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Sample records for attend cervical screening

  1. Review of strategies in promoting attendance for cervical screening.

    Science.gov (United States)

    Demirtas, Basak

    2013-01-01

    The importance of cervical screening has been addressed in numerous studies. However, reviews conducted to explore of strategies to promoting attendance for cervical screening have been limited. This study aimed to explore strategies to promote attendance for cervical screening. A literature search from databases (1994-2011) was undertaken to include papers that identified strategies related to the cervical screening. Twenty-four papers were included in this review. The review of existing strategies identified valuable information on cervical screening and areas that could be improved in meeting womens' needs. The review highlighted important aspects of cervical screening that could be further addressed by promoting strategies to attendance. Assessing women's health beliefs, inpatient cervical cancer screening, nurse-led screening, and cognition-emotion focused programs are among the strategies to promote attendance for pap smear testing.

  2. Audit of Cervical Cancer Screening and Colposcopy Attendance in ...

    African Journals Online (AJOL)

    Women in developing countries generally lack access to cervical cancer preventive services. An audit was performed in rural South Africa to test the hypothesis that women do not follow (pre-)cancerous cervical disease treatment sufficiently, to understand the possible reasons for this non-attendance behavior, and to ...

  3. Audit of Cervical Cancer Screening and Colposcopy Attendance in ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    factors such as human papillomavirus (HPV), no form of cancer better documents the remarkable benefits of early diagnosis and curative therapy on mortality rate than cervical cancer5. Contrary to women in industrialized countries who have relatively easy access to cervical cancer screening services, women in developing ...

  4. Self-Sampling for Human Papillomavirus Testing among Non-Attenders Increases Attendance to the Norwegian Cervical Cancer Screening Programme

    DEFF Research Database (Denmark)

    Enerly, Espen; Bonde, Jesper; Schee, Kristina

    2016-01-01

    Increasing attendance to screening offers the best potential for improving the effectiveness of well-established cervical cancer screening programs. Self-sampling at home for human papillomavirus (HPV) testing as an alternative to a clinical sampling can be a useful policy to increase attendance....... To determine whether self-sampling improves screening attendance for women who do not regularly attend the Norwegian Cervical Cancer Screening Programme (NCCSP), 800 women aged 25-69 years in the Oslo area who were due to receive a 2nd reminder to attend regular screening were randomly selected and invited...... were 33.4% in the intervention group and 23.2% in the control group, with similar attendance rates for both self-sampling devices. Women in the self-sampling subgroup responded favorably to both self-sampling devices and cited not remembering receiving a call for screening as the most dominant reason...

  5. Self-Sampling for Human Papillomavirus Testing among Non-Attenders Increases Attendance to the Norwegian Cervical Cancer Screening Programme.

    Directory of Open Access Journals (Sweden)

    Espen Enerly

    Full Text Available Increasing attendance to screening offers the best potential for improving the effectiveness of well-established cervical cancer screening programs. Self-sampling at home for human papillomavirus (HPV testing as an alternative to a clinical sampling can be a useful policy to increase attendance. To determine whether self-sampling improves screening attendance for women who do not regularly attend the Norwegian Cervical Cancer Screening Programme (NCCSP, 800 women aged 25-69 years in the Oslo area who were due to receive a 2nd reminder to attend regular screening were randomly selected and invited to be part of the intervention group. Women in this group received one of two self-sampling devices, Evalyn Brush or Delphi Screener. To attend screening, women in the intervention group had the option of using the self-sampling device (self-sampling subgroup or visiting their physician for a cervical smear. Self-sampled specimens were split and analyzed for the presence of high-risk (hr HPV by the CLART® HPV2 test and the digene® Hybrid Capture (HC2 test. The control group consisted of 2593 women who received a 2nd reminder letter according to the current guidelines of the NCCSP. The attendance rates were 33.4% in the intervention group and 23.2% in the control group, with similar attendance rates for both self-sampling devices. Women in the self-sampling subgroup responded favorably to both self-sampling devices and cited not remembering receiving a call for screening as the most dominant reason for previous non-attendance. Thirty-two of 34 (94.1% hrHPV-positive women in the self-sampling subgroup attended follow-up. In conclusion, self-sampling increased attendance rates and was feasible and well received. This study lends further support to the proposal that self-sampling may be a valuable alternative for increasing cervical cancer screening coverage in Norway.

  6. Cervical cancer screening program in Thimphu, Bhutan: population coverage and characteristics associated with screening attendance.

    Science.gov (United States)

    Baussano, Iacopo; Tshomo, Ugyen; Clifford, Gary M; Tenet, Vanessa; Tshokey, Tshokey; Franceschi, Silvia

    2014-11-30

    Bhutan has been engaged in good-quality cytology-based cervical screening since 2000 and has vaccinated >90% girls against human papillomavirus (HPV) since 2010. We explored the characteristics associated with lack of previous screening and screening coverage in women age ≥25 years. Women were invited at home or during their attendance at 2 outpatient clinics, in the capital, Thimphu, and nearby Lungthenphu. Age-adjusted odds ratios for lack of previous screening by selected characteristics were computed among 1,620 participating women. In Thimphu an invitation registry allowed to estimate screening history not only among participating women but also among additional 500 women who did not accept to join our study. Among women who had a Pap smear, lack of previous screening was associated with age Bhutan, even in the capital. Better ways to target never-screened women are needed.

  7. Cervical cancer screening: knowledge, health perception and attendance rate among Hong Kong Chinese women

    Directory of Open Access Journals (Sweden)

    Sharron SK Leung

    2010-07-01

    Full Text Available Sharron SK Leung1, Ivy Leung21School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong; 2Quality Healthcare Medical Services, Hong KongPurpose: Cervical cancer screening has been consistently shown to be effective in reducing the incidence rate and mortality from cervical cancer. However, cervical screening attendance rates are still far from satisfactory in many countries. Strategies, health promotion and education programs need to be developed with clear evidence of the causes and factors relating to the low attendance rate. The study aims to assess the prediction of cervical screening attendance rate by Chinese women’s knowledge about cervical cancer and cervical screening as well as their perception of health.Patients and methods: A survey with self-reported questionnaires was conducted on 385 Chinese women recruited from a community clinic in Hong Kong. Participants were Chinese women, Hong Kong residents, aged 18–65 years, able to read Chinese or English, and were not pregnant.Results: Women aged 37 years or less, with at least tertiary education, who perceived having control over their own health and had better knowledge on risk factors, were more likely to attend cervical cancer screening. Many participants had adequate general knowledge but were unable to identify correct answers on the risk factors.Conclusion: Health promotion efforts need to focus on increasing women’s knowledge on risk factors and enhancing their perceived health control by providing more information on the link between screening and early detection with lower incidence rates and mortality from cervical cancer.Keywords: cervical screening attendance, cervical cancer, health perception and knowledge, perceived health control, Chinese

  8. Motivators for women to attend cervical screening: the influential role of GPs.

    LENUS (Irish Health Repository)

    O'Connor, Mairead

    2014-08-01

    Participation in organized cervical cancer screening has declined recently. While research has focussed on barriers to screening participation, less attention has been paid to what motivates women to attend. Moreover, little is known about health care provider\\/practitioner-level barriers and facilitators to participation. Better understanding of these issues could help inform strategies to improve participation.

  9. Consultation rates in cervical screening non-attenders: opportunities to increase screening uptake in GP primary care.

    Science.gov (United States)

    Lim, Anita Wey Wey; Sasieni, Peter

    2015-06-01

    To estimate the proportion of cervical screening non-attenders presenting to general practice (GP) primary care over one year. 137 practices in East London, UK. Anonymous primary care records were downloaded using EMIS web (clinical software). Cervical screening nonattendance was defined as no recorded smear in the last 3.5 years (women aged 25-49) or 5.5 years (women aged 50-64). The last three consultation entries were used to estimate the proportion of non-attenders who consulted in GP over 3 months and 1 year using the Kaplan-Meier method. Newly registered women were assessed separately. Results were calculated for each practice and the median and interquartile range (IQR) across practices are presented. Heterogeneity was assessed using funnel plots. Of 261,810 women, 224,313 (86%) had been registered for >1 year. The proportion classified as non-attenders differed between those registered for >1 year (30%, IQR 27%--35%) and within the last year (49%, IQR 40%--57%), suggesting that screening records were less up-to-date in newly registered women. A median of 32% (IQR: 27%--37%) of non-attenders presented over 3 months, and 60% (IQR: 52%--67%) over 1 year. Funnel plots of the proportion of non-attenders presenting by the number of non-attenders showed substantial variation between practices. Over half of cervical screening non-attenders present to their GP at least once a year, in over 75% of practices. This represents a good opportunity for improving coverage by offering an alternative form of screening, such as self-sampling for human papillomavirus testing. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  10. Reasons for non-attendance to cervical screening and preferences for HPV self-sampling in Dutch women

    NARCIS (Netherlands)

    Bosgraaf, R.P.; Ketelaars, P.J.W.; Verhoef, V.M.; Massuger, L.F.A.G.; Meijer, C.J.W.; Melchers, W.J.G.; Bekkers, R.L.M.

    2014-01-01

    OBJECTIVES: High attendance rates in cervical screening are essential for effective cancer prevention. Offering HPV self-sampling to non-responders increases participation rates. The objectives of this study were to determine why non-responders do not attend regular screening, and why they do or do

  11. Breast and cervical cancer screening among Latinas attending culturally specific educational programs.

    Science.gov (United States)

    Jandorf, Lina; Bursac, Zoran; Pulley, Leavonne; Trevino, Michelle; Castillo, Anabella; Erwin, Deborah O

    2008-01-01

    Latinas in the United States have higher morbidity and mortality rates for breast and cervical cancers (compared with non-Latina Whites), often due to lower screening rates. A community-based participatory research (CBPR) approach could help to improve screening rates by creating a culturally customized educational program for Latino men and women addressing low knowledge, gender roles, and spirituality. This study was designed to assess the effectiveness of a culturally customized program (Esperanza y Vida [Hope and Life]) in increasing breast and cervical cancer screening among Latinas, and to examine how screening rates related to changes in cancer knowledge, differences in ethnic origins, and geographic location. Participants were recruited to attend either a breast and cervical (intervention) or diabetes (control) education program, within a randomized plan. Sixty-nine programs (44 intervention; 25 control) were conducted in Arkansas (AR; n = 39) and New York City (NYC; n = 30) with a total of 847 Latino men and women. Telephone follow-up data were collected on 49% of the women who consented to being contacted 2 months postintervention. At the 2-month follow-up call, screening rates were significantly higher for the intervention versus the control group for clinical breast examination (CBE; 48% vs. 31%; adjusted odds ratio [aOR], 2.2; 95% confidence interval [CI], 1.1-4.2), breast self-examination (45% vs. 27%; aOR, 2.3; 95% CI, 1.1-5.0), and Pap testing (51% vs. 30%; aOR, 3.9; 95% CI, 1.1-14.1), but not for mammography (67% vs. 58%; aOR, 0.7; 95% CI, 0.1-3.6). The aORs accounted for the significant effects of study site (AR vs. NYC) and marital status. Esperanza y Vida has the potential to reduce health disparities in breast and cervical cancer morbidity and mortality rates through increasing cancer screening and thereby increasing early detection.

  12. [Attendance rate in the Polish Cervical Cancer Screening Program in the years 2007-2009].

    Science.gov (United States)

    Spaczyński, Marek; Karowicz-Bilinska, Agata; Rokita, Wojciech; Molińska-Glura, Marta; Januszek-Michalecka, Lucyna; Seroczyński, Przemysław; Uchlik, Joanna; Nowak-Markwitz, Ewa

    2010-09-01

    In Poland in 2007, according to the National Cancer Registry 3431 women were diagnosed with cervical cancer and 1907 died. To change the unfavorable epidemiologic situation, in 2005 the Ministry of Health (MH), the National Health Fund (NHF) and the Polish Gynecological Society following WHO/IARC guidelines developed a National Population-Based Cervical Cancer Screening Program. Its implementation and roll-out started in 2006. The target population are women aged 25 to 59 insured in the National Health Fund. A Pap test is done with a three-year interval, free of charge. The system is based on personal invitations sent by regular post. Invitation to screening is supported by a social educational campaign "Choose Life" run under one slogan and logo across the whole country The NHF data base enables identification of women to screen. Pap smears are collected by gynecologists and since 2008 also by midwives trained and certified by the Program National Coordinating Center Pap test results are reported in the Bethesda 2001 system. The Screening Program has its system of quality assurance and control and is supported by a specially designed computer data base called SIMP (System of Information Monitoring in Prophylaxis) with online access to all records. In addition to organized, population-based screening there is also opportunistic screening in Poland practiced either by private gynecological practices or by some units that cooperate with the National Health Fund, but do Pap tests as an element of comprehensive gynecological examination. Those smears are not registered in the SIMP. Our aim was analysis of attendance rate in the Cervical Cancer Screening Program in the years 2007-2009. We also investigated correlation between screening coverage and invitation sending schedule, as well as between coverage and screening accessibility determined by the number of gynaecological practices where Pap smears are collected. Attendance rate in the Screening Program was evaluated

  13. Performance of the Xpert HPV assay in women attending for cervical screening

    Directory of Open Access Journals (Sweden)

    Jack Cuzick

    2015-12-01

    Full Text Available Objectives: This study evaluated the Xpert HPV Assay in women attending screening in general practice by comparing Xpert with two established HPV tests, cytology and histology. Methods: A prospective study in women aged 20–60 years attending screening in Bristol, Edinburgh and London using residual Preservcyt cytology samples. Sample order was randomised between Roche cobas4800 and Cepheid Xpert assays with Qiagen hc2 third. Results: 3408 cases were included in the primary analysis. Positivity for Xpert was 19.6%, cobas 19.2% and hc2 19.9% with high concordance (kappa=86.8% vs cobas, 81.55 vs hc2. Xpert, cobas and hc2 showed similar sensitivity (98.7%, 97.5%, 98.7% for CIN2+. All pairwise comparisons had high concordance (Kappa ≥0.78 with any abnormal cytology. Xpert and hc2 were positive for all cases of ≥moderate dyskaryosis (N=63, cobas was negative in two. Histology was available for 172 participants. 79 reported CIN2+, 47 CIN3+. All CIN3+ was positive on Xpert and hc2 and one case negative for cobas. One case of CIN2 was negative for all assays. Conclusions: The performance of Xpert HPV Assay in a general screening population is comparable to established HPV tests. It offers simplicity of testing, flexibility with non-batching of individual samples and rapid turnaround time. Keywords: Human papillomavirus, Xpert, Cervical screening, HPV testing

  14. Factors associated with non-attendance, opportunistic attendance and reminded attendance to cervical screening in an organized screening program: a cross-sectional study of 12,058 Norwegian women

    Directory of Open Access Journals (Sweden)

    Eriksen Tormod

    2011-04-01

    Full Text Available Abstract Background Cervical cancer incidence and mortality may be reduced by organized screening. Participant compliance with the attendance recommendations of the screening program is necessary to achieve this. Knowledge about the predictors of compliance is needed in order to enhance screening attendance. Methods The Norwegian Co-ordinated Cervical Cancer Screening Program (NCCSP registers all cervix cytology diagnoses in Norway and individually reminds women who have no registered smear for the past three years to make an appointment for screening. In the present study, a questionnaire on lifestyle and health was administered to a random sample of Norwegian women. The response rate was 68%. To address the predictors of screening attendance for the 12,058 women aged 25-45 who were eligible for this study, individual questionnaire data was linked to the cytology registry of the NCCSP. We distinguished between non-attendees, opportunistic attendees and reminded attendees to screening for a period of four years. Predictors of non-attendance versus attendance and reminded versus opportunistic attendance were established by multivariate logistic regression. Results Women who attended screening were more likely than non-attendees to report that they were aware of the recommended screening interval, a history of sexually transmitted infections and a history of hormonal contraceptive and condom use. Attendance was also positively associated with being married/cohabiting, being a non-smoker and giving birth. Women who attended after being reminded were more likely than opportunistic attendees to be aware of cervical cancer and the recommended screening interval, but less likely to report a history of sexually transmitted infections and hormonal contraceptive use. Moreover, the likelihood of reminded attendance increased with age. Educational level did not significantly affect the women's attendance status in the fully adjusted models. Conclusions The

  15. Knowledge, Attitude and Practice Regarding Cervical Cancer Screening Among Women Attending a Teaching Hospital, Bharatpur, Chitwan.

    Science.gov (United States)

    Shrestha, Smita; Dhakal, Prativa

    2017-03-01

    Objective: To find out the knowledge, attitude and practice regarding cervical cancer screening among women. Materials and methods: A descriptive cross-sectional study design was used to collect data from 96 women. Each woman was selected alternately from Gynae Out-Patient Department of Teaching Hospital. Data was collected by using semi-structured interview schedule to find out knowledge and practice and Likert scale to find out the attitude regarding cervical cancer screening. Data was analyzed by using SPSS version 20.0 and interpreted in terms of descriptive and inferential statistics. Results: Out of 96 women, mean age was 38.83 ± 6.57 and 90.6% respondents followed Hinduism. More than three fourth (85.4%) were literate and 59.4% were housewife. Only 9.4% were involved in cervical cancer prevention and screening awareness programme and 2.1% had family history of cervical cancer. As per the findings, only 34.4% and 27.8% had adequate knowledge and practice respectively whereas cent percent women had favorable attitude. Only education level of women was statistically significant with level of knowledge regarding cervical cancer screening (p = 0.041). There was strong negative correlation between knowledge score and practice score regarding cervical cancer screening among women (r = -0.194). Conclusion: Considerable proportions of women have inadequate knowledge and practice regarding cervical cancer screening. Therefore cervical cancer screening health camps and awareness program should be conducted at community level for women to increase the level of knowledge and practice regarding cervical cancer screening.

  16. Factors affecting attendance to cervical cancer screening among women in the Paracentral Region of El Salvador: a nested study within the CAPE HPV screening program.

    Science.gov (United States)

    Alfaro, Karla M; Gage, Julia C; Rosenbaum, Alan J; Ditzian, Lauren R; Maza, Mauricio; Scarinci, Isabel C; Miranda, Esmeralda; Villalta, Sofia; Felix, Juan C; Castle, Philip E; Cremer, Miriam L

    2015-10-16

    Cervical cancer is the third most commonly occurring cancer among women and the fourth leading cause of cancer-related deaths in women worldwide, with more than 85 % of these cases occurring in developing countries. These global disparities reflect the differences in cervical cancer screening rates between high-income and medium- and low-income countries. At 19 %, El Salvador has the lowest reported screening coverage of all Latin American countries. The purpose of this study is to identify factors affecting public sector HPV DNA-based cervical cancer screening participation in El Salvador. This study was nested within a public sector screening program where health promoters used door-to-door outreach to recruit women aged 30-49 years to attend educational sessions about HPV screening. A subgroup of these participants was chosen randomly and questioned about demographic factors, healthcare utilization, previous cervical cancer screening, and HPV knowledge. Women then scheduled screening appointments at their public health clinics. Screening participants were adherent if they attended their scheduled appointment or rescheduled and were screened within 6 months. The association between non-adherence and demographic variables, medical history, history of cancer, sexual history, birth control methods, and screening barriers was assessed using Chi-square tests of significance and logistic regression. All women (n = 409) enrolled in the study scheduled HPV screening appointments, and 88 % attended. Non-adherence was associated with a higher number of lifetime partners and being under-screened-defined as not having participated in cervical cancer screening within the previous 3 years (p = 0.03 and p = 0.04, respectively); 22.8 % of participants in this study were under-screened. Adherence to cervical cancer screening after educational sessions was higher than expected, in part due to interactions with the community-based health promoters as well as the educational session

  17. Lifestyle and health-related predictors of cervical cancer screening attendance in a Swiss population-based study.

    Science.gov (United States)

    Richard, Aline; Rohrmann, Sabine; Schmid, Seraina M; Tirri, Brigitte Frey; Huang, Dorothy J; Güth, Uwe; Eichholzer, Monika

    2015-12-01

    Since the implementation of cervical cancer (CC) screening, incidence and mortality rates have decreased worldwide. Little is known about lifestyle and health-related predictors of cervical cancer screening attendance in Switzerland. Our aim was to examine the relationship between lifestyle and health-related factors and the attendance to CC screening in Switzerland. We analyzed data of 20-69 years old women (n=7319) of the Swiss Health Survey (SHS) 2012. Lifestyle factors included body mass index, smoking status, alcohol consumption, physical activity and attention to diet. Health-related factors of interest were diabetes, hypertension, high cholesterol levels, chronic diseases, self-perceived health, and psychological distress. We performed multivariable logistic regression analyses with the dichotomized CC screening status as outcome measure and adjusted for demographic factors. Obesity, low physical activity, and not paying attention to diet were statistically significantly associated with lower CC screening participation. High cholesterol levels and history of chronic diseases were statistically significantly positively associated with screening participation. Being obese, physically inactive and non-attention to diet are risk factors for CC screening attendance. These findings are of importance for improving the CC screening practices of low-user groups. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Reasons for non-attendance to cervical screening and preferences for HPV self-sampling in Dutch women.

    Science.gov (United States)

    Bosgraaf, Remko P; Ketelaars, Pleun J W; Verhoef, Viola M J; Massuger, Leon F A G; Meijer, Chris J L M; Melchers, Willem J G; Bekkers, Ruud L M

    2014-07-01

    High attendance rates in cervical screening are essential for effective cancer prevention. Offering HPV self-sampling to non-responders increases participation rates. The objectives of this study were to determine why non-responders do not attend regular screening, and why they do or do not participate when offered a self-sampling device. A questionnaire study was conducted in the Netherlands from October 2011 to December 2012. A total of 35,477 non-responders were invited to participate in an HPV self-sampling study; 5347 women did opt out. Finally, 30,130 women received a questionnaire and self-sampling device. The analysis was based on 9484 returned questionnaires (31.5%) with a self-sample specimen, and 682 (2.3%) without. Among women who returned both, the main reason for non-attendance to cervical screening was that they forgot to schedule an appointment (3068; 32.3%). The most important reason to use the self-sampling device was the opportunity to take a sample in their own time-setting (4763; 50.2%). A total of 30.9% of the women who did not use the self-sampling device preferred after all to have a cervical smear taken instead. Organisational barriers are the main reason for non-attendance in regular cervical screening. Important reasons for non-responders to the regular screening to use a self-sampling device are convenience and self-control. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Cervical cancer knowledge and screening behaviors among female university graduates of year 2012 attending national graduate orientation program, Bhutan.

    Science.gov (United States)

    Dhendup, Tshering; Tshering, Pandup

    2014-03-12

    Cervical cancer is the leading female cancer in Bhutan. This study describes the level of cervical cancer knowledge and screening behaviors among female university graduates attending the National Graduate Orientation Program (NGOP), 2012. A cross-sectional study of female graduates attending NGOP was conducted using self-administered anonymous questionnaire developed through literature reviews and expert discussions to elicit information on demographic characteristics, knowledge, screening behaviors and determinants of cervical cancer. The association of demographic and other important study characteristics with uptake of Pap test was investigated using cross tabulation and Fischer Exact test. Frequencies and percentages were calculated for all the questions. The average age of the participants was 23.43 ± SD 2.73. About 92% (n = 513) of the respondents were aged 25 years or less and 7.9% (n = 44) of the respondents were aged 26 or more. The study revealed low cervical cancer knowledge and poor screening behavior among the graduates. The mean knowledge score was 3.571 (SD1.75, Range 0-8). About 6% (n=34) of the respondents reported undergoing Pap test at least once and 94% reported as never having done Pap test. The most commonly cited reasons for not doing Pap test included "never thought I needed one" (57%, n = 320), "embarrassment of being examined by male health professional" and "fear of finding out cancer". The study revealed evidence of significant association between increasing age, those who are married, knowledge score and those recommended for screening by health professionals with the uptake of Pap test. Our study revealed poor knowledge and screening behaviors among female university graduates in Bhutan. This may be suggestive of even poorer awareness and screening practices among young unmarried women who are less educated or with no education. Although our study group is not appropriate for measuring practice of cervical cancer

  20. Attending cervical cancer screening, opportunities and obstacles: a qualitative study on midwives' experiences telephoning non-attendees in Sweden.

    Science.gov (United States)

    Broberg, Gudrun; Strander, Björn; Ellis, Joy; Adolfsson, Annsofie

    2014-11-01

    As part of a research project aimed at increasing participation in the cervical cancer screening program (CCS), we explored midwives' unique experiences of telephoning non-attendees and offering Pap smear appointments. Twenty midwives, in four focus groups, discussed their experiences of a study investigating ways to increase participation in the CCS. The group discussions were tape-recorded and transcribed verbatim and underwent qualitative content analysis. Speaking with more than 1000 non-attendees provided the midwives with new perspective on the CCS and they realised that improving it might address a number of reasons for not participating. These reasons were often related to logistics, such as scheduling flexibility and appointment booking. The telephone conversations revealed that some women required more individual attention, while it was discovered that others did not require screening. The midwives considered the CCS to be life-saving; participating in this screening activity gave them a sense of satisfaction and pride. This study shows that midwives can improve access and prevent non-attendance at the cervical cancer screening program when they are aware of women's varying requirements for attending screening. © 2014 the Nordic Societies of Public Health.

  1. Changes in cervical cancer screening behavior for women attending Pap Test Week clinics.

    Science.gov (United States)

    Poliquin, V; Decker, K; Altman, Ad; Lotocki, R

    2013-01-01

    This retrospective study of all women who accessed the 2006 Manitoba Pap Test Week clinics was designed to determine factors associated with inadequate cervical cancer screening and changes in cervical cancer screening behavior. Data were acquired using the CervixCheck Manitoba registry and an ancillary database of demographic information collected from clinic attendees. The study included 1124 women. Of these, 53% (n = 598) were under-screened (no Pap test in the previous 2 years) prior to accessing the clinics. Logistic regression analyses demonstrated that older age (odds ratio [OR] = 1.02, 95% confidence interval [CI] 1.01-1.03), no doctor (OR = 1.4, 95% CI 1.05-1.54), and living in Canada clinics. Thirty-seven percent (n = 223) of under-screened women demonstrated improved screening status subsequent to the 2006 Pap Test Week (had a subsequent Papanicolaou [Pap] test performed within 2 years) and these women were more likely to live in an urban setting (P = 0.003), be younger (P clinic compared to having a Pap test performed elsewhere (37% versus 60%, P clinics whose screening status might be most modifiable.

  2. Changes in cervical cancer screening behavior for women attending Pap Test Week clinics

    Directory of Open Access Journals (Sweden)

    Poliquin V

    2013-04-01

    Full Text Available V Poliquin,1 K Decker,2,3 AD Altman,1,2,4 R Lotocki1,2,4 1Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Canada; 2CancerCare Manitoba, Winnipeg, Manitoba, Canada; 3Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, 4Division of Gynecologic Oncology, University of Manitoba, Winnipeg, Manitoba, Canada Objective: This retrospective study of all women who accessed the 2006 Manitoba Pap Test Week clinics was designed to determine factors associated with inadequate cervical cancer screening and changes in cervical cancer screening behavior. Methods: Data were acquired using the CervixCheck Manitoba registry and an ancillary database of demographic information collected from clinic attendees. Results: The study included 1124 women. Of these, 53% (n = 598 were under-screened (no Pap test in the previous 2 years prior to accessing the clinics. Logistic regression analyses demonstrated that older age (odds ratio [OR] = 1.02, 95% confidence interval [CI] 1.01–1.03, no doctor (OR = 1.4, 95% CI 1.05–1.54, and living in Canada < 1 year (OR = 5.5, 95% CI 2.73–11.12 were associated with being under-screened prior to accessing the Pap Test Week clinics. Thirty-seven percent (n = 223 of under-screened women demonstrated improved screening status subsequent to the 2006 Pap Test Week (had a subsequent Papanicolaou [Pap] test performed within 2 years and these women were more likely to live in an urban setting (P = 0.003, be younger (P < 0.001, originate outside Canada (P = 0.006, have lived in Canada for less than 1 year (P = 0.006, and have had an abnormal Pap test result in 2006 (P < 0.001. Previously under-screened women were less likely to become adequately-screened subsequent to 2006 if they had a Pap test performed at a Pap Test Week clinic compared to having a Pap test performed elsewhere (37% versus 60%, P < 0.001. Conclusion: This study identified a subset of under-screened

  3. Detection of human papillomavirus in women attending Pap cervical screening camp at a peripheral hospital of North-Eastern India

    OpenAIRE

    Datta, Sibnarayan; Agarwal, Manisha; Chatterjee, Soumya; GOGOI, HEMANTA KUMAR; Veer, Vijay; Singh, Lokendra

    2013-01-01

    Human papillomavirus (HPV) associated cervical cancer is the leading cause of deaths in India. However, cytological/HPV screening may result in early detection of cervical cancer, resulting in early treatment and reduced mortality. Although reports related to general population is available, data on HPV prevalence among women attending AFMS health care facilities is scarce. Cervical samples were collected for cytological staining by Pap test and molecular detection by PCR, genotyping by HPV s...

  4. Text messages to increase attendance to follow-up cervical cancer screening appointments among HPV-positive Tanzanian women (Connected2Care)

    DEFF Research Database (Denmark)

    Linde, Ditte S; Andersen, Marianne S; Mwaiselage, Julius D

    2017-01-01

    Virus (HPV) during cervical cancer screening. Methods: Connected2Care is a non-blinded, multicentre, parallel-group, randomised controlled trial. Tanzanian Women testing positive to HR HPV at inclusion are randomly assigned in an allocation ratio of 1:1 to the SMS intervention or the control group......Background: Cervical cancer is a major health concern in Tanzania, caused by poor attendance for cervical cancer screening and follow-up of women at risk. Mobile telephone health interventions are proven effective tools to improve health behaviour in African countries. So far, no knowledge exists...... on how such interventions may perform in relation to cervical cancer screening in low-income settings. This study aims to assess the degree to which a Short Message Service (SMS) intervention can increase attendance at appointments among women who have tested positive for High-Risk (HR) Human Papiloma...

  5. Text messages to increase attendance to follow-up cervical cancer screening appointments among HPV-positive Tanzanian women (Connected2Care)

    DEFF Research Database (Denmark)

    Linde, Ditte S; Andersen, Marianne S; Mwaiselage, Julius D

    2017-01-01

    BACKGROUND: Cervical cancer is a major health concern in Tanzania, caused by poor attendance for cervical cancer screening and follow-up of women at risk. Mobile telephone health interventions are proven effective tools to improve health behaviour in African countries. So far, no knowledge exists...... on how such interventions may perform in relation to cervical cancer screening in low-income settings. This study aims to assess the degree to which a Short Message Service (SMS) intervention can increase attendance at appointments among women who have tested positive for high-risk (HR) Human...... provide information on the potential effects, costs, and barriers in implementing an SMS intervention targeting a group of women who are followed up after testing positive for HR HPV and are, therefore, at increased risk of developing cervical cancer. This can guide decision-makers on the effective use...

  6. Human papillomavirus prevalence in women attending routine cervical screening in South Wales, UK: a cross-sectional study

    Science.gov (United States)

    Hibbitts, S; Jones, J; Powell, N; Dallimore, N; McRea, J; Beer, H; Tristram, A; Fielder, H; Fiander, A N

    2008-01-01

    In this cross-sectional population-based study we determine human papillomavirus (HPV) prevalence in South Wales to provide comprehensive baseline data for future assessment of the impact of prophylactic HPV vaccination and to help inform future screening strategies. Liquid-based cytology samples from women attending routine cervical screening were collected (n=10 000: mean age 38 years, 93% cytology negative, and 64.8% from the 50% least deprived LSOA according to social deprivation score (SDS)). High-Risk (HR) and Low-Risk HPV screening was performed using HPV PCR-EIA with genotyping of HR positives and data correlated with age, SDS and cytology. Overall HPV prevalence was 13.5% (9.3% age standardised) and the most frequent HR types were HPV 16, 31, 18 and 58. In HR HPV-positive cases 42.4% had a single HR type and they were predominant in women with severe cytological abnormalities. Here, 66% of all HR HPV cases were in women aged 30 years of age or less and SDS had no significant effect on HPV status. HPV prevalence increased significantly with degree of dyskarosis from 7% in cytology negative samples to 80% in samples with severe cytological abnormalities (P-value <0.0001). Overall, 46% of HR HPV cases were positive for the two HR types targeted by the prophylactic vaccines (HPV 16 and HPV 18). The data presented represents the largest type-specific investigation of HPV prevalence in an unselected UK population. PMID:19034285

  7. High-grade cervical intraepithelial neoplasia in human papillomavirus self-sampling of screening non-attenders

    DEFF Research Database (Denmark)

    Lam, J U H; Elfström, K M; Ejegod, D. M.

    2017-01-01

    BACKGROUND: Self-sampling for human papillomavirus (HPV) offered to women who do not participate in cervical cancer screening is an increasingly popular method to increase screening coverage. The rationale behind self-sampling is that unscreened women harbour a high proportion of undetected...

  8. Risks of Cervical Cancer Screening

    Science.gov (United States)

    ... infection is the major risk factor for cervical cancer. Cervical cancer is a disease in which malignant (cancer) ... following PDQ summaries for more information about cervical cancer: Cervical Cancer Prevention Cervical Cancer Treatment Screening for cervical ...

  9. Detection of human papillomavirus in women attending Pap cervical screening camp at a peripheral hospital of North-Eastern India.

    Science.gov (United States)

    Datta, Sibnarayan; Agarwal, Manisha; Chatterjee, Soumya; Gogoi, Hemanta Kumar; Veer, Vijay; Singh, Lokendra

    2015-04-01

    Human papillomavirus (HPV) associated cervical cancer is the leading cause of deaths in India. However, cytological/HPV screening may result in early detection of cervical cancer, resulting in early treatment and reduced mortality. Although reports related to general population is available, data on HPV prevalence among women attending AFMS health care facilities is scarce. Cervical samples were collected for cytological staining by Pap test and molecular detection by PCR, genotyping by HPV specific primers and sequencing. Apart from finding of atypical cells of undetermined significance (ASCUS) in one subject, no evidence of malignancy was observed. A high prevalence of HPV was found in this study group, which was intermediate between previous reports from general population and cervical cancer patients. All the subjects had infection of high risk HPV type16. HPV prevalence was found similar between different age groups. Although, none of the study subjects had malignant changes, but due to high prevalence of high risk HPV infection and other associated risk factors, these subjects might be at an elevated risk of developing cervical cancer. Regular follow-up of these patients who were detected HPV positive are required to screen for cervical malignancy.

  10. Factors affecting attendance to cervical cancer screening among women in the Paracentral Region of El Salvador: a nested study within the CAPE HPV screening program

    OpenAIRE

    Alfaro, Karla M.; Gage, Julia C.; Rosenbaum, Alan J.; Ditzian, Lauren R.; Maza, Mauricio; Scarinci, Isabel C.; Miranda, Esmeralda; Villalta, Sofia; Felix, Juan C.; Castle, Philip E.; Cremer, Miriam L.

    2015-01-01

    Background Cervical cancer is the third most commonly occurring cancer among women and the fourth leading cause of cancer-related deaths in women worldwide, with more than 85 % of these cases occurring in developing countries. These global disparities reflect the differences in cervical cancer screening rates between high-income and medium- and low-income countries. At 19 %, El Salvador has the lowest reported screening coverage of all Latin American countries. The purpose of this study is to...

  11. Acceptability of cervical cancer screening using visual inspection among women attending a childhood immunization clinic in Uganda

    Directory of Open Access Journals (Sweden)

    Meng Li

    2017-12-01

    Full Text Available Objective: To evaluate the acceptability and performance of cervical cancer (CC screening using visual inspection with acetic acid (VIA integrated into a rural immunization clinic in Uganda. Methods/materials: We conducted a cross-sectional pilot study in rural Uganda. We explored associations between women's characteristics and acceptance of VIA testing. We collected samples for Papanicolaou (Pap smear testing in a random subset of women and used results from this test as a comparator for assessing VIA performance. Results: We enrolled 625 women of whom 571 (91.4% accepted and 54 (8.6% refused CC screening. In the univariate model, age (Odds Ratio (OR=1.10; p-value<0.001 and employment status (OR 2.00; p-value=0.019 were significantly associated with acceptance of VIA screening. In the multivariate model, no characteristic was independently associated with acceptance of VIA screening after adjusting for other factors. Compared to reference Pap smear, CC screening with VIA had a sensitivity of 50% and a specificity of 97.7%. Conclusions: CC screening with VIA is highly acceptable in the setting of rural immunization clinics in Uganda. Studies to assess which screening method would be the most effective and cost-effective are needed before stakeholders can consider adopting screening programs at scale.

  12. Cervical pre-malignant lesions in HIV infected women attending ...

    African Journals Online (AJOL)

    The aims of this study was to determine proportion of HIV infected women with cervical pre-malignant lesions; and compare the use of Visual Inspection of the cervix after application of Acetic acid (VIA) and Papanicolau (Pap) smear in screening for cervical premalignant lesions in HIV positive women attending Care and ...

  13. A pilot study of community-based self-sampling for HPV testing among non-attenders of cervical cancer screening programs in El Salvador.

    Science.gov (United States)

    Laskow, Bari; Figueroa, Ruben; Alfaro, Karla M; Scarinci, Isabel C; Conlisk, Elizabeth; Maza, Mauricio; Chang, Judy C; Cremer, Miriam

    2017-08-01

    To establish the feasibility and acceptability of home-based HPV self-sampling among women who did not attend screening appointments in rural El Salvador. In a cross-sectional study, data were collected from May 2015 to January 2016 among 60 women aged 30-59 years who were not pregnant, provided informed consent, had not been screened in 2 years, had no history of pre-cancer treatment, and did not attend a scheduled HPV screening. Participants completed questionnaires and received educational information before being given an opportunity to self-sample with the Hybrid Capture 2 High Risk HPV DNA Test. Self-sampling was accepted by 41 (68%) participants. Almost all women chose to self-sample because the process was easy (40/41, 98%), could be performed at home (40/41, 98%), and saved time (38/41, 93%), and because they felt less embarrassed (33/41, 80%). The most common reason for declining the test was not wanting to be screened (8/19, 42%). The prevalence of high-risk HPV types among women who accepted self-sampling was 17% (7/41). For most women, community-based self-sampling was an acceptable way to participate in a cervical cancer screening program. In low-resource countries, incorporating community-based self-sampling into screening programs might improve coverage of high-risk women. © 2017 International Federation of Gynecology and Obstetrics.

  14. SCREENING FOR CERVICAL CANCER

    African Journals Online (AJOL)

    Enrique

    ing is started, frequency of screening, ideal and cost-effective technique, provi- sion of screening services to the most needy ... Based on data from Cali, Colombia, the impact of starting cervical screening at different ages shows that starting ... Hospital, Durban, and obtained his. Fellowship in 1996. His current field of.

  15. Text messages to increase attendance to follow-up cervical cancer screening appointments among HPV-positiveTanzanian women (Connected2Care): study protocol for a randomised controlled trial

    DEFF Research Database (Denmark)

    Søndergaard Linde, Ditte; Skovsager-Andersen, Marianne; Mwaiselage, Julius

    2017-01-01

    Background: Cervical cancer is a major health concern in Tanzania, caused by poor attendance for cervical cancer screening and follow-up of women at risk. Mobile telephone health interventions are proven effective tools to improve health behaviour in African countries. So far, no knowledge exists...... on how such interventions may perform in relation to cervical cancer screening in low-income settings. This study aims to assess the degree to which a Short Message Service (SMS) intervention can increase attendance at appointments among women who have tested positive for High-Risk (HR) Human Papiloma...... information on the potential effects, costs and barriers in implementing an SMS intervention targeting a group of women who are followed-up after testing positive for HR HPV and therefore at increased risk of developing cervical cancer. This can guide decision-makers on the effective use of mobile technology...

  16. Cervical cancer -- screening and prevention

    Science.gov (United States)

    ... available to protect against the HPV types that cause most cervical cancer in women. The vaccine is: Given as a ... neoplasia of the lower genital tract (cervix, vulva): etiology, screening, ... Cervical Pathology, and American Society for Clinical Pathology screening ...

  17. Towards a rational cervical cytology screening strategy

    African Journals Online (AJOL)

    1995-01-01

    Jan 1, 1995 ... screening were estimated from cytopathology laboratory records and available demographic data. Age-specific prevalence rates among women who had been screened were compared with age at presentation with cervical cancer at the referral hospital. Attendance for colposcopy follow-up was assessed ...

  18. Attendance at Cervical Cancer Screening and Use of Diagnostic and Therapeutic Procedures on the Uterine Cervix Assessed from Individual Health Insurance Data (Belgium, 2002-2006)

    Science.gov (United States)

    Arbyn, Marc; Fabri, Valérie; Temmerman, Marleen; Simoens, Cindy

    2014-01-01

    Objective To assess the coverage for cervical cancer screening as well as the use of cervical cytology, colposcopy and other diagnostic and therapeutic interventions on the uterine cervix in Belgium, using individual health insurance data. Methods The Intermutualistic Agency compiled a database containing 14 million records from reimbursement claims for Pap smears, colposcopies, cervical biopsies and surgery, performed between 2002 and 2006. Cervical cancer screening coverage was defined as the proportion of women aged 25–64 that had a Pap smear within the last 3 years. Results Cervical cancer screening coverage was 61% at national level, for the target population of women between 25 and 64 years old, in the period 2004–2006. Differences between the 3 regions were small, but varied more substantially between provinces. Coverage was 70% for 25–34 year old women, 67% for those aged 35–39 years, and decreased to 44% in the age group of 60–64 years. The median screening interval was 13 months. The screening coverage varied substantially by social category: 40% and 64%, in women categorised as beneficiary or not-beneficiary of increased reimbursement from social insurance, respectively. In the 3-year period 2004–2006, 3.2 million screen tests were done in the target group consisting of 2.8 million women. However, only 1.7 million women got one or more smears and 1.1 million women had no smears, corresponding to an average of 1.88 smears per woman in three years of time. Colposcopy was excessively used (number of Pap smears over colposcopies = 3.2). The proportion of women with a history of conisation or hysterectomy, before the age of 65, was 7% and 19%, respectively. Conclusion The screening coverage increased slightly from 59% in 2000 to 61% in 2006. The screening intensity remained at a high level, and the number of cytological examinations was theoretically sufficient to cover more than the whole target population. PMID:24690620

  19. [Primary cervical cancer screening].

    Science.gov (United States)

    Vargas-Hernández, Víctor Manuel; Vargas-Aguilar, Víctor Manuel; Tovar-Rodríguez, José María

    2015-01-01

    Cervico-uterine cancer screening with cytology decrease incidence by more than 50%. The cause of this cancer is the human papilloma virus high risk, and requires a sensitive test to provide sufficient sensitivity and specificity for early detection and greater interval period when the results are negative. The test of the human papilloma virus high risk, is effective and safe because of its excellent sensitivity, negative predictive value and optimal reproducibility, especially when combined with liquid-based cytology or biomarkers with viral load, with higher sensitivity and specificity, by reducing false positives for the detection of cervical intraepithelial neoplasia grade 2 or greater injury, with excellent clinical benefits to cervical cancer screening and related infection of human papilloma virus diseases, is currently the best test for early detection infection of human papillomavirus and the risk of carcinogenesis. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  20. Screening for Cervical Cancer

    Science.gov (United States)

    ... they might mean for you. What is cervical cancer? Cervical cancer is cancer that occurs in the cervix. ... to Know About™ Cancer of the Cervix ( National Cancer Institute) Cervical Cancer ( Centers for Disease Control and Prevention) March ...

  1. Current Cervical Carcinoma Screening Guidelines

    Directory of Open Access Journals (Sweden)

    Megan J. Schlichte

    2015-05-01

    Full Text Available A formidable threat to the health of women, cervical carcinoma can be prevented in many cases with adequate screening. The current guidelines for cervical carcinoma screening were created as joint recommendations of the American Cancer Society (ACS, the American Society for Colposcopy and Cervical Pathology (ASCCP and the American Society for Clinical Pathology (ASCP in 2012, and later accepted and promoted by the American Congress of Obstetricians and Gynecologists (ACOG. The 2012 recommendations underscore the utility of molecular testing as an adjunct to cytology screening for certain women and provide guidance to clinicians based on different risk-benefit considerations for different ages. This manuscript will review screening techniques and current recommendations for cervical cancer screening and human papilloma virus (HPV testing, as well as possible future screening strategies.

  2. How can young women be encouraged to attend cervical cancer screening? Suggestions from face-to-face and internet focus group discussions with 30-year-old women in Stockholm, Sweden.

    Science.gov (United States)

    Blomberg, Karin; Tishelman, Carol; Ternestedt, Britt-Marie; Törnberg, Sven; Levál, Amy; Widmark, Catarina

    2011-01-01

    cervical cancer screening (CCS) using Pap-smears has been carried out for decades and is still an essential tool for secondary cancer prevention. Focus has traditionally been on what hinders women's attendance, instead of researching this issue from a positive standpoint, i.e. what factors encourage women to take a Pap-smear? In this article, we therefore explore issues that 30-year-old women have addressed as encouraging CCS attendance, with particular focus on aspects susceptible to intervention. through the population-based cervical cancer screening (PCCSP) registry in Stockholm, Sweden, a stratified random sampling technique was used to recruit women from the same birth cohort with varied CCS histories and results. Nine face-to-face focus groups discussions (FGDs) and 30 internet-based FGDs were conducted with a total of 138 women aged 30. Qualitative analysis was inspired by interpretative description, to generate clinically relevant and useful data. in general, these women expressed positive views about the PCCSP as an existing service, regardless of screening history. They described a wide range of factors encompassing the entire screening trajectory from invitation through follow-up which could motivate young women to CCS participation, including social marketing. Many of the suggestions related to individualization of the PCCSP, as well as a need to understand the relationship between human papilloma virus (HPV) and cervical cancer. [corrected these results are discussed in terms of the inherent tension between population-based public health initiatives and individually-oriented health care provision. Many suggestions given are already incorporated into the existing Stockholm-Gotland screening program, although this information may not reach women who need it. New research should test whether systematic information on HPV may provide a missing link in motivating young women to attend CCS, and which of their suggestions can serve to increase CCS

  3. [Proposal for the modernization of cervical screening procedure in Hungary].

    Science.gov (United States)

    Koiss, Róbert; Boncz, Imre; Hernádi, Zoltán; Szentirmay, Zoltán

    2017-12-01

    Two main considerations played roles in creation of new cervical screening system. One was the proven fact that high-risk human papilloma virus infection plays a role in the development of cervical cancer and pre-cancerous lesions. The other was the implementation of the HPV infection's biological behavior in the new screening strategy. The new screening procedure faithfully reflects the cervical carcinogenesis. An organised, population-based and age differentiated screening method could increase attendance of screening and could decrease the possibility of interval cancer rate due to increased sensitivity. Orv Hetil. 2017; 158(52): 2062-2067.

  4. SCREENING FOR CERVICAL CANCER

    African Journals Online (AJOL)

    Enrique

    Cervical cancer remains a major health concern worldwide, especially in devel- oping countries. It is the commonest malignancy among black women in South. Africa. The quoted incidence of cervical cancer is approximately 30/100 000 women.1 Mortality is higher in developing countries, mainly due to the lack of.

  5. Cervical Cancer Screening with AMIGAS

    Science.gov (United States)

    Lairson, David R.; Chang, Yu-Chia; Byrd, Theresa L.; Smith, Judith Lee; Fernandez, Maria E.; Wilson, Katherine M.

    2015-01-01

    Background Hispanic women have a higher incidence of cervical cancer than all other races and ethnicities. In Hispanic subgroups, Mexican American women were among the least likely to have received cervical cancer screening. In a recent RCT, Ayudando a las Mujeres con Información, Guia, y Amor para su Salud (AMIGAS) was shown to increase cervical cancer screening rates among women of Mexican descent at 6 months in all intervention arms compared to the control arm. Limited information exists about the economics of interventions to increase cervical cancer screening rates among women of Mexican descent. Purpose This study aims to estimate the cost-effectiveness of the alternative AMIGAS intervention methods for increasing cervical cancer screening among low-income women of Mexican descent in three U.S. communities. Methods Cost data were collected from 2008 to 2011 alongside the AMIGAS study of 613 women. Receipt of Pap test within 6 months of intervention was the primary outcome measure in the cost-effectiveness analysis, conducted during 2012–2013. Results The cost per additional woman screened comparing the video-only intervention to usual care was $980. The cost increased to $1,309 with participant time cost included. With an additional cost per participant of $3.90 compared to flipchart only, the full AMIGAS program (video plus flipchart) yielded 6.8% additional women screened. Conclusions Results on the average and incremental cost-effectiveness of the AMIGAS program elements may assist health policymakers and program managers to select and appropriately budget for interventions shown to increase cervical cancer screening among low-income women of Mexican descent. PMID:24842738

  6. Cervical Cancer Screening

    Science.gov (United States)

    ... cervical tissue that is then examined under a microscope in a laboratory. Cervix: The lower, narrow end of the uterus at the top of the vagina. Colposcopy: Viewing of the cervix, vulva, or vagina under magnification with an instrument called a colposcope. Co-Testing: ...

  7. Cervical cancer screening at crossroads

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Rygaard, Carsten; Baillet, Miguel Vazquez-Prada

    2014-01-01

    , screening decreased the incidence of cervical cancer from 34 to 11 per 100,000, age-standardized rate (World Standard Population). Screening is, however, also expensive; Denmark (population: 5.6 million) undertakes close to half a million tests per year, and has 6-8 CIN-treated women for each prevented...... in women vaccinated later. The challenge now is therefore to find an algorithm for screening of a heterogeneous population including non-vaccinated women; women vaccinated prior to start of sexual activity; and women vaccinated later....

  8. Methods for Cervical Cancer Screening

    Directory of Open Access Journals (Sweden)

    Tatiana Vargas-Revilla

    2014-12-01

    This article is divided in three sections: the first one focuses on the general impact of cervical cancer has hadin CostaRica, these condsection gathers information about different methodologies used around the world to detect this cancer and the third one makes reference to the current development of the screening devise in Mexico that works as a monitoring system and can used by women without external assistance.

  9. How does HPV vaccination status relate to risk perceptions and intention to participate in cervical screening?

    DEFF Research Database (Denmark)

    Hestbech, Mie Sara; Gyrd-Hansen, Dorte; Kragstrup, Jakob

    2016-01-01

    will not attend screening because they falsely think that the vaccine has eliminated their cervical cancer risk. The aim of this study was to investigate the association between HPV vaccination status and perceptions of cervical cancer risk; perceptions of vaccine effect; and intention to participate in cervical...... screening. Furthermore, to investigate associations between perceptions of cervical cancer risk and intention to participate in cervical screening. Methods: A random sample of Danish women from the birth cohorts 1993–1995 was invited to complete a web-based questionnaire concerning risk perceptions...... and intentions to participate in cervical screening. Main outcomes were: perceived lifetime-risk of cervical cancer; perceived HPV vaccine effect; and intention to participate in cervical screening. Results: HPV vaccinated women more often than unvaccinated women intended to participate in screening: adjusted...

  10. Cervical cancer screening in France.

    Science.gov (United States)

    Schaffer, P; Sancho-Garnier, H; Fender, M; Dellenbach, P; Carbillet, J P; Monnet, E; Gauthier, G P; Garnier, A

    2000-11-01

    In France, as in other European countries the incidence and mortality rates of carcinoma of the cervix uteri indicate a clear decrease in invasive cancers. Opportunistic screening has spread and, presently, approximately 60% of the female population undergo a regular cytological test. This rate increases up to 80% in the younger age groups and decreases to 20% after the age of 60 years. In 1990, intervention procedures were defined at a consensus conference; the major recommendations were to screen all women exclusively by cervical smears, for ages 25-65 years over a 3-year period. Guidelines on the quality control of cervical smear taking and reading were published by the national agency of evaluation of health intervention (ANAES). Since 1990, four population-based, organised pilot programmes, have been implemented in Isère. Doubs, Bas-Rhin and Martinique. These programmes evaluate the participation rate (from approximately 20-80% depending upon the age and the geographical area), the rate of abnormal tests (0.2-3%), according to the laboratories, the cancer detection rate (0.04%-0.15%) and some other quality indicators. Recently (November 1998) a law was passed stipulating that the screening test will be free of charge when performed in agreement with the national recommendations. A specific organisation for cytological quality control will be implemented. An effort to better identify and to include the screening process the women in the population who are not yet participating has to be made.

  11. Knowledge and practice of cervical cancer screening among female ...

    African Journals Online (AJOL)

    Cervical cancer is the commonest genital tract malignancies in the females and its burden is enormous, to the patient and her community. It is largely preventable or curable when detected at the very early stage through effective screening programme. Very poor clients' attendance has been noticed at the services provided ...

  12. Women's Attitude Towards Cervical Cancer Screening in North ...

    African Journals Online (AJOL)

    Cancer of the cervix is the leading cancer in women in sub Saharan Africa. The aim of this study is to document the views of respondents on how to increase the uptake of cervical cancer screening. This was a cross sectional study of women attending the outpatient clinics of obstetrics and gynaecology in two tertiary ...

  13. Cervical Cancer Screening: A Survey of Current Practice Amongst ...

    African Journals Online (AJOL)

    In the absence of a national screening programme, any hope of minimising death from invasive cervical carcinoma in Nigeria is through increased opportunistic ... Study Design, Setting and Subjects: A self-administered, questionnaire survey of 113 Nigerian gynaecologists who attended the Annual General Meeting and ...

  14. Cervical cancer: screening, diagnosis and staging.

    Science.gov (United States)

    Tsikouras, Panagiotis; Zervoudis, Stefanos; Manav, Bachar; Tomara, Eirini; Iatrakis, George; Romanidis, Constantinos; Bothou, Anastasia; Galazios, George

    2016-01-01

    Purpose: Despite the widespread screening programs, cervical cancer remains the third most common cancer in developing countries. Based on the implementation of cervical screening programs with the referred adoption of improved screening methods in cervical cytology with the knowledge of the important role of the human papilloma virus (HPV) it's incidence is decreased in the developed world. Even if cervical HPV infection is incredibly common, cervical cancer is relatively rare. Depending on the rarity of invasive disease and the improvement of detection of pre-cancerous lesions due to the participation in screening programs, the goal of screening is to detect the cervical lesions early in order to be treated before cancer is developed. In populations with many preventive screening programs, a decrease in cervical cancer mortality of 50-75% is mentioned over the past 50 years. The preventive examination of vagina and cervix smear, Pap test, and the HPV DNA test are remarkable diagnostic tools according to the American Cancer Association guidelines, in the investigation of asymptomatic women and in the follow up of women after the treatment of pre-invasive cervical cancer. The treatment of cervical cancer is based on the FIGO 2009 cervical cancer staging.

  15. THE CERVICAL CANCER SCREENING - UNSOLVED PROBLEMS

    Directory of Open Access Journals (Sweden)

    A. D. Kaprin

    2015-01-01

    Full Text Available The problem of cervical cancer (CC for many decades continues to be the center of attention leading foreign and domestic oncologists. Malignant cervical tumors occupy the leading position among malignant neoplasms of reproductive system in women, second only to breast cancer, despite having far more effective screening compared with this disease. On predictive expert estimates (taking into account population growth and the expected increase in life expectancy by 2020 in developing countries, the rising incidence and prevalence of cervical cancer is 40%, while in developed countries - 11%. If we do not perform timely interventions for prevention and treatment of cervical cancer, after 2050 cervical cancer every year in the world will become sick 1 million women. In the last decade inRussiathere has been a gradual increase in the incidence of cervical cancer: average annual growth rate of 2.21%, General 25,18%. Cervical cancer is one of nosological forms that meet all the requirements of population-based screening. The current Russian normative documents do not give clear answers to questions concerning the age of onset of cervical cancer screening and the time interval between tests, no clear program organized cytological screening of cervical cancer.

  16. The Korean guideline for cervical cancer screening

    Science.gov (United States)

    Min, Kyung-Jin; Lee, Yoon Jae; Suh, Mina; Yoo, Chong Woo; Lim, Myong Cheol; Choi, Jaekyung; Ki, Moran; Kim, Yong-Man; Kim, Jae-Weon; Kim, Jea-Hoon; Park, Eal Whan; Lee, Hoo-Yeon; Lim, Sung-Chul; Cho, Chi-Heum; Hong, Sung Ran; Dang, Ji Yeon; Kim, Soo Young; Kim, Yeol; Lee, Won-Chul

    2015-01-01

    The incidence rate of cervical cancer in Korea is still higher than in other developed countries, notwithstanding the national mass-screening program. Furthermore, a new method has been introduced in cervical cancer screening. Therefore, the committee for cervical cancer screening in Korea updated the recommendation statement established in 2002. The new version of the guideline was developed by the committee using evidence-based methods. The committee reviewed the evidence for the benefits and harms of the Papanicolaou test, liquid-based cytology, and human papillomavirus (HPV) testing, and reached conclusions after deliberation. The committee recommends screening for cervical cancer with cytology (Papanicolaou test or liquid-based cytology) every three years in women older than 20 years of age (recommendation A). The cervical cytology combined with HPV test is optionally recommended after taking into consideration individual risk or preference (recommendation C). The current evidence for primary HPV screening is insufficient to assess the benefits and harms of cervical cancer screening (recommendation I). Cervical cancer screening can be terminated at the age of 74 years if more than three consecutive negative cytology reports have been confirmed within 10 years (recommendation D). PMID:26197860

  17. Intermittent attendance at breast cancer screening

    Directory of Open Access Journals (Sweden)

    Padraic Fleming

    2013-09-01

    Full Text Available Background. To determine why women skip rounds and factors influencing return of previous non attenders (PNAs to breast screening. Design and methods. Retrospective, quantitative, structured questionnaire posted to 2500 women. First PNAs did not attend their first screening appointment in 2007/2008 but then attended in 2010; First Controls first attended in 2010 without missed previous appointments. Women who attended screening in 2006 or earlier then skipped a round but returned in 2010 were Subsequent PNAs; Subsequent Controls attended all appointments.Results. More First Controls than First PNAs had family history of cancer (72.7% vs 63.2%; P=0.003; breast cancer (31.3% vs 24.8%; P=0.04. More PNAs lived rurally; more First PNAs had 3rd level education (33.2% vs 23.6%; P=0.002 and fewer had private insurance than First Controls (57.7% vs 64.8%; P=0.04. Excellent/good health was reported in First PNAs and First Controls (82.9% vs 83.2%, but fewer Subsequent PNAs than Subsequent Controls (72.7% vs 84.9%; P=0.000. Common considerations at time of missed appointment were had mammogram elsewhere (33% First PNA and postponed to next round (16% First PNA, 18.8% Subsequent PNA. Considerations when returning to screening were similar for First PNAs and Subsequent PNAs: I am older (35.4%, 29.6%, I made sure I remembered (29%, 23.6%, could reschedule (17.6%, 20.6%, illness of more concern (16.5%, 19%. More First PNAs stated my family/friends advised (22.3% vs 15.2% or my GP (12.6% vs 4.6% advised me to attend, heard good things about BreastCheck (28.8% vs 13.6%.Conclusions. Intermittent attenders do not fit socio-demographic patterns of non-attenders; GP recommendation and word of mouth were important in women’s return to screening. Fear and anxiety seem to act as a screening facilitator rather than an inhibitor.

  18. Knowledge about cervical cancer and barriers of screening program among women in Wufeng County, a high-incidence region of cervical cancer in China.

    Science.gov (United States)

    Jia, Yao; Li, Shuang; Yang, Ru; Zhou, Hang; Xiang, Qunying; Hu, Ting; Zhang, Qinghua; Chen, Zhilan; Ma, Ding; Feng, Ling

    2013-01-01

    Cervical cancer screening is an effective method for reducing the incidence and mortality of cervical cancer, but the screening attendance rate in developing countries is far from satisfactory, especially in rural areas. Wufeng is a region of high cervical cancer incidence in China. This study aimed to investigate the issues that concern cervical cancer and screening and the factors that affect women's willingness to undergo cervical cancer screening in the Wufeng area. A cross-sectional survey of women was conducted to determine their knowledge about cervical cancer and screening, demographic characteristics and the barriers to screening. Women who were willing to undergo screenings had higher knowledge levels. "Anxious feeling once the disease was diagnosed" (47.6%), "No symptoms/discomfort" (34.1%) and "Do not know the benefits of cervical cancer screening" (13.4%) were the top three reasons for refusing cervical cancer screening. Women who were younger than 45 years old or who had lower incomes, positive family histories of cancer, secondary or higher levels of education, higher levels of knowledge and fewer barriers to screening were more willing to participate in cervical cancer screenings than women without these characteristics. Efforts are needed to increase women's knowledge about cervical cancer, especially the screening methods, and to improve their perceptions of the screening process for early detection to reduce cervical cancer incidence and mortality rates.

  19. Knowledge about cervical cancer and barriers of screening program among women in Wufeng County, a high-incidence region of cervical cancer in China.

    Directory of Open Access Journals (Sweden)

    Yao Jia

    Full Text Available Cervical cancer screening is an effective method for reducing the incidence and mortality of cervical cancer, but the screening attendance rate in developing countries is far from satisfactory, especially in rural areas. Wufeng is a region of high cervical cancer incidence in China. This study aimed to investigate the issues that concern cervical cancer and screening and the factors that affect women's willingness to undergo cervical cancer screening in the Wufeng area.A cross-sectional survey of women was conducted to determine their knowledge about cervical cancer and screening, demographic characteristics and the barriers to screening.Women who were willing to undergo screenings had higher knowledge levels. "Anxious feeling once the disease was diagnosed" (47.6%, "No symptoms/discomfort" (34.1% and "Do not know the benefits of cervical cancer screening" (13.4% were the top three reasons for refusing cervical cancer screening. Women who were younger than 45 years old or who had lower incomes, positive family histories of cancer, secondary or higher levels of education, higher levels of knowledge and fewer barriers to screening were more willing to participate in cervical cancer screenings than women without these characteristics.Efforts are needed to increase women's knowledge about cervical cancer, especially the screening methods, and to improve their perceptions of the screening process for early detection to reduce cervical cancer incidence and mortality rates.

  20. Awareness, perceived risk and practices related to cervical cancer and Pap smear screening: A cross-sectional study among HIV-positive women attending an urban HIV clinic in Johannesburg, South Africa.

    Science.gov (United States)

    Mokhele, Idah; Evans, D; Schnippel, K; Swarts, A; Smith, J S; Firnhaber, C

    2016-12-01

    Cervical cancer is a major cause of cancer-related deaths, especially in the context of the HIV epidemic. To examine awareness, perceived risk and practices related to cervical cancer screening among HIV-positive women. Interviewer-administered structured questionnaires were administered to HIV-positive women (aged ≥18 years) enrolled in a cervical cancer screening study at the Themba Lethu Clinic, Johannesburg, South Africa, from November 2009 to December 2011. Modified Poisson regression with robust standard errors was used to identify factors at enrolment associated with awareness, perceived risk and adequate practice related to cervical screening. Adjusted relative risks (aRRs) with 95% confidence intervals (CIs) are presented. Of the 1 202 women enrolled, 71.3% and 18.2% were aware of the Pap smear and HPV, respectively. Of the 1 192 participants with data evaluated, 76.5% were worried and 23.5% were not worried about cervical cancer; 28.6% of the women had adequate screening practice. Older age (40 - 49 years or ≥50 years v. 18 - 29 years) (aRR 1.63, 95% CI 1.12 - 2.37; aRR 2.22, 95% CI 1.44 - 3.41), higher education (tertiary v. less than grade 10) (aRR 1.39, 95% CI 1.00 - 1.93), initiation on combination antiretroviral therapy (aRR 1.36, 95% CI 1.00 - 1.85) and awareness of Pap smear screening (aRR 16.18, 95% CI 7.69 - 34.01) were associated with adequate screening practice. High levels of Pap smear awareness and low levels of Pap smear screening uptake were observed. However, Pap smear awareness was associated with adequate screening practice. More research into effective health education programmes to address these gaps is needed.

  1. Cervical cancer screening in the Faroe Islands

    DEFF Research Database (Denmark)

    Hammer, Turið; Lynge, Elsebeth; Djurhuus, Gisela W

    2015-01-01

    aim was to provide the first description of cervical cancer screening, and to determine the screening history of women diagnosed with cervical cancer in the Faroe Islands. MATERIAL AND METHODS: Screening data from 1996 to 2012 were obtained from the Diagnostic Centre at the National Hospital...... of the Faroe Islands. They included information on cytology and HPV testing whereas information on histology was not registered consistently. Process indicators were calculated, including coverage rate, excess smears, proportion of abnormal cytological samples, and frequency of HPV testing. Data on cervical...... 1999. At present, 7.0% of samples have abnormal cytology. Of all ASCUS samples, 76-95% were tested for HPV. A total of 58% of women diagnosed with cervical cancer did not participate in screening prior to their diagnosis, and 32% had normal cytology in the previous four years. CONCLUSION: Despite...

