Cervical Cancer Screening Practices Research Articles

Socioeconomic and cultural factors associated with pap smear screening among French women living in Réunion Island

BackgroundRéunion Island is a French overseas territory located in the southern Indian Ocean, with a challenging socioeconomic and multicultural context. Compared to mainland France, Réunion has an overincidence and overmortality of cervical cancer. In order to investigate these two issues, it is important to evaluate the barriers and potential levers to Pap smear screening among female inhabitants of the island. We aimed to identify the specific socio-demographic factors, cultural factors, and living conditions associated with Pap smear screening in Réunion, with a view to increasing uptake.MethodsWe conducted a Knowledge Attitude Behavior and Practices (KABP) survey on cervical cancer screening practices among women aged between 25 and 65 years old living in Réunion Island, selected using random digit dialing sampling. Data were collected using Computer Assistant Telephone Interviews. Weighted chi-squared tests and Student’s t-tests were used to compare women who had up-to-date Pap smear screening with women who did not. Weighted logistic models were used to identify the factors associated with not having up-to-date screening.ResultsA total of 1000 women were included in the study. Of these, 88.1% had a Pap smear test during the previous three years. Factors independently associated with not being up to date were as follows: aged over 55 (AOR 2.3 [1.2–4.3]), no children (AOR 2.5 [1.4–4.3]), having free universal health coverage (AOR 1.7 [1.1–2.7]), an income per unit consumption lower than 1500€ per month (AOR 2.0 [1.1–3.7]), low health literacy (AOR 2.7 [1.7–4.1]), not consulting a general practitioner in the prior 12 months (AOR 3.6 [2.0-6.5]), and a BMI > 30 (AOR 2.6 [1.5–4.4]).ConclusionsThis is the first large-scale survey focusing on recommended Pap smear screening uptake in Réunion Island. Although self-reported screening incidence was higher than in mainland France, national screening policies must take into account the island’s diverse social and cultural characteristics (e.g., an ageing population, low health literacy), while implementing actions to fight against poverty and increase general access to healthcare.

Knowledge, attitudes and practices of cervical cancer screening among female students enrolled in higher education institutions in Cabo Verde.

A descriptive cross-sectional study, using a self-administered structured questionnaire, was conducted in six higher education institutions (HEI) in Cabo Verde between November and December 2020. A total of 618 female undergraduate students were recruited using a simple random sampling technique. Descriptive statistical data analysis was used to report the results. The response rate was 96.6% (n = 618). Most of the participants, 90.6% (549), were single, with average age of 21.79 years (SD =±4). Although most of the participants had already heard about CC (94.6%), most students showed a low knowledge about this disease (86.2%). Moreover, only 9.1% reported having been screened for CC. Most undergraduate female students enrolled in HEI in Cabo Verde have poor knowledge and unfavourable attitudes toward CC. The level of knowledge is quite unsatisfactory. Within this context, the implementation of health policies focused on human papillomavirus education, prevention strategies, and CC screening is crucial.

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.

Cervical cancer screening practices in HIV positive females - a missing link in health care delivery in Pakistan.

