Uptake Of Cervical Cancer Screening Research Articles

Identification and uptake of cervical cancer screening during active surveillance in HIV-positive women attending a primary health care facility in Tshwane District, South Africa

Cervical cancer constitutes 20 - 25% of cancers in women in Sub-Saharan Africa. It is a preventable disease, subject to adequate screening, management and follow up. Nevertheless, more than half a million women worldwide develop invasive cervical cancer annually, with middle-and low-income countries achieving only 19% of successful screening coverage compared with high-income countries (63%). The age-standardised incidence rate for cervical cancer in South Africa is 24.71 per 100 000 women.

What factors influence the uptake of bowel, breast and cervical cancer screening? An overview of international research.

For cancer screening programmes to be effective in early detection it is important that those invited can access screening services and understand the benefits of participation. A better understanding of the factors that matter to potential participants of cancer screening programmes can assist in developing strategies to increase current uptake. We conducted an overview of systematic reviews to answer the question: What factors influence the uptake of cancer screening services (breast, bowel and cervical) in high-income countries? A thematic approach supported by tabular summaries and qualitative heat maps was used to categorize factors, described as 'barriers' or 'facilitators'. A total of 41 systematic reviews met the criteria for inclusion. The barrier with the greatest number of 'hot spots' across all three screening programmes was a fear of the unknown regarding a possible diagnosis of cancer or abnormal screening results, followed closely by a general lack of knowledge surrounding cancer screening programmes. The greatest collective facilitator to uptake was recommendation by a healthcare provider to attend screening. Across all factors 'trust' and 'building trusted relationships' can be seen as integral to the success of cancer screening programmes and must be reflective of collaborative efforts to mitigate barriers and enhance facilitators to uptake. There is future scope to consider interventions that (i) increase demand for screening services, (ii) reduce barriers to uptake of services and/or (iii) are relevant to the healthcare system and those providing services.

Culturally Competent Education and Human Papillomavirus Self-Sampling Achieves Healthy People 2030 Cervical Screening Target Among Low-Income Non-Hispanic Black and Hispanic Women

PURPOSE Disparities in cervical cancer screening, incidence, and mortality exist in the United States. Cervical cancer incidence and mortality rates in Texas are 20% and 32% higher, respectively, than national averages. Within Texas, these rates are significantly higher among non-Hispanic (NH) Black and Hispanic women. Cervical cancer screening uptake is lower among NH Black and Hispanic women (72.9% and 75.9%, respectively) compared with White women (85.5%) in Texas. METHODS During March-August 2023, we conducted a pilot study that offered culturally competent education and human papillomavirus (HPV) self-sampling kits to women in two public housing projects in Houston, TX, that have predominantly NH Black or Hispanic residents. Among those eligible for cervical cancer screening, 35% (n = 24) of the NH Black and 34% (n = 16) of the Hispanic women were found to be underscreened per the US Preventive Services Task Force Guideline. We recruited 40 (24 NH Black and 16 Hispanic) eligible women for our study. The study was approved by the MD Anderson institutional review board and registered with ClinicalTrials.gov ( NCT04614155 —March 11, 2020). RESULTS Seventy-five percent of the NH Black and 87% of the Hispanic participants completed the HPV self-sampling procedures per protocol. Samples of 17% NH Black and 12% Hispanic participants showed a performance error. Overall, cervical cancer screening uptake improved from 65% to 91% among NH Black and from 66% to 96% among Hispanic participants. CONCLUSION Culturally competent education and HPV self-sampling resulted in remarkable improvement in cervical cancer screening uptake among underscreened NH Black and Hispanic women residents of Houston public housing projects. Implementing this strategy could significantly reduce cervical cancer incidence and mortality among similar populations in the United States and globally.