  2. Human papillomavirus detection in cervical scrapes from women attended in the Family Health Program

    OpenAIRE

    Everton Faccini Augusto; Larissa Silva dos Santos; Ledy do Horto dos Santos Oliveira

    2014-01-01

    OBJECTIVES: to survey the prevalence of human papillomavirus, associated risk factors and genotype distribution in women who were referred to cervical cancer screening when attended in a Family Health Program. METHOD: we conducted a cross-sectional survey, investigating 351 women. Polymerase chain reaction for DNA amplification and restriction fragment length polymorphism analysis were used to detect and typify the papillomavirus. RESULTS: virus infection was detected in 8.8% of the ...

  3. Knowledge about Cervical Cancer and Barriers of Screening Program among Women in Wufeng County, a High-Incidence Region of Cervical Cancer in China

    Science.gov (United States)

    Zhou, Hang; Xiang, Qunying; Hu, Ting; Zhang, Qinghua; Chen, Zhilan; Ma, Ding; Feng, Ling

    2013-01-01

    Purpose Cervical cancer screening is an effective method for reducing the incidence and mortality of cervical cancer, but the screening attendance rate in developing countries is far from satisfactory, especially in rural areas. Wufeng is a region of high cervical cancer incidence in China. This study aimed to investigate the issues that concern cervical cancer and screening and the factors that affect women’s willingness to undergo cervical cancer screening in the Wufeng area. Participants and Methods A cross-sectional survey of women was conducted to determine their knowledge about cervical cancer and screening, demographic characteristics and the barriers to screening. Results Women who were willing to undergo screenings had higher knowledge levels. “Anxious feeling once the disease was diagnosed” (47.6%), “No symptoms/discomfort” (34.1%) and “Do not know the benefits of cervical cancer screening” (13.4%) were the top three reasons for refusing cervical cancer screening. Women who were younger than 45 years old or who had lower incomes, positive family histories of cancer, secondary or higher levels of education, higher levels of knowledge and fewer barriers to screening were more willing to participate in cervical cancer screenings than women without these characteristics. Conclusion Efforts are needed to increase women’s knowledge about cervical cancer, especially the screening methods, and to improve their perceptions of the screening process for early detection to reduce cervical cancer incidence and mortality rates. PMID:23843976

  4. Health-care providers' perceptions, attitudes towards and recommendation practice of cervical cancer screening.

    Science.gov (United States)

    Hweissa, N Ab; Lim, J N W; Su, T T

    2016-09-01

    In Libya, cervical cancer is ranked third as the most frequent cancer among women with early diagnosis being shown to reduce morbidity and mortality. Health-care providers can influence women's screening behaviours, and their lack of recommendations for screening can be one of the barriers that affect women's participation in screening programmes. This study aims to assess the health-care provider's perception around cervical cancer screening. In-depth, face-to-face interviews were conducted with 16 health-care providers, from both public and private sectors in Az-Zawiya city, Libya, between February and July of 2014. The interviews were recorded and transcribed, then analysed using thematic analysis. Our findings suggest that health-care providers did not provide sufficient information regarding cervical cancer screening for women who attend health-care facilities. The results highlight the role played by health-care professionals in motivating women to attend cervical cancer screening programs, and the need for health education of health-care providers to offer a precious advice regarding the screening. On the other hand, health-care providers highlighted that implementation of reminding system of cervical cancer screening will support them to improve screening attendance. In addition, health-care providers stressed the necessity for educational and awareness campaigns of cervical cancer screening among Libyan women. © 2016 John Wiley & Sons Ltd.

  5. Cervical cancer screening in the Faroe Islands.

    Science.gov (United States)

    Hammer, Turið; Lynge, Elsebeth; Djurhuus, Gisela W; Joensen, John E; Køtlum, Jóanis E; Hansen, Sæunn Ó; Sander, Bente B; Mogensen, Ole; Rebolj, Matejka

    2015-02-01

    The Faroe Islands have had nationally organised cervical cancer screening since 1995. Women aged 25-60 years are invited every third year. Participation is free of charge. Although several European overviews on cervical screening are available, none have included the Faroe Islands. Our aim was to provide the first description of cervical cancer screening, and to determine the screening history of women diagnosed with cervical cancer in the Faroe Islands. Screening data from 1996 to 2012 were obtained from the Diagnostic Centre at the National Hospital of the Faroe Islands. They included information on cytology and HPV testing whereas information on histology was not registered consistently. Process indicators were calculated, including coverage rate, excess smears, proportion of abnormal cytological samples, and frequency of HPV testing. Data on cervical cancer cases were obtained from the Faroese Ministry of Health Affairs. The analysis of the screening history was undertaken for cases diagnosed in 2000-2010. A total of 52 457 samples were taken in 1996-2012. Coverage varied between 67% and 81% and was 71% in 2012. Excess smears decreased after 1999. At present, 7.0% of samples have abnormal cytology. Of all ASCUS samples, 76-95% were tested for HPV. A total of 58% of women diagnosed with cervical cancer did not participate in screening prior to their diagnosis, and 32% had normal cytology in the previous four years. Despite the difficult geographical setting, the organised cervical cancer screening programme in the Faroe Islands has achieved a relatively high coverage rate. Nevertheless, challenges, e.g. consistent histology registration and sending reminders, still exist.

  6. Exploration of knowledge of cervical cancer and cervical cancer screening amongst HIV-positive women

    Directory of Open Access Journals (Sweden)

    Johanna E. Maree

    2014-10-01

    Full Text Available Background: Although preventable, cervical cancer, an AIDS-related disease, is the second most common cancer amongst South African women and the most common cancer amongst black women. Objective: The objective of the study was to determine what women being treated for HIV and AIDS at a specific healthcare centre in Johannesburg knew about cervical cancer and cervical screening. Method: A survey design was used, with data gathered by means of a self-administered questionnaire. Convenience sampling selected 315 women to participate (n = 315. Descriptive statistics were used to analyse the data and chi-square testing found associations between categorical variables. Results: The majority of respondents (78.7%; n = 248 indicated that they had heard of cervical cancer and 62.9% (n = 198 knew about the Pap smear, with nurses and doctors being the primary source of information. Of the women who knew about the Pap smear, less than one-third had had a smear done, the main reason being fear of the procedure. Conclusion: The study provided evidence that women attending the specific HIV clinic were more knowledgeable about cervical cancer and screening than those of unknown HIV status involved in previous studies. Knowledge was still at a low level, especially when their exceptionally high risk was taken into account. Once again it was found that having knowledge did not necessarily mean having had a Pap smear, which remains a huge challenge in the prevention of cervical cancer.

  7. Impact of Cervical Cancer Screening Guidelines on Screening for Chlamydia.

    Science.gov (United States)

    Ursu, Allison; Sen, Ananda; Ruffin, Mack

    2015-01-01

    The highest prevalence of chlamydia infection in the United States is among people aged 15 to 24 years. We assessed the impact of not doing routine cervical cancer screening on the rates of chlamydia screening in women aged 15 to 21 years. We classified visits to family medicine ambulatory clinics according to their timing relative to the 2009 guideline change that led to more restrictive cervical cancer screening. Women had higher odds of being screened for chlamydia before vs after the guideline change (odds ratio = 13.97; 95% CI, 9.17-21.29; P <.001). Chlamydia and cervical cancer screening need to be uncoupled and new screening opportunities should be identified. © 2015 Annals of Family Medicine, Inc.

  8. Costs Associated with Cervical Cancer Screening

    Centers for Disease Control (CDC) Podcasts

    2009-10-15

    Dr. Tom Cox, a practicing gynecologist and president of the American Society of Colposcopy and Cervical Pathology, provides a brief introduction to cervical cancer screening guidelines and human papillomavirus (HPV) DNA testing.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  9. Cervical Cancer Screening with HPV Test

    Centers for Disease Control (CDC) Podcasts

    2009-10-15

    Dr. Stewart Massad, a professor in the Division of Gynecologic Oncology at Washington University in Saint Louis and a board member of the American Society for Colposcopy and Cervical Cancer Prevention (ASCCP), talks about cotesting with human papillomavirus (HPV) as part of a cervical cancer screening program.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  10. New technology for cervical cancer screening.

    Science.gov (United States)

    Gong, Jiao-Mei; Shen, Yong; He, Yan-Xia; Lei, Dong-Mei; Zhang, Zhan; Li, Xiao-Fu

    2012-11-01

    Cervical cancer is the second most common cancer among women worldwide. With the introduction of organized cervical cytological screening programs, the incidence of cervical cancer has been dramatically reduced. This study aimed to determine the new technology that can potentially afford unique advantages for cervical cancer screening. Cervical specimens collected in PreservCyt were processed for ThinPrep cytological test, the new technology test and human papillomavirus detection. The concordance between the new technology and ThinPrep cytological test was 96.34%, with 931 cases positive and 148 cases negative with both tests (κ = 0.857). The sensitivity and the specificity of the new technology were 99.04% (931/940) and 82.22% (148/180), respectively. Youden index was 0.81. The positive predictive value and the negative predictive value were 96.68% (931/963) and 94.27% (148/157), respectively. In the 124 positive cases of the new technology, human papillomavirus DNA test was positive in 109 cases (87.9%) and negative in 15 cases (12.1%). Compared to the histopathological diagnosis, the sensitivity and the negative predictive value of the new technology were 98.57% (69/70) and 95.45% (21/22), respectively. The screening design will enable evaluation of several competing screening technologies in reducing the incidence of and mortality from cervical cancer. In particular, if the new technology is used as the screening test, it can be a quick screening test and does not depend on the subjective judgment of the doctors. As such, it could potentially afford unique advantages for screening.

  11. Screening frequency and histologic type influence the efficacy of cervical cancer screening: A nationwide cohort study

    Directory of Open Access Journals (Sweden)

    Ying-Cheng Chiang

    2017-08-01

    Conclusions: Pap smear is more effective in screening for cervical SCCs compared to cervical ADCs. Improving adherence to screening recommendations is important for the prevention of cervical SCC, especially in elderly women.

  12. Empowerment beliefs and intention to uptake cervical cancer screening: three psychosocial mediating mechanisms.

    Science.gov (United States)

    Luszczynska, Aleksandra; Durawa, Alicja B; Scholz, Urte; Knoll, Nina

    2012-01-01

    Three studies tested if the associations between women's empowerment beliefs and intentions to attend cervical cancer screening could be explained by mediating psychological mechanisms: control-related beliefs, well being-related beliefs, and beliefs and evaluations referring to social functioning. Data were collected from January to March 2011 in the rural and urban areas across regions of Poland. Study 1 (N = 386) indicated that women with strong empowerment harbored stronger self-efficacy and beliefs that screening participation would make them feel in control of their own health and body. These two types of cognitions were, in turn, associated with stronger cervical cancer screening intentions. Results of Study 2 (N = 527) confirmed three significant well being-related mediators in the relationship between empowerment beliefs and cervical cancer screening: perceived benefits of screening related to well being, appearance satisfaction, discomfort- and shame-related barriers for screening. Finally, Study 3 (N = 424) showed that empowerment enabled receiving higher social support for cervical cancer screening, promoted perceiving fewer barriers for cervical cancer screening-related communication and more social benefits of engaging in cervical cancer screening. Support for cervical cancer screening, social barriers, and benefits were, in turn, related to screening intentions. Across the studies similar shares of intention variance were explained, and thus the hypothesized mediating mechanisms may have similar explanatory power.

  13. Deprived areas and attendance to screening of cervix uteri cancer in a French region.

    Science.gov (United States)

    Challier, B; Meslans, Y; Viel, J F

    2000-02-01

    To examine the relationship between deprivation and attendance to cervical cancer screening. Three deprivation indices (Carstairs, UnderPrivileged Area, Department of Environment) were calculated for women aged 25-65 attending a 1993-95 cervical cancer screening program (Doubs "département", France), with 594 municipalities as statistical units. Weighted multivariate linear regressions were performed, with attendance rate as the dependent variable, and the three deprivation indices in turn as independent variables along with women's mean age, average net income, density of (para)medical amenities, density of population and proportion of women. Per municipality women were numbered 1-29,822 (mean 210). In multivariate models, the three deprivation indices were negatively linked to attendance rate, and so were mean age of women and density of population. Average net income, proportion of women, and density of (para)medical amenities (nurses, laboratories, ambulances, physicians, dentists) were positively associated with attendance rate. In early stages, cervical cancer screening programs should account for populations living in deprived areas, through focused health promotion efforts and easier access to screening facilities.

  14. Knowledge attitudes and practices of cervical cancer screening among urban and rural Nigerian women: a call for education and mass screening.

    Science.gov (United States)

    Nwankwo, K C; Aniebue, U U; Aguwa, E N; Anarado, A N; Agunwah, E

    2011-05-01

    The incidence of cervical cancer has declined in developed nations due to routine use of cervical cancer screening services. In developing nations opportunistic screening is the practice, and many women present with late-stage disease. This study was designed to ascertain the knowledge of the women in Nigeria to cervical cancer, their practice of cervical cancer screening and factors hindering the use of available screening services. A cross-sectional study was done with interviewer-administered questionnaire. Only the consenting women attending an annual Christian religious meeting in 2007 in three towns in Enugu, South Eastern Nigeria participated. Only 15.5% of the respondents were aware of availability of cervical cancer screening services. The awareness significantly varied with the level of educational attainment (Pwomen. Effective female education and free mass screening are necessary for any successful cervical cancer screening programme in Nigeria. © 2010 Blackwell Publishing Ltd.

  15. Methods for Cervical Cancer Screening

    OpenAIRE

    Vargas-Revilla, Tatiana; Seáñez-de-Villa, Jesús Manuel; León-Rovira, Noel; Barrón-Cano, Olivia Maricela

    2015-01-01

    Cervical cancer affects a great portion of the world’s female population,and it became the third cause of death for women in developing countries such as CostaRica.The most common method to diagnose this cancer is the Papanicolaou testor Papsmear; nevertheless, high levels of sensitivity and specificity are required. Consequently, different organizations have developed multiple methods to detect and classify this cancer. This article is divided in three sections: the first one focuses on the ...

  16. Cervical cytopathological changes among women with vaginal discharge attending teaching hospital.

    Science.gov (United States)

    Salih, Magdi M; AlHag, Fatma Tage El Sir; Khalifa, Mohammed Ahmed; El Nabi, Abdulla H

    2017-01-01

    To find cytology changes among women attending obstetrics and gynaecology clinic with complaints of vaginal discharges. This descriptive hospital-based cytological study was conducted at the outpatient clinic of the obstetrics and gynaecology department. Two hundred women with complaints of vaginal discharge were selected. Their detailed histories were documented on a special request form. Pap smears were then obtained and sent for cytological examination to the cytopathology department. All low-grade squamous intraepithelial lesion (LSIL) cases were advised to follow-up with Pap smears in the next 6-12 months. Those with high-grade squamous intraepithelial lesion (HSIL) were further investigated by a cervical biopsy and managed accordingly. The statistical analysis was performed using, the Statistical Package for Social Science (SPSS). Chi-square and cross-tabulation were used in this study. The cytological examination of Pap smears showed no changes (i.e. negative findings) in 88 (44%) cases, while Candida species infection was the most prevalent, which was found in 67 (33.5%) of the cases. Bacterial vaginosis was found in 39 women (19.5%); 6 women (3%) were reported with dyskaryotic changes. Two cases were found to have LSIL and 4 women had HSIL. Infection is common among the illiterate group of women. Women with vaginal discharges should undergo screening tests for evaluation by cervical smear for the early detection of cervical precancer conditions. There is an urgent need to establish a screening program for cervical cancer in Sudan.

  17. The impact of Jade Goody's diagnosis and death on the NHS Cervical Screening Programme.

    Science.gov (United States)

    Lancucki, L; Sasieni, P; Patnick, J; Day, T J; Vessey, M P

    2012-06-01

    In August 2008 the British reality TV star Jade Goody made public her diagnosis of cervical cancer. In February 2009 it was announced that she was terminally ill and she died a few weeks later. A surge in cervical screening attendances associated with these events was widely reported. This paper aims to quantify the size of that effect across England, its duration, and whether it affected some groups of women more than others. The Cervical Screening Programme in England. Routinely collected statistics for the months around Jade Goody's diagnosis and death were compared with those for other periods. About half a million extra cervical screening attendances occurred in England between mid-2008 and mid-2009, the period during which Jade Goody was diagnosed and died; among these were 370 attendances where the test result was suspected neoplasia. At its peak in March 2009, attendance was 70% higher than expected. Increases were seen in both initial and follow-up screening attendances and in colposcopy attendances, and at all ages, though the magnitude was greater for women aged under 50. A substantially greater proportion of the extra attendances of women aged 25-49 on routine recall occurred in women whose attendance was overdue (28% occurred at 60 months or more) and relatively little represented over-screening (8% had been screened within the last 30 months). The pattern of increased attendance mirrored the pattern of media coverage of Jade Goody's diagnosis and death. It is likely that the increased screening resulted in a number of lives saved.

  18. Experiences and unmet needs of women undergoing Pap smear cervical cancer screening: impact on uptake of cervical cancer screening in south eastern Nigeria.

    Science.gov (United States)

    Chigbu, Chibuike O; Onyebuchi, Azubuike K; Egbuji, Chuma C; Ezugwu, Eusebus C

    2015-03-01

    The burden of cervical cancer is on the increase in sub-Saharan Africa mainly due to inadequate provision and utilisation of cervical cancer prevention services. Several evidence-based strategies have been deployed to improve cervical cancer screening uptake without much success. However, patients' experiences and satisfaction with service provision has not been adequately studied. Inefficiencies in service delivery and less fulfilling experiences by women who attend cervical cancer screening could have considerable impact in future voluntary uptake of cervical cancer screening. Six hundred and eighty women who underwent Pap smear screening in three health care facilities in two states in south eastern Nigeria were interviewed to evaluate their satisfaction, willingness to undertake future voluntary screening, unmet needs and correlation between satisfaction level and willingness to undergo future screening. Satisfaction with Pap smear screening correlated positively with willingness to undertake future voluntary screening (Pearson's correlation coefficient = 0.78, P = 0.001). The mean satisfaction score was significantly higher among participants handled by nurses than those handled by the physicians (3.16 ± 0.94 vs 2.52 ± 0.77, P = 0.001). 'Scrapping discomfort' of the spatula was reported as the most dissatisfying aspect of Pap smear experience. The need for less invasive screening procedures was the most unmet need. It was concluded that improving the Pap smear screening experience of women and providing less invasive methods of cervical cancer screening with immediate results could improve uptake of cervical cancer screening in south eastern Nigeria.

  19. Nanomechanical clues from morphologically normal cervical squamous cells could improve cervical cancer screening

    Science.gov (United States)

    Geng, Li; Feng, Jiantao; Sun, Quanmei; Liu, Jing; Hua, Wenda; Li, Jing; Ao, Zhuo; You, Ke; Guo, Yanli; Liao, Fulong; Zhang, Youyi; Guo, Hongyan; Han, Jinsong; Xiong, Guangwu; Zhang, Lufang; Han, Dong

    2015-09-01

    Applying an atomic force microscope, we performed a nanomechanical analysis of morphologically normal cervical squamous cells (MNSCs) which are commonly used in cervical screening. Results showed that nanomechanical parameters of MNSCs correlate well with cervical malignancy, and may have potential in cancer screening to provide early diagnosis.Applying an atomic force microscope, we performed a nanomechanical analysis of morphologically normal cervical squamous cells (MNSCs) which are commonly used in cervical screening. Results showed that nanomechanical parameters of MNSCs correlate well with cervical malignancy, and may have potential in cancer screening to provide early diagnosis. Electronic supplementary information (ESI) available. See DOI: 10.1039/c5nr03662c

  20. Process performance of cervical screening programmes in Europe

    DEFF Research Database (Denmark)

    Ronco, Guglielmo; Ballegooijen, Marjolein van; Becker, Nikolaus

    2009-01-01

    Standardised tables of aggregated data were collected from 15 European national or regional cervical screening programmes and key performance indicators computed as reported in European Union (EU) Guidelines, 2nd edition. Cytological results varied widely between countries both for the total...... intraepithelial lesion (LSIL) cytology. However, cytology-specific PPV also showed remarkable variability. The detection rate of CIN2+ histology ranged from Poland to >1% in England and Denmark. Low attendance for colposcopy after referral was observed in some east-European countries...

  1. Intelligent Screening Systems for Cervical Cancer

    Directory of Open Access Journals (Sweden)

    Yessi Jusman

    2014-01-01

    Full Text Available Advent of medical image digitalization leads to image processing and computer-aided diagnosis systems in numerous clinical applications. These technologies could be used to automatically diagnose patient or serve as second opinion to pathologists. This paper briefly reviews cervical screening techniques, advantages, and disadvantages. The digital data of the screening techniques are used as data for the computer screening system as replaced in the expert analysis. Four stages of the computer system are enhancement, features extraction, feature selection, and classification reviewed in detail. The computer system based on cytology data and electromagnetic spectra data achieved better accuracy than other data.

  2. Intelligent screening systems for cervical cancer.

    Science.gov (United States)

    Jusman, Yessi; Ng, Siew Cheok; Abu Osman, Noor Azuan

    2014-01-01

    Advent of medical image digitalization leads to image processing and computer-aided diagnosis systems in numerous clinical applications. These technologies could be used to automatically diagnose patient or serve as second opinion to pathologists. This paper briefly reviews cervical screening techniques, advantages, and disadvantages. The digital data of the screening techniques are used as data for the computer screening system as replaced in the expert analysis. Four stages of the computer system are enhancement, features extraction, feature selection, and classification reviewed in detail. The computer system based on cytology data and electromagnetic spectra data achieved better accuracy than other data.

  3. Knowledge and attitude towards cervical cancer screening among ...

    African Journals Online (AJOL)

    Background: Cervical cancer is a largely preventable disease. In western countries, the incidence of and mortality associated with cervical cancer has reduced substantially following the introduction of effective cervical screening programmes. This is in contrast to what is obtained in Africa including Nigeria where cervical ...

  4. Factors Contributing to Low Uptake of Cervical Screening in a ...

    African Journals Online (AJOL)

    Introduction: Many factors have been attributed to the unacceptably high incidences of cervical cancer and deaths from cervical cancer in developing countries and include lack of organized cervical cancer screening services and especially lack of information on cervical cancer by women. Aims and Objectives: This study ...

  5. Risk factors for VIA positivity and determinants of screening attendances in Dar es Salaam, Tanzania

    DEFF Research Database (Denmark)

    Kahesa, Crispin; Kjaer, Susanne Kruger; Ngoma, Twalib

    2012-01-01

    of describing risk factors for VIA positivity and determinants of screening attendances in Tanzania, this paper present the results from a comparative analysis performed among women who are reached and not reached by the screening program". METHODS: 14 107 women aged 25--59 enrolled in a cervical cancer...... screening program in Dar es Salaam in the period 2002 -- 2008. The women underwent VIA examination and took part in a structured questionnaire interview. Socioeconomic characteristics, sexual behavior, HIV status and high-risk (HR) HPV infection were determined in a subpopulation of 890 who participated....... CONCLUSION: Women who are widowed/separated, of high parity, of low education and married at a young age are more likely to be VIA positive and thus at risk of developing cervical cancer. The study further documents that a referral linkage between the HIV care and treatment program and the cervical cancer...

  6. Impact of media reporting of cervical cancer in a UK celebrity on a population-based cervical screening programme.

    Science.gov (United States)

    MacArthur, Georgina J; Wright, Melissa; Beer, Helen; Paranjothy, Shantini

    2011-01-01

    To determine the impact of media reporting of cervical cancer in a UK celebrity on cervical screening uptake, response time and colposcopy referral and attendance. Population-based national cervical screening programme for women in Wales, UK. A time series regression analysis of the Welsh national cervical screening and colposcopy databases was used to examine the number of smear tests carried out between 2000 and 2010, stratified by age group and deprivation indicators. Logistic regression was used to analyse colposcopy attendance. Over 33,000 more cervical screening tests than expected were carried out in the year of media reporting (2008/9), 11,539 (35%) of which were in the month of Jade Goody's death. The largest increase was evident in women aged 35-39 years (475 additional tests per month, 95% CI 331-619). Impacts were similar across deprivation quintiles. Colposcopy referrals increased by 18% during the year of media reporting. Increases were observed for all smear test results in 2008/9, particularly among younger women, and further rises were evident in 2009/10 for smear tests showing borderline changes and mild dyskaryosis. The proportion of women attending colposcopy appointments rose in the year of media reporting (χ(2) = 45.8, P celebrity was associated with a significant, but transient, increase in screening uptake and colposcopy referral and attendance. Mass media reporting can play a role in enhanced detection of abnormalities, but public health messages must be communicated effectively to minimize anxiety whilst maximizing case-finding and uptake among non-responders.

  7. Cervical cytopathological changes among women with vaginal discharge attending teaching hospital

    Directory of Open Access Journals (Sweden)

    Magdi M Salih

    2017-01-01

    Conclusion: Infection is common among the illiterate group of women. Women with vaginal discharges should undergo screening tests for evaluation by cervical smear for the early detection of cervical precancer conditions. There is an urgent need to establish a screening program for cervical cancer in Sudan.

  8. Breast and Cervical Cancers Awareness and Screening Practices ...

    African Journals Online (AJOL)

    Only 4/11(36.4%) of those who knew something about cervical cancer mentioned vaginal examination for cervical cancer screening and only one (0.1%) respondent mentioned Pap smear. The poor level of awareness and screening practices for breast and cervical cancers among women in these rural communities ...

  9. [Cervical cancer screening in Switzerland - current practice and future challenges].

    Science.gov (United States)

    Untiet, Sarah; Schmidt, Nicole; Low, Nicola; Petignat, Patrick

    2013-04-01

    At the beginning of the 20th Century, cervical cancer was the leading cause of death from cancer in women. A marked decline in cervical cancer has been observed since the 1960s, in parallel with the introduction of the Papanicolau (Pap) test as a cytological screening method. Today, Pap smear screening is still the most widely used tool for cervical cancer prevention. Testing for human papillomavirus (HPV) in cervical specimens or a combination of Pap and HPV testing are also now available. In this article we compare current guidelines for cervical cancer screening in Switzerland with those in other European countries. In view of the opportunities offered by HPV testing and, since 2008, HPV vaccination, current guidelines for cervical cancer screening should be updated. Both the choice of screening tests and general organization of cervical cancer screening should be reviewed.

  10. The Participation of HPV-Vaccinated Women in a National Cervical Screening Program: Population-Based Cohort Study.

    Directory of Open Access Journals (Sweden)

    Eva Herweijer

    Full Text Available Concerns have been raised that HPV-vaccination might affect women's cervical screening behavior. We therefore investigated the association between opportunistic HPV-vaccination and attendance after invitation to cervical screening.A cohort of all women resident in Sweden, born 1977-1987 (N=629,703, and invited to cervical screening, was followed October 2006 - December 2012. Invitations to screening were identified via the National Quality Register for Cervical Cancer Prevention, as was the primary outcome of a registered smear. Vaccination status was obtained from two nationwide health data registers. Hazard ratios (HR were estimated using Cox regression adjusted for age, education level and income (HRadj. Women were individually followed for up to 6 years, of which the first and second screening rounds were analyzed separately.Screening attendance after three years of follow-up was 86% in vaccinated women (N=4,897 and 75% in unvaccinated women (N=625,804. The crude HR of screening attendance in vaccinated vs. unvaccinated women was 1.31 (95% CI 1.27-1.35 in the first screening round. Adjustment for education and income reduced but did not erase this difference (HRadj=1.09, 95% CI 1.05-1.13. In the second screening round, attendance was likewise higher in HPV-vaccinated women (crude HR=1.26, 95% CI 1.21-1.32; HRadj=1.15, 95% CI 1.10-1.20.HPV-vaccination is so far associated with equal or higher attendance to cervical screening in Sweden in a cohort of opportunistically vaccinated young women. Most but not all of the difference in attendance was explained by socioeconomic differences between vaccinated and unvaccinated women. HPV vaccine effectiveness studies should consider screening attendance of HPV-vaccinated women when assessing incidence of screen-detected cervical lesions.

  11. Benefits of Cervical Cancer Screening by Liquid-Based Cytology as Part of Routine Antenatal Assessment.

    Science.gov (United States)

    Parkpinyo, Nichamon; Inthasorn, Perapong; Laiwejpithaya, Somsak; Punnarat, Tippawan

    2016-01-01

    To determine the prevalence of abnormal cervical cytology, as diagnosed using a liquid-based cytology technique, in pregnant women attending the Antenatal Care (ANC) clinic at Siriraj Hospital. This cross-sectional study included 655 first-visit pregnant women who attended ANC clinic at Siriraj Hospital during June to November 2015 study period. After receiving routine antenatal care, cervical cytology screening was performed with the Siriraj liquid-based cytology technique. All specimens were reviewed by a certi ed cytopathologist using Bethesda System 2001 criteria. Patients with abnormal PAP results characterized as epithelial cell abnormalities were referred to a gynecologic oncologist for further management according to ASCCP Guidelines 2012. Mean age of participants was 28.9±6.2 years. Prevalence of abnormal cervical cytology was 3.4% (95% CI: 2.0-4.7). Among this group, there were ASC-US, ASC-H, LSIL, HSIL for 12(1.8%), 2(0.3%), 7(1.1%) and 1(0.2%), respectively. In 633 specimens of the normal group, infection was identified in 158 specimens (24.1%) which were caused by Candida spp. and Trichomonas vaginalis. Regarding patient perception about the importance of cervical cancer screening, although most women perceived screening to be important, 54% of participants had never been screened for cervical cancer. Rate of loss to follow-up in the postpartum period was as high as 41.8%. Prevalence of abnormal cervical cytology in pregnant women attending the ANC clinic at Siriraj Hospital was 3.4%. Inclusion of cervical cancer screening as part of antenatal assessment can help to identify precancerous lesions or cervical cancers in patients who might otherwise not be screened, thereby facilitating early treatment and improved patient outcomes.

  12. Cervical Cancer Screening in Underserved Populations

    Centers for Disease Control (CDC) Podcasts

    2009-10-15

    Dr. Lisa Flowers, a specialist in human papillovarius (HPV)-related diseases and Director of Colposcopy at Emory University School of Medicine, talks about cervical cancer screening in underinsured or uninsured women.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  13. OPPORTUNISTIC CERVICAL CANCER SCREENING IN PREGNANCY

    Directory of Open Access Journals (Sweden)

    Radha Bai Prabhu T

    2016-01-01

    Full Text Available Introduction: Cervical cancer is the most common malignancy diagnosed during pregnancy. In developing countries where organized screening programmes are lacking, antenatal clinics may provide an opportunity for screening. Objectives: The aim of this study was to analyse the prevalence and management of abnormal cervical cytology in pregnancy. Methodology: This was a prospective study conducted at the Meenakshi Medical College and RI, Kancheepuram, India, from July 2013 to June 2014. Convenience sampling technique was used. After adequate counselling, 300 antenatal mothers between 12 and 34 weeks of gestation were screened with conventional Pap smear. Colposcopy directed biopsy was taken where and when necessary. Results: Among the 300 pregnant women, 90 (30% were primigravidae and 210 (70% were multigravidae. 80% were between 21 and 30 years of age. 290 (96.6% women have never had a pap smear in the past. Conventional Pap smear was taken at 21 weeks of gestation in 20% of cases. ASCUS , LSIL and HSIL were reported in one case each. In those with LSIL and HSIL , Colposcopy directed biopsy was reported as CIN 1 and CIN 2 respectively. These two cases were kept under observation during the antenatal period. The CIN II lesion persisted on postpartum follow up and was treated with LLETZ. Conclusion: In countries like India Pap smear screening during pregnancy is worthwhile and the antenatal clinics provide ample opportunities for the screening.

  14. Psychosocial predictors of first attendance for organised mammography screening

    DEFF Research Database (Denmark)

    Aro, A R; de Koning, H J; Absetz, P

    1999-01-01

    of breast cancer risk as moderate were also predictive of attendance. Expectation of pain at mammography was predictive of non-attendance. CONCLUSION: Mammography screening organised as a public health service was well accepted. A recent mammogram, high reliance on self control of breast cancer......OBJECTIVE: To study psychosocial predictors of attendance at an organised breast cancer screening programme. SETTING: Finnish screening programme based on personal first round invitations in 1992-94, and with 90% attendance rate. METHODS: Attenders (n = 946) belonged to a 10% random sample (n...... = 1680 women, age 50, response rate 64%) of the target population (n = 16,886), non-attenders (n = 641, 38%) came from the whole target population. Predictors were measured one month before the screening invitation. Measures included items for social and behavioural factors, Breast Cancer Susceptibility...

  15. Towards improving cervical cancer screening in Nigeria: A review of ...

    African Journals Online (AJOL)

    Cervical cancer screening is the key to reducing the incidence and mortality of cervical cancer in developing countries. In the absence of a national screening program, healthcare givers in Nigeria are encouraged to routinely inform and screen eligible women. This review aims at equipping health workers for this task by ...

  16. An economic appraisal of a mobile cervical cytology screening service

    African Journals Online (AJOL)

    Objective. Cervical cytology screening is widely accepted as an important strategy in the control of cervical cancer. With increasing competition for health resources the need for information on the cost-effectiveness of different screening programmes has become critical. This paper describes the cost of screening via a ...

  17. Attitude of Patients in a General Hospital to Cervical Cancer Screening

    African Journals Online (AJOL)

    Mass media and Non-governmental Organization activities were the main sources of information on cervical cancer screening. More than one third of the respondent gave no reason for non-utilization of Pap smear. A significant percentage of women attending reproductive health services in this Hospital were not aware of ...

  18. Low adherence to cervical cancer screening after subtotal hysterectomy

    DEFF Research Database (Denmark)

    Andersen, Lea Laird; Møller, Lars Mikael Alling; Gimbel, Helga Margrethe

    2015-01-01

    INTRODUCTION: A reason for not recommending subtotal hysterectomy is the risk of cervical pathology. We aimed to evaluate cervical cancer screening and to describe cervical pathology after subtotal and total hysterectomy for benign indications. METHODS: Data regarding adherence to screening.......7% were not screened. We found a minimum of one abnormal test in 28 (10.8%) after subtotal hysterectomy and one after total hysterectomy. No cervical cancers were found. CONCLUSIONS: Adherence to cervical cancer screening after subtotal hysterectomy in a Danish population is suboptimal and some patients...... have unnecessary tests performed after total hysterectomy. Clarification of the use of cervical/vaginal smears after hysterectomy is needed to identify women at risk of cervical dysplasia or cancer. FUNDING: Research Foundation of Region Zealand, University of Southern Denmark, Nykøbing Falster...

  19. [Attendance in the Norwegian Breast Cancer Screening Programme].

    Science.gov (United States)

    Sebuødegård, Sofie; Sagstad, Silje; Hofvind, Solveig

    2016-09-01

    A high rate of attendance among women invited to the Norwegian Breast Cancer Screening Programme (NBCSP) is essential to achieve optimal effect, including reduction in breast cancer mortality. This article describes attendance in the programme by county, period and women’s age at invitation. All women in the age group 50 – 69 years who are registered in the National Population Register are invited to attend the NBCSP every second year. In the study period 2007 – 2014, 2 142 369 invitations were sent, and 1 600 293 screening examinations were performed for 710 169 women. Use of the data is pursuant to the Cancer Registry Regulations. Altogether 84 % of the women invited attended at least once in the study period. The average attendance rate per screening round was 75 %. In Rogaland, Nordland and Sogn og Fjordane counties more than 80 % attended, while in Oslo the figure was 62 %. The highest rate of attendance recorded was for women in the age group 62 – 67 years. The attendance in the prior screening round was of influence for reattendance. The mammography screening programme has a high level of acceptance among women in the target group. Possible reasons for the variation in attendance among the county districts should be identified.

  20. Human papillomavirus detection in cervical scrapes from women attended in the Family Health Program

    Directory of Open Access Journals (Sweden)

    Everton Faccini Augusto

    2014-01-01

    Full Text Available OBJECTIVES: to survey the prevalence of human papillomavirus, associated risk factors and genotype distribution in women who were referred to cervical cancer screening when attended in a Family Health Program. METHOD: we conducted a cross-sectional survey, investigating 351 women. Polymerase chain reaction for DNA amplification and restriction fragment length polymorphism analysis were used to detect and typify the papillomavirus. RESULTS: virus infection was detected in 8.8% of the samples. Among the 21 different genotypes identified in this study, 14 were high risk for cervical cancer, and the type 16 was the most prevalent type. The infection was associated with women who had non-stable sexual partners. Low risk types were associated with younger women, while the high risk group was linked to altered cytology. CONCLUSION: in this sample attended a Family Health Program, we found a low rate of papillomavirus infection. Virus frequency was associated to sexual behavior. However, the broad range of genotypes detected deserves attention regarding the vaccine coverage, which includes only HPV prevalent types.

  1. Cervical cancer screening and practice in low resource countries ...

    African Journals Online (AJOL)

    Key words: Cervical cancer screening; human papillomavirus, low resource countries; Nigeria; premalignant disease. Introduction. Cervical cancer is the .... It requires transportation from clinic back to the laboratory and multiple patient visits. .... The statistics relating to cervical cancer in Nigeria is worrisome, and if significant ...

  2. Targeting women with free cervical cancer screening: challenges ...

    African Journals Online (AJOL)

    Introduction: the study was conducted to determine the challenges and suggest solutions to conducting free cervical cancer screening among Nigerian women. Methods: awareness was created among women groups and mass media in Osun State for women to undergo free cervical cancer screening programme.

  3. Barriers to utilization of cervical cancer screening services among ...

    African Journals Online (AJOL)

    Cervical cancer (CC) is the second most commonly diagnosed cancer among women of reproductive age group; yet screening for early detection of the disease among them is not a common practice in Nigeria. This study therefore, investigated the barriers to utilization of cervical cancer screening service among women of ...

  4. A Study on Knowledge and Screening for Cervical Cancer among ...

    African Journals Online (AJOL)

    objective of knowing the knowledge of women about cervical cancer, its screening, role of doctor, source of information, and reasons for not undergoing screening if the women had not undergone testing for cervical cancer. Subjects and Methods: This was a questionnaire based cross‑sectional study conducted among the ...

  5. Knowledge, Attitude And Practice Of Screening For Cervical Cancer ...

    African Journals Online (AJOL)

    This low participation in screening for cervical cancer was attributed to several reasons including ignorance of the existence of such a test, lack of awareness of centers where such services are obtainable, ignorance of the importance of screening and the risk factors to the development of cervical cancer. Conclusion: There ...

  6. Screening history in women with cervical cancer in a Danish population-based screening program

    DEFF Research Database (Denmark)

    Kirschner, Benny; Poll, Susanne; Rygaard, Carsten

    2011-01-01

    The aim of this study was to explore the screening histories of all cervical cancers in a Danish screening population. The intention was to decide suboptimal sides of the screening program and to evaluate the significance of routine screening in the development of cervical cancer....

  7. Willingness and acceptability of cervical cancer screening among HIV positive Nigerian women

    Directory of Open Access Journals (Sweden)

    Ezechi Oliver C

    2013-01-01

    Full Text Available Abstract Background The proven benefit of integrating cervical cancer screening programme into HIV care has led to its adoption as a standard of care. However this is not operational in most HIV clinics in Nigeria. Of the various reasons given for non-implementation, none is backed by scientific evidence. This study was conducted to assess the willingness and acceptability of cervical cancer screening among HIV positive Nigerian women. Methods A cross sectional study of HIV positive women attending a large HIV treatment centre in Lagos, Nigeria. Respondents were identified using stratified sampling method. A pretested questionnaire was used to obtain information by trained research assistants. Obtained information were coded and managed using SPSS for windows version 19. Multivariate logistic regression model was used to determine independent predictor for acceptance of cervical cancer screening. Results Of the 1517 respondents that returned completed questionnaires, 853 (56.2% were aware of cervical cancer. Though previous cervical cancer screening was low at 9.4%, 79.8% (1210 accepted to take the test. Cost of the test (35.2% and religious denial (14.0% were the most common reasons given for refusal to take the test. After controlling for confounding variables in a multivariate logistic regression model, having a tertiary education (OR = 1.4; 95% CI: 1.03-1.84, no living child (OR: 1.5; 95% CI: 1.1-2.0, recent HIV diagnosis (OR: 1.5; 95% CI: 1.1-2.0 and being aware of cervical cancer (OR: 1.5; 95% CI: 1.2-2.0 retained independent association with acceptance to screen for cervical cancer. Conclusions The study shows that HIV positive women in our environment are willing to screen for cervical cancer and that the integration of reproductive health service into existing HIV programmes will strengthen rather than disrupt the services.

  8. Breast and cervical cancer screening programme implementation in 16 countries

    DEFF Research Database (Denmark)

    Dowling, Emily C; Klabunde, Carrie; Patnick, Julietta

    2010-01-01

    There is a continuing need to monitor and evaluate the impact of organized screening programmes on cancer incidence and mortality. We report results from a programme assessment conducted within the International Cancer Screening Network (ICSN) to understand the characteristics of cervical screening...... programmes within countries that have established population-based breast cancer screening programmes....

  9. Cervical cancer screening policies and coverage in Europe

    DEFF Research Database (Denmark)

    Anttila, Ahti; von Karsa, Lawrence; Aasmaa, Auni

    2009-01-01

    The aim of the study was to compare current policy, organisation and coverage of cervical cancer screening programmes in the European Union (EU) member states with European and other international recommendations. According to the questionnaire-based survey, there are large variations in cervical...... with education, training and communication among women, medical professionals and authorities are required, accordingly. The study indicates that, despite substantial efforts, the recommendations of the Council of the EU on organised population-based screening for cervical cancer are not yet fulfilled. Decision......-makers and health service providers should consider stronger measures or incentives in order to improve cervical cancer control in Europe....

  10. Women's knowledge about cervical cancer risk factors, screening, and reasons for non-participation in cervical cancer screening programme in Estonia

    Science.gov (United States)

    2011-01-01

    Background The attendance rate in Estonian cervical cancer screening programme is too low therefore the programme is hardly effective. A cross-sectional population based survey was performed to identify awareness of cervical cancer risk factors, reasons why women do not want to participate in cervical screening programme and wishes for better organisation of the programme. Method An anonymous questionnaire with a covering letter and a prepaid envelope was sent together with the screening invitation to 2942 randomly selected women. Results are based on the analysis of 1054 (36%) returned questionnaires. Results Main reasons for non-participation in the national screening programme were a recent visit to a gynaecologist (42.3%), fear to give a Pap-smear (14.3%), long appointment queues (12.9%) and unsuitable reception hours (11.8%). Fear to give a Pap-smear was higher among women aged 30 and 35 than 50 and 55 (RR 1.46; 95% CI: 0.82-2.59) and women with one or no deliveries (RR 1.56, 95% CI: 0.94-2.58). In general, awareness of cervical cancer risk factors is poor and it does not depend on socio-demographic factors. Awareness of screening was higher among Estonians than Russians (RR 1.64, 95% CI: 1.46-1.86). Most women prefer to receive information about screening from personally mailed invitation letters (74.8%). Conclusions Women need more information about cervical cancer risk factors and the screening programme. They prefer personally addressed information sharing. Minority groups should be addressed in their own language. A better collaboration with service providers and discouraging smears outside the programme are also required. PMID:21951661

  11. Cervical screening result communication: a focus-group investigation of English women's experiences and needs.

    Science.gov (United States)

    Goldsmith, M R; Austoker, J; Marsh, G; Kehoe, S T; Bankhead, C R

    2008-10-01

    To explore English women's experiences of cervical screening result communication. Qualitative study consisting of seven focus groups conducted between May 2005 and April 2006. 33 women with a range of screening results (normal, inadequate, borderline and abnormal) who had recently been for cervical screening, and five women who had attended a colposcopy appointment for the first time following screening. Three screening centres (Hampshire, Reading and Sheffield) and one colposcopy clinic (Oxford) in England. Unsatisfactory result communication (eg, delivery of out-of-date and conflicting information) on the part of both screening centres and primary care teams was highlighted. Variable levels of general practitioner involvement in screening result provision were experienced; result-giving strategies included personal as well as generic letters and telephone calls. Means for improving women's understanding of abnormal results were described including the use of diagrams to explain the progression of cell changes, the provision of updates regarding any changes in cell abnormalities between screening tests (ie, lesion progression or regression) and contact with a knowledgeable "intermediary" outside primary care. The timely provision of appropriate information is an important aspect of any screening programme. Our findings suggest that there is scope for improvement in both the delivery and content of cervical screening result notifications. Regular review of patient result-giving strategies on the part of screening centres and general practices could help ensure that screening programme standards for written information are met. Enhanced communication between primary care teams and screening centres could facilitate the provision of consistent and clear result messages thereby improving women's cervical screening experiences.

  12. Women's perspectives on illness when being screened for cervical cancer

    DEFF Research Database (Denmark)

    Hounsgaard, Lise; Augustussen, Mikaela; Møller, Helle

    2013-01-01

    BACKGROUND: In Greenland, the incidence of cervical cancer caused by human papillomavirus (HPV) is 25 per 100,000 women; 2.5 times the Danish rate. In Greenland, the disease is most frequent among women aged 30-40. Systematic screening can identify women with cervical cell changes, which...... if untreated may cause cervical cancer. In 2007, less than 40% of eligible women in Greenland participated in screening. OBJECTIVE: To examine Greenlandic women's perception of disease, their understanding of the connection between HPV and cervical cancer, and the knowledge that they deem necessary to decide...... whether to participate in cervical cancer screening. STUDY DESIGN: The methods used to perform this research were 2 focus-group interviews with 5 Danish-speaking women and 2 individual interviews with Greenlandic-speaking women. The analysis involved a phenomenological-hermeneutic approach with 3 levels...

  13. Cervical screening in Denmark - a success followed by stagnation

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Andersen, Berit; Christensen, Jette

    2018-01-01

    Introduction: Despite an intensive screening activity, the incidence of cervical cancer in Denmark has remained stable for the last 15 years, while regional differences have increased. To search for explanations, we investigated possible weaknesses in the screening program. Material and methods......: Data on the screen-targeted women were retrieved from Statistics Denmark. Data on screening activity were retrieved from the annual reports from 2009 to 2015 on quality of cervical screening. Coverage was calculated as proportion of screen-targeted women with at least one cytology sample within......-up of abnormal findings. Our analysis indicated that the currently high incidence of cervical cancer in Denmark may partly be due to low screening coverage. Also worrisome is a high proportion of non-timely follow-up of abnormal findings. Innovative ways to improve coverage and follow-up are urgently needed....

  14. Mortality of non-participants in cervical screening

    DEFF Research Database (Denmark)

    Dugué, Pierre-Antoine; Lynge, Elsebeth; Rebolj, Matejka

    2014-01-01

    a HR of 2.09 (95% CI: 2.05-2.14) compared to regular participants. The HR for human papillomavirus (HPV)-related cancers other than cervical cancer was 3.80 (95% CI: 2.67-5.41). Younger women, whose coverage rates were higher, had higher all-cause mortality HRs. Women screened more frequently than......The selective uptake of screening by healthy participants and its impact on the evaluation of screening effectiveness in non-randomized studies have been discussed, but hardly studied. We quantified excess mortality among cervical screening non-participants compared to participants. Based on Danish...... healthcare registers, we determined women's participation in cervical screening in 1990-1993 (one screening round) and 1990-1997 (two screening rounds). Women were followed until end of 2010. We computed hazard ratios (HR) comparing non-participants' and participants' risk of death, and analyzed the impact...

  15. Knowledge, attitude and practice of cervical cancer screening ...

    African Journals Online (AJOL)

    Background: Cervical cancer is the most common genital cancer and one of the leading causes of death among female population. Fortunately, this cancer is preventable by screening for premalignant lesions but this is rarely provided and hardly utilised. We assessed the knowledge, attitude and utilisation of cervical ...

  16. Integrating cervical cancer and genital tract infection screening into ...

    African Journals Online (AJOL)

    Symptoms of genital tract infections were reported by 38% of the participants with features of cervicitis being reported by nearly 24%. Conclusion: Integration of cervical cancer screening and genital tract infection identification and treatment into the existing MCH-FP appears feasible. African Health Sciences 2010; 10(1): 58 ...

  17. Risk scoring for selective screening of cervical cancer | Bukar ...

    African Journals Online (AJOL)

    Context: Cervical cancer is the leading cause of cancer related mortality in developing countries. The lack of routine cytological screening in developing countries is largely responsible for this high mortality. Objectives: To develop a risk score that would easily identify women at greater risk of having cervical intraepithelial ...

  18. Knowledge, Attitude and Practice of Cervical Smear as a Screening ...

    African Journals Online (AJOL)

    Context: Carcinoma of the cervix is a preventable disease but it remains the most common genital cancer in African women. Objective: To determine the knowledge, attitude and practice of cervical smear as screening procedure for cervical cancer by female health workers in Ilorin, Nigeria. Study Design, Setting and ...

  19. Cervical cancer knowledge and screening practices among women ...

    African Journals Online (AJOL)

    Background: Cervical cancer remains a major public health challenge in developing countries including Nigeria and contributes signi cantly as a major cause of death among women of reproductive age. This study was conducted to assess knowledge and cervical cancer screening practices among women of reproductive ...

  20. Cervical Cancer Awareness and Screening Uptake among Rural ...

    African Journals Online (AJOL)

    femi oloka

    Cervical Cancer Awareness and Screening Uptake among Rural. Women in Lagos, Nigeria. 1. 2. 1. 3. Oluwole E.O ., Mohammed A.S ., Akinyinka M.R ., Salako O . ABSTRACT. Background: Cervical cancer is the most common cause of female genital cancer and female cancer deaths in developing countries such as ...

  1. A Study on Knowledge and Screening for Cervical Cancer among ...

    African Journals Online (AJOL)

    Very few studies have explored the role of doctor and source of information for awareness of women about cervical cancer in India. Aim: Hence, this study was conducted with the objective of knowing the knowledge of women about cervical cancer, its screening, role of doctor, source of information, and reasons for not ...

  2. knowledge, attitude and practice of cervical cancer screening

    African Journals Online (AJOL)

    Conclusion: knowledge of cervical cancer screening services among female nurses in Nnewi is high while uptake rate is abysmally poor. There is need to ... malignancyl" of the female genital tract in the developing countries "5 and second ... to 35 years with access to treatment can lead to drastic reduction in cervical cancer ...

  3. Randomised trial of intensive academic detailing to promote opportunistic recruitment of women to cervical screening by general practitioners.

    Science.gov (United States)

    Young, Jane M; Ward, Jeanette E

    2003-01-01

    To evaluate a multifaceted intervention involving intensive academic detailing for general practitioners (GPs) to improve recruitment of women for cervical screening. We conducted a cluster randomisation trial involving 39 general practices in inner-metropolitan Sydney. GPs' knowledge, propensity to an opportunistic approach, competence and confidence were assessed by self-report before and after the intervention. To measure GP behaviour, recall of an opportunistic discussion about cervical screening was determined in cross-sectional samples of female patients at baseline (n = 1,090) and post-test (n = 1,062). Knowledge improved marginally in both groups but there were no changes in other GP self-reported measures. At post-test, women attending GPs in the intervention group were no more likely than those in the control group to recall an opportunistic inquiry about their cervical screening status (OR 0.65, 95% CI 0.40-1.08). Women in the intervention group who were overdue for cervical screening were no more likely than their control group counterparts at post-test to recall advice about cervical screening (OR 2.16, 95% CI 0.75-6.14) or written information (OR 0.34, 95% CI 0.04-26.5). Intensive academic detailing does not improve an opportunistic approach to cervical screening in general practice. In an evidence-based climate, implementation of academic detailing as a strategy to improve cervical screening rates in general practice would be premature.

  4. Impact of selected environmental factors on attendance in the Breast and Cervical Cancer Early Detection Programme in the Wielkopolska Province of Poland during 2007–2012

    Directory of Open Access Journals (Sweden)

    Witold Kycler

    2017-09-01

    Full Text Available Breast and cervical cancer represent a significant health and economic issue for Polish society, although if detected early, both can be cured successfully. For this reason, since 2006, according to the National Cancer Combat Programme, population-based screening programmes have been implemented, aimed at reducing the mortality and morbidity for breast and cervical cancer. The aim of this study is to determine which of the selected four environmental factors affect attendance for screening mammography and cytology. Analysis included data from questionnaires filled in during mammography by 582,959 women aged 50–69 years, and 288,142 women during cytology, aged 25–59 years, in 2007–2012 in the Wielkopolska Province of Poland. It was found that the impact of medical staff on the attendance for cytological screening was the strongest statistically significant factor (p = 0,0001. Invitation by name (p=0,001 and other factors (p= 0,0001 also affected the attendance. In the cytological screening, medical staff was the factor that had the greatest impact on attendance. Other factors, such as self-reporting, increased participation in the next screening rounds, although the factors that affect attendance changed over time. Their constant analysis is essential for the efficient and effective evaluation of screening programsme.

  5. Impact of selected environmental factors on attendance in the Breast and Cervical Cancer Early Detection Programme in the Wielkopolska Province of Poland during 2007-2012.

    Science.gov (United States)

    Kycler, Witold; Kubiak, Anna; Rzymski, Paweł; Wilczak, Maciej; Trojanowski, Maciej; Roszak, Magdalena; Włoszczak-Szubzda, Anna; Rzymska, Izabela

    2017-09-21

    Breast and cervical cancer represent a significant health and economic issue for Polish society, although if detected early, both can be cured successfully. For this reason, since 2006, according to the National Cancer Combat Programme, population-based screening programmes have been implemented, aimed at reducing the mortality and morbidity for breast and cervical cancer. The aim of this study is to determine which of the selected four environmental factors affect attendance for screening mammography and cytology. Analysis included data from questionnaires filled in during mammography by 582,959 women aged 50-69 years, and 288,142 women during cytology, aged 25-59 years, in 2007-2012 in the Wielkopolska Province of Poland. It was found that the impact of medical staff on the attendance for cytological screening was the strongest statistically significant factor (p = 0,0001). Invitation by name (p=0,001) and other factors (p= 0,0001) also affected the attendance. In the cytological screening, medical staff was the factor that had the greatest impact on attendance. Other factors, such as self-reporting, increased participation in the next screening rounds, although the factors that affect attendance changed over time. Their constant analysis is essential for the efficient and effective evaluation of screening programsme.

  6. The Effects of New Screening Tests in the Dutch Cervical Cancer Screening Programme

    NARCIS (Netherlands)

    K. Rozemeijer (Kirsten)

    2016-01-01

    markdownabstractCervical cancer is the fourth most common cancer in women all over the world, mainly affecting young women. As cervical cancer is easy to prevent by early detection and treatment of the disease, screening was introduced in the Netherlands in the 1970s. The number of cervical cancer

  7. Integrating cervical cancer screening and preventive therapy into ...

    African Journals Online (AJOL)

    Integrating cervical cancer screening and preventive therapy into reproductive health networks: Notes for the field. ... Data were collected through routine management information systems, which include information on client demographics, service use, first time screening status, HIV status, and screening results. Results: ...

  8. Acceptability of Cervical Cancer Screening in Rural Mozambique

    Science.gov (United States)

    Audet, Carolyn M.; Matos, Carla Silva; Blevins, Meridith; Cardoso, Aventina; Moon, Troy D.; Sidat, Mohsin

    2012-01-01

    In Zambezia province, Mozambique, cervical cancer (CC) screening was introduced to rural communities in 2010. Our study sought to determine whether women would accept screening via pelvic examination and visual inspection with acetic acid (VIA) at two clinical sites near the onset of a new CC screening program. A cross-sectional descriptive study…

  9. Cervical screening with Luviva machine for early detection of ...

    African Journals Online (AJOL)

    Several traditional screening methods such as pap smear test, HPV-DNA screening test, visual inspection with acetic acid or lugol iodine are in vogue with different specificity and sensitivity. LuViva advanced cervical scan is a new automated screening tool that has great promise for the detection of the disease in its

  10. Towards a rational cervical cytology screening strategy - Case study ...

    African Journals Online (AJOL)

    Objectives. To assess cervical cytology screening activity in a peri-urban settlement near Cape Town, with a view to informing rational policy development. Method. Total and age-specific prevalence rates of women who had been screened, relative prevalence by age group of women who had not been screened, and yield ...

  11. Alternative approaches to cervical cancer screening for developing countries.

    Science.gov (United States)

    Wright, Thomas C; Kuhn, Louise

    2012-04-01

    Cervical cancer remains the most common cancer among women living in developing countries, largely because of the failure either to initiate or sustain effective cervical-cancer screening programmes. This potentially preventable and curable cancer continues to cause high mortality among relatively young women residing in low-resource countries. Cytology as a screening test, linked with a robust healthcare infrastructure, has significantly affected cervical cancer prevention in countries that have had sufficient resources to establish and sustain well-conducted programmes. The failure to establish such programmes has stimulated a large body of research into alternative screening tests and approaches to cervical-cancer prevention. Two of the most recent research methods have been visual inspection with acetic acid and molecular testing for high-risk types of human papillomavirus deoxyribonucleic acid. Visual inspection with acetic acid has shown a great deal of promise in cross-sectional studies; however, in randomised-controlled trials, it has been shown to be significantly less effective in reducing cervical cancer or its precursors. The development of point-of-care human papillomavirus or other highly sensitive tests for the prevention of cervical cancer is imperative. It has also been clearly shown that linking testing or screening to treatment (so-called 'screen and treat') without the intervention of colposcopy or the need for sophisticated laboratories may potentially prevent cervical cancer in large numbers of women. Copyright © 2011. Published by Elsevier Ltd.

  12. Automatic screening of cervical cells using block image processing

    National Research Council Canada - National Science Library

    Zhao, Meng; Wu, Aiguo; Song, Jingjing; Sun, Xuguo; Dong, Na

    2016-01-01

    .... In recent years, computer-based algorithms are widely used in cervical cancer screening. Most of the proposed algorithms follow the procedure of segmentation, feature extraction, and then classification...

  13. Grantee Spotlight: Dr. Kolawole Okuyemi - Improving Cervical Cancer Screening Attitudes

    Science.gov (United States)

    Dr. Kolawole Okuyumi is studying cervical cancer screening attitudes and behaviors of African immigrants and refugees in Minnesota, and introducing “cancer” and “cervix” to their everyday vocabulary.

  14. The Vaccine and Cervical Cancer Screen (VACCS) project: Linking ...

    African Journals Online (AJOL)

    cancer remains high and the majority of women who are diagnosed present with ... Linking cervical cancer screening to HPV vaccination in ... the distribution of information leaflets in English or Tswana. During ...... Men and women/girls.

  15. Perception and utilization of cervical cancer screening services ...

    African Journals Online (AJOL)

    raoul

    2012-04-15

    Apr 15, 2012 ... Key words: Female nurses, cervical cancer, cancer screening, utilization, ..... This notion has to be corrected in intervention programs as it could lead to ... Upgrading the knowledge base of nurses therefore becomes ...

  16. Barriers to Cervical Screening Among Sex Workers in Vancouver.

    Science.gov (United States)

    Duff, Putu; Ogilvie, Gina; Shoveller, Jean; Amram, Ofer; Chettiar, Jill; Nguyen, Paul; Dobrer, Sabina; Montaner, Julio; Shannon, Kate

    2016-02-01

    We longitudinally examined the social, structural, and geographic correlates of cervical screening among sex workers in Metropolitan Vancouver, British Columbia, to determine the roles that physical and social geography play in routine reproductive health care access. Analysis drew on (2010-2013) data from an open prospective cohort of sex workers (An Evaluation of Sex Workers' Health Access). We used multivariable logistic regression with generalized estimating equations (GEE) to model correlates of regular cervical screening. At baseline, 236 (38.6%) of 611 sex workers in our sample had received cervical screening, and 63 (10.3%) were HIV-seropositive. In multivariable GEE analysis, HIV-seropositivity (adjusted odds ratio [AOR] = 1.65; 95% confidence interval [CI] = 1.06, 2.58) and accessing outreach services (AOR = 1.35; 95% CI = 1.09, 1.66) were correlated with regular cervical screening. Experiencing barriers to health care access (e.g., poor treatment by health care staff, limited hours of operation, and language barriers) reduced odds of regular Papanicolaou testing (AOR = 0.81; 95% CI = 0.65, 1.00). Sex workers in Metropolitan Vancouver had suboptimal levels of cervical screening. Innovative mobile outreach service delivery models offering cervical screening as one component of sex worker-targeted comprehensive sexual and reproductive health services may hold promise.

  17. Teaching tools to engage Anishinaabek First Nations women in cervical cancer screening: Report of an educational workshop.

    Science.gov (United States)

    Zehbe, Ingeborg; Wood, Brianne; Wakewich, Pamela; Maar, Marion; Escott, Nicholas; Jumah, Naana; Little, Julian

    2016-04-01

    To explore educational strategies for engaging First Nations women in Canada to attend cervical cancer screening. Within a participatory action research framework, semi-structured interviews with health-care providers in First Nations communities revealed that education about the value of screening is perceived as being a key factor to promote cervical cancer screening. To obtain feedback from workshop informants, a 1-day educational workshop was held to identify appropriate educational intervention strategies, which would be applied in a forthcoming randomised controlled cervical screening trial. Common discussion and discussion groups, which were facilitated by a First Nations workshop moderator and a note taker. This workshop helped to strengthen the ethical space dialogue with the First Nations communities with whom the study team had established research partnerships. The workshop atmosphere was relaxed and the invited informants decided that an educational health promotion event for community women needed to be held prior to inviting them to the cervical screening trial. Such an event would provide an opportunity to communicate the importance of attending regular cervical screening allowing women to make informed decisions about screening participation. Complementary promotional items, including an eye-catching pamphlet and storytelling, were also suggested. The key messages from the events and promotional items can help to destigmatise women who develop a type of cancer that is caused by a sexually transmitted virus that affects both men and women. Developing and implementing positive health education that respectfully depicts female bodies, sexuality and health behaviours through a First Nations lens is strongly warranted.

  18. Evaluation of a Worksite Cervical Screening Initiative to Increase Pap Smear Uptake in Malaysia: A Cluster Randomized Controlled Trial

    Science.gov (United States)

    O'Rorke, Michael; Murray, Liam; Su, Tin Tin

    2013-01-01

    Background. Despite the significant burden of cervical cancer, Malaysia like many middle-income countries relies on opportunistic cervical screening as opposed to a more organized population-based program. The aim of this study was to ascertain the effectiveness of a worksite screening initiative upon Papanicolaou smear test (Pap test) uptake among educated working women in Malaysia. Methods. 403 female teachers who never or infrequently attended for a Pap test from 40 public secondary schools in Kuala Lumpur were recruited into a cluster randomized trial conducted between January and November 2010. The intervention group participated in a worksite cervical screening initiative whilst the control group received usual care from the existing cervical screening program. Multivariate logistic regression was performed to determine the impact of the intervention program on Pap smear uptake after 24 weeks of followup. Results. The proportion of women attending for a Pap test was significantly higher in the intervention than in the control group (18.1% versus 10.1%, P value < 0.05) with the worksite screening initiative doubling the Pap smear uptake, adjusted odds ratio 2.44 (95% CI: 1.29–4.62). Conclusion. Worksite health promotion interventions can effectively increase cervical smear uptake rates among eligible workers in middle-income countries. Policy makers and health care providers in these countries should include such interventions in strategies for reducing cervical cancer burden. This trial is registered with IRCT201103186088N1. PMID:24073411

  19. DNA probes for papillomavirus strains readied for cervical cancer screening

    Energy Technology Data Exchange (ETDEWEB)

    Merz, B.

    1988-11-18

    New Papillomavirus tests are ready to come to the aid of the standard Papanicolauo test in screening for cervical cancer. The new tests, which detect the strains of human papillomavirus (HPV) most commonly associated with human cervical cancer, are designed to be used as an adjunct to rather than as a replacement for the Papanicolaou smears. Their developers say that they can be used to indicated a risk of developing cancer in women whose Papanicolaou smears indicate mild cervical dysplasia, and, eventually, to detect papillomavirus infection in normal Papanicolaou smears. The rationale for HPV testing is derived from a growing body of evidence that HPV is a major factor in the etiology of cervical cancer. Three HPV tests were described recently in Chicago at the Third International Conference on Human Papillomavirus and Squamous Cervical Cancer. Each relies on DNA probes to detect the presence of papillomavirus in cervical cells and/or to distinguish the strain of papillomavirus present.

