informatics and Research (NCDIR), Nirmal Bhawan - ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562 110, India
| | - Prashant Mathur
- Indian Council of Medical Research (ICMR) - National Centre for Disease Informatics and Research (NCDIR), Nirmal Bhawan - ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562 110, India.
| |
Collapse
|
3
|
Kothari V, Khullar S, Ts H. Prevalence of Genotype Patterns Associated With High-Risk Human Papillomavirus in Cervical Lesions. Cureus 2024; 16:e58300. [PMID: 38752031 PMCID: PMC11095062 DOI: 10.7759/cureus.58300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2024] [Indexed: 05/18/2024] Open
Abstract
Background Cervical lesions, often linked to high-risk human papillomavirus (HR-HPV) infection, pose a significant public health concern globally. Human HPV is considered the principal etiological factor in the development and transformation of pre-malignant lesions of the cervix leading to cervical carcinoma. The global distribution of HPV genotypes exhibits significant variability, liable to be influenced by the intricate interplay of geographical and biological factors among different HPV types and host immunogenetic elements. Owing to limited research addressing the genotypic distribution of HR-HPV in females with cervical lesions in the western zone of India, this study aims to bridge this gap by providing the prevalence of HR-HPV genotypes in women diagnosed with cervical lesions in this zone. Methodology This observational, cross-sectional study was performed in the Laboratory for Genotype Detection in the western zone of India. The study population comprised a total of 215 females in the age range of 18 to 60 years. A thorough examination of clinical specimens was conducted employing molecular techniques for HPV genotyping using TRUPCR® HPV-HR with a 16/18 Genotyping Kit. DNA Extraction was done using 3B Blackbio Biotech India Ltd. as per the standard protocol. The statistical analysis was performed using SPSS version 28 (IBM Corp., Armonk, NY, USA), and continuous variables were compared using Student's t-test. Results The overall prevalence of HR-HPV in women with cervical lesions in the western zone of India was 62.32% (134/215). The most prevalent genotype was HPV16 at 92/134 (68.65%), followed by HPV18 at 33/134 (24.62%) and HPV52 at 9/134 (6.7%). The overall prevalence of single type was 56.71% (76/134). The most prevalent genotype combination after HPV18 + 59 (29.85%) at 40/134 was HPV52 + 39 + 51 (13.43%) at 18/134. HR-HPV infection was found to be significantly (p < 0.05) associated with factors such as having three or more children, having a lower socioeconomic status, residing in rural areas, and being in a pre-menopausal stage. Conclusions This study focused on assessing the prevalence of the genotypes associated with HR-HPV infection, providing valuable insights into the epidemiology of cervical lesions in the western zone of India. The findings revealed high-risk genotype HPV16 to be the most prevalent type, followed by HPV18 and HPV52. The most prevalent genotype combinations were HPV18 + 59 and HPV52 + 39 + 51. The results of the study would potentiate the wealth of epidemiological data related to HPV infection in cervical lesions and could be employed for guiding future interventions and preventive strategies through orientation programs.
Collapse
Affiliation(s)
- Varun Kothari
- Microbiology, Dr. Sampurnanand Medical College, Jodhpur, IND
| | - Shivani Khullar
- Microbiology, Dr. Sampurnanand Medical College, Jodhpur, IND
| | | |
Collapse
|
4
|
Khanna D, Sharma P, Budukh A, Vishwakarma R, Sharma AN, Bagal S, Tripathi V, Maurya VK, Chaturvedi P, Pradhan S. Rural-urban disparity in cancer burden and care: findings from an Indian cancer registry. BMC Cancer 2024; 24:308. [PMID: 38448839 PMCID: PMC10916062 DOI: 10.1186/s12885-024-12041-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/22/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Cancer incidence and mortality vary across the globe, with nearly two-thirds of cancer-related deaths occurring in low- and middle-income countries. The rural-urban disparity in socio-demographic, behavioural, and lifestyle-related factors, as well as in access to cancer care, is one of the contributing factors. Population-based cancer registries serve as a measure for understanding the burden of cancer. We aimed to evaluate the rural-urban disparity in cancer burden and care of patients registered by an Indian population-based cancer registry. METHODS This study collected data from Varanasi, Uttar Pradesh, India, between 2017 and 2019. Sex and site-specific age-standardised rates for incidence and mortality per 100,000 population were calculated. Rural-urban disparities in cancer incidence and mortality were estimated through rate differences and standardised rate ratios (with 95% confidence intervals). Univariable and multivariable regressions were applied to determine any significant differences in socio-demographic and cancer-related variables according to place of residence (rural/urban). Crude and adjusted odds ratios with 95% confidence intervals were calculated. RESULTS 6721 cancer patients were registered during the study duration. Urban patients were older and had better literacy and socioeconomic levels, while rural patients had higher odds of having unskilled or semi-skilled professions. Diagnostic and clinical confirmation for cancer was significantly higher in urban patients, while verbal autopsy-based confirmation was higher in rural patients. Rural patients were more likely to receive palliative or alternative systems of medicine, and urban patients had higher chances of treatment completion. Significantly higher incidence and mortality were observed for oral cancer among urban men and for cervical cancer among rural women. Despite the higher incidence of breast cancer in urban women, significantly higher mortality was observed in rural women. CONCLUSIONS Low- and middle-income countries are facing dual challenges for cancer control and prevention. Their urban populations experience unhealthy lifestyles, while their rural populations lack healthcare accessibility. The distinctness in cancer burden and pattern calls for a re-evaluation of cancer control strategies that are tailor-made with an understanding of urban-rural disparities. Context-specific interventional programmes targeting risk-factor modifications, cancer awareness, early detection, and accessibility to diagnosis and care are essential.