To probe cervical cancer screening practices in local women positive for human immunodeficiency virus, and to determine the cervical cytological changes in them. The serial cross-sectional study was conducted at the Jinnah Hospital and Services Hospital, Lahore, Pakistan, from April 2019 to October 2020, and comprised female patients aged 18-45 years who were positive for human immunodeficiency virus or acquired immunodeficiency syndrome and were registered with the relevant programme being run by the provincial government in Punjab. Blood samples of all the patients were collected for the determination of human immunodeficiency virus viral load and cluster of differentiation 4+ count. Cervical smears were taken for cytopathological analysis, while the swabs were analysed for culture sensitivity. The same individuals were subjected to the same testing one year later, and the status of the disease and clinical stability or disease progression was explored. Data was analysed using SPSS 25. There were 150 women with mean age 32.08±7.13 years (range: 21-45 years). Age at marriage/sexual activity was 17.33±4.73 years in 15(10%) subjects. Cytological examination showed atypical squamous cells of undetermined significance in 6(4%) of the cases whereas 3(2%) cases showed atypical squamous cells, which cannot rule out high grade squamous intraepithelial lesion on cytology, while the rest were classified as negative for intraepithelial lesion or malignancy. Cervical microbial changes revealed methicillin-resistant staphylococcus aureus infection in 9(6%) cases, extended-spectrum beta-lactamase in 15(10%) cases, whereas fungal infection and trichomonas vaginalis infection were found in 30(20%) smears. There was a significant association between cluster of differentiation 4+ cell count and stability of high-risk patients (p<0.001). After one year, 84(56%) patients remained clinically stable, while 51(34%) developed some chronic illness. There was a significant association between cluster of differentiation 4+ cell count <200/mm3 and the risk of developing a chronic illness (p<0.001). There was a dire need to educate healthcare workers to offer regular cervical screening to patients with high-risk sexually-transmitted infections to prevent them from the morbidity and mortality related to cervical cancer.

Atypical squamous cells of undetermined significance cervical cytology in Bahrain: Reporting rates, high-risk HPV testing, and cytologic and histopathologic follow-up findings.

Atypical squamous cells of undetermined significance cytology (ASC-US) is a challenging and equivocal diagnosis for pathologists in cervical Pap smears. The data on ASC-US cervical cytology in Bahrain are deficient. This study reviewed and identified the reporting rates, high-risk human papillomavirus (HPV) testing results, histopathologic follow-up findings, and the cytologic progression of patients diagnosed with ASC-US in Bahrain. A retrospective chart review was conducted on the medical records of 23,888 women who had Pap smear test results between January 2019 and March 2022 at the main referral tertiary hospital in Bahrain to identify the ASC-US cases. High-risk HPV (hrHPV) genotype was identified, and the histopathological results of the cervical biopsy was recorded. In addition, cytologic follow-up Pap smear tests conducted within 1 year of ASC-US diagnosis were tracked to monitor the progression or regression of ASC-US. In this study, 259 out of 23,888 women reported to have ASC-UC cytology results with a reporting rate of 1.1%. The mean age of the ASC-US cases was 43 ± 11.6. Thirty percent of the ASC-US cases tested positive for hrHPV, and they were predominantly infected with the other hrHPV genotype (75%). When the histopathological changes of the cervix were analyzed, 82.1% had normal histopathologic findings. However, low-grade cervical intraepithelial neoplasia-1 was reported in 2 cases (7.1%), and high-grade cervical lesions (cervical intraepithelial neoplasia-2 and higher) were reported in 3 cases (10.7%). Regarding the cytologic follow-up, most of the ASC-US cases were negative for intraepithelial lesion or malignancy (NILM) (73.8%) or had persistent ASC-US (17.9%). The remaining minority of cases progressed into either low-grade squamous intraepithelial lesions (6%) or high-grade squamous intraepithelial lesions (2.4%). There was a statistically significant and relatively strong association between the cytology follow-up findings and the hrHPV test results (χ2 [2] = 8.869, P < 0.012, Cramer's V = 0.417). This is the first and largest study to characterize the ASC-US cytology cases in Bahrain. The reporting rates of ASC-US fell within the worldwide reported range. Although most of the ASC-US cases regressed into NILM, ASC-US showed progression into more advanced cervical cytologic diagnoses or contributed to the malignant transformation of cervical tissue, especially in the presence of hrHPV infection which was positive in 30% of the ASC-US cases. This emphasizes the role of cotesting (combination of hrHPV genotyping and Pap smear test) and the importance of colposcopic evaluation of those women with cytologic follow-up tests at 1 year of diagnosis. Implementing these recommendations in the cervical cancer screening practice in Bahrain will help in having a better management plan for women diagnosed with ASC-US cervical cytology.

