Cervical Cancer Screening Services Research Articles

Customer-Care Initiatives of Service Providers and the Uptake of Breast and Cervical Cancer Screening Services in Mutare, Zimbabwe

Social marketing globally promotes social mobilization to increase uptake of recommended health services. The Ministry of Health and Child Care in Zimbabwe markets breast and cervical cancer screening for reproductive-age women. Despite efforts, uptake remains low, particularly in Mutare district. To address this, an analytical cross-sectional study was conducted in Dangamvura suburb to explore the relationship between service providers' customer-care initiatives and screening uptake. Qualitative and quantitative data was collected via interviews with 96 women aged 18 to 49, randomly selected from Dangamvura Poly-Clinic departments. Of these women, 13.5% were screened for breast cancer, 30.3% for cervical cancer, and 78.8% expressed intent to screen. 90.3% had accurate knowledge of breast and cervical cancer, but only 30.3% could identify screening sites. Among those screened, 75.8% intended to retest. Primary motivations for screening included a desire for health status knowledge (39.2%) and reproductive system issues (32.1%). Main barriers for non-screened women were lack of motivation (56%) and fear of positive results (16.7%). Logistic regression indicated protective factors for screening uptake: history of reproductive issues (AOR: 9.0678, p: 0.0029), prior breast cancer screening (AOR: 21.4347, p: 0.0006), and age 31 to 49 (AOR: 0.1754, p: 0.0066). Overall, uptake was low, influenced by customer factors (age, reproductive issues, prior breast cancer screening) and cost factors (perceived wait times, screening duration, perceived costs). Future interventions aimed at improving uptake of screening services should be tailored to address fears, misconceptions, and lack of motivation to screen among women of reproductive age.

Non-use and inadequate use of cervical cancer screening among a representative sample of women in the United States.

Women's adherence to the United States (U.S.) Preventive Services Task Force guidelines for cervical cancer screening was determined by examining predisposing, enabling, and needs factors from Andersen's Behavioral Model of Health Services Use conceptual framework. The outcome was operationalized as cervical cancer screening use, non-use, and inadequate-use. Multinomial logistic regression was conducted on data from the 2019 National Health Interview Survey of 7,331 eligible women aged 21-65. Compared with women who used cervical cancer screening services, women aged 30-65 were less likely to be Non-Users than those aged 21-29. Hispanic, Asian, and American Indian/Alaska Native (AIAN) women were more likely to be Non-Users than White women. More educated women were less likely to be Non-Users. Foreign-born women <10 years in the U.S. were more likely to be Non-Users than U.S.-born women. Women with financial hardship were less likely to be Non-Users. Poorer women and uninsured women were more likely to be Non-Users. Women with children in their household were less likely to be Non-Users than those without children. Women who had a well-visit in the past year were less likely to be Non-Users. Women with a history of human papillomavirus (HPV) vaccination were less likely to be Non-Users. Compared with women who used cervical cancer screening services, women aged 30-65 were less likely to be Inadequate-Users. AIAN women were more likely to be Inadequate-Users. Women of other races were less likely to be Inadequate-Users. Employed women were less likely to be Inadequate-Users. Uninsured women were more likely to be Inadequate-Users. Women who had a well-visit within a year were less likely to be Inadequate-Users. Women with past HPV vaccination were more likely to be Inadequate-Users. Smokers were less likely to be Inadequate-Users. Predisposing, enabling, and needs factors are differently associated with non-use and inadequate use of cervical cancer screening. Understanding factors associated with the use, non-use, and inadequate use of cervical cancer screening is crucial to avoid or curb unnecessary tests, increased costs to both society and individuals, and the ill-allocation of limited resources.

