A qualitative exploration of cervical and breast cancer stigma in Karnataka, India

Background: Cancer stigma, which encompasses the negative responses of nations, communities, families, and individuals towards those affected by cancer, presents a growing challenge in low-resourced societies and various parts of the world. In particular, cervical cancer (CCA) stigma has become increasingly prevalent in numerous cultures and societies. This stigma is fueled by the fact that nearly 99% of CCA cases and pre-cancerous cervical lesions are attributed to infection with the sexually transmitted human papillomavirus (HPV). Despite the substantial burden CCA stigma and the availability of widely accessible, cost-effective services, Caribbean women exhibit alarmingly low rates of appropriate CCA screening practices and HPV vaccination for their children, both in the U.S. and the Caribbean. To enhance the effectiveness of CCA prevention efforts in the U.S, it is imperative to include studies involving Caribbean nations with significant immigration to the U.S. Objective: This study aimed to explore the manifestations of cancer stigma among men and women aged 18-85 in Grenada, Jamaica, and Trinidad & Tobago, and its potential impact on CCA prevention behaviors. Design and Methods: Employing a community-based participatory research approach, academic institutions collaborated with community leaders in each country to conduct a cross-sectional qualitative study using focus groups. Thematic analysis was performed using MAXQDA data analysis software to examine the role of stigma in CCA prevention behaviors. Results: Three focus groups were conducted in each country, with a total of 69 participants. Major themes emerged regarding the influence of stigma on CCA cancer prevention efforts, including fatalism, cultural views, and confidentiality. Participants demonstrated knowledge of the sexually transmitted nature of HPV, which causes CCA, contributing to the stigmatization of the disease. Stigma was associated with unwarranted assumptions of female promiscuity. The stigmatization of CCA was characterized by blame and the belief that women with the disease should feel ashamed, creating significant barriers to HPV vaccination and pap testing. Cancer was often regarded as a death sentence and rarely discussed among family and friends, further deterring women from seeking screening, early detection, and support. Fear and misinformation surrounding the pap testing procedure, as well as concerns about medical confidentiality, also hindered screening. Conclusion: Generalized cancer stigma (viewing cancer as a death sentence) and specific CCA cancer stigma (shame and blame) have adverse effects on CCA prevention efforts. Further research is needed to assess the multifaceted dimensions of cancer stigma and inform interventions aimed at improving CCA cancer screening and HPV vaccination in the Caribbean. Investigating and addressing the various dimensions of cancer stigma within the non-patient population are required to inform strategies to reduce stigma’s influence; and thus improve CCA screening and HPV vaccination to prevent cancer and save lives. Citation Format: Kamilah B. Thomas-Purcell, Diadrey-Ann Sealy, Althea Bailey, Sherry-Ann Joseph, Kimlin Ashing. "That’s our culture...”: A qualitative study on factors that influence cervical cancer stigma in the Caribbean [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A058.

Decision letter: A modelled evaluation of the impact of COVID-19 on breast, bowel, and cervical cancer screening programmes in Australia

Editor's evaluation: A modelled evaluation of the impact of COVID-19 on breast, bowel, and cervical cancer screening programmes in Australia

A vision for improved cancer screening in Nigeria.