Collapse
Affiliation(s)
- Divya Khanna
- Department of Preventive Oncology and Varanasi Cancer Registry, Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC) and Homi Bhabha Cancer Hospital (HBCH), Tata Memorial Centres, 221005, Varanasi, Uttar Pradesh, India.
| | - Priyanka Sharma
- Department of Preventive Oncology and Varanasi Cancer Registry, Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC) and Homi Bhabha Cancer Hospital (HBCH), Tata Memorial Centres, 221005, Varanasi, Uttar Pradesh, India
| | - Atul Budukh
- Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, 400012, Mumbai, India
| | - Rajesh Vishwakarma
- Department of Preventive Oncology and Varanasi Cancer Registry, Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC) and Homi Bhabha Cancer Hospital (HBCH), Tata Memorial Centres, 221005, Varanasi, Uttar Pradesh, India
| | - Anand N Sharma
- Department of Preventive Oncology and Varanasi Cancer Registry, Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC) and Homi Bhabha Cancer Hospital (HBCH), Tata Memorial Centres, 221005, Varanasi, Uttar Pradesh, India
| | - Sonali Bagal
- Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, 400012, Mumbai, India
| | - Varsha Tripathi
- Department of Preventive Oncology and Varanasi Cancer Registry, Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC) and Homi Bhabha Cancer Hospital (HBCH), Tata Memorial Centres, 221005, Varanasi, Uttar Pradesh, India
| | - Vijay Kumar Maurya
- Department of Preventive Oncology and Varanasi Cancer Registry, Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC) and Homi Bhabha Cancer Hospital (HBCH), Tata Memorial Centres, 221005, Varanasi, Uttar Pradesh, India
| | - Pankaj Chaturvedi
- Department of Surgical Oncology, Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, 400094, Mumbai, India
| | - Satyajit Pradhan
- Department of Radiation Oncology and Director, Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC) and Homi Bhabha Cancer Hospital (HBCH), Tata Memorial Centres, 221005, Varanasi, Uttar Pradesh, India
| |
Collapse
|
5
|
Chowdhury MZI, Mubin N, Mohib T, Chowdhury N, Chowdhury TF, Laskar AMH, Sultana S, Raihan M, Turin TC. Cancer screening research in Bangladesh: Insights from a scoping review. Glob Public Health 2024; 19:2351186. [PMID: 38752425 DOI: 10.1080/17441692.2024.2351186] [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: 04/17/2023] [Accepted: 04/29/2024] [Indexed: 06/14/2024]
Abstract
This scoping review summarises the findings of research conducted on cancer screening in Bangladesh, including the prevalence, awareness, barriers, and evaluation of screening programmes, by performing a comprehensive search of electronic databases and gray literature. 25 studies that met inclusion criteria were included in the final analysis. Most of the studies were about screening for cervical cancer, were quantitative, were cross-sectional, and were conducted in hospital settings. The main challenges to screening uptake were shyness, fear, a lack of knowledge, and an inadequate understanding of the concept of screening. Visual inspection with acetic acid (VIA) was found to be a simple and cost-efficient way to detect early-stage cervical cancer. However, breast self-examination (BSE) was reported to be insufficient. Education was found to have a positive impact on cancer screening knowledge and practice, but more needs to be done to improve screening rates, such as the utilisation of media, particularly in rural areas. The results of this scoping review highlight Bangladesh's low cancer screening prevalence and uptake and suggest that targeted awareness campaigns and enhanced access to screening services are required to increase cancer screening uptake and reduce the cancer burden in Bangladesh.
Collapse
Affiliation(s)
- Mohammad Ziaul Islam Chowdhury
- Department of Psychiatry, University of Calgary, Calgary, Canada
- Department of General Educational Development, Daffodil International University, Dhaka, Bangladesh
| | - Nazirum Mubin
- Department of Radiotherapy, Dhaka Medical College Hospital, Dhaka, Bangladesh
| | - Tasmira Mohib
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Nashit Chowdhury
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | | | | | - Sanchita Sultana
- School of Health Sciences, Central Michigan University, Mount Pleasant, MI, USA
| | - Mohammad Raihan
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Tanvir C Turin
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| |
Collapse
|
6
|
Roy S, Girotra S, Radhakrishnan A, Basu S. Prevalence and determinants of tobacco consumption and oral cancer screening among men in India: evidence from a nationally representative cross-sectional Survey. J Public Health (Oxf) 2023. [DOI: 10.1007/s10389-023-02161-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 11/24/2023] [Indexed: 07/24/2024] Open
|
7
|
Chintapally N, Nuwayhid M, Arroju V, Muddu VK, Gao P, Reddy BY, Sunkavalli C. State of cancer care in India and opportunities for innovation. Future Oncol 2023; 19:2593-2606. [PMID: 37675499 DOI: 10.2217/fon-2023-0047] [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] [Indexed: 09/08/2023] Open
Abstract
Cancer is one of the leading causes of morbidity and mortality in India. Despite recent medical and technological advances, the cancer burden in India remains high and continues to rise. Moreover, substantial regional disparities in cancer incidence and access to essential medical resources exist throughout the country. While innovative and effective cancer therapies hold promise for improving patient outcomes, several barriers hinder their development and utilization in India. Here we provide an overview of these barriers, including challenges related to patient awareness, inadequate infrastructure, scarcity of trained oncology professionals, and the high cost of cancer care. Furthermore, we discuss the limited availability of cancer clinical trials in the country, along with an examination of potential avenues to enhance cancer care in India. By confronting these hurdles head-on and implementing innovative, pragmatic solutions, we take an indispensable step toward a future where every cancer patient in the country can access quality care.