Utilization of Cervical Cancer Screening Services and its Predictors among Health Workers in Hospitals in the Federal Capital Territory, Nigeria

Background: Cervical cancer (CC) ranks second as the leading cause of cancer morbidity and mortality in Nigeria, despite being preventable through screening. Female health workers (HCWs) are expected to be role models to motivate society towards Cervical Cancer Screening Service (CCSS)uptake. This study assesses the utilization of CCSS and associated factors among HCWs in three area councils of Abuja, Nigeria.&#x0D; Method: A cross-sectional design aimed at assessing the utilization of CCSS by HCWs in 13 health facilities across 3 area councils in Abuja. Study participants were selected using a multi-stage sampling technique. The outcome variable was “ever used CCSS” dichotomized into a “Yes” or “No” response. Factors associated with participants' utilization of CCSS were examined using a binary logistic regression at p&lt;0.05 level of statistical significance.&#x0D; Results: Data from 350 participants (90.6%) were analyzed. Most were married women, 290 (82.9%), between the ages of 21 to 30 years, 275 (78.6%). About twothirds of the participants, (237) reported ever being screened for cervical cancer. Factors associated with CCSS utilization at the bivariate level included marital status, duration of practice, and a negative perception regarding access to cervical cancer services. Perceived access barrier to CCSS was the only strong predictor for CCSS utilization after controlling confounders [Adjusted Odd Ratio: 0.01, 95%CI: 0.01 – 0.03].&#x0D; Conclusion: The perceived access barrier is a strong determinant of the CCSS utilization rate among HCWs in our study site Efforts should be made to ensure access and create awareness about service availability and accessibility among HCWs in the Federal Capital Territory.

Health situation analysis of cervical cancer in Delhi

The capital city of India, Delhi is endowed with a plethora of multi- and super-specialty hospitals, both private and government, for treating various diseases. Patients from around the globe seek medical care in Delhi. The primary healthcare system is robust, with a network of newly established Mohalla and polyclinics. However, when it comes to a sensitive disease, ‘cervical cancer’, all glorious claims mentioned above seem to be inadequate. Cervical cancer is the 2nd most common cancer among Delhi's females. Delhi was 1st state to launch HPV vaccination as a public health program in 2016 despite resistance from civil societies. A situation analysis from literature reveals that cervical cancer screening services at the primary and secondary levels are on the backburner in Delhi, which is also evident from the poor screening habits of Delhi's females (0.7%) according to NFHS-5. This prompts questions regarding organization of the cervical cancer prevention program (NP-NCD) and the delivery of screening services in Delhi. In this review we have tried to illuminate the contemporary landscape of cervical cancer burden, screening, and treatment, while also identifying opportunities for enhancing cervical cancer management in Delhi. The study finds that implementation research targeted at finding barriers in program organization and service delivery would help strengthen the capacity of Delhi’s health system.

HPV and Cervical Cancer Awareness and Screening Practices among Migrant Women: A Narrative Review.

This narrative review explores the barriers and facilitators that migrant women face globally. The review explored a range of studies conducted in various countries, including the United States of America (USA), the United Kingdom (UK), Canada, Australia, and the United Arab Emirates (UAE). It also specialises in the experiences of migrant women living in Sydney, Australia, and women living in Ras Al Khaimah (RAK), UAE. Cervical cancer ranks as the fourth most prevalent form of cancer among women worldwide. It is the fourteenth most common cancer among women in Australia and the fourth most common cancer in the UAE. Despite the availability of vaccinations and cervical screening initiatives in many countries, including the USA, the UK, Canada, Australia, and the UAE, migrant women living in these countries continue to experience considerable health gaps when accessing cervical cancer screening services. Addressing these disparities is crucial to ensuring everyone has equal healthcare access. An electronic search was conducted using three databases to identify articles published between 2011 and 2021. Qualitative, quantitative, and mixed-methods research studies were included in the search. The identified factors were classified into categories of barriers and facilitators of cervical screening uptake, which were then sub-categorized. This narrative review examines the awareness of cervical cancer and screening behaviours, attitudes, barriers, and facilitators associated with cervical cancer screening. According to the study, several factors pose significant obstacles for migrant women worldwide, particularly those living in the USA, the UK, Canada, and Sydney, Australia, and Emirati and non-Emirati women (migrant women) residing in RAK when it comes to undergoing cervical cancer screening. These barriers include inadequate knowledge and emotional, cultural, religious, psychological, and organisational factors. On the other hand, social support, awareness campaigns, and the availability of screening services were found to promote the uptake of cervical cancer screening. The findings from this review suggest that healthcare providers should adopt culturally sensitive approaches to enhance awareness and encourage participation in screening programs among migrant women. Based on the findings of this narrative review, it is strongly suggested that healthcare providers and policymakers prioritise developing culturally sensitive screening initiatives for migrant women. It is essential to address the psychological and emotional barriers that prevent migrant women from accessing screening services. This can be accomplished by offering education and awareness campaigns in their native languages and implementing a community-based approach to encourage social support and increase awareness of cervical cancer and screening services. Furthermore, healthcare providers and organisations should provide educational tools that address common misconceptions based on cultural and religious factors that prevent women from accessing screening services.