Extended HPV typing test performed better predict value for CIN2+ among elderly women in China

ObjectiveThe aim of this study was to examine the cervical cancer screening practices among women residing in Lingang New District of Shanghai. Moreover, the study aimed to delve into the characteristics of HPV infection and cervical lesions in older women (≥60 years old), seeking for more effective method for cervical cancer screening. MethodsThis is a cross-sectional study enrolled women who were referred to colposcopy and cervical histological examination due to abnormal cytology or HPV tests from Shanghai Sixth People's Hospital between January 2018 and December 2022. ResultsA total of 1,931 women (mean age: 41.8 ± 12.5, range: 18–88 years old) were enrolled, 119 individuals aged ≥ 60 and 1732 aged <60. The infection rates of HPV52, 33, 35, 56, 26 and 81 were significantly higher in the elderly group. Multiple HPV infection rates were also higher in this group and were associated with cervical lesions. The probability of LSIL, HSIL and Ca in women over 60 years old was significantly higher compared to women under 60. The top three HPV genotypes in elderly women with CIN2+ were HPV16, 52, and 58. The Yoden index was higher for extended typing for HPV 31/33/45/52/58(0.41) compared to cytology(0.29), high risk HPV without specific typing(0.07), cotest(cytology and high risk HPV, 0.06 or 0.30), or the current shunt strategy(0.07). ConclusionsElderly women still need to continue cervical cancer screening, and extended typing test for HPV16/18/31/33/45/52/58 is a more effective method for this age group.

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.

Knowledge of Pap smear test among reproductive age group women of Kathmandu, Nepal

Cervical cancer is a malignant tumor of the lowermost part of the uterus and a major cause of morbidity and mortality among women in the world. Globally, it is the fifth leading cause of cancer-related deaths among women after cancers of the breast, lungs, stomach and colorectal in developing countries. About 80% of new incidences of cervical cancer occur in developing countries, usually, with less comprehensive cervical cancer prevention programs. The objective of the study is to assess the level of knowledge on cervical cancer and Pap smear tests among Reproductive age group women. A descriptive study was conducted in Gokarneshwor-8, Kathmandu community on 105 respondents through non-probability purposive sampling techniques and data was collected using interviewers administered questionnaires. Out of 105 respondents, a majority (64%) respondents had adequate knowledge of cervical cancer and Pap smear tests, while 36% had inadequate knowledge. This study concluded that the majority of respondents had adequate knowledge of Pap smear tests while only thirty-six percent had inadequate knowledge. Though there is adequate knowledge, only a few respondents had ever done a Pap smear test. Still, there are existing gaps that need more education to connect knowledge with attitudes as well as to uplift the regular practice of cervical cancer screening for eligible women.

Knowledge, Attitudes and Practice Regarding Cervical Cancer and Screening among Women Visiting Selected Primary Health Centres in Ogbomosho, Nigeria

Cervical cancer is one of the most preventable cancers in the world and its` prognosis is better when detected early through cervical cancer screening. The study examined the knowledge, attitudes and practice regarding cervical cancer and screening among women visiting selected primary health centres (PHCs) in Ogbomosho. The study was conducted in May 2021, employing a descriptive cross-sectional design. A sample size of 124 respondents was determined using the Taro-Yamane formula and selected through convenience sampling technique. Data collection utilised a validated questionnaire, with analysis performed using descriptive statistics encompassing frequencies and percentages. Relationships between variables were tested using chi-square at a 0.05 significance level. Findings suggest that more than half (55%) had good knowledge of cervical and cervical cancer screening. The majority (70%) had a good attitude towards cervical cancer and cervical cancer screening. Less than one-third (21%) have had cervical cancer screening done before. Self-reported barriers limiting the practice of cervical cancer screening identified include lack of health education on cervical cancer screening (45.5%), lack of knowledge on the screenings (39.3%), absence of signs and symptoms of cervical cancer (39.3%), low socioeconomic status (29.5%), cost of the procedure (17.9%), unavailability of services (17.9%) and religious beliefs (14.3%). Chi-square analysis showed a statistically significant relationship between the educational status of respondents and their knowledge of cervical cancer screening, likewise, a significant relationship exists between the knowledge of respondents and the practice of cervical cancer screening at P&lt; .05. Conclusively, the study has revealed the practice of cervical cancer screening was found to be low, indicating a disparity between knowledge/attitude and actual screening behaviour, although, knowledge was a key predictor of their screening practices. The way forward is to improve the knowledge of women on cervical cancer and screening via health education while efforts are being put in place to make cervical cancer screening services available at affordable cost.