Collapse
Affiliation(s)
- Neha Chintapally
- Pi Health USA, Cambridge, MA, USA
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | | | | | - Vamshi K Muddu
- Asian Institute of Gastroenterology (AIG) Hospitals, Hyderabad, Telangana, India
| | - Peng Gao
- Pi Health USA, Cambridge, MA, USA
| | | | | |
Collapse
|
8
|
Alkhamis FH, Alabbas ZAS, Al Mulhim JE, Alabdulmohsin FF, Alshaqaqiq MH, Alali EA. Prevalence and Predictive Factors of Cervical Cancer Screening in Saudi Arabia: A Nationwide Study. Cureus 2023; 15:e49331. [PMID: 38143659 PMCID: PMC10748848 DOI: 10.7759/cureus.49331] [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] [Accepted: 11/24/2023] [Indexed: 12/26/2023] Open
Abstract
BACKGROUND Cervical cancer, despite being preventable, is one of the most prevalent cancers among females globally and in Saudi Arabia. The literature demonstrated that, unlike global trends, cervical cancer incidence in Saudi Arabia is increasing. In addition to that, a high proportion of it is discovered in advanced stages. This state of late discovery was attributed to the absence of efficient preventive and screening programs. Observing the scale of the preventable morbidities and mortalities that can be caused by cervical cancer and the efforts and costs that are positioned to fight cervical cancer across the globe and the current ambiguity in the cervical cancer screening prevalence in Saudi Arabia brings the realization of the importance of conducting a study that properly explores the status of cervical cancer screening in Saudi Arabia. AIM This study aims to measure the prevalence and the predictive factors for cervical cancer screening among adult women who were previously sexually active in Saudi Arabia, as well as explore the participants' knowledge and attitude toward cervical cancer and human papillomavirus (HPV) vaccines. METHODS This study was a nationwide cross-sectional study conducted in Saudi Arabia between September 2023 and November 2023 on adult Saudi females between the ages of 21 and 65 years who were previously sexually active and did not undergo a hysterectomy. Data were collected through a convenience sampling technique where a self-administered survey was established and disseminated to the targeted population all over the country with the assistance of data collectors. Cervical cancer screening prevalence and screening predictive factors were measured. Factors associated with cervical cancer screening and knowledge of cervical cancer were tested using a chi-square test, an independent t-test, and an ANOVA test. Multivariate logistic regression was also used to determine predictors of cervical cancer screening. RESULTS The study included 2,337 participants. The prevalence of cervical cancer screening among Saudi females was observed to be 22.1%. The most commonly reported reason for not undergoing cervical cancer screening was that it was never recommended by a physician, as reported by 42.4%. Only 7.6% reported taking the HPV vaccine. The majority of the participants (84.1%) had a low knowledge level about cervical cancer. The multivariate logistic regression model revealed that the following factors were observed to be significantly predictive of undergoing cervical cancer screening: being 46-59 years of age (74% increase rate), having an income greater than 20,000 Saudi Riyals (SRs) (158% increase rate), having a history of gynecological problems (152% increase rate), knowing someone who underwent cervical cancer screening (393% increase rate), and receiving a recommendation from a healthcare practitioner to undergo cervical cancer screening (1300% increase rate). CONCLUSION There are clearly low rates of cervical cancer screening and even lower rates of uptake for the HPV vaccine, which are the prevention measures for cervical cancer. National initiatives and programs that promote HPV vaccine uptake and regular cervical cancer screening are highly recommended to minimize the morbidity and mortality of cervical cancer.
Collapse
Affiliation(s)
| | | | | | | | | | - Eithar A Alali
- Obstetrics and Gynaecology, King Faisal University, Alhofuf, SAU
| |
Collapse
|
9
|
Logaraj M. The effect of the health belief model education for cervical cancer prevention, screening promotion among rural women in Chengalpattu district, Tamil Nadu (HBMECC). JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:166. [PMID: 37404911 PMCID: PMC10317253 DOI: 10.4103/jehp.jehp_1133_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 12/19/2022] [Indexed: 07/06/2023]
Abstract
BACKGROUND The objective of this interventional study is to investigate the efficacy of health belief model-based health education in screening promotion and improving awareness about cervical cancer prevention. MATERIALS AND METHODS A total of 370 rural married respondents were selected using a multistage random sampling method. To gather information from study participants before and after the six-month intervention period, the standard questionnaire instrument paired with a health belief model and cervical cancer knowledge assessments was employed. This quasi-experimental study incorporated health belief model-based education for 45 minutes, supplemented by audio-visual, flipchart, and interactive sessions, and regular motivation was given once every three days until the call for mass screening camps, which were held every 15 days. The data was imported into Excel and analyzed using SPSS 21. A paired test for pre- and post-intervention significance and a cross-tab test for association was utilized. At the end of the study, the percentage of all women screened was estimated. RESULTS The findings revealed that 37.8% of participants were between the ages of 30 and 40, 32.7% had no formal education, and 42% were housewives. The pre-and post-test mean scores for knowledge about cervical cancer and prevention differed, with a mean value difference of 4 for signs of cervical cancer, 24.32 for risk factors, 1.31 for the cervical cancer screening (Pap) test, 1.07 for vaccination, and 0.48 for attitude toward self-assessment of cervical cancer symptoms and attitude toward screening. By the end of the study, 39% of the women had been screened in a mass screening camp and from outside sources. CONCLUSION The health belief model, therefore, assisted in increasing the required information and addressed the perception regarding screening obstacles, consequently increasing the screening rate, and can thus be implemented as an appropriate strategy for instructing women about cervical cancer screening and prevention.
