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Vukomanovic IS, Kocic S, Vukomanovic V, Janicijevic K, Šorak M, Simic V, Djukic S, Djordjevic S, Radevic S. Assessment of Sexual Health and Use of Cervical Cancer Screening among the Female Working Population. IRANIAN JOURNAL OF PUBLIC HEALTH 2024; 53:198-207. [PMID: 38694863 PMCID: PMC11058389 DOI: 10.18502/ijph.v53i1.14696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/09/2023] [Indexed: 05/04/2024]
Abstract
Background Cervical cancer occupies a significant place in the overall structure of morbidity and mortality in developing countries. We focused on the sexual health and use of cervical cancer screening among the female working population of reproductive age in Central Serbia. Methods The research was conducted as a cross-sectional study, according to the methodology Stepwise approach to noncommunicable disease risk factor surveillance WHO. The study population consisted of 1182 female working population aged 18-49 years, living on the territory of Central Serbia. The method of simple random sampling was utilized in the research itself. An anonymous standardized questionnaire was used as a research tool. Results During the first sexual intercourse, 38.9% of the participants reported not having used any of the contraceptives, whereas 74.5% of the participants reported not having used them during their last sexual intercourse and 26.1% of the respondents reported not having had a single Pap smear in their lifetime. The multivariate logistic regression analysis singled out the following factors in women who reported not having done a Pap smear in their lifetime as the most significant ones: age - the youngest age group (OR = 3.30, CI = 1.80-6.04), unemployment (OR = 2.87, CI = 0.07-3.40), women who had never been married or had never been in a common-law marriage (OR = 2.55, CI = 1.40-4.66) and individuals with a medium education level (OR = 2.63, CI = 1.67-4.14). Conclusion In Serbia, all the activities should be directed towards increasing the levels of awareness and knowledge on sexual health and cervical cancer screening services.
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Affiliation(s)
- Ivana Simic Vukomanovic
- Department of Social Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Institute of Public Health Kragujevac, Kragujevac, Serbia
| | - Sanja Kocic
- Department of Social Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Institute of Public Health Kragujevac, Kragujevac, Serbia
| | - Vladimir Vukomanovic
- Department of Nuclear Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Katarina Janicijevic
- Department of Social Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Marija Šorak
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Vera Simic
- Department of Nursing, Secondary Medical School “Beograd”, Belgrade, Serbia
| | - Svetlana Djukic
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Slavica Djordjevic
- Department of the High School of Health, Academy of Vocational Studies, Belgrade, Serbia
| | - Svetlana Radevic
- Department of Social Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Institute of Public Health Kragujevac, Kragujevac, Serbia
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Davidoff AJ, Akif K, Halpern MT. Research on the Economics of Cancer-Related Health Care: An Overview of the Review Literature. J Natl Cancer Inst Monogr 2022; 2022:12-20. [PMID: 35788372 DOI: 10.1093/jncimonographs/lgac011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 03/21/2022] [Indexed: 01/16/2023] Open
Abstract
We reviewed current literature reviews regarding economics of cancer-related health care to identify focus areas and gaps. We searched PubMed for systematic and other reviews with the Medical Subject Headings "neoplasms" and "economics" published between January 1, 2010, and April 1, 2020, identifying 164 reviews. Review characteristics were abstracted and described. The majority (70.7%) of reviews focused on cost-effectiveness or cost-utility analyses. Few reviews addressed other types of cancer health economic studies. More than two-thirds of the reviews examined cancer treatments, followed by screening (15.9%) and survivorship or end-of-life (13.4%). The plurality of reviews (28.7%) cut across cancer site, followed by breast (20.7%), colorectal (11.6%), and gynecologic (8.5%) cancers. Specific topics addressed cancer screening modalities, novel therapies, pain management, or exercise interventions during survivorship. The results indicate that reviews do not regularly cover other phases of care or topics including financial hardship, policy, and measurement and methods.