Cervical cancer screening among women with comorbidities: evidence from the 2022 Tanzania demographic and health survey

BackgroundThe aim of this study is to examine cervical cancer screening (CCS) uptake among women living with hypertension and HIV in Tanzania.MethodsWe used the recently released 2022 Tanzania Demographic and Health Survey. The outcome variable assessed in the study was CCS, whereas chronic morbidities constituted the main explanatory variable. Data analysis was based on observations from 6,298 women aged 30–49 years. Multivariable logistic regression models were used to determine the association between hypertension and HIV status, and CCS uptake. The analyses were computed in STATA 18.ResultsOut of the 6,298 respondents, only 805 (12.8%) had undergone CCS with higher screening uptake among those living with either one of the disease (28.5%) than among those living with neither hypertension or HIV. The highest proportion was found among those who had ever been diagnosed with hypertension (24.1%) and among women with positive HIV test results (36.7%). There was a significantly higher likelihood of undergoing screening for cervical cancer among women living with at least one of the diseases [AOR = 2.4; 95% CI: 1.4–2.8], compared to those without these conditions. Women diagnosed with hypertension showed increased likelihood of undergoing CCS [AOR = 1.4; 95%CI: 1.1–1.7]. Similarly, women with a positive HIV test result demonstrated higher odds of screening uptake [AOR = 5.2; 95%CI: 4.0-6.7].ConclusionThe study found a positive association between comorbidities and CCS uptake in Tanzanian women. Our findings emphasize the critical importance of ensuring accessibility and adherence to essential screenings for individuals with chronic morbid conditions. Future efforts should focus on strengthening existing integrated services and identifying potential barriers to accessing CCS within these healthcare settings to optimize cervical cancer prevention efforts for individuals with chronic morbidities.

Baseline knowledge on risk factors, symptoms and intended behavior of women and men towards screening and treatment of cervical cancer in rural Uganda: a cross-sectional study

BackgroundKnowledge of risk factors and symptoms of cervical cancer has been found to promote uptake of screening of cervical cancer. Most interventions targeted women without much involvement of men (husbands/decision makers) who are often decision makers in many low- and middle-income countries. This study aimed at assessing baseline knowledge and intended behavior of both women and men to enable design specific targeted messages to increase uptake of cervical cancer screening and promote early detection of women with symptoms.MethodsThis cross-sectional study was conducted in two districts in Western Uganda using the modified African Women Awareness of CANcer (AWACAN) questionnaire. Women aged 30—49 years and their husbands/decision makers were interviewed. Knowledge on risk factors and symptoms, intended behavior and barriers towards participation in cervical cancer screening and treatment were assessed. Descriptive and logistic regression analyses were done to establish the association between knowledge levels and other factors comparing women to men.ResultsA total of 724 women and 692 men were enrolled. Of these, 71.0% women and 67.2% men had ever heard of cervical cancer and 8.8% women had ever been screened. Knowledge of risk factors and symptoms of cervical cancer was high and similar for both women and men.Lack of decision making by women was associated with low knowledge of risk factors (X2 = 14.542; p = 0.01), low education (X2 = 36.05, p < 0.01) and older age (X2 = 17.33, p < 0.01). Men had better help seeking behavior than women (X2 = 64.96, p < 0.01, OR = 0.39, 95% CI: 0.31—0.50) and were more confident and skilled in recognising a sign or symptom of cervical cancer (X2 = 27.28, p < 0.01, OR = 0.52, CI (0.40—0.67).ConclusionThe baseline knowledge for cervical cancer was high in majority of participants and similar in both women and men. Their intended behavior towards screening was also positive but screening uptake was very low. This study suggests developing messages on multiple interventions to promote screening behavior in addition to education, consisting of male involvement, women empowerment and making services available, accessible and women friendly.