  20. Young Singaporean women's knowledge of cervical cancer and pap smear screening: a descriptive study.

    Science.gov (United States)

    Shea, Juanna; Klainin-Yobas, Piyanee; Mackey, Sandra

    2013-12-01

    To assess the knowledge of young female Singaporeans regarding cervical cancer and pap smear, the intention to participate in pap smear and whether there is any relationship between knowledge and intention to participate in pap smear screening. While cervical cancer has poor prognosis in the later stages, pap smear is effective in identifying precancerous lesions, which are more treatable. Pap smear screening is available to women in Singapore, but its uptake is opportunistic. Research has shown that knowledge about pap smear and cervical cancer is important determinant of screening behaviour in Singaporean women. Cross-sectional descriptive correlational design was used. Three hundred and ninety-three young Singaporean undergraduates, aged 18-25 years, were recruited via convenience sampling from a local university over a four-month period. Data were collected through self-administered questionnaires. Majority of the participants knew the term 'pap smear' and its function. However, knowledge of the risk factors for cervical cancer was lacking among the young women. Knowledge of pap smear and cervical cancer had a weak correlation with the intention to go for the future uptake of pap smear. Educational efforts among younger Singaporean women on the knowledge of pap smear and risk factors for cervical cancer are needed. Improving knowledge will enable them to understand the importance of reducing exposure to risk factors and regular pap smear screening. All health professionals working with young Asian women should be prepared to educate and counsel young women to participate in pap smear screening according to current guidelines. In particular, knowledge of the age to attend the first pap smear and the recommended frequency for screening need to be targeted for health education. © 2013 John Wiley & Sons Ltd.

  1. Cervical cancer screening in Greenland, 1997-2011

    DEFF Research Database (Denmark)

    Holst, Signe; Wohlfahrt, Jan; Kjær, Susanne Krüger

    2016-01-01

    OBJECTIVE: In spite of the high incidence of cervical cancer in Greenland, no assessment has been made of the impact of organized cervical screening, introduced in 1998, in relation to occurrence of high-grade cervical lesions. The objectives of the present study were to estimate coverage....... To investigate whether possible variation in the incidence of CIN3 were related to differences in screening coverage, we further estimated relative risks of CIN3 within two years of screening among women who participated in the screening program using log-linear binomial regression. RESULTS: Coverage...... of the screening program was low during 1997-2011 with the highest level of 54% observed in 2011. Peaks in CIN3 incidence of around 300 per 100,000 person-years were observed in 1999 and between 2009 and 2011, while the incidence was lower of approximately 100 per 100,000 person-years between 2000 and 2008. During...

  2. The impact of HPV vaccination on future cervical screening

    DEFF Research Database (Denmark)

    Hestbech, Mie Sara; Lynge, Elsebeth; Kragstrup, Jakob

    2015-01-01

    OBJECTIVES: To explore the interplay between primary and secondary prevention of cervical cancer by estimating future screening outcomes in women offered human papillomavirus (HPV) vaccination when they were sexually naïve. DESIGN: Estimation of outcome of liquid-based cytology screening for a post......-HPV vaccination cohort using pre-vaccination screening data combined with HPV vaccination efficacy data reported in the literature. SETTING: Denmark. DATA: The number of screening diagnoses at first screen in a pre-vaccination birth cohort was multiplied by reported risk reductions expected for women who were...... vaccinated for HPV before sexual debut. All identified studies were reviewed by two authors, and weighted pooled estimates of vaccine efficacies were used. MAIN OUTCOME MEASURES: Proportions of positive and false-positive cervical cytologies and positive predictive value (PPV) were calculated using cervical...

  3. A Literature Review of Cervical Cancer Screening in Transgender Men.

    Science.gov (United States)

    Gatos, Kayla C

    2018-02-01

    Most female-to-male (FTM) transgender men retain their cervixes and need comprehensive sexual health care, including cervical cancer screening. According to the literature, FTM individuals obtain cervical cancer screening less frequently and are less likely to be up to date on their Pap tests compared with cisgender women. Misinformation related to human papillomavirus and cervical cancer risk was noted for health care providers and FTM individuals. Absence of transgender-specific guidelines or trained health care providers presents barriers to cervical cancer screening for FTM individuals, and further research is indicated to develop comprehensive guidelines unique to the needs and experiences of this population. © 2018 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

  4. Screening of cervical cancer in Catalonia 2006–2012

    Science.gov (United States)

    de Sanjosé, Silvia; Ibáñez, Raquel; Rodríguez-Salés, Vanesa; Peris, Mercè; Roura, Esther; Diaz, Mireia; Torné, Aureli; Costa, Dolors; Canet, Yolanda; Falguera, Gemma; Alejo, Maria; Espinàs, Josep Alfons; Bosch, F. Xavier

    2015-01-01

    The early detection of intraepithelial lesions of the cervix, through the periodic examination of cervical cells, has been fundamental for the prevention of invasive cervical cancer and its related mortality. In this report, we summarise the cervical cancer screening activities carried out in Catalonia, Spain, within the National Health System during 2008–2011. The study population covers over two million women resident in the area. The evaluation includes 758,690 cervical cytologies performed on a total of 595,868 women. The three-year coverage of cervical cytology among women aged between 25 and 65 years was 40.8%. About 50% of first screened women with negative results had not returned to the second screening round. The introduction of high-risk human papillomavirus DNA (HPV) detection, as a primary screening cotest with cytology among women over age 40 with a poor screening history, significantly improved the detection of cervical intraepithelial neoplasia grade 2 or worse (CIN2+), being far superior to cytology alone. Cotesting did not improve the detection of CIN2+. The use of the HPV test for the triage of atypical squamous cell undetermined significance (ASC-US) improved the selection of women at high risk of CIN2+. Sampling (both cytology and HPV test) was largely performed by midwives (66.7%), followed by obstetricians (23.8%) and nurses (7%). Over half of the centres (54.8%) had full use of online medical records. During the study period, educational activities for professionals and for women were carried out periodically. The organisation of screening as a population activity in which women are actively called to the screening visit and the introduction of HPV testing as a primary screening tool are strongly recommended to ensure the maximum population impact in the reduction of the cervical cancer burden. PMID:25987901

  5. Influences on uptake of reproductive health services in Nsangi community of Uganda and their implications for cervical cancer screening

    Directory of Open Access Journals (Sweden)

    Mirembe Florence

    2007-06-01

    Full Text Available Abstract Background Cervical cancer is the most common female cancer in Uganda. Over 80% of women diagnosed or referred with cervical cancer in Mulago national referral and teaching hospital have advanced disease. Plans are underway for systematic screening programmes based on visual inspection, as Pap smear screening is not feasible for this low resource country. Effectiveness of population screening programmes requires high uptake and for cervical cancer, minimal loss to follow up. Uganda has poor indicators of reproductive health (RH services uptake; 10% postnatal care attendance, 23% contraceptive prevalence, and 38% skilled attendance at delivery. For antenatal attendance, attendance to one visit is 90%, but less than 50% for completion of care, i.e. three or more visits. Methods We conducted a qualitative study using eight focus group discussions with a total of 82 participants (16 men, 46 women and 20 health workers. We aimed to better understand factors that influence usage of available reproductive health care services and how they would relate to cervical cancer screening, as well as identify feasible interventions to improve cervical cancer screening uptake. Results Barriers identified after framework analysis included ignorance about cervical cancer, cultural constructs/beliefs about the illness, economic factors, domestic gender power relations, alternative authoritative sources of reproductive health knowledge, and unfriendly health care services. We discuss how these findings may inform future planned screening programmes in the Ugandan context. Conclusion Knowledge about cervical cancer among Ugandan women is very low. For an effective cervical cancer-screening programme, awareness about cervical cancer needs to be increased. Health planners need to note the power of the various authoritative sources of reproductive health knowledge such as paternal aunts (Sengas and involve them in the awareness campaign. Cultural and economic

  6. [New guidelines in regard to cervical cancer screening].

    Science.gov (United States)

    Vargas-Hernández, Víctor Manuel; Acosta-Altamirano, Gustavo; Moreno-Eutimio, Mario Adán; Vargas-Aguilar, Víctor Manuel

    2014-01-01

    Cancer screening programs have been successful in reducing the incidence and mortality due to cervical cancer. For more than a decade, the human papillomavirus test has been recommended as part of these programs, however, Pap tests is not currently recommended for women 65 years of age who participated adequately in screening programs, continuing with these screening programs is not needed. Screening programs will be different in special populations at greatest risk where tests are frequently needed or use of alternative methods.

  7. False-positive Human Papillomavirus DNA tests in cervical screening

    DEFF Research Database (Denmark)

    Rebolj, Matejka; Pribac, Igor; Lynge, Elsebeth

    2011-01-01

    Based on data from randomised controlled trials (RCT) on primary cervical screening, it has been reported that the problem of more frequent false-positive tests in Human Papillomavirus (HPV) DNA screening compared to cytology could be overcome. However, these reports predominantly operated with a...... with a narrow definition of a (false-)positive test. The aim of this paper was to illustrate how the narrow definition affected the measured adverse effects of HPV DNA screening compared with cytology screening....

  8. [Associated factors for women's non-compliance for cervical cancer screening].

    Science.gov (United States)

    Hernández-Hernández, Dulce María; Linaldi-Yépez, Filiberto; Apresa-García, Teresa; Escudero-de los Ríos, Pedro; Alvarado-Cabrero, Isabel; Ornelas-Bernal, Laura A; Mohar-Betancourt, Alejandro

    2007-01-01

    To identify the associated factors for non-compliance among women for the cervical cancer screening program. A case-control study was carried out in which cases were women who were just diagnosed with cervical cancer (confirmed with pathological study); controls were women not having cervical cancer (negative pathological study). Cases and controls had the same age, lived in the same geographical area and were selected from the primary care facilities. Lack of compliance for cervical cancer screening was defined as the time since the last cytology (no previous Pap test or > or =3 years since last Pap test). A logistic regression analysis served to identify the associated factors to the lack of compliance. There were 279 cases and 392 controls included in the study. The rate of non-compliance among cases was 76.7% and among controls was 29.6%. Among cases 45.5% had never undergone Pap test compared with 9.9% of controls. Main risk factors for non-compliance to attend to cervical cancer screening were age > 65 years (aOR = 2.9, 95% CI 1.6-5-3); illiteracy (aOR = 3.8, 95% CI 1.7-6); use of public transportation to attend to the preventive service (aOR = 2.3, 95% CI 1.2-6.4); more than five pregnancies (aOR = 3.0, 95% CI 1.6-5.3) and lack of knowledge about cervical cancer (aOR = 4.2, 95% CI 3.6-7.2). The rate of non-compliance close to 30% was high; social and cultural risk factors were the most relevant.

  9. How protective is cervical cancer screening against cervical cancer mortality in developing countries? The Colombian case

    Directory of Open Access Journals (Sweden)

    De la Hoz-Restrepo Fernando

    2010-09-01

    Full Text Available Abstract Background Cervical cancer is one of the top causes of cancer morbidity and mortality in Colombia despite the existence of a national preventive program. Screening coverage with cervical cytology does not explain the lack of success of the program in reducing incidence and mortality rates by cervical cancer. To address this problem an ecological analysis, at department level, was carried out in Colombia to assess the relationship between cervical screening characteristics and cervical cancer mortality rates. Methods Mortality rates by cervical cancer were estimated at the department level for the period 2000-2005. Levels of mortality rates were compared to cervical screening coverage and other characteristics of the program. A Poisson regression was used to estimate the effect of different dimensions of program performance on mortality by cervical cancer. Results Screening coverage ranged from 28.7% to 65.6% by department but increases on this variable were not related to decreases in mortality rates. A significant reduction in mortality was found in departments where a higher proportion of women looked for medical advice when abnormal findings were reported in Pap smears. Geographic areas where a higher proportion of women lack health insurance had higher rates of mortality by cervical cancer. Conclusions These results suggest that coverage is not adequate to prevent mortality due to cervical cancer if women with abnormal results are not provided with adequate follow up and treatment. The role of different dimensions of health care such as insurance coverage, quality of care, and barriers for accessing health care needs to be evaluated and addressed in future studies.

  10. Social stratification, risk factor prevalence and cancer screening attendance.

    Science.gov (United States)

    Eisinger, François; Viguier, Jérôme; Touboul, Chantal; Coscas, Yvan; Pivot, Xavier; Blay, Jean-Yves; Lhomel, Christine; Morère, Jean-François

    2015-06-01

    This analysis aimed to assess the extent to which exposure to cancer risk factors and attendance of screening programmes are influenced by social characteristics. The validated Evaluation of deprivation and health inequalities in public health centres (EPICES) index was used to measure social deprivation. A sample of the general population (N=1603) was assessed to search for potential correlations between screening attendance, risk factors and any components of the EPICES score. In 2011, 33% of the population studied was classified as 'vulnerable'. Sex had no significant impact on this rating (32% men, 35% women), whereas occupational status did. Vulnerable individuals were more likely already to have cancer (10 vs. 7%; nonsignificant difference; odds ratio 1.43 [0.98-2.10]). The mean BMI was 26.0 kg/m (SD 4.9) for the vulnerable population versus 24.8 kg/m (SD 3.9) in the nonvulnerable population (P<0.01). The prevalence of current smoking was higher in the vulnerable group (38 vs. 23%, odds ratio 2.03 [1.61-2.56]). In contrast, no statistically significant difference was observed between attendance rates for nationwide organized cancer screening programmes (breast and colorectal; target age group 50-74 years) by the vulnerable and nonvulnerable groups. Social indicators of vulnerable populations are associated with increased rates of risk factors for cancer, but not with screening attendance. Our data support the previously reported marked impact of organized programmes that reduce or even remove inequalities in access to cancer screening. However, although the organized programmes have indeed enabled population-wide, nonselective access to screening, primary prevention as it stands today remains inadequate in the underserved population and further improvements are warranted.

  11. Cervical cancer screening in Belgium and overscreening of adolescents.

    Science.gov (United States)

    Van Kerrebroeck, Helena; Makar, Amin

    2016-03-01

    There has been a marked decrease in the incidence of cervical cancer thanks to cytological screening with the Pap smear test. In Belgium, this screening is rather opportunistic. Over 39% of Belgian women between 25 and 64 years of age are never or only rarely screened by cytological tests. Moreover, there is an excess use of Pap smears because of women who rely on their yearly cervical smear and because many Pap smears are obtained from women beyond the target age range of 25 to 64 years. Sexually active adolescents are increasingly being recognized as a population distinct from adult women. They are at a high risk of acquiring the human papillomavirus (HPV), but most infections and cervical intraepithelial lesions caused by HPV are efficiently cleared by the immune system. We present a description of cervical cancer screening in Belgium using the database of the National Health Insurance Institute (RIZIV/INAMI) and the Belgian Health Care Knowledge Centre (KCE). We describe why elimination of Pap testing in the adolescent population reduces costs and harms without increasing cervical cancer rates. Expectant management, education on the risk factors for cervical cancer and HPV persistence, and HPV vaccination are very important in adolescents and young adults.

  12. Knowledge, attitude and practice of cervical cancer screening (pap ...

    African Journals Online (AJOL)

    Objective: To determine the knowledge and practice of cervical cancer screening among practicing female nurses with a view to sensitizing them as a first step towards increasing screening uptake in the community. Method: A self administered questionnaire survey of all the female nurses working in Nnamdi Azikiwe ...

  13. Uptake of cervical cancer screening: awareness, willingness and ...

    African Journals Online (AJOL)

    Background: Cervical cancer remains the commonest genital tract cancer and yet it is preventable through cytologic screening with Pap smear. Awareness and willingness among target population is an imperative for uptake of screening services. Aim: To contribute to the existing knowledge base, and in particular, bridge ...

  14. Knowledge, attitude and practice of cervical cancer screening (Pap ...

    African Journals Online (AJOL)

    “ABSTRACT. Objective: To determine the knowledge and practice of cervical cancer screening among practicing female nurses with a view to sensitizing them as a first step towards increasing screening uptake in the community. Method: A self administered questionnaire survey of all the female nurses working in Nnamdi ...

  15. Human papillomavirus testing and genotyping in cervical screening

    DEFF Research Database (Denmark)

    Rebolj, Matejka; Lynge, Elsebeth; Bonde, Jesper

    2011-01-01

    Mass vaccination against human papillomavirus (HPV) genotypes 16 and 18 will, in the long term, reduce the incidence of cervical cancer, but screening will remain an important cancer control measure in both vaccinated and unvaccinated women. Since the 1960s, cytology screening has helped to reduce...

  16. Attitudes of women about breast cancer and cervical cancern screening

    Directory of Open Access Journals (Sweden)

    ilknur Aydin Avci

    2015-06-01

    Conclusion: This research revealed that the women had moderate knowlege about breast and cervical cancer screening and artcipation in screening is low. Beside, the women who had BSE and mammography had more PAP smear. [TAF Prev Med Bull 2015; 14(3.000: 235-239

  17. Knowledge, attitude and practice of cervical cancer screening

    African Journals Online (AJOL)

    'i§?i"ABsTRAcT. Objective: To determine the knowledge and practice of cervical cancer screening among practicing female nurses with a view to sensitizing them as a first step towards increasing screening uptake in the community. Method: A self administered questionnaire survey of all the female nurses working in ...

  18. Barriers to utilization of cervical cancer screening services among ...

    African Journals Online (AJOL)

    Barriers to utilization of cervical cancer screening services among non-medical female personnel in tertiary hospitals in south west Nigeria. ... Utilization rate is low at 15%; indecision, 32 .4% feeling of good health, 28.2% and fear of positive results, 18.1 % are the main reasons for not screening. Low level of education and ...

  19. Value for money from HPV vaccination and cervical screening.

    Science.gov (United States)

    Ashton, Toni; Sopina, Elizaveta

    2012-06-01

    Introduction of human papillomavirus (HPV) vaccination programs raises some important questions about the future organization of cervical screening programs. Two studies--from NZ and Canada--have addressed the question of what combination of vaccination and screening strategies might be most cost-effective in preventing cervical cancer. Both studies indicate that some modifications to existing screening programs may be desirable as immunized females enter these programs. Variables in HPV vaccination that are likely to be particularly important for determining the future cost-effectiveness of cervical screening programs include: vaccine uptake rate, compliance with full doses, timely completion of doses, duration of protection, male vaccination and HPV infection rate. If value for money is to be achieved, it is important that the appropriate data are collected so that policy makers can consider the combined impact of these two programs on costs and health outcomes.

  20. Value for money from HPV vaccination and cervical screening

    DEFF Research Database (Denmark)

    Ashton, Toni; Sopina, Elizaveta (Liza)

    2012-01-01

    Introduction of human papillomavirus (HPV) vaccination programs raises some important questions about the future organization of cervical screening programs. Two studies - from NZ and Canada - have addressed the question of what combination of vaccination and screening strategies might be most cost......-effective in preventing cervical cancer. Both studies indicate that some modifications to existing screening programs may be desirable as immunized females enter these programs. Variables in HPV vaccination that are likely to be particularly important for determining the future cost-effectiveness of cervical screening...... programs include: vaccine uptake rate, compliance with full doses, timely completion of doses, duration of protection, male vaccination and HPV infection rate. If value for money is to be achieved, it is important that the appropriate data are collected so that policy makers can consider the combined...

  1. Cervical Abnormalities in South African Women Living With HIV With High Screening and Referral Rates.

    Science.gov (United States)

    Katz, Ingrid T; Butler, Lisa M; Crankshaw, Tamaryn L; Wright, Alexi A; Bramhill, Karen; Leone, Dominick A; Giddy, Janet; Mould, Sean

    2016-12-01

    To determine the prevalence of screening, cervical dysplasia, and malignancy on the basis of histologic diagnoses from colposcopy and large loop excision of the transformation zone among women living with HIV (WLWH) who attended an urban antiretroviral treatment (ART) clinic in KwaZulu-Natal, South Africa. We performed a retrospective cohort study to examine a random sample of 462 WLWH during a 5-year period from 2004 to 2009. Women on ART for Papanicolau test. At baseline, 237 women (54.9%) had an abnormal Papanicolau test, and of these patients, 181 (76.3%) had a Papanicolau test that qualified for further colposcopic evaluation. In addition, 115 women (63.5%) received colposcopy within a median of 39 days from referral. This yielded 74 evaluable histologic samples (64.3%), of which 21.6%, 27.0%, 27.0%, and 1.4% had cervical intraepithelial neoplasia (CIN) 1, CIN2, CIN3, and invasive cervical cancer, respectively. In a large sample of WLWH who received ART in KwaZulu-Natal, South Africa, where Papanicolau test coverage and rates of referral for colposcopy and large loop excision of the transformation zone were high, > 75% of women with evaluable histologic samples had evidence of cervical dysplasia or malignancy. These findings underscore the importance of routine cervical screening upon entry into HIV care to optimize survival.

  2. Mapping HPV Vaccination and Cervical Cancer Screening Practice in the Pacific Region-Strengthening National and Regional Cervical Cancer Prevention

    DEFF Research Database (Denmark)

    Obel, J; McKenzie, J; Buenconsejo-Lum, L E

    2015-01-01

    OBJECTIVE: To provide background information for strengthening cervical cancer prevention in the Pacific by mapping current human papillomavirus (HPV) vaccination and cervical cancer screening practices, as well as intent and barriers to the introduction and maintenance of national HPV vaccinatio...

  3. An empirical study of the 'underscreened' in organised cervical screening: experts focus on increasing opportunity as a way of reducing differences in screening rates.

    Science.gov (United States)

    Williams, Jane H; Carter, Stacy M

    2016-10-06

    Cervical cancer disproportionately burdens disadvantaged women. Organised cervical screening aims to make cancer prevention available to all women in a population, yet screening uptake and cancer incidence and mortality are strongly correlated with socioeconomic status (SES). Reaching underscreened populations is a stated priority in many screening programs, usually with an emphasis on something like 'equity'. Equity is a poorly defined and understood concept. We aimed to explain experts' perspectives on how cervical screening programs might justifiably respond to 'the underscreened'. This paper reports on a grounded theory study of cervical screening experts involved in program organisation. Participants were 23 experts from several countries and a range of backgrounds: gynecology; epidemiology; public health; pathology; general practice; policy making. Data were gathered via semi-structured interview and concepts developed through transcript coding and memo writing. Most experts expressed an intuitive commitment to reducing systematic differences in screening participation or cancer outcomes. They took three different implicit positions, however, on what made organised programs justifiable with respect to underscreened populations. These were: 1) accepting that population screening is likely to miss certain disenfranchised groups for practical and cultural reasons, and focusing on maximising mainstream reach; 2) identifying and removing barriers to screening; and 3) providing parallel tailored screening services that attended to different cultural needs. Positions tended to fall along country of practice lines. Experts emphasised the provision of opportunity for underscreened populations to take up screening. A focus on opportunity appeared to rely on tacit premises not supported by evidence: that provision of meaningful opportunity leads to increased uptake, and that increased uptake of an initial screening test by disadvantaged populations would decrease

  4. CERVICAL ACID PHOSPHATASE: EVALUATION AS AN ADJUVANT TO PAPANICOLAOU SMEAR SCREENING IN CERVICAL CANCER DETECTION

    Directory of Open Access Journals (Sweden)

    Niranjan

    2015-02-01

    Full Text Available INTRODUCTION: Carcinoma of cervix accounts for 15% of all cancers diagnosed worldwide and is the second most common cancer in women. In the year 2000 there were over 4,71,000 new cases diagnosed and 2,88,000 deaths from cervical cancer. (1 Approximately 79% of these deaths occurred in developing countries. (2 Cervical cancer is preventable, but most women in poorer countries do not have access to effective screening programs. In India it is estimated that approximately 100,000 women develop cervical cancer each year. (3 Cancer cervix occupies either the top r ank or second among cancers in women in developing countries, whereas, in the developed countries cancer cervix does not find a place even in top five leading cancers in women. This is due to routine screening by cervical smear. Cervical smear cytology scr eening by Papanicolaou (Pap stained smears is the most efficacious and cost - effective method of cancer screening, decreasing the incidence and mortality from cervical cancer. (4 However, cervical smear screening has significant rates of false - positive and false - negative results, ranging from 10.3% for false positive cases to 5.6% for false negative cases. (5,6 To improve the detection and screening of cancerous and precancerous lesions of the cervix a number of sophisticated tests are available which are e xpensive and can be done only in a tertiary laboratory. To over - come this problems a cost effective cytochemical stain was introduced to measure the acid phosphatase activity in the cervical epithelium. (7 Since the description of the new Cervical Acid Phosphatase Test (CAP Test for visualization of cervical acid phosphatase activity (CAP inside abnormal cervical cells on smears, it has become possible to explore this enzyme as a biomarker for cervical dys plasia, and as a possible surrogate for PAP smear in detection of cervical intraepithelial neoplasia (CIN. AIMS AND OBJECTIVES: To assess the utility of Cervical Acid

  5. Early Cervical Neoplasia: Advances in Screening and Treatment Modalities

    Science.gov (United States)

    Tierney, Brent; Westin, Shannon N.; Schlumbrecht, Matthew P.; Ramirez, Pedro T.

    2015-01-01

    Cervical cancer is one of the most common causes of cancer in women worldwide. However, improvements in screening programs and treatment modalities have significantly reduced the morbidity and mortality of this disease. The discovery that infection with the human papillomavirus (HPV) is a crucial part of the causative pathway in cervical cancer pathogenesis has revolutionized screening, and prompted investigations into alternatives to traditional cytologic evaluation which may be useful in low-resource settings. Concomitant with improved screening has been a shift towards greater detection of both pre-invasive and early-stage neoplastic disease. Earlier detection not only allows for surgical management of disease, with the avoidance of chemotherapy and radiation, but also the possibility of fertility preservation. As surgical technologies advance to encompass minimally-invasive procedures, interventions for early-stage cervical cancer are becoming increasingly effective in disease eradication while permitting patients to maintain their quality of life. PMID:20966891

  6. Two cytological methods for screening for cervical cancer

    DEFF Research Database (Denmark)

    Kirschner, B.; Simonsen, K.; Junge, J.

    2008-01-01

    INTRODUCTION: Denmark has had an organized screening programme for cervical cancer since the 1960s. In spite of this, almost 150 Danish women die from the disease each year. There are currently two different methods for preparation of cervical samples: conventional Papanicolaou smear and liquid......-based cytology. MATERIALS AND METHODS: In 2002, the Department of Pathology, Hvidovre Hospital changed over from the conventional Papanicolaou smear screening method to SurePath liquid-based cytology. This article is based on a retrospective comparison on data from the population screening programme for cervical...... cancer in the Municipality of Copenhagen. RESULTS: The number of tests with the diagnosis of "normal cells" decreased 1% after the conversion to liquid-based cytology, whilst the number of tests with "atypical cells" and "cells suspicious for malignancy" increased by 64.3% and 41.2% respectively...

  7. Association between cervical screening and prevention of invasive cervical cancer in Ontario: a population-based case-control study.

    Science.gov (United States)

    Vicus, Danielle; Sutradhar, Rinku; Lu, Yan; Kupets, Rachel; Paszat, Lawrence

    2015-01-01

    The aim of this study was to estimate the effect of cervical screening in the prevention of invasive cervical cancer among age groups, using a population-based case-control study in the province of Ontario, Canada. Exposure was defined as cervical cytology history greater than 3 months before the diagnosis date of cervical cancer (index date). Cases were women who were diagnosed with cervical cancer between January 1, 1998, and December 31, 2008. Controls were women without a diagnosis of cervical cancer on, or before, December 31, 2008. Two controls were matched to each case on year of birth and income quintile, as of the index date. Conditional logistic regression was used to estimate the odds ratio for having been screened among those with cervical cancer. Cervical cancer screening performed between 3 and 36 months before the index date was protective against invasive cervical cancer in women aged 40 through 69 years. In women younger than 40 years, cervical cancer screening performed 3 to 36 months before the index date was not protective. Cervical screening is associated with a reduced risk for invasive cervical cancer among women older than 40 years. Cervical cancer resources should be focused on maximizing the risk reduction.

  8. HPV immunisation and increased uptake of cervical screening in Scottish women; observational study of routinely collected national data.

    Science.gov (United States)

    Palmer, T J; McFadden, M; Pollock, K G J; Kavanagh, K; Cuschieri, K; Cruickshank, M; Nicoll, S; Robertson, C

    2016-03-01

    To measure the uptake of first invitation to cervical screening by vaccine status in a population-based cohort offered HPV immunisation in a national catch-up campaign. A retrospective observational study of routinely collected data from the Scottish Cervical Screening Programme. Data were extracted and linked from the Scottish Cervical Call Recall System, the Scottish Population Register and the Scottish Index of Multiple Deprivation. Records from 201 023 women born between 1 January 1988 and 30 September 1993 were assessed. Women born in or after 1990 were eligible for the national catch-up programme of HPV immunisation. Attendance for screening was within 12 months of the first invitation at age 20 years. There was a significant decline in overall attendance from the 1988 cohort to the 1993 cohort with the adjusted attendance ratio of the 1988 cohort being 1.49 times (95% CI 1.46-1.52) that of the 1993 cohort. Immunisation compensated for this decrease in uptake with unvaccinated individuals having a reduced ratio of attendance compared with those fully vaccinated (RR=0.65, 95% CI 0.64-0.65). Not taking up the opportunity for HPV immunisation was associated with an attendance for screening below the trend line for all women before the availability of HPV immunisation. HPV immunisation is not associated with the reduced attendance for screening that had been feared. Immunised women in the catch-up cohorts appear to be more motivated to attend than unimmunised women, but this may be a result of a greater awareness of health issues. These results, while reassuring, may not be reproduced in routinely immunised women. Continued monitoring of attendance for the first smear and subsequent routine smears is needed.

  9. Cervical and Breast Cancer Screening After CARES: A Community Program for Immigrant and Marginalized Women.

    Science.gov (United States)

    Dunn, Sheila F; Lofters, Aisha K; Ginsburg, Ophira M; Meaney, Christopher A; Ahmad, Farah; Moravac, M Catherine; Nguyen, Cam Tu Janet; Arisz, Angela M

    2017-05-01

    Marginalized populations such as immigrants and refugees are less likely to receive cancer screening. Cancer Awareness: Ready for Education and Screening (CARES), a multifaceted community-based program in Toronto, Canada, aimed to improve breast and cervical screening among marginalized women. This matched cohort study assessed the impact of CARES on cervical and mammography screening among under-screened/never screened (UNS) attendees. Provincial administrative data collected from 1998 to 2014 and provided in 2015 were used to match CARES participants who were age eligible for screening to three controls matched for age, geography, and pre-education screening status. Dates of post-education Pap and mammography screening up to June 30, 2014 were determined. Analysis in 2016 compared screening uptake and time to screening for UNS participants and controls. From May 15, 2012 to October 31, 2013, a total of 1,993 women attended 145 educational sessions provided in 20 languages. Thirty-five percent (118/331) and 48% (99/206) of CARES participants who were age eligible for Pap and mammography, respectively, were UNS on the education date. Subsequently, 26% and 36% had Pap and mammography, respectively, versus 9% and 14% of UNS controls. ORs for screening within 8 months of follow-up among UNS CARES participants versus their matched controls were 5.1 (95% CI=2.4, 10.9) for Pap and 4.2 (95%=CI 2.3, 7.8) for mammography. Hazard ratios for Pap and mammography were 3.6 (95% CI=2.1, 6.1) and 3.2 (95% CI=2.0, 5.3), respectively. CARES' multifaceted intervention was successful in increasing Pap and mammography screening in this multiethnic under-screened population. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  10. Correlates of women’s intentions to be screened for human papillomavirus for cervical cancer screening with an extended interval

    Directory of Open Access Journals (Sweden)

    Gina S. Ogilvie

    2016-03-01

    Full Text Available Abstract Background High-risk HPV DNA testing has been proposed as a primary tool for cervical cancer screening (HPV-CCS as an alternative to the Papanicolaou cytology- method. This study describes factors associated with women’s intentions to attend cervical cancer screening if high-risk HPV DNA testing (HPV-CCS was implemented as a primary screening tool, and if screening were conducted every 4 years starting after age 25. Methods This online survey was designed using the Theory of Planned Behaviour to assess factors that impact women’s intentions to attend HPV-CCS among women aged 25–69 upon exit of the HPV FOCAL trial. Univariate and regression analyses were performed to compare the demographic, sexual history, and smoking characteristics between women willing and unwilling to screen, and scales for intention to attend HPV-CCS. A qualitative analysis was performed by compiling and coding the comments section of the survey. Results Of the 981 women who completed the survey in full, only 51.4 % responded that they intended to attend HPV-CCS with a delayed start age and extended screening interval. Women who intended to screen were more likely to have higher education (AOR 0.59, 95 % CI [0.37, 0.93], while both positive attitudes (AOR 1.26, 95 % CI [1.23, 1.30] and perceived behavior control (AOR 1.06, 95 % CI [1.02, 1.10] were significant predictors of intention to screen. Among women who provided comments in the survey, a large number of women expressed fears about not being checked more than every 4 years, but 12 % stated that these fears may be alleviated by having more information. Conclusions Acceptability of increased screening intervals and starting age could be improved through enhanced education of benefits. Program planners should consider measures to assess and improve women’s knowledge, attitudes and beliefs prior to the implementation of new screening programs to avoid unintended consequences.

  11. Qualitative study of barriers to cervical cancer screening among Nigerian women

    National Research Council Canada - National Science Library

    Isa Modibbo, Fatima; Dareng, Eileen; Bamisaye, Patience; Jedy-Agba, Elima; Adewole, Ayodele; Oyeneyin, Lawal; Olaniyan, Olayinka; Adebamowo, Clement

    2016-01-01

    To explore the barriers to cervical cancer screening, focusing on religious and cultural factors, in order to inform group-specific interventions that may improve uptake of cervical cancer screening programmes...

  12. The psychological profile of women attending breast-screening tests.

    Science.gov (United States)

    Kreitler, S; Chaitchik, S; Kreitler, H

    1990-01-01

    Though the benefits of early detection of breast cancer are generally known, only few women attend breast-screening examinations. The study was designed to gain insight into the problem by exploring the psychological profile of clinic attenders. In order to find out whether there is such a profile, 210 self-referred women were compared with 210 nonattending women, from the same working and social environments, matched in age, education and occupational level. All subjects were administered 10 tests in 7 domains. The tests were administered as part of a health survey. The results showed that clinic attenders scored higher on negative emotions and total emotions and lower on positive emotions; higher on repression; lower on daydreams; lower on range of self-concept, references to others and negative self-references but higher on positive self-references; scored higher on self-references describing oneself in a functional and in a passive way and scored lower on those describing oneself in terms of one's attitudes, body and appearance; scored lower on neuroticism; scored lower on different somatic complaints and health orientation but higher in alexithymia. No differences were found in authoritarianism, locus of control and self-complexity. Conclusions are that there is a psychological profile of clinic attenders, that it is focused on dysphoric emotions, psychological disease promotion and defensiveness and that it includes characteristics of the construct that is sometimes called the cancer-prone personality.

  13. Does lowering the screening age for cervical cancer in The Netherlands make sense?

    NARCIS (Netherlands)

    van der Aa, Maaike A.; de Kok, Inge M.C.M.; Siesling, Sabine; van Ballegooijen, Marjolein; Coebergh, Jan Willem W.

    2008-01-01

    Recommendations for the age to initiate cervical cancer screening should be directed towards maximum detection of early cervical cancer. However, the screening programme should do more good than harm. The aim of this analysis was to determine whether the target age for cervical cancer screening

  14. Assessment of psychological barriers to cervical cancer screening ...

    African Journals Online (AJOL)

    EB

    Assessment of psychological barriers to cervical cancer screening among women in Kumasi, Ghana using a mixed methods approach. *Williams M1, Kuffour G2, Ekuadzi E3, Yeboah M4, ElDuah M1, Tuffour P2. 1. Department of Health Behavior, University of Alabama at Birmingham, USA. 2. Department of Pharmaceutics ...

  15. Cost analysis of different cervical cancer screening strategies in Mexico

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    Christyn M Beal

    2014-09-01

    Full Text Available Objective. To compare the costs and number of undetected cases of four cervical cancer screening strategies (CCSS in Mexico. Materials and methods. We estimated the costs and outcomes of the following CCSS: a conventional Papanicolaou smear (Pap alone; b high-risk human papilloma virus testing (HR-HPV as primary screening with Pap as reflex triage; c HR-HPV as primary screening with HPV-16/18 typing, liquid-based cytology (LBC and immunostaining for p16/Ki67 testing as reflex triage, and d co-testing with HR-HPV and LBC with HPV-16/18 typing and immunostaining for p16/Ki67 as reflex triage. The outcome of interest was high-grade cervical lesions or cervical cancer. Results. HR-HPV testing, HPV typing, LBC testing and immunostaining is the best alternative because it is the least expensive option with an acceptable number of missed cases. Conclusions. The opportunity costs of a poor quality CCSS is many false negatives. Combining multiple tests may be a more cost-effective way to screen for cervical cancer in Mexico

  16. Knowledge of Cervical Cancer and its Screening Amongst Female ...

    African Journals Online (AJOL)

    Background: Cervical cancer is an important women's reproductive health problem, especially in developing countries. Efforts towards its prevention worldwide have focused on screening women at risk of disease using Pap smears and treating pre-cancerous lesions. A good knowledge and understanding of the level of ...

  17. Cervical Cancer Screening in Enugu, Nigeria. | Chukwuali | Tropical ...

    African Journals Online (AJOL)

    Context: Though preventable by early detection and treatment of the pre-invasive stage, carcinoma of the cervix remains the commonest gynaecological malignancy in Nigeria and a leading cause of death among women. The preventive role of cervical cancer screening is directly related to the proportion of the population ...

  18. Clinic visits and cervical cancer screening in Accra | Adanu | Ghana ...

    African Journals Online (AJOL)

    Methods: A representative sample of women in Accra, Ghana was interviewed and the clinical and demographic factors influencing cervical cancer screening was ... high socioeconomic status and a history over the past month of postmenopausal or intermenstrual bleeding significantly increased the odds of ever having a ...

  19. Cervical cytology screening - knowledge, attitudes and practice in a ...

    African Journals Online (AJOL)

    urban settlements with regard to screening for cervical cancer. Method: A community·based questionnaire survey of 165 women living in a defined area of Khayelitsha, a periurban settlement on the outskirts of Cape Town. Results: Two hundred ...

  20. Knowledge and attitude towards cervical cancer screening among ...

    African Journals Online (AJOL)

    McRoy

    likely they are to make a screening visit and to adhere to recommended follow-up for an abnormal result.[11,12]. Early detection is important in the management of cervical cancer, however most of the women in developing nations present with advanced disease when nothing can be done for them.[13] Several reasons for.

  1. Missed opportunities for cervical screening at Worcester Hospital ...

    African Journals Online (AJOL)

    Worcester Community Health Centre (CHC) for patients 30 years and older who presented at these centres for reasons unrelated to cervical cancer screening. Methods: A descriptive cross-sectional survey was conducted using a questionnaire that was administered through personal interviewing. A sample of 235 patients ...

  2. Adherence barriers and facilitators for cervical screening amongst currently disadvantaged women in the greater Cape Town region of South Africa

    Science.gov (United States)

    De Abreu, Chantelle; Horsfall, Hannah

    2013-01-01

    Abstract Background In South Africa cervical cancer is the second most commonly occurring cancer amongst women, and black African women have the highest risk of developing this disease. Unfortunately, the majority of South African women do not adhere to recommended regular cervical screening. Objectives The purpose of this research was to explore the perceptions, experiences and knowledge regarding cervical screening of disadvantaged women in two informal settlements in South African urban areas. Method The Health Belief Model (HBM) provided a theoretical framework for this study. Four focus groups (n = 21) were conducted, using questions derived from the HBM, and thematic analysis was used to analyse the data. The ages of the women who participated ranged from 21 to 53 years. Results The analysis revealed lack of knowledge about screening as a key structural barrier to treatment. Other structural barriers were: time, age at which free screening is available, and health education. The psychosocial barriers that were identified included: fear of the screening procedure and of the stigmatisation in attending screening. The presence of physical symptoms, the perception that screening provides symptom relief, HIV status, and the desire to know one's physical health status were identified as facilitators of cervical screening adherence. Conclusion This knowledge has the potential to inform healthcare policy and services in South Africa. As globalisation persists and individuals continue to immigrate or seek refugee status in foreign countries, increased understanding and knowledge is required for successful acculturation and integration. Developed countries may therefore also benefit from research findings in developing countries.

  3. [Cervical cancer screening: Is active recruitment worth the effort?].

    Science.gov (United States)

    Morales Martínez, Ángeles; Blanco Rodríguez, Lorena; Morales Martínez, Cristina; Tejuca Somoano, Sonia

    2015-12-01

    To determine the percentage of women who have had a Pap smear in the last 5 years, and the place where it was carried out. To detect cytological abnormalities and precursors of cervical cancer in un-screened or inadequately screened women and the prevalence of HPV-positive determinations. Cross sectional study. Natahoyo Health Centre, Gijón (Spain). Women aged 40-50 years living in the area and assigned to the Health Centre. The information was collected from databases, telephone and home surveys. There was active recruitment of unscreened women or inadequately screened in Primary Care as well as offering to perform cytology and HPV determination. Of the 1420 women aged 40 to 50 years, 1236 (87%) had cytology in the last 5 years, and 184 women (13%) had no screening or it was inadequate. Of these 184 women, 108 (58.7%) agreed to have cytology and HPV test performed. No high-grade cervical dysplasia was diagnosed. The prevalence of HPV-positive was 8.3%. In our population there is a high coverage of opportunistic screening for cervical cancer. The active recruitment of women who were not in the screening program was not useful. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  4. Two distinct groups of non-attenders in an organized mammography screening program

    DEFF Research Database (Denmark)

    Aro, A R; de Koning, H J; Absetz, P

    2001-01-01

    OBJECTIVE: To find out reasons for non-attendance and to study subgroup differences of the non-attenders in an organized mammography screening program. DESIGN: Prospective for background and psychosocial factors, retrospective for reasons of non-attendance. SETTING: Finnish screening based...... on personal first round invitations, with 89% attendance rate. PARTICIPANTS: Four hundred thirty six women with both pre-screening response to socioeconomic and psychosocial measures, and post-screening response reporting reasons of non-attendance. MAIN RESULTS: Most common single reason for non......-attendance was previous recent mammogram (53%), but also reasons related to practical obstacles, worry and fear, knowledge and attitudes, and organization of screening were mentioned. Two distinct groups of non-attenders were found based on the reasons for non-attendance. Those who did not attend because a mammogram...

  5. [Coverage of cervical cancer screening in Catalonia, Spain (2008-2011)].

    Science.gov (United States)

    Rodríguez-Salés, Vanesa; Roura, Esther; Ibáñez, Raquel; Peris, Mercè; Bosch, F Xavier; Coma E, Ermengol; Silvia de Sanjosé

    2014-01-01

    To estimate cervical cytology coverage for the period 2008-2011 by age groups and health regions from data recorded in the medical records of women attending centers within the Catalan national health system. The data used to estimate coverage were obtained from the primary care information system. This information was anonymous and included age, center, date, and the results of cytological smears for a total of 2,292,564 women aged 15 years or more. A total of 758,690 smears were performed in 595,868 women. Among women aged 25-65 years, the estimated coverage was 32.4% of the assigned population and was 40.8% in the population attended. Geographical variation was observed, with higher coverage among health regions closer to Barcelona. Abnormal Pap smears increased slightly from 2008 to 2011 (from 3% to 3.5%, respectively, p <0.001). In women with a negative first smear, the mean interval until the second smear was 2.4 years, but only 50% of women with a negative first smear in 2008 attended a second round during the study period. Cervical screening coverage in the National Health Service of Catalonia includes one in three women. Second round participation was poor. Existing computer systems in primary care centers can ensure monitoring of population-based screening programs for cervical cancer. These systems could be used to plan an organized screening program to ensure wider coverage and better follow-up. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  6. Teenage cervical screening in a high risk American population

    Directory of Open Access Journals (Sweden)

    Songlin Zhang

    2011-01-01

    Full Text Available Background: The new 2009 ACOG guideline for cervical cytology screening changed the starting age to 21 years regardless of the age of onset of sexual intercourse. However, many recent studies have shown a dramatic increase in the incidence of cervical epithelial abnormalities among adolescents within the past two decades. Materials and Methods: For this study, the reports of 156,342 cervical cytology were available of which 12,226 (7.8% were from teenagers. A total of 192 teenagers with high grade intraepithelial lesion (HSIL cervical cytology were identified. The ages ranged from 13 to 19 years with a mean of 17.7 years and a median of 18 years. Among them, 31.3% were pregnant, 12.0% were postpartum, and 13.5% were on oral contraceptive. Ninety-eight had prior cervical cytology. Results: The teenagers had statistically significant higher detection rates of overall abnormal cervical cytology (23.6% vs. 6.6%, P = 0, with 15.4% vs. 3.2% (P = 0 of low grade intraepithelial lesion (LSIL and 1.8% vs. 1.0% (P = 2.56 Χ 10 -13 of HSIL compared to women ≥20 years. The teenage group had the highest abnormal cytology among all age groups. The LSIL/HSIL ratio was 8.5:1 for teenagers and 3.1:1 for women ≥20 years. A total of 131 teenagers had cervical biopsies within 12 months of the HSIL cytology, with diagnoses of 39 CIN 3, 1 VAIN 3, 15 CIN 2, 62 CIN 1, and 14 had a negative histology (CIN 0. Only in 19 of these 39 women, the CIN 2/3 lesion proved to be persistent. Conclusion: We conclude that cytology screening of high risk teenagers is effective in detecting CIN 2/3 lesions. Moreover, treatment and careful follow-up can be realized.

  7. Cervical cancer screening by visual inspection in Côte d'Ivoire, operational and clinical aspects according to HIV status

    Directory of Open Access Journals (Sweden)

    Horo Apollinaire

    2012-03-01

    Full Text Available Abstract Background Cervical cancer screening is not yet standard of care of women attending HIV care clinics in Africa and presents operational challenges that need to be addressed. Methods A cervical cancer screening program based on visual inspection methods was conducted in clinics providing antiretroviral treatment (ART in Abidjan, Côte d'Ivoire. An itinerant team of midwives was in charge of proposing cervical cancer screening to all HIV-positive women enrolled in ART clinics as well as to HIV-negative women who were attending the Abidjan national blood donor clinic. Positively screened women were systematically referred to a colposcopic examination. A phone-based tracking procedure was implemented to reach positively screened women who did not attend the medical consultation. The association between HIV status and cervical cancer screening outcomes was estimated using a multivariate logistic model. Results The frequency of positive visual inspection was 9.0% (95% CI 8.0-10.0 in the 2,998 HIV-positive women and 3.9% (95% CI 2.7-5.1 in the 1,047 HIV-negative ones (p -4. In multivariate analysis, HIV infection was associated with a higher risk of positive visual inspection [OR = 2.28 (95% CI 1.61-3.23] as well as more extensive lesions involving the endocervical canal [OR = 2.42 (95% CI 1.15-5.08]. The use of a phone-based tracking procedure enabled a significant reduction of women not attending medical consultation after initial positive screening from 36.5% to 19.8% (p -4. Conclusion The higher frequency of positive visual inspection among HIV-positive women supports the need to extend cervical cancer screening program to all HIV clinics in West Africa. Women loss to follow-up after being positively screened is a major concern in cervical screening programs but yet, partly amenable to a phone tracking procedure.

  8. Awareness, perception and factors affecting utilization of cervical cancer screening services among women in Ibadan, Nigeria: a qualitative study

    Directory of Open Access Journals (Sweden)

    Ndikom Chizoma

    2012-08-01

    Full Text Available Abstract Background Over the years awareness and uptake of cervical cancer screening services has remained poor in developing countries. Problems associated with cervical cancer incidence include late reporting, ignorance and cultural issues relating to cervical cancer screening. This study sought to explore the awareness, perception and utilization of cervical cancer screening among women in Ibadan as well as factors that influence utilization. Method This is a qualitative study that utilized Eight Focus Group Discussions to collect information from women in selected health facilities in Ibadan, South West, Nigeria. The 82 participants were purposely recruited from women attending Antenatal clinics in 4 secondary and 4 primary health care facilities after approval was received from the Institutional Review Board in charge of the facilities. The focus group discussions were tape recorded and transcribed verbatim. The transcripts were analyzed into themes. Findings The study provided qualitative information on the awareness, perception of the utilization of cervical cancer screening services among women in Ibadan. Participants were mainly married women (92.7%, mean age =27.6, SD =4.5, mainly traders (39% and from Yoruba ethnic backgrounds (87.8% and had secondary education (39%. The respondents reported not being aware of cervical cancer and were not utilizing the services. Though they did not know what cervical cancer screening entailed or the screening methods, they still believed that it is important since like for other diseases will help in early detection and treatment. The participants were eager to get more information from nurses on cervical cancer about cervical cancer screening. The major factors identified by the women that influence screening utilization were ignorance, Illiteracy, belief in not being at risk, having many contending issues, nonchalant attitude to their health, financial constraint and fear of having a positive result

  9. Women's intention to screen and willingness to vaccinate their daughters against cervical cancer - a cross sectional study in eastern Uganda.

    Science.gov (United States)

    Ndejjo, Rawlance; Mukama, Trasias; Musinguzi, Geofrey; Halage, Abdullah Ali; Ssempebwa, John C; Musoke, David

    2017-03-14

    The World Health Organization recommends cervical cancer screening and vaccination programmes as measures to combat cervical cancer. The uptake of these measures remains low in Uganda, most especially in rural areas. An understanding of the factors that influence women's decision to attend screening, and willingness to have their daughters vaccinated against cervical cancer is essential for any attempts to increase uptake of these services. This study assessed the factors associated with intention to screen for cervical cancer among women in eastern Uganda, and willingness to have their daughters vaccinated against the disease. This cross sectional study involved 900 females aged 25 to 49 years in Bugiri and Mayuge districts in eastern Uganda. Data were collected using a pretested semi-structured questionnaire, entered in Epidata version 3.02 and analysed in STATA version 12.0. Unadjusted and adjusted prevalence ratios (PR) were computed using a generalized linear model with Poisson family, and a log link with robust standard errors. Majority 819 (91.0%) of respondents stated that they intended to go for cervical cancer screening in the subsequent six months. Among them, 603 (73.6%) wanted to know their status, 256 (31.3%) thought it was important, 202 (24.7%) wanted to reduce their chances of getting the disease, and 20 (2.4%) had been told to do so by a health worker. Majority 813 (90.4%) of respondents were willing to vaccinate their daughters against cervical cancer. Higher income (adjusted PR = 1.11, 95% CI: 1.03-1.20), cervical cancer screening status (adjusted PR = 0.81, 95% CI: 0.67-0.99) and knowledge of at least one test for cervical cancer (adjusted PR = 0.92, 95% CI: 0.85-0.98) were significantly associated with intention to screen for cervical cancer. No socio-demographic characteristic was associated with willingness to vaccinate daughters among women. There is a very high intention to screen and willingness to vaccinate daughters against

  10. Cervical cancer screening in a sexually transmitted disease clinic: screening adoption experiences from a midwestern clinic.

    Science.gov (United States)

    Meyerson, Beth E; Sayegh, M Aaron; Davis, Alissa; Arno, Janet N; Zimet, Gregory D; LeMonte, Ann M; Williams, James A; Barclay, Lynn; Van Der Pol, Barbara

    2015-04-01

    We examined whether a sexually transmitted disease (STD) clinic could reach women who had not received a Papanicolau (Pap) test in the past 3 years. We also explored staff attitudes and implementation of cervical cancer screening. Women (n = 123) aged 30 to 50 years were offered cervical cancer screening in an Indiana STD clinic. We measured effectiveness by the patients' self-reported last Pap test. We explored adoption of screening through focus groups with 34 staff members by documenting their attitudes about cervical cancer screening and screening strategy adaptation. We also documented recruitment and screening implementation. Almost half (47.9%) of participants reported a last Pap test 3 or more years previously; 30% had reported a last Pap more than 5 years ago, and 11.4% had a high-risk test outcome that required referral to colposcopy. Staff supported screening because of mission alignment and perceived patient benefit. Screening adaptations included eligibility, results provision, and follow-up. Cervical cancer screening was possible and potentially beneficial in STD clinics. Future effectiveness-implementation studies should expand to include all female patients, and should examine the degree to which adaptation of selected adoption frameworks is feasible.

  11. Predictors of non-participation in cervical screening in Denmark

    DEFF Research Database (Denmark)

    Kristensson, Jenny Hansen; Sander, Bente Braad; von Euler-Chelpin, My

    2014-01-01

    screening compliance among women with primary school education only, and limited or no use of primary health care services in general could potentially diminish the current social inequalities in cervical cancer incidence, and thus decrease the overall high incidence of this disease in Denmark.......PURPOSE: The aims of this study were to identify demographic and socio-economic predictors of non-participation in cervical screening in Denmark, and to evaluate the influence of health care use on screening participation. METHODS: A population based register study was undertaken using data from...... the Central Population Register, the national Patobank, and Statistics Denmark. The study included women aged 25-54 years on 1st of January 2002, living in Denmark during the next 5 years, and without a history of total hysterectomy, N=1,052,447. Independent variables included age, civil status, nationality...

  12. Outcomes in cervical screening using various cytology technologies

    DEFF Research Database (Denmark)

    Barken, Sidsel S; Rebolj, Matejka; Lynge, Elsebeth

    2013-01-01

    Unlike for human papillomavirus screening, little is known about the possible age-dependent variation in the outcomes of cervical cytology screening. The aim of our study was to describe age-related outcomes of five cytological technologies in a population-based screening program targeting women...... aged 23-59 years. All cervical cytology from women residing in Copenhagen has been analyzed in the laboratory of the Department of Pathology, Hvidovre University Hospital. We studied five technology phases: (1) conventional cytology with manual reading, (2) conventional cytology with 50% automatically...... signed out as normal, (3) liquid-based cytology (LBC) with 50% automatically signed out as normal, (4) LBC with 25% automatically signed out as normal, and (5) LBC with 25% automatically signed out as normal and with 16 preselected areas for attention in manual reading. We calculated proportion...

  13. Cervical intraepithelial lesions in females attending Women′s Health Clinics in Alexandria, Egypt

    Directory of Open Access Journals (Sweden)

    Mona Abdel-Hadi

    2015-01-01

    Full Text Available Background: Data from Egyptian studies provide widely varying estimates on the prevalence of preinvasive cervical lesions. The aim of this study was to estimate the rate of cervical intraepithelial neoplasia (CIN   in Egyptian women living in Alexandria to clarify the need for implementing a national organized screening program and a vaccination program in our community. Materials and Methods: The study was conducted over a 6 years period and covered the different socioeconomic levels to have a representative sample for women living in Alexandria. All women included did not have any cervical disorder related complaints. Conventional Pap smears were obtained and diagnosed using the Bethesda system. Women with abnormal Pap smears were managed according to the 2006 consensus guidelines within the available facilities. Persistent abnormal cytological results were referred for colposcopic biopsy. Histological results were grouped into: Reactive changes, CIN 1, CIN 2/CIN 3 and adenocarcinoma in-situ (AIS. Results: Out of the 6173 smears included in the study 6072 (98.36% were normal and only 101 (1.63% were abnormal. After colposcopic biopsies, 0.08% had CIN 1, 0.03% had CIN 2, 3 and 0.01% had AIS. Conclusion: We concluded that cervical cancer screening programs, although life-saving for a number of women, are not a sufficiently high priority in our community. Money for national health screening programs should preferably be directed more towards recruiting women for breast cancer screening, since breast cancer accounts for about 33% of all female cancers in Egypt ranking number one, while cervical cancer ranks number 13.

  14. Appalachian women's perspectives on breast and cervical cancer screening.

    Science.gov (United States)

    Schoenberg, Nancy E; Kruger, Tina M; Bardach, Shoshana; Howell, Britteny M

    2013-01-01

    Although breast and cervical cancer screening rates have been increasing over the three past decades, many Appalachian women in the USA do not receive screening, leading to disproportionate mortality rates. The aims of this study were to: (1) better understand barriers to and facilitators of breast and cervical cancer screening among Appalachian women; and (2) identify strategies to increase cancer screening. Eight focus groups and 19 key informant interviews were conducted with 79 participants. Tape-recorded session were transcribed and content analyzed. Findings consistent with screening determinants research include: inadequate personal and community resources, attitudinal and knowledge barriers, and competing demands. Less commonly described factors include family cancer history, personal health habits, and the multiple influences of healthcare providers. Interpreting findings in terms of consumer information processing theory, healthcare providers and supports play a key role in educating and influencing the screening uptake among Appalachian Kentucky women. These findings have the potential to inform innovative and culturally consonant intervention approaches capable of increasing screening and decreasing mortality rates.

  15. Prospective study on determinants of repeat attendance and attendance patterns in breast cancer screening using the Theory of Planned Behaviour.

    NARCIS (Netherlands)

    Drossaert, Constance H.C.; Boer, Hendrik; Seydel, E.R.

    2003-01-01

    This prospective study, using the Theory of Planned Behaviour (TPB) as a theoretical framework, was carried out to identify the determinants of repeat attendance and attendance patterns in organised breast screening. A group of 2657 women filled out a baseline questionnaire, approximately 8 weeks

  16. Temporal Patterns of Cervical Cancer Screening Among Danish Women 55 Years and Older Diagnosed With Cervical Cancer

    DEFF Research Database (Denmark)

    Hammer, Anne; Hee, Lene; Blaakær, Jan

    2018-01-01

    OBJECTIVE: The aim of the study was to describe the screening history in postmenopausal women diagnosed with cervical cancer during 1990-2013 by age and screening period. MATERIALS AND METHODS: This hospital-based cohort study included women 55 years and older diagnosed with cervical cancer...... at Aarhus University Hospital, Denmark, during 1990-2013. Information on their previous history of cervical cancer screening was obtained from the Danish Pathology Databank. RESULTS: Overall, 47.0% (95% CI = 42.6-51.4) had no record of screening before their cervical cancer diagnosis. This proportion...... and in women aged 55 to 64 years. Of cases with a record of screening within 5 years, 84.6% (95% CI = 14.5-21.2) had a normal cytology result, whereas only 8.8% (95% CI = 2.9-14.7) had high-grade squamous intraepithelial lesion or worse. CONCLUSIONS: Cervical cancer in older women may partly be attributed...

  17. Cervical cancer screening coverage in a high-incidence region

    Directory of Open Access Journals (Sweden)

    Cibelli Navarro

    2015-01-01

    Full Text Available OBJECTIVE To analyze the coverage of a cervical cancer screening program in a city with a high incidence of the disease in addition to the factors associated with non-adherence to the current preventive program. METHODS A cross-sectional study based on household surveys was conducted. The sample was composed of women between 25 and 59 years of age of the city of Boa Vista, RR, Northern Brazil who were covered by the cervical cancer screening program. The cluster sampling method was used. The dependent variable was participation in a women’s health program, defined as undergoing at least one Pap smear in the 36 months prior to the interview; the explanatory variables were extracted from individual data. A generalized linear model was used. RESULTS 603 women were analyzed, with an mean age of 38.2 years (SD = 10.2. Five hundred and seventeen women underwent the screening test, and the prevalence of adherence in the last three years was up to 85.7% (95%CI 82.5;88.5. A high per capita household income and recent medical consultation were associated with the lower rate of not being tested in multivariate analysis. Disease ignorance, causes, and prevention methods were correlated with chances of non-adherence to the screening system; 20.0% of the women were reported to have undergone opportunistic and non-routine screening. CONCLUSIONS The informed level of coverage is high, exceeding the level recommended for the control of cervical cancer. The preventive program appears to be opportunistic in nature, particularly for the most vulnerable women (with low income and little information on the disease. Studies on the diagnostic quality of cervicovaginal cytology and therapeutic schedules for positive cases are necessary for understanding the barriers to the control of cervical cancer.

  18. Racial/Ethnic Disparities in Cervical Cancer Screening and Outcomes.

    Science.gov (United States)

    Musselwhite, Laura W; Oliveira, Cristina M; Kwaramba, Tendai; de Paula Pantano, Naitielle; Smith, Jennifer S; Fregnani, José Humberto; Reis, Rui M; Mauad, Edmundo; Vazquez, Fabiana de Lima; Longatto-Filho, Adhemar

    2016-01-01

    Invasive cervical cancer disproportionately affects women without sufficient access to care, with higher rates among minority groups in higher-income countries and women in low-resource regions of the world. Many elements contribute to racial/ethnic disparities in the cervical cancer continuum - from screening and diagnosis to treatment and outcome. Sociodemographic factors, access to healthcare, income and education level, and disease stage at diagnosis are closely linked to such inequities. Despite the identification of such elements, racial/ethnic disparities persist, and are widening in several minority subgroups, particularly in older women, who are ineligible for human papillomavirus (HPV) vaccination and are underscreened. Recent studies suggest that racial/ethnic differences in HPV infection exist and may also have a role in observed differences in cervical cancer. In this review, we provide an overview of the current literature on racial disparities in cervical cancer screening, incidence, treatment and outcome to inform future strategies to reduce persistent inequities. © 2016 S. Karger AG, Basel.

  19. Evaluation of Cervicography Screening for Cervical Cancer in a High Risk Population

    Science.gov (United States)

    2000-02-16

    cervicography in cervical screening. lnt J Gynecol Cancer 1993~ 3:395-398. 16. Urdaneta H. Detecci6n de patologia cervical no diagnosticada por citologia ...cervical screening. lnt J Gynecol Cancer 1993; 3:395-398. 24 Urdaneta H. Detecci6n de patologia cen,-ical no diagnosticada por citologia vaginal

  20. Barriers to adoption of recent technology in cervical screening

    Directory of Open Access Journals (Sweden)

    Jhala Darshana

    2007-01-01

    Full Text Available Abstract The Pap smear is one of the modern success stories in the field of preventive medicine. Since its introduction as a screening test, there has been a dramatic reduction in the incidence of cervical cancer. However, the search for a better screening test continues. The new technologies, including liquid-based cytology (LBC, Human Papilloma Virus (HPV testing and automated or machine-assisted screening have been introduced. However, there is continuous debate about whether society's limited resources are better spent on reaching the underserved rather than on these technologies. Another question is whether these technologies create yet another kind of disparity in delivering preventive care. For example, despite the wide use of LBC (99% of tests submitted to our laboratory are LBC, conventional Pap smears are still used to screen/follow up some women. It is not clear why some providers continue to prefer conventional smear over LBC and what are the barriers for adopting LBC in cervical cancer screening. We hypothesize the lower cost of conventional compared to LBC Pap testing, patient's lower socio-economic indices, a patient's medical history and provider's subspecialty/training all appear to play a role in the choice of using conventional Pap testing rather than LBC. Unintentionally, this choice results in repeat testing, delayed treatment and potentially higher costs than intended. The ultimate goal of this review article is to understand and explore possible barriers and disparities to adopting new technology in cancer screening.

  1. Cervical cancer screening in primary health care setting in Sudan

    DEFF Research Database (Denmark)

    Ibrahim, Ahmed; Aro, Arja R.; Rasch, Vibeke

    2012-01-01

    OBJECTIVE: To determine the feasibility of visual inspection with the use of acetic acid (VIA) as a screening method for cervical cancer, an alternative to the Pap smear used in primary health care setting in Sudan, and to compare sensitivity, specificity, positive and negative predictive values......, and histological diagnosis of positive cases of both tests. METHODS: A cross-sectional study of 934 asymptomatic women living in Khartoum, Sudan, was conducted during 2009-2010. A semi-structured questionnaire containing socio-economic and reproductive variables was used to collect data from each participant...... of this study showed that VIA has higher sensitivity and lower specificity compared to Pap smear, but a combination of both tests has greater sensitivity and specificity than each test independently. It indicates that VIA is useful for screening of cervical cancer in the primary health care setting in Sudan...

  2. Two cytological methods for screening for cervical cancer

    DEFF Research Database (Denmark)

    Kirschner, B.; Simonsen, K.; Junge, J.

    2008-01-01

    -based cytology. MATERIALS AND METHODS: In 2002, the Department of Pathology, Hvidovre Hospital changed over from the conventional Papanicolaou smear screening method to SurePath liquid-based cytology. This article is based on a retrospective comparison on data from the population screening programme for cervical...... cancer in the Municipality of Copenhagen. RESULTS: The number of tests with the diagnosis of "normal cells" decreased 1% after the conversion to liquid-based cytology, whilst the number of tests with "atypical cells" and "cells suspicious for malignancy" increased by 64.3% and 41.2% respectively...... of cervical precancerous lesions with liquid-based cytology. Follow-up histology showed no increase of false positive tests, whilst the share of tests which were "unsatisfactory for evaluation" decreased significantly. Overall, the liquid-based technique would seem to have several advantages compared...