Background: Cervical cancer and breast cancer are the two top leading cases of female cancer in Indonesia. Being the 2nd largest city in Indonesia, Surabaya is being populated by more than 1.5 million females in 2017. This study aimed to describe the demographic characteristic of women living with cervical and breast cancer in order to show the current picture of female cancer situation in Surabayan communities nowadays. Substantial to it, the correlation between time of first diagnosis and type of therapy with current stage of cancer were analyzed to evaluate the cancer management effectiveness in community context.Methods: This cross-sectional study involved six (9.68%) Public Health Centers (PHCs) among 62 PHCs in Surabaya, Indonesia, which were selected by one stage cluster random sampling. There were 140 and 139 women living with cervical and breast cancer participated in this study respectively (n=279). Self-developed demographic questionnaire was used to collect the data. Descriptive statistic, Spearman Rank correlation test, and Mann-Whitney U test were used in data analysis (α<.05).Results: Overall, most respondents were married (77.06%) and were housewives (59.14%). They were high school graduated at majority (44.44%). Family support came from spouse and children (70.25%). Those with breast cancer mostly aged middle-up adulthood (56.12%), while older aged were found in respondents with cervical cancer (72.86%). The majority had been diagnosed with cancer for less than five years (81.36%), but there was a tendency that the longer life expectancy was found in those with cervical cancer. More cervical cancer respondents with advanced stage were found to be long-term survivors (25%). The first time of diagnosis and the type of therapy were significantly different between cases (p=.039 and p=.000 respectively), but the current stage of cancer was not significantly different (p=.239). There was a quite strong correlation between time of first diagnosis and current stage of cancer (ρ = -.409; p=.000), but there was no significant correlation between type of therapy and current stage of cancer (p=.147).Conclusions: The demographic characteristic of women living with cervical and breast cancer has been slowly shifting from elderly or late adulthood, to middle and early adulthood. The first time of diagnosis and the type of therapy were significantly different between cases, but the current stage of cancer was not significantly different. There was a strong significant correlation between time of first diagnosis and current stage of cancer in cervical and breast cancer.

Breast cancer and reproductive system cancers remain significant public health threats for Chinese women. This study aimed to evaluate the latest epidemiological patterns and trends of four female-specific cancers in China. The year- and age-specific estimates of the incidence, mortality, and disability-adjusted life-years (DALYs) associated with breast, cervical, ovarian, and uterine cancers in China from 1990 to 2021 were generated from the Global Burden of Disease, Injuries, and Risk Factors 2021 study. The epidemiological characteristics were analyzed with age-period-cohort models. A Bayesian age-period-cohort model was applied to forecast disease burden from 2022 to 2050. In 2021, China reported 385.84 thousand (95% uncertainty interval [UI], 294.10-489.01 thousand) incident cases of female breast cancer, followed by cervical cancer (132.79 thousand [95% UI, 95.96-172.60 thousand]), uterine cancer (72.02 thousand [95% UI, 53.31-100.00 thousand]), and ovarian cancer (41.24 thousand [95% UI, 30.30-54.55 thousand]). Breast cancer ranked as the primary cause of cancer-related deaths, followed by cervical cancer. The age-specific incidence rate for breast, cervical, ovarian, and uterine cancers are projected to occur in the age groups 60-64 years, 55-59 years, 65-69 years, and 60-64 years, respectively. Breast, ovarian, and uterine cancer cases are projected to rise by 2050, which will exceed those recorded in 2021. Various inequities have been identified across four types of cancers affecting women, which underscores the need for tailored national cancer control strategies. Emphasis should be placed on primary prevention and screening for breast and cervical cancers, whereas efforts for uterine and ovarian cancers should focus on implementing early diagnosis and treatment measures. This study examines the burdens and trends of breast, cervical, ovarian, and uterine cancers among Chinese women from 1990 to 2021. In 2021, breast cancer emerged as the most prevalent, followed by cervical, uterine, and ovarian cancers, with breast cancer also exhibiting the highest mortality rate. The age groups projected to exhibit the highest incidence rates for breast, cervical, ovarian, and uterine cancers are 60-64 years, 55-59 years, 65-69 years, and 60-64 years, respectively. Projections indicate that by 2050, the incidence of breast, ovarian, and uterine cancers will surpass 2021 levels, which underscores the necessity for targeted prevention, early detection, and treatment strategies.

Background: Breast and cervical cancer screening play an important role in reducing cancer mortality. Family history and other screening tools are helpful in reducing cancer burden. Present study is focused on the impact of early screening of cervical and breast cancer on incidence of both cancers with focus on menopausal women ageing 30-70. Methods: It is an epidemiological study in Ajmer municipal area with retrospective and prospective recorded data on cervical and breast cancer screening. Factors which are not considered may drive the observed association Participants of current study were registered and diagnosed with cervical and breast cancer in different hospital of Ajmer municipal area between January 2011-March 2015.468 women aged 30-70 with invasive cervical and breast cancer diagnosed in different major hospitals of Ajmer municipal area. Control participants were matched on area of residence and by age-group. Association between cancer and screening at particular ages are co-related to determine odd ratios. Results: There is evidence that screening was associated with a 32% reduction of cervical cancer and 48% reduction of breast cancer in women aged 45.There is 41% reduction of cervical cancer and 52% reduction of breast cancer in women aged 55.There is no evidence of reduction in incidence of cervical and breast cancer at 35 (Odd Ratio 1.12, 95% confidence interval 0.84 to 1.52). Screening in later age reduces incidence and mortality from cervical and breast cancer. Conclusions: To significantly reduce the breast and cervical cancer mortality, screening should be sturdily intensified to improve long term effectiveness. Quality assessment of early screening should be done via early indicators. New screening modalities have been introduced and some of them should be gradually incorporated into society practice.