Factors influencing cervical cancer screening uptake among the women in Maesot, Tak province, Thailand

Background: Cervical cancer is one of the most significant public health issues in Thailand. The number of women who have had cervical cancer screenings has increased over time; however, if major obstacles are not addressed, it will become challenging to maintain this success. Objectives: This study aimed to identify the magnitude and factors influencing cervical cancer screening uptake among women in Maesot, Tak Province, Thailand. Methods: This cross-sectional study was conducted in Maesot, Thailand. A structured questionnaire was used. Descriptive statistics and multiple logistic regression were used to determine the magnitude of the cervical cancer screening uptake and associated factors. The association was described with an Adjusted Odds Ratio (AOR) and 95% Confidence Interval (95% CI) at the statistically significant level of p-value &lt; 0.05. Results: Of the total 422 women, the average age was 38.82 ±8.46 years. Nearly one-fourth of the respondents were Thai nationals. Almost 70% of respondents were married, and 80% were employed. About one-third of respondents had a high school level of education. The magnitude of Cervical Cancer Screening Uptake (CCSU) was 13.27% (95% CI: 10.34-16.86). Age ≥ 40 years (AOR=2.15, 95%CI: 1.05-4.40), Christian and having others religion (AOR=2.19,95% CI:1.08-4.44), married between 26 years to 43 years (AOR= 2.93, 95%CI: 1.45-5.93), having good knowledge of cervical cancer (AOR= 4.70, 95%CI: 2.22-9.72), and having good knowledge of cervical cancer screening program (AOR= 6.58, 95%CI: 2.82-17.77) were significant predictors of cervical cancer screening. Conclusion: Cervical cancer screening among women in Maesot is lower than that of national coverage of Thailand. Determining factors for the decision to undergo cervical cancer screening uptake include age, religion, age of marriage, knowledge of cervical cancer and knowledge of cervical cancer screening program. To improve uptake, structured screening programs need to be implemented in collaboration with national partners and institutions to decrease the incidence of cervical cancer in Thailand.

Early age at menarche and history of sexually transmitted infections significantly predict cervical cancer screening uptake among women aged 25–49 years: evidence from the 2021 Côte d’Ivoire demographic and health survey

IntroductionCervical cancer is the second dominant type of cancer among Ivorian women with an estimated age-standardised incidence and mortality rate of 31.2 cases and 22.8 deaths per 100,000 women in 2020, respectively. The Ivorian government through its Ministry of Health implemented the National Cancer Control Programme (NCCP) in 2003 with the aim of improving the prevention, early detection and treatment of cancers in Côte d’Ivoire. Yet, there is a low uptake of CCS (1.2%). Thus, making CCS uptake an important public health concern in the country. Understanding of the extent to which reproductive factors predict CCS uptake is limited in literature. This study aimed to investigate reproductive factors as a predictor of women’s uptake of CCS in Côte d’Ivoire.MethodsData from the 2021 Côte d’Ivoire Demographic and Health Survey. A sample of 9,078 women aged 25–49 years were analyzed. The outcome variable was CCS uptake while other variables considered included age at menarche, history of STI, sexual debut, parity, age, educational level, wealth index, health insurance, place of residence, and media exposure. A multivariable logistic regression model was fitted to examine the association between the outcome of interest and predictors at 95% confidence interval.ResultsApproximately, 7.52% of women aged 25–49 years had ever undergone testing for cervical cancer by a healthcare provider. Early menarche was associated with lower odds of CCS uptake [AOR = 0.78; CI = 0.65–0.95]. Compared to those who had no STI, women with a history of STI were more likely to screen for cervical cancer [AOR = 2.63; CI = 2.02–3.42]. Increasing age, higher educational attainment, having health insurance, and being exposed to media were significantly associated with CCS uptake.ConclusionIn Cote d’Ivoire, age at menarche and STI history constitute reproductive factors that were significantly associated with women’s uptake of CCS. It is imperative for public policy to focus on increasing CCS in these higher-risk women (i.e., women who experienced early menarche, women with early sexual debut and higher parity) through increased sensitization on cervical cancer risk factors.

