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Assefa AA, Feleke T, G/Tsadik SA, Degela F, Zenebe A, Abera G. Utilization and associated factors of cervical cancer screening service among eligible women attending maternal health services at Adare General Hospital, Hawassa city, Southern Ethiopia. Sci Rep 2024; 14:2774. [PMID: 38307895 PMCID: PMC11239803 DOI: 10.1038/s41598-024-52924-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 01/25/2024] [Indexed: 02/04/2024] Open
Abstract
This particular study aimed to assess the magnitude of cervical cancer screening service utilization and associated factors among eligible women attending maternal health services at Adare General Hospital, Hawassa city, Southern Ethiopia, 2022. Institution-based cross-sectional study was conducted using a systematic random sampling technique among 299 eligible women from March 1- to April 30, 2022. Data was collected through face-to-face interviews using a pretested structured questionnaire. Data was also entered into Epi-data version 3.1 and exported to SPSS version 25.0 for analysis. Both bivariable and multi-variable logistic regression model was fitted and the presence of association was declared at a p value of less than 0.05. The strenth of association was determined using adjusted odd ratios together with a 95% confidence interval. Among interviewed women, 19.8% (95% CI 15.5%, 24.0%) of them had screened for cervical cancer at least once within the past five years. Place of residence (AOR = 0.37; 95% CI 0.14-0.96), modern contraception use (AOR = 2.49; 95% CI 1.04-5.96), discussion about cervical cancer with healthcare providers (AOR = 2.34; 95% CI 1.08-5.07), and comprehensive knowledge about cervical cancer (AOR = 0.25; 95% CI 0.10-0.62) were independently associated with cervical cancer screening service utilization. The study depicted relatively low utilization of cervical cancer screening services. The women were more likely to utilize the service if they are dwellers of urban residences, used modern contraception, had discussion about cervical cancer with healthcare providers, and had good comprehensive knowledge about cervical cancer. Thus, women living in rural areas should get more emphasis on cervical cancer prevention strategies, and improving consistent discussion about cervical cancer with clients visiting for maternal health services by healthcare providers in health facilities also be recommended.
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Affiliation(s)
- Abiyu Ayalew Assefa
- Department of Public Health, Hawassa College of Health Sciences, P.O. Box 84, Hawassa, Ethiopia.
| | - Tihun Feleke
- Hawassa College of Health Sciences, Research and Community Service Directorate, P.O. Box 84, Hawassa, Ethiopia
| | | | - Fekadu Degela
- Department of Public Health, Hawassa College of Health Sciences, P.O. Box 84, Hawassa, Ethiopia
| | - Andualem Zenebe
- Department of Public Health, Hawassa College of Health Sciences, P.O. Box 84, Hawassa, Ethiopia
| | - Geleta Abera
- Department of Public Health, Hawassa College of Health Sciences, P.O. Box 84, Hawassa, Ethiopia
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Luizaga CTDM, Jardim BC, Wünsch V, Eluf J, Silva GAE. Recent changes in trends of mortality from cervical cancer in Southeastern Brazil. Rev Saude Publica 2023; 57:25. [PMID: 37075421 PMCID: PMC10118416 DOI: 10.11606/s1518-8787.2023057004709] [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: 03/18/2022] [Accepted: 07/08/2022] [Indexed: 04/21/2023] Open
Abstract
OBJECTIVE To analyze the trends of cervical cancer mortality in Brazilian Southeastern states, and to compare them to Brazil and other regions between 1980 and 2020. METHODS Time series study based on data from the Sistema de Informações de Mortalidade (Brazilian Mortality Information System). Death data were corrected by proportional redistribution of deaths from ill-defined causes and cervical cancer of unspecified portion. Age-standardized and age-specific rates were calculated by screening target (25-39 years; 40-64 years) and non-target (65 years or older) age groups. Annual percentage changes (APC) were estimated by linear regression model with breakpoints. The coverage of Pap Smear exam in the Unified Health System (SUS) was evaluated between 2009 and 2020 according to age group and locality. RESULTS There were increases in corrected mortality rates both in 1980 and in 2020 in all regions, with most evident increments at the beginning of the series. There was a decrease in mortality nationwide between 1980-2020; however, the state of São Paulo showed a discrete upward trend in 2014-2020 (APC=1.237; 95%CI 0.046-2.443). Noteworthy is the trend increment in the 25-39 year-old group in all study localities, being sharper in the Southeast region in 2013-2020 (APC=5.072; 95%CI 3.971-6.185). Screening coverage rates were highest in São Paulo and lowest in Rio de Janeiro, with a consistent decline from 2012 onwards at all ages. CONCLUSIONS São Paulo is the first Brazilian state to show a reversal trend in mortality from cervical cancer. The changes in mortality patterns identified in this study point to the need for reorganization of the current screening program, which should be improved to ensure high coverage, quality, and adequate follow-up of all women with altered test results.