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Affiliation(s)
- Amy J Davidoff
- Healthcare Assessment Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Kaitlin Akif
- Office of the Associate Director, Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Michael T Halpern
- Healthcare Assessment Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
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Casas CPR, Albuquerque RDCRD, Loureiro RB, Gollner AM, Freitas MGD, Duque GPDN, Viscondi JYK. Cervical cancer screening in low- and middle-income countries: A systematic review of economic evaluation studies. Clinics (Sao Paulo) 2022; 77:100080. [PMID: 35905574 PMCID: PMC9335392 DOI: 10.1016/j.clinsp.2022.100080] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 05/04/2022] [Indexed: 11/28/2022] Open
Abstract
Economic assessments are relevant to support the decision to incorporate more cost-effective strategies to reduce Cervical Cancer (CC) mortality. This systematic review analyzes the economic evaluation studies of CC prevention strategies (HPV DNA-based tests and conventional cytology) in low- and middle-income countries. Medline, EMBASE, CRD, and LILACS were searched for economic evaluation studies that reported cost and effectiveness measures of HPV DNA-based tests for CC screening and conventional cytology in women, without age, language, or publication date restrictions. Selection and data extraction were carried out independently. For comparability of results, cost-effectiveness measures were converted to international dollars (2019). Report quality was assessed using the CHEERS checklist. The Dominance Matrix Ranking (DRM) was used to analyze and interpret the results. The review included 15 studies from 12 countries, with cost-effectiveness analyzes from the health system's perspective and a 3% discount rate. The strategies varied in age and frequency of screening. Most studies used the Markov analytical model, and the cost-benefit threshold was based on the per capita GDP of each country. The sensitivity analysis performed in most studies was deterministic. The completeness of the report was considered sufficient in most of the items evaluated by CHEERS. The Dominance Interpretation (DRM) varied; in 6 studies, the HPV test was dominant, 5 studies showed a weak dominance evaluating greater effectiveness of the HPV test at a higher cost, yet in 2 studies conventional cytology was dominant. Although the context-dependent nature of economic evaluations, this review points out the challenge of methodological standardization in the analytical models.
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Affiliation(s)
- Carmen Phang Romero Casas
- Centro de Desenvolvimento Tecnológico em Saúde (CDTS), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil.
| | | | - Rafaela Borge Loureiro
- Laboratório de Epidemiologia (Lab-Epi), Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil
| | - Angela Maria Gollner
- Hospital Universitário da Universidade Federal de Juiz de Fora (HU-UFJF/ EBSERH), Juiz de Fora, MG, Brazil
| | - Marina Gonçalves de Freitas
- Câmara de Regulação do Mercado de Medicamentos (CMED), Agência Nacional de Vigilância Sanitária (ANVISA), Brazil
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Bespalov A, Barchuk A, Auvinen A, Nevalainen J. Cancer screening simulation models: a state of the art review. BMC Med Inform Decis Mak 2021; 21:359. [PMID: 34930233 PMCID: PMC8690438 DOI: 10.1186/s12911-021-01713-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/06/2021] [Indexed: 12/09/2022] Open
Abstract
Background Nowadays, various simulation approaches for evaluation and decision making in cancer screening can be found in the literature. This paper presents an overview of approaches used to assess screening programs for breast, lung, colorectal, prostate, and cervical cancers. Our main objectives are to describe methodological approaches and trends for different cancer sites and study populations, and to evaluate quality of cancer screening simulation studies. Methods A systematic literature search was performed in Medline, Web of Science, and Scopus databases. The search time frame was limited to 1999–2018 and 7101 studies were found. Of them, 621 studies met inclusion criteria, and 587 full-texts were retrieved, with 300 of the studies chosen for analysis. Finally, 263 full texts were used in the analysis (37 were excluded during the analysis). A descriptive and trend analysis of models was performed using a checklist created for the study. Results Currently, the most common methodological approaches in modeling cancer screening were individual-level Markov models (34% of the publications) and cohort-level Markov models (41%). The most commonly evaluated cancer types were breast (25%) and colorectal (24%) cancer. Studies on cervical cancer evaluated screening and vaccination (18%) or screening only (13%). Most studies have been conducted for North American (42%) and European (39%) populations. The number of studies with high quality scores increased over time. Conclusions Our findings suggest that future directions for cancer screening modelling include individual-level Markov models complemented by screening trial data, and further effort in model validation and data openness. Supplementary Information The online version contains supplementary material available at 10.1186/s12911-021-01713-5.