Understanding Knowledge, Attitude, and Uptake of Cervical Cancer Screening among Women in Kiryandongo General Hospital

Cervical cancer remains a significant public health concern globally, particularly in low-income countries where mortality rates are disproportionately high. This cross-sectional study aimed to assess the knowledge, attitude, and uptake of cervical cancer screening among reproductive-aged women attending Kiryandongo General Hospital in Uganda. A sample size of 288 participants was determined using a modified Daniel’s formula, and data was collected using investigator-administered questionnaires. Results revealed that while the majority of participants had heard about cervical cancer, knowledge about its causative agent, risk factors, and preventive measures was low. Despite this, a considerable proportion expressed positive attitudes towards screening and willingness to undergo screening. However, the uptake of cervical cancer screening was alarmingly low, with only 4.9% of participants having been screened. These findings underscore the urgent need for comprehensive awareness campaigns and improved access to screening services in order to address the knowledge gaps and increase uptake of cervical cancer screening among women in the study area. Keywords: Cervical Cancer Screening, Pap smears, Health education, Knowledge, Attitude, Uptake, Reproductive-aged women

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 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.

Abstract 4803: Cancer screening, knowledge, and fatalism among Chinese, Korean, and South Asian residents of New York City

Abstract Background: Asian New York City (NYC) residents have the lowest screening rates by race across cancer type. Past studies indicate heterogeneity within the Asian American population, yet few have examined differences in screening uptake and related factors among Asian ethnic subgroups in NYC. Further, cancer screening knowledge and cancer fatalism have been found to impact cancer screening uptake, and effects vary by race, ethnicity, immigration status, and cancer type. Objective: Our study aimed to examine differences in cancer screening uptake, knowledge, and fatalism among Chinese, Korean, and South Asian NYC adults and to examine the effects of cancer screening knowledge and cancer fatalism on cancer screening uptake. Methods: We used data from NYU Langone Perlmutter Cancer Center’s Cancer Community Health Resources and Needs Assessment survey. The survey was developed and distributed in 10 languages in collaboration with 23 community partners. Data were collected from NYC adults with recruitment strategies focused on immigrant and non-English language preference communities from Oct. 2021 - Dec. 2022. Multivariable logistic and multinomial regression analyses were used to examine differences in breast, cervical, and colorectal cancer (CRC) screening uptake; breast and CRC screening knowledge; and cancer fatalism between Chinese, Korean, and South Asian (Bangladeshi, Pakistani, Asian Indian, and Nepali) adults; and to examine the effects of breast and CRC screening knowledge on breast and CRC screening uptake and cancer fatalism on breast, cervical, and CRC screening uptake (n=1,045). Analyses were restricted by age and sex using United States (U.S.) Preventive Services Task Force guidelines. Results: The sample was 60.0% female with a mean age of 45.7 years; 83.1% of participants were born outside of the U.S., 49.9% of participants were Chinese, 22.8% were Korean, and 27.3% were South Asian. Korean women had 0.52 (95%CI: 0.31, 0.88) times lower odds of Pap test uptake than Chinese women; South Asian adults had 0.44 (95%CI: 0.24, 0.80) times lower odds of CRC screening uptake than Chinese adults. Korean adults had 1.68 (95%CI: 1.17, 2.41) times higher odds of knowing the correct age to begin having mammograms compared to Chinese adults; South Asian adults had 0.66 (95%CI: 0.46, 0.94) times lower odds of knowing the correct age to begin CRC screening compared to Chinese adults. Korean adults had a 0.39 (95%CI: 0.25, 0.63) and 0.22 (95%CI: 0.13, 0.37) times lower odds of some and high cancer fatalism, respectively, compared to Chinese adults. No associations were found between cancer screening knowledge or cancer fatalism and cancer screening uptake. Conclusions: Our study adds to the current literature on the diversity of cancer needs, beliefs, and behaviors among Asian Americans. The findings indicate the need for ethnic-specific cultural tailoring for future cancer screening interventions. Citation Format: Isabel I. Curro, Chloe A. Teasdale, Laura Wyatt, Yousra Yusuf, Victoria Foster, Sonia Sifuentes, Perla Chebli, Julie A. Kranick, Simona C. Kwon, Chau Trinh-Shevrin, Madison N. LeCroy. Cancer screening, knowledge, and fatalism among Chinese, Korean, and South Asian residents of New York City [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 4803.