Collapse
Affiliation(s)
- Muthunarayanan Logaraj
- Department of Community Medicine, SRM Medical College and Hospital, SRM IST, Kattankulathur, Tamil Nadu, India
| |
Collapse
|
10
|
Pradhan MR, Mondal S, Mudi PK. Gynecological morbidity and treatment-seeking among older adult (aged 45-59) women in India. Reprod Health 2023; 20:64. [PMID: 37106377 PMCID: PMC10134576 DOI: 10.1186/s12978-023-01611-1] [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: 12/25/2022] [Accepted: 04/16/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Women's gynecological health needs are not limited to the reproductive years of their life. Women are at risk of hormonal changes, gynecological malignancies, and various genitourinary conditions as they move toward menopause and beyond. Concerns about older women's sexual and reproductive health and rights (SRHR) continue to be taboo in many countries, of little interest to researchers and professionals in the field of healthcare, and a "blind spot" in discussions about policy as a whole. Despite the widespread agreement, the life course approach to addressing SRHR concerns has received minimal attention. The study estimates the prevalence, assesses the correlates, and treatment-seeking of gynecological morbidity (GM) among older adult women aged 45-59 years (N = 18,547) in India. METHOD The analysis was based on the nationally representative Longitudinal Ageing Study (2016-2017) data that adopted a multistage stratified area probability cluster sampling to select respondents. The outcome variables used in this analysis were 'had any GM' and 'sought treatment for any GM.' Women with any morbidity such as per vaginal bleeding, foul-smelling vaginal discharge, uterus prolapses, mood swings/irritability, fibroid/cyst, and dry vagina causing painful intercourse were considered to have any GM. Of the respondents with GM, who sought a doctor's consultation or treatment were considered 'sought treatment for any GM.' Binary logistic regression was conducted to examine the adjusted effect of socioeconomic and demographic predictors of GM and treatment-seeking. Stata (V 16) was used for statistical analyses with a 5% significance level. RESULTS Fifteen percent of the women had any GM, and only 41% of them sought treatment. Age, marital status, education, number of pregnancies, hysterectomy, involvement in household decision-making, social group, religion, wealth status, and region were significantly associated with GM. The odds of treatment-seeking were higher among women with 10+ years of schooling (OR 1.66, CI 1.23, 2.23), with hysterectomy (OR 7.36, CI 5.92, 9.14), with five-plus pregnancies (OR 1.25, CI 0.96, 1.64), and those from the richest (OR 1.91, CI 1.40, 2.60) households than their respective counterparts. CONCLUSION Many older adult women experience GM, and treatment-seeking is inadequate. The GM prevalence and treatment-seeking vary considerably by socioeconomic and demographic characteristics. Results suggest community-level awareness generation and the inclusion of this otherwise ignored group in programs targeting better health and wellbeing of women.
Collapse
Affiliation(s)
- Manas Ranjan Pradhan
- Department of Fertility and Social Demography, International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai, 400088, India
| | - Sourav Mondal
- Department of Fertility and Social Demography, International Institute for Population Sciences, Mumbai, India.
| | - Prasanna Kumar Mudi
- Department of Fertility and Social Demography, International Institute for Population Sciences, Mumbai, India
| |
Collapse
|
11
|
Shruti T, Khanna D, Khan A, Dandpat A, Tiwari M, Singh AG, Mishra A, Shetty A, Birur P, Chaturvedi P. Status and Determinants of Early Detection of Oral Premalignant and Malignant Lesions in India. Cancer Control 2023; 30:10732748231159556. [PMID: 36809192 PMCID: PMC9947682 DOI: 10.1177/10732748231159556] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
It has been over four decades since the launch of the National Cancer Control Programme in India, yet the cancer screening rates for oral cancer remain unremarkable. Moreover, India is bracing a large burden of oral cancer with poor survival rates. An effective public health programme implementation relies on a multitude of factors related to cost-effective evidence-based interventions, the healthcare delivery system, public health human resource management, community behaviour, partnership with stakeholders, identifying opportunities and political commitment. In this context, we discuss the various challenges in the early detection of oral premalignant and malignant lesions and potential solutions.
Collapse
Affiliation(s)
- Tulika Shruti
- Departmentof Preventive Oncology,
Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC) and Homi Bhabha
Cancer Hospital (HBCH), Tata Memorial Centres, Varanasi, India
| | - Divya Khanna
- Departmentof Preventive Oncology,
Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC) and Homi Bhabha
Cancer Hospital (HBCH), Tata Memorial Centres, Varanasi, India,Divya Khanna, MD, Department of Preventive
Oncology, Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC) and Homi
Bhabha Cancer Hospital (HBCH), Tata Memorial Centres, Banaras Hindu University,
Campus, Sundar Bagiya Colony, Sundarpur, Varanasi 221005, India.
| | - Aqusa Khan
- Departmentof Preventive Oncology,
Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC) and Homi Bhabha
Cancer Hospital (HBCH), Tata Memorial Centres, Varanasi, India
| | - Abhishek Dandpat
- Departmentof Preventive Oncology,
Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC) and Homi Bhabha
Cancer Hospital (HBCH), Tata Memorial Centres, Varanasi, India
| | - Manish Tiwari
- Department of Head and Neck
Oncology, Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC) and Homi
Bhabha Cancer Hospital (HBCH), Tata Memorial Centres, Varanasi, India
| | - Arjun G. Singh
- Department of Head and Neck
Oncology, Tata Memorial Centre, Mumbai, India
| | - Aseem Mishra
- Department of Head and Neck
Oncology, Mahamana Pandit Madan Mohan Malaviya Cancer Centre (MPMMCC) and Homi
Bhabha Cancer Hospital (HBCH), Tata Memorial Centres, Varanasi, India
| | | | - Praveen Birur
- Department of Oral Medicine and
Radiology, Consultant Biocon Foundation and Integrated Head and Neck Programme,
Mazumdar Shaw Medical Foundation, KLES Institute of Dental
Sciences, Bengaluru, India
| | - Pankaj Chaturvedi
- Department of Surgical Oncology, Homi Bhabha National
Institute, Anushakti Nagar, India,Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
| |
Collapse
|
12
|
Kumari M, Kamat S, Singh SK, Kumar A, Jayabaskaran C. Inhibition of Autophagy Increases Cell Death in HeLa Cells through Usnic Acid Isolated from Lichens. PLANTS (BASEL, SWITZERLAND) 2023; 12:519. [PMID: 36771602 PMCID: PMC9919968 DOI: 10.3390/plants12030519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/19/2023] [Accepted: 01/19/2023] [Indexed: 06/18/2023]
Abstract
The Western Ghats, India, is a hotspot for lichen diversity. However, the pharmacological importance of lichen-associated metabolites remains untapped. This study aimed to evaluate the cytotoxic potential of lichens of this region. For this, sixteen macrolichens were collected and identified from two locations in the Western Ghats. The acetone extract of Usnea cornuta (UC2A) showed significant cytotoxicity towards multiple human cancer cell lines. Interestingly, co-treatment with chloroquine (CQ), an autophagy inhibitor, increased the cytotoxic potential of the UC2A extract. A gas chromatography mass spectrometry (GCMS) study revealed usnic acid (UA), atraric acid and barbatic acid as the dominant cytotoxic compounds in the UC2A extract. Further, UA was purified and identified from the UC2A extract and evaluated for cytotoxicity in HeLa cells. The monodansyl cadaverine and mitotracker red double staining revealed the autophagy-inducing activities of UA, and the inhibition of autophagy was confirmed via CQ treatment. Autophagy inhibition increased the cytotoxicity of UA by 12-16% in a concentration-dependent manner. It also increased lipid peroxidation, ROS levels and mitochondrial depolarization and decreased glutathione availability. A decrease in zeta potential and a 40% increase in caspase 3/7 activity were also noted after CQ treatment of UA-treated cells. Thus, cytotoxicity of UA can be increased by inhibiting autophagy.
