Cervical Cancer Screening Services Research Articles

Assessment of Knowledge and Attitude towards Cervical Cancer Screening among Women in Reproductive Age in Chawama Compound, Lusaka, Zambia

Cervical cancer is a cancer of the cervix, the organ connecting the uterus and the vagina. It is predominantly caused by human papilloma virus (HPV), which is a sexually transmittable infection-causing pathogen. The purpose of this study was to assess the knowledge and attitudes toward cervical cancer screening among women of the reproductive age group in the Chawama compound Lusaka district. A descriptive cross-sectional research design was used to collect data. The researcher used a questionnaire that included both structured and open-ended questions. Results: Results of this study showed knowledge 59 (73.75%) out of 80 respondents had good knowledge on cervical cancer. The study also revealed that (22%) 18 out of 80 respondents have been screened for cervical cancer, and (78%) 62 out of 80 respondents had never been screened for cervical cancer. The respondents who agreed that cultural beliefs could hinder women from going for cervical cancer were, 18 (22%) out of 80, and 62 (78%) out of 80 denied that cultural beliefs cannot hinder women from going for cervical cancer screening. There is therefore needed to create proper awareness and sensitization of cervical cancer screening as well as improve cervical cancer screening services. Keywords: Attitude, Cervical cancer, Cervical cancer screening, Knowledge.

The prevalence of cervical abnormalities: Comparison of youth with perinatally acquired HIV and older women in Botswana.

Cervical cancer burden and prevalence of precursor lesions is unknown among young women living with HIV in high prevalence settings. Current cervical cancer screening guidelines in resource-limited settings with high HIV prevalence typically exclude adolescents and young women. After observing two cases of advanced cervical cancer among young women with perinatally acquired HIV, a pilot screening programme was established in Botswana. To compare the prevalence of cervical abnormalities in young women with perinatally acquired HIV with women aged 30-49 years, regardless of HIV status. We conducted a cross-sectional study of 30-49-year-old women who had visual inspection with acetic acid screening through the Botswana public sector programme, and youth (aged 15-24 years) with perinatally acquired HIV, at a single referral site between 2016 and 2018. We describe the prevalence of cervical abnormalities in each group as well as the crude prevalence ratio. The prevalence of cervical abnormalities in women 30-49 years of age was 10.9% (95% confidence interval [CI]: 10.4, 11.4), and 10.1% (95% CI: 4.7, 18.3) for youth. The crude prevalence ratio was 1.07 (95% CI: 0.58, 2.01). Inclusion of youth living with HIV in cervical cancer screening services should be considered in settings with a high prevalence of HIV and cervical cancer.

Utilization of cervical cancer screening services and its associated factors in Iran: a case–control study

BackgroundConsidering the high incidence rate of cervical cancer (CC) in Iran, screening is an effective way of reducing the impact of the disease due to early detection. Thus, the recognition of the factors affecting the use of cervical cancer screening (CCS) services is essential.The present study aimed to determine the associated factors of CCS in women living in the suburbs of Bandar Abbas in the south of Iran.MethodsThe present case–control study was conducted between January and March 2022 in the suburban areas of Bandar abbas. Two hundred participants were assigned to the case group and 400 participants were assigned to the control group. A self-constructed questionnaire was used to collect the data. This questionnaire contained demographic information, reproductive information, knowledge of CC, knowledge of CCS and access to the screening. Univariate and multivariate regression analyses were run to analyze the data. The data were analyzed in STATA 14.2 at a significance level of p < 0.05.ResultsThe mean and standard deviation of participants’ age in the case group was 30.33 ± 4.892, and in the control group was 31.35 ± 6.149. The mean and standard deviation of knowledge in the case group was 10.21 ± 1.815 and in the control group was 7.24 ± 2.447. The mean and standard deviation of access was 43.72 ± 6.339 in the case and 37.17 ± 4.828 in the control group. The results of multivariate regression analysis showed the following factors increased the odds of CCS: knowledge (OR medium = 18.697, OR high = 13.413), access (OR medium = 4.028, OR high = 8.126), being married (OR = 3.193), being educated (OR diploma = 2.587, OR university degree = 1.432), middle and high SES (OR Middle = 6.078, OR Upper = 6.608), and not smoking (OR = 1.144). Also, women's reproductive status, including history of sexually transmitted diseases (OR = 2.612), use of oral contraceptives (OR = 1.579), sexual hygiene (OR = 8.718).ConclusionsIn the light of the present findings, it can be concluded that besides increasing suburban women’s knowledge, their access to screening facilities should be improved. The present findings showed the need to remove the barriers to CCS in women of low SES to increase the rate of CCS. The present findings contribute to a better understanding of factors involved in CCS.