  3. Risk stratification in cervical cancer screening by complete screening history: Applying bioinformatics to a general screening population.

    Science.gov (United States)

    Baltzer, Nicholas; Sundström, Karin; Nygård, Jan F; Dillner, Joakim; Komorowski, Jan

    2017-07-01

    Women screened for cervical cancer in Sweden are currently treated under a one-size-fits-all programme, which has been successful in reducing the incidence of cervical cancer but does not use all of the participants' available medical information. This study aimed to use women's complete cervical screening histories to identify diagnostic patterns that may indicate an increased risk of developing cervical cancer. A nationwide case-control study was performed where cervical cancer screening data from 125,476 women with a maximum follow-up of 10 years were evaluated for patterns of SNOMED diagnoses. The cancer development risk was estimated for a number of different screening history patterns and expressed as Odds Ratios (OR), with a history of 4 benign cervical tests as reference, using logistic regression. The overall performance of the model was moderate (64% accuracy, 71% area under curve) with 61-62% of the study population showing no specific patterns associated with risk. However, predictions for high-risk groups as defined by screening history patterns were highly discriminatory with ORs ranging from 8 to 36. The model for computing risk performed consistently across different screening history lengths, and several patterns predicted cancer outcomes. The results show the presence of risk-increasing and risk-decreasing factors in the screening history. Thus it is feasible to identify subgroups based on their complete screening histories. Several high-risk subgroups identified might benefit from an increased screening density. Some low-risk subgroups identified could likely have a moderately reduced screening density without additional risk. © 2017 UICC.

  4. Barriers and facilitators to cervical cancer screening among Pakistani and Somali immigrant women in Oslo: a qualitative study

    Directory of Open Access Journals (Sweden)

    Gele AA

    2017-07-01

    Full Text Available Abdi A Gele,1,2 Samera A Qureshi,1 Prabhjot Kour,1 Bernadette Kumar,1 Esperanza Diaz1,3 1Norwegian Center for Minority Health Research, 2Department of Health, Institute of Nursing and Health Promotion, Oslo and Akershus University College, Oslo; 3Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway Abstract: Norway has a low incidence and mortality rate of cervical cancer, which is mainly due to the high participation rate of women in cervical cancer screening. However, the attendance of cervical cancer screening was reported to be low among immigrant women. For this reason, we conducted a qualitative study to obtain better insight into perceived barriers and challenges to cervical cancer screening among Somali and Pakistani women in the Oslo region. A convenient sample of 35 (18 Pakistani, 17 Somali women were recruited for the study in collaboration with Somali and Pakistani community partners. Focus group discussions were used to explore barriers and facilitators to cervical cancer screening, whereas the Ecological Model was used as the framework for the study. The study found three levels of barriers to cervical cancer screening. The individual level included a lack of understanding of the benefits of the screening. The sociocultural level included the stigma attached to the disease and the belief that women who are unmarried are sexually inactive. The system-related level included a lack of trust toward the health care system. Based on the study results, and using a common denominator approach for the immigrant groups included, the study recommends three communication strategies with the potential to improve women’s participation in cervical cancer screening: 1 in-person communication and information material at health centers; 2 verbal communication with women through seminars and workshops to educate them about their risk of cancer and the importance of screening and 3 the initiation of better recall

  5. ACOG Recommendations and Guidelines for Cervical Cancer Screening and Management

    Centers for Disease Control (CDC) Podcasts

    2009-10-15

    Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about ACOG's recommendations for cervical cancer screening and management.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  6. Can transabdominal ultrasound be used as a screening test for short cervical length?

    Science.gov (United States)

    Friedman, Alexander M; Srinivas, Sindhu K; Parry, Samuel; Elovitz, Michal A; Wang, Eileen; Schwartz, Nadav

    2013-03-01

    Universal transvaginal cervical length screening can be associated with a significant logistical burden. We hypothesized that there is a threshold cervical length measured by transabdominal ultrasound above which risk for short transvaginal cervical length is extremely low. This prospective cohort study evaluated a consecutive series of women offered universal transvaginal cervical length screening during anatomy ultrasound. Transabdominal measurement of the cervix-obtained before and after voiding for each patient-was performed before transvaginal ultrasound. The study was powered to detect a transabdominal cervical length cutoff with 95% sensitivity (95% confidence interval, 90-99%) for transvaginal cervical length of ≤25 mm. One thousand two hundred seventeen women were included in the analysis. Prevoid transabdominal cervical length ≤36 mm detects 96% of transvaginal cervical lengths ≤25 mm with 39% specificity. A prevoid transabdominal cervical length ≤35 mm detects 100% of transvaginal cervical lengths ≤20 mm with 41% specificity. Transabdominal images of the cervix could not be obtained in 6.2% of women prevoid and 17.9% of women postvoid. Transabdominal cervical length screening successfully identifies women at very low risk for short transvaginal cervical length. Transabdominal screening may significantly reduce the burden of universal cervical length screening by allowing approximately 40% of women to avoid transvaginal ultrasound. To ensure high sensitivity of transabdominal screening, approximately 60% of patients will still require a transvaginal study. Copyright © 2013 Mosby, Inc. All rights reserved.

  7. Making sense of information about HPV in cervical screening: a qualitative study

    OpenAIRE

    Waller, J.; McCaffery, K.; Nazroo, J.; Wardle, J.

    2005-01-01

    Introducing human papillomavirus ( HPV) testing into cervical cancer screening has the potential to change the way that women understand cervical cancer, the psychological impact of abnormal screening results and the likelihood of future participation in screening. The study used in- depth interviews to examine how women make sense of information about HPV in the context of cervical cancer screening. A total of 74 women were recruited following participation in HPV testing. Women varied widel...

  8. Cervical cancer screening and adherence to follow-up among Hispanic women study protocol: a randomized controlled trial to increase the uptake of cervical cancer screening in Hispanic women.

    Science.gov (United States)

    Duggan, Catherine; Coronado, Gloria; Martinez, Javiera; Byrd, Theresa L; Carosso, Elizabeth; Lopez, Cathy; Benavides, Maria; Thompson, Beti

    2012-05-06

    In the US, Hispanic women have a higher incidence of, and mortality from, cervical cancer than non-Hispanic white women. The reason for this disparity may be attributable to both low rates of screening and poor adherence to recommended diagnostic follow-up after an abnormal Pap test. The 'Cervical Cancer Screening and Adherence to Follow-up Among Hispanic Women' study is a collaboration between a research institution and community partners made up of members from community based organizations, the Yakima Valley Farm Workers Clinic and the Breast, Cervical, and Colon Health Program of the Yakima District . The study will assess the efficacy of two culturally-appropriate, tailored educational programs designed to increase cervical cancer screening among Hispanic women, based in the Yakima Valley, Washington, US. A parallel randomized-controlled trial of 600 Hispanic women aged 21-64, who are non-compliant with Papanicolau (Pap) test screening guidelines. Participants will be randomized using block randomization to (1) a control arm (usual care); (2) a low-intensity information program, consisting of a Spanish-language video that educates women on the importance of cervical cancer screening; or (3) a high-intensity program consisting of the video plus a 'promotora' or lay-community health educator-led, home based intervention to encourage cervical cancer screening. Participants who attend cervical cancer screening, and receive a diagnosis of an abnormal Pap test will be assigned to a patient navigator who will provide support and information to promote adherence to follow-up tests, and any necessary surgery or treatment. Primary endpoint: Participants will be tracked via medical record review at community-based clinics, to identify women who have had a Pap test within 7 months of baseline assessment. Medical record reviewers will be blinded to randomization arm. Secondary endpoint: An evaluation of the patient navigator program as a method to improve adherence and

  9. Cervical cancer screening and adherence to follow-up among Hispanic women study protocol: a randomized controlled trial to increase the uptake of cervical cancer screening in Hispanic women

    Directory of Open Access Journals (Sweden)

    Duggan Catherine

    2012-05-01

    Full Text Available Abstract Background In the US, Hispanic women have a higher incidence of, and mortality from, cervical cancer than non-Hispanic white women. The reason for this disparity may be attributable to both low rates of screening and poor adherence to recommended diagnostic follow-up after an abnormal Pap test. The 'Cervical Cancer Screening and Adherence to Follow-up Among Hispanic Women' study is a collaboration between a research institution and community partners made up of members from community based organizations, the Yakima Valley Farm Workers Clinic and the Breast, Cervical, and Colon Health Program of the Yakima District . The study will assess the efficacy of two culturally-appropriate, tailored educational programs designed to increase cervical cancer screening among Hispanic women, based in the Yakima Valley, Washington, US. Methods/design A parallel randomized-controlled trial of 600 Hispanic women aged 21–64, who are non-compliant with Papanicolau (Pap test screening guidelines. Participants will be randomized using block randomization to (1 a control arm (usual care; (2 a low-intensity information program, consisting of a Spanish-language video that educates women on the importance of cervical cancer screening; or (3 a high-intensity program consisting of the video plus a ‘promotora’ or lay-community health educator-led, home based intervention to encourage cervical cancer screening. Participants who attend cervical cancer screening, and receive a diagnosis of an abnormal Pap test will be assigned to a patient navigator who will provide support and information to promote adherence to follow-up tests, and any necessary surgery or treatment. Primary endpoint: Participants will be tracked via medical record review at community-based clinics, to identify women who have had a Pap test within 7 months of baseline assessment. Medical record reviewers will be blinded to randomization arm. Secondary endpoint: An evaluation of the patient

  10. Violence against women and cervical cancer screening: a systematic review.

    Science.gov (United States)

    Leite, Franciéle Marabotti Costa; Amorim, Maria Helena Costa; Primo, Cândida Caniçali; Gigante, Denise Petrucci

    2017-08-01

    To present a systematic review of papers published on the relationship between violence against women and cervical cancer screening. Violence against women is a serious public health problem. This phenomenon can have negative effects on victims' health and affect the frequency at which they receive cervical cancer screening. A systematic literature review. This study was carried out in October 2015 with searches of the Lilacs, PubMed and Web of Science databases using the following keywords: violence, domestic violence, battered women, spouse abuse, Papanicolaou test, vaginal smears, early detection of cancer and cervix uteri. Eight papers published between 2002-2013 were included in this review, most of which were cross-sectional studies. Three studies found no association between victimisation and receiving Pap testing, and five studies reported an association. These contradictory results were due to higher or lower examination frequencies among the women who had experienced violence. The results of this study indicate that the association between violence against women and cervical cancer screening remains inconclusive, and they demonstrate the need for more detailed studies to help clarify this relationship. Professionals who aid women should be knowledgeable regarding the perception and detection of violence so that they can interrupt the cycle of aggression, which has harmful impacts on victims' health. © 2016 John Wiley & Sons Ltd.

  11. Inadequate cervical cancer screening among mid-aged Australian women who have experienced partner violence

    NARCIS (Netherlands)

    Loxton, Deborah; Powers, Jennifer; Schofield, Margot; Hussain, Rafat; Hosking, Stacey

    Objectives. Partner violence is linked to cervical cancer and other gynaecological conditions. However, results of current research into associations between partner violence and cervical cancer screening have been inconclusive. Therefore, the current research investigates the association between

  12. Cervical cancer screening, human papillomavirus vaccination practices and current infrastructure in Israel.

    Science.gov (United States)

    Schejter, Eduardo; Bornstein, Jacob; Siegler, Efraim

    2013-11-22

    The incidence rates for premalignant lesions in Jewish women in Israel are similar to those observed in Western countries, but the incidence of cervical cancer in Israel is low; this discrepancy is not yet clearly understood. Because of the low incidence of cervical cancer in Israel, it was decided to base cervical cancer prevention on opportunistic screening: every woman from the ages of 35-54 years can have a Pap test smear free of charge every 3 years. Over the last decade 12.2% of the women population had an annual Pap test. From 36 to 50% of women who attended the Clalit Health Maintenance Organization (HMO) and the Maccabi HMO, the two largest HMOs in Israel, did so. There were also discrepancies between women of different socio-economic status (SES): Israel Society of Obstetrics and Gynecology recommends continuing cytologic screening in vaccinated women as recommended for the general population. This article forms part of a regional report entitled "Comprehensive Control of HPV Infections and Related Diseases in Israel" Vaccine Volume 31, Supplement 8, 2013. Updates of the progress in the field are presented in a separate monograph entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012. Copyright © 2013. Published by Elsevier Ltd.

  13. [Costs of population cervical cancer screening program in Poland between 2007-2009].

    Science.gov (United States)

    Spaczyński, Marek; Karowicz-Bilinska, Agata; Kedzia, Witold; Molińska-Glura, Marta; Seroczyński, Przemysław; Januszek-Michalecka, Lucyna; Rokita, Wojciech; Nowak-Markwitz, Ewa

    2010-10-01

    Screening programs may contribute to decreasing the mortality rate in a given population and their main target, in case of cervical cancer; is to find and to cure preclinical stages of this malignancy. Regularly repeated tests in defined time intervals can diagnose the illness at its early stages but the results come with a high cost. Population program of early detection of cervical cancer has been conducted since 2007 and is run by the Central Coordinating Center and 16 regional centers. Funds for promotional, educational, monitoring and medical activities are obtained from the National Health Service. The aim of this study was to present the cost-effectiveness of the Program between 2007 and 2009. The material for the analysis was obtained from the SIMP system, where all the data about women participating in the Program are implemented. The analysis of the cervical carcinoma treatment and procedure costs was made on the basis of the National Health Service estimates. The number of new cervical carcinoma cases was calculated with the help of the newly introduced system code--C53. Between 2007 and 2009 the cost of one cytological smear was similar in all regions (about 10 PLN). The highest costs were noted in Lubuski and Swietokrzyski regions. The costs of promotional and educational activities amounted up to 4.5 million PLN. A single cervical smear test cost for one woman has increased in the analyzed years from 3.95 up to 7.34 PLN. The total cost of one woman cytological examination--medical and non-medical elements--was more than 60 PLN. In 2009, 622 new cases of cervical cancer were found thanks to the Program. The cost of one case of cervical cancer diagnosis was 15 000 PLN. The total costs of all cases of cervical cancer in 2009 was 45.5 million PLN. The situation calls for creating new and effective tools for monitoring medical, epidemiological and financial parameters of the Program. Otherwise, the estimates of the health and social impact of the Program

  14. Cervical cancer screening in Australia: modelled evaluation of the impact of changing the recommended interval from two to three years

    Directory of Open Access Journals (Sweden)

    Howard Kirsten

    2010-11-01

    Full Text Available Abstract Background The National Cervical Screening Program in Australia currently recommends that sexually active women between the ages of 18-70 years attend routine screening every 2 years. The publically funded National HPV Vaccination Program commenced in 2007, with catch-up in females aged 12-26 years conducted until 2009; and this may prompt consideration of whether the screening interval and other aspects of the organized screening program could be reviewed. The aim of the current evaluation was to assess the epidemiologic outcomes and cost implications of changing the recommended screening interval in Australia to 3 years. Methods We used a modelling approach to evaluate the effects of moving to a 3-yearly recommended screening interval. We used data from the Victorian Cervical Cytology Registry over the period 1997-2007 to model compliance with routine screening under current practice, and registry data from other countries with 3-yearly recommendations to inform assumptions about future screening behaviour under two alternative systems for screening organisation - retention of a reminder-based system (as in New Zealand, or a move to a call-and-recall system (as in England. Results A 3-yearly recommendation is predicted to be of similar effectiveness to the current 2-yearly recommendation, resulting in no substantial change to the total number of incident cervical cancer cases or cancer deaths, or to the estimated 0.68% average cumulative lifetime risk of cervical cancer in unvaccinated Australian women. However, a 3-yearly screening policy would be associated with decreases in the annual number of colposcopy and biopsy procedures performed (by 4-10% and decreases in the number of treatments for pre-invasive lesions (by 2-4%. The magnitude of the decrease in the number of diagnostic procedures and treatments would depend on the method of screening organization, with call-and-recall screening associated with the highest reductions. The

  15. A Study on Knowledge and Screening for Cervical Cancer among Women in Mangalore City

    OpenAIRE

    Harsha Kumar, HN; Tanya, Shubham

    2014-01-01

    Background: Most of the cervical cancer cases are diagnosed late leading to poor outcomes. Very few studies have explored the role of doctor and source of information for awareness of women about cervical cancer in India. Aim: Hence, this study was conducted with the objective of knowing the knowledge of women about cervical cancer, its screening, role of doctor, source of information, and reasons for not undergoing screening if the women had not undergone testing for cervical cancer. Subject...

  16. Cervical acid phosphatase detection: A guide to abnormal cells in cytology smear screening for cervical cancer

    Directory of Open Access Journals (Sweden)

    Deb Prabal

    2008-01-01

    Full Text Available Background: Cervical acid phosphatase-Papanicolaou (CAP-PAP test has recently been described for detection of acid phosphatase enzyme in abnormal squamous cells, and has been proposed as a biomarker-based technology for the screening of cervical cancer. Materials and Methods: Eighty-one consecutive cervical smears were subjected to routine Papanicolaou (Pap staining as well as CAP-PAP, which combined cytochemical staining for acid phosphatase with modified Pap stain. Statistical evaluation of its utility was examined. Results: Of 81 smears, 16 (19.75% showed the presence of mature squamous cells with acid phosphatase by CAP-PAP technique and were considered positive. Of these 16, atypical squamous cells of undetermined significance (ASCUS or above were initially diagnosed in five of the corresponding routine Pap smears. After re-evaluation with CAP-PAP, eight of the routine Pap smears were considered to have ASCUS or above. Of these eight, three were reported as low-grade squamous intraepithelial lesions and five as ASCUS on conventional Pap smears. The remaining 8/16 CAP-PAP-positive cases were negative for atypical squamous cells on the corresponding Pap smears. None of the CAP-PAP-negative smears were positive on routine Pap smear screening. Conclusions: This study highlights the efficacy of CAP-PAP in quality assurance of cervical smear screening. It is also an inexpensive method for segregating smears for subsequent re-screening. In the absence of trained cytologists in peripheral laboratories, this technique can be adopted for identifying smears that would require proper evaluation.

  17. Predictors of non-participation in cervical screening in Denmark.

    Science.gov (United States)

    Kristensson, Jenny Hansen; Sander, Bente Braad; von Euler-Chelpin, My; Lynge, Elsebeth

    2014-04-01

    The aims of this study were to identify demographic and socio-economic predictors of non-participation in cervical screening in Denmark, and to evaluate the influence of health care use on screening participation. A population based register study was undertaken using data from the Central Population Register, the national Patobank, and Statistics Denmark. The study included women aged 25-54 years on 1st of January 2002, living in Denmark during the next 5 years, and without a history of total hysterectomy, N=1,052,447. Independent variables included age, civil status, nationality, level of education, and use of health care. Associations with non-participation in screening were determined with logistic regression. Main predictors of non-participation were limited or no contact with dental services (odds ratio (OR)=2.36), general practitioners (OR=1.75), and high age (OR=1.98). Other important factors for non-participation were primary school education only (OR=1.53), not being married (OR=1.49), and foreign nationality (OR=1.32). A 2-1.5-fold difference in non-participation in cervical screening in Denmark was found across various population sub-groups. Increased screening compliance among women with primary school education only, and limited or no use of primary health care services in general could potentially diminish the current social inequalities in cervical cancer incidence, and thus decrease the overall high incidence of this disease in Denmark. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Exploring Chinese Women's Perception of Cervical Cancer Risk as It Impacts Screening Behavior: A Qualitative Study.

    Science.gov (United States)

    Gu, Can; Chen, Wei-Ti; Zhang, Qiue; Chow, Ka Ming; Wu, Jianzhen; Tao, Lijian; Chan, Carmen W H

    Chinese women rarely undergo regular cervical screening. Women's decisions about cervical screening may be influenced by their perception of the risk of cervical cancer. Therefore, understanding how women perceive the risk of cervical cancer, how personal risk factors are interpreted, and the influence of cultural issues on cervical screening behavior is important. The aim of this study is to understand cervical cancer risk perception and the role of personal risk factors as they influence screening behavior among Chinese women. An exploratory qualitative research design was used. We conducted semistructured, in-depth interviews of 27 women in Changsha, a medium-size city in Hunan province, China. Participants identified that cervical cancer had serious consequences, but they distanced themselves psychologically from the disease because they felt that "cervical cancer is a shameful and deadly disease." Although women identified some of the risk factors for the disease, they had little specific knowledge of human papillomavirus infection, its association with cervical cancer, and the importance of cervical screening. This study contributes new knowledge to the understanding of cervical screening behavior within a specific social and cultural context. Better efforts should be made to educate Chinese women on the risk of cervical cancer and emphasize that effective cancer treatments are available and that there is a good chance of survival. Nurses working with Chinese women should ensure that the information they provide is culturally sensitive, particularly by acknowledging the normative beliefs of this population group.

  19. Raman spectroscopy for screening and diagnosis of cervical cancer.

    Science.gov (United States)

    Lyng, Fiona M; Traynor, Damien; Ramos, Inês R M; Bonnier, Franck; Byrne, Hugh J

    2015-11-01

    Cervical cancer is the fourth most common cancer in women worldwide and mainly affects younger women. The mortality associated with cervical cancer can be reduced if the disease is detected at the pre-cancer stage. Current best-practice methods include cytopathology, HPV testing, and histopathology, but these methods are limited in terms of subjectivity, cost, and time. There is an unmet clinical need for new methods to aid clinicians in the early detection of cervical pre-cancer. These methods should be objective and rapid and require minimal sample preparation. Raman spectroscopy is a vibrational spectroscopic technique by which incident radiation is used to induce vibrations in the molecules of a sample and the scattered radiation may be used to characterise the sample in a rapid and non-destructive manner. Raman spectroscopy is sensitive to subtle biochemical changes occurring at the molecular level, enabling spectral variations corresponding to disease onset to be detected. Over the past 15 years, there have been numerous reports revealing the potential of Raman spectroscopy together with multivariate statistical analysis for the detection of a variety of cancers. This paper discusses the recent advances and challenges for cervical-cancer screening and diagnosis and offers some perspectives for the future.

  20. [The Nordic cervical screening programmes through 1995. Evaluation of incidence and mortality rates, targeted age groups and screening intervals.].

    Science.gov (United States)

    Sigurdsson, K

    1999-11-01

    practically non-existent after the age of 60 among correctly screened women. A strong correlation is found between increased attendance rates and the proportion of cases diagnosed with a Pap smear at stages IA and IB occult. The latter cases mainly occur among women under the Hge of 45 and start to appear less than two years after a normal smear. Well-organised screening is more effective than spontaneous screening in reducing the risk of cervical cancer. Screening should preferably start soon after age 20 with a screening interval of two to three years. The screening interval can pro-bably be extended to four years at the age of 50 and screening could stop at the age of 60 to 64 among regularly screened women.

  1. Effects of peer health education on perception and practice of screening for cervical cancer among urban residential women in south-east Nigeria: a before and after study.

    Science.gov (United States)

    Mbachu, Chinyere; Dim, Cyril; Ezeoke, Uche

    2017-06-09

    Effective female education on cervical cancer prevention has been shown to increase awareness and uptake of screening. However, sustaining increase in uptake poses a challenge to control efforts. Peer health education has been used as an effective tool for ensuring sustained behavior change. This study was undertaken to assess the effectiveness of peer health education on perception, willingness to screen and uptake of cervical cancer screening by women. A before and after intervention study was undertaken in 2 urban cities in Enugu state, Nigeria among women of reproductive age attending women's meeting in Anglican churches. Multistage sampling was used to select 300 women. Peer health education was provided once monthly for 3 consecutive sessions over a period of 3 months. Data was collected at baseline and after the intervention using pre-tested questionnaires. Descriptive statistics and tests of significance of observed differences and associations were done at p-value of perception for cervical cancer and perception of benefits of early detection through screening. Practice of screening for cervical cancer increased by 6.8% and the observed difference was statistically significant (p = 0.02). This was significantly associated with marital status, level of education, employment status and parity (p perception of benefits of early detection of cervical cancer through screening. It is also effective for increasing their practice of screening for cervical cancer.

  2. Mass Media Campaign Improves Cervical Screening across All Socio-Economic Groups

    Science.gov (United States)

    Anderson, Jenny O.; Mullins, Robyn M.; Siahpush, Mohammad; Spittal, Matthew J.; Wakefield, Melanie

    2009-01-01

    Low socio-economic status (SES) has been associated with lower cervical screening rates. Mass media is one known strategy that can increase cervical screening participation. This study sought to determine whether a mass media campaign conducted in Victoria, Australia, in 2005 was effective in encouraging women across all SES groups to screen. Data…

  3. Reaching women in the Peruvian Andes through cervical cancer screening campaigns: assessing attitudes of stakeholders and patients.

    Science.gov (United States)

    Luque, John S; Maupin, Jonathan N; Ferris, Daron G; Guevara Condorhuaman, Wendy S

    2016-01-01

    Peru is characterized by high cervical cancer incidence and mortality rates. The country also experiences significant gaps in quality cervical cancer screening coverage for the population. This descriptive mixed methods study conducted in Cusco, Peru, aimed to assess the attitudes and perceptions of medical staff, health care workers, and patients toward a cervical cancer screening program that included both clinic-based and community outreach services conducted by a nongovernmental organization clinic (CerviCusco). The study also explored patient knowledge and attitudes around cervical cancer and about the human papillomavirus (HPV) to inform patient education efforts. The study employed structured interviews with key informants (n=16) primarily from CerviCusco, which provides cervical cancer prevention, screening, diagnosis and treatment services, and surveys with a sample of patients (n=30) receiving services at the clinic and at screening campaigns. The majority of key informant medical staff participants felt that the general public had a very negative view of government health services. One theme running throughout the interviews was the perception that the general population lacked a culture of preventive health care and would wait until symptoms were severe before seeking treatment. Regarding services that were received by patients at CerviCusco, the participants responded that the prices were reasonable and more affordable than some private clinics. Patients attending the rural health campaigns liked that the services were free and of good quality. CerviCusco has demonstrated its capacity to provide screening outreach campaigns to populations who had not previously had access to liquid-based cytology services. The finding that patients had generally low levels of knowledge about cervical cancer and the HPV vaccine prompted the development of culturally and linguistically appropriate educational and promotional materials to improve the educational component

  4. Electrical Bioimpedance Analysis: A New Method in Cervical Cancer Screening

    Directory of Open Access Journals (Sweden)

    Lopamudra Das

    2015-01-01

    Full Text Available Cervical cancer is the second most common female cancer worldwide and a disease of concern due to its high rate of incidence of about 500,000 women annually and is responsible for about 280,000 deaths in a year. The mortality and morbidity of cervical cancer are reduced through mass screening via Pap smear, but this technique suffers from very high false negativity of around 30% to 40% and hence the sensitivity of this technique is not more than 60%. Electrical bioimpedance study employing cytosensors over a frequency range offers instantaneous and quantitative means to monitor cellular events and is an upcoming technique in real time to classify cells as normal and abnormal ones. This technology is exploited for label-free detection of diseases by identifying and measuring nonbiological parameters of the cell which may carry the disease signature.

  5. Inequalities in Pap smear screening for cervical cancer in Brazil.

    Science.gov (United States)

    Martínez-Mesa, Jeovany; Werutsky, Gustavo; Campani, Raquel Barth; Wehrmeister, Fernando César; Barrios, Carlos Henrique

    2013-10-01

    To examine the risk factors associated with never being screened for cervical cancer (CC) in Brazil. Using the National Household Sample Survey 2008 (PNAD), we analyzed data from 102,108 Brazilian women ages 25-64years. The patients were analyzed as having been or never having been screened with a Pap smear (Yes/No). Age-adjusted prevalence of never-screening was analyzed using a Chi-squared test. Crude and adjusted models using Poisson regression were performed. The prevalence of never-screened women for CC was 12.9%, 11.5% and 22.2% in Brazil in general, urban and rural areas, respectively. The Brazilian region with the highest prevalence of never-screening was the North (17.4%, 14.7% and 27.3% in general, urban and rural areas, respectively). The factors associated with a higher risk for never being screened were the following: poverty, younger age, lower educational level, non-white skin color, a greater number of children, no supplemental health insurance and not having visited a doctor in the past 12months. Socioeconomic and demographic conditions lead to inequalities in access to Pap smear screening in Brazil. Public health policy addressing these risk groups is necessary. © 2013.

  6. Analysis of the determinants of low cervical cancer screening uptake among Nigerian women

    Directory of Open Access Journals (Sweden)

    Humphrey Nwobodo

    2016-08-01

    Full Text Available Cervical cancer causes an estimated 266,000 deaths globally, 85% of which occurs in developing countries. It is a preventable disease, if detected and treated early via screen and treat, yet its burden is still huge in Nigeria. In 2012, 21.8% cases and 20.3% deaths due to cervical cancer were recorded in Nigeria. This review, therefore, aims at understanding the determinants of low cervical cancer screening in Nigeria in order to contribute in reducing the burden of the disease. Literature were obtained from Global Health, Popline and PubMed databases; WHO and other relevant websites using Eldis search engine; and from libraries in the University of Leeds and WHO in Geneva. Conceptual framework for analyzing the determinants of cervical cancer screening uptake among Nigerian women was formed by inserting service delivery component of the WHO health system framework into a modified Health Belief Model. Wrong perception of cervical cancer and cervical cancer screening due to low level of knowledge about the disease and inadequate cervical cancer preventive were identified as the major determinants of low cervical cancer screening uptake in Nigeria. Among women, belief in being at risk and/or severity of cervical cancer was low just as belief on benefits of cervical cancer screening, unlike high belief in barriers to screening. Support from the community and screening skills among health-workers were inadequate. Improving uptake of cervical cancer screening will reduce the burden of the disease. Therefore, researchers and other stakeholders interested in prevention of cervical cancer should carry-out studies to identify interventions that could address the key determinants of low cervical cancer screening among Nigerian women.

  7. Screening of cervical cancer by VIA among women in Rajshahi Medical College Hospital

    Directory of Open Access Journals (Sweden)

    N Yusuf

    2012-02-01

    Full Text Available Objective: To find out different grades of cervical intraepithelial lesions of cervix with visual inspection of cervix with acetic acid (VIA. Methods: VIA was carried out in 540 eligible women attending Gynaecology Outpatient Department for gynecological problems. The women underwent a complete clinical evaluation. All screened women (540 were evaluated by colposcopy and biopsies which were taken from different quadrants of the cervix. The final diagnosis was based on histology, which allowed direct estimation of sensitivity, specificity, and predictive values of VIA and colposcopy. Those with abnormal lesions diagnosed by histology were considered as true positive. Results: Out of 540 patients screened, 212 (39.27% were VIA positive. More patients with cervical lesions were detected by VIA than colposcopy. There were 63 (11.67% women with histologic cervical intraepithelial neoplasia (CIN I, which was found in 150 (27.78% by VIA and 138 (25.56% by colposcopy. VIA and colposcopy yielded high grade CIN II in the same number of patients. Biopsy proven cancer was found in 24 (4.45% which was detected in 18 (3.33% by VIA and colposcopy. Sensitivity and specificity of VIA were 68.50% and 70.45% respectively. Positive predictive value was 41.04% and negative predictive value was 90.85%. Conclusions: VIA can differentiate a normal cervix from a precancerous cervix with reasonable accuracy. The sensitivity and specificity of VIA are comparable to the other studies. So VIA may reduce the cervical intraepithelial lesions both in urban and rural areas.

  8. Breast and cervical cancer screening behaviours among colorectal cancer survivors in Nova Scotia

    Science.gov (United States)

    Corkum, M.; Urquhart, R.; Kephart, G.; Hayden, J.A.; Porter, G.

    2014-01-01

    Purpose We analyzed patterns and factors associated with receipt of breast and cervical cancer screening in a cohort of colorectal cancer survivors. Methods Individuals diagnosed with colorectal cancer in Nova Scotia between January 2001 and December 2005 were eligible for inclusion. Receipt of breast and cervical cancer screening was determined using administrative data. General-population age restrictions were used in the analysis (breast: 40–69 years; cervical: 21–75 years). Kaplan–Meier and Cox proportional hazards models were used to assess time to first screen. Results Of 318 and 443 colorectal cancer survivors eligible for the breast and cervical cancer screening analysis respectively, 30.1% [95% confidence interval (ci): 21.2% to 39.0%] never received screening mammography, and 47.9% (95% ci: 37.8% to 58.0%) never received cervical cancer screening during the study period. Receipt of screening before the colorectal cancer diagnosis was strongly associated with receipt of screening after diagnosis (hazard ratio for breast cancer screening: 4.71; 95% ci: 3.42 to 6.51; hazard ratio for cervical cancer screening: 6.83; 95% ci: 4.58 to 10.16). Conclusions Many colorectal cancer survivors within general-population screening age recommendations did not receive breast and cervical cancer screening. Future research should focus on survivors who meet age recommendations for population-based cancer screening. PMID:25302037

  9. Gardnerella infection as distinguished from cervical dysbacteriosis: the advantageous spin-off of cervical screening.

    Science.gov (United States)

    Klomp, Johanna M; Ouwerkerk-Noordam, Elisabeth; Boon, Mathilde E; van Haaften, Maarten; Heintz, A Peter M

    2009-01-01

    To evaluate cytologic diagnoses of dysbacteriosis and Gardnerella infection and to obtain insight into the diagnostic problems of Gardnerella. One hundred randomly selected samples of each of 3 diagnostic series were rescreened by 2 pathologists, resulting in 2 rescreening diagnoses and a consensus diagnosis. A smear was considered unequivocal when the original O code and the O code of the consensus diagnoses were equal and discordant when the flora diagnoses of the 2 pathologists differed. Discordance was highest in the dysbacteriotic series (20%) and lowest in the healthy group (4%). Unequivocal diagnoses were established in 65% of the dysbacteriotic smears, 80% of the Gardnerella smears and 93% of the healthy smears. Misclassification of Gardnerella occurred in the presence of clusters of bacteria mixed with spermatozoa. Blue mountain cells in Gardnerella infection can be identified unequivocally in cervical smears. Because of the clinical importance of treating Gardnerella, such advantageous spin-offs of cervical screening should be exploited.

  10. Design and evaluation of a theory-based, culturally relevant outreach model for breast and cervical cancer screening for Latina immigrants.

    Science.gov (United States)

    White, Kari; Garces, Isabel C; Bandura, Lisa; McGuire, Allison A; Scarinci, Isabel C

    2012-01-01

    Breast and cervical cancer are common among Latinas, but screening rates among foreign-born Latinas are relatively low. In this article we describe the design and implementation of a theory-based (PEN-3) outreach program to promote breast and cervical cancer screening to Latina immigrants, and evaluate the program's effectiveness. We used data from self-administered questionnaires completed at six annual outreach events to examine the sociodemographic characteristics of attendees and evaluate whether the program reached the priority population - foreign-born Latina immigrants with limited access to health care and screening services. To evaluate the program's effectiveness in connecting women to screening, we examined the proportion and characteristics of women who scheduled and attended Pap smear and mammography appointments. Among the 782 Latinas who attended the outreach program, 60% and 83% had not had a Pap smear or mammogram, respectively, in at least a year. Overall, 80% scheduled a Pap smear and 78% scheduled a mammogram. Women without insurance, who did not know where to get screening and had not been screened in the last year were more likely to schedule appointments (P < .05). Among women who scheduled appointments, 65% attended their Pap smear and 79% attended the mammogram. We did not identify significant differences in sociodemographic characteristics associated with appointment attendance. Using a theoretical approach to outreach design and implementation, it is possible to reach a substantial number of Latina immigrants and connect them to cancer screening services.

  11. The impact of a television soap opera on the NHS Cervical Screening Programme in the North West of England.

    Science.gov (United States)

    Howe, Andy; Owen-Smith, Vicci; Richardson, Judith

    2002-12-01

    Mass media interventions can influence health care utilization but the effect of televised fictional accounts of illness upon national screening programmes is unknown. Our aim was to evaluate the impact of a Coronation Street story line, in which one of the characters died from cervical cancer, on the National Health Service (NHS) Cervical Screening Programme. The study involved a retrospective analysis of information held on cervical screening databases ('Exeter' computer systems) of the nine Health Authorities constituting the Lancashire and Greater Manchester zones of the North West Region of the NHS. The number of cervical smears performed in the community, in women over 25 years of age, whose previous smear was normal and who were on routine recall, during a 6 month period that included the story line, was compared with those taken over the same period in the previous year. The proportions of smears classified by a screening interval of 'unscheduled', 'on time', 'overdue' or 'no previous smear' were compared. The number of smears performed increased from 65,714 in 2000 to 79,712 in 2001, an increase of 13,998 (21.3 percent; 95 per cent confidence interval (CI) 21.0-21.6 per cent) in the 19 weeks after the story line. The increase in the number of smears occurred in all categories of screening interval, with the largest increase seen in those attending 'on-time' (26 per cent). We have demonstrated a large impact of a soap opera story line on the cervical screening programme although the benefit to health is not clear. Further research will determine the long-term effect of the story.

  12. Patients with cervical cancer: why did screening not prevent these cases?

    NARCIS (Netherlands)

    Bie, R.P. de; Vergers-Spooren, H.C.; Massuger, L.F.A.G.; Siebers, A.G.; Salet-van der Pol, M.R.; Vedder, J.E.M.; Melchers, W.J.G.; Bulten, J.; Bekkers, R.L.M.

    2011-01-01

    OBJECTIVE: The objective of the study was to assess the screening history of women with cervical cancer and review normal cervical smears 5 years preceding the diagnosis. STUDY DESIGN: Cytological and histological results of 401 women treated for invasive cervical cancer between 1991 and 2008 at the

  13. Cervical Cancer Screening Interventions for U.S. Latinas: A Systematic Review

    Science.gov (United States)

    Corcoran, Jacqueline; Dattalo, Patrick; Crowley, Meghan

    2012-01-01

    The high cervical cancer mortality rate among Latinas compared with other ethnic groups in the United States is of major concern. Latina women are almost twice as likely to die from cervical cancer as non-Hispanic white women. To improve Latina cervical cancer screening rates, interventions have been developed and tested. This systematic review…

  14. Differences in coverage patterns in cervical cytology screening

    Science.gov (United States)

    Smith, Amy; Gale, Alastair G.; Wooding, David S.; Purdy, Kevin J.

    2003-05-01

    The visual screening of cervical smears is a complex process requiring appropriate slide coverage to detect any unusual appearances without making any omission errors. In examining a smear the observer has both to move the microscope stage appropriately to bring different slide areas into view, plus visually search the information presented within the binocular visual field. This study examined the patterns of slide coverage by different individuals when they inspected liquid based cervical smears. A binocular microscope was first adapted in order to record both the physical movement of the stage by the observer and also to access the microscope"s visual field. An image of the area of the smear under the microscope was displayed on a PC monitor and observers" eye movements were recorded as they searched this. By manually adjusting the microscope controls they also moved the stage and all stage movements and focussing were also recorded. The behaviour was examined of both novices and an expert screener as they searched a number of test cervical smears. It was found that novices adopted a regular examination pattern, which maximized slide coverage, albeit slowly. In contrast, the experienced screener covered the slides faster and more effectively ensuring more overlap between microscope fields.

  15. Adherence barriers and facilitators for cervical screening amongst currently disadvantaged women in the greater Cape Town region of South Africa

    Directory of Open Access Journals (Sweden)

    Chantelle De Abreu

    2013-01-01

    Full Text Available Background: In South Africa cervical cancer is the second most commonly occurring cancer amongst women, and black African women have the highest risk of developing this disease. Unfortunately, the majority of South African women do not adhere to recommended regular cervical screening.Objectives: The purpose of this research was to explore the perceptions, experiences and knowledge regarding cervical screening of disadvantaged women in two informal settlements in South African urban areas.Method: The Health Belief Model (HBM provided a theoretical framework for this study. Four focus groups (n = 21 were conducted, using questions derived from the HBM, and thematic analysis was used to analyse the data. The ages of the women who participated ranged from 21 to 53 years.Results: The analysis revealed lack of knowledge about screening as a key structural barrier to treatment. Other structural barriers were: time, age at which free screening is available, and health education. The psychosocial barriers that were identified included: fear of the screening procedure and of the stigmatisation in attending screening. The presence of physical symptoms, the perception that screening provides symptom relief, HIV status, and the desire to know one’s physical health status were identified as facilitators of cervical screening adherence.Conclusion: This knowledge has the potential to inform healthcare policy and services in South Africa. As globalisation persists and individuals continue to immigrate or seek refugee status in foreign countries, increased understanding and knowledge is required for successful acculturation and integration. Developed countries may therefore also benefit from research findings in developing countries.

  16. Finnish women’s knowledge and attitudes regarding HPV and cervical cancer screening

    OpenAIRE

    Kampman, Iiro Joonas

    2016-01-01

    Cervical cancer is the 19th most common cancer amongst women in Finland. In our country there are around 150 new diagnoses yearly and 50 deaths due to cervical cancer (1). The Human Papilloma Virus is the most central and a necessary factor in the development of cervical cancer (2). HPV causes histologic changes in the cervix that are detectable in cervical cancer screening conducted with cytological smears (”Pap-smears”) (2). A key factor in the efficacy of cervical cancer screening, as in a...

  17. Cervical cancer screening in the era of HPV vaccination: A review of shifting paradigms in cytopathology.

    Science.gov (United States)

    Barroeta, Julieta E; Adhikari-Guragain, Deepti; Grotkowski, Carolyn E

    2017-10-01

    Significant changes in cervical cancer screening practice, guidelines, and prevention of cervical cancer have taken place in recent years including the raising of initial cervical cancer screening age, changes in frequency of cytology screening, and the adoption of high risk HPV and cytology co-testing for some patients; the introduction of the bivalent, quadrivalent, and 9-valent HPV vaccines; and the recent approval of high risk HPV testing as primary screening with the use of cytology as triage in positive cases. This review discusses the significance of primary HPV screening, the impact of HPV vaccination in the prevalence of cervical cancer and its precursors, the interplay between high risk HPV testing and vaccination, and the implications for clinical and cytological management. Future strategies for cervical screening in the post-vaccination era are also discussed. © 2017 Wiley Periodicals, Inc.

  18. What promotes cervical cancer screening among Chamorro women in California?

    Science.gov (United States)

    Tanjasiri, Sora P; Mouttapa, Michele; Sablan-Santos, Lola; Quitugua, Lourdes F

    2012-12-01

    Pacific Islander women represent a significant at-risk population for cervical cancer, yet little is known about the modifiable factors associated with routine Pap testing. Therefore, the aims of this paper are to report and discuss the known and unknown factors associated with cervical cancer screening among Chamorro women in California. This cross-sectional study explored the factors associated with receipt of regular Pap testing among Chamorro women age 18 years and older in California. A self-administered survey was designed and distributed to women in order to understand their knowledge, beliefs and behaviors regarding routine receipt of Pap tests. Only about two-thirds of women had received a Pap test within the past 2 years, which is below the U.S. average of 72 %. Significant predictors included younger age, health insurance coverage, knowledge of screening frequency, and medically correct beliefs regarding risk groups. These factors, however, accounted for less than 16 % of the variance in Pap testing behavior. We discuss the poor predictive value of existing demographic and theoretical variables, and discuss potentially new areas of research that can aid in the development of future intervention studies. Study limitations and implications are also discussed.

  19. Influencing factors on cervical cancer screening from the Kurdish women's perspective: A qualitative study.

    Science.gov (United States)

    Rasul, V H; Cheraghi, M A; Behboodi Moqadam, Z

    2015-01-01

    Aim:This study was aimed to explore and describe the Kurdish women's perception of cervical cancer screening. Methods: A qualitative design based on a conventional content analysis approach. Purposive sampling was applied to 19 women chosen, who had a Pap smear or refused to have one. The study was performed in the Kurdistan Region, Iraq. Semi-structure din-depth individual interviews were carried out to collect data. Results: Four main themes including conflict, belief, and awareness about cervical cancer screening and socio-cultural factors emerged during data analysis Conclusions: Cervical cancer has a high mortality rate in the developing countries. However, only a few Kurdish women participated in the cervical cancer screening in the Kurdistan Region, Iraq. Understanding the factors associated with the women's perception of cervical cancer could guide future educational planning and clinical interventions improve the cervical cancer screening.

  20. Women's participation in a cervical cancer screening program in northern Peru

    National Research Council Canada - National Science Library

    Winkler, J; Bingham, A; Coffey, P; Penn Handwerker, W

    .... In an effort to increase knowledge about screening participation in low-resource settings, this study sought to identify key factors affecting women's participation in a cervical screening program in north central Peru...

  1. Cost-Utility Analysis of Human Papillomavirus Vaccination and Cervical Screening on Cervical Cancer Patient in Indonesia.

    Science.gov (United States)

    Setiawan, Didik; Dolk, Franklin Christiaan; Suwantika, Auliya A; Westra, Tjalke Arend; WIlschut, Jan C; Postma, Maarten Jacobus

    2016-05-01

    Although cervical cancer is a preventable disease, the clinical and economic burdens of cervical cancer are still substantial issues in Indonesia. The main purpose of this study was to model the costs, clinical benefits, and cost-utility of both visual inspection with acetic acid (VIA) screening alone and human papillomavirus (HPV) vaccination in addition to VIA screening in Indonesia. We developed a population-based Markov model, consisting of three health states (susceptible, cervical cancer, and death), to assess future costs, health effects, and the cost-utility of cervical cancer prevention strategies in Indonesia. We followed a cohort of 100,000 females 12 to 100 years old and compared VIA screening alone with the addition of HPV vaccination on top of the screening to "no intervention." The implementation of VIA screening alone and in combination with HPV vaccination would reduce the cervical cancer incidence by 7.9% and 58.5%, corresponding to 25 and 98 deaths avoided within the cohort of 100,000, respectively. We also estimated that HPV vaccination combined with VIA screening apparently yielded a lower incremental cost-effectiveness ratio at international dollar 1863/quality-adjusted life-year (QALY), compared with VIA screening alone (I$3126/QALY). Both strategies could however be definitely labeled as very cost-effective interventions, based on a threshold suggested by the World Health Organization. The incremental cost-effectiveness ratio was sensitive to the discount rate, cervical cancer treatment costs, and quality of life as part of the QALY. The addition of HPV vaccination on top of VIA screening could be a cost-effective strategy in Indonesia even if relatively conservative assumptions are applied. This population-based model can be considered as an essential tool to inform decision makers on designing optimal strategies for cervical cancer prevention in Indonesia. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes

  2. Knowledge, attitude and practice of cervical cancer screening among market women in Zaria, Nigeria

    OpenAIRE

    Saad Aliyu Ahmed; Kabiru Sabitu; Suleiman Hadejia Idris; Rukaiya Ahmed

    2013-01-01

    Background: Cervical cancer is the most common genital cancer and one of the leading causes of death among female population. Fortunately, this cancer is preventable by screening for premalignant lesions but this is rarely provided and hardly utilised. We assessed the knowledge, attitude and utilisation of cervical cancer screening among market women in Sabon Gari, Zaria. Materials and Methods: This was a cross-sectional study to evaluate the knowledge, attitude and practice of cervical cance...

  3. Knowledge and beliefs regarding cervical cancer screening and HPV vaccination among urban and rural women in León, Nicaragua

    Directory of Open Access Journals (Sweden)

    Hannah D. Rees

    2017-10-01

    cancer screening arose from interviews and built on quantitative findings: (1 women’s embarrassment due to the intimate nature of the Pap smear and male gender of exam provider discourages screening; (2 women believe Pap smears and cervical cancer are associated with sexual promiscuity, and this association stigmatizes women with the disease; (3 knowledge of cervical cancer prevention is limited to those who regularly attend health centers; and (4 women find screening inconvenient, believing understaffed clinics increase patient wait time, limit time patients spend with clinicians, and delay Pap results. A fifth theme indicates (5 participants’ acceptance of a potential HPV immunization program. Discussion Future interventions should focus on increasing access to information about cervical cancer prevention for women who do not regularly attend health centers. Furthermore, our results suggest that if funding were allocated to make the HPV vaccine accessible in Nicaragua, it would be well received.

  4. Cervical and Breast Cancer-Screening Knowledge of Women with Developmental Disabilities

    Science.gov (United States)

    Parish, Susan L.; Swaine, Jamie G.; Luken, Karen; Rose, Roderick A.; Dababnah, Sarah

    2012-01-01

    Women with developmental disabilities are significantly less likely than women without disabilities to receive cervical and breast cancer screening according to clinical guidelines. The reasons for this gap are not understood. The present study examined the extent of women's knowledge about cervical and breast cancer screening, with the intention…

  5. Cervical cancer risk factors and feasibility of visual inspection with acetic acid screening in Sudan

    DEFF Research Database (Denmark)

    Ibrahim, Ahmed; Rasch, Vibeke; Pukkala, Eero

    2011-01-01

    To assess the risk factors of cervical cancer and the feasibility and acceptability of a visual inspection with acetic acid (VIA) screening method in a primary health center in Khartoum, Sudan.......To assess the risk factors of cervical cancer and the feasibility and acceptability of a visual inspection with acetic acid (VIA) screening method in a primary health center in Khartoum, Sudan....

  6. Do general practices adhere to organizational guidelines for effective cervical cancer screening?

    NARCIS (Netherlands)

    Hermens, R P; Hak, E; Hulscher, M E; Mulder, J; Braspenning, J C; Grol, R P

    BACKGROUND: Well-organized cervical screening has been shown to be effective in the reduction of both morbidity and mortality from cancer of the uterine cervix. In The Netherlands, the GP plays an important role in the cervical screening. The question is whether the general practices are able to

  7. Using the Theory of Planned Behavior to Understand Cervical Cancer Screening among Latinas

    Science.gov (United States)

    Roncancio, Angelica M.; Ward, Kristy K.; Sanchez, Ingrid A.; Cano, Miguel A.; Byrd, Theresa L.; Vernon, Sally W.; Fernandez-Esquer, Maria Eugenia; Fernandez, Maria E.

    2015-01-01

    To reduce the high incidence of cervical cancer among Latinas in the United States it is important to understand factors that predict screening behavior. The aim of this study was to test the utility of theory of planned behavior in predicting cervical cancer screening among a group of Latinas. A sample of Latinas (N = 614) completed a baseline…

  8. Implementing universal cervical length screening in asymptomatic women with singleton pregnancies: challenges and opportunities

    NARCIS (Netherlands)

    Pedretti, Michelle K.; Kazemier, Brenda M.; Dickinson, Jan E.; Mol, Ben W. J.

    2017-01-01

    Cervical length (CL) screening has been successfully utilised to identify asymptomatic women, with a singleton pregnancy, at risk of preterm birth (PTB), thereby providing an opportunity to offer interventions that may reduce that risk. Cervical length screening with ultrasound is most effectively

  9. US Navy Women's Experience of an Abnormal Cervical Cancer Screening.

    Science.gov (United States)

    Braun, Lisa A; Kennedy, Holly Powell; Sadler, Lois S; Dixon, Jane; Womack, Julie; Wilson, Candy

    2016-01-01

    Recent policy revisions allow greater inclusion of military women in operational and/or deployable positions (ie, shipboard, overseas, and war zone duty assignments), but these positions can create unique health care challenges. Military members are often transient due to deployments and change of duty stations, impacting timely follow-up care for treatable health conditions. There has been minimal research on challenges or strategies in preventive health screening and follow-up for US military women. The purpose of this qualitative research study was to describe US Navy women's experiences with abnormal cervical cancer screenings requiring colposcopic follow-up care. Ship- and shored-based women receiving care at a military colposcopy clinic completed interviews about their experience. Two forms of narrative analysis, Labov's sociolinguistic structural analysis and Braun and Clarke's thematic analysis, were employed to gain a more robust understanding of the women's experiences. The sample was comprised of 26 women (16 ship-based, 10 shore-based). Five themes were identified: 1) It's like this bombshell (initial abnormal results notification); 2) I didn't understand (self-discovery process); 3) Freaked (emotional toll); 4) It's kind of like this back and forth (scheduling and navigating care); and 5) It really opened my eyes (lessons learned). The women's stories highlighted some issues unique to military health care, such as operational demands and follow-up care; other issues are likely common for most women learning about an abnormal cervical cancer screening result. Areas important for practice and future research include improving notification practices, providing information, understanding women's fear, and continuity of care. Research exploring educational initiatives and self-management practices are critical within military populations. © 2016 by the American College of Nurse-Midwives.

  10. Adherence to cervical cancer screening in an Italian SLE cohort

    Directory of Open Access Journals (Sweden)

    R. Talarico

    2011-06-01

    Full Text Available Objective: Papanicolau (Pap smear abnormalities are more frequently observed in systemic lupus erythematosus (SLE respect to the general population. The primary objective of the present study was to evaluate the adherence to cervical cancer (CC screening in an Italian cohort of SLE patients and, secondly, to evaluate the disease-related factors possibly influencing the patients’ behavior. Methods: Consecutive 25 to 64 year old SLE patients and aged- matched healthy women were enrolled for the study. All patients were interviewed during ambulatory visits, at admission to the clinic or by a telephone contact; disease related variables were also collected from the clinical charts. Results: 140 SLE patients (mean age 48.3±12 years and 70 controls matched for demographic and sociocultural characteristics were enrolled. Ninety-three SLE patients (66.4% declared to perform the Pap test at least every three years (23.6% yearly and 42.8% when asked by the screening programs while 47 (33.6% did not perform regular CC screening (16.4% never did the test and 17.1% only occasionally. No significant differences were observed between patients and controls in cancer screening adherence. No significant associations were observed between the screening program behaviours and disease-related variables. Conclusions: Despite the growing evidence of an increased risk of CC in SLE, and regardless of the broad availability of screening programs and official recommendations, our results show insufficient CC surveillance among SLE patients and emphasize to rheumatologists and/or general practitioners the importance to discuss with patients this aspect during routine evaluations in order to encourage compliance to the recommended preventive measures.

  11. Re-attendance at biennial screening mammography following a repeated false positive recall

    NARCIS (Netherlands)

    Klompenhouwer, Elisabeth G.; Duijm, Lucien E. M.; Voogd, Adri C.; den Heeten, Gerard J.; Strobbe, Luc J.; Louwman, Marieke W.; Coebergh, Jan Willem; Venderink, Dick; Broeders, Mireille J. M.

    2014-01-01

    We determined the re-attendance rate at screening mammography after a single or a repeated false positive recall and we assessed the effects of transition from screen-film mammography (SFM) to full-field digital mammography (FFDM) on screening outcome in women recalled twice for the same

  12. Hysterectomy and its impact on the calculated incidence of cervical cancer and screening coverage in Denmark

    DEFF Research Database (Denmark)

    Lam, Janni Uyen Hoa; Lynge, Elsebeth; Njor, Sisse Helle

    2015-01-01

    , the incidence rate of cervical cancer and the screening coverage for women aged 23-64 years on 31 December 2010 were calculated with and without adjustments for hysterectomies undertaken for reasons other than cervical cancer. They were calculated as the number of cases divided by 1) the total number of woman......BACKGROUND: The incidence rates of cervical cancer and the coverage in cervical cancer screening are usually reported by including in the denominator all women from the general population. However, after hysterectomy women are not at risk anymore of developing cervical cancer. Therefore, it makes...... sense to determine the indicators also for the true at-risk populations. We described the frequency of total hysterectomy in Denmark and its impact on the calculated incidence of cervical cancer and the screening coverage. MATERIAL AND METHODS: With data from five Danish population-based registries...

  13. The budget impact of cervical cancer screening using HPV primary screening.

    Science.gov (United States)

    Wright, Thomas; Huang, Joice; Baker, Edward; Garfield, Susan; Hertz, Deanna; Cox, J Thomas

    2016-03-01

    This study assessed the clinical and budgetary impacts of human papillomavirus (HPV) primary screening with HPV16/18 genotyping, in contrast to current cervical cancer screening strategies. A decision-tree framework and Markov model were used to model clinical and cost implications of screening and diagnosis of disease. A model was developed to compare the annual clinical and budgetary impact of HPV screening with genotyping versus cytology, and co-testing with and without genotyping. Epidemiology and test performance inputs are from the literature and the Addressing THE Need for Advanced HPV Diagnostics (ATHENA) trial. Costs are from a US payer perspective. Clinical impact was measured as the resulting incidence of cervical cancer, and budget impact is reported as annual cost per screened woman. The model considered the impact of patient noncompliance (loss to follow-up) at both the initial screen and re-test. Cytology was found to be inferior to both co-testing and HPV primary screening. Co-testing was inferior to co-testing with genotyping. Co-testing with genotyping every 3 years (incidence = 5.5 per 100,000 women; annual investment = $61) or 5 years (incidence = 7.4 per 100,000 women; annual investment = $37) was slightly more effective, but more costly than HPV primary screening every 3 years (incidence = 6.2 per 100,000 women; annual investment = $48) or 5 years (incidence = 8.1 per 100,000 women; annual investment = $30). Genotyping strategies were relatively stable to the effects of patient noncompliance. Primary HPV screening with genotyping represents a sensible combination of clinical effectiveness and costs, while reducing the risks associated with patient noncompliance.

  14. Increased uptake of cervical screening by women with HIV infection in Auckland regardless of ethnicity, requirement for an interpreter or level of education.

    Science.gov (United States)

    Lowe, Michele; Handy, Rupert; Ingram, Joan; Nisbet, Mitzi; Ritchie, Stephen; Thomas, Mark; Briggs, Simon

    2016-07-15

    Current guidelines recommend that women with HIV infection receive annual cervical smears. We evaluated the uptake of annual cervical smears by women with HIV infection under the care of the Infectious Disease Service at Auckland City Hospital. In an attempt to identify potential barriers to regularly receiving an annual cervical smear, we invited the women to complete a questionnaire. The responses from women who had regularly received an annual cervical smear were compared with those who had not. The proportion of women who had received a cervical smear increased from 44% in 2001, to 73% in 2010 (p=0.001). Ninety-three women (76%) completed the study questionnaire. No statistically significant differences were found in the questionnaire responses between the women who had regularly received an annual cervical smear and those who had not. The proportion of women in this cohort who received a cervical smear in 2010 is comparable with other studies of women with HIV infection in New Zealand and overseas. We have not been able to identify barriers that prevent women with HIV infection in Auckland regularly receiving an annual cervical smear. We plan to encourage women who have not received a cervical smear in the previous 2-year period to have a cervical smear performed when they attend the Infectious Disease Clinic, and will continue to notify the National Cervical Screening Programme that all women who are newly diagnosed with HIV infection should have an annual recall code attached to future cervical smear reports. We expect that these interventions will further increase the proportion of women with HIV infection in Auckland who receive an annual cervical smear.

  15. Sociodemographic predictors of cervical cancer screening in women with a medical disability.

    Science.gov (United States)

    Martin, Shari; Orlowski, Marietta; Ellison, Sylvia A

    2013-01-01

    The purpose of this project was to describe cervical cancer screening rates in women with medical disabilities living in Ohio, and explore the relationship of select sociodemographic factors to cervical cancer screening participation. A chart abstraction of 350 randomly selected women, ages 20 to 80 years and enrolled in a statewide home care waiver program, was completed in July 2008. Less than half of the women (45.4%) had obtained a cervical cancer screening within the past 3 years. Controlling for age and third-party insurance, the odds of being screened decreased 20% with each activity of daily living requiring assistance (odds ratio = .815, 95% confidence interval [.696, .953]). Previous studies indicate that women with self-reported limitations are less likely to report a cervical cancer screening. The gap for screenings appears greater for women with a medical disability.

  16. Cost-effectiveness of strategies to increase screening coverage for cervical cancer in Spain: the CRIVERVA study

    Directory of Open Access Journals (Sweden)

    Marta Trapero-Bertran

    2017-02-01

    Full Text Available Abstract Background The aim of the study is to carry out a cost-effectiveness analysis of three different interventions to promote the uptake of screening for cervical cancer in general practice in the county of Valles Occidental, Barcelona, Spain. Methods Women aged from 30 to 70 years (n = 15,965 were asked to attend a general practice to be screened. They were randomly allocated to one of four groups: no intervention group (NIG; one group where women received an invitation letter to participate in the screening (IG1; one group where women received an invitation letter and informative leaflet (IG2; and one group where women received an invitation letter, an informative leaflet and a phone call reminder (IG3. Clinical effectiveness was measured as the percentage increase in screening coverage. A cost-effectiveness analysis was performed from the perspective of the public health system with a time horizon of three to five years – the duration of the randomised controlled clinical trial. In addition, a deterministic sensitivity analysis was performed. Results are presented according to different age groups. Results The incremental cost-effectiveness ratio (ICER for the most cost-effective intervention, IG1, compared with opportunistic screening was € 2.78 per 1% increase in the screening coverage. The age interval with the worst results in terms of efficiency was women aged < 40 years. Conclusions In a population like Catalonia, with around 2 million women aged 30 to 70 years and assuming that 40% of these women were not attending general practice to be screened for cervical cancer, the implementation of an intervention to increase screening coverage which consists of sending a letter would cost on average less than € 490 for every 1000 women. Trial registration ClinicalTrials.gov Identifier: NCT01373723 .

  17. Risk factors for VIA positivity and determinants of screening attendances in Dar es Salaam, Tanzania

    National Research Council Canada - National Science Library

    Kahesa, Crispin; Kjaer, Susanne Kruger; Ngoma, Twalib; Mwaiselage, Julius; Dartell, Myassa; Iftner, Thomas; Rasch, Vibeke

    2012-01-01

    .... With the aim of describing risk factors for VIA positivity and determinants of screening attendances in Tanzania, this paper present the results from a comparative analysis performed among women...

  18. [Validation of three screening tests used for early detection of cervical cancer].

    Science.gov (United States)

    Rodriguez-Reyes, Esperanza Rosalba; Cerda-Flores, Ricardo M; Quiñones-Pérez, Juan M; Cortés-Gutiérrez, Elva I

    2008-01-01

    to evaluate the validity (sensitivity, specificity, and accuracy) of three screening methods used in the early detection of the cervical carcinoma versus the histopathology diagnosis. a selected sample of 107 women attended in the Opportune Detection of Cervicouterine Cancer Program in the Hospital de Zona 46, Instituto Mexicano del Seguro Social in Durango, during the 2003 was included. The application of Papa-nicolaou, acetic acid test, and molecular detection of human papillomavirus, and histopatholgy diagnosis were performed in all the patients at the time of the gynecological exam. The detection and tipification of the human papillomavirus was performed by polymerase chain reaction (PCR) and analysis of polymorphisms of length of restriction fragments (RFLP). Histopathology diagnosis was considered the gold standard. The evaluation of the validity was carried out by the Bayesian method for diagnosis test. the positive cases for acetic acid test, Papanicolaou, and PCR were 47, 22, and 19. The accuracy values were 0.70, 0.80 and 0.99, respectively. since the molecular method showed a greater validity in the early detection of the cervical carcinoma we considered of vital importance its implementation in suitable programs of Opportune Detection of Cervicouterino Cancer Program in Mexico. However, in order to validate this conclusion, cross-sectional studies in different region of country must be carried out.

  19. Barriers for Compliance to Breast, Colorectal, and Cervical Screening Cancer Tests among Hispanic Patients

    Directory of Open Access Journals (Sweden)

    Christine Miranda-Diaz

    2015-12-01

    Full Text Available Hispanics are less likely to undergo screening tests for colorectal cancer and cervical cancer than non-Hispanic whites. Compliance with mammography, fecal occult blood testing (FOBT, colonoscopy, and cervical smears (PAP and barriers for compliance were studied. A descriptive study was performed with 194 ambulatory patients while they attended routine medical visits. Women are more likely than men to undergo a colonoscopy. Conversely, FOBT was most likely reported by men. Reasons for compliance with FOBT differed by gender. Men were most likely to avoid FOBT due to lack of knowledge whereas women reported that physicians do not recommend the procedure. Both men and women reported that lack of physician’s recommendation was their primary reason for not undergoing a colonoscopy. Men tend to report lack of knowledge about colonoscopy procedure. A higher mammogram utilization rate was reported by women older than 40 years. PAP smears were reported by 74% of women older than 21 years. The major reasons for avoiding mammography and PAP tests were having a busy schedule, fear, and feeling uncomfortable during the procedure. In a multivariate regression analysis, occupational status was found to be a predictor for compliance with FOBT and colonoscopy.

  20. Non-attendance in mammography screening and women's social network: a cohort study on the influence of family composition, social support, attitudes and cancer in close relations.