Collapse
Affiliation(s)
- Madhuree Kumari
- Department of Biochemistry, Indian Institute of Science, Bangalore 560012, India
| | - Siya Kamat
- Department of Biochemistry, Indian Institute of Science, Bangalore 560012, India
| | - Sandeep Kumar Singh
- Division of Microbiology, Indian Agricultural Research Institute, Pusa, New Delhi 110012, India
| | - Ajay Kumar
- Centre of Advanced Study in Botany, Banaras Hindu University, Varanasi 221005, India
| | - C. Jayabaskaran
- Department of Biochemistry, Indian Institute of Science, Bangalore 560012, India
| |
Collapse
|
13
|
Ganeshkumar P. Audio-Visual Training Improves Awareness and Willingness of Cervical Cancer Screening among Healthy Indian Women: Findings from a Survey. South Asian J Cancer 2023; 12:23-29. [PMID: 36851929 PMCID: PMC9966178 DOI: 10.1055/s-0042-1751094] [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] [Indexed: 10/15/2022] Open
Abstract
Priya GaneshkumarObjectives We evaluated the impact of a standardized, simple audio-visual (AV) training video developed in regional languages on cervical cancer awareness among apparently healthy women and their willingness to undergo regular cervical cancer screening. Materials and Methods This cross-sectional noninterventional multicentric survey was conducted in 69 centers across 14 states in India and one center in UAE among women aged between 18 and 88 years attending clinics for a variety of indications. Using a short questionnaire, cervical cancer awareness and willingness to undergo cervical cancer screening were assessed before and after the AV training. Statistical Analysis In addition to descriptive analysis, improvement in awareness after the AV training was assessed using McNemar's test, and comparison of responses between subgroups was performed using Pearson chi-squared test. Results The survey was completed by 3,188 apparently healthy women (mean age: 36.8 ± 11.3 years). Before AV training, correct answers were given to only 4/6 questions by majority of the participants; most participants were unaware about the main cause of cervical cancer (1,637/3,188, 51.4%), availability of cervical cancer screening tests (1,601/3,188, 50.2%), and cervical cancer vaccines (1,742/3,188, 54.6%). Only 576 women (18.1%) had undergone cervical cancer screening in the past. After the AV training, the proportion of women correctly responding to all six questions improved significantly (p < 0.05), and 84.4% (2691/3188) women showed willingness to undergo periodic cervical cancer screening. Compared to unmarried and professional women, although married women and home-makers had lower awareness scores, the latter subgroups had more often undergone previous cervical cancer screening. Conclusion It is possible to improve cervical cancer awareness among healthy women, and to enhance their willingness to undergo regular cervical cancer screening tests using a simple, six minute-long, standardized AV training material.
Collapse
Affiliation(s)
- Priya Ganeshkumar
- Sainiwas Healthcare, Shivaji Nagar, Wagle Estate, Thane, Maharashtra, India
| |
Collapse
|
14
|
Sen S, Khan PK, Wadasadawala T, Mohanty SK. Socio-economic and regional variation in breast and cervical cancer screening among Indian women of reproductive age: a study from National Family Health Survey, 2019-21. BMC Cancer 2022; 22:1279. [PMID: 36476339 PMCID: PMC9727878 DOI: 10.1186/s12885-022-10387-9] [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: 07/09/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In India, breast and cervical cancers account for two-fifths of all cancers and are predominantly prevalent among women in the reproductive age group. The Government of India recommended screening of breast and cervical cancer among women aged 30 years and over. This study examines the socio-economic and regional variations of breast and cervical screening among Indian women in the reproductive age. METHODS A full sample of 707,119 women aged 15-49 and a sub-sample of 357,353 women aged 30-49 from National Family Health Survey-5 (2019-21) were used in the analysis. Self-reported ever screening for breast and cervical cancer for women aged 15-49 and women aged 30-49 were outcome variables. A set of socio-economic and risk factors associated with breast and cervical cancer screening were used as the predictors. Logistic regression was used to understand the significant correlates of cancer screening and, concentration index and concentration curve were used to assess the socio-economic inequality in breast and cervical cancer screening. RESULTS The proportion of breast and cervical cancer screening among women aged 30-49 were 877 and 1965 per 100,000 women respectively. Cancer screening was lower among women who were poor, young, had lower educational attainment and resided in rural areas. The concentration index was 0.2 for ever screening of breast cancer and 0.15 for cervical cancer among women aged 30-49 years. The concertation curve for screening of both breast and cervical cancers was pro-rich. Women with higher educational attainment [OR:1.46, 95% CI: 1.31-1.62], aged 40-49 years [OR:1.35; 95% CI: 1.28-1.43], resided in the western [OR:1.62; 95% CI:1.4-1.87] or southern [OR:6.66; 95% CI:5.93-7.49] region had significantly higher odds of up taking either of the screening. The pattern of breast and cervical cancer screening among women aged 15-49 was similar to that of women 30-49. CONCLUSION The overall proportion of cancer screening among women in 30-49 age group is low in India. Early screening and treatment can reduce the burden of these cancers. Creating awareness and providing knowledge on cancer could be a key strategy for reducing the burden of breast and cervical cancers among women in the reproductive age in India.
