Uptake Of Cervical Screening Research Articles

Addressing Underscreening for Cervical Cancer among South Asian Women: Using Concept Mapping to Compare Service Provider and Service User Perspectives of Cervical Screening in Ontario, Canada

Cervical cancer is largely preventable through screening and treatment of cervical lesions. In the province of Ontario, South Asian women have some of the lowest rates of screening. The roles of service providers—those in healthcare and community services—and their interactions with screen-eligible people can greatly impact the uptake of screening. In our study, we used concept mapping (CM) to engage over 70 South Asian service users (i.e., those eligible for cervical screening) and service providers to identify a range of ideas and experiences that impact uptake of cervical screening for South Asian women, which were then rated by 45 participants in terms of ‘importance’ and ‘ease to address’ to encourage participation in cervical screening. Overall, ideas related to knowledge and education were rated as most important and easiest to address by both groups. Some differences were seen with South Asian service users valuing the importance of addressing ‘cultural beliefs and influences specific to sexual health’ more than service providers, while service providers valued the importance of addressing ‘lack of comfort and supportive relationships’ more than South Asian service users. Future interventions should target the knowledge and education needs of service users and increase service providers’ awareness of cultural beliefs and influences specific to sexual health.

Improving cervical screening uptake in under-served patient populations

Improving cervical screening uptake in under-served patient populations

Uptake of cervical screening and acceptability of HPV self-sampling in Irish Traveller women

Abstract Introduction Irish Travellers are a minority ethnic group. The 2010 All-Ireland Traveller Health Study noted the life expectancy of Traveller women was 11 years shorter than women in the general population. Coverage of the CervicalCheck, the Irish cervical screening programme, is 78.7% overall, however, there is no recently published data on the attendance of Traveller women. This study sought to determine participation by eligible Traveller women in CervicalCheck and the acceptability of HPV self-sampling. Methodology A face-to-face cross-sectional survey, adapted from the National Cancer Control Programme’s 2022 National Survey on Cancer Awareness, was disseminated to Irish Travellers via Primary Health Care Travellers Project peer researchers, following ethical approval, May to December 2023. Results 451 Travellers participated; 286 (63.4%) were female. Of these, 178 (62.2%) were in the eligible age group for cervical screening. 134 (75.3%) advised they had received an invitation to screening; 121 (68% of all eligible; 90% of all receiving an invitation) advised they had attended at least once (regular attenders 88 (49.4%); 27 (15.2%) irregular attenders). Of all responders in the screening eligible age group, 36 (20.2%) reported HPV self-sampling as acceptable; 18 (50%) of these were non or irregular attenders at screening. Similar proportions of 25-45 year-olds (20.4%) and 46-65 year-olds (20%) reported HPV self-sampling as acceptable. Conclusions Irish Traveller women face barriers to accessing mainstream health services. Uptake of cervical screening overall is lower compared to the general population in this study; one issue may be unreliable postal service to Travellers and non-receipt of invitations. While the overall acceptability of HPV self-sampling was low at 20.2%, half of those who would self-sample did not attend or attended irregularly. HPV self-sampling has the potential to improve cervical screening rates among Traveller women. Key messages • Irish Traveller women’s uptake of cervical screening is lower than general population. • HPV self sampling has potential to improve cervical screening rates in Travellers.

Community Health Worker Service: addressing the needs of Gypsy/Travellers in Scotland