Abstract 2143: Association between health insurance coverage and stage of diagnosis for cervical cancer among women in Indiana from 2011-2019

Abstract Introduction: Cervical cancer is one of the most common types of cancer among women and it is caused by infection from the human papillomavirus (HPV). The incidence rates of cervical cancer have increased in Indiana from 7.8 in 2008-2012 to 8.4 in 2013-2017. In 2020, the screening rate for cervical cancer among women in Indiana was 76% when compared to a national average of 78%. Women diagnosed at earlier stages for cervical cancer had higher relative survival of 0.98 than those diagnosed at later stages with a relative survival of 0.43. Health insurance status is an important determinant for health outcomes for patients with cancer. This study aims to assess the extent to which health insurance coverage is a contributing factor to the stage of cervical cancer diagnosis. Methods: We examined reported cases of cervical cancer among women (N=2518) using cervical cancer registry data from the Indiana State Department of Health from 2011-2019. Using multinomial logistic regression model, we examined the associations of both race/ethnicity and insurance status with stage of diagnosis after adjusting for age at diagnosis. Results: In this sample, the average age at diagnosis was 48.98 years (SD = 14.98). The largest proportion of the sample was between 45 to 64 years of age (41.7%), Non-Hispanic White (85.5%), had private insurance coverage (41.8%), had cervix uteri, NOS as the primary site of diagnosis (76.5%), lived in a metropolitan area (74.5%) and had squamous cell carcinoma (73.4%). The largest percentage of Non-Hispanic White patients had private insurance (50.9%), whereas the largest percentage of Black patients had Medicaid (39.3%). 20.2% of Hispanic patients were uninsured when compared to 7.7% Non-Hispanic White and 3.6% Black patients. The multivariate analysis shows that women who are uninsured (OR = 2.475) and those who have Medicaid (OR = 2.321) were significantly more likely to be diagnosed at the regional stage than the in-situ stage compared to women with private insurance. Additionally, women who are uninsured (OR = 4.432) and those who have Medicaid (OR = 3.007) were significantly more likely to be diagnosed at the distant stage than in-situ, compared to women with private insurance. Conclusion: The findings show that insurance status is associated with the stage of diagnosis for cervical cancer and detection at regional or distant stages often leads to higher morbidity. Impact - Increased coverage for routine cervical cancer screening and preventive care services is recommended, especially for uninsured women and women with public insurance such as Medicaid or Medicare. Citation Format: Mrithula Suresh Babu, Monica L. Kasting, Natalia M. Rodriguez. Association between health insurance coverage and stage of diagnosis for cervical cancer among women in Indiana from 2011-2019 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2143.

Abstract 821: Uptake of cervical cancer screening services by women living with HIV in Kajiado County Kenya