Understanding Barriers and Facilitators of Breast and Cervical Cancer Screening among Singapore Women: A Qualitative Approach.

The uptake of breast and cervical cancer screening services among women in Singapore remains inadequate. Little is known about how gender norms influence women's decision to undergo these screening services in a multi-ethnic Asian context. This research aimed to explore how gender-based qualitative factors influence women's decision to screen. Qualitative data were collected using semi-structured interviews from 40 racially diverse women aged 25 and above who had visited polyclinics for their chronic disease management. Women were recruited using a purposive maximum variation sampling strategy to ensure representation of their views from the three major ethnic groups and based on inclusion criteria. Interviews were conducted either face-to-face or via telephone call. Interviews were audiotaped and lasted 30 minutes on average. Interviews were conducted until data saturation was reached. The data was transcribed and analysed thematically. Gender norms and gender non-concordance with the healthcare professionals did not inhibit women from undergoing breast and cervical cancer screening services to a large extent. Women were empowered and had a central role in decision-making for screening services. Healthcare initiatives such as subsidies and mobile health applications facilitated the uptake of breast and cervical cancer screening services but can be improved further. Some of the barriers reported by Malay Muslims were not dissimilar to previous qualitative studies with women in this ethnic and religious group. Gender socialisation, empowerment, and healthcare initiatives did not inhibit our study participants' decision to undergo breast and cervical cancer screening services. However, new initiatives and strengthening of the existing healthcare initiatives are needed to overcome any remnants of gender-related nuances and convert non-doers into doers.

Preferences for Breast and Cervical Cancer Screening Among Women and Men in Kenya: Key Considerations for Designing Implementation Strategies to Increase Screening Uptake.

Breast and cervical cancer incidence rates and mortality rates in Kenya are high. Screening is globally accepted as a strategy for early detection and downstaging of these cancers for better outcomes, but despite the efforts established by the Kenyan government to provide these services to eligible populations, uptake has remained disproportionately low. Using data from a larger study aimed at understanding the implementation and scale-up of cervical cancer screening services, we analyzed data to compare the preferences for breast and cervical cancer screening services between men and women (25-49years) in rural and urban communities in Kenya. Participants were recruited in concentric circles starting at the center of six subcounties. One woman and one man per household were enrolled for data collection on a continuous basis. More than 90% of both men and women had a monthly income of less than US $500. The top three preferred sources of information on screening for cancers affecting women were health care providers; community health volunteers; and media such as television, radio, newspapers, and magazines. More women (43.6%) than men (28.0%) trusted community health volunteers to provide health information on cancer screening. Printed materials and mobile phone messages were preferred by approximately 30% of both genders. Over 75% of both men and women preferred an integrated model of service delivery. These findings show that there are many similarities that can be leveraged when designing implementation strategies for population-wide breast and cervical cancer screening hence reducing the challenge of addressing diverse preferences of men and women which may not be easy to reconcile.

HPV and Cervical Cancer: A Review of Epidemiology and Screening Uptake in the UK.

Cervical cancer is the fourth most common malignancy in females worldwide, and a leading cause of death in the United Kingdom (UK). The human papillomavirus (HPV) is the strongest risk factor for developing cervical intraepithelial neoplasia and cancer. Across the UK, the national HPV immunisation programme, introduced in 2008, has been successful in protecting against HPV-related infections. Furthermore, the National Health Service (NHS) implemented the cytology-based cervical cancer screening service to all females aged 25 to 64, which has observed a decline in cervical cancer incidence. In the UK, there has been an overall decline in age-appropriate coverage since April 2010. In 2019, the COVID-19 pandemic disrupted NHS cancer screening and immunisation programmes, leading to a 6.8% decreased uptake of cervical cancer screening from the previous year. Engagement with screening has also been associated with social deprivation. In England, incidence rates of cervical cancer were reported to be 65% higher in the most deprived areas compared to the least, with lifestyle factors such as cigarette consumption contributing to 21% of cervical cancer cases. In this article, we provide an update on the epidemiology of cervical cancer, and HPV pathogenesis and transmission, along with the current prevention programmes within the NHS.