Abstract Background Members of the Gypsy/Traveller community in the United Kingdom face significant health inequalities compared to the general population, including lower life expectancy, higher rates of morbidity and suicide and poorer infant and child outcomes. This study evaluated the implementation of community-based lay workers in Scotland - the Gypsy/Traveller Community Health Worker (CHW) service. Methods This multi-method qualitative study (December 2021 to August 2023) included 16 individual interviews, five focus groups, one workshop, two informal discussions, and one site visit. Participants were stakeholders, CHWs, and members of the Gypsy/Traveller community. Additionally, 116 documents were analysed. The framework method, Proctor’s implementation outcomes and thematic analysis were used for data analysis. Results CHWs reached approximately 1,000 individuals across six National Health Services (NHS) Boards. The implementation outcomes showed that the intervention was accepted and feasible. A third-sector organization (Black and Minority Ethnic Carers of People Project - MECOPP), played a crucial role in successfully delivering the CHW service. This innovative intervention employed members of the Gypsy/Traveller community as lay healthcare workers to break down barriers to accessing healthcare and other services (e.g., uptake of cervical screening, vaccination, housing, and sanitation). The CHWs were trusted, ensured healthcare information was culturally appropriate and successfully addressed discriminatory behaviours in health and social care. Limited resources pose challenges to the sustainability of the service. Conclusions The Gypsy/Traveller CHW service enhanced prevention, acted as a bridge between communities and health systems and addressed the wider determinants of health. The Gypsy/Traveller community still faces discriminatory, racist, and stigmatising behaviours, which further impede the quality, delivery, and accessibility of care. Key messages • The Community Health Worker service was acceptable and feasible in the Gypsy/Traveller community, acting as a bridge between community and health systems and increasing access to services. • Community Health Worker Service is an important strategy for delivering healthcare support through their sector organizations to address historical discrimination against minority ethnic groups.

Understanding influences of cervical screening attendance among women of low socio-economic position

Abstract Women of lower socio-economic position (SEP) have a higher incidence of cervical cancer and lower uptake of cervical screening. The Integrated Screening Action Model (I-SAM) is a behaviour model aimed to guide intervention development that considers how individuals engage with screening through their environment, capability, opportunity, and motivation. The I-SAM can be used to understand behaviour of cervical screening. We aimed to understand perceptions and awareness of HPV screening among women aged 25-65 of low SEP living in an urban area in Ireland. Semi-structured interviews were conducted with women who self-reported regular or irregular screening attendance, no university-level education, low-income employment or not working, aged 25-65 and living in Dublin. Participants were recruited via community organisations. Data were analysed using I-SAM in a framework analysis to map barriers and enablers of attendance of regular and irregular attenders. Of the seventeen women interviewed, seven attended screening irregularly. Participants thought they had opportunity to attend when they were reminded and supported to attend by peers and healthcare professionals. Participants wanted to promote screening in the community and to normalise conversations on sexual health. Participants felt fear of cancer was a driver and deterrent to attend screening due to cancer running in the family, past health issues and abnormal cell treatments, and wanting to be there for their family. Few were aware of HPV or the switch to HPV screening. Irregular attenders were unsure how to book or find information on screening. Campaigns should involve communities that are less likely to attend to improve visibility of screening. Healthcare professionals could opportunistically promote HPV screening in primary care and community settings. Campaigns should be aimed at improving literacy of HPV screening, address concerns of cancer risk and support navigation through screening. Key messages • Understanding of HPV cervical screening is limited and campaigns are needed to improve awareness and literacy. • Public health campaigns should engage with communities to promote screening via community groups and healthcare professionals.

Self-Screening for Cervical Cancer Offered through a Digital Platform in a Region of British Columbia with Lower Screening Rates.

Cervical cancer is highly preventable through vaccination, early detection, and treatment, yet is the fourth most common cancer globally. HPV testing is superior to cytology for the detection of cervical pre-cancer, and jurisdictions around the world are implementing HPV primary screening, which offers the opportunity for self-screening, an important self-care intervention. Digital health solutions are also increasingly important components of self-care. In this study, we assessed the acceptability and completion of self-screening for cervical cancer offered through a digital platform within a low screening uptake region of British Columbia. The primary objective of this study was to evaluate the acceptability of self-screening for cervical cancer offered through a digital platform as measured by return rates of self-screening kits. Patients due or overdue for cervix screening were invited to participate. Eligible participants registered online to receive a self-screening kit, which included a device for vaginal self-screening, instructions, and a return envelope, sent to their home. After self-screening using the vaginal device, HPV testing was conducted. HPV-negative participants were returned to routine screening, and HPV-positive participants were recommended for cytology or colposcopy. Attendance rates at follow-up were evaluated. Participants were invited to complete an acceptability survey. From April 2019 to December 2023, 283 participants were sent kits, with 207 kits returned for a completion rate of 73%. Of valid samples (n = 202), 15 were HPV positive, and 93% attended follow-up care. Most respondents found the CervixCheck website easy to use, informative, and secure and were satisfied with receiving their results online. CervixCheck had a high completion rate among participants who were sent a self-screening kit. High compliance with recommended follow-up and high acceptability of self-screening for cervical cancer was observed. Most participants indicated they would self-screen again in the future. Innovative approaches to cervical screening, including self-screening and the use of digital health interventions, are ways to enhance equity and improve uptake of cervical screening.