Background: Breast and cervical cancer remain a major cause of morbidity and mortality for wo­men in Indonesia. Although this cancer can be de­tected early, women are still less active in self-detecting breast and cervical cancer, so both cancers are found at an advanced stage. This study aimed to explore how women's knowledge, barriers, and motivations are related to early detection of breast and cervical cancer. Subjects and Method: This was a qualitative study, with focus group discussions (FGDs) and interviews with key informants. Discussions and in­terviews were conducted in the community within Ledok Kulon village, Bojonegoro Regency, East Java, Indonesia. Participants: FGD partici­pants involved 20 women, 10 women underwent FDG about cervical cancer and 10 other women conducted FGD about breast cancer. Three key informants interviewed with health worker and administrator that allow triangulation of res­pon­ses thereby increasing the validity of the findings. Participants were aged 20 to ≥60 years, with no history of symptoms or previous diagnosis of breast or cervical cancer. The women were inter­viewed in October-November 2019. The trans­cri­bed data were analyzed using content analysis. Results: Participants' knowledge about under­stan­ding, risk factors, signs and symptoms of breast and cervical cancer was still lacking. Par­ticipants attributed the cause of cervical cancer to the vaginal wound resulting in cervical cancer and signs of symptoms such as heartburn. Whe­reas for breast cancer participants were not know the signs and symptoms, they only said there was a lump in the breast. Barriers to screening were ashamed to be examined by health workers, afraid of testing procedures, feeling healthy and there were no signs of cancer. Screening motiva­tion were experiencing signs and symptoms of can­cer, family history of the disease and aware­ness of the disease/screening service. Conclusion: The study participants' knowledge of breast and cervical cancer was still lacking. To improve breast and cervical cancer screening, efforts must focus on reducing identified barriers and increasing motivation. Keyword s : knowledge, barriers, motivation, breast and cervical cancer screening Correspondence: Afriza Umami. Diploma III of Medical Records, School of Health Sciences Muhammadiyah Bojone­go­ro, Jl. A.Yani No.14, Bojonegoro, Indonesia. Email: afrizaumami20@gmail.com. Mobile: +62­8­225­4348041. Journal of Health Promotion and Behavior (2020), 5(1): 1-10 https://doi.org/10.26911/thejhpb.2020.05.01.01

This study covers a wide range of cancers, focusing on cervical, lung, and breast cancer. Developing fast, accurate, and interpretable machine learning models for early diagnosis is critical to reducing the multifactorial mortality associated with these cancer types. Using a two-stage hybrid feature selection method, this study evaluates classification models using specific cervical, lung, and breast cancer data obtained from the UCI Machine Learning Repository. The cervical cancer dataset contains 36 features, the lung cancer dataset contains 16 features, and the breast cancer dataset contains 31 features. In the first stage, a random forest architecture is used for feature selection to identify features 5,7, and 7 that show a strong correlation with their cancer while reducing the difference between them. In Stage 2. Logistic regression (LR), naive bayes (NB), support vector machine (SVM), random forest (RF), and decision making (DT) were used to identify cervical cancer, lung, and breast cancer patients for five selections.