Abstract Background: This project is an African Caribbean Cancer Consortium (AC3) facilitated study: Women living with HIV (WLHIV) are more susceptible to cancer due to their immune-compromised status. The Kenya Ministry of Health recommends that women diagnosed with HIV should be screened for cervical cancer annually by either visual inspection with acetic acid (VIA) or visual inspection with Lugol’s iodine (VILI), cytology and testing for HPV once every two years. Objective: We determined the uptake of cervical cancer screening and HPV testing by women living with HIV (WLHIV) in Kajiado County in 2022. Methodology: The electronic health information system was used to abstract data for WLHIV in Kajiado county. Kajiado county has 57 antiretroviral (ART) facilities. However, our analysis accessed data from 38 facilities whose data is captured in the health information system. Authorized health care workers from the county were requested to abstract redacted data from the health information system. No personal identifiers were collected from the system as a means of protecting the privacy of individuals and abiding with the Kenya’s data protection law. Authorization to access the county was obtained from the county’s department of health while ethical approval was obtained from Mount Kenya University’s Institutional Scientific and Ethics Review Committee. Results: A total of 16,827 people living with HIV were enrolled for care at the 38 ART selected sites in 2022. Out on the total population that was enrolled for care, 11,785 (70%) were women with an age range of 15 to 49 years. A total of 3342 WLHIV, representing 28.36% of the target population, were screened by using visual inspection with acetic acid (VIA). Data for other methods of screening and HPV testing was not available in the health information systems. Of those screened, 3240 (97%) tested negative, 78 (2.3%) had positive results while 24 (0.7%) had suspicious lesions. Conclusion: Our analysis shows low uptake of cervical cancer screening services with only 28.36% of the targeted women being screened in 2022. The only available testing method (VIA) is less robust as compared to cytology and HPV testing. We also found a gap in reporting of HPV testing in the county. We thus recommend implementation science research examining the systemic barriers to HPV testing and reporting to better inform best practice HPV-related cancer prevention and control policy and practice to reduce cancer-related morbidity and mortality among WLHIV. Citation Format: Caren Kamau, Alice Njoroge, Francis Makokha, Kimlin T. Ashing. Uptake of cervical cancer screening services by women living with HIV in Kajiado County Kenya [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 821.

Factors Influencing the Uptake of Cervical Cancer Screening Services among Women Attending Gynecological OPD at KIUTH, Ishaka-Bushenyi, South Western Uganda

This work aimed to determine the factors influencing uptake of cervical cancer screening services among women attending gynecologic OPD at KIUTH, Ishaka-Bushenyi, South-western Uganda. A cross sectional study design and Quantitative approach was used. 100 women attending gynecologic OPD at KIUTH were selected using Kish Leslie formular. Data collected using a questionnaire was entered and analyzed using SPSS, presented in frequency, percentage and P-values tables. 41.2% were aged 25-31 years and the minority 2.0% being &gt;45 years. 65.7% coming away from Ishaka; married 73.7% for 1-5 or 11-20 years each accounting for 32.5%. 37.4% while 30(30.3%) reached tertiary education level. 42.4% were unemployed whereas 7.1% were simply housewives. 50.0% had 2-4 children, and only 18.3% had &lt;2 children. 86.9% were aware while 13.1% who weren’t. 56.8% got their information concerning cervical cancer and its screening from health facility compared to 3.7% from press. 34.7% had knowledge on screening recommendation among adult women who specified it being 22.1% every three years and 12.6% yearly. 88.4% specified it to be treatable if detected early with a P-value=&lt;0.01*, 73.5% knows a local health facility offering the services; p-value=0.05, 53(62.4%) of 62.2% claim that results return time could influence the testing uptake, pvalue=0.18, also, 89.2% agreed that Recommendation/counseling affects the uptake of cervical cancer screening/testing p-Value=0.05, as well as having tested before 43.4% already tested had a p-value=0.05. Long distance to HF affects 75.9% aware of screening of 77.1% p-value=0.49, cervical test cost affect with 75.6% aware of the services p-value=0.55, and Gender of HW where 39.5% who were aware of the services out of 47.5% agreed that it affects uptake p-value=&lt;0.001. According to the study findings, awareness/knowledge of cervical cancer screening/testing services among women attending KIUTH stands at 86.9%; whose info is mostly from health facility and Television/Radio. Early detection; availing of local health facility, short results return time, Recommendation/counselling and having tested before increases uptake whereas the long distance to the health facility, cervical test cost and longest distances reduces uptake of cervical cancer and screening services/testing. Keywords: Cervical cancer, Screening services, Healthy facility, Women, OPD.