    Science.gov (United States)

    Manjer, Åsa Ritenius; Emilsson, Ulla Melin; Zackrisson, Sophia

    2015-06-28

    Mammography screening can reduce breast cancer mortality. The aim of the present study was to investigate non-attendance in mammography screening in relation to different aspects of a women's social network, attitudes and cancer in close relations. Data from the Malmö Diet and Cancer Study baseline examination in 1991-1996 was used. A re-examination began in 2007, and 1452 women participated. Family composition, social support, sense of belonging, attitudes on screening and breast cancer risk and on previous cancer in close relations were investigated in relation to self-reported participation in mammography screening using logistic regression analysis, yielding odds ratios with 95 % confidence intervals. Both attendees (98.0 %) and non-attendees (95.2 %) considered mammography screening important. Non-attendance in mammography screening was associated with being unmarried vs. married (2.40:1.30-4.45) and with not having vs. having children (1.77:1.08-2.92). Non-attendees planned to abstain from mammography screening in the future more often than attendees (4.78:2.56-8.90), and they had often abstained from cervical cancer screening (1.69:1.04-2.75). No other statistically significant association was found. This study indicates that family composition, but not necessarily the presence or absence of social support, perceived cancer risk or cancer in close relations, may affect non-attendance in mammography screening. A positive attitude towards mammography screening was found among both attendees and non-attendees, although the latter group planned to a lesser degree to attend mammography screening in the future.

  1. Breast and cervical cancer screening in obese minority women.

    Science.gov (United States)

    Ferrante, Jeanne M; Chen, Ping-Hsin; Jacobs, Abbie

    2006-06-01

    Studies using survey data from mostly white women showed that obese women are less likely than nonobese women to undergo breast and cervical cancer screening. It is unclear if these findings are true in nonwhite women. Using chart audit data, we examined the relationship between obesity and mammography and Pap smear screening among minority women. Data from retrospective chart review of women in three urban New Jersey academic family medicine practices were analyzed (n = 1809) using hierarchical logistic regression models. Outcome measures were being up-to-date in mammography and Pap smears among obese and nonobese women. There was no difference in mammography rates among obese and nonobese women. Independent risk factors for not being up-to-date in mammography included age 40-49, smoking, and comorbidity. Obese women were less likely than nonobese women to be upto- date in Pap smears (69% vs. 77%, p = 0.001). In multivariate analysis, obesity was associated with 25% decreased odds of being up-to-date on Pap smears (OR, 0.75, 95% CI, 0.58-0.99, p = 0.041). Age >or=65 years was also associated with decreased odds of being up-to-date in Pap smears. Hispanic women had increased odds of being up-to-date in mammography (OR 2.43, 95% CI 1.63-3.63) and Pap smears (OR 1.94, 95% CI 1.24-3.03) compared with white women. Obesity was associated with decreased Pap smear screening but not with decreased mammography. Further studies are needed to determine barriers and effective interventions to improve screening in obese minority women.

  2. Attending the breast screening programme after breast cancer treatment: a population-based study.

    Science.gov (United States)

    de Munck, Linda; Kwast, Annemiek; Reiding, Dick; de Bock, Geertruida H; Otter, Renée; Willemse, Pax H B; Siesling, Sabine

    2013-12-01

    In the Netherlands, breast cancer patients are treated and followed at least 5 years after diagnosis. Furthermore, all women aged 50-74 are invited biennially for mammography by the nationwide screening programme. The relation between the outpatient follow-up (follow-up visits in the outpatient clinic for 5 years after treatment) and the screening programme is not well established and attending the screening programme as well as outpatient follow-up is considered undesirable. This study evaluates potential factors influencing women to attend the screening programme during their outpatient follow-up (overlap) and the (re-)attendance to the screening programme after 5 years of outpatient follow-up. Data of breast cancer patients aged 50-74 years, treated for primary breast cancer between 1996 and 2007 were selected from the Netherlands Cancer Registry and linked to the National Breast Cancer Screening Programme in the Northern region. Cox regression analyses were used to study women (re-)attending the screening programme over time, possible overlap with the outpatient follow-up and factors influencing this. In total 11227 breast cancer patients were included, of whom 19% attended the screening programme after breast cancer treatment, 4.4% within 5 years and 15.4% after more than 5 years. Factors that independently influenced attendance within 5 years as well as more than 5 years after treatment were: interval tumours (HR 0.77; 95%CI 0.61-0.97 and HR 0.69; 95%CI 0.53-0.88, ref: screen-detected tumours), receiving adjuvant radiotherapy (HR 0.65; 95%CI 0.47-0.90 and HR 0.66; 95%CI 0.47-0.93; ref: none) and diagnosis of in situ tumours (HR 1.67; 95%CI 1.25-2.23 and HR 1.39; 95%CI 1.05-1.85; ref: stage I tumours). Non-screen related tumours (HR 0.41; 95%CI 0.29-0.58) and recent diagnosis (HR 0.89 per year; 95%CI 0.86-0.92) were only associated with attendance within 5 years after treatment. The interrelation between outpatient follow-up and screening should be improved to

  3. Sociodemographic gradients in breast and cervical cancer screening in Korea: the Korean National Cancer Screening Survey (KNCSS) 2005-2009.

    Science.gov (United States)

    Park, Mi Jin; Park, Eun-Cheol; Choi, Kui Son; Jun, Jae Kwan; Lee, Hoo-Yeon

    2011-06-17

    Cancer screening rates in Korea for five cancer types have increased steadily since 2002. With regard to the life-time cancer screening rates in 2009 according to cancer sites, the second highest was breast cancer (78.1%) and the third highest was cervical cancer (76.1%). Despite overall increases in the screening rate, disparities in breast and cervical cancer screening, based on sociodemographic characteristics, still exist. Data from 4,139 women aged 40 to 74 years from the 2005 to 2009 Korea National Cancer Screening Survey were used to analyze the relationship between sociodemographic characteristics and receiving mammograms and Pap smears. The main outcome measures were ever having had a mammogram and ever having had a Pap smear. Using these items of information, we classified women into those who had had both types of screening, only one screening type, and neither screening type. We used logistic regression to investigate relationships between screening history and sociodemographic characteristics of the women. Being married, having a higher education, a rural residence, and private health insurance were significantly associated with higher rates of breast and cervical cancer screening after adjusting for age and sociodemographic factors. Household income was not significantly associated with mammograms or Pap smears after adjusting for age and sociodemographic factors. Disparities in breast and cervical cancer screening associated with low sociodemographic status persist in Korea.

  4. Qualitative study of barriers to cervical cancer screening among Nigerian women.

    Science.gov (United States)

    Isa Modibbo, Fatima; Dareng, Eileen; Bamisaye, Patience; Jedy-Agba, Elima; Adewole, Ayodele; Oyeneyin, Lawal; Olaniyan, Olayinka; Adebamowo, Clement

    2016-01-11

    To explore the barriers to cervical cancer screening, focusing on religious and cultural factors, in order to inform group-specific interventions that may improve uptake of cervical cancer screening programmes. We conducted four focus group discussions among Muslim and Christian women in Nigeria. Discussions were conducted in two hospitals, one in the South West and the other in the North Central region of Nigeria. 27 Christian and 22 Muslim women over the age of 18, with no diagnosis of cancer. Most participants in the focus group discussions had heard about cervical cancer except Muslim women in the South Western region who had never heard about cervical cancer. Participants believed that wizardry, multiple sexual partners and inserting herbs into the vagina cause cervical cancer. Only one participant knew about the human papillomavirus. Among the Christian women, the majority of respondents had heard about cervical cancer screening and believed that it could be used to prevent cervical cancer. Participants mentioned religious and cultural obligations of modesty, gender of healthcare providers, fear of disclosure of results, fear of nosocomial infections, lack of awareness, discrimination at hospitals, and need for spousal approval as barriers to uptake of screening. These barriers varied by religion across the geographical regions. Barriers to cervical cancer screening vary by religious affiliations. Interventions to increase cervical cancer awareness and screening uptake in multicultural and multireligious communities need to take into consideration the varying cultural and religious beliefs in order to design and implement effective cervical cancer screening intervention programmes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. Challenges to cervical screening in a developing country: The case of Malaysia

    DEFF Research Database (Denmark)

    Othman, Nor Hayati; Rebolj, Matejka

    2009-01-01

    OBJECTIVES: Many developing countries, including Malaysia, will need to continue relying on cervical screening because they will not be able to cover their entire female adolescent populations with HPV vaccination. The aim of this paper was to establish the extent of the health care, informational......, financial and psychosocial barriers to cervical screening in Malaysia. METHODS: A literature search was made for reports on implementation, perceptions and reception of cervical screening in Malaysia published between January 2000 and September 2008. RESULTS: Despite offering Pap smears for free since 1995......: Improving screening coverage will remain an important strategy for combating cervical cancer in Malaysia. The focus should be on the policy-making context, improving awareness and the screening infrastructure, and making the service better accessible to women....

  6. Do invitations for cervical screening provide sufficient information to enable informed choice?

    DEFF Research Database (Denmark)

    Kolthoff, Sie Karen; Hestbech, Mie Sara; Jørgensen, Karsten Juhl

    2016-01-01

    OBJECTIVE: To investigate whether invitations for publicly funded cervical screening provide sufficient information to enable an informed choice about participation. DESIGN: Cross-sectional study using a checklist of 23 information items on benefits and harms from cervical screening and the risks...... OUTCOME MEASURES: Number of information items presented in invitations for cervical screening. RESULTS: We contacted 21 coordinating units from 11 countries and 20 (95%) responded. Of these, four units did not issue invitations, but the remaining 16 coordinating units in 10 different countries supplied...... a sample. The invitations for cervical screening were generally information poor and contained a median of only four out of 23 information items possible (17%), ranging from 0 to 12 (0-52%). The most important harms of cancer screening, overdiagnosis and overtreatment, were typically downplayed...

  7. An Educational Training on Cervical Cancer Screening Program for Rural Healthcare Providers in India

    Directory of Open Access Journals (Sweden)

    Rita Caroline Isaac

    2014-03-01

    Full Text Available Conventional, cytology based Cervical cancer screening programmes used in the developed world is often not practical in developing countries. Training of health care work force on a feasible, low-tech, screening methods is urgently needed in low resource settings. Twenty providers including doctors and nurses participated in a 2-days training workshop organized by a Community Health Center in rural South India. The pre-post-training assessment showed significant improvement in knowledge about cervical cancer, ‘low tech’ screening, treatment options and counseling among the participants.  Twenty volunteers screened at the workshop, 2 women (10% tested positive and one had CINIII lesion and the other had cervical cancer stage IIIB. After the training, the participants felt confident about their ability to counsel and screen women for cervical cancer.

  8. Effect of a pre-screening survey on attendance in colorectal cancer screening: a double-randomized study in Finland.

    Science.gov (United States)

    Helander, Sanni; Hakama, Matti; Malila, Nea

    2014-06-01

    To explore effects of a pre-screening life style survey on the subsequent attendance proportion in colorectal cancer screening. Finnish colorectal cancer screening programme in 2011. Double randomized and controlled follow-up design. The study population comprised of 31,951 individuals born in 1951. In 2010 to a random sample of every sixth (n = 5,312) person we sent a 7-paged life style questionnaire, and to another random sample of every sixth person (n = 5,336) a 10-paged life style and quality of life questionnaire. One year later, in 2011, 31,484 individuals of the original cohort were independently randomized (1:1) for colorectal cancer screening (n = 15,748) or control group (n = 15,736). Of those who were invited for screening, 5185 had received a questionnaire during the previous year. 5870 individuals (55.1 %) responded to the questionnaire in 2010. The overall attendance at screening in 2011 was 59.0 % in those born in 1951 (i.e. the 60-year-olds). In those who had been sent the survey the attendance in screening was 56.6% (57.3% for the short and 56.0% for the long questionnaire) and in those who had not received the questionnaire it was 60.2% (P < 0.001). We believe that the observed reduction in attendance in those who had been sent a questionnaire earlier is generally true. Thus, if any survey is enclosed in the screening invitation, this finding should be taken into account when planning the programme. Any extra effort requested may reduce the attendance proportion for screening, reducing the population level impact of screening. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  9. Reaching women in the Peruvian Andes through cervical cancer screening campaigns: assessing attitudes of stakeholders and patients

    Directory of Open Access Journals (Sweden)

    Luque JS

    2016-10-01

    Full Text Available John S Luque,1 Jonathan N Maupin,2 Daron G Ferris,3,4 Wendy S Guevara Condorhuaman4 1Department of Public Health Sciences, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, 2School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, 3Department of Obstetrics and Gynecology, Augusta University, Augusta, GA, USA; 4CerviCusco, Cusco, Peru Background: Peru is characterized by high cervical cancer incidence and mortality rates. The country also experiences significant gaps in quality cervical cancer screening coverage for the population.Objective: This descriptive mixed methods study conducted in Cusco, Peru, aimed to assess the attitudes and perceptions of medical staff, health care workers, and patients toward a cervical cancer screening program that included both clinic-based and community outreach services conducted by a nongovernmental organization clinic (CerviCusco. The study also explored patient knowledge and attitudes around cervical cancer and about the human papillomavirus (HPV to inform patient education efforts.Methods: The study employed structured interviews with key informants (n=16 primarily from CerviCusco, which provides cervical cancer prevention, screening, diagnosis and treatment services, and surveys with a sample of patients (n=30 receiving services at the clinic and at screening campaigns.Results: The majority of key informant medical staff participants felt that the general public had a very negative view of government health services. One theme running throughout the interviews was the perception that the general population lacked a culture of preventive health care and would wait until symptoms were severe before seeking treatment. Regarding services that were received by patients at CerviCusco, the participants responded that the prices were reasonable and more affordable than some private clinics. Patients attending the rural health campaigns liked that the services

  10. Cervical cancer screening in the era of human papillomavirus testing and vaccination.

    Science.gov (United States)

    Murphy, Jeanne; Mark, Hayley

    2012-01-01

    Cervical cancer screening algorithms have changed with the introduction of testing for human papillomavirus (HPV) and better understanding of the natural history of HPV. This review was undertaken to present recent developments related to cervical cancer screening, with HPV testing as a focus. Specifically, guidelines now recommend initiating cervical cancer screening at age 21, stopping at age 65 to 70 if previous tests are normal, and screening no more than every 2 to 3 years. Human papillomavirus testing is now incorporated into guidelines for cervical cancer screening in the United States, with the major impact being the lengthening of recommended screening intervals. Primary screening with HPV testing, although not yet approved in the United States, may serve to increase access to care for the millions of underserved women worldwide who bear most of the burden of cervical cancer. Despite clear guidelines from authoritative sources, many clinicians (including midwives) overscreen women. In cervical cancer screening, as in many areas of women's health care, performing tests that are unlikely to result in useful information may lead to harm. © 2012 by the American College of Nurse-Midwives.

  11. Assessment of psychological barriers to cervical cancer screening ...

    African Journals Online (AJOL)

    Background: Cervical cancer is the leading cause of cancer death among women in Ghana, West Africa. The cervical cancer mortality rate in Ghana is more than three times the global cervical cancer mortality rate. Pap tests and visual inspection with acetic acid wash are widely available throughout Ghana, yet less that 3% ...

  12. Cervical cytology screening - knowledge, attitudes and practice in a ...

    African Journals Online (AJOL)

    Half of the interviewees believed that women with cervical cancer could be cured. The majority believed that they themselves were vulnerable to developing cervical cancer (70.3%), but almost half (45.5%) had a fatalistic attitude in this regard. Almost all (99.4%) would seek treatment if they believed they had cervical cancer ...

  13. Using the Theory of Planned Behavior to Understand Cervical Cancer Screening Among Latinas.

    Science.gov (United States)

    Roncancio, Angelica M; Ward, Kristy K; Sanchez, Ingrid A; Cano, Miguel A; Byrd, Theresa L; Vernon, Sally W; Fernandez-Esquer, Maria Eugenia; Fernandez, Maria E

    2015-10-01

    To reduce the high incidence of cervical cancer among Latinas in the United States it is important to understand factors that predict screening behavior. The aim of this study was to test the utility of theory of planned behavior in predicting cervical cancer screening among a group of Latinas. A sample of Latinas (N = 614) completed a baseline survey about Pap test attitudes subjective norms, perceived behavioral control, and intention to be screened for cervical cancer. At 6 months postbaseline, cervical cancer screening behavior was assessed. Structural equation modeling was used to test the theory. Model fit statistics indicated good model fit: χ(2)(48) = 54.32, p = .246; comparative fit index = .992; root mean square error of approximation = .015; weighted root mean square residual = .687. Subjective norms (p = .005) and perceived behavioral control (p theory of planned behavior in predicting cervical cancer screening among Latinas. This knowledge can be used to inform the development of a theory of planned behavior-based intervention to increase cervical cancer screening among Latinas and reduce the high incidence of cervical cancer in this group of women. © 2015 Society for Public Health Education.

  14. Innovative approaches to cervical cancer screening for sex trade workers: an international scoping review.

    Science.gov (United States)

    Thulien, Naomi S

    2014-03-01

    Female sex trade workers are among those at highest risk for developing and dying of cervical cancer, and yet many-particularly the most marginalized-are less likely than other women to be screened. This review summarizes global findings on innovative approaches to cervical cancer screening for female sex trade workers, highlights current gaps in the delivery of cervical cancer screening for female sex trade workers globally, and suggests areas for future research and policy development. A scoping review of peer-reviewed publications and grey literature was conducted. Medline (OVID), PubMed, EMBASE, and SCOPUS were searched for relevant studies written in English. There were no limitations placed on dates. Grey literature was identified by hand searching and through discussion with health care providers and community outreach workers currently working with sex trade workers. Twenty-five articles were deemed suitable for review. Articles detailing innovative ways for female sex trade workers to access cervical cancer screening were included. Articles about screening for sexually transmitted infections were also included if the findings could be generalized to screening for cervical cancer. Articles limited to exploring risk factors, knowledge, awareness, education, prevalence, and incidence of cervical cancer among sex trade workers were excluded from the review. Successful screening initiatives identified in the studies reviewed had unconventional hours of operation, understood the difference between street-based and venue-based sex trade workers, and/or used peers for outreach. Two significant gaps in health care service delivery were highlighted in this review: the limited use of unorthodox hours and the nearly exclusive practice of providing sexually transmitted infection screening for female sex trade workers without cervical cancer screening. In addition, although street-based (as opposed to venue-based) sex trade workers are likely at higher risk for

  15. [Attendance of the fourth (2008-2009) screening round of the Hungarian organized, nationwide breast cancer screening program].

    Science.gov (United States)

    Boncz, Imre; Döbrőssy, Lajos; Péntek, Zoltán; Kovács, Attila; Budai, András; Imre, László; Vajda, Réka; Sebestyén, Andor

    2013-12-01

    Organised, nationwide screening for breast cancer with mammography in the age group between 45 and 65 years with 2 years screening interval started in Hungary in January 2002. The aim of this study is to analyze the attendance rate of nationwide breast screening programme for the 2008-2009 years. The data derive from the database of the National Health Insurance Fund Administration. The ratio of women in the age group 45-65 years was calculated having either a screening mammography or a diagnostic mammography in the 4th screening round of the programme. In the years 2000-2001, 7.6% of the women had an opportunistic screening mammography while in 2008-2009 31.2% of the target population had screening mammography within the organized programme. During the same periods 20.2% (2000-2001) and 20.4% (2008-2009) of women had a diagnostic mammography. Thus the total (screening and diagnostic) coverage of mammography increased from 26.6% (2000-2001) to 50.1% (2008-2009). The attendance rate failed to change between 2002 and 2009. In order to decrease the mortality due to breast cancer, the attendance rate of mammography screening programme should be increased. Orv. Hetil., 154(50), 1975-1983.

  16. Psychological Impact of Primary Screening (PIPS) for HPV: a protocol for a cross-sectional evaluation within the NHS cervical screening programme.

    Science.gov (United States)

    McBride, Emily; Marlow, Laura; Forster, Alice S; Moss, Sue; Myles, Jonathan; Kitchener, Henry; Patnick, Julietta; Waller, Jo

    2016-12-23

    The NHS Cervical Screening Programme is now using human papillomavirus (HPV) testing as the primary test in six sentinel sites in England, with the intention of rolling this out across the whole of England. Previous research evaluating HPV testing in the cervical screening context suggests that an HPV-positive result may increase anxiety beyond that associated with abnormal cytology, but this has not been explored in the context of primary HPV testing. The main aim of this study is to explore the impact of the HPV primary screening programme on anxiety and distress. A cross-sectional between-groups design (total N ∼ 673) will be employed to assess the psychological impact of different HPV and cytology results at three time points: shortly after receiving the results, and 6 and 12 months later. Women will fall into one of six groups based on their screening results. The primary outcomes will be anxiety and general distress. Secondary outcomes will include understanding of screening results, perceived risk of cervical cancer, psychosexual functioning, intention to attend future screening and knowledge of HPV. General linear modelling will be used to test for differences between groups and changes over the three time points. Health Research Authority approval was received on 26 September 2016. Ethical approval was received from London- Surrey Borders NHS Research Ethics Committee on 30 August 2016. Section 251 approval was received from the Confidentiality Advisory Group on 24 August 2016. Results will be disseminated via peer-reviewed publication and presentation at national and international conferences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  17. Psychological impact of positive cervical cancer screening results among Japanese women.

    Science.gov (United States)

    Isaka, Yukari; Inada, Haruhiko; Hiranuma, Yuri; Ichikawa, Masao

    2017-02-01

    While cervical cancer screening is useful for detecting and then treating the disease at an early stage, most women with screen-positive results are free from cervical cancer but nevertheless subject to the unnecessary worry entailed in receiving such results. The purpose of this study was to examine whether receiving a screen-positive result was actually related to psychological distress among Japanese women who underwent cervical cancer screening. We conducted a questionnaire survey at health facilities in a semiurban city of Ibaraki prefecture, involving 1744 women who underwent cervical cancer screening and 72 who received screen-positive results and then underwent further testing. We used the K6 scale to assess their psychological distress (K6 score ≥5) and performed multiple logistic regression analyses to estimate the relative effect of receiving screen-positive results on psychological distress. Psychological distress was more prevalent among women with screen-positive results (OR 2.22; 95 % CI 1.32-3.74), while it was also related to history of mental health consultation (OR 2.26; 95 % CI 1.69-3.01) and marital status (OR 1.32; 95 % CI 1.02-1.70). Receiving a positive cervical cancer screening result was associated with psychological distress. To alleviate this psychological impact, the current form of communicating the screening results should be reconsidered.

  18. Effectiveness Modelling and Economic Evaluation of Primary HPV Screening for Cervical Cancer Prevention in New Zealand.

    Science.gov (United States)

    Lew, Jie-Bin; Simms, Kate; Smith, Megan; Lewis, Hazel; Neal, Harold; Canfell, Karen

    2016-01-01

    New Zealand (NZ) is considering transitioning from 3-yearly cervical cytology screening in women 20-69 years (current practice) to primary HPV screening. We evaluated HPV-based screening in both HPV-unvaccinated women and cohorts offered HPV vaccination in New Zealand (vaccination coverage ~50%). A complex model of HPV transmission, vaccination, cervical screening, and invasive cervical cancer was extensively validated against national population-based datasets. Sixteen potential strategies for HPV screening were considered. Most primary HPV strategies were more effective than current practice, for both unvaccinated women and cohorts offered vaccination. The optimal strategy for both groups was 5-yearly HPV screening in women aged 25-69 years with partial genotyping for HPV 16/18 and referral to colposcopy, and cytological triage of other oncogenic types. This is predicted to reduce cervical cancer incidence and mortality by a further 12-16% and to save 4-13% annually in program costs (excluding overheads). The findings are sensitive to assumptions about future adherence to initiating screening at 25 years. Primary HPV screening with partial genotyping would be more effective and less costly than the current cytology-based screening program, in both unvaccinated women and cohorts offered vaccination. These findings have been considered in a review of cervical screening in NZ.

  19. Attitudes towards cytology and human papillomavirus self-sample collection for cervical screening among Hindu women in London, UK: a mixed methods study.

    Science.gov (United States)

    Cadman, Louise; Ashdown-Barr, Lesley; Waller, Jo; Szarewski, Anne

    2015-01-01

    To explore the attitudes, views and understanding of women attending a Hindu temple in London, UK towards cervical screening, human papillomavirus (HPV) testing and two HPV self-sample collection devices: the Dacron swab and Evalyn(®) brush. A mixed methods design comprising a survey and four focus groups was adopted. Focus group discussions were recorded and transcribed verbatim and explored using thematic framework analysis. A total of 185 Hindu women completed surveys and 23 attended focus groups. Of the respondents 75% aged 25-64 years reported having cervical screening within the last 5 years; 85% had attended college or university. Familiar barriers to attendance for screening were identified: fear of pain and the test result, embarrassment, screener's attitude, inconvenient appointment times and difficulty with child care. Additional barriers cited included age and country of birth, with older and Indian-born women thought to be less likely to attend for screening. Self-collected sampling had a mixed reception. Women were not confident that their sample would be as good as a clinician sample and expressed concern about the impact that a positive HPV result might have on their relationships. Screening attendance in this highly educated group of Hindu women was slightly lower than in the general population (75% of women aged 25-64 years had been screened in the last 5 years compared with 79% in England as a whole). Familiar barriers to screening were identified. Women felt able to collect their own sample for HPV testing with a Dacron swab but lacked confidence that it would be as good as that obtained by a clinician. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. Chinese women's motivation to receive future screening: the role of social-demographic factors, knowledge and risk perception of cervical cancer.

    Science.gov (United States)

    Gu, Can; Chan, Carmen W H; He, Guo-Ping; Choi, K C; Yang, Sheng-Bo

    2013-04-01

    This paper adopted Protection Motivation Theory (PMT) to examine Chinese women's knowledge and perceptions of cervical cancer risk and factors influencing their motivation to receive future screening. A cross-sectional survey was conducted with 167 Chinese women (142 women were willing to receive a screening in the future and 25 women were not) in 2007 to collect women's socio-demographic information and sexual history, perceptions related to body health and knowledge about cervical cancer and screening, and Protection Motivation Theory measures. The majority of women stated they intended to receive future screening and response efficacy was significantly associated with their intention. However, no significant association was observed between sexual history and protection motivation. Using multivariate analysis, cancer in relatives (odds ratio, OR = 9.97, 95% CI [1.44-436.3], p = 0.010), a perception that visiting a doctor regularly is important to health (OR = 9.85, 95% CI [1.61-999.9], p = 0.009)), and ever attending for cervical screening during the previous three years (OR = 3.49, 95% CI [1.23-11.02], p = 0.016) were significantly associated with women' motivation to receive future screening. The findings of this study highlight the important role of women's beliefs in the value of cervical screening and previous screening experience in motivating them to receive a screening. Education intervention is needed to provide information and raise public awareness about the importance of cervical screening to women's health. Culture-related beliefs and social motivational processes in addition to those specified by PMT need to be addressed. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Association of Cervical Cancer Screening with Knowledge of Risk Factors, Access to Health Related Information, Health Profiles, and Health Competence Beliefs among Community-Dwelling Women in Japan

    Science.gov (United States)

    Oba, Shino; Toyoshima, Masato; Ogata, Hiromitsu

    2017-01-01

    Objective: The aim of this study was to evaluate the past attendance for cervical cancer screening with knowledge of risk factors, access to health-related information, health profiles and health competence beliefs among Japanese women. Methods: Women ages 25, 30, 35, 40, 45, 50, 55, and 60 were contacted cross-sectionally as part of a project for the Japanese Ministry of Health, Labour and Welfare in Nikaho, Akita prefecture Japan between June 2010 and March 2011, and 249 women were analyzed for the current study. The questionnaire asked about past cervical cancer screening. Knowledge of each cervical cancer risk factor was determined on a four-point scale. A barriers to information access scale was utilized to assess the degree of difficulty in accessing health-related information. Health profiles were measured using the EuroQOL EQ-5D. Perceived health competence was measured using a scale (PHCS). The association was evaluated with odds ratios with 95% confidence interval were calculated from a logistic regression analysis after adjustment for age and potential confounders. The trend across the level was also assessed. Results: Women who knew that sexual intercourse at young age was a risk factor were significantly more likely to have participated in cervical cancer screening sometime in their lives (p for trend =0.02). Women who had pain/discomfort and those who had anxiety/depression were significantly more likely to have participated in cervical screening within the past two years (odds ratio [OR]: 2.02, 95% confidence interval [CI]: 1.04–3.94; OR: 2.32, 95% CI: 1.05–5.16, respectively). Women with higher PHCS were significantly more likely to have attended for cervical screened at some point in their lives (p=0.04). Conclusion: This study observed that specific knowledge of cervical cancer risk factors, health profiles and PHCS were associated with the past attendance for cervical cancer screening among women in a community. Further researches are

  2. Association of Cervical Cancer Screening with Knowledge of Risk Factors, Access to Health Related Information, Health Profiles, and Health Competence Beliefs among Community-Dwelling Women in Japan

    Science.gov (United States)

    Oba, Shino; Toyoshima, Masato; Ogata, Hiromitsu

    2017-08-27

    Objective: The aim of this study was to evaluate the past attendance for cervical cancer screening with knowledge of risk factors, access to health-related information, health profiles and health competence beliefs among Japanese women. Methods: Women ages 25, 30, 35, 40, 45, 50, 55, and 60 were contacted cross-sectionally as part of a project for the Japanese Ministry of Health, Labour and Welfare in Nikaho, Akita prefecture Japan between June 2010 and March 2011, and 249 women were analyzed for the current study. The questionnaire asked about past cervical cancer screening. Knowledge of each cervical cancer risk factor was determined on a four-point scale. A barriers to information access scale was utilized to assess the degree of difficulty in accessing health-related information. Health profiles were measured using the EuroQOL EQ-5D. Perceived health competence was measured using a scale (PHCS). The association was evaluated with odds ratios with 95% confidence interval were calculated from a logistic regression analysis after adjustment for age and potential confounders. The trend across the level was also assessed. Results: Women who knew that sexual intercourse at young age was a risk factor were significantly more likely to have participated in cervical cancer screening sometime in their lives (p for trend =0.02). Women who had pain/discomfort and those who had anxiety/depression were significantly more likely to have participated in cervical screening within the past two years (odds ratio [OR]: 2.02, 95% confidence interval [CI]: 1.04–3.94; OR: 2.32, 95% CI: 1.05–5.16, respectively). Women with higher PHCS were significantly more likely to have attended for cervical screened at some point in their lives (p=0.04). Conclusion: This study observed that specific knowledge of cervical cancer risk factors, health profiles and PHCS were associated with the past attendance for cervical cancer screening among women in a community. Further researches are

  3. Frequency of cervical intraepithelial neoplasia treatment in a well-screened population

    DEFF Research Database (Denmark)

    Barken, Sidsel Svennekjaer; Rebolj, Matejka; Andersen, Erik Søgaard

    2012-01-01

    Treatment of cervical intraepithelial neoplasia (CIN) detectable at screening has helped reduce the incidence of cervical cancer, but has also led to overtreatment. The estimates of overtreatment have often focused on a particular grade of CIN or age group. The aim of this paper was to provide...

  4. Positive diagnostic values and histological detection ratios from the Rotterdam cervical cancer screening programme

    NARCIS (Netherlands)

    F.A. Kreuger; H. Beerman (Henk); H.G. Nijs (Huub); M. van Ballegooijen (Marjolein)

    1998-01-01

    textabstractBACKGROUND: In organized screening programmes for cervical cancer, pre-cancerous lesions are detected by cervical smears. However, during follow-up after a positive smear these pre-cancerous lesions are not always found. The purpose of the study is to

  5. The problem of false-positive human papillomavirus DNA tests in cervical screening

    DEFF Research Database (Denmark)

    Rebolj, Matejka; Pribac, Igor; Frederiksen, Maria Eiholm

    2013-01-01

    Human Papillomavirus (HPV) testing has been extensively studied in randomized controlled trials of primary cervical screening. Based on encouraging results concerning its high detection rates and a high negative predictive value for high-grade cervical intraepithelial neoplasia (CIN), HPV testing...

  6. Restriction of human papillomavirus DNA testing in primary cervical screening to women above age 30

    DEFF Research Database (Denmark)

    Rebolj, Matejka; Njor, Sisse H; Lynge, Elsebeth

    2012-01-01

    Cervical screening with human papillomavirus (HPV) testing is less specific for high-grade cervical intraepithelial neoplasia (=CIN3) than cytology. The aim of this systematic review was to determine whether a restriction of HPV testing to women aged at least 30 years would eliminate the problem...

  7. Extended duration of the detectable stage by adding HPV test in cervical cancer screening

    NARCIS (Netherlands)

    M.E. Van Den Akker-van Marie (M.); M. van Ballegooijen (Marjolein); L. Rozendaal (Lawrence); C.J.L.M. Meijer (Chris); J.D.F. Habbema (Dik)

    2003-01-01

    textabstractThe human papillomavirus test (HPV) test could improve the (cost-) effectiveness of cervical screening by selecting women with a very low risk for cervical cancer during a long period. An analysis of a longitudinal study suggests that women with a negative Pap smear and a negative HPV

  8. Perceived ethical acceptability of financial incentives to improve diabetic eye screening attendance.

    Science.gov (United States)

    Wadge, Hester; Bicknell, Colin; Vlaev, Ivo

    2015-01-01

    To test the ethical acceptability of using financial incentives to increase diabetic retinopathy screening attendance. Financial incentives could be an effective way to increase attendance at screening for diabetic retinopathy, although there can be ethical concerns about this approach. Survey of people with diabetes in North West London. Those who were due to attend a screening appointment were invited to complete a questionnaire. Key demographic variables included age, gender, and deprivation. A questionnaire was issued to those invited to attend screening in North West London and those who run the screening service. The questionnaire captured views on aspects of the ethical problem and different incentive types. It captured views on the different dimensions of the ethical problem and different types of incentive. In order to understand how views might vary within a population, demographic variables were used to analyze the results. Vouchers were found to be the most acceptable form of incentive, significantly more so than cash payments. Most rejected the notion of targeting those who need incentivizing, preferring equality. Age was an important factor, with those aged between 40 and 64 the most optimistic about the potential benefits. Higher levels of deprivation were linked to increased acceptability scores. While some ethical concerns are strongly held among certain groups, there is also much support for the principle of incentivizing positive behaviors. This paves the way for future research into the effectiveness of incentivizing diabetic retinopathy screening attendance.

  9. Using Intervention Mapping as a Participatory Strategy: Development of a Cervical Cancer Screening Intervention for Hispanic Women

    Science.gov (United States)

    Byrd, Theresa L.; Wilson, Katherine M.; Smith, Judith Lee; Heckert, Andrea; Orians, Carlyn E.; Vernon, Sally W.; Fernandez-Esquer, Maria E.; Fernandez, Maria E.

    2012-01-01

    Cervical cancer is preventable with treatment of precancerous lesions and treatable at early stages. Hispanics have higher rates of cervical cancer and lower rates of screening. "Ayndando a las Mujeres con Informaccion, Guia, y Amor para su Salud" (AMIGAS) is an intervention to increase cervical cancer screening in U.S. women of Mexican…

  10. Celebrities and screening: a measurable impact on high-grade cervical neoplasia diagnosis from the ‘Jade Goody effect' in the UK

    Science.gov (United States)

    Casey, G M; Morris, B; Burnell, M; Parberry, A; Singh, N; Rosenthal, A N

    2013-01-01

    Background: The celebrity Jade Goody's cervical cancer diagnosis was associated with increased UK cervical screening attendance. We wanted to establish if there was an increase in high-grade (HG) cervical neoplasia diagnoses, and if so, what the characteristics of the women with HG disease were. Methods: We analysed prospective data on 3233 consecutive colposcopy referrals in North East London, UK, from 01 April 2005 to 30 June 2010. Characteristics and outcomes of pre- and post-Goody cohorts were compared. Results: Goody's diagnosis was associated with an increased incidence of colposcopy referrals in all subsequent annual quarters (incidence rate ratio (IRR) 1.3–1.9, Pcelebrities' diagnoses might encourage screening in at-risk populations. PMID:23963142

  11. Cervical cancer screening in the United States, 1993-2010: characteristics of women who are never screened.

    Science.gov (United States)

    Chen, Han-Yang; Kessler, Courtenay L; Mori, Naoyo; Chauhan, Suneet P

    2012-11-01

    Regular Pap test screening has contributed to decreasing cervical cancer incidence and mortality over the past decades, yet half of the women diagnosed with cervical cancer have never had a Pap test. Our study aims to examine the cervical cancer screening rate, identify socioeconomic and demographic risk factors associated with adult women who have never had a Pap test, and examine the relationship of screening with use of related health services. Using Behavioral Risk Factor Surveillance System data (1993-2010), a multivariable survey logistic regression model was fitted to estimate odds ratios for associations between risk factors and the outcome of never screened. Between 1993 and 2010, 81.3% of respondents reported they had a Pap test within 3 years; 6.2% were never screened. For women who had a recent checkup, 5.5% were never screened. Among women who had a hysterectomy, 69.4% had a Pap test within 3 years. The multivariable analysis showed that age, race/ethnicity, education, annual household income, never married, and currently uninsured were significantly (pnever screened. Screening programs accompanied by adequate treatment options should target women at high risk for never being screened, which could decrease cervical cancer incidence and mortality.

  12. Perceptions of risk and barriers to cervical cancer screening at Moi ...

    African Journals Online (AJOL)

    Background: Affordable screening cervical cancer methods using visual inspection with acetic acid (VIA) and with Lugol's iodine (VILI) are being developed. Scaling up of screening services requires an understanding of the user perceptions about screening. Objectives: Determine the perceptions of risk and barriers to ...

  13. Development of a self-administered questionnaire to screen patients for cervical myelopathy

    Directory of Open Access Journals (Sweden)

    Sekiguchi Yasufumi

    2010-11-01

    Full Text Available Abstract Background In primary care, it is often difficult to diagnose cervical myelopathy. However, a delay in treatment could cause irreversible aftereffects. With a brief and effective self-administered questionnaire for cervical myelopathy, cervical myelopathy may be screened more easily and oversight may be avoided. As there is presently no screening tool for cervical myelopathy, the aim of this study was to develop a self-administered questionnaire for the screening of cervical myelopathy. Methods A case-control study was performed with the following two groups at our university hospital from February 2006 to September 2008. Sixty-two patients (48 men, 14 women with cervical myelopathy who underwent operative treatment were included in the myelopathy group. In the control group, 49 patients (20 men, 29 women with symptoms that could be distinguished from those of cervical myelopathy, such as numbness, pain in the upper extremities, and manual clumsiness, were included. The underlying conditions were diagnosed as carpal tunnel syndrome, cubital tunnel syndrome, thoracic outlet syndrome, tarsal tunnel syndrome, diabetes mellitus neuropathy, cervical radiculopathy, and neuralgic amyotrophy. Twenty items for a questionnaire in this study were chosen from the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire, which is a new self-administered questionnaire, as an outcome measure for patients with cervical myelopathy. Data were analyzed by univariate analysis using the chi-square test and by multiple logistic regression analysis. According to the resulting odds ratio, β-coefficients, and p value, items were chosen and assigned a score. Results Eight items were chosen by univariate and multiple logistic regression analyses and assigned a score. The Hosmer-Lemeshow statistic showed p = 0.805. The area under the receiver operation characteristic curve was 0.86. The developed questionnaire had a sensitivity of 93.5% and a

  14. Determinants of acceptance of cervical cancer screening in Dar es Salaam, Tanzania

    DEFF Research Database (Denmark)

    Kahesa, Crispin; Kjaer, Susanne; Mwaiselage, Julius

    2012-01-01

    ABSTRACT: OBJECTIVE: To describe how demographic characteristics and knowledge of cervical cancer influence screening acceptance among women living in Dar es Salaam, Tanzania. METHODS: Multistage cluster sampling was carried out in 45 randomly selected streets in Dar es Salaam. Women between...... the ages of 25--59 who lived in the sampled streets were invited to a cervical cancer screening; 804 women accepted and 313 rejected the invitation. Information on demographic characteristics and knowledge of cervical cancer were obtained through structured questionnaire interviews. RESULTS: Women aged 35...... to accept screening in comparison with women who had five or more children (ORs 3.21). Finally, knowledge of cervical cancer and awareness of the existing screening program were also associated with increased acceptance rates (ORs of 5.90 and 4.20). CONCLUSION: There are identifiable subgroups where...

  15. Avoiding piecemeal research on participation in cervical cancer screening: the advantages of a social identity framework

    National Research Council Canada - National Science Library

    Tribe, Candice; Webb, Janine

    2014-01-01

    ...  The aim of this study is to show how consideration of a broader definition of participation and better integration of the theoretical conceptualization of participation in cervical cancer screening...

  16. Improving population-based cervical cancer screening in general practice : effects of a national strategy

    NARCIS (Netherlands)

    Hermens, R P; Hak, E; Hulscher, M E; Mulder, J; Tacken, M A; Braspenning, J C; Grol, R P

    OBJECTIVE: To assess the effects of a Dutch national prevention programme, aimed at general practitioners (GPs), on the adherence to organizational guidelines for effective cervical cancer screening in general practice. To identify the characteristics of general practices determining success.

  17. Knowledge, Attitudes and Practices Regarding Cervical Cancer and Screening among Haitian Health Care Workers

    Directory of Open Access Journals (Sweden)

    Leilah Zahedi

    2014-11-01

    Full Text Available It is estimated that Haiti has the highest incidence of cervical cancer in the Western Hemisphere. There are currently no sustainable and affordable cervical cancer screening programs in Haiti. The current status of screening services and knowledge of health care professionals was assessed through a Knowledge, Attitudes, and Practices survey on cervical cancer screening and prevention. It was distributed to Project Medishare for Haiti health care workers (n = 27 in the Central Plateau. The majority (22/27 of participants stated pre-cancerous cells could be detected through screening, however, only four had ever performed a pap smear. All of the participants felt a screening program should be started in their area. Our data establishes that knowledge is fairly lacking among healthcare workers and there is an opportunity to train them in simple, cost effective “screen-and-treat” programs that could have a great impact on the overall health of the population.

  18. Knowledge, attitudes and practices regarding cervical cancer and screening among Haitian health care workers.

    Science.gov (United States)

    Zahedi, Leilah; Sizemore, Emma; Malcolm, Stuart; Grossniklaus, Emily; Nwosu, Oguchi

    2014-11-10

    It is estimated that Haiti has the highest incidence of cervical cancer in the Western Hemisphere. There are currently no sustainable and affordable cervical cancer screening programs in Haiti. The current status of screening services and knowledge of health care professionals was assessed through a Knowledge, Attitudes, and Practices survey on cervical cancer screening and prevention. It was distributed to Project Medishare for Haiti health care workers (n = 27) in the Central Plateau. The majority (22/27) of participants stated pre-cancerous cells could be detected through screening, however, only four had ever performed a pap smear. All of the participants felt a screening program should be started in their area. Our data establishes that knowledge is fairly lacking among healthcare workers and there is an opportunity to train them in simple, cost effective "screen-and-treat" programs that could have a great impact on the overall health of the population.

  19. Preferences for colorectal cancer screening techniques and intention to attend: a multi-criteria decision analysis.

    Science.gov (United States)

    Hummel, J Marjan; Steuten, Lotte G M; Groothuis-Oudshoorn, C J M; Mulder, Nick; Ijzerman, Maarten J

    2013-10-01

    Despite the expected health benefits of colorectal cancer screening programs, participation rates remain low in countries that have implemented such a screening program. The perceived benefits and risks of the colorectal cancer screening technique are likely to influence the decision to attend the screening program. Besides the diagnostic accuracy and the risks of the screening technique, which can affect the health of the participants, additional factors, such as the burden of the test, may impact the individuals' decisions to participate. To maximise the participation rate of a screening program for a new colorectal cancer program in the Netherlands, it is important to know the preferences of the screening population for alternative screening techniques. The aim of this study was to explore the impact of preferences for particular attributes of the screening tests on the intention to attend a colorectal cancer screening program. We used a web-based questionnaire to elicit the preferences of the target population for a selection of colon-screening techniques. The target population consisted of Dutch men and women aged 55-75 years. The analytic hierarchy process (AHP), a technique for multi-criteria analysis, was used to estimate the colorectal cancer screening preferences. Respondents weighted the relevance of five criteria, i.e. the attributes of the screening techniques: sensitivity, specificity, safety, inconvenience, and frequency of the test. With regard to these criteria, preferences were estimated between four alternative screening techniques, namely, immunochemical fecal occult blood test (iFOBT), colonoscopy, sigmoidoscopy, and computerized tomographic (CT) colonography. A five-point ordinal scale was used to estimate the respondents' intention to attend the screening. We conducted a correlation analysis on the preferences for the screening techniques and the intention to attend. We included 167 respondents who were consistent in their judgments of the

  20. Barriers to cervical cancer screening in Mulanje, Malawi: a qualitative study

    Directory of Open Access Journals (Sweden)

    Victoria K Fort

    2011-03-01

    Full Text Available Victoria K Fort1, Mary Sue Makin2, Aaron J Siegler1, Kevin Ault3, Roger Rochat11Rollins School of Public Health, Atlanta, Georgia, USA; 2Mulanje Mission Hospital, Mulanje, Malawi; 3Emory University Medical School, Atlanta, Georgia, USABackground: In Malawi, cervical cancer is the most prevalent form of cancer among women, with an 80% mortality rate. The Mulanje Mission Hospital has offered free cervical cancer screening for eight years; however, patients primarily seek medical help for gynecologic complaints after the disease is inoperable.Methods: We investigated how women in rural Malawi make health-seeking decisions regarding cervical cancer screening using qualitative research methods. The study was conducted between May and August of 2009 in Mulanje, Malawi.Results: This study found that the primary cue to action for cervical cancer screening was symptoms of cervical cancer. Major barriers to seeking preventative screening included low knowledge levels, low perceived susceptibility and low perceived benefits from the service. Study participants did not view cervical cancer screening as critical health care. Interviews suggested that use of the service could increase if women are recruited while visiting the hospital for a different service.Conclusion: This study recommends that health care providers and health educators target aspects of perceived susceptibility among their patients, including knowledge levels and personal risk assessment. We believe that continued support and advertisement of cervical cancer screening programs along with innovative recruitment strategies will increase usage density and decrease unnecessary deaths from cervical cancer in Malawi.Keywords: cervical cancer, interviews, health care, Mulanje Mission Hospital

  1. Obesity and screening for breast, cervical, and colorectal cancer in women: a review.

    Science.gov (United States)

    Cohen, Sarah S; Palmieri, Rachel T; Nyante, Sarah J; Koralek, Daniel O; Kim, Sangmi; Bradshaw, Patrick; Olshan, Andrew F

    2008-05-01

    The literature examining obesity as a barrier to screening for breast, cervical, and colorectal cancer has not been evaluated systematically. With the increasing prevalence of obesity and its impact on cancer incidence and mortality, it is important to determine whether obesity is a barrier to screening so that cancers among women at increased risk because of their body size can be detected early or prevented entirely. On the basis of 32 relevant published studies (10 breast cancer studies, 14 cervical cancer studies, and 8 colorectal cancer studies), the authors reviewed the literature regarding associations between obesity and recommended screening tests for these cancer sites among women in the U.S. The most consistent associations between obesity and screening behavior were observed for cervical cancer. Most studies reported an inverse relation between decreased cervical cancer screening and increasing body size, and several studies reported that the association was more consistent among white women than among black women. For breast cancer, obesity was associated with decreased screening behavior among white women but not among black women. The literature regarding obesity and colorectal cancer screening adherence was mixed, with some studies reporting an inverse effect of body size on screening behavior and others reporting no effect. Overall, the results indicated that obesity most likely is a barrier to screening for breast and cervical cancers, particularly among white women; the evidence for colorectal cancer screening was inconclusive. Thus, efforts to identify barriers and increase screening for breast and cervical cancers may be targeted toward obese women, whereas outreach to all women should remain the objective for colorectal cancer screening programs.

  2. Socio-economic inequalities in breast and cervical cancer screening practices in Europe: influence of the type of screening program

    NARCIS (Netherlands)

    Palència, Laia; Espelt, Albert; Rodríguez-Sanz, Maica; Puigpinós, Rosa; Pons-Vigués, Mariona; Pasarín, M. Isabel; Spadea, Teresa; Kunst, Anton E.; Borrell, Carme

    2010-01-01

    Methods A cross-sectional study was performed using individual-level data from the WHO World Health Survey (2002) and data regarding the implementation of cancer screening programmes. The study population consisted of women from 22 European countries, aged 25-69 years for cervical cancer screening

  3. Cervical Cancer Screening Program by Visual Inspection: Acceptability and Feasibility in Health Insurance Companies

    Directory of Open Access Journals (Sweden)

    Apollinaire G. Horo

    2015-01-01

    Full Text Available Objective. To assess willingness to participate and diagnostic accuracy of visual inspection for early detection of cervical neoplasia among women in a health insurance company. Patients and Method. Cervical cancer screening was systematically proposed to 800 women after consecutive information and awareness sessions. The screening method was visual inspection with acetic acid (VIA or Lugol’s iodine (VILI. Results. Among the 800 identified women, 640 (82% have accepted the screening, their mean age was 39 years, and 12.0% of them were involved in a polygamist couple. 28.2% of women had prior cervical screening. VIA has been detected positive in 5.9% of women versus 8.6% for VILI. The sensitivity was 72.9% and specificity was 95.2% for VIA versus 71.2% and 97.3% for VILI respectively. The histological examination highlighted a nonspecific chronic cervicitis in 4.6%, CIN1 lesions in 5.91%, and CIN2/3 in 1.2% of the cases. Conclusion. Cervical cancer screening by visual inspection showed appropriate diagnostic accuracy when used to detect early cervical lesions. It is a simple and easy to perform method that could be introduced progressively in the health insurance policy while waiting for a national screening program.

  4. Cervical cancer screening in rural South Africa among HIV-infected migrant farm workers and sex workers.

    Science.gov (United States)

    Afzal, Omara; Lieber, Molly; Dottino, Peter; Beddoe, Ann Marie

    2017-05-01

    At an HIV clinic in the Limpopo province of South Africa, chart reviews revealed long delays in addressing abnormal Pap smears, difficulty in referrals, poor quality and lost results, and increasing cases of cervical cancer. To address these barriers, a "see and treat" approach to screening was proposed. The objective was to integrate this method into current HIV care offered by local providers and to obtain demographic and risk factor data for use in future educational and intervention programs in the region. A cross sectional study of HIV farm workers and at-risk sex workers attending an HIV clinic was performed with visual inspection with acetic acid (VIA). Those with positive screens were offered cryotherapy. Clinic charts were reviewed retrospectively for Pap smear results for the previous year at the time of program initiation and at 12 and 18 months post-program. A total of 403 participants consented and underwent screening with VIA (306 Farm workers and 97 sex workers participated). 83.9% of participants (32.9% sex workers and 100% farm workers) were HIV +. VIA was positive in 30.5% of participants, necessitating cryotherapy. There was no significant difference in VIA positivity between HIV + farm workers and sex workers. There was a positive correlation between Pap smears and VIAs results. We demonstrate successful integration of cervical cancer screening using VIA for HIV + farm workers and sex workers into an existing HIV treatment and prevention clinic in rural South Africa, addressing and treating abnormal results promptly.

  5. Does lack of resources impair access to breast and cervical cancer screening in Japan?

    Science.gov (United States)

    Sano, Hiroshi; Goto, Rei; Hamashima, Chisato

    2017-01-01

    To assess the impact of the quantity of resources for breast and cervical cancer screening on the participation rates in screening in clinical settings in municipalities, as well as to clarify whether lack of resources impairs access to cancer screening in Japan. Of the 1,746 municipalities in 2010, 1,443 (82.6%) and 1,469 (84.1%) were included in the analyses for breast and cervical cancer screening, respectively. In order to estimate the effects of the number of mammography units and of gynecologists on the participation rates in breast and cervical cancer screening in clinical settings, multiple regression analyses were performed using the interaction term for urban municipalities. The average participation rate in screening in clinical settings was 6.01% for breast cancer, and was 8.93% for cervical cancer. The marginal effect of the number of mammography units per 1,000 women was significantly positive in urban municipalities (8.20 percent point). The marginal effect of the number of gynecologists per 1,000 women was significantly positive in all municipalities (2.54 percent point) and rural municipalities (3.68 percent point). Lack of mammography units in urban areas and of gynecologists particularly in rural areas impaired access to breast and cervical cancer screening. Strategies are required that quickly improve access for the residents and increase their participation rates in cancer screening.

  6. Challenges to cervical screening in a developing country: The case of Malaysia.

    Science.gov (United States)

    Othman, Nor Hayati; Rebolj, Matejka

    2009-01-01

    Many developing countries, including Malaysia, will need to continue relying on cervical screening because they will not be able to cover their entire female adolescent populations with HPV vaccination. The aim of this paper was to establish the extent of the health care, informational, financial and psychosocial barriers to cervical screening in Malaysia. A literature search was made for reports on implementation, perceptions and reception of cervical screening in Malaysia published between January 2000 and September 2008. Despite offering Pap smears for free since 1995, only 47.3% of Malaysian women have been screened. Several factors may have contributed to this. No national call-recall system has been established. Women are informed about cervical screening primarily through mass media rather than being individually invited. Smears are free of charge if taken in public hospitals and clinics, but the waiting times are often long. The health care system is unequally dense, with rural states being underserved compared to their urban counterparts. If the screening coverage was to increase, a shortage of smear-readers would become increasingly apparent. Improving screening coverage will remain an important strategy for combating cervical cancer in Malaysia. The focus should be on the policy-making context, improving awareness and the screening infrastructure, and making the service better accessible to women.

  7. Cervical cancer screening and treatment of cervical intraepithelial neoplasia in female sex workers using “screen and treat” approach

    Directory of Open Access Journals (Sweden)

    Joshi S

    2015-05-01

    Full Text Available Smita Joshi,1 Vinay Kulkarni,2 Trupti Darak,2 Uma Mahajan,1 Yogesh Srivastava,3 Sanjay Gupta,3 Sumitra Krishnan,1 Mahesh Mandolkar,2 Alok Chandra Bharti31Hirabai Cowasji Jehangir Medical Research Institute (HCJMRI, Jehangir Hospital Premises, Pune, Maharashtra, India; 2Prayas Health Group, Amrita Clinic, Pune, India; 3Institute for Cytology and Preventive Oncology, Indian Council of Medical Research, New Delhi, IndiaObjective: Female sex workers (FSWs are at an increased risk of human immunodeficiency virus (HIV as well as human papillomavirus (HPV infections and thus have an increased risk of cervical intraepithelial neoplasia (CIN and cervical cancer. We evaluated the feasibility of “screen and treat approach” for cervical cancer prevention and the performance of different screening tests among FSWs.Methods: Women were screened using cytology, VIA (visual inspection with acetic acid, and VILI (visual inspection with Lugol’s iodine and underwent colposcopy, biopsy, and immediate treatment using cold coagulation, if indicated, at the same visit.Results: We screened 300 FSWs of whom 200 (66.67% were HIV uninfected and 100 (33.34% were HIV infected. The overall prevalence of CIN 2–3 lesions was 4.7%. But all women with CIN 2–3 lesions were HIV infected, and thus the prevalence of CIN 2–3 lesions in HIV-infected FSWs was 14/100 (14%, 95% confidence interval: 7.2–20.8. All of them screened positive by all three screening tests. Cold coagulation was well tolerated, with no appreciable side effects.Conclusion: Cervical cancer prevention by “screen and treat” approach using VIA, followed by ablative treatment, in this high-risk group of women is feasible and can be implemented through various targeted intervention programs. Keywords: cytology, VIA, VILI, CIN, cold coagulation, cervical cancer, HPV, FSWs

  8. Comparative study between Pap smear and visual inspection using acetic acid as a method of cervical cancer screening.

    Science.gov (United States)

    Begum, S A; Rashid, M H; Nessa, A; Aziz, M A; Zakaria, S M; Roy, J S

    2012-01-01

    This prospective study was done for the comparison of visual inspection using acetic acid (VIA) and Pap smear as a method of cervical cancer screening. This study was also done to determine the proportion of women screened positive with VIA and proportion of women screened positive with Pap smear. Another aim was to compare the sensitivity and specificity of VIA and Pap smear. A total of 300 women attended to the outpatient gynecologic clinic and cervical cancer screening programme at Bangabandhu Sheikh Mujib Medical University (BSMMU) were included. On VIA, 23 out of 300 women screened had aceto-white lesions. On Pap smear, 14 out of the 300 women had ASCUS or worse lesions. Of the 300 enrolled women, 11 were positive on both VIA and cytology; 12 were positive on VIA only; and 3 were positive on cytology only. Those women (n=26) who showed positive test result with either VIA or Pap smear or both tests were further subjected to colposcopy directed biopsy. Histology was taken as gold standard to compare the performance of VIA and cytology (Pap's smear). Histological diagnosis of CIN/cancer was made in 18 Positive cases out of the total 26 patients who underwent biopsy. Pap smear picked up 10 out of the 18 biopsy-proven cases whereas VIA could identify 17 out of the 18 CIN/carcinoma cervices. VIA was more sensitive (94.44%) than pap smear (55.55%), which was statistically significant. However, the specificity of VIA was slightly lower (97.87%) than that of cytology (98.58%). The PPV of VIA was 73.91% versus 71.42 % for Pap smear.

  9. Self-collection based HPV testing for cervical cancer screening among women living with HIV in Uganda: a descriptive analysis of knowledge, intentions to screen and factors associated with HPV positivity.

    Science.gov (United States)

    Mitchell, Sheona M; Pedersen, Heather N; Eng Stime, Evelyn; Sekikubo, Musa; Moses, Erin; Mwesigwa, David; Biryabarema, Christine; Christilaw, Jan; Byamugisha, Josaphat K; Money, Deborah M; Ogilvie, Gina S

    2017-01-13

    Women living with HIV (WHIV) are disproportionately impacted by cervical dysplasia and cancer. The burden is greatest in low-income countries where limited or no access to screening exists. The goal of this study was to describe knowledge and intentions of WHIV towards HPV self-collection for cervical cancer screening, and to report on factors related to HPV positivity among women who participated in testing. A validated survey was administered to 87 HIV positive women attending the Kisenyi Health Unit aged 30-69 years old, and data was abstracted from chart review. At a later date, self-collection based HPV testing was offered to all women. Specimens were tested for high risk HPV genotypes, and women were contacted with results and referred for care. Descriptive statistics, Chi Square and Fischer-exact statistical tests were performed. The vast majority of WHIV (98.9%) women did not think it necessary to be screened for cervical cancer and the majority of women had never heard of HPV (96.4%). However, almost all WHIV found self-collection for cervical cancer screening to be acceptable. Of the 87 WHIV offered self-collection, 40 women agreed to provide a sample at the HIV clinic. Among women tested, 45% were oncogenic HPV positive, where HPV 16 or 18 positivity was 15% overall. In this group of WHIV engaged in HIV care, there was a high prevalence of oncogenic HPV, a large proportion of which were HPV genotypes 16 or 18, in addition to low knowledge of HPV and cervical cancer screening. Improved education and cervical cancer screening for WHIV are sorely needed; self-collection based screening has the potential to be integrated with routine HIV care in this setting.

  10. Cervical Cancer Prevention

    Science.gov (United States)

    ... keep cancer from starting. General Information About Cervical Cancer Cervical cancer is a disease in which malignant (cancer) ... information about cervical cancer: Cervical Cancer Screening Cervical Cancer Treatment Cervical Cancer Prevention Key Points Avoiding risk factors and ...

  11. Cervical screening within HIV care: findings from an HIV-positive cohort in Ukraine.

    Directory of Open Access Journals (Sweden)

    Heather Bailey

    Full Text Available HIV-positive women have an increased risk of invasive cervical cancer but cytologic screening is effective in reducing incidence. Little is known about cervical screening coverage or the prevalence of abnormal cytology among HIV-positive women in Ukraine, which has the most severe HIV epidemic in Europe.Poisson regression models were fitted to data from 1120 women enrolled at three sites of the Ukraine Cohort Study of HIV-infected Childbearing Women to investigate factors associated with receiving cervical screening as part of HIV care. All women had been diagnosed as HIV-positive before or during their most recent pregnancy. Prevalence of cervical abnormalities (high/low grade squamous intraepithelial lesions among women who had been screened was estimated, and associated factors explored.Overall, 30% (337/1120 of women had received a cervical screening test as part of HIV care at study enrolment (median 10 months postpartum, a third (115/334 of whom had been tested >12 months previously. In adjusted analyses, women diagnosed as HIV-positive during (vs before their most recent pregnancy were significantly less likely to have a screening test reported, on adjusting for other potential risk factors (adjusted prevalence ratio (APR 0.62, 95% CI 0.51-0.75 p<0.01 for 1(st/2(nd trimester diagnosis and APR 0.42, 95% CI 0.28-0.63 p<0.01 for 3(rd trimester/intrapartum diagnosis. Among those with a cervical screening result reported at any time (including follow-up, 21% (68/325 had a finding of cervical abnormality. In adjusted analyses, Herpes simplex virus 2 seropositivity and a recent diagnosis of bacterial vaginosis were associated with an increased risk of abnormal cervical cytology (APR 1.83 95% CI 1.07-3.11 and APR 3.49 95% CI 2.11-5.76 respectively.In this high risk population, cervical screening coverage as part of HIV care was low and could be improved by an organised cervical screening programme for HIV-positive women. Bacterial vaginosis

  12. Cervical Screening within HIV Care: Findings from an HIV-Positive Cohort in Ukraine

    Science.gov (United States)

    Bailey, Heather; Thorne, Claire; Semenenko, Igor; Malyuta, Ruslan; Tereschenko, Rostislav; Adeyanova, Irina; Kulakovskaya, Elena; Ostrovskaya, Lyudmila; Kvasha, Liliana; Cortina-Borja, Mario; Townsend, Claire L.

    2012-01-01

    Introduction HIV-positive women have an increased risk of invasive cervical cancer but cytologic screening is effective in reducing incidence. Little is known about cervical screening coverage or the prevalence of abnormal cytology among HIV-positive women in Ukraine, which has the most severe HIV epidemic in Europe. Methods Poisson regression models were fitted to data from 1120 women enrolled at three sites of the Ukraine Cohort Study of HIV-infected Childbearing Women to investigate factors associated with receiving cervical screening as part of HIV care. All women had been diagnosed as HIV-positive before or during their most recent pregnancy. Prevalence of cervical abnormalities (high/low grade squamous intraepithelial lesions) among women who had been screened was estimated, and associated factors explored. Results Overall, 30% (337/1120) of women had received a cervical screening test as part of HIV care at study enrolment (median 10 months postpartum), a third (115/334) of whom had been tested >12 months previously. In adjusted analyses, women diagnosed as HIV-positive during (vs before) their most recent pregnancy were significantly less likely to have a screening test reported, on adjusting for other potential risk factors (adjusted prevalence ratio (APR) 0.62, 95% CI 0.51–0.75 p<0.01 for 1st/2nd trimester diagnosis and APR 0.42, 95% CI 0.28–0.63 p<0.01 for 3rd trimester/intrapartum diagnosis). Among those with a cervical screening result reported at any time (including follow-up), 21% (68/325) had a finding of cervical abnormality. In adjusted analyses, Herpes simplex virus 2 seropositivity and a recent diagnosis of bacterial vaginosis were associated with an increased risk of abnormal cervical cytology (APR 1.83 95% CI 1.07–3.11 and APR 3.49 95% CI 2.11–5.76 respectively). Conclusions In this high risk population, cervical screening coverage as part of HIV care was low and could be improved by an organised cervical screening programme for HIV

  13. Impact of health education intervention on knowledge and perception of cervical cancer and cervical screening uptake among adult women in rural communities in Nigeria.

    Science.gov (United States)

    Abiodun, Olumide A; Olu-Abiodun, Oluwatosin O; Sotunsa, John O; Oluwole, Francis A

    2014-08-07

    Cervical cancer is a disease of public health importance affecting many women and contributing to avoidably high levels of cancer deaths in Nigeria. In spite of the relative ease of prevention, the incidence is on the increase. This study aimed to determine the effect of health education on the awareness, knowledge and perception of cervical cancer and screening among women in rural Nigerian communities. The study design was quasi-experimental. The study was carried out among adult women in Odogbolu (intervention) and Ikenne (control) local government areas (LGA) of Ogun state. Three hundred and fifty (350) women were selected per group by multistage random sampling technique. Data was collected by semi structured interviews with the aid of questionnaire. The intervention consisted of structured health education based on a movie. The intervention raised the level of awareness of cervical cancer and screening to 100% (p women with very good knowledge of cervical cancer and screening rose from 2% to 70.5% (χ(2) = 503.7, p women who had undertaken cervical screening from 4.3% to 8.3% (p = 0.038). The major reason stated by the women for not having had cervical screening done was lack of awareness about cervical cancer and screening. There was statistically significant difference between the intervention and control groups concerning their knowledge attitude and practice towards cervical and screening (p education based on a movie is effective in creating awareness for and improving the knowledge and perception of adult women about cervical cancer and screening. It also improves the uptake of cervical cancer screening. The creation of awareness is very crucial to the success of a cervical cancer prevention programme.