Factors associated with uptake of breast and cervical cancer screening among Nepalese women: Evidence from Nepal Demographic and Health Survey 2022.

Breast cancer screening (BCS) and cervical cancer screening (CCS) are integral parts of initiatives to reduce the burden associated with these diseases. In this context, we aimed to determine factors associated with BCS and CCS uptake among Nepalese women aged 30 to 49 years using data from the Nepal Demographic Health Survey (NDHS) 2022. We performed a weighted analysis to account complex survey design of the NDHS 2022. We employed univariable and multivariable logistic regression to determine factors associated with the uptake of BCS and CCS and results were presented as crude odds ratio and adjusted odds ratio (AOR) along with 95% confidence interval (CI). The uptake of BCS and CCS among Nepalese women aged 30 to 49 years were 6.5% and 11.4% respectively. Women from Terai compared to mountain region (AOR = 0.54, 95%CI: 0.31, 0.93) and those engaged in agriculture compared to non-working (AOR = 0.59, 95%CI: 0.42, 0.82) women had lower odds of BCS uptake. Conversely, Dalit women compared to Brahmin/Chhetri (AOR = 2.08, 95%CI: 1.37, 3.16), and women with basic (AOR = 1.49, 95%CI: 1.04, 2.13), secondary (AOR = 1.96, 95%CI: 1.33, 2.88), and higher education (AOR = 2.80, 95% CI: 1.51, 5.19) compared to those with no education had higher odds of BCS uptake. Women from rural areas (AOR = 0.76, 95%CI: 0.61, 0.96), and those living in Bagmati (AOR = 2.16, 95% CI: 1.44, 3.23) and Gandaki (AOR = 2.09, 95%CI: 1.40, 3.14) provinces had higher odds of CCS uptake compared to their urban counterparts and those living in Koshi province, respectively. The odds of CCS increased with age (AOR = 1.06, 95%CI: 1.04, 1.08). Women with secondary education (AOR = 1.47, 95%CI: 1.06, 2.04) had higher odds of CCS uptake compared to those without education. Similarly, married women (AOR = 8.24, 95%CI: 1.03, 66.21), and those with health insurance (AOR = 1.41, 95%CI: 1.08, 1.83) had higher odds of CCS. In conclusion, the uptake of both BCS and CCS was relatively poor among Nepalese women indicating a need for targeted and tailored intervention to increase BCS and CCS uptake.

Selective under-representation of Pacific peoples in population estimates for health indicator measurements in Aotearoa New Zealand misinforms policy making