Perception and Practice of Cervical Cancer Screening among Female Professionals Attending Gynaecology Clinic at A University Teaching Hospital

Background: By using the right screening tools and preventative measures, cervical cancer can be avoided. However, the underuse of preventative measures is caused by a lack of information and awareness. Professional women with sufficient knowledge can have a significant positive impact on the attitudes and behaviours of the broader public. So, we evaluated how professional women perceived and used cervical cancer screening. Objectives: To evaluate how female professionals who visit gynaecology clinics view and approach cervical cancer screening. Methods: A cohort of 160 consenting female professionals working at the Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria, were used in this facility-based, single-center, descriptive, cross-sectional study. Participants filled up questionnaires about their knowledge assessment, screening for cervical cancer, and personal characteristics that influence them. Simple percentages, charts, and IBM SPSS Statistics 26 for Windows, version 26.0 (IBM Corp., Armonk, NY, USA) were used to portray and analyse the data. Results: The analysis employed a total of 160 questionnaires completed by research participants. All of the selected female professionals knew about cervical cancer screening, with nurses (49.3%) making up the majority. However, just 29.6% of them were aware that cervical cancer is connected to sexually transmitted diseases, and 33.2% were unaware that it is connected to age at first sexual activity. Only 93.2% of respondents had heard of Pap smears, despite the fact that every respondent had heard and read about cervical cancer and its screening. Despite the knowledge, only 44 (27.5%) had performed Pap tests and only 76(47.5%) had ever recommended cervical cancer screening to people. Of the women surveyed, 148 (92.5%) said they would be willing to have a cervical cancer screening, while 18 (11.25%) said they would decline. Conclusion: Despite more knowledge and awareness, the rate of cervical cancer screening among female professionals in Nnewi is still below average and insufficient. Cervical cancer can be avoided. Eliminating the morbidity and mortality frequently linked with cervical cancer would need deliberate efforts to increase screening methods' uptake and utilisation.

Cervical cancer screening among female health workers: Evidence from a secondary health facility in Northern Malawi

Cervical cancer is preventable and curable if identified early. Although health workers have a critical role in influencing beliefs and practices of the entire population, some studies have shown paradoxical efforts among female health workers themselves-a threat towards attainment of the triple-intervention strategy as propagated by the World Health Organization (WHO). The study aimed to assess knowledge, attitudes and practices of cervical cancer screening among female health workers.The study used a descriptive cross-sectional design. Data entry and analysis were carried out using IBM Statistical Package for Social Scientists (SPSS) version 20.0 (SPSS, Michigan Avenue, Chicago, IL, USA).The response rate was 65.4 % and mean age of 32 years with standard deviation=±8.397. The majority of participants were nurses n = 31 (43.3). There was poor knowledge on signs/symptoms and risk factors as only 15.7 % were aware of multiple sexual partners, 7.1 % for each early sexual encounter and uncircumcised men as risk factors. Regarding willingness, 77.1 % were willing to have the screening test. Their practices were rated poor as only 35.7 % (n = 25) had ever undergone screening within the past 6 years.There was poor knowledge, fair attitudes and poor practices of cervical cancer screening among female health workers. As part of the efforts to achieve sustainable development goal (SDG) target 3.4 and the attainment of WHO 90–70-90 target by 2030; this study recommends scaling up health education, social mobilization and Human Papillomavirus (HPV) vaccinations to support awareness, detection and treatment of cervical cancer. Acceptability of the current screening methods must be further explored.