Cancer Prevention in a Postpandemic World: A One-Stop-Shop Approach

BackgroundCancer has remained one of the leading causes of death worldwide. In Lesotho, breast and cervical cancers contribute about 43% of all the cancer cases annually.AimThis study is aimed at comparing knowledge, attitudes, and practices between breast and cervical cancers among females in Maseru.SettingsThis study consists of women residing in five study sites which have clinics that offer cervical and breast cancer-screening services.MethodsA cross-sectional study was conducted in June 2021 in Maseru, the Capital city of Lesotho. The participants were interviewed using a pre-tested questionnaire, through which their knowledge, practices about, and attitudes towards breast and cervical cancers were assessed.ResultsA total of 228 women aged 15–75 years participated in the study and the majority were aged 30 years and above. Of the women interviewed for cervical cancer, 89.5% had heard of it, 11.8% had heard of its screening, and 7.4% had at least one examination. Similarly, for breast cancer, 77.6% of women who had heard of it, 72.9% had heard of screening, and 40.1% of women did at least one examination.ConclusionThe majority of women were more knowledgeable about cervical cancer than breast cancer. However, more women had heard about breast cancer screening than cervical cancer screening. Therefore, there is a need for awareness campaigns related to cervical cancers’ screening.ContributionThere is an urgent need to intensify awareness about cervical and breast cancer screening and availability of services at the nearby clinics.

BackgroundThe most commonly diagnosed cancers among women are breast and cervical cancers, with cervical cancer being a relatively bigger problem in low and middle income countries (LMICs) than breast cancer.MethodsThe main aim of this study was to asses factors associated with and socioeconomic inequalities in breast and cervical cancer screening among women aged 15–64 years in Botswana. This study is part of the broad study on Chronic Non-Communicable Diseases in Botswana conducted (NCD survey) in 2016. The NCD survey was conducted across 3 cities and towns, 15 urban villages and 15 rural areas of Botswana. The survey collected information on several NCDs and risk factors including cervical and breast cancer screening. The survey adopted a multistage sampling design and a sample of 1178 participants (males and females) aged 15 years and above was selected in both urban and rural areas of Botswana. For this study, a sub-sample of 813 women aged 15–64 years was selected and included in the analysis. The inequality analysis was conducted using decomposition analysis using ADePT software version 6. Logistic regression models were used to show the association between socioeconomic variables and cervical and breast cancer screening using SPSS version 25. All comparisons were considered statistically significant at 5%.ResultsOverall, 6% and 62% of women reported that they were screened for breast and cervical cancer, respectively. Women in the poorest (AOR = 0.16, 95% CI = 0.06–0.45) and poorer (AOR = 0.37, 95% CI = 0.14–0.96) wealth quintiles were less likely to report cervical cancer screening compared to women in the richest wealth quintile. Similarly, for breast cancer, the odds of screening were found to be low among women in the poorest (AOR = 0.39, 95% CI = 0.06–0.68) and the poorer (AOR = 0.45, 95% CI = 0.13–0.81)) wealth quintiles. Concentration indices (CI) showed that cervical (CI = 0.2443) and breast cancer (CI = 0.3975) screening were more concentrated among women with high SES than women with low SES. Wealth status was observed to be the leading contributor to socioeconomic inequality observed for both cervical and breast cancer screening.ConclusionsFindings in this study indicate the need for concerted efforts to address the health care needs of the poor in order to reduce cervical and breast cancer screening inequalities.

The most commonly diagnosed cancers among women are breast and cervical cancers, with cervical cancer being a relatively bigger problem in low and middle income countries (LMICs) than breast cancer. The main aim of this study was to asses factors associated with and socioeconomic inequalities in breast and cervical cancer screening among women aged 15-64 years in Botswana. This study is part of the broad study on Chronic Non-Communicable Diseases in Botswana conducted (NCD survey) in 2016. The NCD survey was conducted across 3 cities and towns, 15 urban villages and 15 rural areas of Botswana. The survey collected information on several NCDs and risk factors including cervical and breast cancer screening. The survey adopted a multistage sampling design and a sample of 1178 participants (males and females) aged 15 years and above was selected in both urban and rural areas of Botswana. For this study, a sub-sample of 813 women aged 15-64 years was selected and included in the analysis. The inequality analysis was conducted using decomposition analysis using ADePT software version 6. Logistic regression models were used to show the association between socioeconomic variables and cervical and breast cancer screening using SPSS version 25. All comparisons were considered statistically significant at 5%. Overall, 6% and 62% of women reported that they were screened for breast and cervical cancer, respectively. Women in the poorest (AOR = 0.16, 95% CI = 0.06-0.45) and poorer (AOR = 0.37, 95% CI = 0.14-0.96) wealth quintiles were less likely to report cervical cancer screening compared to women in the richest wealth quintile. Similarly, for breast cancer, the odds of screening were found to be low among women in the poorest (AOR = 0.39, 95% CI = 0.06-0.68) and the poorer (AOR = 0.45, 95% CI = 0.13-0.81)) wealth quintiles. Concentration indices (CI) showed that cervical (CI = 0.2443) and breast cancer (CI = 0.3975) screening were more concentrated among women with high SES than women with low SES. Wealth status was observed to be the leading contributor to socioeconomic inequality observed for both cervical and breast cancer screening. Findings in this study indicate the need for concerted efforts to address the health care needs of the poor in order to reduce cervical and breast cancer screening inequalities.