BackgroundThe Census of Populations and Dwellings’ is the five yearly population count of Aotearoa New Zealand. Best available populations (BAP) are subnational projections based on census data and demographic assumptions developed for healthcare planning and funding allocation but are also used as the denominator for health indicator monitoring. Pacific people are systematically undercounted, but the impact on health statistics is not well studied. For COVID-19 vaccination coverage, health service user (HSU) data were considered a more reliable denominator than BAP but introduced new biases. We aimed to understand how the choice of denominator population impacts estimates of population size and health system performance for Pacific people at a local level.MethodsWe described how declining census response rates affected population data quality. We compared BAP and HSU data at district level. For the indicators ‘access to primary care’ and ‘cervical cancer screening uptake’ we replaced currently used BAP denominators with HSU and examined the impact for different ethnic groups in different geographic districts.ResultsOverall Census 2018 response declined by 10%, but for Māori and Pacific people by 21% and 23%, respectively. This inequitably affected BAP accuracy. Census undercount was highest in the district with the largest Pacific populations, where HSU exceeded BAP most. Notably, ‘access to primary care’ for Pacific people in this district consistently exceeds 100%. Using BAP, both health indicators are currently estimated as highest for Pacific people compared to other ethnic groups, but when based on HSU, they dropped to lowest. Similar, but less pronounced trends occurred in other districts. Changes in trends over time for both indicators coincided mostly with adjustments in BAP, rather than changes in the numerators.ConclusionsThe current use of BAP denominators for health statistics does not enable reliable monitoring of key health indicators for Pacific people. HSU denominators are also unsuitable for monitoring health. Exploring the feasibility of a real-time population register is strongly recommended as a new, transparent, way of obtaining more reliable, timely population data to guide policymaking and underpin a more equitable health system under the health reforms. Meanwhile, reporting of ethnic specific outcomes need to include a clear assessment of the potential for bias due to inaccurate population estimates.

Uptake of Cervical Cancer Screening and Its Barriers Using Health Belief Model Among Health Professionals Working in Public Hospitals in South Gondar Zone, Northcentral Ethiopia: Multicenter Cross-Sectional Study.

Cervical cancer is a malignant neoplasm that originates in the cervix, and it is a leading cause of mortality, with 270,000 deaths every year globally. Of these, 85% occur in developing countries, including Ethiopia. Routine cervical cancer screening and early treatment can prevent up to 80% of cervical cancers. Health professionals are expected to screen for and be screened for cervical cancer. However, there is limited information about the uptake of cervical cancer screening among health professionals in the study area. This study aimed to determine the magnitude of cervical cancer screening uptake and identify its barriers among health professionals. A multicenter cross-sectional study design was conducted among health professionals from December 01 to 30, 2022. A total of 164 respondents were included in the study, and simple random sampling was used to select the respondents. Variables with a p-value of <0.05 at 95% confidence interval (CI) were considered significantly associated with the outcome variable. Of the total respondents, 112 (68.3%) were younger than the age of 30 years, with a mean age of 29.4 years ranging from 21 to 45 years. Seventy-nine of the respondents (48.2%) have work experience of 6-10 years, and 103 (62.8%) are nurses in profession. In this study, the magnitude of cervical cancer screening uptake was 28.1% (95% CI: 27.7%-35.6%). Moreover, attitude (adjusted odds ratio [AOR] = 3.3, 95% CI: 2.1-5.1), age at first sexual intercourse (AOR = 2.1, 95% CI: 1.3-3.4), having history of sexually transmitted infections (STIs; AOR = 3.6, 95% CI: 1.5-11.6), knowing someone who had been screened (AOR = 2.9, 95% CI: 1.8-4.8), and cervical cancer screening training (AOR = 1.6, 95% CI: 1.1-2.9) were significantly associated with cervical cancer screening. Generally, this study reported that the magnitude of cervical cancer screening uptake was low. The study also indicated that attitude, age at first sexual intercourse, history of STIs, knowing someone who had been screened, and training of cervical cancer screening were independent predictors of uptake of cervical cancer screening.

Real-World Cervical Cancer Screening Uptake and Predictors of Visual Inspection With Acetic Acid Positivity Among Women Living With HIV in Care Programs in Western Kenya.