Barriers to cervical cancer screening in Africa: a systematic review

IntroductionAfrica has one of the highest burdens of cervical cancer in the world. The unacceptably high incidence and mortality rates could be reduced through implementing a comprehensive approach to its prevention and control that includes screening, which however, is low in most low-and-middle-income countries. Hence, this systematic review aims at exploring factors that prevent women from utilising cervical cancer screening services in the region.MethodsA mixed method systematic review was conducted. A search was performed on PubMed (Medline), EMBASE, CINAHL (EBSCOHOST) and Scopus databases for articles published until May 2019 without time, language or study design limits. Two reviewers critically appraised the included studies independently using the standard quality assessment criteria for evaluating primary research papers. Results of the quantitative and mixed methods studies were transformed into qualitative data and synthesised using thematic analysis.ResultsFrom a potential 2 365 studies, 24 from 11 countries met the eligibility criteria and were selected; eight qualitative, 13 quantitative, and three that used the mixed-method approach. The primary barriers were identified as poor access to screening services, lack of awareness and knowledge on cervical cancer and screening, and socio-cultural influences. Service providers perceived lack of skills, screening equipment and supplies, and staff shortages as the major barriers to the provision of screening services.ConclusionBarriers to cervical cancer screening in Africa are multifaceted and require a holistic approach that will address them concurrently at the health system, individual, interpersonal, community and structural levels. Political will complimented by stakeholder involvement is required in the development and implementation of strategies that will ensure acceptability, availability, accessibility, and affordability of screening to minimise barriers in accessing the service.

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

BackgroundWomen with HIV have a higher risk of getting cervical cancer due to induced immunosuppression. Though this burden could be avoided through early identification and appropriate management, there is a paucity of information about the utilization of cervical cancer screening (CCS) services in Lira City, Uganda. This study investigated the level and factors associated with the utilization of cervical cancer screening services among HIV-positive women aged 18 to 49 years at Lira Regional Referral Hospital, Lira City, Uganda.MethodsWe conducted a facility-based cross-sectional study employing quantitative techniques. We used consecutive sampling to recruit 297 HIV-positive women at the ART clinic of Lira Regional Referral Hospital. A structured researcher-administered questionnaire was used to collect data. Descriptive statistics were performed to summarize the data. A modified Poisson regression using robust standard errors was performed to ascertain the factors associated with the utilization of cervical cancer screening. Prevalence ratios at 95% confidence intervals were reported.ResultsOut of 297 respondents, 175(58.9%) utilized cervical cancer screening in this study. The factors found to be associated with CCS were; having ever heard of CCS (Adjusted Prevalence Ratio [PR] 1.80, 95% CI 1.31–2.49, p < 0.001), knowing where CCS is done (Adjusted PR 1.99, 95% CI 1.42–2.81, p < 0.001), fear of CCS outcomes (Adjusted PR 0.67, 95% CI 0.54–0.84,p < 0.001), not knowing whether CCS is beneficial or not (Adjusted PR 0.39, 95% CI 0.20–0.75,p = 0.005) and having friends/relatives who screened for cervical cancer (Adjusted PR 1.31, 95% CI 1.09–1.59, p = 0.005).ConclusionThe level of utilization of cervical cancer screening services among HIV-positive women was suboptimal. Implementation of structured interventions aimed at improving cervical cancer screening awareness among HIV-positive women is crucial. Additionally, to increase opportunities for screening and knowledge on cervical cancer prevention, screening programs can target HIV-positive women during their routine clinic visits.

Exploring self-care and cervical cancer prevention attitudes and practices among Moroccan and Pakistani immigrant women in Catalonia, Spain: a comparative qualitative study.

Self-care and preventive health strategies may trigger health inequities when individuals' cultural values and health beliefs are not fully understood and considered. In the case of cervical cancer (CC) screening programs immigrant women have shown lower attendance compared with native women, which increases the risk of late diagnosis and, consequently, a lower probability of survival. HPV self-sampling for CC screening has been recently added to the World Health Organization's (WHO) list of self-care interventions as a promising tool to reduce this disparity and improve screening coverage. In Catalonia, Spain, the introduction of HPV self-sampling as a part of the new population-based CC screening program, is a significant step. However, there is a lack of research addressing self-care and prevention among immigrant populations in this region. This study aims to fill this gap exploring self-care and prevention attitudes and practices among Moroccan and Pakistani women. We conducted focus groups and individual interviews with 36 Moroccan and 37 Pakistani women in Barcelona, Spain. The topic guide of the focus groups included case vignettes to stimulate the discussion and a semi-structured questionnaire was used for the interviews. Our findings show that most Moroccan and Pakistani women do not prioritize self-care and prevention. They seek care for symptom treatment rather than disease prevention. In this sense, they reported not having the habit of doing regular check-ups and their self-care and prevention attitudes and practices seemed to be conditioned by cultural values. The implementation of an effective call and recall system could enhance the engagement of these populations with CC screening services. This study provides evidence on how universal concepts of self-care and prevention may not aligned with more collectivist societies, emphasizing the limited applicability and motivation of global self-care interventions guidelines for individuals with different cultural backgrounds and values. Therefore, the successful implementation of CC screening programs or any other self-care intervention requires the adoption of culturally appropriate strategies.