  14. Effects of numerical information on intention to participate in cervical screening among women offered HPV vaccination

    DEFF Research Database (Denmark)

    Hestbech, Mie Sara; Gyrd-Hansen, Dorte; Kragstrup, Jakob

    2016-01-01

    Objectives: To investigate the effects of different types of information about benefits and harms of cervical screening on intention to participate in screening among women in the first cohorts offered human papilloma virus (HPV) vaccination. Design: Randomised survey study. Setting: Denmark...... of cervical screening: no information; non-numerical information; and two numerical information modules. Moreover, we provided HPV-vaccinated women in one of the arms with numerical information about benefits and harms in two steps: firstly, information without consideration of HPV vaccination...... and subsequently information conditional on HPV vaccination. Main outcome measure: Self-reported intention to participate in cervical screening. Results: A significantly lower proportion intended to participate in screening in the two groups of women receiving numerical information compared to controls...

  15. Follow-up of abnormal or inadequate test results in the Danish Cervical Cancer Screening Program

    DEFF Research Database (Denmark)

    Kristiansen, Bettina Kjær

    2014-01-01

    Denmark has a higher incidence of cervical cancer than other Nordic countries, although all Danish women (aged 23–65) are screened regularly to identify possible cervical dysplasia or asymptomatic invasive cancer. Annually 40 000 women receives an abnormal or inadequate test result and a follow......-up recommendation. However problems with delayed follow-up may threaten the effectiveness of the Danish Cervical Cancer Screening Program, as 20% of women are delayed and dysplasia potentially can progress into cancer. Delayed follow-up is found in situations where women either consciously or unconsciously postpone...... will be of great importance to the future organisation of cervical and colorectal cancer screening programmes in Denmark, but will also have international interest because of their similar challenges....

  16. Making sense of information about HPV in cervical screening: a qualitative study.

    Science.gov (United States)

    Waller, J; McCaffery, K; Nazroo, J; Wardle, J

    2005-01-31

    Introducing human papillomavirus (HPV) testing into cervical cancer screening has the potential to change the way that women understand cervical cancer, the psychological impact of abnormal screening results and the likelihood of future participation in screening. The study used in-depth interviews to examine how women make sense of information about HPV in the context of cervical cancer screening. A total of 74 women were recruited following participation in HPV testing. Women varied widely in their beliefs about the aetiology of cervical cancer and its relationship with sexual activity, as well as in their understanding of the sexually transmitted nature of HPV. While some women who understood that HPV is sexually transmitted were able to integrate this into their existing model of cervical cancer, others were shocked by the link between cervical cancer and sex, of which they had been previously unaware. Women were generally reassured to know that HPV is common, has no symptoms, can lie dormant for many years, can clear up on its own and need not raise concerns about transmission to sexual partners. Women's understanding of HPV varied considerably, even after participation in testing. The way in which information is presented to women will be crucial in minimising the negative psychological impact of testing positive and ensuring that participation in screening remains high.

  17. Awareness of cervical cancer and screening in a Nigerian female ...

    African Journals Online (AJOL)

    Background: Cervical cancer, although largely preventable, remains a leading cause of cancer death among females in the developing world. The study was aimed at providing useful information on awareness of market women, who are from diverse social backgrounds, about cervical cancer and evaluate the extent of ...

  18. Cervical Cancer Screening by Female Workers in South East Nigeria

    African Journals Online (AJOL)

    Cervical cancer is the commonest genital tract cancer worldwide and one of the leading causes of death from cancer among women in developing countries . It is therefore a major female reproductive health problem. Roughly 80% of newly diagnosed cases of cervical cancer are in developing countries. Rates are highest ...

  19. Screening for Cervical Cancer: Experience from a University ...

    African Journals Online (AJOL)

    Background: Cervical cancer is the most common gynecological cancer among women in Nigeria. The incidence is on the increase and poses a public health problem. The etiological agent is the human papilloma virus that is sexual transmitted. The cervical cancer incidence is related to lifestyle, poverty and sexual ...

  20. Screening for cervical neoplasia in Mamelodi lessons from an ...

    African Journals Online (AJOL)

    M. J. Heystek, E. T. M. de Jonge, H. P. Meyer,. B. G. Lindeque. Aim. To determine the prevalence of abnormal cervical cytological findings in an unscreened population; to assess patients' awareness of cervical cancer and the importance of early diagnosis; and to evaluate the accuracy of visual inspection of the cervix as a ...

  1. Knowledge and practice of cervical cancer screening at the Imo ...

    African Journals Online (AJOL)

    Those who were aware of cervical cancer were 13.6% as against 6% who were aware of Pap smear. Only 2.4% of the 450 respondents had ever had a cervical cytology performed on them. The most frequent reason given for not using the service was lack of physician referral. Culture was found to negatively impact on the ...

  2. Mobilization for cervical cancer screening: lessons from a poor-urban Yoruba community in Nigeria.

    Science.gov (United States)

    Thomas, J O; Babarinsa, I A; Ajayi, I O; Fawole, O; Ojemakinde, K O; Omigbodun, A O

    2005-03-01

    Cervical cancer is a major public health problem worldwide and it remains one of the commonest malignancies in Nigeria. Screening remains the most effective tool for the detection of pre-invasive stages of cervical cancer, giving the opportunity for prompt and effective treatment before the emergence of invasive disease. In Nigeria, as in most developing countries, the concept of screening for cancer and its pre-emptive treatment is underdeveloped. The fact that the facilities and logistics for cervical cancer screening are generally located in the hospital setting, a place where one goes when ill, according to local beliefs, makes acceptance more difficult. That Nigeria urgently needs to set up or develop cervical screening programmes that will reach women outside the hospital setting in a culturally acceptable milieu is not in doubt. A community cervical screening survey for the prevalence of cervical intraepithelial neoplasia and HPV infection was initiated in Idikan, a poor-urban inner core area of Ibadan. The challenges and experiences encountered in the execution of the project which could serve as useful knowledge to those undertaking similar exercises, requiring mass mobilization for cancer screening of an uninformed group, are highlighted. Our experience in the course of this study is important as it brought out the probable influences of community dynamics and social organization in illness decisions and prescriptions for health operative in this particular population group. Cervical cancer screening programmes should therefore make provisions to accommodate the occasional outcomes as we had encountered. In addition, screening programmes in developing societies would require sensitive designs that should address the cultural attitudes, personal conflicts, expectations of treatment and overall context of preventive care.

  3. Current techniques in screening for cervical cancer in Spain: updated recommendations.

    Science.gov (United States)

    Puig-Tintoré, Luis M; Torné, Aureli; Alonso, Immaculada

    2008-09-01

    A population-based survey (AFRODITA Study) was conducted in Spain in order to estimate the coverage and factors associated with cervical cancer cytological screening. The results of this survey indicate that the rate of screening for cervical cancer in Spain is 75.6% in women between 18 and 65 years. This high rate of opportunistic cervical cancer screening possibly has increased in the last 5 years. However, screening participation still needs to be improved in older women, women living in rural areas, women at a low socioeconomic level, and women living in certain autonomous regions. Conversely, an overuse of cytology has been observed in Spain, as a result of opportunistic screening. A survey in 2005, carried out in 14 public and private Spanish cytological laboratories, showed that among 409,443 women, the mean rate of abnormal cytology (a diagnosis of at least atypical cells of undetermined significance on a Pap smear) was 3.5% with a range of 0.5%-7.0% in Spain. We believe that this low rate of abnormal Pap smears is the result of repeated annual opportunistic screening in a low-risk population of women. A new Spanish consensus protocol for screening for cervical carcinoma was developed in 2006 by the Spanish Society of Gynaecology and Obstetrics, the Spanish Association of Cervical Pathology and Colposcopy, the Spanish Society of Cytology, and the Spanish Society of Anatomic Pathology. In order to rationalize the use of cervical cancer screening in Spain, the recommendations of the new Spanish consensus screening protocol must be followed.

  4. Obesity and screening compliance for breast and cervical cancer in Korean women.

    Science.gov (United States)

    Park, Jin Kyun; Park, Hyun Ah; Park, Jin Joo; Cho, Young Gyu

    2012-01-01

    This study was performed to assess whether the weight status is associated with screening rates of breast and cervical cancer in Korean women. Study participants included women aged between 30 and 80 years from the 4th Korea National Health and Nutrition Examination Survey from 2007 to 2009. Body mass index was classified into ~18.4 kg/m2 (underweight), 18.5~22.9 kg/m2 (normal), 23~24.9 kg/m2 (overweight), 25.0~29.9 kg/m2 (moderate obesity) and 30.0 kg/m2~ (severe obesity) according to the Asia Pacific Standards of WHO recommended definition of obesity. Screening rates of breast and cervical cancer were estimated by the recommendation of the National Cancer Screening Program of the National Cancer Center, Korea. The overall screening rates for breast and cervical cancer were 51.3% and 50.1%, respectively. After covariate adjustment, the screening rates for breast cancer (adjusted odds ratio, 0.70; 95% confidence interval, 0.51 to 0.97) and cervical cancer (adjusted odds ratio, 0.71; 95% confidence interval, 0.53 to 0.94) were significantly lower in the women with severe obesity. Obesity is associated with lower compliance with breast and cervical cancer screening guidelines in Korean women.

  5. Cervical Cancer Screening and Its Associated Factors Among North Korean Defectors Living in South Korea.

    Science.gov (United States)

    Park, Jeongok; Kim, HeesSook; Yang, Wonhee; Lee, HaeWon; Park, Sang Min

    2018-02-01

    North Korean defectors (NKD) have many health problems related to insufficient nutrition, trauma from escaping, and being exposed to infectious diseases, but little research exists on their cancer screening. A total of 638 NKD participated in this cross-sectional survey. South Korean natives (SKN) who participated in the Korean National Health and Nutrition Examination Survey V were selected using age matching to each NKD. Fisher's exact tests and logistic regression were used for data analysis. The cervical cancer screening rate of NKD was significantly lower than for SKN (42 and 70 %, respectively; P < .001). The adjusted proportions of cervical cancer screening for NKD in all age groups under 60 years (P < .01) and having education beyond high school (P < .001) were significantly lower than that of SKN. NKD who had education under a high school level were more likely to have cervical cancer screening compared to NKD with education beyond a high school level (OR 1.81, 95 % CI 1.12-2.93). NKD were less likely to receive appropriate cervical cancer screening compared to SKN, especially those aged 30-39 years or married. Tailored interventions for NKD are needed to improve cervical cancer screening compliance.

  6. Understanding Cervical Cancer Screening Intentions Among Latinas Using An Expanded Theory of Planned Behavior Model

    Science.gov (United States)

    Roncancio, Angelica M.; Ward, Kristy K.; Fernandez, Maria E.

    2016-01-01

    We examined the utility of an expanded Theory of Planned Behavior (TPB) model in predicting cervical cancer screening intentions among Latinas. The model included acculturation and past cervical cancer screening behavior along with attitude, subjective norms, and perceived behavioral control. This cross-sectional study included a sample of 206 Latinas who responded to a self-administered survey. Structural equation modeling was employed to test the expanded TPB model. Acculturation (p= .025) and past screening behavior (p= .001) along with attitude (p= .019), subjective norms (p= .028), and perceived behavioral control (p= .014) predicted the intention to be screened for cervical cancer. Our findings suggest that the TPB is a useful model for understanding cervical cancer screening intentions among Latinas when both past behavior and culture are included. This highlights the importance of culture on behavior and indicates a need to develop culturally sensitive, theory-based interventions to encourage screening and reduce cervical cancer-related health disparities in Latinas. PMID:23930898

  7. HPV testing for cervical cancer screening appears more cost-effective than Papanicolau cytology in Mexico.

    Science.gov (United States)

    Flores, Yvonne N; Bishai, David M; Lorincz, Attila; Shah, Keerti V; Lazcano-Ponce, Eduardo; Hernández, Mauricio; Granados-García, Víctor; Pérez, Ruth; Salmerón, Jorge

    2011-02-01

    To determine the incremental costs and effects of different HPV testing strategies, when compared to Papanicolau cytology (Pap), for cervical cancer screening in Mexico. A cost-effectiveness analysis (CEA) examined the specific costs and health outcomes associated with (1) no screening; (2) only the Pap test; (3) only self-administered HPV; (4) only clinician administered HPV; and (5) clinician administered HPV plus the Pap test. The costs of self- and clinician-HPV testing, as well as with the Pap test, were identified and quantified. Costs were reported in 2008 US dollars. The health outcome associated with these screening strategies was defined as the number of high-grade cervical intraepithelial neoplasia or cervical cancer cases detected. This CEA was performed using the perspective of the Mexican Institute of Social Security (IMSS) in Morelos, Mexico. Screening women between the ages of 30-80 for cervical cancer using clinical-HPV testing or the combination of clinical-HPV testing, and the Pap is always more cost-effective than using the Pap test alone. This CEA indicates that HPV testing could be a cost-effective screening alternative for a large health delivery organization such as IMSS. These results may help policy-makers implement HPV testing as part of the IMSS cervical cancer screening program.

  8. Diagnostic accuracy of high-risk HPV genotyping in women with high-grade cervical lesions: evidence for improving the cervical cancer screening strategy in China.

    Science.gov (United States)

    Xu, Huihui; Lin, Aifen; Shao, Xiujuan; Shi, Weiwu; Zhang, Yang; Yan, Weihua

    2016-12-13

    Currently, clinical data for primary HPV screening alone are lacking in China. Here, we evaluate cervical cancer screening with primary HPV genotyping, as well as possible future screening strategy. Overall, high-risk HPV (hrHPV) prevalence was 18.2% among hospital-based population in Taizhou area. For cervical intraepithelial neoplasia 2 or worse (CIN2+), the sensitivity of primary hrHPV genotyping strategy and current cervical cancer screening strategy were 93.5%, and 71.1%, respectively; whereas the specificity was 17.5%, and 62.4%, respectively. Current cervical screening strategy had slightly higher positive predictive values (28.4%) for CIN2+ than hrHPV genotyping strategy (21.9%), whereas primary hrHPV genotyping strategy demonstrated higher negative predictive values (94.7%) than current cervical screening strategy (91.1%). Compared to HPV35/39/45/51/56/59/66/68 genotypes, the odds ratios (OR) for CIN2+ in HPV16/18/31/33/52/58 infection women were 3.2 (95% confidence interval [CI] 2.3-4.1). Primary hrHPV genotyping strategy provides a better predictive value than HPV16/18 genotyping alone in guiding the clinical management of the current cervical cancer screening. HPV testing without adjunctive cytology may be sufficiently sensitive for primary cervical cancer screening.

  9. “I want to save my life”: Conceptions of cervical and breast cancer screening among urban immigrant women of South Asian and Chinese origin

    Directory of Open Access Journals (Sweden)

    Jennifer Hulme

    2016-10-01

    Full Text Available Abstract Background Breast and cervical cancer screening rates remain low among immigrant women and those of low socioeconomic status. The Cancer Awareness: Ready for Education and Screening (CARES project ran a peer-led multi-lingual educational program between 2012 and 2014 to reach under and never-screened women in Central Toronto, where breast and cervical cancer screening rates remain low. The objective of this qualitative study was to better understand how Chinese and South Asian immigrants – the largest and most under-screened immigrant groups according to national and provincial statistics - conceive of breast and cervical cancer screening. We explored their experiences with screening to date. We explicitly inquired about their perceptions of the health care system, their screening experiences with family physicians and strategies that would support screening in their communities. Methods We conducted 22 individual interviews and two focus groups in Bengali and Mandarin with participants who had attended CARES educational sessions. Transcripts were coded through an iterative constant comparative and interpretative approach. Results Themes fell into five major, overlapping domains: risk perception and concepts of preventative health and screening; health system engagement and the embedded experience with screening; fear of cancer and procedural pain; self-efficacy, obligation, and willingness to be screened; newcomer barriers and competing priorities. These domains all overlap, and contribute to screening behaviours. Immigrant women experienced a number of barriers to screening related to ‘navigating newness’, including transportation, language barriers, arrangements for time off work and childcare. Fear of screening and fear of cancer took many forms; painful or traumatic encounters with screening were described. Female gender of the provider was paramount for both groups. Newly screened South Asian women were reassured by their

  10. "I want to save my life": Conceptions of cervical and breast cancer screening among urban immigrant women of South Asian and Chinese origin.

    Science.gov (United States)

    Hulme, Jennifer; Moravac, Catherine; Ahmad, Farah; Cleverly, Shelley; Lofters, Aisha; Ginsburg, Ophira; Dunn, Sheila

    2016-10-13

    Breast and cervical cancer screening rates remain low among immigrant women and those of low socioeconomic status. The Cancer Awareness: Ready for Education and Screening (CARES) project ran a peer-led multi-lingual educational program between 2012 and 2014 to reach under and never-screened women in Central Toronto, where breast and cervical cancer screening rates remain low. The objective of this qualitative study was to better understand how Chinese and South Asian immigrants - the largest and most under-screened immigrant groups according to national and provincial statistics - conceive of breast and cervical cancer screening. We explored their experiences with screening to date. We explicitly inquired about their perceptions of the health care system, their screening experiences with family physicians and strategies that would support screening in their communities. We conducted 22 individual interviews and two focus groups in Bengali and Mandarin with participants who had attended CARES educational sessions. Transcripts were coded through an iterative constant comparative and interpretative approach. Themes fell into five major, overlapping domains: risk perception and concepts of preventative health and screening; health system engagement and the embedded experience with screening; fear of cancer and procedural pain; self-efficacy, obligation, and willingness to be screened; newcomer barriers and competing priorities. These domains all overlap, and contribute to screening behaviours. Immigrant women experienced a number of barriers to screening related to 'navigating newness', including transportation, language barriers, arrangements for time off work and childcare. Fear of screening and fear of cancer took many forms; painful or traumatic encounters with screening were described. Female gender of the provider was paramount for both groups. Newly screened South Asian women were reassured by their first encounter with screening. Some Chinese women preferred

  11. Awareness of Cervical Cancer Causes and Predeterminants of Likelihood to Screen Among Women in Haiti.

    Science.gov (United States)

    McCarthy, Schatzi H; Walmer, Kathy A; Boggan, Joel C; Gichane, Margaret W; Calo, William A; Beauvais, Harry A; Brewer, Noel T

    2017-01-01

    Cervical cancer is the leading cause of cancer deaths among women in Haiti. Given this high disease burden, we sought to better understand women's knowledge of its causes and the sociodemographic and health correlates of cervical cancer screening. Participants were 410 adult women presenting at clinics in Léogâne and Port-au-Prince, Haiti. We used bivariate and multivariate logic regression to identify correlates of Pap smear receipt. Only 29% of respondents had heard of human papillomavirus (HPV), whereas 98% were aware of cervical cancer. Of those aware of cervical cancer, 12% believed that sexually transmitted infections (STIs) cause it, and only 4% identified HPV infection as the cause. Women with a previous sexually transmitted infection were more likely to have had Pap smear (34% vs 71%, odds ratio = 3.45; 95% CI = 1.57-7.59). Screening was also more likely among women who were older than the age of 39 years, better educated, and employed (all p cervical cancer screening. This sample of Haitian women had limited awareness of HPV and cervical cancer causes; but when provided with health information, they saw the benefits of cancer screening. Future initiatives should provide health education messages, with efforts targeting young and at-risk women.

  12. Women's autonomy and cervical cancer screening in the Lesotho Demographic and Health Survey 2009.

    Science.gov (United States)

    Viens, Laura J; Clouston, Sean; Messina, Catherine R

    2016-02-01

    There are vast global disparities in the burden of cervical cancer; 85% of incident cases and 87% of deaths occur in the developing world. There is a growing body of literature asserting that women's autonomy is associated with a broad range of health outcomes. This study examined the relationship between women's autonomy and cervical cancer screening to inform interventions in global cervical cancer care. A generalized estimating equation approach to logistic regression was used to analyze associations between women's autonomy indicators and both cervical cancer screening knowledge and personal history in a cross sectional sample of 4049 married women in Lesotho. More than half of the women surveyed (65.2%) had never heard of a pap smear, and only 7.2% had ever had one. Women who participated in all types of household decision-making were 1.4 times more likely to have heard of a pap smear (estimated risk ratio = 1.4, 95% confidence interval: 1.0, 1.8) compared to women with lower participation levels (p = 0.032). This study extends earlier research demonstrating that women's autonomy predicts improved health outcomes, to include cervical cancer screening awareness, but not action. This finding, that augmenting women's autonomy improves cervical cancer screening awareness, adds yet another to the myriad reasons for focusing global attention on issues of gender equity. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. The Association of Social Support and Education with Breast and Cervical Cancer Screening

    Science.gov (United States)

    Documet, Patricia; Bear, Todd M.; Flatt, Jason D.; Macia, Laura; Trauth, Jeanette; Ricci, Edmund M.

    2015-01-01

    Background: Disparities in breast and cervical cancer screening by socioeconomic status persist in the United States. It has been suggested that social support may facilitate screening, especially among women of low socioeconomic status. However, at present, it is unclear whether social support enables mammogram and Pap test compliance. Purpose:…

  14. Factors affecting the uptake of cervical cancer screening among nurses in Singapore.

    Science.gov (United States)

    Tay, Kaijun; Tay, Sun K; Tesalona, Katherine C; Rashid, Nadia M R; Tai, Esther Y S; Najib, Sitti J M

    2015-09-01

    To identify factors other than socioeconomic status that influence participation in cervical cancer screening. A prospective, questionnaire-based, cross-sectional study was conducted among all female nurses working at Singapore General Hospital, Singapore, between November 1 and December 15, 2013. Characteristics assessed included age, knowledge score (0-10, on the basis of 10 true-or-false statements), perceived risk of cervical cancer, and health facility use. Among 2000 nurses, 1622 (81.1%) responded. The mean knowledge score was 4.70±1.76. Among 1593 nurses who reported on self-perception of risk, 97 (6.1%) reported high risk, 675 (42.4%) reported low risk, and 821 (51.5%) reported uncertainty. Of the 815 nurses reporting on their history of screening, 344 (42.2%) were screened regularly, 103 (12.6%) underwent opportunistic screening, and 368 (45.2%) had never undergone screening. The likelihood of screening was increased among women aged 35-4years, those who had recent experience of medical screening, those who had recently had a specialist consultation, or those who had recently had a consultation with a gynecologist (P<0.001 for all). Nurses undergoing regular screening reported positive effects of a doctor's recommendation, husband's encouragement, people talking about screening, and people close to the respondent undergoing screening. Advocacy and herd signaling positively influenced the cervical cancer screening rate. Copyright © 2015. Published by Elsevier Ireland Ltd.

  15. New screening in fetal medicine: prediction of preterm delivery by transvaginal cervical ultrasound in the first trimester of pregnancy

    OpenAIRE

    Greco, Elena

    2013-01-01

    Descrizione, sviluppo e validazione di un nuovo metodo di screening per il parto pretermine spontaneo mediante misurazione della cervice uterina con ecografia transvaginale nel primo trimestre di gravidanza.

  16. Socioeconomic factors affecting colorectal, breast and cervical cancer screening in an Asian urban low-income setting at baseline and post-intervention.

    Science.gov (United States)

    Wee, Liang En; Koh, Gerald Choon-Huat; Chin, Run Ting; Yeo, Wei Xin; Seow, Branden; Chua, Darren

    2012-07-01

    Inequalities in cancer screening are little studied in Asian societies. We determined whether area and individual measures of socio-economic status (SES) affected cancer screening participation in Singapore and prospectively evaluated an access-enhancing community-based intervention. The study population involved all residents aged >40 years in two housing estates comprising of owner-occupied (high-SES area) and rental (low-SES area) flats. From 2009 to 2011, non-adherents to regular screening for colorectal/breast/cervical cancer were offered free convenient screening over six months. Pre- and post-intervention screening rates were compared with McNemar's test. Multi-level logistic regression identified factors of regular screening at baseline; Cox regression analysis identified predictors of screening post-intervention. Participation was 78.2% (1081/1383). In the low-SES area, 7.7% (33/427), 20.4% (44/216), and 14.3% (46/321) had regular colorectal, cervical and breast cancer screening respectively. Post-intervention, screening rates in the low-SES area rose significantly to 19.0% (81/427), 25.4% (55/216), and 34.3% (74/216) respectively (p<0.001). Area SES was more consistently associated with screening than individual SES at baseline. Post-intervention, for colorectal cancer screening, those with higher education were more likely to attend (p=0.004); for female cancer screening, the higher-income were less likely to attend (p=0.032). Access-enhancing community-based interventions improve participation among disadvantaged strata of Asian societies. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Hearing screening in a group of paediatric patients attending an hiv ...

    African Journals Online (AJOL)

    The aim of this investigation is to screen hearing function in a group of paediatric patients attending a HIV/AIDS clinic at a hospital in Gauteng, South Africa. There is a dearth of ... An exploratory descriptive, non-experimental and observational design with no control group and non-randomization of participants was used.

  18. Cost-effectiveness of HIV screening of patients attending clinics for sexually transmitted diseases in Amsterdam

    NARCIS (Netherlands)

    Bos, JM; Fennema, JSA; Postma, MJ

    2001-01-01

    Objective: To estimate the cost-effectiveness of universal HIV screening of patients attending a clinic for sexually transmitted diseases (STD) in Amsterdam. Design: Cost effectiveness analysis. Methods: A Bernoulli model for the secondary transmission of HIV was linked with epidemiological data on

  19. Drinking Game Participation among Undergraduate Students Attending National Alcohol Screening Day

    Science.gov (United States)

    Cameron, Jennifer M.; Heidelberg, Natalie; Simmons, Lisa; Lyle, Sarah B.; Mitra-Varma, Kathakali; Correia, Chris

    2010-01-01

    Objectives, Participants, Methods: Drinking game participation has increased in popularity among college students and is associated with increased alcohol consumption and alcohol-related problems. The current study investigated drinking game participation among 133 undergraduates attending National Alcohol Screening Day (NASD) in April of 2007.…

  20. Attitudes and practice of cervical cancer screening among female university students from 25 low, middle income and emerging economy countries.

    Science.gov (United States)

    Pengpid, Supa; Peltzer, Karl

    2014-01-01

    Cervical cancer, the third commonest cancer in women worldwide, can be prevented through early detection by cervical screening (Pap smear). The aim of this study was to investigate the attitudes and practice of cervical cancer screening among female undergraduate university students from 25 low, middle income and emerging economy countries. Using anonymous questionnaires, data were collected from 9,194 female undergraduate university students aged 18-26 years (mean age 20.9, SD=2.0) from 26 universities in 25 countries across Asia, Africa and the Americas. Overall, 11.6% of the female students indicated that they had conducted one or more times a cervical (Pap) smear test; 8.3% among 18-20 year-olds and 15.6% among 21-26 year-old students. There was considerable country variation on having had a cervical (Pap) smear test among 21-26 year-old female university students, ranging from 59.2% in Colombia and 50.9% in Barbados to 0% in India and 1.0% in Tunesia. Logistic regression showed that cervical cancer screening importance or positive attitude were highly associated with the cervical screening practice. Moreover, risky sexual behaviour and tobacco use, two cervical cancer risk factors, were associated with screening. Cervical cancer screening practices were found to be inadequate and efforts should be made to develop programmes that can increase the uptake of cervical cancer screening.

  1. Prevalence and risk factors for non-carious cervical lesions in children attending special needs schools in India.

    Science.gov (United States)

    Kumar, Sandeep; Kumar, Arunoday; Debnath, Nitai; Kumar, Amit; K Badiyani, Bhumika; Basak, Debashish; S A Ali, Mohamed; B Ismail, Mohammed

    2015-03-01

    We assessed the prevalence and risk factors for development of non-carious cervical lesions (NCCLs) in children attending special needs schools in India. The participants were 395 children aged 12-15 years with disabilities in learning, communication, physical function, and/or development. A questionnaire was designed in order to collect information on sociodemographic characteristics, oral hygiene practices, dietary habits, and risk factors for NCCLs. The chi-square test, bivariate analysis, and logistic regression analysis were used to analyze the data. Presence of NCCLs was associated with use of toothpowder or other materials for teeth cleaning, use of harder toothbrushes, use of a horizontal scrub technique for toothbrushing, consumption of a vegetarian diet, and greater consumption of lemon. The overall prevalence of NCCLs was 22.7%. Most lesions involved minimal loss of contour or defects children attending special needs schools.

  2. Use of claims data to estimate annual cervical cancer screening percentages in Portland metropolitan area, Oregon.

    Science.gov (United States)

    Abdullah, Nasreen; Laing, Robert S; Hariri, Susan; Young, Collette M; Schafer, Sean

    2016-04-01

    Human papillomavirus (HPV) vaccine should reduce cervical dysplasia before cervical cancer. However, dysplasia diagnosis is screening-dependent. Accurate screening estimates are needed. To estimate the percentage of women in a geographic population that has had cervical cancer screening. We analyzed claims data for (Papanicolau) Pap tests from 2008-2012 to estimate the percentage of insured women aged 18-39 years screened. We estimated screening in uninsured women by dividing the percentage of insured Behavioral Risk Factor Surveillance Survey respondents reporting previous-year testing by the percentage of uninsured respondents reporting previous-year testing, and multiplying this ratio by claims-based estimates of insured women with previous-year screening. We calculated a simple weighted average of the two estimates to estimate overall screening percentage. We estimated credible intervals using Monte-Carlo simulations. During 2008-2012, an annual average of 29.6% of women aged 18-39 years were screened. Screening increased from 2008 to 2009 in all age groups. During 2009-2012, the screening percentages decreased for all groups, but declined most in women aged 18-20 years, from 21.5% to 5.4%. Within age groups, compared to 2009, credible intervals did not overlap during 2011 (except age group 21-29 years) and 2012, and credible intervals in the 18-20 year group did not overlap with older groups in any year. This introduces a novel method to estimate population-level cervical cancer screening. Overall, percentage of women screened in Portland, Oregon fell following changes in screening recommendations released in 2009 and later modified in 2012. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Protection motivation theory in predicting intention to receive cervical cancer screening in rural Chinese women.

    Science.gov (United States)

    Bai, Yang; Liu, Qing; Chen, Xinguang; Gao, Yanduo; Gong, Huiyun; Tan, Xiaodong; Zhang, Min; Tuo, Jiyu; Zhang, Yuling; Xiang, Qunying; Deng, Fenghua; Liu, Guiling

    2017-07-27

    Despite the significance of cervical cancer screening, motivating more women to participate remains a challenge in resource-limited settings. In this study, we tested the protection motivation theory (PMT) in predicting screening intentions. Participants were women from Wufeng, a typical rural county in China. Participants (n = 3000) with no cervical cancer history were recruited from 10 randomly selected villages. As mediating variables, 6 PMT constructs (Perceived Risk, Fear Arousal, Perceived Severity, Response Efficacy, Response Cost, and Self-Efficacy) were measured using the standardized questionnaire. Structural equation modeling (SEM) method was employed to test PMT-based prediction models. Of the total sample, 57.77% believed that regular screening may reduce cervical cancer risk, and 45.26% agreed that women should be screened regularly. Our data fit the PMT model well (GFI = 0.95, AGFI = 0.93, CFI = 0.90, RMSEA = 0.06, SRMR = 0.04, Chi-square/df = 2.47). Knowledge of screening was directly and positively associated with screening intention. Age, annual income, and awareness of and prior experience with screening were significantly associated with screening intention by enhancing cervical cancer risk perception and by reducing response cost (PPMT can be used as guidance to investigate cervical cancer screening intentions among rural women in China with focus on cancer knowledge, some demographic factors, and awareness of and previous experience with screening. These findings, if verified with longitudinal data, can be used for intervention program development. Copyright © 2017 John Wiley & Sons, Ltd.

  4. Breast and cervical cancer screening and associated factors among older adult women in South Africa.

    Science.gov (United States)

    Peltzer, Karl; Phaswana-Mafuya, Nancy

    2014-01-01

    Little is known about the cancer screening prevalence and correlates in older adults from different racial backgrounds. In the context of heightened efforts for prevention and early diagnosis, we collected information on screening for two major types of cancers: cervical and breast cancer in order to establish their prevalence estimates and correlates among older South African women who participated in the Study of Global Ageing and Adults Health (SAGE) in 2008. We conducted a national population-based cross-sectional study with a multi-stage stratified cluster sample of 3,840 individuals aged 50 years or older in South Africa in 2008. In this analysis, we only considered the female subsample of (n=2202). The measures used included socio-demographic characteristics, health variables, anthropometric and blood pressure measurements. Multivariable regression analysis was performed to assess the association of socio-demographic factors, health variables and cancer screening. Overall, regarding cervical cancer screening, 24.3% ever had a Papanicolaou (PAP) smear test, and regarding breast cancer screening, 15.5% ever had a mammography. In multivariate logistic regression analysis, younger age, higher education, being from the White or Coloured population group, urban residence, greater wealth, and suffering from two or more chronic conditions were associated with cervical cancer screening, and higher education, being from the White or Indian/Asian population group, greater wealth, having a health insurance, and suffering from two or more chronic conditions were associated with breast cancer screening. Cancer screening coverage remains low among elderly women in South Africa in spite of the national guideline recommendations for regular screening in order to reduce the risk of dying from these cancers if not detected early. There is a need to improve accessibility and affordability of early cervical and breast cancer screening for all women to ensure effective prevention

  5. Cervical cancer screening among women aged 18-30 years - United States, 2000-2010.

    Science.gov (United States)

    2013-01-04

    Screening women for cervical cancer can save lives. However, among young women, cervical cancer is relatively rare, and too-frequent screening can lead to high costs and adverse events associated with overtreatment. Before 2012, cervical cancer screening guidelines of the American College of Obstetricians and Gynecologists (ACOG), American Cancer Society (ACS), and U.S. Preventive Services Task Force (USPSTF) differed on age to start and how often to get screened for cervical cancer. In 2012, however, all three organizations recommended that 1) screening by Papanicolau (Pap) test should not be used for women aged <21 years, regardless of initiation of sexual activity, and 2) a screening interval of 3 years should be maintained for women aged 21-30 years. ACS and ACOG explicitly recommend against yearly screening. To assess trends in Pap testing before the new guidelines were introduced, CDC analyzed 2000-2010 data from the Behavioral Risk Factor Surveillance System (BRFSS) for women aged 18-30 years. CDC found that, among women aged 18-21 years, the percentage reporting never having been screened increased from 26.3% in 2000 to 47.5% in 2010, and the proportion reporting having had a Pap test in the past 12 months decreased from 65.0% to 41.5%. Among those aged 22-30 years, the proportion reporting having had a Pap test within the preceding 12 months decreased from 78.1% to 67.0%. These findings showed that Pap testing practices for young women have been moving toward the latest guidelines. However, the data also showed a concerning trend: among women aged 22-30 years, who should be screened every 3 years, the proportion who reported never having had a Pap test increased from 6.6% to 9.0%. More effort is needed to promote acceptance of the latest evidence-based recommendations so that all women receive the maximal benefits of cervical cancer screening.

  6. Why does cervical cancer occur in a state-of-the-art screening program?

    Science.gov (United States)

    Castle, Philip E; Kinney, Walter K; Cheung, Li C; Gage, Julia C; Fetterman, Barbara; Poitras, Nancy E; Lorey, Thomas S; Wentzensen, Nicolas; Befano, Brian; Schussler, John; Katki, Hormuzd A; Schiffman, Mark

    2017-09-01

    The goal of cervical screening is to detect and treat precancers before some become cancer. We wanted to understand why, despite state-of-the-art methods, cervical cancers occured in relationship to programmatic performance at Kaiser Permanente Northern California (KPNC), where >1,000,000 women aged ≥30years have undergone cervical cancer screening by triennial HPV and cytology cotesting since 2003. We reviewed clinical histories preceding cervical cancer diagnoses to assign "causes" of cancer. We calculated surrogate measures of programmatic effectiveness (precancers/(precancers and cancers)) and diagnostic yield (precancers and cancers per 1000 cotests), overall and by age at cotest (30-39, 40-49, and ≥50years). Cancer was rare and found mainly in a localized (treatable) stage. Of 623 cervical cancers with at least one preceding or concurrent cotest, 360 (57.8%) were judged to be prevalent (diagnosed at a localized stage within one year or regional/distant stage within two years of the first cotest). Non-compliance with recommended screening and management preceded 9.0% of all cancers. False-negative cotests/sampling errors (HPV and cytology negative), false-negative histologic diagnoses, and treatment failures preceded 11.2%, 9.0%, and 4.3%, respectively, of all cancers. There was significant heterogeneity in the causes of cancer by histologic category (pcervical cancers, most of which are detected early by screening. Screening may become less efficient at older ages. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. The Association of Obesity and Cervical Cancer Screening: A Systematic Review and Meta-Analysis

    OpenAIRE

    Maruthur, NM; Bolen, S; Brancati, FL; Clark, JM

    2008-01-01

    Obese women are at an increased risk of death from cervical cancer, but the explanation for this is unknown. Through our systematic review, we sought to determine whether obesity is associated with cervical cancer screening and if this association differs by race. We identified original articles evaluating the relationship between body weight and Papanicolaou testing in the United States through electronic (PubMed, CINAHL, and the Cochrane Library) and manual searching. We excluded studies in...

  8. Using communication to manage uncertainty about cervical cancer screening guideline adherence among Appalachian women

    OpenAIRE

    Cohen, Elisia L.; Gordon, Allison Scott; Record, Rachael; Shaunfield, Sara; Jones, Grace M.; Collins, Tom

    2016-01-01

    Changes to the United States Preventive Services Task Force (USPSTF) recommendations for cervical cancer preventive services have led to patient confusion, especially in medically underserved populations. We investigated how patient uncertainty concerning cervical cancer screening guidelines is appraised and managed through communication with healthcare providers by conducting in-depth, face-to-face interviews with 24 adult women between the ages of 24 and 65 (m = 41, SD = 14) living in Appal...

  9. Human papillomavirus type-specific prevalence in the cervical cancer screening population of Czech women.

    Directory of Open Access Journals (Sweden)

    Ruth Tachezy

    Full Text Available BACKGROUND: Infection with high-risk human papillomavirus (HPVtypes has been recognized as a causal factor for the development of cervical cancer and a number of other malignancies. Today, vaccines against HPV, highly effective in the prevention of persistent infection and precancerous lesions, are available for the routine clinical practice. OBJECTIVES: The data on the prevalence and type-specific HPV distribution in the population of each country are crucial for the surveillance of HPV type-specific prevalence at the onset of vaccination against HPV. METHODS: Women attending a preventive gynecological examination who had no history of abnormal cytological finding and/or surgery for cervical lesions were enrolled. All samples were tested for the presence of HPV by High-Risk Hybrid Capture 2 (HR HC2 and by a modified PCR-reverse line blot assay with broad spectrum primers (BS-RLB. RESULTS: Cervical smears of 1393 women were analyzed. In 6.5% of women, atypical cytological findings were detected. Altogether, 28.3% (394/1393 of women were positive for any HPV type by BS-RLB, 18.2% (254/1393 by HR HC2, and 22.3% (310/1393 by BS-RLB for HR HPV types. In women with atypical findings the prevalence for HR and any HPV types were significantly higher than in women with normal cytological findings. Overall, 36 different HPV types were detected, with HPV 16 being the most prevalent (4.8%. HPV positivity decreased with age; the highest prevalence was 31.5% in the age group 21-25 years. CONCLUSIONS: Our study subjects represent the real screening population. HPV prevalence in this population in the Czech Republic is higher than in other countries of Eastern Europe. Also the spectrum of the most prevalent HPV types differs from those reported by others but HPV 16 is, concordantly, the most prevalent type. Country-specific HPV type-specific prevalences provide baseline information which will enable to measure the impact of HPV vaccination in the future.

  10. Knowledge and acceptability of human papillomavirus vaccination and cervical cancer screening among women in Karnataka, India.

    Science.gov (United States)

    Montgomery, Martha P; Dune, Tanaka; Shetty, Prasanna K; Shetty, Avinash K

    2015-03-01

    Cervical cancer is the leading cause of cancer-related mortality among women in India; however, participation in prevention and screening is low and the reasons for this are not well understood. In a cross-sectional survey in August 2008, 202 healthy women in Karnataka, India completed a questionnaire regarding knowledge, attitudes, and practices related to human papillomavirus (HPV) and cervical cancer. Factors associated with vaccination and Papanicolau (Pap) smear screening acceptance were explored. Thirty-six percent of women had heard of HPV while 15% had heard of cervical cancer. Five percent of women reported ever having a Pap smear, and 4% of women felt at risk of HPV infection. Forty-six percent of women were accepting of vaccination, but fewer (21%) were willing to have a Pap smear. Overall, knowledge related to HPV and cervical cancer topics was low. Women with negative attitudes toward HPV infection were 5.3 (95% confidence interval (CI) 2.8-10) times more likely to accept vaccination but were not significantly more likely to accept Pap smear (odds ratio 1.5, 95% CI 0.7-3.0). Cost and a low level of perceived risk were the most frequent factors cited as potential barriers. Improving awareness of HPV and cervical cancer through health care providers in addition to increasing access to vaccination and screening through government-sponsored programs may be feasible and effective methods to reduce cervical cancer burden in India.

  11. Knowledge, attitudes and practice toward cervical cancer screening among Sikkimese nursing staff in India

    OpenAIRE

    Rahman, Hafizur; Kar, Sumit

    2015-01-01

    Objectives: To assess baseline knowledge of cancer cervix, screening and practice of Pap smear screening among Sikkimese staff nurses in India. Materials and Methods: Between April 2012 and February 2013, a predesigned, pretested, self -administered multiple responses questionnaire survey was conducted among staff nurses′ working in various hospitals of Sikkim. Questionnaire contained information about their demographics, knowledge of cervical cancer, its risk factors, screening methods, atti...

  12. Change in Provider Beliefs Regarding Cervical Cancer Screening Intervals After an Educational Intervention.

    Science.gov (United States)

    Benard, Vicki B; Greek, April; Roland, Katherine B; Hawkins, Nikki A; Lin, Lavinia; Saraiya, Mona

    2016-05-01

    Current cervical cancer screening guidelines include the option of lengthening the screening interval to 5 years for average-risk women aged 30-65 years when screened with Pap and human papillomavirus (HPV) test (co-test). Because many providers are reluctant to extend screening intervals, we launched an educational intervention to promote recommended screening practices. The study objective was to assess changes in provider attitudes and beliefs to extending screening intervals among low-income women. The study was conducted in 15 clinics in Federally Qualified Health Centers in Illinois. Providers in the intervention arm received a multicomponent educational intervention. Fifty-six providers (n = 29 intervention and n = 27 control) completed baseline and 12-month follow-up surveys assessing beliefs and intentions about extending screening intervals. The 12-month assessment showed providers in the intervention arm were significantly more likely than those in the control arm to recommend a 3-year screening interval (guideline recommendation at time of study) with a normal co-test result. Providers who received the intervention were significantly more likely to agree that routine co-testing is the best way to screen for cervical cancer, that extending the screening interval would be good, easy, and beneficial, and to disagree that the increased screening interval would cause patients to lose contact with the medical system. Educating providers on the natural history of HPV infection and cervical cancer and the benefits of extended intervals increased their willingness to follow guidelines. This study provides evidence that an educational intervention delivered with HPV testing materials may be effective in encouraging appropriate cervical screening intervals.

  13. Screen Time at Home and School among Low-Income Children Attending Head Start.

    Science.gov (United States)

    Fletcher, Erica N; Whitaker, Robert C; Marino, Alexis J; Anderson, Sarah E

    2014-06-01

    To describe the patterns of screen viewing at home and school among low-income preschool-aged children attending Head Start and identify factors associated with high home screen time in this population. Few studies have examined both home and classroom screen time, or included computer use as a component of screen viewing. Participants were 2221 low-income preschool-aged children in the United States studied in the Head Start Family and Child Experiences Survey (FACES) in spring 2007. For 5 categories of screen viewing (television, video/DVD, video games, computer games, other computer use), we assessed children's typical weekday home (parent-reported) and classroom (teacher-reported) screen viewing in relation to having a television in the child's bedroom and sociodemographic factors. Over half of children (55.7%) had a television in their bedroom, and 12.5% had high home screen time (>4 hours/weekday). Television was the most common category of home screen time, but 56.6% of children had access to a computer at home and 37.5% had used it on the last typical weekday. After adjusting for sociodemographic characteristics, children with a television in their bedroom were more likely to have high home screen time [odds ratio=2.57 (95% confidence interval: 1.80-3.68)]. Classroom screen time consisted almost entirely of computer use; 49.4% of children used a classroom computer for ≥1 hour/week, and 14.2% played computer games at school ≥5 hours/week. In 2007, one in eight low-income children attending Head Start had >4 hours/weekday of home screen time, which was associated with having a television in the bedroom. In the Head Start classroom, television and video viewing were uncommon but computer use was common.

  14. Design and methods of the evaluation of an HPV-based cervical cancer screening strategy in Mexico: The Morelos HPV Study.

    Science.gov (United States)

    Flores, Yvonne; Shah, Keerti; Lazcano, Eduardo; Hernández, Mauricio; Bishai, David; Ferris, Daron G; Lörincz, Attila; Hernández, Pilar; Salmerón, Jorge

    2002-01-01

    The purpose of this paper is to describe the design and methodology of the Morelos HPV Study. The main objective of this study is to examine the use of two different methods for obtaining HPV DNA specimens, self-collected vaginal and clinician-collected cervical, to detect pre-invasive cervical lesions and cancer. This study was conducted within the regular population-based framework of the Mexican Institute of Social Security (IMSS) cervical cancer screening program in Morelos. A total of 7,868 women were recruited between May and October 1999 and are representative of the population of women attending cervical cancer screening services at the 23 IMSS clinics in the state of Morelos in 1999. Women were provided with a detailed description of the study before signing an informed consent form. Basic data were obtained from all participants using a standard IMSS registration form. During the initial recruitment visit, a randomly selected subsample of 1,069 participants were interviewed to collect additional information about cervical cancer risk factors, acceptability of the HPV and Pap tests, as well as patient costs. Before the pelvic exam, participants were asked to provide a self-collected vaginal specimen for HPV testing. All participants underwent a pelvic examination that involved collecting a cervical sample for the Pap smear and a clinician-collected HPV specimen. Data were evaluated from 7,732 women with complete information for the three tests. The 1,147 women who received at least one positive result (Pap, self- and/or clinician-HPV tests) were invited to return for a colposcopic examination. During colposcopy, biopsies were taken as appropriate, to histologically confirm a diagnosis of cervical intraepithelial neoplasia (CIN) 2/3 or invasive cancer. A total of 1,015 women attended colposcopy, and 101 women received a histologically-confirmed CIN 2/3 or cervical cancer diagnosis. The initial enrollment activities of the Morelos HPV study are the basis for

  15. Design and methods of the evaluation of an HPV-based cervical cancer screening strategy in Mexico: the Morelos HPV study

    Directory of Open Access Journals (Sweden)

    Flores Yvonne

    2002-01-01

    Full Text Available Objective. The purpose of this paper is to describe the design and methodology of the Morelos HPV Study. The main objective of this study is to examine the use of two different methods for obtaining HPV DNA specimens, self-collected vaginal and clinician-collected cervical, to detect pre-invasive cervical lesions and cancer. Material and Methods. This study was conducted within the regular population-based framework of the Mexican Institute of Social Security (IMSS cervical cancer screening program in Morelos. A total of 7,868 women were recruited between May and October 1999 and are representative of the population of women attending cervical cancer screening services at the 23 IMSS clinics in the state of Morelos in 1999. Women were provided with a detailed description of the study before signing an informed consent form. Basic data were obtained from all participants using a standard IMSS registration form. During the initial recruitment visit, a randomly selected subsample of 1 069 participants were interviewed to collect additional information about cervical cancer risk factors, acceptability of the HPV and Pap tests, as well as patient costs. Before the pelvic exam, participants were asked to provide a self-collected vaginal specimen for HPV testing. All participants underwent a pelvic examination that involved collecting a cervical sample for the Pap smear and a clinician-collected HPV specimen. Data were evaluated from 7 732 women with complete information for the three tests. The 1 147 women who received at least one positive result (Pap, self- and/or clinician-HPV tests were invited to return for a colposcopic examination. During colposcopy, biopsies were taken as appropriate, to histologically confirm a diagnosis of cervical intraepithelial neoplasia (CIN 2/3 or invasive cancer. A total of 1,015 women attended colposcopy, and 101 women received a histologically-confirmed CIN 2/3 or cervical cancer diagnosis. Conclusions. The initial

  16. Determinants of gastric cancer screening attendance in Korea: a multi-level analysis.

    Science.gov (United States)

    Chang, Yunryong; Cho, Belong; Son, Ki Young; Shin, Dong Wook; Shin, Hosung; Yang, Hyung-Kook; Shin, Aesun; Yoo, Keun-Young

    2015-05-01

    We aimed to assess individual and area-level determinants of gastric cancer screening participation. Data on gastric cancer screening and individual-level characteristics were obtained from the 2007-2009 Fourth Korea National Health and Nutrition Examination Survey. The area-level variables were collected from the 2005 National Population Census, 2008 Korea Medical Association, and 2010 National Health Insurance Corporation. The data were analyzed using multilevel logistic regression models. The estimated participation rate in gastric cancer screening adhered to the Korea National Cancer Screening Program guidelines was 44.0% among 10,658 individuals aged over 40 years who were included in the analysis. Among the individual-level variables, the highest income quartile, a college or higher education level, living with spouse, having a private health insurance, limited general activity, previous history of gastric or duodenal ulcer, and not currently smoking were associated with a higher participation rate in gastric cancer screening. Urbanization showed a significant negative association with gastric cancer screening attendance among the area-level factors (odds ratio (OR) = 0.73; 95% confidence interval (CI) = 0.57-0.93 for the most urbanized quartile vs. least urbanized quartile). There are differences in gastric cancer screening attendance according to both individual and regional area characteristics.

  17. The Icelandic and Nordic cervical screening programs: trends in incidence and mortality rates through 1995.

    Science.gov (United States)

    Sigurdsson, K

    1999-07-01

    The objective of cervical cancer screening is to lower the incidence and mortality rates of the disease. This study evaluates the effectiveness of cervical screening and the UICC and EC screening recommendations based on the Nordic screening experience. The study analyzes the features of the Icelandic and the Nordic screening programs and the observed trends in the incidence and mortality rates in these countries through 1995. Organized screening started in all the Nordic countries soon after 1960 and had nation-wide coverage in all these countries, except in Denmark (45% coverage in 1991), by around 1973 but in Norway screening was only spontaneous up to late in 1994. Up to 1985 the target age group and screening interval were most intensive in Iceland, followed by Finland, Sweden and Denmark. All countries except Finland lowered the lower age limit and intensified the screening intervals after 1985. Through the period 1986-1995 the reduction in both the mortality and the incidence rates was greatest in Iceland (mortality: 76% and incidence: 67%) and Finland (73% and 75%, respectively), intermediate in Sweden (60% and 55%, respectively) and Denmark (55% and 54%, respectively), and lowest in Norway (43% and 34%, respectively). The age-specific incidence in the 20-29 age group has been increasing since 1971 in all the Nordic countries, except in Finland, where the yearly registered age-specific incidence has been increasing in the targeted 30-54 age group since 1991. In Iceland screening has greatly affected the rate of all stages of squamous cell carcinoma, but not the rate of adeno- and adenosquamous carcinomas. In fact the rate of adenocarcinoma has been increasing. Organized screening is more effective than spontaneous screening in reducing the risk of cervical cancer. Although differences in environmental, biological and ethnic factors may call for different screening strategies, screening should preferably start soon after age 20 with a screening interval of 2

  18. CDC Activities for Improving Implementation of Human Papillomavirus Vaccination, Cervical Cancer Screening, and Surveillance Worldwide.

    Science.gov (United States)

    Senkomago, Virginia; Duran, Denise; Loharikar, Anagha; Hyde, Terri B; Markowitz, Lauri E; Unger, Elizabeth R; Saraiya, Mona

    2017-12-01

    Cervical cancer incidence and mortality rates are high, particularly in developing countries. Most cervical cancers can be prevented by human papillomavirus (HPV) vaccination, screening, and timely treatment. The US Centers for Disease Control and Prevention (CDC) provides global technical assistance for implementation and evaluation of HPV vaccination pilot projects and programs and laboratory-related HPV activities to assess HPV vaccines. CDC collaborates with global partners to develop global cervical cancer screening recommendations and manuals, implement screening, create standardized evaluation tools, and provide expertise to monitor outcomes. CDC also trains epidemiologists in cancer prevention through its Field Epidemiology Training Program and is working to improve cancer surveillance by supporting efforts of the World Health Organization in developing cancer registry hubs and assisting countries in estimating costs for developing population-based cancer registries. These activities contribute to the Global Health Security Agenda action packages to improve immunization, surveillance, and the public health workforce globally.

  19. Knowledge and Attitudes About Human Papilloma Virus (HPV) Vaccination and Cervical Cancer Screening Among Women in Rural Uganda

    Science.gov (United States)

    2016-06-15

    1- Knowledge and attitudes about Human Papilloma Virus (HPV) vaccination and cervical cancer screening among women in rural Uganda Authors...Oncogenic Human Papilloma virus (HPV) strains 16 and 18. While cervical cancer is widely understood as a fatal disease, knowledge and awareness of...Abstract Cervical cancer is one of the major causes of death among women worldwide. There is an established linkage between cervical cancer and

  20. Routine HIV screening of sexually transmitted disease clinic attenders has favourable cost-effectiveness ratio in low HIV prevalence settings

    NARCIS (Netherlands)

    Bos, JM; van der Meijden, WI; Swart, W; Postma, MJ

    2002-01-01

    HIV screening for attenders of clinics for sexually transmitted disease (STD) may identify individuals with high-risk sexual behaviour and avert HIV infections in partners. Extending our previous analysis in AIDS, we performed an economic evaluation of HIV screening of STD-clinic attenders in

  1. Understanding Hmong women's beliefs, feelings, norms, and external conditions about breast and cervical cancer screening.

    Science.gov (United States)

    Lor, Maichou; Khang, Pa Yiar; Xiong, Pa; Moua, Kao Feng; Lauver, Diane

    2013-01-01

    To describe the beliefs, feelings, norms, and external conditions regarding breast and cervical cancer screening in a sample of Hmong women. In a descriptive design, female Hmong researchers recruited 16 Hmong women (ages 24-73) at a community center. Guided by the Theory of Care Seeking Behavior (TCSB), researchers asked participants semi-structured questions about their beliefs, feelings, norms, and external conditions in a group setting. Researchers documented responses in writing and audio recordings. Guided by theory, we used directed content analysis to categorize responses. Participants' beliefs' about screening included uncertainty about causes of breast and cervical cancer, uncertainty about Western forms of treatments, and terminal illness as outcomes of such cancer. Many felt embarrassed about breast and cervical cancer screening. Their cultural norms about undressing for an exam and listening to authority figures were different from Western norms. External conditions that influenced participants' for screenings included difficulties in communicating with interpreters and clinicians. Consistent with the TCSB, Hmong women's beliefs, affect, cultural norms and external conditions helped to understand their use of breast and cervical screening. Findings could guide nursing and public health interventions to improve culturally sensitive, cancer screening for Hmong women. © 2013 Wiley Periodicals, Inc.

  2. The association of obesity and cervical cancer screening: a systematic review and meta-analysis.

    Science.gov (United States)

    Maruthur, Nisa M; Bolen, Shari D; Brancati, Frederick L; Clark, Jeanne M

    2009-02-01

    Obese women are at an increased risk of death from cervical cancer, but the explanation for this is unknown. Through our systematic review, we sought to determine whether obesity is associated with cervical cancer screening and whether this association differs by race. We identified original articles evaluating the relationship between body weight and Papanicolaou (Pap) testing in the United States through electronic (PubMed, CINAHL, and the Cochrane Library) and manual searching. We excluded studies in special populations or those not written in English. Two reviewers sequentially extracted study data and independently extracted quality using standardized forms. A total of 4,132 citations yielded 11 relevant studies. Ten studies suggested an inverse association between obesity and cervical cancer screening. Compared to women with a normal BMI, the combined odds ratios (95% CI) for Pap testing were 0.91 (0.80-1.03), 0.81 (0.70-0.93), 0.75 (0.64-0.88), and 0.62 (0.55-0.69) for the overweight and class I, class II, and class III obesity categories, respectively. Three out of four studies that presented the results by race found this held true for white women, but no study found this for black women. In conclusion, obese women are less likely to report being screened for cervical cancer than their lean counterparts, and this does not hold true for black women. Less screening may partly explain the higher cervical cancer mortality seen in obese white women.

  3. Barriers to utilisation of cervical cancer screening in Sub Sahara Africa: a systematic review.

    Science.gov (United States)

    Lim, J N W; Ojo, A A

    2017-01-01

    Cervical cancer is the commonest cause of cancer-related death in Sub Sahara Africa (SSA). Both primary and secondary preventive services are available but utilisation remain low. This systematic review aims to summarise reported barriers preventing women from utilising cervical cancer screening services in SSA. Electronic searches on MEDLINE, EMBASE, PsycINFO, BIOSIS preview, Global Health, PubMed, Cochrane library, CINAHL, ISI Web of Knowledge and Google scholar and quality assessment of the included studies were performed. A meta-analysis was applied to identify major themes. Eight studies exploring reasons women did not utilise cervical cancer screening were included. Women in SSA reported similar barriers despite cultural and language diversity in the region. Women reported fear of screening procedure and negative outcome, low level of awareness of services, embarrassment and possible violation of privacy, lack of spousal support, societal stigmatisation, cost of accessing services and health service factors like proximity to facility, facility navigation, waiting time and health care personnel attitude. Strategies for improving uptake and utilisation of cervical screening in SSA should focus on improving cervical health education, addressing cultural beliefs and practices and improving spousal support and empowering women, as well as addressing physical access problem, costs and improving staff attitude. © 2016 John Wiley & Sons Ltd.

  4. The Clinical Role of HPV Testing in Primary and Secondary Cervical Cancer Screening

    Directory of Open Access Journals (Sweden)

    G. Hoste

    2013-01-01

    Full Text Available Traditional population-based cervical screening programs, based on cytology, have successfully reduced the burden of cervical cancer. Nevertheless limitations remain and new screening methods are emerging. Despite vaccination against the 2 most oncogenic types (HPV 16/18, cervical cancer screening will have to continue as an essential public health strategy. As the acquisition of an HR-HPV infection is critical in the progression to (pre-cancerous cervical lesions, recent research has focused on HR-HPV detection. The sensitivity of HPV testing in primary and secondary prevention outweighs that of cytology, at the cost of slightly lower specificity. Although most of the HR-HPV infections are cleared after conization, new evidence from numerous studies encourages the implementation of HR-HPV testing and genotyping to improve posttreatment surveillance. An HR-HPV test 6 months after conization is a promising useful clinical marker to detect persistence and prevent progression. This review highlights the clinical role of HPV testing in primary and secondary cervical cancer screening.

  5. Age Specific Cytological Abnormalities in Women Screened for Cervical Cancer in the Emirate of Abu Dhabi.

    Science.gov (United States)

    Al Zaabi, Muna; Al Muqbali, Shaikha; Al Sayadi, Thekra; Al Ameeri, Suhaila; Coetsee, Karin; Balayah, Zuhur; Ortashi, Osman

    2015-01-01

    Cervical cancer is the second most common cancer in women worldwide, with about 500,000 new cases and 270,000 deaths each year. Globally, it is estimated that over one million women currently have cervical cancer, most of whom have not been diagnosed, or have no access to treatment that could cure them or prolong their lives. In the United Arab Emirates (UAE) cervical cancer is the third most common cancer in women. A population-based cross-sectional retrospective survey of cervical smear abnormalities was conducted in the Emirate of Abu Dhabi, UAE, from January 2013 to December 2013 by collecting consecutive liquid-based cytology samples from the Department of Pathology at the SKMC Hospital in Abu Dhabi city. The total number of women screened for cervical cancer for the year 2013 at SKMC was 4,593, with 225 (4.89%) abnormal smears. The majority of the abnormal smear results were atypical squamous cells of undetermined significance (ASCUS) 114 (2.48%). This study showed 60% increase in the rate of abnormal cervical smears in the UAE over the last 10 years. In this study the highest incidence of high grade abnormalities were seen in women above the age of 61 years (1.73%), this might be due to the fact that this group of women missed the chance of screening of cervical cancer earlier in their lives or could be explained by the well-known second peak of HPV infection seen in many prevalence studies. We conclude that the rate of abnormal cervical smear in the screened Abu Dhabi women is not different from the rate in developed countries. A notable increase in both low and high grade abnormalities has occurred within the last decade.

  6. Vietnamese American women’s beliefs and perceptions on cervical cancer, cervical cancer screening, and cancer prevention vaccines: A community-based participatory study

    Directory of Open Access Journals (Sweden)

    Connie Kim Yen Nguyen-Truong

    2017-12-01

    Full Text Available Cervical cancer remains commonly diagnosed in Vietnamese American women. Despite efforts to increase cervical cancer screening among Vietnamese American women, participation rates are persistently lower than the national goal. The objective of this study is to explore beliefs of Vietnamese American women about cervical cancer, cervical cancer screening, and cancer prevention vaccines. A qualitative descriptive investigation captured group perceptions about meaning and beliefs of cervical cancer, screening, and cancer prevention vaccines, and participants’ stories using a community-based participatory research approach. Forty Vietnamese American women were recruited from the Portland, Oregon metropolitan area into four focus groups. Using a process of directed content analysis, focus group transcripts were coded for themes. We found that cervical cancer continues to be a difficult topic to discuss, and Vietnamese American women may not bring the topic up themselves to their health care providers. Some women experienced intense emotions of fear or shame of having their cervix examined. Women delayed seeking cervical cancer screening and needed to have early warning signs, which guided them as to when to seek health care. Women focused on cleanliness through vaginal and/or perineal washing as primary prevention for cervical cancer. There were limited awareness and knowledge about cancer prevention vaccines, specifically the human papillomavirus. Some women relied heavily on their informal social networks of family, friends, or community for health knowledge. Fear and misunderstanding dominated the beliefs of Vietnamese American women about cervical cancer screening and prevention. These findings underscored the importance of having culturally-specific findings, which will inform a multicomponent intervention to promote cervical cancer screening and cancer prevention vaccine uptake within this population.

  7. Trend in cervical cancer screening in Spain (2003-2009) and predictors of adherence.

    Science.gov (United States)

    Martín-López, Rocío; Hernández-Barrera, Valentín; de Andres, Ana Lopez; Carrasco-Garrido, Pilar; de Miguel, Angel Gil; Jimenez-Garcia, Rodrigo

    2012-01-01

    Cervical cancer remains a public health problem in developed countries. Early detection of both premalignant lesions and cervical cancer through an appropriate screening programme may decrease its incidence and mortality. High rates of participation are essential to ensure the desired impact on the population. The aims of this study were to assess the use of Pap smears in Spain in 2009 to identify factors associated with screening adherence (predictors) and assess the trend from 2003 to 2009. We included women surveyed in the European Health Interview Survey for Spain. Cervical cancer screening included self-reported Pap smears over the last 3 years. The target age range was 25-64 years. The following independent variables were analysed: sociodemographic variables, chronic conditions, and lifestyle. Predictors of Pap smear adherence were explored using multivariate logistic regression. The screening coverage in the target population was 66.1% (95% confidence interval: 64.8-67.4). Undergoing Pap smears was associated positively with the following: being married, higher levels of education and income, having visited a general practitioner in previous weeks, and suffering from musculoskeletal disease. Belonging to an older age group (55-64 years) and obesity were associated with nonadherence to Pap smears. We did not find significant differences when we compared cervical cancer screening adherence over time since 2003. Adherence to cervical cancer screening in Spain does not seem to be improving. An effort must be made, and the implementation of population-based programmes instead of opportunistic screening could be considered, to recruit women who are less likely to undergo screening.

  8. Comparing barriers to colorectal cancer screening with barriers to breast and cervical screening: a population-based survey of screening-age women in Great Britain.