To achieve the WHO cervical cancer elimination targets, countries globally must achieve 70% cervical cancer screening (CCS) coverage. We evaluated CCS uptake and predictors of screening positive at two public HIV care programs in western Kenya. From October 2007 to February 2019, data from the Family AIDS Care and Education Services (FACES) and Academic Model Providing Access to Healthcare (AMPATH) programs in western Kenya were analyzed. The study population included women age 18-65 years enrolled in HIV care. Screening uptake was calculated annually and overall, determining the proportion of eligible women screened. Multivariate logistic regression assessed predictors of positive screening outcomes. There were 57,298 women living with HIV (WLWHIV) eligible for CCS across both programs during the study period. The mean age was 31.4 years (IQR, 25.9-37.8), and 39% were on antiretroviral therapy (ART) at the first CCS-eligible visit. Of all eligible women, 29.4% (95% CI, 29.1 to 29.8) underwent CCS during the study period, 27.0% (95% CI, 26.5 to 27.4) in the AMPATH program, and 35.6% (95% CI, 34.9 to 36.4) in the FACES program. Annual screening uptake varied greatly in both programs, with coverage as low as 1% of eligible WLWHIV during specific years. Age at first screening, CD4 count within 90 days of screening, current use of ART, and program (AMPATH v FACES) were each statistically significant predictors of positive screening. CCS uptake at two large HIV care programs in Kenya fell short of the WHO's 70% screening target. Screening rates varied significantly on the basis of the availability of funding specific to CCS, reflecting the limitations of vertical funding programs.

Factors Associated With the Uptake of Cervical Cancer Screening Among Family Medicine Physicians, Compared With Women of the Community in Riyadh, Saudi Arabia.

Cervical cancer is the ninth diagnosed cancer among Saudi women. The majority of cervical cancer cases occur in women who did not undergo screening. However, the screening rates in several countries, including Saudi Arabia, remain suboptimal. It is important to identify the factors associated with the uptake of screening and predictors of screening in order to increase the uptake rate. To determine the factors associated with the uptake of cervical cancer screening among family medicine physicians (FMPs), compared with women of the community. This was a cross-sectional study conducted in the central region (Riyadh), Kingdom of Saudi Arabia from February 2021 for 12 months on female physicians and women of the community. An electronic questionnaire was used to investigate the demographics of women and variables related to the uptake of screening. A total of 126 FMP and 127 women from the community were included. The factors affecting screening among FMP included age (P=0.013), health insurance (P=0.002), availability of Pap smear (P˂0.001), and physician encouragement (P˂0.001). The factors affecting the screening of community women included the availability of Pap smears (P˂0.001) and physician encouragement (P˂0.001). Multivariate analysis revealed that physician encouragement of Pap smear was a significant predictor of screening among FMP (OR=8.26, P˂0.001) and community women (OR=6.67, P˂0.001). The perceived benefit was the only predictor for screening among FMP (OR=0.75, P=0.004). The uptake of cervical cancer screening was higher in the community women. The factors linked to the uptake differed among the two groups, but the support of doctors played a significant role in the likelihood of uptake, regardless of the group of women. It is recommended to enhance the guidance of medical personnel in recommending screening during clinic visits for the specific target group. Additionally, there should be increased education on the significance of screening and efforts to educate the community about cervical cancer and screening.

Faktor-Faktor yang Mempengaruhi Cakupan Skrining Kanker Serviks dan Loss to Follow Up pada Wanita dengan IVA Positif yang Menjalani Krioterapi di Negara Berkembang: Scoping Review

Background: Cervical cancer is one of the main health problems in developing country and the second most common cancer in Indonesian women. For a better outcome, it is necessary to pay attention for discovery of the disease at an early stage. Single visit approach with visual inspection of acetic acid (VIA) followed by cryotherapy considered efficient and cost effective. However, low uptake of screening and loss to follow up after cryotherapy remain the biggest challenge.Objective: We aimed to identify factors affecting low uptake of cervical cancer screening and loss to follow up women with VIA positive undergone cryotherapy in developing countries.Method: This study is a literature review with scoping review design. Systematic search were conducted from databases PubMed, ScienceDirect, SAGE journals, Scopus and Google Scholar. Total 42 articles were selected for analysis, 35 articles discussed factors affecting cervical cancer screening uptake in developing countries and 7 articles discussed loss to follow-up women with VIA positive undergone cryotherapy.Results and Discussion: Factors identified affecting cervical cancer screening uptake and loss to follow up from demand side included lack of knowledge, perception and awareness, access constrain, fear or shame feeling and cost related problem. From supply side or healthcare system, these factors included lack of trained providers, lack of infrastructure, lack of information, coordination and communication, as well as ineffective administrative processes.Conclusion: Problems of cervical cancer screening uptake and loss to follow up after cryotherapy were identified from demand side and health service provider side. Recommendation of service improvement must consider influencing factors and limitations encountered on the field. Keywords: cervical cancer, screening, visual inspection of acetic acid, loss to follow-up, cryotherapy