Providing a localised cervical cancer screening course for general practice nurses.

Cervical cancer screening programs in Australia have been developed to detect early precancerous changes in women with a cervix aged between 25 and 74. Yet, many barriers remain to the uptake of cervical screening. Barriers include a lack of culturally appropriate service provision, physical access, poor health literacy, emotional difficulties, socio-economic disadvantage and not having access to a female service provider. In remote and very remote areas of Australia, additional barriers experienced by Aboriginal or Torres Strait Islander peoples include a distrust of healthcare providers and a lack of services, resulting in a much higher rate of diagnosis and death from cervical cancer. General practice nurses (GPNs) are well placed to conduct cervical screening tests (CSTs) after they have undertaken additional education and practical training. GPNs' increase in scope of practice is beneficial to general practice as it helps to remove some barriers to cervical screening. In addition, GPNs conducting CSTs reduce GP workload and burnout and increase teamwork. GPNs working in metropolitan clinics have greater access to training facilities, whereas those working in rural and remote clinics are required to travel potentially long distances to complete practical assessments. This highlights the need for training to be made available in rural and remote areas. The aim of this forum paper is therefore to generate further discussion on the need for training programs to be made available in rural and remote areas to aid the upskilling of GPNs.

Far behind 90-70-90’s screening target: the prevalence and determinants of cervical cancer screening among Sub-Saharan African women: evidence from Demographic and Health Survey

BackgroundCervical cancer screening is the primary goal in 90-70-90 targets to reduce cervical cancer incidence and mortality by identifying and treating women with precancerous lesions. Although several studies have been conducted in Sub-Saharan African (SSA) countries on cervical cancer screening, their coverage was limited to the regional or national level, and/or did not address individual- and community-level determinants, with existing evidence gaps to the wider SSA region using the most recent data. Hence, this study aimed to assess the pooled prevalence and multilevel correlates of cervical cancer screening among women with SSA.MethodsThis study was conducted using the Demographic Health Survey data (2015–2022) from 11 countries, and a total weighted sample of 124,787 women was considered in the analysis. Using multilevel mixed-effects logistic regression, the influence of each factor on cervical cancer screening uptake was investigated, and significant predictors were reported using the adjusted odds ratio (aOR) with their respective 95% confidence intervals (95% CI).ResultsThe overall weighted prevalence of cervical cancer screening was 10.29 (95% CI: 7.77, 11.26), with the highest and lowest screening rates detected in Namibia and Benin at 39.3% (95% CI: 38.05, 40.54) and 0.5% (95% CI: 0.36, 0.69), respectively. Higher cervical screening uptake was observed among women aged 35–49 [aOR = 4.11; 95% CI: 3.69, 4.58] compared to 15–24 years, attending higher education [aOR = 2.71; 95% CI: 2.35, 3.23] than no formal education, being in the richest wealth quintile [aOR = 1.45; 95% CI: 1.26, 1.67], having a recent visit to a health facility [aOR = 1.83; 95% CI: 1.71, 1.95], using contraception [aOR = 1.54; 95% CI: 1.45, 1.64], recent sexual activity [aOR = 3.59; 95% CI: 2.97, 4.34], and listening to the radio [aOR = 1.78; 95%CI: 1.60, 2.15].ConclusionThe overall prevalence of cervical cancer screening in SSA countries was found to be low; only one in every ten women has been screened. Strengthening universal health coverage, and promoting screening programs with an emphasis on rural areas and low socioeconomic status are key to improving screening rates and equity. Additionally, integrating cervical cancer screening with existing reproductive health programs, e.g. contraceptive service would be important.

Important and Feasible Actions to Address Cervical Screening Participation amongst South Asian Women in Ontario: A Concept Mapping Study with Service Users and Service Providers.