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Affiliation(s)
| | - Beatriz Cordeiro Jardim
- Universidade do Estado do Rio de JaneiroInstituto de Medicina Social Hesio CordeiroRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social Hesio Cordeiro. Rio de Janeiro, RJ, Brasil
- nstituto Nacional de CâncerRio de JaneiroRJBrasilInstituto Nacional de Câncer. Rio de Janeiro, RJ, Brasil
| | - Victor Wünsch
- Fundação Oncocentro de São PauloSão PauloSPBrasilFundação Oncocentro de São Paulo. São Paulo, SP, Brasil
- Universidade de São PauloFaculdade de Saúde PúblicaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. São Paulo, SP, Brasil
| | - José Eluf
- Universidade de São PauloFaculdade de MedicinaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Medicina. São Paulo, SP, Brasil
| | - Gulnar Azevedo e Silva
- Universidade do Estado do Rio de JaneiroInstituto de Medicina Social Hesio CordeiroRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social Hesio Cordeiro. Rio de Janeiro, RJ, Brasil
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Omoyeni O, Tsoka-Gwegweni J. Knowledge, attitudes and practices of cervical cancer screening among rural women in KwaZulu-Natal, South Africa. Pan Afr Med J 2022; 42:188. [PMID: 36212930 PMCID: PMC9508371 DOI: 10.11604/pamj.2022.42.188.26172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 09/01/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION cervical cancer continues to be a major cause of morbidity and mortality among women in the developing world. Despite the national cervical cancer screening programme, findings show low levels of knowledge and practices of cervical cancer screening among rural women in South Africa (SA). The purpose of this study was to determine the knowledge, attitudes and practices of cervical cancer screening among rural women in KwaZulu-Natal, SA. METHODS an observational cross-sectional study was performed. The study was conducted at three rural clinics. A systematic sampling technique was used to select 283 women, aged 18-65 years. Data were collected using a standardised structured self-administered questionnaire. Data were analysed using descriptive and analytic statistics. RESULTS findings showed a high level of awareness of cervical cancer (93.3%, n=264) and the Pap smear test (95.1%, n=269). Knowledge of cervical cancer-associated factors, symptoms, screening methods and treatment was poor (28.0%, n=79). An overwhelming majority (81.8%, n=231) displayed a positive attitude towards cervical cancer screening. The practice of cervical cancer screening was fairly good (66.8%, n=189). The results showed that socio-demographics were not statistically significantly associated with knowledge of cervical cancer and cervical cancer screening. CONCLUSION despite the inadequate knowledge of women, attitudes towards cervical cancer and screening were generally positive. Health care practitioners are encouraged to focus not only on creating awareness but also on improving knowledge so as women will not only undergo screening but appreciate the importance of cervical cancer screening.
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Affiliation(s)
- Oluwatosin Omoyeni
- Department of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, KwaZulu-Natal, South Africa
| | - Joyce Tsoka-Gwegweni
- Department of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, KwaZulu-Natal, South Africa,,Office of the Dean, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa,Corresponding author: Joyce Tsoka-Gwegweni, Office of the Dean, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
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Yadav K, Hariprasad R, Gupta R, Upadhayay S, Sharma V, Kumari M, Mehrotra R, Kumar S, Gupta S, Singh S. Cancer awareness & its association with demographic variables & mobile phone usage among the rural population of a district in north India. Indian J Med Res 2022; 156:94-103. [PMID: 36510902 PMCID: PMC9903391 DOI: 10.4103/ijmr.ijmr_3145_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background & objectives Lack of awareness is one of the major reasons for the high morbidity and mortality associated with cancers. The present study was aimed to evaluate the awareness of prevalent cancers among the rural population in a district of north India and its association specifically with mobile phone usage. Methods Using a stratified random sampling technique, households in three villages of Gautam Buddh Nagar district of India were selected. A house-to-house survey on cancer awareness was conducted among adults in selected households and data were analyzed to check for the association of such an awareness with sociodemographic factors and internet usage. Results The study included 59 males and 145 females, with majority (115) being in the age group of 18-30 yr. Although most (96.5%) of the participants were aware of cancer, the common risk factors and warning signs of cancer were known to only a few. Specific risk factors for cervical and breast cancers were, however, not known to a majority (79.9% and 72.2%). A significant association between the awareness of general risk factors and warning signs as well as specific aspects including risk factors for breast, cervical and oral cancer, HPV vaccine and the education level of the participants (P<0.05 for all). Knowledge of risk factors, warning signs and cancer prevention modalities was higher among mobile phone users who accessed internet for health information. There was no significant association between age group and cancer risk factor awareness, though females were more aware of the risk factors for breast cancer (P=0.002). Interpretation & conclusions The findings of this study highlight the existing low level of awareness of cervical and breast cancers among the rural population. The association of cancer awareness with education level and mobile phone-based internet usage suggests the potential utility of internet-based platforms such as m-health programmes for cancer prevention activities.
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Affiliation(s)
- Kavita Yadav
- Division of Cytopathology, ICMR-National Institute for Cancer Prevention & Research, Noida, Uttar Pradesh, India
| | - Roopa Hariprasad
- Division of Clinical Oncology, ICMR-National Institute for Cancer Prevention & Research, Noida, Uttar Pradesh, India
| | - Ruchika Gupta
- Division of Cytopathology, ICMR-National Institute for Cancer Prevention & Research, Noida, Uttar Pradesh, India
| | - Shravan Upadhayay
- Division of WHO FCTC Global Knowledge Hub on Smokeless Tobacco, ICMR-National Institute for Cancer Prevention & Research, Noida, Uttar Pradesh, India
| | - Vishwas Sharma
- Division of Cytopathology, ICMR-National Institute for Cancer Prevention & Research, Noida, Uttar Pradesh, India
| | - Malasha Kumari
- Division of Cytopathology, ICMR-National Institute for Cancer Prevention & Research, Noida, Uttar Pradesh, India
| | - Ravi Mehrotra
- Department of Health Research, Indian Cancer Research Consortium, Delhi, India
| | - Sanjeev Kumar
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Sanjay Gupta
- Division of Cytopathology, ICMR-National Institute for Cancer Prevention & Research, Noida, Uttar Pradesh, India,For correspondence: Dr Sanjay Gupta, Division of Cytopathology, ICMR-National Institute of Cancer Prevention and Research, I-7, Sector-39, Noida 201 301, Uttar Pradesh, India e-mail:
| | - Shalini Singh
- Division of Clinical Oncology, ICMR-National Institute for Cancer Prevention & Research, Noida, Uttar Pradesh, India
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Gupta R, Kumar N, Sood N, Sharda A, Kumar D, Gupta S. Knowledge, Practice, and Skills in Cytology-Based Cervical Cancer Screening: Impact Assessment of Training Workshop for the Pathologists. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:58-64. [PMID: 32514726 DOI: 10.1007/s13187-020-01785-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
There is a paucity of trained cytopathologists in low-resource settings for effective cervical cancer screening. There has been no documented report of the impact of a dedicated training program in cervical cytology on pathologists' knowledge and skill in this field. The present study aimed to evaluate the efficacy of the regularly conducted training workshops on the attending pathologists' knowledge, practice, and skills in cervicovaginal smear reporting. Our institute, a premier cancer research institute, has conducted 10 cytology-based cervical cancer screening workshops for pathologists with pre- and post-training evaluation using sets of digital images and a questionnaire (knowledge score). Additionally, feedback on diagnostic skills was taken at a 1-month and 6-month interval post-workshop using a separate set of digital images of cervical lesions. A Google form-based questionnaire was designed to seek the participants' feedback on the perceived improvement in knowledge and skills. All the data thus collected were analyzed to assess the efficacy of these workshops in imparting the desired knowledge and skills. A total of 350 participants were enrolled in these workshops. The average knowledge score improved from 10.56 (± 3.23) in the pre-training questionnaire to 21.17 (± 2.41) in the post-training evaluation, making a 100.5% increase (P < 0.001). Similarly, the diagnostic accuracy on digital images was enhanced from 8.6 (± 2.12) to 19.5 (± 4.28) immediately post-training and was maintained at 17.6 (± 3.87) at 1-month and 16.4 (± 4.26) at a 6-month interval (P < 0.001). The majority of the participants reported fair to a marked improvement in their knowledge, practice, and confidence in reporting cervical cytology in the response to form-based questionnaire. One-fifth of the responders also acknowledged the assistance of the knowledge gained during the workshop in refinement or initiation of cervical cytology at their set-up. Our experience of conducting these regular workshops demonstrates the utility of such training programs in human resource development in the field of cervical cytology for enhancement of cervical cancer screening in resource-constrained settings.
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Affiliation(s)
- Ruchika Gupta
- Division of Cytopathology, ICMR-National Institute of Cancer Prevention and Research, I-7, Sector-39, Noida, 201301, India
| | - Neeta Kumar
- Department of Pathology, Faculty of Dentistry, Jamia Millia Islamia (Central University), New Delhi, India
| | - Neelam Sood
- Department of Pathology, Deen Dayal Upadhyay Hospital, Hari Nagar, New Delhi, India
| | - Akhileshwar Sharda
- Division of Cytopathology, ICMR-National Institute of Cancer Prevention and Research, I-7, Sector-39, Noida, 201301, India
| | - Dinesh Kumar
- Division of Cytopathology, ICMR-National Institute of Cancer Prevention and Research, I-7, Sector-39, Noida, 201301, India
| | - Sanjay Gupta
- Division of Cytopathology, ICMR-National Institute of Cancer Prevention and Research, I-7, Sector-39, Noida, 201301, India.
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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.
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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
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Nwaozuru U, Obiezu-Umeh C, Obi-Jeff C, Shato T, Gbaja-Biamila T, Oladele D, Idigbe I, Tucker J, Ezechi O, Iwelunmor J. A systematic review of randomized control trials of HPV self-collection studies among women in sub-Saharan Africa using the RE-AIM framework. Implement Sci Commun 2021; 2:138. [PMID: 34911573 PMCID: PMC8672475 DOI: 10.1186/s43058-021-00243-5] [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: 01/19/2021] [Accepted: 11/17/2021] [Indexed: 12/24/2022] Open
Abstract
Introduction Self-collection of samples for HPV testing may increase women’s access to cervical cancer screening in low- and middle-income settings. However, implementation remains poor in many regions. The purpose of this systematic review was to examine implementation data from randomized controlled trials evaluating human papillomavirus (HPV) self-collection testing among women in sub-Saharan Africa using the RE-AIM (Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance) framework. Methods We searched four electronic databases (PubMed, CINAHL, Web of Science, and Global Health) for pragmatic randomized controlled trials that promote HPV self-collection among women in sub-Saharan Africa. Study selection and data extraction were conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) checklist. Two researchers independently extracted information from each article using a RE-AIM data extraction tool. The reporting of RE-AIM dimensions was summarized and synthesized across included interventions. Results We identified 2008 citations, and eight studies were included. These reported on five unique interventions. The five interventions were conducted in five countries: Cameroon, Ethiopia, Kenya, Nigeria, and Uganda. Intervention reach (80%) was the most commonly reported RE-AIM dimension, followed by adoption (56%), efficacy/effectiveness (52%), implementation (47%), and maintenance (0%). All the interventions described increased uptake of HPV testing among study participants (effectiveness). However, the majority of the studies focused on reporting internal validity indicators such as inclusion criteria (100%) and exclusion criteria (100%), and few reported on external validity indicators such as participation rate (40%), intervention cost (40%), staff selection (20%), and cost of maintenance (0%). Conclusions Our review highlights the under-reporting of external validity indicators such as participation rate, intervention, and maintenance costs in studies of self-collection for HPV testing among women in SSA. Future research should focus on including factors that highlight internal validity factors and external validity factors to develop a greater understanding of ways to increase not only reach but also implementation and long-term maintenance of these interventions. Such data may advance the translation of HPV interventions into practice and reduce health disparities in SSA. Findings highlight the need for innovative tools such as participatory learning approaches or open challenges to expand knowledge and assessment of external validity indicators to ultimately increase the uptake of HPV testing among women in SSA. Supplementary Information The online version contains supplementary material available at 10.1186/s43058-021-00243-5.