Collapse
Affiliation(s)
- Soumendu Sen
- grid.419349.20000 0001 0613 2600Department of Population and Development, International Institute for Population Sciences, Mumbai, India
| | - Pijush Kanti Khan
- grid.464858.30000 0001 0495 1821International Institute of Health Management Research, Delhi, India
| | - Tabassum Wadasadawala
- grid.450257.10000 0004 1775 9822Department of Radiation Oncology, Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Sanjay K Mohanty
- grid.419349.20000 0001 0613 2600Department of Population and Development, International Institute for Population Sciences, Mumbai, India
| |
Collapse
|
15
|
Holroyd TA, Yan SD, Srivastava V, Srivastava A, Wahl B, Morgan C, Kumar S, Yadav AK, Jennings MC. Designing a Pro-Equity HPV Vaccine Delivery Program for Girls Who Have Dropped Out of School: Community Perspectives From Uttar Pradesh, India. Health Promot Pract 2022; 23:1039-1049. [PMID: 34636268 DOI: 10.1177/15248399211046611] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
India experiences a substantial burden of cervical cancer and accounts for nearly one third of cervical cancer deaths worldwide. While human papillomavirus (HPV) vaccines have been introduced subnationally in some states, HPV has not yet been rolled out nationally. Given the target age group, schools are the most common delivery channel for HPV vaccines, but this fails to account for local girls who never attended or no longer attend school. We conducted a qualitative, design-informed, community-based study conducted in Uttar Pradesh, India. We assessed facilitators and barriers among out-of-school girls and proposed program characteristics to inform the design of pro-equity HPV vaccine delivery programs for out-of-school girls. Programs should improve parental knowledge of the risk of cervical cancer, engage vaccinated girls as vaccine champions, utilize varied media options for low-literacy populations, and ensure that HPV vaccine services are accessible and flexible to accommodate out-of-school girls. In areas with poor or irregular school attendance among adolescent girls, HPV vaccine coverage will remain suboptimal until programs can effectively address their needs and reach this priority population. Our findings present a meaningful opportunity for program planners to purposefully design HPV vaccination programs according to these parameters, rather than modifying existing programs to include HPV vaccine. Adolescent girls, their parents, and other community members should be involved in program design to ensure that the program can effectively meet the needs of adolescent girls who are not in school.
Collapse
Affiliation(s)
- Taylor A Holroyd
- Johns Hopkins School of Public Health, Baltimore, MD, USA.,International Vaccine Access Center, Baltimore, MD, USA
| | - Shirley D Yan
- Johns Hopkins School of Public Health, Baltimore, MD, USA.,International Vaccine Access Center, Baltimore, MD, USA
| | | | | | - Brian Wahl
- Johns Hopkins School of Public Health, Baltimore, MD, USA.,International Vaccine Access Center, Baltimore, MD, USA
| | - Christopher Morgan
- Jhpiego, Baltimore, MD, USA.,University of Melbourne, Melbourne, Victoria, Australia
| | | | - Amit K Yadav
- MAMTA Health Institute for Mother and Child, Lucknow, Uttar Pradesh, India
| | - Mary Carol Jennings
- Johns Hopkins School of Public Health, Baltimore, MD, USA.,International Vaccine Access Center, Baltimore, MD, USA
| |
Collapse
|
16
|
Vasanthakumar A, Rejeeth C, Vivek R, Ponraj T, Jayaraman K, Anandasadagopan SK, Vinayaga Moorthi P. Design of Bio-Graphene-Based Multifunctional Nanocomposites Exhibits Intracellular Drug Delivery in Cervical Cancer Treatment. ACS APPLIED BIO MATERIALS 2022; 5:2956-2964. [PMID: 35620928 DOI: 10.1021/acsabm.2c00280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The advent of bio-nanotechnology has revolutionized nanodrug delivery by improving drug efficacy and safety. Nevertheless, acceptable carriers for therapeutic molecules are one of the most difficult challenges in drug delivery. Graphene material-based (GMB) and polymer-based drug-loaded nanocarriers have both demonstrated clinical advantages in delivering drugs of interest in vitro/in vivo. Cisplatin (CDDP) is an inorganic chemotherapeutic drug that is commonly used to treat a variety of cancers. However, its clinical use is associated with drug resistance and few side effects, which reduces its antitumor effects. Therefore, we developed a CDDP-loaded chitosan-functionalized graphene oxide nanocomposite (CDDP@CS-GO NC)-based nanodrug delivery system (NDDS). Flow cytometry and confocal imaging show that the CDDP@CS-GO NCs lead to significantly increased intracellular drug accumulation in tumor cells. Cancer cells take up the nanocomposite via endocytosis and can generate intracellular reactive oxygen species (ROS) to increase mitochondrial membrane potential loss (Δψm) and enable cytochrome-c release, followed by the dysregulation of Bcl-2 into the cytosol and activation of caspase-3 to induce cancer cell apoptosis. In vitro experiments demonstrated the excellent cancer therapeutic effect with few side effects of the carriers. CDDP@CS-GO NCs are expected to play an important role in responsive NDDSs for cancer therapy.