Stigma May Exacerbate Disproportionately Low Guideline-Concordant Treatment Rates for Patients With Advanced-Stage Lung Cancer in the United States

National guidelines balance risks and benefits of population-level cancer screening among adults with average risk. Older adults are not recommended to receive routine screening, but many continue to be screened (ie, are overscreened). To assess the prevalence of overscreening for colorectal, cervical, and breast cancers among older adults as well as differences in overscreening by metropolitan status. The cross-sectional study examined responses to a telephone survey of 176 348 community-dwelling adults. Participants were included if they met age and sex criteria, and they were excluded from each cancer-specific subsample if they had a history of that cancer. Data came from the 2018 Behavioral Risk Factor Surveillance System, administered by the US Centers for Disease Control and Prevention. Metropolitan status, according to whether participants lived in a metropolitan statistical area. Overscreening was assessed using US Preventive Services Task Force definitions, ie, whether participants self-reported having a screening after the recommended upper age limit for colorectal (75 years), cervical (65 years), or breast (74 years) cancer. Of 176 348 participants (155 411 [88.1%] women; mean [SE] age, 75.0 [0.04] years; 150 871 [85.6%] non-Hispanic white; 60 456 [34.3%] with nonmetropolitan residence) the cancer-specific subsamples contained 20 937 [11.9%] men and 34 244 [19.4%] women for colorectal cancer, 82 811 [47.0%] women for cervical cancer, and 38 356 [21.8%] women for breast cancer. Overall, 9461 men (59.3%; 95% CI, 57.6%-61.1%) were overscreened for colorectal cancer; 14 463 women (56.2%; 95% CI, 54.7%-57.6%), for colorectal cancer; 31 988 women (45.8%; 95% CI, 44.9%-46.7%), for cervical cancer; and 26 198 women (74.1%; 95% CI, 73.0%-75.3%), for breast cancer. Overscreening was more common in metropolitan than nonmetropolitan areas for colorectal cancer among women (adjusted odds ratio [aOR], 1.23; 95% CI, 1.08-1.39), cervical cancer (aOR, 1.20; 95% CI, 1.11-1.29), and breast cancer (aOR, 1.36; 95% CI, 1.17-1.57). Overscreening for cervical and breast cancers was also associated with having a usual source of care compared with not (eg, cervical cancer: aOR, 1.87; 95% CI, 1.56-2.25; breast cancer: aOR, 2.08; 95% CI, 1.58-2.76), good, very good, or excellent self-reported health compared with fair or poor self-reported health (eg, cervical cancer: aOR, 1.21; 95% CI, 1.11-1.32; breast cancer: aOR, 1.47; 95% CI, 1.28-1.69), an educational attainment greater than a high school diploma compared with a high school diploma or less (eg, cervical cancer: aOR, 1.14; 95% CI, 1.06-1.23; breast cancer: aOR, 1.30; 95% CI, 1.16-1.46), and being married or living as married compared with other marital status (eg, cervical cancer: OR, 1.36; 95% CI, 1.26-1.46; breast cancer: OR, 1.54; 95% CI, 1.34-1.77). In this study, overscreening for cancer among older adults was high, particularly for women living in metropolitan areas. Overscreening could be associated with health care access and patient-clinician relationships. Additional research on why overscreening persists and how to reduce overscreening is needed to minimize risks associated with cancer screening among older adults.