Regular cervical screening can largely prevent the development of cervical cancer and innovative methods are needed to better engage people in screening. In Ontario, Canada, South Asian women have some of the lowest rates of screening in the province. In this study, we used concept mapping to engage two stakeholder groups-South Asian service users and service providers-to identify and prioritize points of intervention to encourage the uptake of cervical screening. After participants brainstormed a master list of statements, 45 participants rated the statements based off 'importance' and 'ease to address' in relation to encouraging cervical screening. A bivariate plot (X-Y graph) that shows the average rating values for each statement across the two rating variables (a 'go-zone' display) was produced to display priorities for implementation. Statements that were considered high priority to address reflected issues around education and awareness including understanding and communication related to cervical screening and preventative care, as well as the need for trusted sources of information. Statements that were considered high priority but challenging to implement were centered around fear, stigma, discomfort, family and personal priorities. This study highlighted that stigma, norms and social relations that impact the uptake of screening must be addressed in order for education and awareness raising to be effective and to move people from conviction around screening to action.

A 'smear campaign' against patient-excluded policy changes: a reflection on the language used in cervical screening programmes.

Cervical screening has transformed the diagnosis of cervical cancer. However, uptake within the national screening programme is not uniform across demographics. This raises the question of whether medical language, which conveys essential information but also shapes attitudes towards engaging with healthcare, is part of the problem. The term "smear test" has been used for generations and is embedded in colloquial and medical vocabulary. However, there is a danger that the phrase may conjure images of an unpleasant or even reckless ordeal, potentially contributing to unnecessary patient anxiety. To evaluate patient attitudes towards the terms "cervical smear" and "cervical brush". Female participants from a single GP surgery were randomly sampled. Data from questionnaires were then subjected to thematic analysis. Half of patients interviewed did not feel either term would significantly influence cervical screening uptake. Equal numbers of patients expressed an overall preference for each of the two terms, and the remaining 28% expressed no preference. Qualitative data revealed some patients favoured the familiarity of the term "cervical smear", and others preferred the descriptive accuracy of "cervical brush". It is imperative to consult target groups and use inclusive language that minimises stigmatising or negative connotations. Modifying language alone is unlikely to remedy the current access barriers in UK cervical screening. Instead, a multifaceted approach that also targets education and addresses systemic issues could offer a more sustainable strategy. Ultimately, prioritising a patient-centred approach could improve access to life-saving screening.

Effectiveness of couple education and counseling on uptake of cervical cancer screening among women in Southern Ethiopia: a cluster randomized trial

Cervical cancer is a major public health problem worldwide. Women die of the disease due to low early screening practices and its detection at advanced stages particularly in developing countries. Therefore, this study aimed to determine the effectiveness of couple education and counseling on the uptake of cervical screening among women. The study employed random allocation of 16 clusters into two study arms. A total of 288 women participated in the study. Structured home-based education and counseling were provided to the intervention group, while the control group received standard of care. Surveys were completed at baseline and end line. This study demonstrated that the proportion of women who had been aware of cervical cancer and screening grew from 22.9 to 100%, participants’ mean knowledge scores showed improvement from 3.18 to 11.99, and cervical screening uptake increased from 2.1% to 72.5% in the intervention group (p < 0.001). Also, the difference in differences of screening uptake between the study groups was statistically significant (p = 0.021).The study shows the effectiveness of the intervention package in improving the uptake of cervical screening in the study setting. Therefore, we recommend that creating awareness, increasing knowledge, and improving women’s perceptions through structured home-based couple education and counseling is important to improve cervical screening uptake among the target women.

Patient preference and acceptability of self-sampling for cervical screening in colposcopy clinic attenders: A cross-sectional semi-structured survey.