Knowledge, perception and cervical cancer screening practices among nurses and midwives: a case study of Our Lady of Grace Hospital in the Asikuma Odoben Brakwa district, Central region-Ghana

Background: Cervical cancer prevention can be achieved through comprehensive programs involving education, awareness creation, vaccination, screening, and early treatment. Health workers have a vital role to play in achieving this. Hence, they must be adequately equipped with the requisite knowledge of the condition since they provide information to their clients.Objective: This study determined the knowledge, perception, and screening practices on cervical cancer among female nurses and midwives in the Central Region of Ghana.Method: A quantitative descriptive cross-sectional survey amongst nurses and midwives was used for the study. A conveniencesampling technique was applied to yield a representative sample of 130 female nurses and midwives working in Our Lady of Grace Hospital in the Central Region, Ghana. Data was collected from the participants using a self-administered questionnaire.The data was analysed using SPSS version 20, and standard descriptive statistics such as proportions were used to summarize the survey data.Results: Almost all the nurses (99%) had heard of cervical cancer. Majority (97.1%) of the respondents believed cervical cancer is preventable however, 67.6% also believed that it is incurable. Almost half (42.2%) of the respondents did not perceive themselves as at risk of cervical cancer. Thus, only 11.8% of the nurses had ever screened for cervical cancer. However, majority (92.2%) were willing to recommend the screening to others.Conclusion: The respondents of this study had some knowledge of cervical cancer however had low patronage for recommendedscreening practices. Therefore, strategies must be implemented to increase screening practices among female nurses.

Factors affecting cervical cancer screening among Yemeni immigrant women in Klang Valley, Malaysia: A cross sectional study

Introduction Cervical cancer is a significant public health problem for women worldwide. It is the fourth most frequent cancer in women globally. While early detection of cancerous lesions through screening tests leads to a better prognosis and a better chance of being cured, the number of people who go for screening is still low, especially for groups that are marginalized, like immigrant women. Objective The purpose of this study was to identify cervical cancer screening practices and factors influencing screening status among Yemeni immigrant women living in the Klang Valley, Malaysia. Method A cross-sectional study among 355 randomly selected respondents between the ages of 20 and 65 was conducted through an online survey. A questionnaire was sent directly to the participants via WhatsApp. The analysis was conducted using SPSS 25 with a significance level of 0.05. It included descriptive analysis, chi-square and multiple logistic regression. Results The response rate was 59%, with the majority of the respondents being married and between the ages of 35 and 49. Screening was reported at 23.1% in the previous three years. The final model revealed that age group 50–65 years (AOR = 5.39, 95% CI: 1.53–18.93), insurance status (AOR 2.22, 95% CI = 1.15–4.3), knowledge (AOR = 6.67, 95% CI = 3.45–12.9), access to health care facilities (AOR = 4.64, 95% CI = 1.29–16.65), and perceived barriers (AOR = 2.5, 95% CI = 1.3–4.83) were significant predictors of cervical screening uptake among Yemeni immigrant women in Malaysia (p&lt;0.05). Conclusion According to the results, cervical cancer screening was found to be low among Yemeni immigrant women. The predictors were age group 50–65 years, insurance status, knowledge, access to health care facilities and perceived barriers. Efforts to enhance immigrant women’s participation in cervical cancer screening must tackle barriers to access to healthcare services as well as expand cervical cancer screening education programs.