Utilization and associated factors of cervical cancer screening service among eligible women attending maternal health services at Adare General Hospital, Hawassa city, Southern Ethiopia

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.

Attitudes of women towards screening, prevention and treatment of cervical cancer in Namibia.

Cervical cancer is among the top causes of cancer-related deaths among women globally. The aim of the study was to assess the attitudes of women of reproductive age towards cervical cancer services in the Otjozondjupa region, Namibia. The setting of this study was the Otjozondjupa region, one of the 14 regions of Namibia. A quantitative, cross-sectional, descriptive study was used. The data were collected with a questionnaire from a stratified sample of 381 out of the 37066 study population of women of reproductive age across four districts of the region. Descriptive data analysis was performed using Statistical Package for Social Science version 25. The findings revealed that most respondents (83.1%) had an overall neutral attitude towards the screening, prevention, and treatment of cervical cancer; they were not concerned about the risk of cervical cancer and would not practice health-seeking behaviours regarding cervical cancer services. The respondents were indifferent with regard to prevention, screening, and management services for cervical cancer, implying that they would not use available cervical cancer services. Attitudes of women of reproductive age towards cervical cancer services were highlighted. Subsequently, an educational programme for nurses to enhance the utilisation of cervical cancer services among women of reproductive age in the Otjozondjupa region, Namibia, was developed. Guidelines were developed to facilitate the implementation and evaluation of the educational programme activities to enhance the utilisation of cervical cancer screening services among women of reproductive age.

Cervical Cancer Awareness and Screening Practices Amongst Women in Ras Al-Khaimah, UAE and Migrant Women in Sydney, Australia

Cervical cancer is the fifth most common cancer in the UAE and the fourteenth most common cancer among women in Australia (Sung et al., 2021). Despite the introduction of vaccinations and cervical screening programs in both countries, Emirati and non-Emirati women living in Ras Al Khaimah and migrant women living in Sydney still face significant health disparities when accessing cervical cancer screening services. Currently, there is a lack of literature examining the obstacles to and facilitators of cervical screening among these groups of women. This study aimed to better understand the knowledge and awareness of cervical cancer and factors that hinder or promote access to cervical screening among these groups, which is crucial if healthcare professionals and policymakers are to deliver culturally sensitive services. This study was conducted in Ras Al Khaimah (RAK) and Sydney. The results identified several barriers to cervical cancer screening participation, including lack of knowledge, emotional, cultural, religious and psychological barriers, and organizational factors. The findings have implications for policies to address these barriers and encourage women to participate in health awareness initiatives and screening services.

Examining the Challenges and Strategies for Improving Cervical Cancer Screening in Nigeria

Background: Cervical cancer is one of the most treatable cancers when detected early and managed. Unfortunately, the mortality rate is projected to surge in Nigeria.Objective: This review aims to provide updated information on challenges and strategies for improving cervical cancer screening in Nigeria.Methods: In this review, scientific papers published in electronic databases including PubMed, Scopus, and Google Scholar were retrieved using search themes such as “cervical cancer”, “risk factors”, and “preventive methods” were examined.Results: The true prevalence of cervical cancer is underestimate in Nigeria because most cases of cervical cancer are not documented. Lack of awareness, cultural barriers, poor infrastructure, unfavorable perception, shortage of supplies, lack of partner involvement, provider-related factors, poor monitoring, and evaluation system were the major barriers that hinder cervical cancer screening service in Nigeria.Conclusion: Lack of awareness, unfavorable perception, problems with health system structure and process, and cultural conditions were major barriers in Nigeria. Hence, packages of intervention is necessary create awareness, provide essential equipment, increase access to health facilities, and strengthening follow up system is indispensable for service improvement by the government and non-governmental organizations, world health organization inclusive.International Journal of Human and Health Sciences Vol. 08 No. 01 Jan’24 Page: 22-31

Implementation of cervical cancer prevention and screening across five tertiary hospitals in Nepal and its policy implications: A mixed-methods study.