Collapse
Affiliation(s)
- Alagarsamy Vasanthakumar
- Bio-materials and Nanomedicine Laboratory, Department of Human Genetics and Molecular Biology, School of Life Sciences, Bharathiar University, Coimbatore 641046, Tamil Nadu, India
| | - Chandrababu Rejeeth
- Molecular Therapeutic Laboratory, Department of Biochemistry, Periyar University, Salem 636011, Tamil Nadu, India
| | - Raju Vivek
- Bio-Nano Therapeutics Research Laboratory, Department of Zoology, School of Life Sciences, Bharathiar University, Coimbatore 641046, Tamil Nadu, India
| | - Thondhi Ponraj
- Proteomics and Molecular Cell Physiology Laboratory, Department of Zoology, School of Life Sciences, Bharathiar University, Coimbatore 641046, Tamil Nadu, India
| | - Karunyadevi Jayaraman
- Department of Microbial Biotechnology, Bharathiar University, Coimbatore 641046, Tamil Nadu, India
| | - Suresh Kumar Anandasadagopan
- Department of Biochemistry and Biotechnology, Central Leather Research Institute, Council of Scientific and Industrial Research (CSIR), Adyar, Chennai 600020, Tamil Nadu, India
| | - Puthamohan Vinayaga Moorthi
- Bio-materials and Nanomedicine Laboratory, Department of Human Genetics and Molecular Biology, School of Life Sciences, Bharathiar University, Coimbatore 641046, Tamil Nadu, India
| |
Collapse
|
17
|
Gangopadhyay A. Elimination of cervical cancer as a public health problem-how shorter brachytherapy could make a difference during COVID-19. Ecancermedicalscience 2022; 16:1352. [PMID: 35510136 PMCID: PMC9023303 DOI: 10.3332/ecancer.2022.1352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Indexed: 01/09/2023] Open
Abstract
The World Health Organization has called for elimination of cervical cancer as a public health problem and has adopted strategies in this regard. However, the estimates for achieving the goals depend on the ability to provide timely treatment in a certain proportion of cases. The coronavirus disease 2019 pandemic has had a serious impact on healthcare delivery in many low and middle income countries (LMICs) with the highest burden of cervical cancer; funds and infrastructure are being reallocated to deal with the emergency, and cancer care has been seriously affected. In the absence of clear and reliable estimates, the exact extent of disruption remains unclear. It is, therefore, essential that pragmatic approaches are adopted to save lives. There has been considerable debate regarding the use of the 9 Gy × 2 fractions high dose rate brachytherapy schedule for the treatment of locally advanced cervical carcinoma. However, in LMICs with the highest global burden of locally advanced cervical cancer cases, radiation facilities have been using this fractionation schedule in many cases to deal with the overwhelming number of patients, who would have otherwise been denied timely treatment. In view of the current pandemic, and the difficulties in accessing and delivering timely healthcare, mortality owing to delayed treatment cannot be denied in LMICs, which already have underequipped healthcare facilities. Use of the shortest available fractionation schedule to provide timely treatment would serve to save more lives in regions with high incidence and mortality from the disease.
Collapse
|
18
|
Sudha B, Kumar NS, Sumathi S. Absence of Knowledge and Awareness About Cervical Cancer Among Educated Women: A Need for Education About Cervical Cancer. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2022. [DOI: 10.1007/s40944-022-00611-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
19
|
Mehrotra R, Yadav K. Cervical Cancer: Formulation and Implementation of Govt of India Guidelines for Screening and Management. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2022; 20:4. [PMID: 34977333 PMCID: PMC8711687 DOI: 10.1007/s40944-021-00602-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 11/30/2021] [Accepted: 12/09/2021] [Indexed: 11/26/2022]
Abstract
Purpose Cervical cancer is the second most common cancers of women in India, despite being largely preventable. This review traces the journey of formulation of the Operational Guidelines for the management of common cancers and its implementation. Methods A literature review was done to document the process of formulation of the guidelines, in addition to inputs from the officials involved in the process of developing them. Results The review covers the pre-existing challenges in the National cancer control program and helps in providing recommendations for the future of cervical cancer screening, considering the COVID pandemic and the limitations of the public health system in India. Conclusion The implementation of early diagnosis of cervical cancer on a national scale as envisaged in the Operational Guidelines for the management of common cancers is a herculean task. A concerted approach for the implementation of cervical cancer control and HPV vaccination will hopefully bring fruitful results going forward.
Collapse
Affiliation(s)
- Ravi Mehrotra
- Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Kavita Yadav
- Centre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi, India
| |
Collapse
|
20
|
Verma M, Srivastava K, Singhal S, Bhatt MLB. Problems associated with inadequate surgery in patients with cervical cancer: Can they be avoided? CANCER RESEARCH, STATISTICS, AND TREATMENT 2022. [DOI: 10.4103/crst.crst_52_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
21
|
Mohan L, Karthika M. A community-based cervical cancer screening program in Alappuzha district of Kerala using camp approach. J Family Med Prim Care 2022; 11:1152-1157. [PMID: 35495785 PMCID: PMC9051726 DOI: 10.4103/jfmpc.jfmpc_1260_21] [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: 06/25/2021] [Revised: 10/11/2021] [Accepted: 10/20/2021] [Indexed: 12/01/2022] Open
Abstract
Background: Cervical cancer is a major cause of preventable cancer related death in women, particularly in middle-income developing countries. Screening of cervical pre-cancer by cytology remains an effective strategy for prevention of mortality. However, there is paucity of community-based studies in Kerala. The aim of this study was to determine the prevalence of cervical precancerous lesions and to study the associated epidemiological factors through camp approach. Materials and Methods: A cross–sectional study was carried out among women in Alappuzha district, Kerala, by conducting community-based screening camps covering all the panchayaths from February 2017 to January 2019. Statistical Analysis Used: Descriptive statistics including mean for continuous variables and frequency along with their percentage for categorical variables were determined. Pearson’s Chi-square test was used to determine the strength of the association between variables. Statistical significance was set at P value less than 0.05. Results: Out of 5241 women screened, majority (62.9%) were in the reproductive age group (31–50 years) with mean age of 47.1 ± 10.3 years. The prevalence of precancerous lesions of cervix was 6.37%, which consisted of low-grade squamous intraepithelial lesion (LSIL) in 2.2%, high-grade squamous intraepithelial lesion (HSIL) in 0.5% and Carcinoma-in-situ in 0.2%. Risk factors that had significant association with cervical precancerous lesions were lower education status, genital infections, early marriage age and high parity. Conclusion: Well planned community-based screening programs can help to identify the exact prevalence of cervical pre-cancer in a region and the associated epidemiological factors leading to formulation of effective elimination strategies.