Prevalence and predictors of cervical cancer screening among HIV-positive women in rural western Uganda: insights from the health-belief model

BackgroundWomen living with HIV are at increased risk of developing cervical cancer (CC). Screening for cancer is an important preventive strategy for the early detection of precancerous lesions and its management. There has been inadequate evidence on cervical cancer screening (CCS) practices among HIV-positive women in rural western Uganda. This study aimed to assess the prevalence and predictors of CCS among HIV-positive women, as well as knowledge and practices regarding cervical cancer screening.MethodsA cross-sectional, analytical study was conducted among HIV-positive women attending HIV care facilities located in rural settings of western Uganda. A validated and interview-based data collection form was used to capture statistics regarding demographics, HIV care, obstetric profile, health belief constructs, and knowledge and history of CCS from the participants. Bivariate and multivariate logistic regression analyses were used to correlate women’s characteristics and health beliefs toward CCS practices.ResultsThe prevalence of CCS among HIV-positive women was found to be 39.1% (95%CI: 14.0–71.7). A multivariate logistic regression analysis showed that post-secondary education attainment (AOR = 3.21; 95%CI = 2.12–7.28), four years or more lapsing after being diagnosed as HIV-positive (AOR = 2.87; 95%CI = 1.34–6.13), having more than one child (AOR = 1.87; 95%CI = 1.04–3.35), antenatal care attendance (AOR = 1.74; 95%CI = 1.02–3.43), post-natal care attendance (AOR = 3.75; 95%CI = 1.68–5.89), and having good knowledge regarding CC (AOR = 1.26; 95%CI = 1.98–3.02) were positively associated with adherence to CCS among HIV-positive women in western Uganda. Health Belief Model (HBM) constructs like the perceived risk of developing CC (AOR = 1.82; 95%CI = 1.16–2.01), worries about developing CC (AOR = 5.01; 95%CI = 4.26–8.32), believing that CC leads to death (AOR = 2.56; 95%CI = 1.64–3.56), that screening assists in early identification (AOR = 2.12; 95%CI = 1.84–3.74) and treatment (AOR = 4.63; 95%CI = 2.78–6.43) of precancerous lesions, reducing the risk of mortality (AOR = 1.84; 95%CI = 1.12–2.75), and the reassurance provided by negative test results (AOR = 2.08; 95%CI = 1.33–4.22) were positively associated with adhering to CCS. A female doctor performing the screening (AOR = 2.02; 95%CI = 1.57–3.98) as well as offering a free screening service (AOR = 3.23; 95%CI = 1.99–4.38) were significantly associated with CCS. Meanwhile, screening being painful (AOR = 0.28; 95%CI = 0.12–0.45), expensive (AOR = 0.36; 95%CI = 0.24–0.53), time-consuming (AOR = 0.30; 95%CI = 0.19–0.41), embarrassing (AOR = 0.02; 95%CI = 0.01–0.06), and the fear of positive results (AOR = 0.04; 95%CI = 0.02–0.10) were found to have a significant negative association with adhering to CCS.ConclusionsOnly one-third of HIV-positive women had undergone CCS. Variables including secondary education attainment, four years or more lapsing after being diagnosed as HIV-positive, having more than one child, antenatal care attendance, post-natal care attendance, and knowledge about CC were positively associated with CCS adherence. Educational programs should be geared towards the risk of CC, severity of cases, benefits of screening, and reducing barriers associated with screening, which can significantly improve cervical CCS among HIV-positive women. The study proposes the incorporation of free screening services and the inclusion of trained female staff in CC prevention policies to improve CCS.

Knowledge and Practices of Cervical Cancer Screening among Females of the Reproductive Age (15 - 49) of Ngwerere Catchment in Chongwe

Knowledge and Practices of Cervical Cancer Screening among Females of the Reproductive Age (15 - 49) of Ngwerere Catchment in Chongwe

Abstract A058: "That’s our culture...”: A qualitative study on factors that influence cervical cancer stigma in the Caribbean

Abstract 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 &amp; 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.