In Nepal, cervical cancer is the most common cancer among women despite the existing policies. This study intends to assess the implementation of cervical cancer prevention and screening through service utilization by women, knowledge and attitude among health professionals, and the perceptions of stakeholders in Nepal. This mixed-methods study was conducted in 2022 across five tertiary hospitals in Kathmandu, Nepal. The quantitative study comprised the health professionals and women attending gynecology outpatient clinics from the selected hospitals. The qualitative study comprised stakeholders including service providers and experts on cervical cancer from selected hospitals, civil societies, and the Ministry of Health and Population. The utilization of screening through pap smear among 657 women across five hospitals was 22.2% and HPV vaccination was 1.5%. The utilization of cervical cancer screening was associated with older age [adjusted odds ratio (AOR) = 1.09, CI: 1.07, 8.19], married (AOR = 3.024, CI: 1.12, 8.19), higher education (AOR = 3.024, CI:1.12, 8.42), oral contraceptives use (AOR = 2.49, CI: 1.36, 4.39), and ever heard of cervical cancer screening (AOR = 13.28, CI: 6.85, 25.73). Among 254 health professionals, the knowledge score was positively associated with them ever having a training [Standardized Beta (β) = 0.20, CI: 0.44, 2.43)] and having outreach activities in their hospital (β = 0.19 CI: 0.89, 9.53) regarding cervical cancer screening. The female as compared to male health professionals (β = 0.16, CI: 0.41, 8.16, P = 0.03) and having a cervical cancer screening guideline as compared to none (β = 0.19 CI: 0.89, 9.53, P = 0.026) were more likely to have a better attitude for screening. The qualitative findings among 23 stakeholders reflected implementation challenges in policy, supply, service delivery, providers, and community. This study showed low utilization of prevention and services by women and implementation gaps on cervical cancer prevention and screening services across five tertiary hospitals in Kathmandu, Nepal. The findings could help designing more focused interventions.

Assessment of Sexual Health and Use of Cervical Cancer Screening among the Female Working Population.

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. 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. 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). In Serbia, all the activities should be directed towards increasing the levels of awareness and knowledge on sexual health and cervical cancer screening services.

Outcome and barriers to cervical cancer screening amongst human immunodeficiency virus-positive women attending Aminu Kano Teaching Hospital, Kano State, Nigeria

Sub-Saharan Africa carries the overwhelming share of the global burden of human immunodeficiency virus (HIV) infection and of HIV-associated cervical cancer. Screening is an effective strategy for the prevention, early diagnosis and prompt management of cervical precancerous lesions among HIV-positive women. This study assessed the outcome and barriers to cervical cancer screening among HIV-positive women attending Aminu Kano Teaching Hospital, Kano. Using a cross sectional study design, a pro forma was used to collect data and screen 740 HIV-positive women. Screening was done using visual inspection with acetic acid and Lugol’s iodine and the data were analysed using SPSS version 24.0. The age of the patients ranged from 25 to 49 years with a mean age of 30.7 ± 2.4 years. Majority (n=698; 94.3%) were  30 years and married (n=592; 80.0%). Almost half (n=362; 48.9%) had secondary level of education and many (n=520; 70.3%) were unemployed. A few (n=42; 5.7%) had positive results on visual inspection with acetic acid and a lesser proportion (n=26; 3.5%) had positive screening results on visual inspection with Lugol’s iodine. Lack of awareness of screening services for cervical cancer was found to be a barrier to cervical cancer screening and treatment among two-thirds (n=565; 76.4%) of the patients while a substantial proportion (n=592; 80.0%) reported that their personal belief which was strengthened by their religion prevented them from accessing cervical cancer screening services. Also, two-thirds (n=493; 66.6%) agreed that their culture which considers cervical screening a taboo was a barrier to screening. There is a need for targeted and enhanced education with counselling to optimize the uptake of screening for cervical cancer among HIV-positive women in HIV treatment centers. The generated data can guide in the provision of evidence-based policy and decision-making.