Collapse
|
22
|
Negi J, Nambiar D. Intersectional social-economic inequalities in breast cancer screening in India: analysis of the National Family Health Survey. BMC WOMENS HEALTH 2021; 21:324. [PMID: 34493267 PMCID: PMC8424809 DOI: 10.1186/s12905-021-01464-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 08/14/2021] [Indexed: 11/23/2022]
Abstract
Background Breast cancer incidence rates are increasing in developing countries including India. With 1.3 million new cases of cancer been diagnosed annually, breast cancer is the most common women’s cancer in India. India’s National Family Health Survey (NFHS-4) data 2015–2016 shows that only 9.8% of women between the ages of 15 and 49 had ever undergone breast examination (BE). Further, access to screening and treatment is unequally distributed, with inequalities by socio-economic status. It is unclear, however, if socio-economic inequalities in breast examination are similar across population subgroups. Methods We compared BE coverage in population sub-groups categorised by place of residence, religion, caste/tribal groups, education levels, age, marital status, and employment status in their intersection with economic status in India. We analysed data for 699,686 women aged 15–49 using the NFHS-4 data set conducted during 2015–2016. Descriptive (mean, standard errors, and confidence intervals) of women undergoing BE disaggregated by dimensions of inequality (education, caste/tribal groups, religion, place of residence) and their intersections with wealth were computed with national weights using STATA 12. Chi-square tests were performed to assess the association between socio-demographic factors and breast screening. Additionally, the World Health Organisation’s Health Equity Assessment Toolkit Plus was used to compute summary measures of inequality: Slope index for inequality (SII) and Relative Concentration Indices (RCI) for each intersecting dimension. Results BE coverage was concentrated among wealthier groups regardless of other intersecting population subgroups. Wealth-related inequalities in BE coverage were most pronounced among Christians (SII; 20.6, 95% CI: 18.5–22.7), married (SII; 14.1, 95% CI: 13.8–14.4), employed (SII: 14.6, 95%CI: 13.9, 15.3), and rural women (SII; 10.8, 95% CI: 10.5–11.1). Overall, relative summary measures (RCI) were consistent with our absolute summary measures (SII). Conclusions Breast examination coverage in India is concentrated among wealthier populations across population groups defined by place of residence, religion, age, employment, and marital status. Apart from this national analysis, subnational analyses may also help identify strategies for programme rollout and ensure equity in women’s cancer screening. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01464-5.
Collapse
Affiliation(s)
- Jyotsna Negi
- Independent Consultant, 62 Stratford Rd, Kensington, California, 94707, USA.
| | - Devaki Nambiar
- The George Institute for Global Health, New Delhi, India.,Faculty of Medicine, University of New South Wales, Sydney, Australia.,Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| |
Collapse
|
23
|
Chawla B, Taneja N, Awasthi AA, Kaur KN, Janardhanan R. Knowledge, attitude, and practice on screening toward cervical cancer among health professionals in India-A review. ACTA ACUST UNITED AC 2021; 17:17455065211017066. [PMID: 34396854 PMCID: PMC8371743 DOI: 10.1177/17455065211017066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background: Globally, 570,000 cases of cervical cancer and 311,000 deaths from the
disease occurred in 2018. Cervical cancer is the fourth most common cancer
in women. About 96,922 new cervical cancer cases are diagnosed annually in
India. Objective: To summarize the knowledge, attitude, and practice toward screening of
cervical cancer among health professionals in India. Materials and methods: Health sciences electronic databases PubMed and Google Scholar were searched
for studies published between 2012 and March 2020. Keywords used for the
search were (“CERVICAL CANCER”), (“SCREENING”), (“KNOWLEDGE”), (“ATTITUDE”),
(“PRACTICE”), (“HEALTH PROFESSIONALS”), AND (“INDIA”). A total of 22
articles were included in the review based on the eligibility criteria.
Statistical software SPSS-V.23 was used for the statistical application. Results: A total of 22 studies met the inclusion criteria with total of 6811 health
professionals. The age of the study participants ranged from 18 to 60 years.
The overall knowledge of cervical cancer among health professionals was
75.15%. The knowledge toward signs and symptoms and risk factors was
adequate among health professionals. The knowledge, attitude, and practice
toward screening was 86.20%, 85.47%, and 12.70%, respectively. Conclusion: The health professionals have optimum level of knowledge of cervical cancer
and knowledge of screening of cervical cancer with appropriate attitude
toward screening with low uptake of practice toward screening.
Collapse
Affiliation(s)
- Bhavika Chawla
- Laboratory of Disease Dynamics & Molecular Epidemiology, Amity Institute of Public Health, Amity University, Noida, India
| | - Neha Taneja
- Laboratory of Disease Dynamics & Molecular Epidemiology, Amity Institute of Public Health, Amity University, Noida, India.,Laboratory of Health Data Analytics & Visualization Environment, Amity Institute of Public Health, Amity University, Noida, India
| | - Aanchal Anant Awasthi
- Laboratory of Health Data Analytics & Visualization Environment, Amity Institute of Public Health, Amity University, Noida, India
| | - Karuna Nidhi Kaur
- Laboratory of Disease Dynamics & Molecular Epidemiology, Amity Institute of Public Health, Amity University, Noida, India
| | - Rajiv Janardhanan
- Laboratory of Disease Dynamics & Molecular Epidemiology, Amity Institute of Public Health, Amity University, Noida, India.,Laboratory of Health Data Analytics & Visualization Environment, Amity Institute of Public Health, Amity University, Noida, India
| |
Collapse
|
24
|
Vasishtha G, Mohanty SK. Spatial Pattern of Multidimensional and Consumption Poverty in Districts of India. SPATIAL DEMOGRAPHY 2021. [DOI: 10.1007/s40980-021-00089-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|