    Science.gov (United States)

    Lo, Siu Hing; Waller, Jo; Wardle, Jane; von Wagner, Christian

    2013-06-01

    Uptake of cancer screening tends to be lower for colorectal cancer (CRC) than cervical or breast cancer. Dislike of the test itself has often been identified as a barrier to CRC screening with the Faecal Occult Blood (FOB) test, but there have been no head-to-head comparisons of the three tests. Women aged 50-80 (n = 890) were recruited in spring 2012 as part of a population-based TNS Research International survey in Great Britain. Those in the eligible age range were asked if they had ever participated in breast, cervical or CRC screening. For each screening test, women who had never participated were asked for their 'main reason' using a checklist of barriers. Among eligible women, 67%, 83% and 90% reported ever having been screened for CRC, cervical and breast cancer respectively. More socioeconomically deprived women were less likely to report any screening, and single women were less likely to report CRC or breast screening than married women. Age was not associated with participation. Overall there were few differences between tests in the reported barriers, but dislike of the test was endorsed more often for CRC screening. This was the first study to compare barriers to participation in organised screening programmes for CRC, breast and cervical cancer. Cancer screening tests share many barriers, but dislike of the test appears to be a stronger barrier to CRC screening. Women who are non-participants in more than one programme may have more global barriers to screening, such as cancer fatalism. The findings suggest that uptake of CRC screening could be improved by targeting the unpleasantness of stool sampling.

  9. Can visual inspection with acetic acid be used as an alternative to Pap smear in screening cervical cancer?

    Directory of Open Access Journals (Sweden)

    Hend S. Saleh

    2014-09-01

    Conclusion: VIA a good screening, simple test, has low cost and high sensitivity in comparison to Pap smear. So, it can be used as alternative screening modality for cervical cancer in low resource locations.

  10. Effect of cervical cancer education and provider recommendation for screening on screening rates: A systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Jonah Musa

    Full Text Available Although cervical cancer is largely preventable through screening, detection and treatment of precancerous abnormalities, it remains one of the top causes of cancer-related morbidity and mortality globally.The objective of this systematic review is to understand the evidence of the effect of cervical cancer education compared to control conditions on cervical cancer screening rates in eligible women population at risk of cervical cancer. We also sought to understand the effect of provider recommendations for screening to eligible women on cervical cancer screening (CCS rates compared to control conditions in eligible women population at risk of cervical cancer.We used the PICO (Problem or Population, Interventions, Comparison and Outcome framework as described in the Cochrane Collaboration Handbook to develop our search strategy. The details of our search strategy has been described in our systematic review protocol published in the International Prospective Register of systematic reviews (PROSPERO. The protocol registration number is CRD42016045605 available at: http://www.crd.york.ac.uk/prospero/display_record.asp?src=trip&ID=CRD42016045605. The search string was used in Pubmed, Embase, Cochrane Systematic Reviews and Cochrane CENTRAL register of controlled trials to retrieve study reports that were screened for inclusion in this review. Our data synthesis and reporting was guided by the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA. We did a qualitative synthesis of evidence and, where appropriate, individual study effects were pooled in meta-analyses using RevMan 5.3 Review Manager. The Higgins I2 was used to assess for heterogeneity in studies pooled together for overall summary effects. We did assessment of risk of bias of individual studies included and assessed risk of publication bias across studies pooled together in meta-analysis by Funnel plot.Out of 3072 study reports screened, 28 articles were found to

  11. Effect of cervical cancer education and provider recommendation for screening on screening rates: A systematic review and meta-analysis

    Science.gov (United States)

    Achenbach, Chad J.; O’Dwyer, Linda C.; Evans, Charlesnika T.; McHugh, Megan; Hou, Lifang; Simon, Melissa A.; Murphy, Robert L.; Jordan, Neil

    2017-01-01

    Background Although cervical cancer is largely preventable through screening, detection and treatment of precancerous abnormalities, it remains one of the top causes of cancer-related morbidity and mortality globally. Objectives The objective of this systematic review is to understand the evidence of the effect of cervical cancer education compared to control conditions on cervical cancer screening rates in eligible women population at risk of cervical cancer. We also sought to understand the effect of provider recommendations for screening to eligible women on cervical cancer screening (CCS) rates compared to control conditions in eligible women population at risk of cervical cancer. Methods We used the PICO (Problem or Population, Interventions, Comparison and Outcome) framework as described in the Cochrane Collaboration Handbook to develop our search strategy. The details of our search strategy has been described in our systematic review protocol published in the International Prospective Register of systematic reviews (PROSPERO). The protocol registration number is CRD42016045605 available at: http://www.crd.york.ac.uk/prospero/display_record.asp?src=trip&ID=CRD42016045605. The search string was used in Pubmed, Embase, Cochrane Systematic Reviews and Cochrane CENTRAL register of controlled trials to retrieve study reports that were screened for inclusion in this review. Our data synthesis and reporting was guided by the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). We did a qualitative synthesis of evidence and, where appropriate, individual study effects were pooled in meta-analyses using RevMan 5.3 Review Manager. The Higgins I2 was used to assess for heterogeneity in studies pooled together for overall summary effects. We did assessment of risk of bias of individual studies included and assessed risk of publication bias across studies pooled together in meta-analysis by Funnel plot. Results Out of 3072 study reports screened

  12. Scaling up cervical cancer screening in the midst of human papillomavirus vaccination advocacy in Thailand

    Directory of Open Access Journals (Sweden)

    Teerawattananon Yot

    2010-07-01

    Full Text Available Abstract Background Screening tests for cervical cancer are effective in reducing the disease burden. In Thailand, a Pap smear program has been implemented throughout the country for 40 years. In 2008 the Ministry of Public Health (MoPH unexpectedly decided to scale up the coverage of free cervical cancer screening services, to meet an ambitious target. This study analyzes the processes and factors that drove this policy innovation in the area of cervical cancer control in Thailand. Methods In-depth interviews with key policy actors and review of relevant documents were conducted in 2009. Data analysis was guided by a framework, developed on public policy models and existing literature on scaling-up health care interventions. Results Between 2006 and 2008 international organizations and the vaccine industry advocated the introduction of Human Papillomavirus (HPV vaccine for the primary prevention of cervical cancer. Meanwhile, a local study suggested that the vaccine was considerably less cost-effective than cervical cancer screening in the Thai context. Then, from August to December 2008, the MoPH carried out a campaign to expand the coverage of its cervical cancer screening program, targeting one million women. The study reveals that several factors were influential in focusing the attention of policymakers on strengthening the screening services. These included the high burden of cervical cancer in Thailand, the launch of the HPV vaccine onto the global and domestic markets, the country’s political instability, and the dissemination of scientific evidence regarding the appropriateness of different options for cervical cancer prevention. Influenced by the country’s political crisis, the MoPH’s campaign was devised in a very short time. In the view of the responsible health officials, the campaign was not successful and indeed, did not achieve its ambitious target. Conclusion The Thai case study suggests that the political crisis was a

  13. Screening for cervical neoplasia in Mamelodi lessons from an ...

    African Journals Online (AJOL)

    black population of South Africa, is high, and is regarded by both medical'·3 and political4 authorities as a major health problem. Cervical carcinoma is the most important cancer- related cause of death in black women and mortality rates. Departments of Family Medicine and Obstetrics and Gynaecology,. University of ...

  14. Cervical Cancer Awareness and Screening Uptake among Rural ...

    African Journals Online (AJOL)

    Background: Cervical cancer is the most common cause of female genital cancer and female cancer deaths in developing countries such as Nigeria. The most recent government estimates put the number of new cases at 25,000 per year. According to the latest global estimates, 493, 000 new cases occur each year and ...

  15. The Vaccine and Cervical Cancer Screen (VACCS) project ...

    African Journals Online (AJOL)

    Information on cervical cancer and HPV vaccination was provided to 19 primary schools in Western Cape and Gauteng provinces participating in the study. Girls with parental consent and child assent were vaccinated during school hours at their schools. Results. A total of 3 465 girls were invited to receive HPV vaccine, ...

  16. Screening for Cervical Cancer: A Review of Outcome among Infertile ...

    African Journals Online (AJOL)

    The etiological organism of the disease is the human papilloma virus (HPV) that is sexually transmitted and sexually transmitted infections play a major role in the causation of infertility in developing countries. Aim: The aim of this study is to determine the prevalence of abnormal cervical smear among infertile women at ...

  17. Evaluation Of Cervical Cancer Screening Program At A Rural ...

    African Journals Online (AJOL)

    and practices on risk factors for cervical cancer and Pap smear and to design an intervention to improve Pap smear uptake. Methods: A cross-sectional population based descriptive study was undertaken at a rural community of South Africa targeting women 30 years and over. The assessment was performed by means of a ...

  18. Knowledge and practice of cervical cancer screening among female ...

    African Journals Online (AJOL)

    Introduction: Cervical cancer is the second most common cancer affecting women worldwide. It is a preventable disease but still remains a leading cause of cancer deaths in developing countries like Nigeria despite the availability of preventive and curative protocols. Objective: The aim of this study was to determine the ...

  19. The effect of Māori ethnicity misclassification on cervical screening coverage.

    Science.gov (United States)

    Sandiford, Peter; Salvetto, Micol; Bramley, Dale; Wong, Samuel; Johnson, Lannes

    2013-04-05

    There is a large difference in the cervical screening coverage rate between Māori and European women in New Zealand. This paper examines the extent to which this difference is due to misclassification of ethnicity. Data from Waitemata District Health Board's two Primary Health Organisations (PHOs) was used to identify the population of Waitemata domiciled women aged 25-69 years eligible for cervical screening. Their cervical screening status was obtained from the National Cervical Screening Programme register (NCPS-R). Data from Auckland and Waitemata DHBs was used to determine the women's ethnicity in the National Health Index (NHI). Women who had withdrawn from the NCSP-R, women who were deceased and women for whom an NHI ethnicity code could not be obtained were excluded from the analysis. Ethnicity codes from the three sources (PHO registers, NCSP-R and NHI) were compared to identify women classified as non-Māori in the NCSP-R but Maori in either of the other two data sources. The effect on Maori cervical screening coverage rates of not counting these women was assessed. Within the study population there was a total of 6718 women identified as Māori on the NCSP of whom 5242 had been screened within the last 3 years and 1476 who had not. In addition to these, there were 2075 women identified as Māori in either the PHO or NHI databases but not in the NCSP-R who had been screened within the preceding 3 years, and a further 2094 who had not been screened. There were also 797 women identified as Maori in the NHI or PHO datasets who were not on the NCSP-R (and therefore were not screened). If all screened women classified as Māori from any source were counted, Waitemata DHB's Māori screening coverage rate would rise from 49.3% to 68.8% (or to 61.0% and 63.2% respective if just PHO and NHI Māori were counted). Misclassification of ethnicity could explain (in absolute terms) up to 19.5% of the 35.0% difference in cervical screening coverage rate between M

  20. Description of the national situation of cervical cancer screening in the member states of the European Union

    DEFF Research Database (Denmark)

    Anttila, Ahti; Ronco, Guglielmo; Lynge, Elsebeth

    2009-01-01

    This report up-dates information on the national situation of cervical cancer screening in the member states of the European Union. There is yet high diversity in the status of cervical screening, and rapid changes expected to occur in the situation in many countries. It is important to underline...

  1. Screening for cervical and breast cancer: is obesity an unrecognized barrier to preventive care?

    Science.gov (United States)

    Wee, C C; McCarthy, E P; Davis, R B; Phillips, R S

    2000-05-02

    Compared with thinner women, obese women have higher mortality rates for breast and cervical cancer. In addition, obesity leads to adverse social and psychological consequences. Whether obesity limits access to screening for breast and cervical cancer is unclear. To examine the relation between obesity and screening with Papanicolaou (Pap) smears and mammography. Population-based survey. United States. 11 435 women who responded to the "Year 2000 Supplement" of the 1994 National Health Interview Survey. Screening with Pap smears and mammography was assessed by questionnaire. In women 18 to 75 years of age who had not previously undergone hysterectomy (n = 8394), fewer overweight women (78%) and obese women (78%) than normal-weight women (84%) had had Pap smears in the previous 3 years (P obese women (-5.3% [CI, -8.0% to -2.6%]). In women 50 to 75 years of age (n = 3502), fewer overweight women (64%) and obese women (62%) than normal-weight women (68%) had had mammography in the previous 2 years (P obese women. Overweight and obese women were less likely to be screened for cervical and breast cancer with Pap smears and mammography, even after adjustment for other known barriers to care. Because overweight and obese women have higher mortality rates for cervical and breast cancer, they should be targeted for increased screening.

  2. The clinical utility of HPV DNA testing in cervical cancer screening strategies.

    Science.gov (United States)

    Bhatla, Neerja; Moda, Nidhi

    2009-09-01

    Cervical cancer continues to be the commonest cause of death among women in developing countries, largely due to the failure to the inability to sustain effective cytology-based screening programs. While this burden may come down following implementation of the human papillomavirus (HPV) vaccine, screening will still be required. HPV DNA testing is a promising new technology for cervical cancer prevention and is the most reproducible of all cervical cancer screening tests. Presently, the two assays most widely used for the detection of genital types are the polymerase chain reaction (PCR) and Hybrid Capture 2 assays (hc2). Rapid, affordable tests are expected to be available soon. HPV DNA testing can be used in a variety of clinical scenarios that include primary screening in women older than 30 yr; as an adjunctive test to cytology; in the triage of women with an equivocal cytologic report, e.g., ASC-US; or for follow-up post-treatment for cervical intraepithelial neoplasia (CIN). HPV DNA testing can also be performed on self-collected samples, which allows screening in remote areas and also in women who refuse gynecologic examination.

  3. Knowledge of cervical cancer and screening among women in east-central England.

    Science.gov (United States)

    Philips, Z; Avis, M; Whynes, D K

    2005-01-01

    This study assesses the extent and accuracy of women's knowledge of cervical cancer, risk factors, and the efficacy of the national screening program. Data were obtained from a questionnaire survey of randomly selected women eligible for screening, drawn from a population in east-central England. The majority of women in the sample overestimated the current incidence of cervical cancer, both absolutely and relative to other cancers. Perceiving incidence to be high was associated with reporting worries about the disease. With respect to the screening process, 78.3% believe that the smear abnormality rate is higher than it actually is, and only 7.6% correctly appreciate that the abnormality rate is highest at younger ages. With respect to performance, 16.3% believed the smear test to be completely accurate, and more than half overestimated the likely number of cancer cases prevented by screening. While certain cervical cancer risk factors were correctly assigned by the majority of women, undue emphasis was placed on genetic influence, while the risks posed by human papillomavirus infection were unfamiliar to almost half of the sample. We conclude that women typically possess only a partial picture of risk factors and overestimate both the incidence of cervical cancer and the efficacy of screening.

  4. Cervical Cancer Screening Barriers and Risk Factor Knowledge Among Uninsured Women.

    Science.gov (United States)

    Akinlotan, Marvellous; Bolin, Jane N; Helduser, Janet; Ojinnaka, Chinedum; Lichorad, Anna; McClellan, David

    2017-08-01

    A steady decline in cervical cancer incidence and mortality in the United States has been attributed to increased uptake of cervical cancer screening tests such as Papanicolau (Pap) tests. However, disparities in Pap test compliance exist, and may be due in part to perceived barriers or lack of knowledge about risk factors for cervical cancer. This study aimed to assess correlates of cervical cancer risk factor knowledge and examine socio-demographic predictors of self-reported barriers to screening among a group of low-income uninsured women. Survey and procedure data from 433 women, who received grant-funded cervical cancer screenings over a span of 33 months, were examined for this project. Data included demographics, knowledge of risk factors, and agreement on potential barriers to screening. Descriptive analysis showed significant correlation between educational attainment and knowledge of risk factors (r = 0.1381, P < 0.01). Multivariate analyses revealed that compared to Whites, Hispanics had increased odds of identifying fear of finding cancer (OR 1.56, 95% CI 1.00-2.43), language barriers (OR 4.72, 95% CI 2.62-8.50), and male physicians (OR 2.16, 95% CI 1.32-3.55) as barriers. Hispanics (OR 1.99, 95% CI 1.16-3.44) and Blacks (OR 2.06, 95% CI 1.15-3.68) had a two-fold increase in odds of agreeing that lack of knowledge was a barrier. Identified barriers varied with age, marital status and previous screening. Programs aimed at conducting free or subsidized screenings for medically underserved women should include culturally relevant education and patient care in order to reduce barriers and improve screening compliance for safety-net populations.

  5. The acceptability of vaginal smear self-collection for screening for cervical cancer: a systematic review

    Directory of Open Access Journals (Sweden)

    Natalia Serrano Doratioto Faria Braz

    Full Text Available Cervical cancer is a major cause of death in adult women. However, many women do not undergo cervical cancer screening for the following reasons: fear, shame, physical limitations, cultural or religious considerations and lack of access to health care services. Self-collected vaginal smears maybe an alternative means of including more women in cervical cancer screening programs. The objective of this systematic review was to evaluate the acceptability of vaginal smear self-collection for cervical cancer screening. We selected articles from PubMed, the Cochrane Library and Embase that were published between January 1995 and April 2016. Studies written in English, French, Italian, Portuguese or Spanish that involved women between 18 and 69 years of age who had engaged in sexual intercourse were included in this review. The review was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Nineteen studies were ultimately evaluated in this review. Most of the included studies (n=17 demonstrated that the self-collection method exhibited outstanding acceptability among women with respect to cervical cancer screening, and only two studies indicated that self-collection exhibited low acceptability among women in this context. The acceptability of self-collection was determined subjectively (without standardized questionnaires in 10 studies (53% and via structured and validated questionnaires in the remaining studies. The results of our review suggest that the self-collection method is well-accepted and may therefore encourage greater participation in cervical cancer screening programs. However, additional studies are required to verify these results.

  6. European guidelines for quality assurance in cervical cancer screening. Summary of the supplements on HPV screening and vaccination

    Directory of Open Access Journals (Sweden)

    Lawrence von Karsa

    2015-12-01

    Full Text Available In a project coordinated by the International Agency for Research on Cancer (IARC 31 experts from 11 European countries and IARC have developed supplements to the current European guidelines for quality assurance in cervical cancer screening. The supplements take into account the potential of primary testing for human papillomavirus (HPV and vaccination against HPV infection to improve cervical cancer prevention and control and will be published by the European Commission in book format. They include 62 recommendations or conclusions for which the strength of the evidence and the respective recommendations is graded. While acknowledging the available evidence for more efficacious screening using HPV primary testing compared to screening based on cytology, the authors and editors of the supplements emphasize that appropriate policy and programme organization remain essential to achieve an acceptable balance between benefit and harm of any screening or vaccination programme. A summary of the supplements and all of the graded recommendations are presented here in journal format to make key aspects of the updated and expanded guidelines known to a wider professional and scientific community. Keywords: Mass screening, Vaccination, Cervical neoplasms, Human papillomavirus, Evidence-based guidelines, Population-based programme

  7. Specialized survivor clinic attendance increases adherence to cardiomyopathy screening guidelines in adult survivors of childhood cancer.

    Science.gov (United States)

    Marr, Kristin C; Agha, Mohammad; Sutradhar, Rinku; Pole, Jason D; Hodgson, David; Guttmann, Astrid; Greenberg, Mark; Nathan, Paul C

    2017-10-01

    To determine if attendance at a specialized clinic for adult survivors of childhood cancer is associated with better rates of adherence to the Children's Oncology Group (COG) Long-term Follow-up (LTFU) guidelines for cardiomyopathy screening. We conducted a retrospective population-based study using administrative data in Ontario, Canada of 5-year survivors diagnosed between 1986 and 2005 at risk of therapy-related late cardiomyopathy. Patients were classified into three groups based on the recommended frequency of screening: annual, every 2 years, and every 5 years. Of 1811 eligible survivors followed for median 7.8 years (range 0-14.0), patients were adherent to screening for only 8.6% of their period of follow-up. Survivor clinic utilization had the strongest association with increased rates of adherence: when compared to no attendance, ≥ 5 clinic visits/10-year period had RR of adherence of 10.6 (95% CI 5.7-19.5) in the annual group, 3.3 (95% CI 2.3-4.8) in the every 2-year group, and 2.3 (95% CI 1.6-3.2) in the every 5-year group. Additional factors associated with increased adherence after adjusting for clinic attendance included annual assessment by a general practioner, female sex, diagnosis prior to 2003, and living in a rural area. In a model of specialized survivor care, increased clinic utilization is associated with improved patient adherence to COG LTFU cardiomyopathy screening guidelines. Specialized survivor clinics may improve health outcomes in survivors through improved adherence to screening. However, rates of adherence remain suboptimal and further multifacetted strategies need to be explored to improve overall rates of screening in adult survivors of childhood cancer.

  8. Cost of the Cervical Cancer Screening Program at the Mexican Social Security Institute

    Directory of Open Access Journals (Sweden)

    Víctor Granados-García

    2014-09-01

    Full Text Available Objective. To estimate the annual cost of the National Cervical Cancer Screening Program (CCSP of the Mexican Institute of Social Security (IMSS. Materials and methods. This cost analysis examined regional coverage rates reported by IMSS. We estimated the number of cytology, colposcopy, biopsy and pathology evaluations, as well as the diagnostic test and treatment costs for cervical intraepithelial neoplasia grade II and III (CIN 2/3 and cervical cancer. Diagnostic test costs were estimated using a micro-costing technique. Sensitivity analyses were performed. Results. The cost to perform 2.7 million cytology tests was nearly 38 million dollars, which represents 26.1% of the total program cost (145.4 million. False negatives account for nearly 43% of the program costs. Conclusion. The low sensitivity of the cytology test generates high rates of false negatives, which results in high institutional costs from the treatment of undetected cervical cancer cases.

  9. Knowledge creation using artificial intelligence: a twin approach to improve breast screening attendance.

    Science.gov (United States)

    Baskaran, Vikraman; Bali, Rajeev K; Arochena, Hisbel; Naguib, Rauf N G; Wallis, Matthew; Wheaton, Margot

    2006-01-01

    Knowledge management (KM) is rapidly becoming established as a core organizational element within the healthcare industry to assist in the delivery of better patient care. KM is a cyclical process which typically starts with knowledge creation (KC), progresses to knowledge sharing, knowledge accessibility and eventually results in new KC (in the same or a related domain). KC plays a significant role in KM as it creates the necessary "seeds" for propagating many more knowledge cycles. This paper addresses the potential of KC in the context of the UK's National Health Service (NHS) breast screening service. KC can be automated to a greater extent by embedding processes within an artificial intelligence (AI) based environment. The UK breast screening service is concerned about non-attendance and this paper discusses issues pertaining to increasing attendance.

  10. Perceived Benefits and Barriers of Cervical Cancer Screening Among Chinese American Women.

    Science.gov (United States)

    Tung, Wei-Chen; Lu, Minggen; Granner, Michelle

    2017-03-01

    To explore the perceived benefits and barriers to cervical cancer screening among Chinese American women using stages of the Transtheoretical Model of Change.
. Cross-sectional design with self-report surveys. 
. Chinese communities (e.g., churches, supermarkets, restaurants) in Northern California and Northern Nevada. 
. 121 Chinese women aged 21-65 years living in Northern California and Northern Nevada. 
. A snowball sampling technique using personal contacts was used.
. Stages of change and perceived benefits and barriers to cervical cancer screening. 
. Participants in the action/maintenance stage were most likely to believe that cervical cancer was treatable if caught early. Women in the contemplation/preparation stage were more likely to state that they worried about or feared screening, that it was too expensive, and that they would want to use Chinese medicine to cure an illness before trying Western medicine. Women in the precontemplation/relapse stage were most likely to report that they did not know where to get screened and that their partner would not want them to be screened.
. Perceived benefits and barriers to screening were differentially associated with the stages of change. Results may support culturally sensitive and theory-based programs to improve screening rates among Chinese American women. 
. The results suggest the importance of cultural sensitivity among nursing providers when working with Chinese Americans to provide more relevant, holistic care.

  11. Factors associated with breast and cervical cancer screening behavior among African immigrant women in Minnesota.

    Science.gov (United States)

    Harcourt, Nonyelum; Ghebre, Rahel G; Whembolua, Guy-Lucien; Zhang, Yan; Warfa Osman, S; Okuyemi, Kolawole S

    2014-06-01

    Immigrant populations in the United States (US) have lower cancer screening rates compared to none immigrant populations. The purpose of this study was to assess the rates of cancer screening and examine factors associated with cancer screening behavior among African immigrant women in Minnesota. A cross sectional survey of a community based sample was conducted among African immigrants in the Twin Cities. Cancer screening outcome measures were mammography and Papanicolau smear test. The revised theoretical model of health care access and utilization and the behavioral model for vulnerable populations were utilized to assess factors associated with cancer screening. Only 61 and 52% of the age eligible women in the sample had ever been screened for breast and cervical cancer respectively. Among these women, duration of residence in the US and ethnicity were significant determinants associated with non-screening. Programs to enhance screening rates among this population must begin to address barriers identified by the community.

  12. Low rates of cervical cancer screening among urban immigrants: a population-based study in Ontario, Canada.

    Science.gov (United States)

    Lofters, Aisha K; Moineddin, Rahim; Hwang, Stephen W; Glazier, Richard H

    2010-07-01

    Women who are immigrants or socioeconomically disadvantaged have been found to have significantly lower cervical cancer screening rates than their peers in Toronto, Ontario, Canada. The objective of this study was to examine rates of appropriate cervical cancer screening among women living in Ontario, Canada, using recent registration with Ontario's universal health insurance plan as an indicator of immigrant status. This retrospective cohort study included 2,273,995 screening-eligible women aged 25 to 69 years, who resided in Ontario's metropolitan areas during the calendar years 2003, 2004, and 2005. A validated algorithm was applied to the Ontario-wide physicians' claims database to determine which women had undergone cervical cancer screening with a Pap test during the 3-year period. Appropriate cervical cancer screening occurred for 61.1% of women. Despite adjustment for physician contact and pregnancy rates, cervical cancer screening rates were especially low among: women aged 50 to 69 years; women living in low-income areas; and women who had registered with Ontario's universal health insurance plan within the preceding 10 years, a group consisting largely of recent immigrants. Women with all 3 of these characteristics had a screening rate of 31.0% compared with 70.5% among women with none of these characteristics. Within a system of universal health insurance, appropriate cervical cancer screening is significantly lower among women who are older, living in low-income areas, or recent immigrants. Efforts to reduce disparities in cervical cancer screening should focus on women with these characteristics.

  13. Cervical cancer screening attitudes and beliefs of Malaysian women who have never had a pap smear: a qualitative study.

    Science.gov (United States)

    Wong, L P; Wong, Y L; Low, W Y; Khoo, E M; Shuib, R

    2008-01-01

    Attitudes toward cervical cancer and participation in early detection and screening services are well known to be profoundly affected by cultural beliefs and norms. This study explored the attitudes and sociocultural beliefs on cervical cancer screening among Malaysian women. In this qualitative study, in-depth interviews were conducted with 20 Malaysian women, ages 21 to 56 years, who have never had a Papanicolaou (Pap) smear. Respondents generally showed a lack of knowledge about cervical cancer screening using Pap smear, and the need for early detection for cervical cancer. Many believed the Pap smear was a diagnostic test for cervical cancer, and since they had no symptoms, they did not go for Pap screening. Other main reasons for not doing the screening included lack of awareness of Pap smear indications and benefits, perceived low susceptibility to cervical cancer, and embarrassment. Other reasons for not being screened were related to fear of pain, misconceptions about cervical cancer, fatalistic attitude, and undervaluation of own health needs versus those of the family. Women need to be educated about the benefits of cervical cancer screening. Health education, counseling, outreach programs, and community-based interventions are needed to improve the uptake of Pap smear in Malaysia.

  14. The influence of the 'cancer effect' on young women's responses to overdiagnosis in cervical screening.

    Science.gov (United States)

    Phillips, Katelyn; Hersch, Jolyn; Turner, Robin; Jansen, Jesse; McCaffery, Kirsten

    2016-10-01

    To examine the 'cancer effect' (higher risk perceptions and negative emotion in cancer-related contexts) on young women's responses to overdiagnosis (identification and treatment of inconsequential disease) in cervical cancer screening. In a randomised experimental study, 168 women aged 17-24 read 1 of 4 texts outlining benefits and harms of cervical cancer screening or a fictitious non-cancer screening test; each presented with or without overdiagnosis information. Screening intentions and psychosocial outcomes were measured (T1). Overdiagnosis information was then presented to participants who did not receive it initially and intentions reassessed (T2). Mean screening intentions were not significantly different across groups. The distribution of intentions for cancer vs non-cancer screening differed significantly. Cancer information led to more extreme responses. Participants receiving overdiagnosis information at T2 reduced their screening intentions significantly. Perceived risk of disease was lower when overdiagnosis information was presented (non-cancer condition only). Higher negative emotion predicted higher screening intentions (cancer condition only). This pattern of results suggests that a 'cancer effect' may be present among young women given identical information about cancer and non-cancer screening. The 'cancer effect' may contribute to community eagerness for cancer screening despite provision of information about harms like overdiagnosis. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  15. Induced versus spontaneous attendance of breast-screening tests by women.

    Science.gov (United States)

    Chaitchik, S; Kreitler, S

    1991-01-01

    Despite the availability of services and information, not enough women undergo breast-screening tests. A previous study showed that clinic attenders differ from nonattenders in emotions, personality, self-concept, neuroticism, psychosomatics, and health attitudes. Some of these resembled the cancer-prone personality. The present study was designed to test whether nonattenders have higher repression that supports denial and could be persuaded by positive inducements to undergo the tests. Other goals were to examine if the new sample replicates the former findings and if it differs from clinic attenders. The subjects were 210 spontaneous clinic attenders and 210 matched controls from the previous study and 46 positively induced women. They were administered questionnaires assessing emotions, personality, daydreaming, self-concept, neuroticism, somatic complaints, alexithymia, and health attitudes. The findings were that the induced sample scored higher on repressiveness, had more cancer-affected blood relatives, and responded favorably to the positive inducements. They differed from the controls in most of the variables the clinic attenders did but differed from the clinic attenders in 30% of the variables, manifesting more extreme correspondence to the cancer-prone personality. The findings indicate possibilities of drawing more individuals to undergo the tests by emphasizing the positive anxiety-reducing approach.

  16. Primary HPV screening for cervical cancer prevention: results from European trials

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Rebolj, Matejka

    2009-01-01

    Six European, randomized, controlled trials that will compare human papillomavirus (HPV) testing with cytological testing for cervical screening are under way. We reviewed the results published so far to compare the benefits and costs for participating women. At baseline screening, use of HPV...... for each extra detected CIN2+ case; although, in another trial, this number was 49 in women > or =35 years of age. The outcome of HPV testing versus cytological testing depends not only on the relative accuracy of the primary test but also on how radical the different triage procedures are. In two trials...... of a switch from primary screening with cytological testing to primary screening with HPV testing....

  17. Validation of cervical cancer screening methods in HIV positive women from Johannesburg South Africa.

    Directory of Open Access Journals (Sweden)

    Cynthia Firnhaber

    Full Text Available HIV-infected women are at increased risk for developing cervical cancer. Women living in resource-limited countries are especially at risk due to poor access to cervical cancer screening and treatment. We evaluated three cervical cancer screening methods to detect cervical intraepithelial neoplasia grade 2 and above (CIN 2+ in HIV-infected women in South Africa; Pap smear, visual inspection with 5% acetic acid (VIA and human papillomavirus detection (HPV.HIV-infected women aged 18-65 were recruited in Johannesburg. A cross-sectional study evaluating three screening methods for the detection of the histologically-defined gold standard CIN-2 + was performed. Women were screened for cervical abnormalities with the Digene HC2 assay (HPV, Pap smear and VIA. VIA was performed by clinic nurses, digital photographs taken and then later reviewed by specialist physicians. The sensitivity, specificity and predictive valves for CIN-2 + were calculated using maximum likelihood estimators.1,202 HIV-infected women participated, with a median age of 38 years and CD4 counts of 394 cells/mm(3. One third of women had a high grade lesion on cytology. VIA and HPV were positive in 45% and 61% of women respectively. Estimated sensitivity/specificity for HPV, Pap smear and VIA for CIN 2+ was 92%/51.4%, 75.8%/83.4% and 65.4/68.5% (nurse reading, respectively. Sensitivities were similar, and specificities appeared significantly lower for the HPV test, cytology and VIA among women with CD4 counts ≤200 cells/mm(3 as compared to CD4 counts >350 cells/mm(3.Although HPV was the most sensitive screening method for detecting CIN 2+, it was less specific than conventional cytology and VIA with digital imaging review. Screening programs may need to be individualized in context of the resources and capacity in each area.

  18. Non-attendance of mammographic screening: the roles of age and municipality in a population-based Swedish sample.

    Science.gov (United States)

    Zidar, Maria Norfjord; Larm, Peter; Tillgren, Per; Akhavan, Sharareh

    2015-12-30

    Inequality in health and health care is increasing in Sweden. Contributing to widening gaps are various factors that can be assessed by determinants, such as age, educational level, occupation, living area and country of birth. A health care service that can be used as an indicator of health inequality in Sweden is mammographic screening. The non-attendance rate is between 13 and 31 %, while the average is about 20 %. This study aims to shed light on three associations: between municipality and non-attendance, between age and non-attendance, and the interaction of municipality of residence and age in relation to non-attendance. The study is based on data from the register that identifies attenders and non-attenders of mammographic screening in a Swedish county, namely the Radiological Information System (RIS). Further, in order to provide a socio-demographic profile of the county's municipalities, aggregated data for women in the age range 40-74 in 2012 were retrieved from Statistics Sweden (SCB), the Public Health Agency of Sweden, the National Board of Health and Welfare, and the Swedish Social Insurance Agency. The sample consisted of 52,541 women. Analysis conducted of the individual data were multivariate logistic regressions, and pairwise chi-square tests. The results show that age and municipality of residence associated with non-attendance of mammographic screening. Municipality of residence has a greater impact on non-attendance among women in the age group 70 to 74. For most of the age categories there were differences between the municipalities in regard to non-attendance to mammographic screening. Age and municipality of residence affect attendance of mammographic screening. Since there is one sole and pre-selected mammographic screening facility in the county, distance to the screening facility may serve as one explanation to non-attendance which is a determinant of inequity. From an equity perspective, lack of equal access to health and health care

  19. Results of a randomized controlled trial to increase cervical cancer screening among rural Latinas.

    Science.gov (United States)

    Thompson, Beti; Carosso, Elizabeth A; Jhingan, Esther; Wang, Lei; Holte, Sarah E; Byrd, Theresa L; Benavides, Maria C; Lopez, Cathy; Martinez-Gutierrez, Javiera; Ibarra, Genoveva; Gonzalez, Virginia J; Gonzalez, Nora E; Duggan, Catherine R

    2017-02-15

    Latinas have the highest rates of cervical cancer in the United States and the second highest rate of cervical cancer mortality. One factor in the disparity is the relatively low rate of screening for cervical cancer in this population. Eligible women who were out of adherence with cervical cancer screening (>3 years since their last Papanicolaou [Pap] test) were identified via medical record review by a federally qualified local health center. The effects of a low-intensity intervention (video delivered to participants' homes; n = 150) and a high-intensity intervention (video plus a home-based educational session; n = 146) on cervical cancer screening uptake in comparison with a control arm (usual care; n = 147) were investigated. A cost-effectiveness analysis of the interventions was conducted: all intervention costs were calculated, and the incremental cost-effectiveness ratio was computed. Finally, women with positive Pap tests were provided navigation by a community health educator to ensure that they received follow-up care. A total of 443 Latinas participated. Seven months after randomization, significantly more women in the high-intensity arm received a Pap test (53.4%) in comparison with the low-intensity arm (38.7%; P cancer; these women received navigation for follow-up care. A culturally appropriate, in-home, promotora-led educational intervention was successful in increasing cervical cancer screening among Latinas. Cancer 2017;123:666-674. © 2016 American Cancer Society. © 2016 American Cancer Society.

  20. Knowledge, facilitators and barriers to cervical cancer screening among women in Uganda: a qualitative study

    OpenAIRE

    Ndejjo, Rawlance; Mukama, Trasias; Kiguli, Juliet; Musoke, David

    2017-01-01

    Objectives To explore community knowledge, facilitators and barriers to cervical cancer screening among women in rural Uganda so as to generate data to inform interventions. Design A qualitative study using focus group discussions and key informant interviews. Setting Discussions and interviews carried out in the community within two districts in Eastern Uganda. Participants Ten (10) focus group discussions with 119 screening-eligible women aged between 25 and 49 years and 11 key informant in...

  1. Harms of cervical cancer screening in the United States and the Netherlands.

    Science.gov (United States)

    Habbema, Dik; Weinmann, Sheila; Arbyn, Marc; Kamineni, Aruna; Williams, Andrew E; M C M de Kok, Inge; van Kemenade, Folkert; Field, Terry S; van Rosmalen, Joost; Brown, Martin L

    2017-03-01

    We studied harms related to cervical cancer screening and management of screen-positive women in the United States (US) and the Netherlands. We utilized data from four US integrated health care systems (SEARCH), the US National Health Interview Survey, New Mexico state, the Netherlands national histopathology registry, and included studies on adverse health effects of cervical screening. We compared the number of Papanicolaou (Pap) smear tests, abnormal test results, punch biopsies, treatments, health problems (anxiety, pain, bleeding and discharge) and preterm births associated with excisional treatments. Results were age-standardized to the 2007 US population. Based on SEARCH, an estimated 36 million Pap tests were performed in 2007 for 91 million US women aged 21-65 years, leading to 2.3 million abnormal Pap tests, 1.5 million punch biopsies, 0.3 million treatments for precancerous lesions, 5 thousand preterm births and over 8 million health problems. Under the Netherlands screening practice, fewer Pap tests (58%), abnormal test results (64%), punch biopsies (75%), treatment procedures (40%), preterm births (60%) and health problems (63%) would have occurred. The SEARCH data did not differ much from other US data for 2007 or from more recent data up to 2013. Thus compared to the less intensive screening practice in the Netherlands, US practice of cervical cancer screening may have resulted in two- to threefold higher harms, while the effects on cervical cancer incidence and mortality are similar. The results are also of high relevance in making recommendations for HPV screening. Systematic collection of harms data is needed for monitoring and for better incorporation of harms in making screening recommendations. © 2016 UICC.

  2. European guidelines for quality assurance in cervical cancer screening: recommendations for cytology laboratories.

    NARCIS (Netherlands)

    Wiener, H.G.; Klinkhamer, P.; Schenck, U.; Arbyn, M.; Bulten, J.; Bergeron, C.; Herbert, A.

    2007-01-01

    The quality of a cervical cytology laboratory depends on adequate handling and staining of the samples, screening and interpretation of the slides and reporting of the results. These guidelines give an overview of procedures recommended in Europe to manage the balance between best patient care

  3. Knowledge of cervical cancer and screening practices of nurses at a ...

    African Journals Online (AJOL)

    Objectives: To determine nurses' awareness of cervical cancer and their own screening practices at a hospital in Tanzania. Methods: A descriptive cross sectional study using questionnaires on 137 nurses. Data analysis was made by descriptive statistics and chi square tests. Results: Less than half of the nurses had ...

  4. Facing possible illness detected through screening--experiences of healthy women with pathological cervical smears

    DEFF Research Database (Denmark)

    Hounsgaard, Lise; Petersen, Lone Kjeld; Pedersen, Birthe D

    2007-01-01

    The aim of this study is to gain knowledge about women's perceptions of illness based on their abnormal PAP smears, following screening for cervical cancer. The study uses a phenomenological, hermeneutic approach inspired by Ricoeur's theory of interpretation. Twelve women, aged between 23 and 59...

  5. Cost-effectiveness of cervical cancer screening: Cytology versus human papillomavirus DNA testing

    NARCIS (Netherlands)

    J.M. van Rosmalen (Joost); I.M.C.M. de Kok (Inge); M. van Ballegooijen (Marjolein)

    2012-01-01

    textabstractObjective To determine the most cost-effective screening programme for cervical cancer. Design Cost-effectiveness analysis from a societal perspective. Setting The Netherlands. Population Dutch women who have not been invited for human papillomavirus (HPV) vaccination. Methods We

  6. Pap screening as preventive tool against cervical cancer: a report of ...

    African Journals Online (AJOL)

    The incidence of cervical cancer in the developed countries has significantly reduced as a result of well-organized and coordinated Pap screening program, which is aimed at detection of pre-invasive lesions that are then promptly treated. We report a 45-year old woman whose immediate elder sister had breast carcinoma, ...

  7. Having a Pap smear, quality of life before and after cervical screening: a questionnaire study

    NARCIS (Netherlands)

    Korfage, I. J.; van Ballegooijen, M.; Wauben, B.; Looman, C. W. N.; Habbema, J. D. F.; Essink-Bot, M.-L.

    2012-01-01

    Please cite this paper as: Korfage I, van Ballegooijen M, Wauben B, Looman C, Habbema J, Essink-Bot M. Having a Pap smear, quality of life before and after cervical screening: a questionnaire study. BJOG 2012;119:936944. Objective To assess the health-related quality of life (HRQoL) impact of

  8. Epidemiologic differentiation of diagnostic and screening populations for the assessment of cervical dysplasia using optical technologies.

    Science.gov (United States)

    Pham, Bryan; Rhodes, Helen; Milbourne, Andrea; Adler-Storthz, Karen; Follen, Michele; Scheurer, Michael E

    2012-02-01

    We report here the logistic modeling of the epidemiologic differences between a diagnostic population and a screening population recruited for the study of optical technologies for cervical cancer detection. The goal of this analysis was to determine if there were differences in the sociodemographic or clinical factors between subjects recruited to our diagnostic and screening trials. Epidemiologic data were obtained from a risk factor interview as a component of a multicenter Phase II clinical trial that used fluorescence and reflectance point spectroscopy to diagnose cervical disease. Participants with recent or past abnormal findings on a Papanicolaou smear were grouped into the diagnostic (high-risk) population, whereas those with a history of normal findings on Papanicolaou smears and no cervical treatments were grouped into the screening (low-risk) population. Our model revealed that nonwhite race, higher than a high school education, and peri- and postmenopausal status were associated with the screening population. A history of genital infections, current oral contraceptive use, human papillomavirus positivity (by Hybrid Capture II and consensus polymerase chain reaction), and worst histological diagnosis at clinic visit were important predictors of being in the diagnostic group. We were successful in recruiting 2 distinctive populations and anticipate being able to use these results to more correctly classify women at higher risk for cervical lesions in our future studies of optical spectroscopy. Copyright © 2012 Elsevier HS Journals, Inc. All rights reserved.

  9. From Cancer Screening to Treatment: Service Delivery and Referral in the National Breast and Cervical Cancer Early Detection Program

    Science.gov (United States)

    Miller, Jacqueline W.; Hanson, Vivien; Johnson, Gale D.; Royalty, Janet E.; Richardson, Lisa C.

    2015-01-01

    The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides breast and cervical cancer screening and diagnostic services to low-income and underserved women through a network of providers and health care organizations. Although the program serves women 40-64 years old for breast cancer screening and 21-64 years old for cervical cancer screening, the priority populations are women 50-64 years old for breast cancer and women who have never or rarely been screened for cervical cancer. From 1991 through 2011, the NBCCEDP provided screening and diagnostic services to more than 4.3 million women, diagnosing 54,276 breast cancers, 2554 cervical cancers, and 123,563 precancerous cervical lesions. A critical component of providing screening services is to ensure that all women with abnormal screening results receive appropriate and timely diagnostic evaluations. Case management is provided to assist women with overcoming barriers that would delay or prevent follow-up care. Women diagnosed with cancer receive treatment through the states' Breast and Cervical Cancer Treatment Programs (a special waiver for Medicaid) if they are eligible. The NBCCEDP has performance measures that serve as benchmarks to monitor the completeness and timeliness of care. More than 90% of the women receive complete diagnostic care and initiate treatment less than 30 days from the time of their diagnosis. Provision of effective screening and diagnostic services depends on effective program management, networks of providers throughout the community, and the use of evidence-based knowledge, procedures, and technologies. PMID:25099897

  10. Diagnostic performance of dual-staining cytology for cervical cancer screening: A systematic literature review.

    Science.gov (United States)

    Tjalma, Wiebren A A

    2017-03-01

    Cervical cancer screening saves lives. Secondary prevention in cervical cancer screening relies on the results of primary cytology and/or HPV testing. However, primary screening with cytology has a low sensitivity, and HPV screening has a low specificity. This means that either cancers are missed, or women are over-treated. To improve performance outcomes, the concept of dual-stain cytology (CINtec ® PLUS Cytology test) has been introduced. In this approach, additional staining with p16/Ki-67 is performed in cases where cytology results are abnormal (LSIL or ASCUS) and/or HPV-positive. Another way to describe this approach might be "diagnostic" cytology. In order to assess the value of this "diagnostic cytology", a systematic literature review was conducted of dual-stain cytology performance across multiple studies until May 2016. In a Belgian screening population (women age 25-65 years), dual-stain cytology was significantly more sensitive (66%) and slightly less specific (-1.0%) than cytology. In the population referred to colposcopy or with abnormal cytology (ASCUS, LSIL), dual-staining showed a significantly higher increase in specificity, and a slightly lower sensitivity than HPV testing. Specificity gains resulted in fewer false positives and an increase in the number of correct referrals to colposcopy. Dual-staining with p16/Ki-67 cytology is an attractive biomarker approach for triage in cervical cancer screening. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Unifying Screening Processes Within the PROSPR Consortium: A Conceptual Model for Breast, Cervical, and Colorectal Cancer Screening

    Science.gov (United States)

    Kim, Jane J.; Schapira, Marilyn M.; Tosteson, Anna N. A.; Zauber, Ann G.; Geiger, Ann M.; Kamineni, Aruna; Weaver, Donald L.; Tiro, Jasmin A.

    2015-01-01

    General frameworks of the cancer screening process are available, but none directly compare the process in detail across different organ sites. This limits the ability of medical and public health professionals to develop and evaluate coordinated screening programs that apply resources and population management strategies available for one cancer site to other sites. We present a trans-organ conceptual model that incorporates a single screening episode for breast, cervical, and colorectal cancers into a unified framework based on clinical guidelines and protocols; the model concepts could be expanded to other organ sites. The model covers four types of care in the screening process: risk assessment, detection, diagnosis, and treatment. Interfaces between different provider teams (eg, primary care and specialty care), including communication and transfer of responsibility, may occur when transitioning between types of care. Our model highlights across each organ site similarities and differences in steps, interfaces, and transitions in the screening process and documents the conclusion of a screening episode. This model was developed within the National Cancer Institute–funded consortium Population-based Research Optimizing Screening through Personalized Regimens (PROSPR). PROSPR aims to optimize the screening process for breast, cervical, and colorectal cancer and includes seven research centers and a statistical coordinating center. Given current health care reform initiatives in the United States, this conceptual model can facilitate the development of comprehensive quality metrics for cancer screening and promote trans-organ comparative cancer screening research. PROSPR findings will support the design of interventions that improve screening outcomes across multiple cancer sites. PMID:25957378

  12. Improving the quality of communication in organised cervical cancer screening programmes.

    Science.gov (United States)

    Giordano, Livia; Webster, Premila; Anthony, Charles; Szarewski, Anne; Davies, Philip; Arbyn, Marc; Segnan, Nereo; Austoker, Joan

    2008-07-01

    To provide health professionals involved in cervical cancer screening with an insight into the complex issues relating to communication about screening and to provide a framework for a more effective communication strategy. This paper has been compiled by a multidisciplinary pan-European group of health professionals and cancer advocates from several European screening programmes. European surveys on screening communication, literature reviews and group discussion were used for this purpose. Information on cervical screening must be accessible, relevant, comprehensible, comprehensive, client-centred, phase-specific and multilevel. An effective communication strategy should consider health professionals' screening knowledge and their communication skills, consumers' health literacy skills and the communication needs of specific sub-groups in the target population. Co-operation between screening professionals, advocacy groups and journalists should be promoted. To communicate effectively and appropriately is a complex task which can be influenced by a number of factors. Screening workers need better information themselves and must take into account the needs and characteristics of the target population. This document should provide a useful tool to help screening professionals in designing and developing good quality and effective communication strategies.

  13. HPV immunisation and cervical screening--confirmation of changed performance of cytology as a screening test in immunised women: a retrospective population-based cohort study.

    Science.gov (United States)

    Palmer, T J; McFadden, M; Pollock, K G J; Kavanagh, K; Cuschieri, K; Cruickshank, M; Cotton, S; Nicoll, S; Robertson, C

    2016-03-01

    To document the effect of bivalent HPV immunisation on cervical cytology as a screening test and assess the implications of any change, using a retrospective analysis of routinely collected data from the Scottish Cervical Screening Programme (SCSP). Data were extracted from the Scottish Cervical Call Recall System (SCCRS), the Scottish Population Register and the Scottish Index of Multiple Deprivation. A total of 95 876 cytology records with 2226 linked histology records from women born between 1 January 1988 and 30 September 1993 were assessed. Women born in or after 1990 were eligible for the national catch-up programme of HPV immunisation. The performance of cervical cytology as a screening test was evaluated using the key performance indicators used routinely in the English and Scottish Cervical Screening Programmes (NHSCSP and SCSP), and related to vaccination status. Significant reductions in positive predictive value (16%) and abnormal predictive value (63%) for CIN2+ and the mean colposcopy score (18%) were observed. A significant increase (38%) in the number of women who had to be referred to colposcopy to detect one case of CIN2+ was shown. The negative predictive value of negative- or low-grade cytology for CIN2+ increased significantly (12%). Sensitivity and specificity, as used by the UK cervical screening programmes, were maintained. The lower incidence of disease in vaccinated women alters the key performance indicators of cervical cytology used to monitor the quality of the screening programme. These findings have implications for screening, colposcopy referral criteria, colposcopy practice and histology reporting.

  14. The terminology of pre-invasive cervical lesions in the UK cervical screening programme.

    Science.gov (United States)

    Herrington, C S

    2015-12-01

    The terminology of non-invasive epithelial abnormalities associated with an elevated risk of having or developing invasive cervical carcinoma (pre-invasive lesions) has been modified frequently over time as understanding of the underlying biology, and approaches to disease management, have changed. The arguments are now converging on the conclusion that the most appropriate terminology for cervical squamous intraepithelial abnormalities should be two-tier rather than three-tier. Given the findings of the Lower Anogenital Squamous Terminology (LAST) project in the USA, which have recently been endorsed by the World Health Organisation classification of tumours of female reproductive organs, the recommended terms are low-grade and high-grade squamous intraepithelial lesion (SIL), with the option of including the relevant cervical intraepithelial neoplasia (CIN) grade in parentheses. Although, at first sight, this appears to represent only a small change, there is a fundamental conceptual difference between the systems. The CIN system requires, first, the identification of a CIN lesion and, second, the determination of its grade on a continuum, with subsequent division into three grades. The SIL system is based on the existence of two different forms of human papillomavirus (HPV) infection, with productive infection leading to low-grade SIL and transforming infection leading to high-grade SIL. © 2015 John Wiley & Sons Ltd.

  15. Cervical cancer screening in developing countries at a crossroad: Emerging technologies and policy choices.

    Science.gov (United States)

    Catarino, Rosa; Petignat, Patrick; Dongui, Gabriel; Vassilakos, Pierre

    2015-12-10

    Cervical cancer (CC) represents the fourth most common malignancy affecting women all over the world and is the second most common in developing areas. In these areas, the burden from disease remains important because of the difficulty in implementing cytology-based screening programmes. The main obstacles inherent to these countries are poverty and a lack of healthcare infrastructures and trained practitioners. With the availability of new technologies, researchers have attempted to find new strategies that are adapted to low- and middle-income countries (LMIC) to promote early diagnosis of cervical pathology. Current evidence suggests that human papillomavirus (HPV) testing is more effective than cytology for CC screening. Therefore, highly sensitive tests have now been developed for primary screening. Rapid molecular methods for detecting HPV DNA have only recently been commercially available. This constitutes a milestone in CC screening in low-resource settings because it may help overcome the great majority of obstacles inherent to previous screening programmes. Despite several advantages, HPV-based screening has a low positive predictive value for CC, so that HPV-positive women need to be triaged with further testing to determine optimal management. Visual inspection tests, cytology and novel biomarkers are some options. In this review, we provide an overview of current and emerging screening approaches for CC. In particular, we discuss the challenge of implementing an efficient cervical screening adapted to LMIC and the opportunity to introduce primary HPV-based screening with the availability of point-of-care (POC) HPV testing. The most adapted screening strategy to LMIC is still a work in progress, but we have reasons to believe that POC HPV testing makes part of the future strategies in association with a triage test that still needs to be defined.

  16. Epidemiological patterns of cervical human papillomavirus infection among women presenting for cervical cancer screening in North-Eastern Nigeria.

    Science.gov (United States)

    Manga, Mohammed Mohammed; Fowotade, Adeola; Abdullahi, Yusuf Mohammed; El-Nafaty, Aliyu Usman; Adamu, Danladi Bojude; Pindiga, Hamidu Umar; Bakare, Rasheed Ajani; Osoba, Abimbola Olu

    2015-01-01

    Sub-Saharan countries including Nigeria have the highest burden of Human Papillomavirus (HPV) infection in the world. Most studies on HPV surveillance in Nigeria were done in the southern part of the country. Geographical and socio-cultural diversity of Nigeria makes these data unlikely to be universally representative for the entire country. Northern Nigeria especially the North-East carries a higher prevalence of cervical cancer and many of its risk factors. The region may be harbouring a higher prevalence of HPV infection with a possibility of different genotypic distribution. This study was carried out to determine the burden and confirm the predominant HPV genotypes among women presenting for cervical cancer screening at the Federal Teaching Hospital Gombe (FTHG), North-eastern, Nigeria. The study was an observational hospital based cross sectional study among women who presented for cervical cancer screening in FTHG. A total of 209 consenting women were tested for cervical HPV infection using PCR. DNA sequencing was carried out on positive samples to determine the prevalent HPV genotypes. The prevalence of cervical HPV infection among the participants with mean age of 39.6 ± 10.4 years was 48.1 %. The five most predominant genotypes were 18, 16, 33, 31 and 35, with prevalence of 44.7 %, 13.2 %, 7.9 %, 5.3 % and 5.3 % respectively. Other genotypes observed were 38, 45, 56, 58, 82 and KC5. Multiple HPV infections were detected among 7.9 % of participants. Risk factors such as level of education (X (2) = 15.897; p = 0.007), age at sexual debut (X (2) = 6.916; p = 0.009), parity (X (2) = 23.767; p = 0.000), number of life time sexual partners (X (2) = 7.805; p = 0.005), age at first pregnancy (X (2) = 10.554; p = 0.005) and history of other malignancies (X (2) = 7.325; p = 0.007) were found to have a statistically significant association with HPV infection. This study identified a high burden of HPV

  17. Understanding cervical cancer prevention and screening in Chuukese women in Hawaii.

    Science.gov (United States)

    Wong, Vanessa S; Kawamoto, Crissy T

    2010-06-01

    Cervical cancer is the primary cause of death due to cancer in women in Chuuk State, Federated States of Micronesia. The Chuukese population is the fastest growing segment of the Micronesian community in Hawaii. Little is known about the health beliefs or practices of this population in Hawaii. The purpose of this project was to describe the knowledge, attitudes, and beliefs of Chuukese women in Hawaii regarding cervical cancer prevention and screening. Research assistants from the Chuukese community were recruited and trained as members of the research team. A culturally sensitive survey tool was developed and piloted by the research team and used to interview ten key informants from the Chuukese community in Honolulu, Hawaii. There is limited knowledge about cervical cancer, especially the association with human papillomavirus (HPV). This may be indicative of a lack of health information in general. Fear, privacy concerns, lack of awareness and cultural beliefs represent the main barriers mentioned when discussing cervical cancer. Education, done in a group setting with other women, is the most recommended method of informing this community and improving preventive and screening services for cervical cancer in these women. Hawaii Medical Journal Copyright 2010.

  18. An opto-electronic joint detection system based on DSP aiming at early cervical cancer screening

    Science.gov (United States)

    Wang, Weiya; Jia, Mengyu; Gao, Feng; Yang, Lihong; Qu, Pengpeng; Zou, Changping; Liu, Pengxi; Zhao, Huijuan

    2015-02-01

    The cervical cancer screening at a pre-cancer stage is beneficial to reduce the mortality of women. An opto-electronic joint detection system based on DSP aiming at early cervical cancer screening is introduced in this paper. In this system, three electrodes alternately discharge to the cervical tissue and three light emitting diodes in different wavelengths alternately irradiate the cervical tissue. Then the relative optical reflectance and electrical voltage attenuation curve are obtained by optical and electrical detection, respectively. The system is based on DSP to attain the portable and cheap instrument. By adopting the relative reflectance and the voltage attenuation constant, the classification algorithm based on Support Vector Machine (SVM) discriminates abnormal cervical tissue from normal. We use particle swarm optimization to optimize the two key parameters of SVM, i.e. nuclear factor and cost factor. The clinical data were collected on 313 patients to build a clinical database of tissue responses under optical and electrical stimulations with the histopathologic examination as the gold standard. The classification result shows that the opto-electronic joint detection has higher total coincidence rate than separate optical detection or separate electrical detection. The sensitivity, specificity, and total coincidence rate increase with the increasing of sample numbers in the training set. The average total coincidence rate of the system can reach 85.1% compared with the histopathologic examination.

  19. Cervical and breast cancer screening participation for women with chronic conditions in France: results from a national health survey

    OpenAIRE

    Constantinou, Panayotis; Dray-Spira, Rosemary; Menvielle, Gwenn

    2016-01-01

    Background Comorbidity at the time of diagnosis is an independent prognostic factor for survival among women suffering from cervical or breast cancer. Although cancer screening practices have proven their efficacy for mortality reduction, little is known about adherence to screening recommendations for women suffering from chronic conditions. We investigated the association between eleven chronic conditions and adherence to cervical and breast cancer screening recommendations in France. Metho...

  20. Outcomes of a Decade of Routine Cervical Screening in a Canadian Adolescent Obstetrics Clinic.

    Science.gov (United States)

    Korkidakis, Ann; Bryson, Peter; Jamieson, Mary Anne

    2016-01-01

    New recommendations from the Ontario Cervical Cancer Screening Program indicate that initiation of screening should be delayed to age 21. However, there is sparse evidence pertaining to pregnant adolescents. Our objective was to determine whether early cervical cancer screening in pregnant adolescents confers an advantage over delayed screening in the prevention of cervical carcinoma. We conducted a retrospective cohort study of cervical cancer screening in all pregnant adolescents receiving antenatal care through an obstetrics clinic for adolescents between 2000 and 2010. Clinic attendees had an antenatal and/or postpartum Pap smear, with follow-up according to standard recommendations. Results were recorded together with information on regression, persistence, or progression of abnormal cytology, colposcopy referrals, and cervical biopsies. There is a single regional colposcopy clinic. At least one Pap smear result was documented in 365 of the 388 patients. Of these 365 smears, 88 had abnormal cytology, 76 (86.4%) of which were reported as atypical cells of undetermined significance/low-grade squamous intraepithelial lesion, 11 (12.5%) high-grade squamous intraepithelial lesion (HSIL), and one atypical glandular cells (1.1%). Follow-up cytology was available for 78 patients. No patient lost to follow-up had subsequent referrals for colposcopic assessment in the region. Overall, cytologic abnormalities regressed in 75 (96.1%), persisted in two (2.6%), and progressed in one patient (1.3%). Twenty-three patients (of 365) required a total of 68 colposcopy visits and 17 biopsies, but ultimately only three loop electrosurgical excision procedures (LEEPs) and one laser vaporization were performed. Only one LEEP in a 20-year-old demonstrated HSIL. This population of pregnant adolescents had a high incidence of low-grade cervical abnormalities with a high rate of regression. Routinely screening these pregnant adolescents resulted in numerous repeat visits, repeat Pap

  1. Clinical Validation of Anyplex II HPV HR Detection Test for Cervical Cancer Screening in Korea.

    Science.gov (United States)

    Jung, Sunkyung; Lee, Byungdoo; Lee, Kap No; Kim, Yonggoo; Oh, Eun-Jee

    2016-03-01

    The Anyplex II HPV HR detection kit (Seegene Inc, Seoul, Korea) is a new, multiplex, real-time polymerase chain reaction assay to detect individual 14 high-risk (HR) human papillomavirus (HPV) types in a single tube. To evaluate the clinical performance of the HPV HR kit in predicting high-grade squamous intraepithelial lesions and cervical intraepithelial lesions grade 2 or worse in cervical cancer screening. We analyzed 1137 cervical samples in Huro Path medium (CelltraZone, Seoul, Korea) from Korean women. The clinical performance of the HPV HR kit was compared with Hybrid Capture 2 (Qiagen, Valencia, California) using the noninferiority score test in a routine cervical cancer screening setting. The intralaboratory and interlaboratory agreements of HPV HR were also evaluated. Overall agreement between the 2 assays was 92.4% (1051 of 1137) with a κ value of 0.787. Clinical sensitivity of HPV HR for high-grade squamous intraepithelial lesions and cervical intraepithelial lesions grade 2 or worse was 94.4% (95% confidence interval [CI], 89.2-99.7) and 92.5% (95% CI, 84.3-100.0), respectively. The respective values for Hybrid Capture 2 were 93.1% (95% CI, 87.2-98.9) and 87.5% (95% CI, 77.3-99.7). Clinical sensitivity and specificity of HPV HR were not inferior to those of Hybrid Capture 2 (P = .005 and P = .04, respectively). The HPV HR showed good intralaboratory and interlaboratory reproducibility at 98.0% (κ = 0.953) and 97.4% (κ = 0.940), respectively. The HPV HR demonstrates comparable performance to the Hybrid Capture 2 test and can be useful for HPV-based cervical cancer screening testing.

  2. Using communication to manage uncertainty about cervical cancer screening guideline adherence among Appalachian women.

    Science.gov (United States)

    Cohen, Elisia L; Gordon, Allison Scott; Record, Rachael; Shaunfield, Sara; Jones, Grace M; Collins, Tom

    Changes to the United States Preventive Services Task Force (USPSTF) recommendations for cervical cancer preventive services have led to patient confusion, especially in medically underserved populations. We investigated how patient uncertainty concerning cervical cancer screening guidelines is appraised and managed through communication with healthcare providers by conducting in-depth, face-to-face interviews with 24 adult women between the ages of 24 and 65 (m = 41, SD = 14) living in Appalachia Kentucky. In general, participants expressed a high degree of uncertainty about the updated cervical cancer screening guidelines and appraised this uncertainty as both a danger and an opportunity. Communication with healthcare providers served both to exacerbate and to mitigate patient uncertainty. The study identifies how health care providers may use the change in USPSTF guidelines as a 'teachable moment' to productively counsel patients on the importance of timely screening, the typical progression of certain types of high-risk HPV infection to cervical cancer, and the importance of follow-up care.

  3. Knowledge, behavior and beliefs related to cervical cancer and screening among Turkish women.

    Science.gov (United States)

    Reis, Nesrin; Bebis, Hatice; Kose, Sevinc; Sis, Asli; Engin, Raziye; Yavan, Tulay

    2012-01-01

    The aims of this study were to explore Turkish women's knowledge, behavior and beliefs related to cervical cancer and screening. The study was performed in two cities in the East of Turkey between September 2009 and April 2010, with a sampling group of 387 women. Data were collected by means of an interview form with the Health Belief Model Scale for Cervical Cancer and Pap Smear Test - Turkish Version. Women in the research group were found to have poor knowledge, inadequate health behavior and low/medium level false beliefs regarding cervical cancer screening. There was relation between health beliefs and characteristics of women and particularly education (F = 10.80, p = 0.01). Similarly, it was found that Pap smear barriers were influenced by demographic characteristics and that women with low-level education (p = 0.001), divorced women (p = 0.05), women with low-income(p = 0.05), women who gave their first birth when they were 18 or younger (p = 0.05) and women not applying any contraceptive method at all (p = 0.01) were determined to have negative Pap smear barriers. Primarily the knowledge, attitudes and beliefs of women in the target group should be evaluated to increase their participation in cervical cancer screening and to prepare effective education strategies.

  4. [Factors associated with non-participation in screening for cervical cancer in Southern Brazil].

    Science.gov (United States)

    Cesar, Juraci A; Horta, Bernardo L; Gomes, Gildo; Houlthausen, Ricardo S; Willrich, Roselane M; Kaercher, Alessandra; Iastrenski, Francisco M

    2003-01-01

    Early detection of cervical cancer substantially increases the probability of cure. The aim of this study was to determine the prevalence and factors associated with non-participation in cervical cancer screening among women 15 to 49 years of age in Rio Grande, Southern Brazil. A representative survey was carried out using a systematic sample based on a census tract. Trained interviewers used standard, individualized, household questionnaires to interview the women. Data analysis used logistic regression according to a previously determined hierarchical framework. Among 1,302 women interviewed, 57% had never had a Pap smear. The risk factors most closely associated with non-participation in screening were black or brown skin color, young age, low family income, low schooling, living alone, and first childbirth after 25 years of age. Coverage for early detection of cervical cancer was very low. In addition, women at high risk of developing cervical cancer were shown to have a significantly higher risk of non-participation in this type of screening.