Effectiveness of a culturally tailored text messaging program for promoting cervical cancer screening in accra, Ghana: a quasi-experimental trial

IntroductionDespite breakthroughs in cervical cancer detection, resource-constrained countries continue to have a disproportionately high incidence and death rate. Mhealth has been identified as an important tool for increasing cervical cancer screening rates in Sub-Saharan Africa. We determined whether sending Ghanaian women culturally tailored one-way mobile phone SMS text messages about cervical cancer would encourage the uptake of the human papillomavirus (HPV) test.MethodsFrom August to November 2016, 88 women aged 18 to 39 living or working in an urban community (Accra, Ghana) participated in a quasi-experimental study. For 8 weeks, 32 SMS messages regarding cervical cancer were developed and sent to the personal phones of intervention arm participants (n = 42). Women in the control group (n = 46) received SMS texts with general health and lifestyle advice. Fischer’s exact tests were performed to assess cervical cancer screening uptake and associated reasons for non-uptake between the intervention and control groups (p < 0.05).ResultsAt the baseline, women differed in terms of ethnicity and wealth. After the intervention, participants’ self-reported risk factors for cervical cancer, such as early menarche, usual source of medical treatment, family history of cancer, smoking, and alcohol history, changed. None of the women in the intervention group sought cervical cancer screening after the intervention, but only one (2.2%) of the control arm participants did. Almost all the women (> 95%) agreed that an HPV test was essential and that regular healthcare check-ups could help prevent cervical cancer. Some women believed that avoiding particular foods could help prevent cervical cancer (23.8% intervention vs. 58.7% control, p < 0.001). Time constraints and out-of-pocket expenses were significant barriers to cervical cancer screening. Conclusion: A one-way SMS delivered to urban women did not increase cervical cancer screening attendance. The time spent in screening facilities and the lack of coverage by the National Health Insurance Scheme limited screening uptake. We urge for the establishment of screening centers in all healthcare facilities, as well as the inclusion of cervical cancer screening in healthcare programs through cost-sharing.

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.

Uptake of cervical cancer screening and associated factors among human immune virus positive women attending antiretroviral therapy clinic in public health facilities, Northeast Ethiopia, 2022: A cross-sectional study.

Although cervical cancer is the most prevalent cancer in women and has a high morbidity, mortality, and low quality of life burden among human immune virus-positive women, there is little evidence of it in northeastern Ethiopia. Sought to determine the magnitude and associated factors of cervical cancer screening among human immune virus-positive women in public health facilities in northeastern Ethiopia. A multicentered, institution-based cross-sectional study with 401 participants using the systematic random sampling technique was employed. The data was gathered through personal interviews and chart reviews. The predictors were established via multivariate logistic regression analysis. The magnitude of cervical cancer screening was 19.2% (15.7%-22.9%). Multiparity, bad obstetric history, hearing about cervical cancer, recommendations from medical professionals, duration of antiretroviral therapy >10 years, a family record of cervical cancer, and knowing cervical cancer were revealed to be predictors of testing for cervical cancer. The magnitude of cervical cancer screening was 19.2% (15.7%-22.9%). Multiparity, bad obstetric history, hearing about cervical cancer, recommendations from medical professionals, duration of antiretroviral therapy >10 years, a family record of cervical cancer, and knowing cervical cancer were revealed to be predictors of testing for cervical cancer.