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Affiliation(s)
- Aleksandr Bespalov
- Faculty of Social Sciences, Tampere University, Arvo, Box 100, 33014, Tampere, Finland. .,Petrov National Research Medical Center of Oncology, Leningradskaya 68, Pesochny, Saint-Petersburg, Russia, 197758.
| | - Anton Barchuk
- Faculty of Social Sciences, Tampere University, Arvo, Box 100, 33014, Tampere, Finland.,Institute for Interdisciplinary Health Research, European University, Shpalernaya Ulitsa, 1, Saint-Petersburg, Russia, 191187
| | - Anssi Auvinen
- Faculty of Social Sciences, Tampere University, Arvo, Box 100, 33014, Tampere, Finland
| | - Jaakko Nevalainen
- Faculty of Social Sciences, Tampere University, Arvo, Box 100, 33014, Tampere, Finland
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The Health State of Women in Serbia in the Period 2006-2016. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2021. [DOI: 10.2478/sjecr-2018-0059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Abstract
Women’s health is of particular importance because of the large and specific sensitivity of this population group and the fact that women are consistently concerned about their own health, but also about the health of their children, parents and other family members. The aim of this study was to considering the health of women in Serbia in the period from 2006 to 2016, in order to highlight the priority problems, which would serve to create preventive programs and measures aimed at improving the health of this population group. Chronic non-communicable diseases (malignancies, acute coronary syndrome, diabetes mellitus, etc) are the leading causes of morbidity and mortality, and one of the main reasons for the use of health care in the population of women in our country in the period from 2006 to 2016. How it comes to preventable diseases, actions in the field of health promotion should be directed at preventing or modifying risk factors that are responsible for the occurrence of these diseases, as well as the creation of national strategies for the prevention and control, monitoring the performance of screening and other preventive programs, planning and organization of health care. By promoting healthy lifestyles, empowering women and their active participation in the community can have significant positive effects on raising the health potential of this population.
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Soper BC, Nygård M, Abdulla G, Meng R, Nygård JF. A hidden Markov model for population-level cervical cancer screening data. Stat Med 2020; 39:3569-3590. [PMID: 32854166 DOI: 10.1002/sim.8681] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 06/02/2020] [Accepted: 06/11/2020] [Indexed: 12/19/2022]
Abstract
The Cancer Registry of Norway has been administrating a national cervical cancer screening program since 1992 by coordinating triennial cytology exam screenings for the female population between 25 and 69 years of age. Up to 80% of cancers are prevented through mass screening, but this comes at the expense of considerable screening activity and leads to overtreatment of clinically asymptomatic precancers. In this article, we present a continuous-time, time-inhomogeneous hidden Markov model which was developed to understand the screening process and cervical cancer carcinogenesis in detail. By leveraging 1.7 million individual's multivariate time-series of medical exams performed over a 25-year period, we simultaneously estimate all model parameters. We show that an age-dependent model reflects the Norwegian screening program by comparing empirical survival curves from observed registry data and data simulated from the proposed model. The model can be generalized to include more detailed individual-level covariates as well as new types of screening exams. By utilizing individual screening histories and covariate data, the proposed model shows potential for improving strategies for cancer screening programs by personalizing recommended screening intervals.
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Affiliation(s)
- Braden C Soper
- Computing Directorate, Lawrence Livermore National Laboratory, Livermore, California, USA
| | - Mari Nygård
- Research Department, Cancer Registry of Norway, Oslo, Norway
| | - Ghaleb Abdulla
- Computing Directorate, Lawrence Livermore National Laboratory, Livermore, California, USA
| | - Rui Meng
- Department of Statistics, University of California, Santa Cruz, California, USA
| | - Jan F Nygård
- Registry Informatics Department, Cancer Registry of Norway, Oslo, Norway
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