Knowledge, attitudes, and practices regarding cervical cancer screening among women in metropolitan Lima, Peru: a cross-sectional study

Ethnic inequalities in coverage and use of women's cancer screening in Peru

OBJECTIVE

This study aimed to assess ethnic inequalities in the coverage and utilization of cancer screening services among women in Peru.

METHODS

Data from the 2017-2023 Demographic and Family Health Survey in Peru were analyzed to evaluate ethnic disparities in screening coverage for breast and cervical cancer, including clinical breast examination (CBE), Pap smear test (PST), and mammography. Measures such as the GINI coefficient and Slope Index of Inequality (SII) were used to quantify coverage and utilization disparities among ethnic groups.

RESULTS

The study included 70,454 women aged 30-69. Among women aged 40-69, 48.31% underwent CBE, 84.06% received PST, and 41.69% underwent mammography. It was found inequalities in coverage for any cancer screening (GINI: 0.10), mammography (GINI: 0.21), CBE (GINI: 0.19), and PST (GINI: 0.06), in 25 Peruvian regions. These inequalities were more pronounced in regions with larger populations of Quechua, Aymara, and Afro-Peruvian women. In rural areas, Quechua or Aymara women (SII: -0.83, -0.95, and - 0.69, respectively) and Afro-Peruvian women (SII: -0.80, -0.92, and - 0.58, respectively) experienced heightened inequalities in the uptake of CBE, mammography, and PST, respectively. Like Quechua or Aymara women (SII: -0.50, SII: -0.52, and SII: -0.50, respectively) and Afro-Peruvian women (SII: -0.50, SII: -0.58, and SII: -0.44, respectively) with only a primary education.

CONCLUSION

Ethnic inequalities affect breast and cervical cancer screening coverage across regions in Peru. In Quechua, Aymara, and Afro-Peruvian women the uptake of mammography, CBE, and PST was less frequently than their white or mestizo counterparts. These inequalities are attributed to sociodemographic conditions such as lower education levels and residence in rural or non-capital areas.

Factors associated with utilization of cervical cancer screening services among HIV-positive women aged 18 to 49 years at Lira regional referral hospital, Northern Uganda

BACKGROUND

Women with HIV have a higher risk of getting cervical cancer due to induced immunosuppression. Though this burden could be avoided through early identification and appropriate management, there is a paucity of information about the utilization of cervical cancer screening (CCS) services in Lira City, Uganda. This study investigated the level and factors associated with the utilization of cervical cancer screening services among HIV-positive women aged 18 to 49 years at Lira Regional Referral Hospital, Lira City, Uganda.

METHODS

We conducted a facility-based cross-sectional study employing quantitative techniques. We used consecutive sampling to recruit 297 HIV-positive women at the ART clinic of Lira Regional Referral Hospital. A structured researcher-administered questionnaire was used to collect data. Descriptive statistics were performed to summarize the data. A modified Poisson regression using robust standard errors was performed to ascertain the factors associated with the utilization of cervical cancer screening. Prevalence ratios at 95% confidence intervals were reported.

RESULTS

Out of 297 respondents, 175(58.9%) utilized cervical cancer screening in this study. The factors found to be associated with CCS were; having ever heard of CCS (Adjusted Prevalence Ratio [PR] 1.80, 95% CI 1.31-2.49, p < 0.001), knowing where CCS is done (Adjusted PR 1.99, 95% CI 1.42-2.81, p < 0.001), fear of CCS outcomes (Adjusted PR 0.67, 95% CI 0.54-0.84,p < 0.001), not knowing whether CCS is beneficial or not (Adjusted PR 0.39, 95% CI 0.20-0.75,p = 0.005) and having friends/relatives who screened for cervical cancer (Adjusted PR 1.31, 95% CI 1.09-1.59, p = 0.005).

CONCLUSION

The level of utilization of cervical cancer screening services among HIV-positive women was suboptimal. Implementation of structured interventions aimed at improving cervical cancer screening awareness among HIV-positive women is crucial. Additionally, to increase opportunities for screening and knowledge on cervical cancer prevention, screening programs can target HIV-positive women during their routine clinic visits.

Determination of the Relationship Between Gynecological Cancer Awareness and Fear of Cancer in Women Using Social Media and the Affecting Factors

BACKGROUND

Understanding the relationship between fear of gynecological cancer and awareness of cancer in women may help oncology nurses increase women's participation in gynecological cancer screening.

OBJECTIVE

To examine the relationship between women's gynecological cancer awareness and cancer fear using social media and the affecting factors.

METHODS

In a descriptive and cross-sectional study design, online data were collected from 1231 women aged 20 to 69 years through social media using the Descriptive Information Form, the Gynecological Cancer Awareness Scale (GCAS), and the Cancer Worry Scale (CWS). Analytic tests included paired t tests, analysis of variance, and post hoc correlations and structural equation modeling.

RESULTS

The women's total mean GCAS score was above moderate (152 ± 17), and their mean CWS score was high (19 ± 5). There was no relationship between the GCAS and CWS mean scores. Characteristics of participants with high awareness of gynecological cancer were being young, having a high educational level, having children, living in a province, having a history of cancer or family history of cancer, and having regular gynecological examinations, Papanicolaou smear tests, breast self-examination, and vulva examinations (P < .05). The fear of cancer was higher in women with children, a family history of cancer, and regular gynecological examination behaviors (P < .05).

CONCLUSION

Awareness of gynecological cancer was not significantly statistically associated with fear of cancer. Certain sociodemographic and gynecological characteristics are associated with awareness of gynecological cancer and/or fear of cancer.

IMPLICATIONS FOR PRACTICE

Oncology nurses may plan individualized or large-scale educational events that may make use of social media to enhance accurate awareness of gynecological cancer and related examinations in women.

Using Delphi method to develop Chinese women's cervical cancer screening intention scale based on planned behavior theory

BACKGROUND

Cervical cancer is the most common malignant tumor in women with a high mortality rate. However, the awareness and participation of women in cervical cancer screening were not high, and rare attention was paid to cervical cancer screening. The extensive promotion and execution of cervical cancer screening in China are still facing difficulties. In order to fully comprehend and evaluate the barriers and promote factors of cervical cancer screening in women, the objective of this study was to develop a scientifically sound and clinically useful Chinese cervical cancer screening intention scale. This study would allow for the development of targeted interventions which may contribute to the increase of individual participation in cervical cancer screening going forward.

METHODS

This study used the Delphi method to construct a Chinese cervical cancer screening intention scale based on the theory of planned behavior (TPB) and evaluate its validity. The study was based on the overview of the TPB questionnaire proposed by Ajzen, and was conducted through the literature search and two rounds of the Delphi expert consultation. According to the literature search published from 2012 to 2022, the scale item pool was established and a questionnaire was designed. A survey of 16 experts from 6 different provinces, cities and regions in China was conducted, and the Delphi technique was used to collect and analyze expert opinions data.

RESULTS

The final scale consisted of 4 dimensions and 23 items. The response rates in two rounds of expert consultation were 80% and 93.75%, respectively, with authority coefficients of 0.928 and 0.930. Variation coefficients varied from 0.07 to 0.21. Dimensions included "attitude towards behavior", "subjective norm", "perceived behavioral control" and "behavioral intention".

CONCLUSIONS

Women's cervical cancer screening intentions could be assessed with the scale, since it had high validity and reliability, as well as high authority and coordination, meanwhile affording explanations and improving the efficiency of interventions.