Low vaginal self-sampling has been pioneered as an important development to improve uptake of cervical screening globally. Limited research is available in specific patient groups in the UK exploring views around self-sampling to detect high-risk human papillomavirus (hrHPV) DNA. Therefore, we explored patient views to support development of a novel point-of-care self-sampling cervical cancer screening device, by undertaking a cross-sectional semi-structured questionnaire survey to explore preferences, acceptability, barriers and facilitators around self-sampling. Patients attending a colposcopy clinic, 25-64 years old, were invited to participate after having carried out a low vaginal self-sample using a regular flocked swab. Participants self-completed an anonymous 12-point questionnaire. Quantitative data were analysed in MS Excel and Graphpad Prism, and qualitative data with Nvivo. We recruited 274 patients with a questionnaire response rate of 76%. Acceptability of self-sampling was high (95%, n = 187/197; Cronbachs-α = 0.778). Participants were asked their choice of future screening method: a) low vaginal self-sampling, b) healthcare professional collected vaginal swab, c) cervical brush sample with healthcare professional speculum examination, or d) no preference. Preferences were: a) 37% (n = 74/198), b) 19% (n = 37/198); c) 9% (n = 17/198), and d) 35% (n = 70/198), showing no single option as a strong preference. Key motivators were: Test simplicity (90%, n = 170/190), speed (81%, n = 153/190) and less pain (65%, n = 123/190). Barriers included lack of confidence taking the sample (53%, n = 10/19), resulting in preference for a healthcare professional sample (47%, n = 9/19). Whilst self-sampling showed high acceptability, lack of strong preference for screening method may reflect that respondents attending colposcopy are already engaged with screening and have differing perception of cervical cancer risk. This group appear less likely to 'switch' to self-sampling, and it may be better targeted within primary and community care, focusing on under-screened populations. Any shift in this paradigm in the UK requires comprehensive education and support for patients and providers.

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 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.

Less known but greatly feared: Cervical cancer in Ethiopia, community awareness

To improve a community's awareness and attitude towards cervical cancer, strong evidence is needed to inform contextually appropriate policies. This study aims to explore community awareness about cervical cancer from the perspective of women, men and health extension workers (HEWs). The research was conducted from May to July 2021 in Jimma, Ethiopia. A total of 23 in-depth interviews were conducted. The study included married and unmarried women (15–19 and 25–29 years old), men of similar ages (married and unmarried), and HEWs. Furthermore, eight separate focus group discussions (FGDs) were conducted with both men and women. Thematic analysis was used to draw findings from the interviews and FGDs. Community awareness about cervical cancer was very limited. However, people who knew of it believed that cancer is fatal. A few participants were aware of cervical cancer through its symptoms, but most people did not know it by name and had never heard about HPV as the cause of cervical cancer. There was little understanding of HPV risk, transmission factors, prevention, vaccination, screening, or treatment. Participants considered their participation in this study as their first chance to learn about the disease. HEWs had limited knowledge about HPV and cervical cancer. Study participants demonstrated favorable attitudes towards HPV vaccination, cervical screening, and treatment after they received basic information about cervical cancer from the data collectors. Participants and HEWs strongly suggested awareness creation programs for the wider community members, including active involvement of men and HEWs in cervical cancer interventions. There is a critical information gap regarding cervical cancer, its cause and risk factors, HPV transmission, cervical screening, and treatment programs. Limited community awareness leads to poor uptake of cervical screening in the few settings where it is available. Therefore, community awareness programs about HPV, cervical cancer, and available services should improve the community's awareness of cervical cancer and HPV.

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

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

Transgender and non-binary peoples experiences of cervical cancer screening: A scoping review.

To synthesise the literature about transgender and non-binary people's experiences of cervical cancer screening and identify ways to improve screening. Transgender people often face barriers to accessing health services including cervical screening, where transgender people have a lower uptake than cisgender women. A scoping review was undertaken following the Arksey and O'Malley (2005) framework and the PRISMA-ScR checklist. Following database searching of Medline via PubMed, Web of Science, Scopus and CINHAL, 23 papers published between 2008 and 2003 were included. Papers were included if they shared trans and non-binary people's experiences of cervical screening and were written in English. There were no date or geographical data restrictions due to the paucity of research. Transgender people experience barriers to cervical screening including gender dysphoria, a history of sexual trauma, and mistrust in health professionals or health services, which can result in having negative experiences of screening or avoiding screening. Health professionals can help to create a positive experience by informing themselves about best practices for trans+ health. Changes are required to improve transgender people's experiences and uptake of cervical screening. Improving medical education about trans health and updating health systems would help to combat issues discussed. Having an understanding of the reasons why accessing health services can be more difficult for transgender people will help health professionals to provide appropriate care for transgender patients. This paper details this in the context of cervical cancer screening and can be applied to other areas of healthcare. We have adhered to relevant EQUATOR guidelines and used the PRISMA-ScR reporting method. No Patient or Public Contribution.