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Affiliation(s)
- Ucheoma Nwaozuru
- College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette, Ave, Saint Louis, Missouri, 63104, USA
| | - Chisom Obiezu-Umeh
- College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette, Ave, Saint Louis, Missouri, 63104, USA
| | - Chisom Obi-Jeff
- Direct Consulting and Logistics, Federal Capital Territory, Abuja, Nigeria
| | - Thembekile Shato
- Implementation Science Center for Cancer Control and Prevention Research Center, Brown School, Washington University in St. Louis, One Brookings Drive, Campus Box, 1196, St. Louis, Missouri, 63130, USA
| | - Titilola Gbaja-Biamila
- Clinical Sciences Division, Nigerian Institute of Medical Research, Medical Compound, 6 Edmund Crescent, Yaba, Lagos, Nigeria
| | - David Oladele
- Clinical Sciences Division, Nigerian Institute of Medical Research, Medical Compound, 6 Edmund Crescent, Yaba, Lagos, Nigeria
| | - Ifeoma Idigbe
- Clinical Sciences Division, Nigerian Institute of Medical Research, Medical Compound, 6 Edmund Crescent, Yaba, Lagos, Nigeria
| | - Joseph Tucker
- University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.,London School of Hygiene and Tropical Medicine, London, UK
| | - Oliver Ezechi
- Clinical Sciences Division, Nigerian Institute of Medical Research, Medical Compound, 6 Edmund Crescent, Yaba, Lagos, Nigeria
| | - Juliet Iwelunmor
- College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette, Ave, Saint Louis, Missouri, 63104, USA.
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Atnafu T, Daka DW, Debela TF, Ergiba MS. Women's Satisfaction with Cervical Cancer Screening Services and Associated Factors in Maternal Health Clinics of Jimma Town Public Health Facilities, Southwest Ethiopia. Cancer Manag Res 2021; 13:7685-7696. [PMID: 34675665 PMCID: PMC8504707 DOI: 10.2147/cmar.s327369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/24/2021] [Indexed: 11/23/2022] Open
Abstract
Background Despite the existence of proven interventions for cervical cancer, low coverage and uptake of existing screening and treatment services remains the main challenge to prevention and control of cervical cancer in developing countries. This study aimed to assess women’s satisfaction with cervical cancer screening services and factors associated with it in public health facilities of Jimma town, Southwest Ethiopia. Methods A facility-based cross-sectional study was conducted from March 20 to May 20, 2020. All women aged between 30 and 49 years who visited health facilities during the data collection period were interviewed consecutively. Composite variables were computed from existing data for satisfaction, knowledge, and attitude. A 95% confidence interval was constructed for all outcome variables and multivariate logistic regression was used to identify predictors of satisfaction. Results Out of 205 interviewed women, 41% (95% CI: 34–47) were satisfied with cervical cancer screening services. One-hundred and seventeen (57%, 95% CI: 50–64) women had good comprehensive knowledge of cervical cancer screening and 121 (59%, 95% CI: 52–66) had favorable attitude. Satisfaction with cervical cancer screening service was statistically associated with occupational status, religion, perceived length of waiting time to see a provider, and knowledge of cervical cancer. Conclusion Satisfaction with cervical cancer screening services was low in public health facilities of Jimma town. Slightly more than half of women had good knowledge and favorable attitude regarding cervical cancer screening. Among the clinical factors, only perceived length of waiting time to see a provider and women’s knowledge of cervical cancer were statistically associated with satisfaction with screening services. Therefore, efforts should be made to improve level of satisfaction, knowledge and attitude of women toward cervical cancer and screening services.
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Affiliation(s)
- Tigist Atnafu
- Department of Planning, Monitoring and Evaluation, Jimma Medical Center, Jimma, Ethiopia
| | - Dawit Wolde Daka
- Department of Health Policy and Management, Jimma University, Jimma, Ethiopia
| | - Tilahun Fufa Debela
- Department of Health Policy and Management, Jimma University, Jimma, Ethiopia
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Gupta R, Sharda A, Kumar D, Fulzele R, Dwivedi R, Gupta S. Cervical Cancer Screening: Is the Age Group 30-65 Years Optimum for Screening in Low-Resource Settings? J Obstet Gynaecol India 2021; 71:530-536. [PMID: 34602765 DOI: 10.1007/s13224-021-01479-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/22/2021] [Indexed: 12/01/2022] Open
Abstract
Background An Operational Framework document for population-wide screening of common cancers in India was launched in 2016. The target age for screening is 30-65 years for cervical, breast and oral cancers. This study was designed to review the frequency and distribution of cervical lesions among women aged 21-29, 30-65 and > 65 years. Study Design A retrospective review of all satisfactory cervical smears (n = 79,896) received over a ten-year period (2010-2019) was conducted. Three age bands were defined: 21-29 years, 30-65 years and > 65 years. The frequency and distribution of the various epithelial cell abnormalities (ECAs) across the three age bands were calculated. Cytohistologic correlation was performed wherever available. Results Of the 1357 ECAs (1.7% of all smears), about 16.9% were seen in the age band 21-29 years, while 4.5% presented in > 65 years of age. About 80% of the ECAs seen in younger women were low-grade squamous lesions, while 75% of lesions in women > 65 years were high-grade squamous abnormalities. Among the total 512 significant high-grade and malignant (squamous and glandular) lesions, 5.6% presented in women 21-29 years, while 10.1% were seen in > 65 years of age. Conclusion Majority of the significant cervical lesions would be detected if the screening focuses on the 30-65 years age group. However, about 19% of high-grade squamous preneoplastic lesions (ASC-H/ HSIL) and 13% of preneoplastic glandular lesions (AGC-N) are likely to be missed if women 21-29 years and > 65 years are excluded. The cost of screening incurred by including these age groups has to be weighed against the benefits derived, especially in low-resource settings. In the absence of universal implementation of HPV immunization, there is a felt need to enhance cervical cancer awareness and encourage screening, more so in high-risk category and symptomatic females beyond the selected age group.