Setting Up a Cytology Laboratory for Cervical Cancer Screening in a Developing Country: A One Year’s Early Experience at a Private Facility

Introduction: Widespread cytology-based method of screening such as Pap smear test has significantly led to a reduction in the incidence and mortality associated with cervical cancer in many developed countries. In these countries, facilities needed for early detection of cervical cancer such as cytology laboratories are existent and generally available to their population. In a developing country like Somalia, access to cytology services for cervical cancer screening remains limited and as result majority of patients present with advanced stage disease (stage III &amp; IV) that is too difficult to treat. Intervention: To address this challenge, the management of AL-Zahra Specialty Hospital contracted a cytologist based in Uganda to guide in setting-up of cytology laboratory in the heart of Mogadishu, Somalia so as to provide cervical cancer screening and diagnostics services to the population. Other interventions made by the visiting cytologist involved guiding the procurement officer in the purchase of basic equipment, reagents, consumables and training of health care staff. This resulted into conducting 1020 cervical cytological tests over a period of 12months (1st September, 2018 to 30th September 2019). Lesions learnt: In order to increase access to cytology services, we learnt that the federal government of Somalia should consider making cervical cytology (pap smear test) as part of routine screening policy for all sexually active women as part of health care package. An increase in sample volume may be improved through awareness campaigns and conducting community screening activities. Conclusion: Somalia, a developing country has made great strides towards addressing the limited facilities for cervical cancer screening by using very limited funding. We hope that our experiences shall provide technical guidance &amp; direction to physicians, laboratory managers and investors who wish to establish similar cervical cytology laboratories in an economically constrained low-resource setting.

The Facilitating Factors and Barriers for Nurses, to Utilize the Screening Services for Cervical Cancer in Tertiary Hospital of South India

Background: Cervical cancer screening needs to be considered as an integral part of maintaining women’s healthincluding the healthcare providers.Objective: The objective of the study was to assess the barriers and facilitators, women health professionals face,when accessing the cervical cancer screening services.Research Method: This is a descriptive, cross-sectional , mixed method study. The participants of the study werefemale nurses from selected tertiary level hospital from Tamilnadu, India. For quantitative method, standardizedvalidated tool was used with author’s permission. The participants participated were 125 in number. Qualitativeinterviews were conducted.Results: The result showed that the common perception about the pap- smear procedure was being uncomfortable,anxiety provoking and painful as expressed by (35.2%, 33.6 and 33.6%) respectively. This overall poor attitudeand carelessness of the female nurses may greatly hamper the screening program. Major barriers for cervicalcancer screening among the nurses were found to be as follows: 31.2% said Taking off Clothes for the screeningprocedure is considered as a barrier, 20% said they do not prefer the presence of male staff during the procedureand 20% said its time consuming.Conclusion: To conclude, if health care providers lack health awareness, they cannot motivate their patientsto do the same. Thus, the initial step in breast and cervical cancer screening is health care providers shouldfocus of their own health.

Cervical Cancer Screening Service Utilization and Associated Factors Among Women Living With HIV Receiving Anti-Retroviral Therapy at Adama Hospital Medical College, Ethiopia.

Cervical cancer is the second highest cause of cancer-related mortality in the world, and it is one of the top 20 causes of mortality in Ethiopia. Even though cervical cancer is more common among women living with HIV, the utilization of cervical cancer screening services remains low in Ethiopia. This study aimed to assess cervical cancer screening service utilization and associated factors among women living with HIV receiving anti-retroviral therapy at Adama Hospital Medical College, Ethiopia. An institution-based cross-sectional study was conducted among a sample of 304 women living with HIV from 1st-30th June 2022. Data were collected using an interviewer-administered questionnaire. The data were entered into Epi info version 7 and exported to SPSS version 25 for analysis. Bi-variable logistic regression analysis was used to identify candidate variables at p < .25. Finally, multivariable logistic regression analysis was used to identify the independent predictors of cervical cancer screening service utilization at p < .05 with 95% confidence intervals. The magnitude of cervical cancer screening service utilization was 26.9% (95% CI: 22.0, 32.6). Being a government employee (AOR: 8.09, 95% CI: 1.5, 41.19), having a family history of cervical cancer (AOR: 3.4, 95% CI: 1.02, 11.9), being aware of cervical cancer screening (AOR: 3.75, 95% CI: 2.11, 14.7), having a history of sexually transmitted infection (AOR: 3.14, 95% CI: 1.95, 10.2), and heard about cervical cancer (AOR: 2.6, 95% CI: 1.05, 6.41) were associated with cervical cancer screening service utilization. The magnitude of cervical cancer screening service utilization was low. It was associated with occupation status, family history of cervical cancer, awareness about cervical cancer screening, history of STI, and ever heard about cervical cancer. Thus, to maximize utilization, health education programs and other multidisciplinary strategies had to be implemented.