Factors Influencing Utilization of Cervical Cancer Screening Services among Women 20 Years or More Attending KIU-Teaching Hospital in Ishaka Bushenyi

Worldwide, cervical cancer strikes almost half a million women every year and is fatal in approximately half of these cases, particularly those in developing countries where screening programs are not well established with over 493,000 new cases of cervical cancer occurring each year among women, and 274,000 women dying of the disease annually. This study was designed to determine factors influencing the utilization of cervical screening services among women over 20 years attending KIUTH, Ishaka Bushenyi, Western Uganda. A descriptive cross-sectional study among 70 women 20 years or more attending KIUTH in Bushenyi district was sampled randomly and using a self-administered questionnaire, data was collected, coded, entered, and analyzed using IBM SPSS version 20; presented in frequency and percentage charts and tables and P-Values where necessary. According to the study findings, 70% had ever screened for cervical cancer. Using Pap smear (51.4%), VIA (37.1%) and Histology (11.4%). The majority 56(80.0%) had ever heard about cervical cancer. Mostly 39(55.7%) acquired their information from Health workers and to a considerable extent 20(28.6%) from media 55(78.6%) for expensiveness as the main hindrance. 52.4% not screened were not aware of the availability of the services. Nonetheless, 42(85.7%) among the screened agreed that the services were available but this was not statistically significant. A significant effect was noted with health workers’ sensitization about STIs 44(89.8%); 33(67.3%) further agreed that services cover cancer (cervical) prevention offering professional advice 42(85.7%). Once counseled, 33(82.5%) agreed that cervical cancer could be prevented. The utilization level stands at a good position with up to 70% screening mostly using pap smear. On an individual level; Health workers and media increases awareness and thus utilization. Statistically, health facilities/workers could further empower the utilization of cervical cancer screening through sensitization, counseling, and guidance concerning utilization. However, affordability, safety, and accessibility of such services and misinformation remain a hindrance to the utilization of cervical cancer screening services. Keywords: Cervical cancer, Women, Cervical screening, Pap smear.

Factors influencing the uptake and utilization of cervical cancer screening services among women attending public health centers in Addis Ababa, Ethiopia: mixed methods study

BackgroundCervical cancer is the second cause of cancer deaths among Ethiopian women. Despite multifaceted government efforts, the uptake and utilization of cervical cancer screening remain very low. This study aimed to assess factors influencing the uptake and utilization of cervical cancer screening at public health centers in Addis Ababa.MethodsA convergent parallel mixed-method study was employed to collect data through eight focus group discussions with 66 women purposively recruited from outpatient clinics, and cross-sectional face-to-face exit interviews with 80 women attending cervical cancer clinics in four high-patient volume health centers. The group interviews were tape-recorded, transcribed in Amharic, translated into English, and a thematic analysis approach was used in the analysis. Exit interview data were collected using a structured questionnaire in the Open Data Kit tool on an android tablet. STATA version 17 was used for descriptive and inferential data analyses. Statistical significance was set at p < 0.05.ResultsThe majority of focus group discussion participants had lack of knowledge of cervical cancer and its screening services. The major barriers to the uptake of screening were inadequate public awareness, fear of the procedure, embarrassment, provider’s gender, lack of male partner support, and childcare. Women aged 40 years and above were 13.9 times more likely to utilize cervical cancer screening than those under 30 years (AOR = 13.85; 95% CI: 1.40, 136.74). There was a strong preference for a female provider (AOR = 7.07; 95% CI: 1.53, 32.75) among women screened after attending antiretroviral therapy clinics and those screened due to abnormal vaginal bleeding than women referred from family planning clinics (AOR = 6.87; 95% CI: 1.02, 46.44). Safety of screening was negatively associated with women aged 30–39 (AOR = 0.045; 95% CI: 0.003, 0.696), and those who attended primary education, and secondary education and above, (AOR = 0.016; 95% CI: 0.001, 0.262), and (AOR = 0.054; 95% CI: 0.004, 0.724), respectively.ConclusionsThe study identified low public awareness, inadequate provider preference, safety concerns, and poor male partner support for cervical cancer screening. We recommend the decision-makers enhance public messages, maintain provider choices, ensure safety, and engage males to improve the uptake and utilization of cervical cancer screening.