Knowledge, practice of cervical cancer screening and associated factors among women police members of Addis Ababa police commission Ethiopia

BackgroundCervical cancer is a public health problem. It is one of the leading causes of death in women worldwide and the second leading cause of female cancer-related deaths. Cervical cancer screening enables the detection of abnormal cervical cells, including precancerous cervical lesions, as well as early-stage cervical cancer. Routine cervical screening has been shown to reduce both the incidence and mortality of the disease.ObjectiveThe aim of this study was to assess knowledge, practice of cervical cancer screening and associated factors among women police members at Addis Ababa police commission Ethiopia 2022.MethodAn institutional-based cross-sectional study was conducted at the Addis Ababa police commission in the Lidet Sub-city police department from December 1st to January 30th, 2022. The data were collected through a structured, self-administered questionnaire from 361 randomly selected police officers. The collected data were analyzed using SPSS version 26 software in descriptive statistics, binary, and multivariable logistic regression analysis to identify factors associated with the outcome variable at PV = 0.05 with an AOR and 95% CI. Results: The complete response rate was 97.57% (361/371). This found that 59.5% of the total study participants were aged between 18 and 29 years old, and 47.3% were married in marital status. This study determined knowledge status of police commission towards cervical cancer screening revealed that 183(49.5%) had good knowledge, with identified factors which increases likelihood of good knowledge were attitude [AOR = 2.03, 95%CI;( 1.25–3.3)] and cervical cancer screening practice [AOR = 2.0, 95%CI (1.15–3.53)] respectively.This is determined the prevalence of cervical cancer screening practice was 68(18.4%)with 95% CI(14.3–22.4) with identified factors which increases likelihood of cervical cancer screening practice were age, [AOR = 3.24, 95% CI;( 1.08–9.75)], marital status [AOR = 3.88,95%CI,(1.55–9.73)] monthly income [AOR = 4.82,95%CI;(1.44–16.12)],religion[AOR = 8.65,95%CI,( 1.65–45.46)] and knowledge [AOR = 2.35,95%CI;( 1.22–4.52)] respectively. The main reason reported for not practice of cervical cancer screening was feeling healthy.Conclusion and recommendationThis study identified that the knowledge status of female police commissioners were poor and practice of cervical cancer screening were found to be very low. Some of the factors associated with the cervical cancer screening practice were age, marital status, monthly income and knowledge of the women. In addition, feeling being health was associated poor practice of cervical cancer screening. To alleviate this problem the health authorities at different level of the health system should take massive awareness creation activities through various communication channels about screening service prepare screening campaign.

Midwives as the Primary Care Providers: Knowledge, Attitude, Practice, and Skill of Early Detection of Cervical Cancer Using Visual Inspection with Acetic Acid.

Cervical cancer is the third most common malignancy in women globally. It is also the leading cause of death for women in Indonesia. When detected at an early precancerous stage, cervical cancer is largely preventable. Early detection with Visual Inspection with Acetic Acid (VIA) is an acceptable, affordable, and safe alternative method in developing countries. Midwives, as primary health care providers, can perform VIA at various health center levels. This study evaluated the knowledge, attitude, practice, and skill of cervical cancer screening with VIA among midwives in Denpasar. A cross-sectional study was conducted among 70 midwives at Public Health Centers in Denpasar, Bali, Indonesia, from July-August 2022. The data were collected using a structured knowledge, attitude, and practice questionnaire. An obstetrician-gynecologist assessed the skills with a standardized checklist. Data were analyzed using univariate, bivariate, and multivariate analysis on SPSS version 26. A level of p<0.05 was considered significant with a prevalence ratio (PR) and 95% confidence interval (CI). Out of all midwives, 42 (60.0%) were knowledgeable, 42 (60.0%) had a favorable attitude, 36 (51.4%) had good practice of VIA, and 54 (77.1%) had competent skills. Knowledge (PR=5.00, 95%CI=1.76-14.16), attitude (PR=2.92, 95%CI=1.08-7.89), and skill (PR=11.90, 95%CI=2.44-57.84) were associated with the practice of VIA. Age group and work experience were strongly associated with the training and skill of VIA. Most midwives in Denpasar were knowledgeable, had a favorable attitude, good practice, and competent skills to perform cervical cancer screening using VIA.