Abstract A118: Uptake of cervical cancer screening services in urban Zimbabwe: Healthcare provider perspectives

Abstract Background: In sub-Saharan Africa, Zimbabwe is among the top 6 countries with the highest cervical cancer incidence and mortality rates. Despite the disproportionate and growing burden, uptake of cervical cancer screening remains low. Little is known about the perceptions of healthcare providers who play a vital role in the provision and implementation of cervical cancer screening. This study explores healthcare provider perceptions of the factors that influence the uptake of cervical cancer screening in Zimbabwe. Methods: One-on-one in-depth interviews were conducted with healthcare providers currently or previously involved in cervical cancer prevention programs at select hospitals and clinics in Harare and Chinhoyi – two urban cities in Zimbabwe. A deductive thematic approach was used to analyze qualitative data to understand factors influencing the provision and uptake of cervical cancer screening. Results: We conducted 21 interviews with healthcare providers working in cervical cancer prevention for an average of 4 years. Three main themes related to the provision of cervical cancer screening were funding availability through donor support, demand of screening services, and availability of technical and human resources. Experiencing symptoms and no-cost screening services were perceived as facilitators for uptake of cervical cancer screening, while lack of adequate health education about cervical cancer and misconceptions about the screening procedure and outcomes were perceived as barriers to uptake of screening. Majority of the providers recommended increased sensitization and health education through various platforms; outreach initiatives; and training of more healthcare providers to conduct cervical cancer screening. Conclusion: This study contributes to a holistic understanding and identification of intervention points to effectively increase uptake of cervical cancer screening. Multi-level strategies promoting awareness of cervical cancer screening and strengthening healthcare systems may contribute significantly to increasing cervical cancer screening rates which in turn will lead to reducing the burden of cervical cancer in Zimbabwe. Citation Format: Thembekile Shato, Ucheoma Nwaozuru, Eric Adjei Boakye, Qiang John Fu, Juliet Iwelunmor, Anne Sebert Kuhlmann. Uptake of cervical cancer screening services in urban Zimbabwe: Healthcare provider perspectives [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A118.

Patient-Related Factors Influencing Uptake of Cervical Cancer Screening Services among Outpatient HIV-Positive Women at PCEA Chogoria Hospital, Tharaka-Nithi, Kenya

Patient-Related Factors Influencing Uptake of Cervical Cancer Screening Services among Outpatient HIV-Positive Women at PCEA Chogoria Hospital, Tharaka-Nithi, Kenya

Knowledge, Perceived Risks and Factors Affecting the Utilization of Cervical Screening Services among Females in Owerri North LGA

Background: Globally, cervical cancer screening services involves procedures put in to prevent and checkmate complications in the cervix. Lack of cervical screening services can lead to cervical cancers, one of the leading causes of death in women, which begin in cells on the surface of the cervix. The objective of this study was to determine the knowledge, perceived risks and factors affecting the utilization of cervical screening services among females in Owerri North LGA. Methods: A descriptive cross sectional study was employed in this research. The multi-stage simple random sampling procedure was employed to obtain a sample size of 424 respondents and a self-administered semi structured questionnaire was used to gather data for this study. The Statistical Package for the Social Sciences (SPSS) was used in the analysis of the data gotten from the study. Results: The results of this study revealed that majority, 27.8% (118) of the women represented age groups between 25-34 and 45-49. For the level of knowledge of cervical screening services, most of the respondents 86.4% (366) demonstrated knowledge of cervical screening, while 13.6% (58) denied. The study also showed a good number of females, about 41.2% (175), agreed that it was risky to avoid uptake of cervical screening. Majority of the respondents reported demonstrated their approval to utilize cervix screening if offered a chance (85.9%), while 14.1% (60) denied based on results from level of knowledge of cervical screening. 19.3% (82) reported family/husband acceptance, 18.7% (79) said “distance to facility” as some of the factors affecting the utilization of cervical screening practice. Further results for the test of a statistically significant association between socio-demographic characteristics and level of knowledge of cervical screening services, age (p=0.010), parity (p=0.0008), level of income (p=0.0092) and level of education (p=0.0327) were associated with level of knowledge of cervical screening services. Conclusion: In conclusion, this study showed good knowledge of the perceived risks of cervical screening among the females but this did not translate to willingness to utilize screening and awareness campaigns must provide accurate information on cervical screening so that females can make informed choices was recommended by this study