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Affiliation(s)
- Ruchika Gupta
- Division of Cytopathology, ICMR-National Institute of Cancer Prevention and Research, I-7, Sector-39, Noida, Uttar Pradesh 201301 India
| | - Akhileshwar Sharda
- Division of Cytopathology, ICMR-National Institute of Cancer Prevention and Research, I-7, Sector-39, Noida, Uttar Pradesh 201301 India
| | - Dinesh Kumar
- Division of Cytopathology, ICMR-National Institute of Cancer Prevention and Research, I-7, Sector-39, Noida, Uttar Pradesh 201301 India
| | - Rajshree Fulzele
- Division of Clinical Oncology, ICMR-National Institute of Cancer Prevention and Research, I-7, Sector-39, Noida, Uttar Pradesh 201301 India
| | - Reena Dwivedi
- Division of Clinical Oncology, ICMR-National Institute of Cancer Prevention and Research, I-7, Sector-39, Noida, Uttar Pradesh 201301 India
| | - Sanjay Gupta
- Division of Cytopathology, ICMR-National Institute of Cancer Prevention and Research, I-7, Sector-39, Noida, Uttar Pradesh 201301 India
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Alfaro K, Maza M, Cremer M, Masch R, Soler M. Removing global barriers to cervical cancer prevention and moving towards elimination. Nat Rev Cancer 2021; 21:607-608. [PMID: 34376828 PMCID: PMC8353608 DOI: 10.1038/s41568-021-00396-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Cervical cancer is a disease of inequality. The majority of cervical cancer cases can be prevented through vaccination against the human papillomavirus (HPV) (primary prevention) and screening and early treatment of precancerous lesions caused by HPV infections (secondary prevention), and it can be controlled if treated in early stages (tertiary prevention). However, significant gaps in access to care have shifted the burden of disease to resource-poor countries in Africa, Asia and Latin America. The recent World Health Organization’s Call to Action to eliminate cervical cancer is a unique opportunity to galvanize change and remove barriers to prevention and care.
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Affiliation(s)
- Karla Alfaro
- Basic Health International, San Salvador, El Salvador.
| | - Mauricio Maza
- Basic Health International, San Salvador, El Salvador
| | - Miriam Cremer
- Basic Health International, Pittsburgh, PA, USA
- Ob/Gyn and Women's Health Institute, Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
| | | | - Montserrat Soler
- Basic Health International, Pittsburgh, PA, USA
- Ob/Gyn and Women's Health Institute, Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
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Zamani M, Robson JM, Fan A, Bono MS, Furst AL, Klapperich CM. Electrochemical Strategy for Low-Cost Viral Detection. ACS CENTRAL SCIENCE 2021; 7:963-972. [PMID: 34235257 PMCID: PMC8227598 DOI: 10.1021/acscentsci.1c00186] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Indexed: 05/08/2023]
Abstract
Sexually transmitted infections, including the human immunodeficiency virus (HIV) and the human papillomavirus (HPV), disproportionally impact those in low-resource settings. Early diagnosis is essential for managing HIV. Similarly, HPV causes nearly all cases of cervical cancer, the majority (90%) of which occur in low-resource settings. Importantly, infection with HPV is six times more likely to progress to cervical cancer in women who are HIV-positive. An inexpensive, adaptable point-of-care test for viral infections would make screening for these viruses more accessible to a broader set of the population. Here, we report a novel, cost-effective electrochemical platform using gold leaf electrodes to detect clinically relevant viral loads. We have combined this platform with loop-mediated isothermal amplification and a CRISPR-based recognition assay to detect HPV. Lower limits of detection were demonstrated down to 104 total copies of input nucleic acids, which is a clinically relevant viral load for HPV DNA. Further, proof-of-concept experiments with cervical swab samples, extracted using standard extraction protocols, demonstrated that the strategy is extendable to complex human samples. This adaptable technology could be applied to detect any viral infection rapidly and cost-effectively.
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Affiliation(s)
- Marjon Zamani
- Department
of Biomedical Engineering, Boston University, Boston, Massachusetts 02215, United States
| | - James M. Robson
- Department
of Biomedical Engineering, Boston University, Boston, Massachusetts 02215, United States
| | - Andy Fan
- Department
of Biomedical Engineering, Boston University, Boston, Massachusetts 02215, United States
| | - Michael S. Bono
- Department
of Biomedical Engineering, Boston University, Boston, Massachusetts 02215, United States
| | - Ariel L. Furst
- Department
of Chemical Engineering, Massachusetts Institute
of Technology, Cambridge, Massachusetts 02139, United States
- (A.L.F.)
| | - Catherine M. Klapperich
- Department
of Biomedical Engineering, Boston University, Boston, Massachusetts 02215, United States
- (C.M.K.)
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12
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Knowledge, attitude, practice, and self-efficacy of women regarding cervical cancer screening. Obstet Gynecol Sci 2020; 64:216-225. [PMID: 33355856 PMCID: PMC7991003 DOI: 10.5468/ogs.20236] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 10/14/2020] [Indexed: 12/17/2022] Open
Abstract
Objective Iran has a low incidence of cervical cancer (CC). The country is introducing an organized screening system, including human papillomavirus screening. Studies show a high dropout rate among eligible women in continuing testing. Methods This descriptive-analytic study was part of the first phase of a clinical trial conducted on a random sample of 400 women aged 18–49 in Andimeshk City, Khuzestan Province, in 2020. The data collection tool consisted of a man-made questionnaire that included domains of demographic characteristics, knowledge, attitude, practice, and self-efficacy in the Pap smear test. The data were analyzed with Stata-16 using linear and logistic regression models. Results The mean knowledge, attitude, and self-efficacy scores were 6.80±2.33, 34.99±4.32, and 28.67±7.34, respectively. In the multiple models, every unit increase in the knowledge or attitude scores raised the mean self-efficacy score by 1.04 and 0.48, respectively (P<0.001). Every unit increase in the knowledge and self-efficacy scores increased the chance of performing Pap smear 1.61 and 1.41 times, respectively (P<0.001). Conclusion Given the association of women’s knowledge and self-efficacy with practice in performing the Pap smear, it seems that an effective program promoting women’s health behavior regarding CC screening would include applied education to raise community awareness and improve women’s attitudes, self-efficacy, and practice.
