Impact of Cancer Awareness Drive on Generating Awareness of and Improving Screening for Cervical Cancer: A Study Among Schoolteachers in India

Behavioral interventions towards knowledge and awareness of reproductive cancer care: A study on select Indians using an online survey

BACKGROUND

The behavioral aspects of human beings influence the incidences of cancer cases directly and indirectly. The factors like positive thinking and motivation were found to change the behavior toward knowledge and awareness of cancer. The main objective of the study is to assess the knowledge and awareness of select Indians about reproductive cancer.

MATERIALS AND METHODS

The online survey method assessed various components of knowledge and awareness about reproductive cancer. A Google Form has been distributed through social media platforms such as e-mail, Instagram, Facebook, and WhatsApp. The coded data has been computed in SPSS (version 25) by IBM (USA) for the analysis. Univariate and bivariate data analysis has been drawn to justify the objective.

RESULTS

Nearly 68 percent of the respondents were aware of reproductive cancer. Among them, 17 percent know about cervical cancer, and 12.5 percent have awareness about breast cancer. Electronic and print media (41.2 percent) were major sources of information about reproductive cancer. Nearly 48 percent of respondents reported that multiple sexual partners and poor sexual hygiene were risk factors for reproductive cancer. Around 57 percent of respondents reported reproductive cancer is preventable, 59 percent knew about cancer screening, and 63.5 percent knew the treatment process. The gender of the respondents was associated (p-value = 0.002) with awareness of reproductive cancer. It has been found that there is a significant association between knowledge of screening tests and the treatment process of reproductive cancer. The marital status of respondents is strongly associated (p-value = 0.000) with the awareness of reproductive cancer.

CONCLUSION

The factors like knowledge of reproductive cancer and awareness proceed as an important role in cancer prevention. A gender-neutral cancer awareness program is needed to increase cancer awareness irrespective of marital status.

A Review on the Use of the HPV Vaccine in the Prevention of Cervical Cancer

The main risk factor for invasive cervical carcinoma is persistent infection by the high-risk human papillomavirus (HPV). HPV is the most prevalent sexually transmitted infection (STI) and has been linked to 15 different cancers. Cervical cancer is one of the most frequent cancers among women, particularly in resource-limited countries. Cervical cancer is an HPV disease with the highest worldwide burden in resource-limited nations. With improved medical care and nationwide screening programmes, the mortality rate from cervical cancer has decreased in the past 40 years. Many developing nations have been shown to have inadequate knowledge and health-seeking practices, making proper awareness and immunisation programmes necessary. The best strategy to reduce the incidence of cervical cancer is through the administration of HPV vaccines along with routine cervical screening. The HPV vaccine is crucial for public health. Vaccinations against all HPV subtypes, namely, bivalent, quadrivalent, and nonavalent, are available. Financial issues are the main barrier to HPV vaccination. The framework for behavioural and social drivers of vaccination, which includes practical concerns, motivation, social processes, thoughts, and feelings, is widely used to uncover important aspects linked with HPV vaccination. The burden of cervical cancer due to HPV and the advantages of HPV vaccination are summarised in this review article.

A blended educational intervention program on Pap-test related behavior among Iranian women

OBJECTIVE

To assess the effect of a blended educational program to promote performing the PST among Iranian women.

DESIGN

In a randomized control trial four main variables; knowledge, attitude, self-efficacy, and practice about PST was evaluated using a man-made questionnaire for PST.

SETTING

Women aged 18-49 living in Andimeshk (Khuzestan, Iran), covered by 16 health centers, participated in study from November 2019 till April 2019.

METHOD

The educational intervention conducted to increasing women's performing the PST. The experimental group received an intervention, whereas the control group received usual care. Participants were tested at four-time points: pre-test (baseline), post-test 1 (immediately after the program's completion) post-test 2 (4 weeks after the program's completion) and post-test 3 (12 weeks after the program completion).

RESULTS

A total of 84 women with average aged 32.27 (42 in the experimental group, 42 in the control group) were recruited from 16 health centers in Andimeshk, southern Iran. Significant group differences were found at different times in knowledge, attitude, self-efficacy, and practice about PST.

CONCLUSION

A blended method was effective in sustaining the effects of the educational program in the experimental group. The development of appropriate teaching method on restricted situation such as COVID-19 pandemic to promote participation is suggested.