Seksualno ponašanje i prevalencija korišćenja skrininga karcinoma grlića materice u Šumadijskom okrugu

Introduction/Aim. Reproductive health and cervical cancer screeaning are public health priorities. The aim of the study was to asses the sexual behavior and prevalence of cervical cancer screening use in the Šumadija District, Serbia. Methods. The research was conducted as a cross-sectional study. The study population consisted of 510 females aged 18 -49 years, living on the territory of the Šumadija District. An anonymous standardised questionnaire was used as a research tool based on the research protocol entitled "The World Health organization, STEPwise Approach to Noncommunicable Disease Risk Factor Surveillance (STEPS)". Results. During the first sexual intercourse, 60.1% of the surveyed population used some of the contraceptives, whereas during the last sexual intercourse, 72.5% of the female respondents reported not having used any of these. Out of the total number of female respondents, every fifth respondent reported not having had a single Pap smear in her lifetime performed (22.8%), i. e. 85.0% of the female respondents aged 19 -29 years (p &lt; 0.001), every third female respondent who had completed elementary school (28.4%) p = 0.009, and every third respondent who was not married (33.3%) (p = 0.01). Conclusion. All the activities should be directed towards increasing the levels of accessibility and availability of the institutions and cervical cancer screening services provided there. In addition, resource capacities should be enhanced as well (medical staff, rooms, equipment).

Cervical cancer screening practices and its associated factors among females of reproductive age in Durame town, Southern Ethiopia.

An estimated 22 million Ethiopian women between the ages of 15 and 49 are affected by cervical cancer each year, with 7095 cases and 4732 fatalities. Cervical cancer screening is one of the prevention methods, although Ethiopia has a low coverage rate. Furthermore, data on the use of cervical cancer screening services in the country is scarce. Therefore, we aimed to assess cervical cancer screening practices and its associated factors among females of reproductive age in Durame, Southern Ethiopia. A community-based cross-sectional study was conducted using a multi-stage sampling technique among 460 females of reproductive age from March to April 2020. Data were collected using interviewer-administered questionnaires and analyzed using the Statistical Package for Social Science (SPSS) Version 20. Bivariable and multivariable logistic regressions were carried out to determine the association between independent and dependent variables. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) and a P-value < 0.05 were used to declare the statistical association. We found that cervical cancer screening practice in this study was 13.8% [95% CI:(10.4-17.2)]. Having a positive attitude [AOR = 5.2, 95% CI:(1.4, 20.0)], having a good knowledge [AOR = 5.4, 95% CI:(1.5,19.5)], being informed about cervical cancer by health professionals [AOR = 3.5, 95% CI:(1.3,9.8)], average monthly income greater than 3000 Ethiopian Birr (ETB) [AOR = 4.9, 95% CI:(1.1, 22)], and having a history of sexually transmitted infections [AOR = 4.2, 95% CI:(1.4,12.85)] were the factors associated with cervical cancer screening practice. The practice of cervical cancer screening was found to be very low, being influenced by women's attitudes, knowledge, having health professionals as sources of information, monthly income, and history of sexually transmitted infections. Thus, it is necessary to increase awareness and knowledge about cervical cancer and improve attitudes toward cervical screening services to improve the uptake of the screening. Health professionals also have to play a pivotal role in properly addressing information about cervical cancer.

Knowledge and attitudes relating to cervical and breast cancer among women in Maseru, Lesotho.

Cancer 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. This study is aimed at comparing knowledge, attitudes, and practices between breast and cervical cancers among females in Maseru. This study consists of women residing in five study sites which have clinics that offer cervical and breast cancer-screening services. A 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. A 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. The 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.Contribution: There is an urgent need to intensify awareness about cervical and breast cancer screening and availability of services at the nearby clinics.