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13
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Human Papillomavirus Infection and Cervical Cancer: Epidemiology, Screening, and Vaccination-Review of Current Perspectives. JOURNAL OF ONCOLOGY 2019; 2019:3257939. [PMID: 31687023 PMCID: PMC6811952 DOI: 10.1155/2019/3257939] [Citation(s) in RCA: 183] [Impact Index Per Article: 36.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 09/04/2019] [Accepted: 09/09/2019] [Indexed: 02/07/2023]
Abstract
Viral infections contribute as a cause of 15–20% of all human cancers. Infection by oncogenic viruses can promote different stages of carcinogenesis. Among many types of HPV, around 15 are linked to cancer. In spite of effective screening methods, cervical cancer continues to be a major public health problem. There are wide differences in cervical cancer incidence and mortality by geographic region. In addition, the age-specific HPV prevalence varies widely across different populations and showed two peaks of HPV positivity in younger and older women. There have been many studies worldwide on the epidemiology of HPV infection and oncogenic properties due to different HPV genotypes. However, there are still many countries where the population-based prevalence has not yet been identified. Moreover, cervical cancer screening strategies are different between countries. Organized cervical screening programs are potentially more effective than opportunistic screening programs. Nevertheless, screening programs have consistently been associated with a reduction in cervical cancer incidence and mortality. Developed countries have achieved such reduced incidence and mortality from cervical cancer over the past 40 years. This is largely due to the implementation of organized cytological screening and vaccination programs. HPV vaccines are very effective at preventing infection and diseases related to the vaccine-specific genotypes in women with no evidence of past or current HPV infection. In spite of the successful implementation of the HPV vaccination program in many countries all over the world, problems related to HPV prevention and treatment of the related diseases will continue to persist in developing and underdeveloped countries.
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14
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Black E, Hyslop F, Richmond R. Barriers and facilitators to uptake of cervical cancer screening among women in Uganda: a systematic review. BMC Womens Health 2019; 19:108. [PMID: 31399092 PMCID: PMC6688246 DOI: 10.1186/s12905-019-0809-z] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 08/02/2019] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Uganda has one of the highest age-standardized incidence rates of cervical cancer in the world. The proportion of Ugandan women screened for cervical cancer is low. To evaluate barriers and facilitators to accessing cervical cancer screening, we performed a systematic review of reported views of Ugandan women and healthcare workers. The aim of this review is to inform development of cervical cancer screening promotional and educational programs to increase screening uptake and improve timely diagnosis for women with symptoms of cervical cancer. METHODS Fourteen studies that included the views of 4386 women and 350 healthcare workers published between 2006 and 2019 were included. Data were abstracted by two reviewers and findings collated by study characteristics, study quality, and barriers and facilitators. RESULTS Nineteen barriers and twenty-one facilitators were identified. Study settings included all districts of Uganda, and the quality of included studies was variable. The most frequently reported barriers were embarrassment, fear of the screening procedure or outcome, residing in a remote or rural area, and limited resources / health infrastructure. The most frequent facilitator was having a recommendation to attend screening. CONCLUSION Understanding the barriers and facilitators to cervical cancer screening encountered by Ugandan women can guide efforts to increase screening rates in this population. Additional studies with improved validity and reliability are needed to produce reliable data so that efforts to remove barriers and enhance facilitators are well informed.
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Affiliation(s)
- Eleanor Black
- School of Public Health and Community Medicine, University of New South Wales, UNSW, Sydney, NSW 2052 Australia
| | - Fran Hyslop
- School of Public Health and Community Medicine, University of New South Wales, UNSW, Sydney, NSW 2052 Australia
| | - Robyn Richmond
- School of Public Health and Community Medicine, University of New South Wales, UNSW, Sydney, NSW 2052 Australia
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15
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Black E, Hyslop F, Richmond R. Barriers and facilitators to uptake of cervical cancer screening among women in Uganda: a systematic review. BMC Womens Health 2019. [PMID: 31399092 DOI: 10.1186/s12905‐019‐0809‐z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Uganda has one of the highest age-standardized incidence rates of cervical cancer in the world. The proportion of Ugandan women screened for cervical cancer is low. To evaluate barriers and facilitators to accessing cervical cancer screening, we performed a systematic review of reported views of Ugandan women and healthcare workers. The aim of this review is to inform development of cervical cancer screening promotional and educational programs to increase screening uptake and improve timely diagnosis for women with symptoms of cervical cancer. METHODS Fourteen studies that included the views of 4386 women and 350 healthcare workers published between 2006 and 2019 were included. Data were abstracted by two reviewers and findings collated by study characteristics, study quality, and barriers and facilitators. RESULTS Nineteen barriers and twenty-one facilitators were identified. Study settings included all districts of Uganda, and the quality of included studies was variable. The most frequently reported barriers were embarrassment, fear of the screening procedure or outcome, residing in a remote or rural area, and limited resources / health infrastructure. The most frequent facilitator was having a recommendation to attend screening. CONCLUSION Understanding the barriers and facilitators to cervical cancer screening encountered by Ugandan women can guide efforts to increase screening rates in this population. Additional studies with improved validity and reliability are needed to produce reliable data so that efforts to remove barriers and enhance facilitators are well informed.