Factors associated with cervical screening coverage: a longitudinal analysis of English general practices from 2013 to 2022.

Cervical cancer remains an important global public health concern. Understanding the factors contributing to a decline in screening uptake in high-income countries is fundamental to improving screening rates. We aimed to identify general practice and patient characteristics related to cervical screening coverage in England between 2013 and 2022. We analyzed a panel of 59271 General Practice (GP)-years from 7881 GP practices. We applied correlated random effects regression to examine the association between cervical screening uptake and a rich set of GP practice workforce, size, quality and patient characteristics. Our results show a decline in overall screening rates from 2013/14 to 2021/22 from 77% to 72%. We find GP workforce and list size characteristics are strongly related to screening rates. An increase in 1 FTE Nurse per 1000 patients is related to a 1.94 percentage point increase in cervical screening rates. GP practices located in more deprived areas have lower screening rates. GP workforce and patient characteristics need to be considered by decision-makers to increase screening rates. The implementation of self-sampling screening methods could help address some of the current barriers to screening, including lack of healthcare staff and facilities.

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.

Abstract C106: Association between cancer risk perception and patient-centered communication and cervical cancer screening behavior among African Americans (AA) and Sub-Saharan African immigrant (SAI) women

Abstract Background- Black women in the US have disproportionately higher mortality and shortest survival than any ethnic or racial group for cervical cancer. Many factors contribute to the elevated cancer burden, including cancer risk perceptions and knowledge as well as patient centered communication behaviors that may influence cervical cancer screening uptake. Misperceptions of cancer risk and limited knowledge may decrease the use of preventive cancer screening. In addition, patients who encounter clinicians who practice communication not reflective of patient-centeredness may be less likely to participate in regular cancer screening. The aim of this study was to determine if cervical screening uptake among Black women was associated with cancer risk perceptions and knowledge and clinician communication behavior. Methods- We conducted a cross-sectional survey of Black women (African Americans (AA) and sub-Saharan African (SAI) recruited from Lexington, KY and surrounding towns. Data included sociodemographics, measures of cancer perceptions, and patient-centered communication. The chi-squared test of association and multiple linear regression were used to assess the unadjusted and adjusted associations among cancer risk perceptions and knowledge, patient-centered communication, and receipt of pap test. Data analysis was conducted using SAS, version 9.4 with an alpha of .05. Results- In the sample of 116 Black women who were age appropriate for pap screening (n = 48 SAI; n = 68 AA), nearly two-thirds had received a pap test (63%) in concordance with guidelines. Compared to those who had not had a pap, women who had received a pap test endorsed the statement ‘it seems like everything causes cancer (p=.006),’ while fewer agreed ‘when I think about cancer, I automatically think about death (p&amp;lt;.001)’. Both responses remained significant after adjusting for age, ethnicity, health insurance status and having a primary care provider. A higher proportion of women agreed with the six patient-centered communication items in the bivariate analysis, and remained significant in the adjusted modeling for the responses to the following three items: 1) During the past 12 months, how often did doctors, nurses, or other health professionals give you the chance to ask all the health-related questions you had?; 2) In the past 12 months, how often did you feel you could rely on doctors, nurses, or other health professionals to take care of your health care needs?; and 3) During the past 12 months, how often did doctors, nurses, or other health professionals make sure you understood the things you needed to do to take care of your health? Conclusion- Evaluation of cancer risk perceptions and patient-centered communication provide useful guidance for the development of interventions for Black women. Future research should target Black women that have misperceptions of cancer risk and limited knowledge for cervical cancer awareness. Clinicians should practice communication reflective of patient-centeredness to promote cervical cancer screening behavior. Citation Format: Adebola Adegboyega, Amanda Wiggins, Mark Dignan. Association between cancer risk perception and patient-centered communication and cervical cancer screening behavior among African Americans (AA) and Sub-Saharan African immigrant (SAI) women [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 C106.