Public health impact and cost-effectiveness of switching from bivalent to nonavalent vaccine for human papillomavirus in Norway: incorporating the full health impact of all HPV-related diseases

AimThe objective of this study was to estimate and compare the cost-effectiveness of switching from a bivalent to a nonavalent human papillomavirus (HPV) vaccination program in Norway, incorporating all nonavalent vaccine-preventable HPV-related diseases and in the context of the latest cervical cancer screening program.MethodsA well-established dynamic transmission model of the natural history of HPV infection and disease was adapted to the Norwegian population. We determined the number of cases of HPV-related diseases and subsequent number of deaths, and the economic burden of HPV-related disease under the current standard of care conditions of bivalent and nonavalent vaccinations of girls and boys aged 12 years.ResultsCompared to bivalent vaccination, nonavalent vaccination averted an additional 4,357 cases of HPV-related cancers, 421,925 cases of genital warts, and 543 cases of recurrent respiratory papillomatosis (RRP) over a 100-year time horizon. Nonavalent vaccination also averted an additional 1,044 deaths over the 100-year time horizon when compared with bivalent vaccination. Total costs were higher for the nonavalent strategy (10.5 billion NOK [€1.03 billion] vs. 9.3–9.4 billion NOK [€915–925 million] for bivalent vaccination). A switch to nonavalent vaccination had a higher vaccination cost (4.4 billion NOK [€433 million] vs. 2.7 billion NOK [€266 million] for bivalent vaccination) but resulted in a savings of 627–694 million NOK [€62–68 million] in treatment costs. A switch to nonavalent vaccination demonstrated an incremental cost-effectiveness ratio of 102,500 NOK (€10,086) per QALY versus bivalent vaccination.ConclusionsUsing a model that incorporated the full range of HPV-related diseases, and the latest cervical cancer screening practices, we found that switching from bivalent to nonavalent vaccination would be considered cost-effective in Norway.

Examining the perceived impact of the COVID-19 pandemic on cervical cancer screening practices among clinicians practicing in Federally Qualified Health Centers: A mixed methods study.

The COVID-19 pandemic led to reductions in cervical cancer screening and colposcopy. Therefore, in this mixed methods study we explored perceived pandemic-related practice changes to cervical cancer screenings in federally qualified health centers (FQHCs). Between October 2021 and June 2022, we conducted a national web survey of clinicians (physicians and advanced practice providers) who performed cervical cancer screening in FQHCs in the United States during the post-acute phase of the COVID-19 pandemic, along with a sub-set of qualitative interviews via video conference, to examine perceived changes in cervical cancer screening practices during the pandemic. A total of 148 clinicians completed surveys; a subset (n=13) completed qualitative interviews. Most (86%) reported reduced cervical cancer screening early in the pandemic, and 28% reported continued reduction in services at the time of survey completion (October 2021- July 2022). Nearly half (45%) reported staff shortages impacting their ability to screen or track patients. Compared to clinicians in Obstetrics/Gynecology/Women's health, those in family medicine and other specialties more often reported reduced screening compared to pre-pandemic. Most (92%) felt that screening using HPV self-sampling would be very or somewhat helpful to address screening backlogs. Qualitative interviews highlighted the impacts of staff shortages and strategies for improvement. Findings highlight that in late 2021 and early 2022, many clinicians in FQHCs reported reduced cervical cancer screening and of pandemic-related staffing shortages impacting screening and follow-up. If not addressed, reduced screenings among underserved populations could worsen cervical cancer disparities in the future. This study was funded by the American Cancer Society, who had no role in the study's design, conduct, or reporting.