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Affiliation(s)
- Eleanor Black
- School of Public Health and Community Medicine, University of New South Wales, UNSW, Sydney, NSW, 2052, Australia
| | - Fran Hyslop
- School of Public Health and Community Medicine, University of New South Wales, UNSW, Sydney, NSW, 2052, Australia.
| | - Robyn Richmond
- School of Public Health and Community Medicine, University of New South Wales, UNSW, Sydney, NSW, 2052, Australia
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Balmagambetova SK, Tinelli A, Urazayev ON, Sakieva KZ, Koyshybaev AK, Zholmukhamedova DA, Urazayeva ST. HPV Types Distribution in General Female Population and
in Women Diagnosed with Cervical Cancer Across Western
Kazakhstan. Asian Pac J Cancer Prev 2019; 20:1089-1096. [PMID: 31030478 PMCID: PMC6948905 DOI: 10.31557/apjcp.2019.20.4.1089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Objective: to detect the HPV types distribution both in general female population and in women with first diagnosed cervical cancer, including viral load in both groups. Methods: Qualitative detection and quantification of HPV was performed by PCR-Real time method based on the Russian equipment and test systems (“DNA-Technology” LLC, Russia). The DNA of low-risk (HPV 6, 11, 44) and possibly / potentially / high carcinogenic risk (HPV 16, 18, 26, 31, 33 , 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 73, 82), a total of 21 types, were detected. Results: During the period of 2014-2017 total 1,166 clinically healthy women were tested for HPV, as well as 73 women diagnosed with CaCx. Overall prevalence of HPV in female population was determined as 25.0% (95% CI 22.3;27.7, p = 0.05). Top-5 leading HPV types: 16 (26.4%); 31 (10.1%); 51 (9.4%); 52 (9.0%); 6 (7.9%). Average viral load was 5.5±3.8 (CI 95% 5.1;5.9). In women diagnosed with CaCx ranking was as follows – 16 (54.1%), 31 (11.2%), 18 / 58 (5.1% each), 33 / 45 (4.1% each). Type 16 appeared to be one of the most significant risk factors of the CaCx development (p=0.00007, phi 0.35, Pierson’s X 2 15.9). Average viral load in patients with CaCx was 6.9±4.0 (95% CI 6.1;7.7). A reliable relationship between the cancer staging and the viral load was found (p = 0.043, n = 73). Domination of type 16 calls for urgent need the transition to HPV primary screening and resumption of immunization program discontinued in 2014. The study is registered in ISRCTN registry, No. ISRCTN71514910 (01.02.2018).
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Affiliation(s)
- Saule K Balmagambetova
- West Kazakhstan Marat Ospanov State Medical University, 68, Maresyev Street, Aktobe, Kazakhstan.
| | - Andrea Tinelli
- Department of Obstetrics and Gynecology, Division of Experimental Endoscopic Surgery, Imaging, Technology and Minimally Invasive Therapy, Vito Fazzi Hospital, Lecce, Italy
| | - Olzhas N Urazayev
- West Kazakhstan Marat Ospanov State Medical University, 68, Maresyev Street, Aktobe, Kazakhstan.
| | - Kanshaiym Z Sakieva
- West Kazakhstan Marat Ospanov State Medical University, 68, Maresyev Street, Aktobe, Kazakhstan.
| | - Arip K Koyshybaev
- West Kazakhstan Marat Ospanov State Medical University, 68, Maresyev Street, Aktobe, Kazakhstan.
| | - Dinara A Zholmukhamedova
- West Kazakhstan Marat Ospanov State Medical University, 68, Maresyev Street, Aktobe, Kazakhstan.
| | - Saltanat T Urazayeva
- West Kazakhstan Marat Ospanov State Medical University, 68, Maresyev Street, Aktobe, Kazakhstan.
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Gultekin M, Karaca MZ, Kucukyildiz I, Dundar S, Keskinkilic B, Turkyilmaz M. Mega Hpv laboratories for cervical cancer control: Challenges and recommendations from a case study of Turkey. PAPILLOMAVIRUS RESEARCH 2019; 7:118-122. [PMID: 30878532 PMCID: PMC6426700 DOI: 10.1016/j.pvr.2019.03.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 12/21/2018] [Accepted: 03/10/2019] [Indexed: 12/31/2022]
Abstract
Cervical cancer is the fourth most common cancer among women in the world. It is estimated that one woman dies every 2 min from cervical cancer. Nearly all cervical cancers are preventable by early detection and treatment through screening or HPV vaccination. In 2018, World Health Organization (WHO) made a global call for action toward the elimination of cervical cancer. Cervical cancer screening involves a complex organized program, which begins with a call/recall system based on personal invitation of eligible women, followed by participation in screening, and leading to diagnosis, treatment, and management as appropriate. An effective cervical screening program with high coverage is dependent on each country's infrastructure and human resource capacity. Efforts to develop an effective program is particularly challenging in low and middle income countries (LMIC) where resources are limited. For an effective strategy, Turkey redesigned the country's cervical screening program. The local call/recall system and centralized monitoring system of individual women were re-vamped with an automated evaluation system. The revised screening program includes the use of primary HPV testing with a well-defined protocol outlining the algorithms of management (i.e., screening intervals and referral), a single nationwide centralized diagnostic laboratory, and a sustainable agreement with the HPV diagnostics industry. This system allows for traceable, real-time monitoring of screening visits and specimens. Turkey reports on the first four years of this re-vamped organized program and shares lessons learnt from the implementation of this new program.
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Affiliation(s)
- Murat Gultekin
- Hacettepe University Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Ankara, Turkey.