Cervical Epithelial Abnormalities and Associated Factors among HIV-Infected Women in Lagos, Nigeria: A Cytology-Based Study

Introduction: As it may not be feasible to provide cervical cancer screening services to all HIV-infected women in most resource-limited settings, there is a need to identify those who are most at risk. We determined the prevalence, patterns, and associated factors of cervical cytological abnormalities among HIV-infected women in Lagos, Nigeria. Methods: This descriptive cross-sectional study was conducted among HIV-infected women at the adult HIV treatment and colposcopy clinics of a university teaching hospital in Lagos, Nigeria, between October 2018 and December 2019. A cervical sample was collected from each woman to detect cervical cytological abnormalities. Results: Of the 593 enrolled women, cervical cytological abnormalities were present in 40 (6.7%). Most (37.5%) of the women with cytological abnormalities had atypical squamous cells of undetermined significance. Age at coitarche (<20 vs. ≥20 years: adjusted odds ratio, 2.42; 95% confidence interval, 1.21–4.83, p = 0.01) was the only factor that was independently associated with cervical epithelial abnormalities. Conclusion: The prevalence of cervical cytological abnormalities in our study is lower than most previous reports in Africa. Sexual debut at an early age was significantly associated with cytological abnormalities. It is necessary to confirm the findings of this study through a well-designed and adequately powered longitudinal study.

Determinants of cervical cancer screening service utilization among women attending healthcare services in Amhara region referral hospitals: a case–control study

BackgroundCervical cancer is the second leading cause of cancer-related death and one of the top 20 causes of death among women in Ethiopia. Cervical cancer screening service has a vital value to reduce morbidity and mortality. Even though cervical cancer screening service utilization in Ethiopia is unacceptably low, its determinant factors were not well studied in the study area. Hence, this study was aimed at filling this information gap. This study aimed to identify determinants of cervical cancer screening service utilization among women attending healthcare services in Amhara region referral hospitals, Ethiopia.MethodsHospital-based case–control study was conducted among 441 women (147 cases and 294 controls) from May to July 2021. Cases were included consecutively and controls were selected using a systematic random sampling technique from the randomly selected hospitals. A pretested interviewer-administered questionnaire was used to collect the data from respondents. The data were entered into Epi data version 4.6 and exported to SPSS version 25 for analysis. Bivariable and multivariable logistic regression analysis was employed. Adjusted odds ratio with its 95% confidence interval and p value < 0.05 were used to estimate the strength and significance of the association.ResultA total of 147 cases and 294 controls were enrolled in this study. Women with 30–39 years-old [AOR = 2.3; 95% CI 1.21, 4.68] and 40–49 years-old [AOR = 4.4 95% CI 1.97, 10.12], urban residence [AOR = 2.6; 95% CI 1.36, 5.21], secondary education [AOR = 4.4; 95% CI 2.18, 8.87] and diploma and above [AOR = 2.0; 95% CI: 1.05, 4.59], ever gave birth [AOR = 9.4; 95% CI 4.92, 18.26], having multiple sexual partners [AOR = 2.8; 95% CI 1.60, 5.03], good knowledge towards cervical cancer screening [AOR = 3.6; 95% CI 2.07, 6.43] and positive attitude on cervical cancer screening [AOR = 2.0, 95% CI 1.20, 3.70] were significant determinants of cervical cancer screening service utilization.ConclusionIn this study, age (30–39 and 40–49), urban residence, secondary education, ever gave birth, good knowledge of cervical cancer screening, positive attitude towards cervical cancer screening, and having multiple sexual partners were significant determinants of cervical cancer screening service utilization. There is a need to strengthen the policy and health education on safe sexual practices and healthy lifestyles through information dissemination and communication to scale up screening service utilization.

Barriers to uptake of cervical cancer screening services in low-and-middle-income countries: a systematic review