Sexual Dysfunction in Carcinoma Cervix: Assessment in Post Treated Cases by LENTSOMA Scale

Treatment for cervical cancer consists of hysterectomy, radiotherapy, chemotherapy and targeted therapy in different combination based on stage at presentation. However, late consequences of such radical treatments are known but not many Indian studies have reported it. Quality of life and impact on sexual health has become an important issue in view of long survival of cervical cancer patients. LENTSOMA scale is one such scale validated for scoring radiotherapy related morbidity. However, there is need for a comprehensive scale covering all aspects of physical and psychological disruptions to provide complete recovery and rehabilitation. The study was prospective and patients who were treated for cervical cancer on follow up were included in this study. A total of 85 patients, who were treated with surgery, radiotherapy, chemotherapy alone or in combination, comprising of stage I to stage IV disease, participated in this study. Findings of this study showed that pain during intercourse and altered sexual life were reported by 32.9% and 25.9% patients respectively whereas 24.7% found it problematic and in 22.3% patients, alteration in interest in sex were reported. Vaginal stenosis was seen in 75.29% of patients after treatment with decreased frequency of intercourse after treatment was seen in 16.4 % of patients. Combination of surgery and radiotherapy in cervical cancer patients caused more sexual dysfunction and dissatisfaction, especially in lower age group. Treatment morbidity in term of sexual function was more with advanced stage disease and with the patients on longer follow up. Sexual function is an important aspect of quality of life but there is no single self-report measure in routine clinical follow up use which is brief, easy to complete and incorporates all (physical, psychological, emotional) aspects of sexual health for people affected by cancer.

The effect of web-based education on Pap smear behaviours of teachers

OBJECTIVE

Web-based education would be useful for gaining health-related behaviours. The aim of the study was to determine the effect of web-based education on Pap smear behaviours of teachers.

METHODS

The study was an experimental-control groups with a longitudinal type. The sample consisted of 1,290 teachers (experimental: 678, control: 612). The educational videos about cervical cancer and Pap smear test were sent to the experimental group via the web. Three months later, the teachers in both groups were contacted by telephone and asked whether they have a Pap smear test or not, reasons for not having it and test results. A qualitative interview was conducted with 20 teachers in the experimental group to evaluate the web-based education.

RESULTS

At the beginning of the study, 25.9% of the teachers in both groups had a Pap smear test. After three months, having a Pap smear test was found to be statistically significantly higher in the experimental group (31.6%) than the control group (23.2%). According to the result of pathology, in the control group cervical cancer (n = 1), in the experimental group CIN1 (n = 1) and HPV53 (n = 1) were diagnosed.

CONCLUSION

The web-based education was found to be effective in Pap smear behaviours of teachers.

Urinary Dysfunction Assessment in Long-Term Survivors of Carcinoma Cervix Using LENT SOMA Scale: An Indian Study Addressing Quality of Life Issues

Background:

Carcinoma cervix is the second most common type of cancer in the world. With the increasing proportion of women surviving carcinoma of the cervix, quality of life has been an important clinical issue. Since there are very few studies from India, this study is to assess urinary dysfunction issues in patients of carcinoma cervix treated with multimodality therapy using the LENT SOMA scores.

Methods:

The study was prospective and patients treated between 1995 - 2007 on follow up were included in this study after ethical clearance. A total of 85 patients were accrued comprising 6 stage IB, 6 stage II A, 25 stage II B, 2 stage IIIA, 45 stage III B and 1 stage IV A disease. Sixty-six patients were treated with radiotherapy in which 46 patients received chemoradiotherapy and 19 had surgery prior to post-operative radiotherapy. The mean age was 47.81 years with a range of 25-68 years. Completion of LENT SOMA scale and Statistical analysis was done.

Results:

Mean score for BU (Bladder/Urethra) was highest (0.0758) in fifth year of treatment whereas UK (Ureter/Kidney score was highest (0.0408) after 4 years. Bladder score was more in 60-69 years of age and in stage IIIB patients of cervical cancers. Bladder morbidity was more in patients who received chemoradiotherapy and in patients who received radiotherapy with boost where Bladder and Urethra morbidity was more in patients who were treated with Extended Field radiation.

Conclusions:

The LENT SOMA system was acceptable and feasible to use and gave us an insight into the morbidity in our patients and to develop effective management plans to reduce the post treatment symptoms and improve quality of life.

HPV Vaccination of Girl Child in India: Intervention for Primary Prevention of Cervical Cancer

Over the past 40 years mortality from carcinoma of the cervix has fallen due to improved treatment and the introduction of national screening programs. Awareness and health-seeking practices have been shown to be poor in many developing countries, necessitating the need for proper awareness and vaccination program The HPV vaccination is of public health importance. The Indian Academy of Pediatrics Committee on Immunization (IAPCOI) recommends offering HPV vaccine to all females who can afford the vaccine. Vaccination can be given to females as young as 9 years as well as in those aged 13–26 years who have not previously completed vaccination. The primary obstacle to HPV vaccination is financial. There are bivalent, Quadrivalent and Nonavalent HPV vaccines available based on protection against number of HPV subtypes. HPV vaccination and regular cervical screening is the most effective way to prevent cervical cancer. Parents/caregivers of child must be educated regarding HPV vaccination before offering this chemoprophylaxis against cervical cancer. Gaps and barriers to the access and delivery of HPV vaccination need to be identified, so that scientific and public health communities and civil society can be mobilised to adopt the vaccination policy.