| | | | | | - Selin Dundar
- Turkish Ministry of Health, Public Health Institute, Department of Cancer Control, Turkey
| | - Bekir Keskinkilic
- Turkish Ministry of Health, Public Health Institute, Department of Cancer Control, Turkey
| | - Murat Turkyilmaz
- Turkish Ministry of Health, Public Health Institute, Department of Cancer Control, Turkey
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18
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Endeshaw M, Clarke T, Senkomago V, Saraiya M. Cervical Cancer Screening Among Women by Birthplace and Percent of Lifetime Living in the United States. J Low Genit Tract Dis 2018; 22:280-287. [PMID: 30063576 PMCID: PMC6664302 DOI: 10.1097/lgt.0000000000000422] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The aim of the study was to provide national estimates of Pap test receipt, by birthplace, and percent of lifetime in the United States (US). MATERIALS AND METHODS Pooled nationally representative data (2005, 2008, 2013, 2015) from the National Health Interview Survey were used to examine differences in Pap test receipt among adult US women by birthplace and percent of lifetime in the US. Descriptive estimates were age-adjusted. Regression models were adjusted for selected sociodemographic and healthcare access and utilization factors and presented as predicted margins. RESULTS Foreign-born women 18 years and older were more than twice as likely to have never received a Pap test compared with US-born women (18.6% vs 6.8%). Regression models showed that foreign-born women from Mexico (9.8%), South America (12.6%), Caribbean (14.6%), Southeast Asia (13.7%), Central Asia (20.4%), South Asia (22.9%), Middle East (25.0%), Africa (27.8%), Europe (16.4%), and Former Soviet Union (28.2%) were more likely to be unscreened compared with US-born women (7.6%). Foreign-born women who spent less than 25% of their life in the US had higher prevalence of never having a Pap test (20%) compared with foreign-born who spent more than 25% of their life in the US (12.7%). CONCLUSIONS Using national survey, we found that where a woman is born and the percent of her lifetime spent residing in the US do impact whether she gets screened at least once in her lifetime. IMPACT These findings may inform cervical cancer screening efforts targeting foreign-born women.
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Affiliation(s)
- Meheret Endeshaw
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
| | - Tainya Clarke
- Division of Health Interview Statistics, Centers for Disease Control and Prevention, National Center for Health Statistics, Atlanta, GA
| | - Virginia Senkomago
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
| | - Mona Saraiya
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
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19
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Opportunities and challenges for introducing HPV testing for cervical cancer screening in sub-Saharan Africa. Prev Med 2018; 114:205-208. [PMID: 30031013 PMCID: PMC6095940 DOI: 10.1016/j.ypmed.2018.07.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 07/13/2018] [Accepted: 07/17/2018] [Indexed: 11/23/2022]
Abstract
To protect women against cervical cancer, the World Health Organization recommends that women aged 30 to 49 years be screened with tests that detect human papillomavirus (HPV). If the countries that have the greatest burden of this disease-especially those in sub-Saharan Africa-are not to be left behind, we must understand the challenges they face and identify measures that can help them take full advantage now of innovations that are transforming screening services in wealthier countries. We reviewed policy documents and published literature related to Kenya, Tanzania, and Uganda, and met with key personnel from government and nongovernmental organizations. National policy makers understand the value of HPV testing in terms of its superior sensitivity and the programmatic advantages that could result from using self-collected samples. However, while these countries have national cervical cancer prevention strategies, and some have national departments or units for cervical cancer prevention, screening is rare, funding scarce, and quality low. Age guidelines are not strictly followed, with scarce resources being used to screen many women younger than the recommended ages. Published evidence of the benefits of HPV testing-including performance, safety, and cost-effectiveness-must be provided to ministry of health leaders, along with information on anticipated costs for training personnel, purchasing supplies, providing facility space, and maintaining test kits. Despite the obstacles, a joint effort on the part of global and national stakeholders to introduce molecular screening methods can bring better protection to the women who need it most.
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20
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Aimagambetova G, Azizan A. Epidemiology of HPV Infection and HPV-Related Cancers in Kazakhstan: a Review. Asian Pac J Cancer Prev 2018; 19:1175-1180. [PMID: 29801397 PMCID: PMC6031825 DOI: 10.22034/apjcp.2018.19.5.1175] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background: Cancer is one of the most prevalent causes of mortality worldwide. In the cervix it is considered to be caused by different high-risk human papillomavirus (HPV) types. Although many studies have already been conducted worldwide on the epidemiology of HPV infection and their oncogenic properties, limited data are available on HPV prevalence, incidence and genotype specific dissemination in Kazakhstan. Methods: To review the distribution of HPV infection, electronic databases (e.g. PubMed, Web of Science and Google Scholar) were searched for peer reviewed articles in English. The study was performed during June-July 2017 with a review of 39 relevant articles, published up to July 31, 2017. The following inclusion criteria were applied: general population data, cytology results available, and use of polymerase chain reaction (PCR) and/or Hybrid Capture® 2, Digene Corp., USA for HPV detection. Results: As reported in limited studies, the prevalence of HPV infection in Kazakhstan ranges from 43.8% to 55.8%. However, the scenario with regard to epidemiology of HPV related cancers in Kazakhstan is not very clear. One study reported a decline of laryngeal cancer observed during the recent years, whereas cervical cancer incidence has increased to about 3000 new cervical cancer cases, and about 1,000 cervical cancer deaths each year. Conclusion: The high incidence of cervical cancer with a significant mortality rate in Kazakhstan is evidence of HPV infection abundance despite an absence of HPV screening and low public awareness of the problem. Having a well-informed understanding of the role of HPV infection could enhance the public’s acceptance of screening and intervention programs to reduce morbidity and mortality in the country due to HPV infection. Thus, the purpose of this review article is to summarize the existing data, identifying directions for future research on HPV epidemiology and HPV-related diseases in Kazakhstan.
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Affiliation(s)
- Gulzhanat Aimagambetova
- Department of Biomedical Sciences, Nazarbayev University School of MedicineKazakhstan. gulzhanat.
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21
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Mehrotra R, Kaushik R. A stitch in time saves nine: Answer to the cancer burden in India. Indian J Med Res 2018; 147:121-124. [PMID: 29806598 PMCID: PMC5991128 DOI: 10.4103/ijmr.ijmr_388_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Indexed: 11/23/2022] Open
Affiliation(s)
- Ravi Mehrotra
- ICMR-National Institute of Cancer Prevention & Research, Noida 201 301, Uttar Pradesh, India
| | - Ravi Kaushik
- Division of Preventive Oncology, ICMR-National Institute of Cancer Prevention & Research, Noida 201 301, Uttar Pradesh, India
- ICMR-National Institute of Cancer Prevention & Research, Noida 201 301, Uttar Pradesh, India
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