ObjectivesLow-and-middle-income countries (LMICs) bear a disproportionate burden of cervical cancer mortality. We aimed to identify what is currently known about barriers to cervical cancer screening among women in LMICs and propose remedial actions.DesignThis was a systematic review using Medical Subject Headings (MeSH) terms in Google Scholar, PubMed, Scopus, and Web of Science databases. We also contacted medical associations and universities for grey literature and checked reference lists of eligible articles for relevant literature published in English between 2010 and 2020. We summarized the findings using a descriptive narrative based on themes identified as levels of the social ecological model.SettingWe included studies conducted in LMICs published in English between 2010 and 2020.ParticipantsWe included studies that reported on barriers to cervical cancer screening among women 15 years and older, eligible for cervical cancer screening.ResultsSeventy-nine articles met the inclusion criteria. We identified individual, cultural/traditional and religious, societal, health system, and structural barriers to screening. Lack of knowledge and awareness of cervical cancer in general and of screening were the most frequent individual level barriers. Cultural/traditional and religious barriers included prohibition of screening and unsupportive partners and families, while social barriers were largely driven by community misconceptions. Health system barriers included policy and programmatic factors, and structural barriers were related to geography, education and cost. Underlying reasons for these barriers included limited information about cervical cancer and screening as a preventive strategy, poorly resourced health systems that lacked policies or implemented them poorly, generalised limited access to health services, and gender norms that deprioritize the health needs of women.ConclusionA wide range of barriers to screening were identified across most LMICs. Urgent implementation of clear policies supported by health system capacity for implementation, community wide advocacy and information dissemination, strengthening of policies that support women’s health and gender equality, and targeted further research are needed to effectively address the inequitable burden of cervical cancer in LMICs.

Mobilizing stakeholders to drive the cervical cancer elimination agenda in Kenya: The national cervical cancer stakeholders' forum 2022.

Kenya is among the nineteen countries in Sub-Saharan Africa with the highest burden of cervical cancer globally. The high burden of cervical cancer in developing countries reflects the absence of effective cervical cancer prevention programs with limited resources invested to provide comprehensive services. We aimed to engage stakeholders in a structured consultative forum, to gain insights and forge effective partnerships to drive the cervical cancer elimination agenda in Kenya. The National Cervical Cancer Stakeholders Consultative Forum was organized as a part of activities to commemorate the National Cervical Cancer Awareness Month on 19th January 2022 in Nairobi, Kenya. The overall goal of the meeting was to provide a forum to sensitize stakeholders on the National Cervical Cancer Prevention and Control Program (NCCP) with a view to strengthen partnerships, increase coordination for improved service delivery and to provide a forum for resource mobilisation and alignment of key stakeholders towards elimination of cervical cancer in Kenya. Nominal group technique was adopted for structured discussions, and the findings analysed to derive key themes. Key challenges to primary and secondary prevention of cervical cancer were identified as low awareness, stigma and misinformation, high unmet need for treatment of early lesions, few health care providers with capacity to screen and treat, inadequate supplies, inefficient health information systems and poor referral pathways. Championing integration of cervical cancer screening and treatment services into routine health programs, strengthening policy implementation and robust monitoring and evaluation were identified as critical interventions. The National Cervical Cancer Stakeholders Forum 2022 provided insights for enabling Kenya to progress on the 2030 elimination targets. Such forums can be useful in bringing all actors together to evaluate achievements and identify opportunities for more effective national cervical cancer prevention and control programs.

Prevalence of cervical human papillomavirus in Mexico, 2010-2017: analysis of 2.7 million women.

Prevalence of cervical high-risk human papillomavirus (hrHPV) infection varies greatly. Data on distribution of hrHPV infection constitute important evidence for decision-making when implementing HPV testing into cervical cancer screening programs. We estimate the prevalence of cervical hrHPV infection in a large sample of women in a middle-income country and explore variation by age, community marginalization and region in women using public cervical cancer screening services. Records covering 2010-2017 from a registry of hrHPV test results (Hybrid Capture 2 and polymerase chain reaction) in 2,737,022 women 35-64years were analyzed. In this observational study, 32 states were categorized into five geographical regions and classified by degree of marginalization. We stratified by test type and estimated crude and adjusted prevalence and rate ratios and used Poisson models and joinpoint regression analysis. Prevalence was higher in women 35-39years, at 10.4% (95% CI 10.3-10.5) and women 60-64years, at 10.1% (95% CI 10.0-10.3). Prevalence was higher in the southeast, at 10.5% (95% CI 10.4-10.6). Women living in less marginalized areas had a significantly higher prevalence, at 10.3% (95% CI 10.2-10.4) compared to those in highly marginalized areas, at 8.7% (95% CI 8.5-8.7). HPV16 infection was detected in 0.92% (2,293/23,854) of women and HPV18 infection was detected in 0.39% (978/23,854) of women. Understanding the distribution of HPV prevalence has value as evidence for developing policy in order to improve cervical cancer screening strategies. These results will constitute evidence to allow decision makers to better choose where to focus those resources that they do have.