  5. Implementing targeted cervical cancer screening videos at the point of care.

    Science.gov (United States)

    Montealegre, Jane R; Gossey, John Travis; Anderson, Matthew L; Chenier, Roshanda S; Chauca, Glori; Rustveld, Luis O; Jibaja-Weiss, Maria L

    2014-12-01

    To develop and implement educational videos to improve cervical cancer health literacy for patients within a safety net healthcare system. Testimonial-style videos were developed with the goal of describing the Pap test to low literacy patients and motivating them to participate in regular cervical cancer screening. Nurses were trained to use the electronic medical record to identify patients due or past due for a Pap test according to the current screening guidelines. They played the video for all eligible patients as they waited to be seen by their physician in clinical examination rooms. Four 2-minute videos were developed in English, Spanish, and Vietnamese. Videos were made available on desktop computers in 458 exam rooms at 13 community health centers. Integration of educational videos into the workflow of high-volume community health centers is feasible. Future work will focus on optimizing uptake of the videos as well as assessing their efficacy for improving cervical cancer health literacy. Integrating targeted videos into patient flow may be a feasible way to address health literacy barriers to cervical cancer screening within a busy workflow environment. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Awareness, perceived risk and practices related to cervical cancer ...

    African Journals Online (AJOL)

    Awareness, perceived risk and practices related to cervical cancer and Pap smear screening: A crosssectional study among HIV-positive women attending an urban HIV clinic in Johannesburg, South Africa.

  7. Contextual determinants of participation in cervical cancer screening in France, 2010.

    Science.gov (United States)

    Araujo, Mélanie; Franck, Jeanna-Eve; Cadot, Emmanuelle; Gautier, Arnaud; Chauvin, Pierre; Rigal, Laurent; Ringa, Virginie; Menvielle, Gwenn

    2017-06-01

    Some contextual factors associated with participation in cervical cancer screening are reported in the literature, but few studies have examined their combined effect. Our objective was to assess the role of contextual characteristics, separately and in combination, in participation in cervical cancer screening in France. Marginal Poisson regression models - taking into account the correlation between women in a given commune - were conducted using data from the Baromètre Santé 2010 survey. The characteristics of the commune of residence of the women studied were the potential spatial accessibility to general practitioners (GP) and gynecologists, the agglomeration category, and the socioeconomic level. The analyses were performed in 3380 women, 88.2% of whom were up to date with their cervical cancer screening. Once the individual characteristics were taken into account, the screening participation rate was similar in all the communes, with the exception of those with poor access to a gynecologist and good access to a GP, where the rate was 6% lower (95%CI: 0.5-11%) than in the communes with good access to both GP and gynecologist. The same association with accessibility was observed in small agglomerations. Compared to women living in the more advantaged communes, the screening participation rate was 8% (2-12%) lower in those living in the more disadvantaged ones, except when accessibility to both types of physician was high. We observed an association between potential spatial accessibility to care in women's residential communities and their cervical cancer screening practices, in particular in small agglomerations, rural communes, and more disadvantaged communes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Widening the cervical cancer screening net in a South African township: who are the underserved?

    Science.gov (United States)

    Bradley, Janet; Risi, Liliana; Denny, Lynette

    2004-03-01

    Cervical cancer screening services in South Africa have failed to reach the majority of the population and to significantly reduce mortality. A household survey in a predominantly Black African population living in a low-income township on the outskirts of Cape Town was undertaken to ascertain the characteristics of women reporting never having been screened. In our group of 664 representatively sampled women. 45% of women reported having had a cervical screening test. However, in what at first glance appears to be a fairly homogeneous population, there were significant differences in the types of women who access and who do not access cervical smear services. The underserved tend to be the older, poorer, less educated, and unemployed (or working in the informal sector) women. They tend to live in nonpermanent dwellings without a partner, they do not know anyone else who has had a cervical smear, and they have not recently sought care for other ailments, or used contraception. Cervical cancer is a slow-to-develop, eminently preventable disease, and yet opportunistic screening through antenatal and family planning services has failed to reach the women most at risk. Efforts in the future must include targeting older women in health centres where they present for other curative services (diabetes, hypertension). Most importantly, areas of the community with the greatest concentration of marginalized women need to be targeted through peer education and other innovative programs. As the underserved tend to be the poorer and less educated women in the community, we must ensure that messages are culturally relevant and appropriate and have a holistic focus on women's physical, mental, and emotional health.

  9. Public Awareness and Knowledge of Pap Smear as a Screening Test for Cervical Cancer among Saudi Population in Riyadh City.

    Science.gov (United States)

    Al Khudairi, Hassan; Abu-Zaid, Ahmed; Alomar, Osama; Salem, Hany

    2017-01-17

    To explore the public awareness, knowledge, and attitudes of Saudi women towards Pap smear as a screening test for cervical cancer. A descriptive cross-sectional study took place in four major secondary and tertiary healthcare hospitals located in the capital city Riyadh between January 2016 and June 2016. A self-administered, coded, close-ended survey was randomly distributed to 1000 non-single women attending the obstetrics/gynecology outpatient clinics or inpatient wards. Five hundred and seven women participated in the survey (overall response rate: 50.7%). The vast majority of respondents aged between 20-40 years (88%) and were married (94.1%), Saudi citizens (96.5%), university educated (45.6%) and housewives (64.5%). A total of 234 women (46.2%) did not hear whatsoever about Pap smear previously. Only 273 women (53.9%) heard about it, mostly during their hospital visits for obstetric/gynecologic purposes (57.1%). A sum of 381 women (75.2%) did not do a single Pap smear previously. A sum of 383 women (75.5%) reported that their physicians never advised them to do Pap smear. Regarding knowledge of Pap smear, 415 women (82%) did not know when to start doing Pap smear, 471 women (92.9%) did not know how frequently they should do Pap smear and 476 women (93.9%) did not know when to stop doing Pap smear. Moreover, 456 women (89.9%) did not know the difference between Pap smear and high vaginal swap. A total of 429 women (84.6%) never requested their physician to do Pap smear. Almost all women (95.3%) expressed an interest in knowing more information about the Pap smear screening test. The awareness and knowledge of Pap smear as a screening test for cervical cancer among Saudi population living in Riyadh is unsatisfactory. There is an urgent necessity to educate and foster awareness concerning cervical cancer and its screening through Pap smear.

  10. Uptake of community-based, self-collected HPV testing vs. visual inspection with acetic acid for cervical cancer screening in Kampala, Uganda: preliminary results of a randomised controlled trial.

    Science.gov (United States)

    Moses, Erin; Pedersen, Heather N; Mitchell, Sheona M; Sekikubo, Musa; Mwesigwa, David; Singer, Joel; Biryabarema, Christine; Byamugisha, Josaphat K; Money, Deborah M; Ogilvie, Gina S

    2015-10-01

    To compare two cervical cancer screening methods: community-based self-collection of high-risk human papillomavirus (HR-HPV) testing and visual inspection with acetic acid (VIA). Pilot randomised controlled trial of 500 women aged 30-65 in the community of Kisenyi, Uganda. Women randomised to self-collection-based HR-HPV testing provided a cervico-vaginal swab for HR-HPV, and results were provided by phone after laboratory testing. Women who tested HPV positive were referred for VIA at the local health unit. Women randomised to VIA underwent screening at the local health unit, where women who tested positive with VIA were provided cryotherapy at time of screening, as per local standard of care. Women were referred for colposcopy when indicated. Outcome measures were uptake of screening, HR-HPV prevalence, VIA result and treatment rates. In the HR-HPV arm, 248 of 250 (p < 0.01) women provided samples, while in the VIA arm, 121 of 250 (48.4%) women attended screening. Among the 73 of 248 HR-HPV-positive women, 45.2% (N = 33) attended VIA screening for follow-up, 21.2% (N = 7) of whom screened positive; five received treatment and two were missing clinical follow-up records. Of the 121 women in the VIA arm who attended screening, 13.2% (N = 16) screened positive; seven received cryotherapy, three refused treatment, five were referred to colposcopy; and one woman had suspected cervical cancer and received treatment after confirmatory testing. This pilot study demonstrated trial feasibility and willingness of the women to participate and be randomised successfully into the two arms. Self-collection-based cervical cancer screening had a higher uptake than VIA. © 2015 John Wiley & Sons Ltd.

  11. A Mixed Methods Review of Education and Patient Navigation Interventions to Increase Breast and Cervical Cancer Screening for Rural Women.

    Science.gov (United States)

    Falk, Derek

    2018-02-07

    Reviews have assessed studies of breast and cervical cancer screening access and utilization for rural women, but none analyze interventions to increase screening rates. A mixed methods literature search identified studies of breast and/or cervical cancer prevention education and patient navigation interventions for rural women. Rural areas need greater implementation and evaluation of screening interventions as these services address the challenges of delivering patient-centered cancer care to un-/underserved communities. The lack of intervention studies on breast and cervical cancer education and patient navigation programs compared to urban studies highlights the need for validation of these programs among diverse, rural populations.

  12. CLASSIFICATION OF CERVICAL CANCER CELLS IN PAP SMEAR SCREENING TEST

    Directory of Open Access Journals (Sweden)

    S. Athinarayanan

    2016-05-01

    Full Text Available Cervical cancer is second topmost cancers among women but also, it was a curable one. Regular smear test can discover the sign of precancerous cell and treated the patient according to the result. However sometimes the detection errors can be occurred by smear thickness, cell overlapping or by un-wanted particles in the smear and cytotechnologists faulty diagnosis. Therefore the reason automatic cancer detection was developed. This was help to increase cancer cell mindfulness, diagnosis accuracy with low cost. This detection process consists of some techniques of the image preprocessing that is segmentation and effective texture feature extraction with SVM classification. Then the Final Classification Results of this proposed technique was compared to the previous classification techniques of KNN and ANN and the result would be very useful to cytotechnologists for their further analysis

  13. Automated cervical precancerous cells screening system based on Fourier transform infrared spectroscopy features.

    Science.gov (United States)

    Jusman, Yessi; Mat Isa, Nor Ashidi; Ng, Siew-Cheok; Hasikin, Khairunnisa; Abu Osman, Noor Azuan

    2016-07-01

    Fourier transform infrared (FTIR) spectroscopy technique can detect the abnormality of a cervical cell that occurs before the morphological change could be observed under the light microscope as employed in conventional techniques. This paper presents developed features extraction for an automated screening system for cervical precancerous cell based on the FTIR spectroscopy as a second opinion to pathologists. The automated system generally consists of the developed features extraction and classification stages. Signal processing techniques are used in the features extraction stage. Then, discriminant analysis and principal component analysis are employed to select dominant features for the classification process. The datasets of the cervical precancerous cells obtained from the feature selection process are classified using a hybrid multilayered perceptron network. The proposed system achieved 92% accuracy.

  14. Appalachian women’s perspectives on breast and cervical cancer screening

    Science.gov (United States)

    Schoenberg, NE; Kruger, TM; Bardach, S; Howell, BM

    2016-01-01

    Introduction Although breast and cervical cancer screening rates have been increasing over the three past decades, many Appalachian women in the USA do not receive screening, leading to disproportionate mortality rates. The aims of this study were to: (1) better understand barriers to and facilitators of breast and cervical cancer screening among Appalachian women; and (2) identify strategies to increase cancer screening. Methods Eight focus groups and 19 key informant interviews were conducted with 79 participants. Tape-recorded session were transcribed and content analyzed. Results Findings consistent with screening determinants research include: inadequate personal and community resources, attitudinal and knowledge barriers, and competing demands. Less commonly described factors include family cancer history, personal health habits, and the multiple influences of healthcare providers. Conclusions Interpreting findings in terms of consumer information processing theory, healthcare providers and supports play a key role in educating and influencing the screening uptake among Appalachian Kentucky women. These findings have the potential to inform innovative and culturally consonant intervention approaches capable of increasing screening and decreasing mortality rates. PMID:24016336

  15. High grade squamous intraepithelial lesion in inmates from Ohio: cervical screening and biopsy follow-up

    Directory of Open Access Journals (Sweden)

    Rofagha Soraya

    2006-01-01

    Full Text Available Abstract Background Cervical carcinoma remains the second leading cause of cancer death in women worldwide and sexual behavior is regarded as the main contributing factor. We studied cervical cytology screening with surgical biopsy follow-up in women prisoners and compared the findings to those in the general population. Methods We reviewed 1024 conventional cervical smears, 73 cervical biopsies and 2 loop electrosurgical excision procedure (LEEP specimens referred to us from the Correctional Center in Columbus, Ohio during a 12-month period. The results were compared to 40,993 Pap smears from the general population for the same 12-month period. Results High grade squamous intraepithelial lesion (HGSIL was diagnosed in 1.3% of the cervical smears from the inmate population versus 0.6% in the general population (p < 0.01. The unsatisfactory rate was 1.6% compared to 0.3% in the general population (p < 0.01. Among the study population, follow-up tissue diagnosis was obtained in 24.3% of the abnormal cytology results (ASCUS, LGSIL, and HGSIL. Of the HGSIL Pap smears, 61.5% had a subsequent tissue diagnosis. Thirty-nine biopsies (52% of the all inmate biopsies and LEEP showed CIN II/III (cervical intraepithelial neoplasia II/III. Eight of these thirty-nine follow-up biopsies diagnosed as CIN II/III had a previous cervical cytology diagnosis of ASCUS. The average age for HGSIL was 30.5 years (S.D. = 5.7 and for low grade squamous intraepithelial lesion (LGSIL was 27.2 years (S.D. = 6.1. Conclusion A significantly higher prevalence of HGSIL cervical cytology and unsatisfactory smears was encountered in female inmates, with tissue follow-up performed in less than two thirds of the patients with HGSIL. These results are in keeping with data available in the literature suggesting that the inmate population is high-risk and may be subject to less screening and tissue follow-up than the general population. Clinicians should proceed with urgency to improve

  16. Cervical smear cytology on routine screening in a semi urban population in New Delhi: A review of 610 cases

    Directory of Open Access Journals (Sweden)

    Safia Rana

    2013-01-01

    Full Text Available Background: Cervical cancer is an important public health problem among adult women in many developing countries. Cervical cytology became the standard screening test for cervical cancer and premalignant cervical lesions with the introduction of the Papanicolau (Pap smear. The most widely used system for describing PAP smear result is the Bethesda System 2001. Material and Methods: This study was aimed at evaluating the entire spectrum of types and frequencies of cervical cytological abnormalities i.e. infective, pre-cancerous and cancerous, in women who underwent routine cytological cervical screening at our hospital which caters largely to women of low socio-economic status. Results: A total of 610 cases of cervical pap smears were received in our cytology laboratory during this two year period, 348(57% abnormal Pap smears, and 238(39% cases which were normal. Out of the 348 cases, 306(50.2% cases were reported to have inflammatory/reactive/reparative changes whereas epithelial cell abnormality was reported in 42 cases. Discussion: Cervical smear cytology also plays an important role in the diagnosis of cervical infections which are common in women of the reproductive age group. Conclusion: Hence, the need of the hour is an effective screening programme that is based on available resources and is readily available to the low socio-economic and disadvantaged sections of our society.

  17. Age-Related Differences in Health Beliefs Regarding Cervical Cancer Screening Among Korean American Women

    Science.gov (United States)

    Lee, Eunice E.; Eun, Young; Lee, Shin-Young; Nandy, Karabi

    2012-01-01

    Cervical cancer screening rates among older Korean American (KA) women are much lower than the rates for younger KA women, even though the overall cancer screening rates in the population continue to have one of the lowest Papanicolaou (Pap) test adherence rates compared with non-Hispanic White women. Variables based on the Health Belief Model related to cervical cancer screening were compared by age group among KA women. A telephone survey was conducted with 189 KA women living in the midwestern United States. Perceived barriers to having a Pap test predicted the outcome variable of having had Pap tests in the preceding 3 years in older KA women who were 65 or older, but not in younger women who were between 40 and 64 years old. Having physical examinations without symptoms in the preceding 2 years predicted the outcome variable in both age groups. Intervention strategies for all KA women should focus on encouraging them to receive routine physical examinations. In addition, attempts should be made to reduce perception of barriers in older KA women to improve their cervical cancer screening behaviors. PMID:22477716

  18. HPV for cervical cancer screening (HPV FOCAL): Complete Round 1 results of a randomized trial comparing HPV‐based primary screening to liquid‐based cytology for cervical cancer

    National Research Council Canada - National Science Library

    Ogilvie, Gina S; Krajden, Mel; van Niekerk, Dirk; Smith, Laurie W; Cook, Darrel; Ceballos, Kathy; Lee, Marette; Gentile, Laura; Gondara, Lovedeep; Elwood‐Martin, Ruth; Peacock, Stuart; Stuart, Gavin; Franco, Eduardo L; Coldman, Andrew J

    2017-01-01

    Complete Round 1 data (baseline and 12‐month follow‐up) for HPV FOCAL, a randomized trial establishing the efficacy of HPV DNA testing with cytology triage as a primary screen for cervical cancer are presented...

  19. Modeling human papillomavirus and cervical cancer in the United States for analyses of screening and vaccination

    Directory of Open Access Journals (Sweden)

    Ortendahl Jesse

    2007-10-01

    Full Text Available Abstract Background To provide quantitative insight into current U.S. policy choices for cervical cancer prevention, we developed a model of human papillomavirus (HPV and cervical cancer, explicitly incorporating uncertainty about the natural history of disease. Methods We developed a stochastic microsimulation of cervical cancer that distinguishes different HPV types by their incidence, clearance, persistence, and progression. Input parameter sets were sampled randomly from uniform distributions, and simulations undertaken with each set. Through systematic reviews and formal data synthesis, we established multiple epidemiologic targets for model calibration, including age-specific prevalence of HPV by type, age-specific prevalence of cervical intraepithelial neoplasia (CIN, HPV type distribution within CIN and cancer, and age-specific cancer incidence. For each set of sampled input parameters, likelihood-based goodness-of-fit (GOF scores were computed based on comparisons between model-predicted outcomes and calibration targets. Using 50 randomly resampled, good-fitting parameter sets, we assessed the external consistency and face validity of the model, comparing predicted screening outcomes to independent data. To illustrate the advantage of this approach in reflecting parameter uncertainty, we used the 50 sets to project the distribution of health outcomes in U.S. women under different cervical cancer prevention strategies. Results Approximately 200 good-fitting parameter sets were identified from 1,000,000 simulated sets. Modeled screening outcomes were externally consistent with results from multiple independent data sources. Based on 50 good-fitting parameter sets, the expected reductions in lifetime risk of cancer with annual or biennial screening were 76% (range across 50 sets: 69–82% and 69% (60–77%, respectively. The reduction from vaccination alone was 75%, although it ranged from 60% to 88%, reflecting considerable parameter

  20. Modeling human papillomavirus and cervical cancer in the United States for analyses of screening and vaccination.

    Science.gov (United States)

    Goldhaber-Fiebert, Jeremy D; Stout, Natasha K; Ortendahl, Jesse; Kuntz, Karen M; Goldie, Sue J; Salomon, Joshua A

    2007-10-29

    To provide quantitative insight into current U.S. policy choices for cervical cancer prevention, we developed a model of human papillomavirus (HPV) and cervical cancer, explicitly incorporating uncertainty about the natural history of disease. We developed a stochastic microsimulation of cervical cancer that distinguishes different HPV types by their incidence, clearance, persistence, and progression. Input parameter sets were sampled randomly from uniform distributions, and simulations undertaken with each set. Through systematic reviews and formal data synthesis, we established multiple epidemiologic targets for model calibration, including age-specific prevalence of HPV by type, age-specific prevalence of cervical intraepithelial neoplasia (CIN), HPV type distribution within CIN and cancer, and age-specific cancer incidence. For each set of sampled input parameters, likelihood-based goodness-of-fit (GOF) scores were computed based on comparisons between model-predicted outcomes and calibration targets. Using 50 randomly resampled, good-fitting parameter sets, we assessed the external consistency and face validity of the model, comparing predicted screening outcomes to independent data. To illustrate the advantage of this approach in reflecting parameter uncertainty, we used the 50 sets to project the distribution of health outcomes in U.S. women under different cervical cancer prevention strategies. Approximately 200 good-fitting parameter sets were identified from 1,000,000 simulated sets. Modeled screening outcomes were externally consistent with results from multiple independent data sources. Based on 50 good-fitting parameter sets, the expected reductions in lifetime risk of cancer with annual or biennial screening were 76% (range across 50 sets: 69-82%) and 69% (60-77%), respectively. The reduction from vaccination alone was 75%, although it ranged from 60% to 88%, reflecting considerable parameter uncertainty about the natural history of type-specific HPV

  1. Utilization of cervical cancer screening services and trends in screening positivity rates in a 'screen-and-treat' program integrated with HIV/AIDS care in Zambia.

    Directory of Open Access Journals (Sweden)

    Mulindi H Mwanahamuntu

    Full Text Available In the absence of stand-alone infrastructures for delivering cervical cancer screening services, efforts are underway in sub-Saharan Africa to dovetail screening with ongoing vertical health initiatives like HIV/AIDS care programs. Yet, evidence demonstrating the utilization of cervical cancer prevention services in such integrated programs by women of the general population is lacking.We analyzed program operations data from the Cervical Cancer Prevention Program in Zambia (CCPPZ, the largest public sector programs of its kind in sub-Saharan Africa. We evaluated patterns of utilization of screening services by HIV serostatus, examined contemporaneous trends in screening outcomes, and used multivariable modeling to identify factors associated with screening test positivity.Between January 2006 and April 2011, CCPPZ services were utilized by 56,247 women who underwent cervical cancer screening with visual inspection with acetic acid (VIA, aided by digital cervicography. The proportion of women accessing these services who were HIV-seropositive declined from 54% to 23% between 2006-2010, which coincided with increasing proportions of HIV-seronegative women (from 22% to 38% and women whose HIV serostatus was unknown (from 24% to 39% (all p-for trend<0.001. The rates of VIA screening positivity declined from 47% to 17% during the same period (p-for trend <0.001, and this decline was consistent across all HIV serostatus categories. After adjusting for demographic and sexual/reproductive factors, HIV-seropositive women were more than twice as likely (Odds ratio 2.62, 95% CI 2.49, 2.76 to screen VIA-positive than HIV-seronegative women.This is the first 'real world' demonstration in a public sector implementation program in a sub-Saharan African setting that with successful program scale-up efforts, nurse-led cervical cancer screening programs targeting women with HIV can expand and serve all women, regardless of HIV serostatus. Screening program

  2. Utilization of cervical cancer screening services and trends in screening positivity rates in a 'screen-and-treat' program integrated with HIV/AIDS care in Zambia.

    Science.gov (United States)

    Mwanahamuntu, Mulindi H; Sahasrabuddhe, Vikrant V; Blevins, Meridith; Kapambwe, Sharon; Shepherd, Bryan E; Chibwesha, Carla; Pfaendler, Krista S; Mkumba, Gracilia; Vwalika, Belington; Hicks, Michael L; Vermund, Sten H; Stringer, Jeffrey Sa; Parham, Groesbeck P

    2013-01-01

    In the absence of stand-alone infrastructures for delivering cervical cancer screening services, efforts are underway in sub-Saharan Africa to dovetail screening with ongoing vertical health initiatives like HIV/AIDS care programs. Yet, evidence demonstrating the utilization of cervical cancer prevention services in such integrated programs by women of the general population is lacking. We analyzed program operations data from the Cervical Cancer Prevention Program in Zambia (CCPPZ), the largest public sector programs of its kind in sub-Saharan Africa. We evaluated patterns of utilization of screening services by HIV serostatus, examined contemporaneous trends in screening outcomes, and used multivariable modeling to identify factors associated with screening test positivity. Between January 2006 and April 2011, CCPPZ services were utilized by 56,247 women who underwent cervical cancer screening with visual inspection with acetic acid (VIA), aided by digital cervicography. The proportion of women accessing these services who were HIV-seropositive declined from 54% to 23% between 2006-2010, which coincided with increasing proportions of HIV-seronegative women (from 22% to 38%) and women whose HIV serostatus was unknown (from 24% to 39%) (all p-for trend<0.001). The rates of VIA screening positivity declined from 47% to 17% during the same period (p-for trend <0.001), and this decline was consistent across all HIV serostatus categories. After adjusting for demographic and sexual/reproductive factors, HIV-seropositive women were more than twice as likely (Odds ratio 2.62, 95% CI 2.49, 2.76) to screen VIA-positive than HIV-seronegative women. This is the first 'real world' demonstration in a public sector implementation program in a sub-Saharan African setting that with successful program scale-up efforts, nurse-led cervical cancer screening programs targeting women with HIV can expand and serve all women, regardless of HIV serostatus. Screening program performance can

  3. Less medical intervention after sharp demarcation of grade 1-2 cervical intraepithelial neoplasia smears by neural network screening

    NARCIS (Netherlands)

    Kok, MR; Boon, ME; Schreiner-Kok, PG; Hermans, J; Grobbee, DE; Kok, LP

    2001-01-01

    BACKGROUND. Neural network technology has been used for the daily screening of cervical smears in The Netherlands since 1992. The authors believe this method might have the potential to demarcate diagnoses of Grade 1-2 cervical intraepithelial neoplasia (CIN 1-2). METHODS. Of 133,196 women who were

  4. Clinical validation of high risk HPV DNA testing versus ThinPrep cytology for primary cervical cancer screening

    Directory of Open Access Journals (Sweden)

    Mahmoud El-Morsi Aboul-Fotouh

    2013-06-01

    Conclusions: ThinPrep smears and hr-HPV DNA detection by HC-II performed very well with regard to identifying high grade lesions. HPV DNA testing is a promising new technology for cervical cancer prevention and can be used for primary screening in conjunction with cervical cytology for women aged 30 years and older.

  5. Comparison of Pap Smear and Colposcopy in Screening for Cervical Cancer in Patients with Secondary Immunodeficiency.

    Science.gov (United States)

    Karimi-Zarchi, Mojgan; Zanbagh, Leila; Shafii, Alireza; Taghipour-Zahir, Shokouh; Teimoori, Soraya; Yazdian-Anari, Pouria

    2015-11-01

    Cervical cancer is the second most common cancer among women worldwide. The sensitivity of conventional Pap smear in detecting cervical lesions before cervical cancer is 51%, which means the false negative value is 49%. The aim of this study was to compare two methods for screening for cervical cancer in patients with secondary immunodeficiency, i.e., the conventional Pap smear and colposcopy. This cross-sectional study was conducted on 101 immunodeficient patients who were referred to the Gynecologic Clinic at Shahid Sadughi Hospital in Yazd from March 2011 to August 2012. All patients underwent the Pap test, a colposcopy, and a cervical biopsy, with the latter being considered as the gold-standard test. The most frequency of immunodeficiency was noted among patients with rheumatoid arthritis (53.3%), and this was followed by patients who were undergoing chemotherapy (30.7%), patients with lupus erythematosus (12.9%), and patients with AIDS (3%). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the Pap smear were 18.2, 98.5, 85.5, 71.3, and 72.2%, respectively. The respective values for colposcopy were 66.7, 98.94, 80, 97.9, and 97%, respectively. In this study the accuracy, sensitivity, specificity, and negative predictive values of colposcopy were higher than those for the Pap smear in detecting high-grade, cervical, pre-malignant lesions (cervical intraepithelial neoplasia: CIN ≥ 2). Therefore, an annual colposcopy is advised for secondary immunodeficient patients instead of a Pap smear.

  6. Salud es Vida: a Cervical Cancer Screening Intervention for Rural Latina Immigrant Women.

    Science.gov (United States)

    Luque, John S; Tarasenko, Yelena N; Reyes-Garcia, Claudia; Alfonso, Moya L; Suazo, Norma; Rebing, Laura; Ferris, Daron G

    2017-12-01

    This study examined the feasibility and efficacy of Salud es Vida-a promotora-led, Spanish language educational group session on cervical cancer screening (Pap tests)-self-efficacy (belief in ability to schedule and complete a Pap test), and knowledge among immigrant Hispanic/Latina women from farmworker backgrounds. These women are disproportionately burdened with cervical cancer, with mortality rates significantly higher than non-Hispanic whites. The two-arm, quasi-experimental study was conducted in four rural counties of Southeast Georgia in 2014-2015. Hispanic/Latina immigrant women aged 21-65 years and overdue for a Pap test were included as intervention (N = 38) and control (N = 52) group participants. The intervention was developed in partnership with a group of promotoras to create the toolkit of materials which includes a curriculum guide, a brochure, a flipchart, a short animated video, and in-class activities. Twelve (32 %) intervention group participants received the Pap test compared to 10 (19 %) control group participants (p = 0.178). The intervention group scored significantly higher on both cervical cancer knowledge recall and retention than the control group (p < 0.001). While there was no statistically significant difference in cervical cancer screening self-efficacy scores between the group participants, both groups scored higher at follow-up, adjusting for the baseline scores. The group intervention approach was associated with increased cervical cancer knowledge but not uptake of Pap test. More intensive interventions using patient navigation approaches or promotoras who actively follow participants or conducting one-on-one rather than group sessions may be needed to achieve improved screening outcomes with this population.

  7. CLINIC VISITS AND CERVICAL CANCER SCREENING IN ACCRA

    African Journals Online (AJOL)

    2010-06-01

    Jun 1, 2010 ... regular medical check-ups5 and so one area in which opportunistic screening could be maximized is when women visit general and gynaecology clinics for cura- tive services since Pap smears could be performed easi- ly by general duty medical officers who have been trained to carry out the procedure.

  8. Cervical Cancer Awareness and Screening Uptake among Rural ...

    African Journals Online (AJOL)

    femi oloka

    cancer by the respondents 50 (83.3%). (Table III). More than half 37(61.7%)} knew that all women are at risk of cancer of the cervix. Majority (81.7%) knew that regular screening and not having multiple sexual partners were among methods of prevention of. Table I: Socio-demographic characteristics of Respondents.

  9. Cervical cancer screening among certified nurses in Enugu ...

    African Journals Online (AJOL)

    Fifty three percent of the respondents attributed the cause of cancer of the cervix to sexually transmitted infection and 2.2% of them identified human papilloma virus as a factor. Only 28 (12.2%) of the respondents have ever done pap smear test. The commonest reason given by the nurses who had never been screened was ...

  10. Awareness and Practice of Cervical Smear as A Screening Procedure for Cervical Cancer among Female Nurses in A Tertiary Hospital in South-South Nigeria

    Directory of Open Access Journals (Sweden)

    Imoh Unang

    2011-12-01

    Full Text Available AIM: Carcinoma of the cervix, the second most common cancer among women remains a public health problem. Though this preventable cancer occurs more commonly in the developing world, it is almost non-existent in developed countries where there are well established screening programs. The aim of this study is to determine the degree of awareness and practice of cervical smear as a screening procedure for cervical cancer among female nurses in a tertiary health facility in south-south Nigeria. METHOD: Semi-structured questionnaires were distributed to all the female nurses at the University of Uyo Teaching Hospital. RESULTS: The ages of the respondents were between 21 - 60 years with the modal age group being 31- 40 years (48.9%. Majority of the respondents were married (59.7% and 36.4% of them had practiced nursing for over 10 years. Majority of the respondents (94.3% had heard of the cervical smear and 79.5% of the nurses knew that cervical smears were used to detect premalignant diseases of the cervix. Only 7.4% of the nurses had undergone screening for cervical cancer. Common reasons given by the respondents who had not screened were not being a candidate for cervical cancer (31.9% and ignorance as to where screening is done (28.8%. The most common sources of information about cervical smear were the hospital (87.5% and textbooks (13.6%. CONCLUSION: The level of awareness of the cervical smear as a preventive tool for cervical cancer was high but utilization of the test was disappointingly low. Modern concepts of cancer prevention and control should be included in the curriculum of the school of nursing and nurses should be involved in the organisation of health talks to members of the community on cervical cancer and its prevention. The print and electronic media should be made to participate in the dissemination of information on the prevention of cervical cancer in our environment. [TAF Prev Med Bull 2011; 10(6.000: 675-680

  11. Cervical and breast cancer screening participation for women with chronic conditions in France: results from a national health survey.

    Science.gov (United States)

    Constantinou, Panayotis; Dray-Spira, Rosemary; Menvielle, Gwenn

    2016-03-31

    Comorbidity at the time of diagnosis is an independent prognostic factor for survival among women suffering from cervical or breast cancer. Although cancer screening practices have proven their efficacy for mortality reduction, little is known about adherence to screening recommendations for women suffering from chronic conditions. We investigated the association between eleven chronic conditions and adherence to cervical and breast cancer screening recommendations in France. Using data from a cross-sectional national health survey conducted in 2008, we analyzed screening participation taking into account self-reported: inflammatory systemic disease, cancer, cardiovascular disease, chronic respiratory disease, depression, diabetes, dyslipidemia, hypertension, obesity, osteoarthritis and thyroid disorders. We first computed age-standardized screening rates among women who reported each condition. We then estimated the effect of having reported each condition on adherence to screening recommendations in logistic regression models, with adjustment for sociodemographic characteristics, socioeconomic position, health behaviours, healthcare access and healthcare use. Finally, we investigated the association between chronic conditions and opportunistic versus organized breast cancer screening using multinomial logistic regression. The analyses were conducted among 4226 women for cervical cancer screening and 2056 women for breast cancer screening. Most conditions studied were not associated with screening participation. Adherence to cervical cancer screening recommendations was higher for cancer survivors (OR = 1.73 [0.98-3.05]) and lower for obese women (OR = 0.73 [0.57-0.93]), when accounting for our complete range of screening determinants. Women reporting chronic respiratory disease or diabetes participated less in cervical cancer screening, except when adjusting for socioeconomic characteristics. Adherence to breast cancer screening recommendations was lower for

  12. Cervical cancer risk factors and feasibility of visual inspection with acetic acid screening in Sudan

    Directory of Open Access Journals (Sweden)

    Ibrahim A

    2011-04-01

    Full Text Available Ahmed Ibrahim1, Vibeke Rasch2, Eero Pukkala3, Arja R Aro11Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark; 2Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark; 3Institute for Statistical and Epidemiological Cancer Research, Finnish Cancer Registry, Helsinki, FinlandObjectives: To assess the risk factors of cervical cancer and the feasibility and acceptability of a visual inspection with acetic acid (VIA screening method in a primary health center in Khartoum, Sudan.Methods: A cross-sectional prospective pilot study of 100 asymptomatic women living in Khartoum State in Sudan was carried out from December 2008 to January 2009. The study was performed at the screening center in Khartoum. Six nurses and two physicians were trained by a gynecologic oncologist. The patients underwent a complete gynecological examination and filled in a questionnaire on risk factors and feasibility and acceptability. They were screened for cervical cancer by application of 3%–5% VIA. Women with a positive test were referred for colposcopy and treatment.Results: Sixteen percent of screened women were tested positive. Statistically significant associations were observed between being positive with VIA test and the following variables: uterine cervix laceration (odds ratio [OR] 18.6; 95% confidence interval [CI]: 4.64–74.8, assisted vaginal delivery (OR 13.2; 95% CI: 2.95–54.9, parity (OR 5.78; 95% CI: 1.41–23.7, female genital mutilation (OR 4.78; 95% CI: 1.13–20.1, and episiotomy (OR 5.25; 95% CI: 1.15–23.8. All these associations remained statistically significant after adjusting for age, educational level, employment, and potential confounding factors such as smoking, number of sexual partners, and use of contraceptive method. Furthermore, the VIA screening method was found to be feasible and acceptable to participants.Conclusion: This pilot study showed that women who have uterine

  13. [History of the development of screening tests for cervical cancer].

    Science.gov (United States)

    Herrera, Yelda A; Piña-Sánchez, Patricia

    2015-01-01

    Cervical cancer (CC) is one of the best known malignancies. Currently, it is accepted that the etiological factor is persistent infection with high-risk human papillomavirus (HPV). Even before the identification of its etiological factors, methods such as Pap cytology and colposcopy were developed as tools for early diagnosis on CC and its precursor lesions. At the time when such tests were being developed, they were not fully accepted by the scientific community of the time; however, as time went by, the dissemination of knowledge, and more extensive application, these tests were finally included within the international guidelines. The implementation of programs with adequate coverage and quality allowed a significant reduction in the incidence and mortality of CC. However this did not occur widely, and CC is still a public health problem in developing countries. From the epidemiological and molecular viewpoint, knowledge on HPVs laid the foundations for the development of new prevention strategies based on vaccination and molecular detection of the causal agent, currently accepted as strategies for primary and secondary prevention. It is expected that the implementation of these strategies will have a greater impact on the control on CC and other malignancies associated with HPV infection.

  14. Breast and cervical cancer screening among South Asian immigrants in the United States.

    Science.gov (United States)

    Menon, Usha; Szalacha, Laura A; Prabhughate, Abhijit

    2012-01-01

    South Asian (SA) immigrants (from Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka) constitute the fastest growing of all Asian American immigrants to the United States, with a growth rate of 106% from 1990 to 2001. Data are lacking on health behaviors of this population subgroup, including cancer-related information. : The purpose of this study was to assess rates and correlates of breast and cervical cancer screening in a community sample of SAs. Participants were recruited from among attendees of 3 community-based agency programs. Data were collected in English, Hindi, and Gujarati from a convenience sample of 198 participants. Two-thirds of the sample (n = 127, 65.5%) had ever had a mammogram, whereas only a third (n = 65, 32.8%) had ever had a Papanicolaou smear or vaginal examination. Several predisposing factors (eg, country of birth, years in the United States, acculturation, age, and acknowledged barriers to screening) were significant predictors of breast and cervical screening, whereas the only enabling factor was past screening behavior. Additional study is warranted on cultural aspects of cancer screening behaviors. These data are formative on facilitators and barriers to mammogram and Papanicolaou test completion among these understudied minority women. Nurses who practice in primary care may begin to target health education based on sociodemographics of SA women and emphasize discussion of barriers to screening.

  15. Smartphone Use for Cervical Cancer Screening in Low-Resource Countries: A Pilot Study Conducted in Madagascar: e0134309

    National Research Council Canada - National Science Library

    Rosa Catarino; Pierre Vassilakos; Stefano Scaringella; Manuela Undurraga-Malinverno; Ulrike Meyer-Hamme; Dominique Ricard-Gauthier; Juan Carlos Matute; Patrick Petignat

    2015-01-01

    .... Each performed a human papillomavirus (HPV) self-sample as a primary screen. Women testing positive for HPV were referred for VIA followed by D-VIA, cervical biopsy and endocervical curettage according to routine protocol...

  16. A fall-off in cervical screening coverage of younger women in developed countries

    DEFF Research Database (Denmark)

    Lancucki, L; Fender, M; Koukari, A

    2010-01-01

    overall coverage rose in the period, the rise was not as steep in the youngest group of women. Data for each available 5-year age group for the different countries shows a similar gradient in most, regardless of the absolute level of coverage. Although the trend is not uniform in every country, it appears......OBJECTIVES: To analyse cervical screening coverage data by age over time in a number of developed countries throughout the world, with specific emphasis on trends for younger women and on age differentials between younger and older women. METHODS: Routinely collected cervical screening statistics...... that generally the gap between coverage of younger women and coverage of older women increased, sometimes dramatically, between the mid-1990s and the mid-2000s. CONCLUSIONS: There is a general trend in developed countries towards lower coverage in young women (25-29 years old). No common underlying cause has...

  17. Cervical cancer screening of underserved women in the United States: results from the National Breast and Cervical Cancer Early Detection Program, 1997-2012.

    Science.gov (United States)

    Tangka, Florence K L; Howard, David H; Royalty, Janet; Dalzell, Lucinda P; Miller, Jacqueline; O'Hara, Brett J; Sabatino, Susan A; Joseph, Kristy; Kenney, Kristy; Guy, Gery P; Hall, Ingrid J

    2015-05-01

    The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides breast and cervical cancer screens to low-income, uninsured, and underinsured women. We describe the number and proportion of women eligible for cervical cancer screening services and the proportion of eligible women screened over the period 1997-2012. Low-income, uninsured, and underinsured women aged 18-64 years who have not had a hysterectomy are eligible for cervical cancer screening through the NBCCEDP. We estimated the number of low-income, uninsured women using data from the US Census Bureau. We adjusted our estimates for hysterectomy status using the National Health Interview Survey and the Behavioral Risk Factor Surveillance System. We used data from the NBCCEDP to describe the number of women receiving NBCCEDP-funded screening and calculated the proportion of eligible women who received screening through the NBCCEDP at the national level (by age group, race/ethnicity) and at the state level by age group. We used the Medical Expenditure Panel Survey to estimate the proportion of NBCCEDP-eligible women who were screened outside the NBCCEDP and the proportion that are not screened. We estimate that in 2010-2012, 705,970 women aged 18-64 years, 6.5 % (705,970 of 9.8 million) of the eligible population, received NBCCEDP-funded Pap tests. We estimate that 60.2 % of eligible women aged 18-64 years were screened outside the NBCCEDP and 33.3 % were not screened. The NBCCEDP provided 623,603 screens to women aged 40-64 years, an estimated 16.5 % of the eligible population, and 83,660 screens to women aged 18-39 years, representing an estimated 1.2 % of the eligible population. The estimated proportions of eligible women screened in each state ranged from 1.5 to 32.7 % and 5 % to 73.2 % among the 18-64 and 40-64 years age groups, respectively. Changes in the proportion of eligible women screened over the study period were nonsignificant. Although the program provided cervical

  18. Perception and utilization of cervical cancer screening services ...

    African Journals Online (AJOL)

    Eighty-eight percent correctly perceived CC to be preventable and 82.0% believed that screening should be carried out as soon as sexual intercourse starts irrespective of age. Only 32.6% had ever used CCSS facility and main reasons for non-use included lack of time (50.8%), fear of result (13.9%) and not being sexually ...

  19. Trends in Cervical Cancer Screening in Title X-Funded Health Centers - United States, 2005-2015.

    Science.gov (United States)

    Fowler, Christina I; Saraiya, Mona; Moskosky, Susan B; Miller, Jacqueline W; Gable, Julia; Mautone-Smith, Nancy

    2017-09-22

    Cervical cancer screening is critical to early detection and treatment of precancerous cells and cervical cancer. In 2015, 83% of U.S. women reported being screened per current recommendations, which is below the Healthy People 2020 target of 93% (1,2). Disparities in screening persist for women who are younger (aged 21-30 years), have lower income, are less educated, are uninsured, lack a source of health care, or who self-identify as Asian or American Indian/Alaska Native (2). Women who are never screened or rarely screened are more likely to develop cancer and receive a cancer diagnosis at later stages than women who are screened regularly (3). In 2013, cervical cancer was diagnosed in 11,955 women in the United States, and 4,217 died from the disease (4). Aggregated administrative data from the Title X Family Planning Program were used to calculate the percentage of female clients served in Title X-funded health centers who received a Papanicolaou (Pap) test during 2005-2015. Trends in the percentage of Title X clients screened for cervical cancer were examined in relation to changes in cervical cancer screening guidelines, particularly the 2009 American College of Obstetricians and Gynecologists (ACOG) update that raised the age for starting cervical cancer screening to 21 years (5) and the 2012 alignment of screening guidelines from ACOG, the U.S. Preventive Services Task Force (USPSTF) and the American Cancer Society (ACS) on the starting age (21 years), screening interval (3 or 5 years), and type of screening test (6-8). During 2005-2015, the percentage of female clients screened for cervical cancer dropped continually, with the largest declines occurring in 2010 and 2013, notably a year after major updates to the recommendations. Although aggregated data contribute to understanding of cervical cancer screening trends in Title X centers, studies using client-level and encounter-level data are needed to assess the appropriateness of cervical cancer screening

  20. Influence of Spirituality and Modesty on Acceptance of Self-Sampling for Cervical Cancer Screening.

    Science.gov (United States)

    Dareng, Eileen O; Jedy-Agba, Elima; Bamisaye, Patience; Isa Modibbo, Fatima; Oyeneyin, Lawal O; Adewole, Ayodele S; Olaniyan, Olayinka B; Dakum, Patrick S; Pharoah, Paul D; Adebamowo, Clement A

    2015-01-01

    Whereas systematic screening programs have reduced the incidence of cervical cancer in developed countries, the incidence remains high in developing countries. Among several barriers to uptake of cervical cancer screening, the roles of religious and cultural factors such as modesty have been poorly studied. Knowledge about these factors is important because of the potential to overcome them using strategies such as self-collection of cervico-vaginal samples. In this study we evaluate the influence of spirituality and modesty on the acceptance of self-sampling for cervical cancer screening. We enrolled 600 participants in Nigeria between August and October 2014 and collected information on spirituality and modesty using two scales. We used principal component analysis to extract scores for spirituality and modesty and logistic regression models to evaluate the association between spirituality, modesty and preference for self-sampling. All analyses were performed using STATA 12 (Stata Corporation, College Station, Texas, USA). Some 581 (97%) women had complete data for analysis. Most (69%) were married, 50% were Christian and 44% were from the south western part of Nigeria. Overall, 19% (110/581) of the women preferred self-sampling to being sampled by a health care provider. Adjusting for age and socioeconomic status, spirituality, religious affiliation and geographic location were significantly associated with preference for self-sampling, while modesty was not significantly associated. The multivariable OR (95% CI, p-value) for association with self-sampling were 0.88 (0.78-0.99, 0.03) for spirituality, 1.69 (1.09-2.64, 0.02) for religious affiliation and 0.96 (0.86-1.08, 0.51) for modesty. Our results show the importance of taking cultural and religious beliefs and practices into consideration in planning health interventions like cervical cancer screening. To succeed, public health interventions and the education to promote it must be related to the target

  1. Screening for cervical cancer precursors with p16/Ki-67 dual-stained cytology

    DEFF Research Database (Denmark)

    Ikenberg, Hans; Bergeron, Christine; Schmidt, Dietmar

    2013-01-01

    Pap cytology is known to be more specific but less sensitive than testing for human papillomavirus (HPV) for the detection of high-grade cervical intraepithelial neoplasia (CIN2+). We assessed whether p16/Ki-67 dual-stained cytology, a biomarker combination indicative of transforming HPV infections......, can provide high sensitivity for CIN2+ in screening while maintaining high specificity. Results were compared with Pap cytology and HPV testing....

  2. Cervical cancer screening in adolescents: an evidence-based internet education program for practice improvement among advanced practice nurses.

    Science.gov (United States)

    Choma, Kim; McKeever, Amy E

    2015-02-01

    The literature reports great variation in the knowledge levels and application of the recent changes of cervical cancer screening guidelines into clinical practice. Evidence-based screening guidelines for the prevention and early detection of cervical cancer offers healthcare providers the opportunity to improve practice patterns among female adolescents by decreasing psychological distress as well as reducing healthcare costs and morbidities associated with over-screening. The purpose of this pilot intervention study was to determine the effects of a Web-based continuing education unit (CEU) program on advanced practice nurses' (APNs) knowledge of current cervical cancer screening evidence-based recommendations and their application in practice. This paper presents a process improvement project as an example of a way to disseminate updated evidence-based practice guidelines among busy healthcare providers. This Web-based CEU program was developed, piloted, and evaluated specifically for APNs. The program addressed their knowledge level of cervical cancer and its relationship with high-risk human papillomavirus. It also addressed the new cervical cancer screening guidelines and the application of those guidelines into clinical practice. Results of the study indicated that knowledge gaps exist among APNs about cervical cancer screening in adolescents. However, when provided with a CEU educational intervention, APNs' knowledge levels increased and their self-reported clinical practice behaviors changed in accordance with the new cervical cancer screening guidelines. Providing convenient and readily accessible up-to-date electronic content that provides CEU enhances the adoption of clinical practice guidelines, thereby decreasing the potential of the morbidities associated with over-screening for cervical cancer in adolescents and young women. © 2014 Sigma Theta Tau International.

  3. HPV self-sampling or the Pap-smear: a randomized study among cervical screening nonattenders from lower socioeconomic groups in France.

    Science.gov (United States)

    Sancho-Garnier, H; Tamalet, C; Halfon, P; Leandri, F X; Le Retraite, L; Djoufelkit, K; Heid, P; Davies, P; Piana, L

    2013-12-01

    Today in France, low attendance to cervical screening by Papanicolaou cytology (Pap-smear) is a major contributor to the 3,000 new cervical cancer cases and 1,000 deaths that occur from this disease every year. Nonattenders are mostly from lower socioeconomic groups and testing of self-obtained samples for high-risk Human Papilloma virus (HPV) types has been proposed as a method to increase screening participation in these groups. In 2011, we conducted a randomized study of women aged 35-69 from very low-income populations around Marseille who had not responded to an initial invitation for a free Pap-smear. After randomization, one group received a second invitation for a free Pap-smear and the other group was offered a free self-sampling kit for HPV testing. Participation rates were significantly different between the two groups with only 2.0% of women attending for a Pap-smear while 18.3% of women returned a self-sample for HPV testing (p ≤ 0.001). The detection rate of high-grade lesions (≥CIN2) was 0.2‰ in the Pap-smear group and 1.25‰ in the self-sampling group (p = 0.01). Offering self-sampling increased participation rates while the use of HPV testing increased the detection of cervical lesions (≥CIN2) in comparison to the group of women receiving a second invitation for a Pap-smear. However, low compliance to follow-up in the self-sampling group reduces the effectiveness of this screening approach in nonattenders women and must be carefully managed. Copyright © 2013 UICC.

  4. Effective interventions to facilitate the uptake of breast, cervical and colorectal cancer screening: an implementation guideline

    Directory of Open Access Journals (Sweden)

    Brouwers Melissa C

    2011-09-01

    Full Text Available Abstract Background Appropriate screening may reduce the mortality and morbidity of colorectal, breast, and cervical cancers. Several high-quality systematic reviews and practice guidelines exist to inform the most effective screening options. However, effective implementation strategies are warranted if the full benefits of screening are to be realized. We developed an implementation guideline to answer the question: What interventions have been shown to increase the uptake of cancer screening by individuals, specifically for breast, cervical, and colorectal cancers? Methods A guideline panel was established as part of Cancer Care Ontario's Program in Evidence-based Care, and a systematic review of the published literature was conducted. It yielded three foundational systematic reviews and an existing guidance document. We conducted updates of these reviews and searched the literature published between 2004 and 2010. A draft guideline was written that went through two rounds of review. Revisions were made resulting in a final set of guideline recommendations. Results Sixty-six new studies reflecting 74 comparisons met eligibility criteria. They were generally of poor to moderate quality. Using these and the foundational documents, the panel developed a draft guideline. The draft report was well received in the two rounds of review with mean quality scores above four (on a five-point scale for each of the items. For most of the interventions considered, there was insufficient evidence to support or refute their effectiveness. However, client reminders, reduction of structural barriers, and provision of provider assessment and feedback were recommended interventions to increase screening for at least two of three cancer sites studied. The final guidelines also provide advice on how the recommendations can be used and future areas for research. Conclusion Using established guideline development methodologies and the AGREE II as our methodological

  5. Effective interventions to facilitate the uptake of breast, cervical and colorectal cancer screening: an implementation guideline.

    Science.gov (United States)

    Brouwers, Melissa C; De Vito, Carol; Bahirathan, Lavannya; Carol, Angela; Carroll, June C; Cotterchio, Michelle; Dobbins, Maureen; Lent, Barbara; Levitt, Cheryl; Lewis, Nancy; McGregor, S Elizabeth; Paszat, Lawrence; Rand, Carol; Wathen, Nadine

    2011-09-29

    Appropriate screening may reduce the mortality and morbidity of colorectal, breast, and cervical cancers. Several high-quality systematic reviews and practice guidelines exist to inform the most effective screening options. However, effective implementation strategies are warranted if the full benefits of screening are to be realized. We developed an implementation guideline to answer the question: What interventions have been shown to increase the uptake of cancer screening by individuals, specifically for breast, cervical, and colorectal cancers? A guideline panel was established as part of Cancer Care Ontario's Program in Evidence-based Care, and a systematic review of the published literature was conducted. It yielded three foundational systematic reviews and an existing guidance document. We conducted updates of these reviews and searched the literature published between 2004 and 2010. A draft guideline was written that went through two rounds of review. Revisions were made resulting in a final set of guideline recommendations. Sixty-six new studies reflecting 74 comparisons met eligibility criteria. They were generally of poor to moderate quality. Using these and the foundational documents, the panel developed a draft guideline. The draft report was well received in the two rounds of review with mean quality scores above four (on a five-point scale) for each of the items. For most of the interventions considered, there was insufficient evidence to support or refute their effectiveness. However, client reminders, reduction of structural barriers, and provision of provider assessment and feedback were recommended interventions to increase screening for at least two of three cancer sites studied. The final guidelines also provide advice on how the recommendations can be used and future areas for research. Using established guideline development methodologies and the AGREE II as our methodological frameworks, we developed an implementation guideline to advise on

  6. Comparison of Pap smear, visual inspection with acetic acid, and digital cervicography as cervical screening strategies.

    Science.gov (United States)

    Khodakarami, Nahid; Farzaneh, Farah; Aslani, Fatemeh; Alizadeh, Kamyab

    2011-11-01

    To compare the sensitivity, specificity, positive and negative predictive values (PPV and NPV), and accuracy of Pap smear, visual inspection with acetic acid (VIA) and digital cervicography (DC). This is a cross-sectional study on 100 women in the age group of 20-60 years, sequentially using the Pap test, the VIA, and the DC for screening. All women underwent colposcopic biopsy as the gold standard in comparing the methods. Of the total of 100 women with the mean age 36.0 years, 17 cases were recognized positive for abnormal cervical cell by gold standard. The sensitivity, specificity, PPV, NPV, and accuracy of the Pap test, the VIA, and the DC were 23.5, 100, 100, 86.5, and 87%; 62.5, 98.8, 90.9, 93.2, and 92.9%; and 46.7, 97.6, 77.8, 91, and 89.8%, respectively, for cervical neoplasia. The Pap test had low sensitivity but high specificity, whereas VIA had a high sensitivity in addition to being easy and low-cost. Adjuvant methods of screening such as VIA can be a valuable alternative to the Pap test for cervical cancer screening in low-resource settings.

  7. Facilitators and barriers to cervical cancer screening, diagnosis, and enrollment in Medicaid: experiences of Georgia's Women's Health Medicaid Program enrollees.

    Science.gov (United States)

    Blake, Sarah C; Andes, Karen; Hilb, Laura; Gaska, Karie; Chien, Linien; Flowers, Lisa; Adams, E Kathleen

    2015-03-01

    Although cervical cancer incidence and mortality rates have declined in the USA, African American women have a higher incidence rate of cervical cancer and a higher percentage of late-stage diagnosis than white women. Previous analyses by the authors showed that, even after adjusting for age, provider location, and availability, African American women were almost half as likely as white women to be diagnosed or enter Medicaid while at an early stage of their cervical cancer. To understand why these differences exist, we undertook a qualitative examination of the cervical cancer experiences of women enrolled in Georgia's Women's Health Medicaid Program (WHMP). Life history interviews were conducted with 24 WHMP enrollees to understand what factors shaped their cervical cancer experiences, from screening through enrollment in Medicaid. We also examined whether these factors differed by race in order to identify opportunities for increasing awareness of cervical cancer screening among underserved women. Results suggest that many women, especially African Americans, lacked understanding and recognition of early symptoms of cervical cancer, which prevented them from receiving a timely diagnosis. Additionally, participants responded positively to provider support and good communication but wished that their doctors explained their diagnosis more clearly. Finally, women were able to enroll in Medicaid without difficulty due largely to the assistance of clinical staff. These findings support the need to strengthen provider education and public health efforts to reach low-income and minority communities for screening and early detection of cervical cancer.

  8. Challenges to cervical screening in a developing country: The case of Malaysia

    DEFF Research Database (Denmark)

    Othman, Nor Hayati; Rebolj, Matejka

    2009-01-01

    OBJECTIVES: Many developing countries, including Malaysia, will need to continue relying on cervical screening because they will not be able to cover their entire female adolescent populations with HPV vaccination. The aim of this paper was to establish the extent of the health care, informational...... in public hospitals and clinics, but the waiting times are often long. The health care system is unequally dense, with rural states being underserved compared to their urban counterparts. If the screening coverage was to increase, a shortage of smear-readers would become increasingly apparent. CONCLUSIONS...

  9. Cervicitis

    Science.gov (United States)

    ... a sexually transmitted infection, such as chlamydia or gonorrhea. Cervicitis can develop from noninfectious causes, too. Successful ... result from common sexually transmitted infections (STIs), including gonorrhea, chlamydia, trichomoniasis and genital herpes. Allergic reactions. An ...

  10. Cervicitis

    Science.gov (United States)

    ... virus ( genital herpes ) Human papilloma virus ( genital warts ) Trichomoniasis Other things that can cause cervicitis include: A ... the discharge under a microscope (may show candidiasis , trichomoniasis , or bacterial vaginosis) Pap test Tests for gonorrhea ...

  11. [The impact of natural history and genital tract distribution of human papillomavirus on technology for cervical cancer screening].

    Science.gov (United States)

    Wu, Z N; Chen, W

    2016-04-01

    Human papillomavirus (HPV) infection is the necessary cause of cervical cancer. There is a close relationship between the amount of DNA, mRNA and protein expression in the natural history of virus and the cervical lesion. This article is aimed to elaborate the natural history and genital tract distribution of high risk HPV, and also evaluate the HPV based cervical cancer screening technology from the perspective of the natural history of HPV, which is meaningful for screening and clinical practice in devising and utilizing different detection technology.

  12. Las mujeres saludables: reaching Latinas for breast, cervical and colorectal cancer prevention and screening.

    Science.gov (United States)

    Larkey, Linda

    2006-02-01

    Community health advisors have effectively promoted breast and cervical cancer prevention and screening among low-income Latina women. Specific elements of such programs, such as enhanced social support, may explain successes. Promotion of colorectal cancer screening has been less studied. Promotoras de Salud (i.e., Latina health advisors) implemented a 12-week program among women recruited from community-based organizations. The program educated 366 Latinas in breast, cervical and colorectal cancer prevention and screening and emphasized social support among class members. Pre- and post-intervention assessments demonstrated significant increases for fruit and vegetable consumption (3.05 to 3.60 servings/day), and physical activity (65.15 to 122.40 minutes/week). Of women previously non-compliant, 39 percent, 31 percent and 4 percent received Pap tests, mammography, and fecal occult blood test (FOBT), respectively. A culturally aligned education program using community health advisors and emphasizing social support among participants may improve prevention and selected screening behaviors, but more intensive interventions may be required for colorectal cancer screening compliance.

  13. Current Technologies and Recent Developments for Screening of HPV-Associated Cervical and Oropharyngeal Cancers

    Science.gov (United States)

    Shah, Sunny S.; Senapati, Satyajyoti; Klacsmann, Flora; Miller, Daniel L.; Johnson, Jeff J.; Chang, Hsueh-Chia; Stack, M. Sharon

    2016-01-01

    Mucosal infection by the human papillomavirus (HPV) is responsible for a growing number of malignancies, predominantly represented by cervical cancer and oropharyngeal squamous cell carcinoma. Because of the prevalence of the virus, persistence of infection, and long latency period, novel and low-cost methods are needed for effective population level screening and monitoring. We review established methods for screening of cervical and oral cancer as well as commercially-available techniques for detection of HPV DNA. We then describe the ongoing development of microfluidic nucleic acid-based biosensors to evaluate circulating host microRNAs that are produced in response to an oncogenic HPV infection. The goal is to develop an ideal screening platform that is low-cost, portable, and easy to use, with appropriate signal stability, sensitivity and specificity. Advances in technologies for sample lysis, pre-treatment and concentration, and multiplexed nucleic acid detection are provided. Continued development of these devices provides opportunities for cancer screening in low resource settings, for point-of-care diagnostics and self-screening, and for monitoring response to vaccination or surgical treatment. PMID:27618102

  14. Implementing a Fee-for-Service Cervical Cancer Screening and Treatment Program in Cameroon: Challenges and Opportunities.

    Science.gov (United States)

    DeGregorio, Geneva; Manga, Simon; Kiyang, Edith; Manjuh, Florence; Bradford, Leslie; Cholli, Preetam; Wamai, Richard; Ogembo, Rebecca; Sando, Zacharie; Liu, Yuxin; Sheldon, Lisa Kennedy; Nulah, Kathleen; Welty, Thomas; Welty, Edith; Ogembo, Javier Gordon

    2017-07-01

    Cervical cancer screening is one of the most effective cancer prevention strategies, but most women in Africa have never been screened. In 2007, the Cameroon Baptist Convention Health Services, a large faith-based health care system in Cameroon, initiated the Women's Health Program (WHP) to address this disparity. The WHP provides fee-for-service cervical cancer screening using visual inspection with acetic acid enhanced by digital cervicography (VIA-DC), prioritizing care for women living with HIV/AIDS. They also provide clinical breast examination, family planning (FP) services, and treatment for reproductive tract infection (RTI). Here, we document the strengths and challenges of the WHP screening program and the unique aspects of the WHP model, including a fee-for-service payment system and the provision of other women's health services. We retrospectively reviewed WHP medical records from women who presented for cervical cancer screening from 2007-2014. In 8 years, WHP nurses screened 44,979 women for cervical cancer. The number of women screened increased nearly every year. The WHP is sustained primarily on fees-for-service, with external funding totaling about $20,000 annually. In 2014, of 12,191 women screened for cervical cancer, 99% received clinical breast exams, 19% received FP services, and 4.7% received treatment for RTIs. We document successes, challenges, solutions implemented, and recommendations for optimizing this screening model. The WHP's experience using a fee-for-service model for cervical cancer screening demonstrates that in Cameroon VIA-DC is acceptable, feasible, and scalable and can be nearly self-sustaining. Integrating other women's health services enabled women to address additional health care needs. The Cameroon Baptist Convention Health Services Women's Health Program successfully implemented a nurse-led, fee-for-service cervical cancer screening program using visual inspection with acetic acid-enhanced by digital cervicography in

  15. Need for expanded HPV genotyping for cervical screening

    Directory of Open Access Journals (Sweden)

    Jack Cuzick

    2016-12-01

    Full Text Available The focus for HPV genotyping has largely been on types 16 and 18, based on their high prevalence in cervix cancer. However screening is focussed on the detection of high grade precursor lesions (CIN3 and CIN2, where other types have a greater role. While HPV16 retains its high predictive value in this context, HPV31 and especially HPV33 emerge as important types with higher positive predictive values (PPVs than HPV18. Additionally full typing indicates that types 39, 56, 59 and 68 have much lower PPVs than types 16, 18, 31, 33, 35, 45, 51, 52 and 58 and they should be considered as ‘intermediate risk’ types, whereas type 66 should not be treated as having an increased risk. Available data are summarized to support this view.

  16. Factors associated with cervical cancer screening in a safety net population.

    Science.gov (United States)

    Heberer, Meredith A; Komenaka, Ian K; Nodora, Jesse N; Hsu, Chiu-Hsieh; Gandhi, Sonal G; Welch, Lauren E; Bouton, Marcia E; Aristizabal, Paula; Weiss, Barry D; Martinez, Maria Elena

    2016-10-10

    To identify factors associated with Papanicolaou-smear (Pap-smear) cervical cancer screening rates in a safety net population. From January 2012 to May 2013, the use of Pap-smear was determined for all patients seen at the breast clinic in a safety net hospital. Health literacy assessment was performed using the validated Newest Vital Sign. The records of patients were reviewed to determine if they had undergone Pap-smears for cervical cancer screening. Sociodemographic information was collected included age, education, monthly income, race/ethnicity, employment, insurance status, and primary care provider of the patient. Logistic regression analysis was then performed to determine factors associated with utilization of Pap-smears. Crude and adjusted odds ratios derived from multivariate logistic regression models were calculated as well as the associated 95%CIs and P-values. Overall, 39% had Pap-smears in the prior 15 mo, 1377 consecutive women were seen during the study period and their records were reviewed. Significantly more patients with adequate health literacy underwent Pap-smears as compared to those with limited health literacy (59% vs 34%, P < 0.0001). In multivariate analysis, patients with adequate health literacy, younger patients, and those with later age of first live birth were more likely to undergo Pap-smears. Patients whose primary care providers were gynecologists were also significantly more likely to have Pap-smears compared to other specialties (P < 0.0001). Patients younger than 21 years or older than 65 years underwent screening less frequently (11% and 11%, respectively) than those 21-64 years (41%, P < 0.0001). Race, ethnicity, language, and insurance status were not associated with Pap-smear screening rates. Patient health literacy and primary care physician were associated with Pap-smear utilization. Development of interventions to target low health literacy populations could improve cervical cancer screening.

  17. Breast and cervical cancer screening specific effects of depression and obesity.

    Science.gov (United States)

    Ludman, Evette J; Ichikawa, Laura E; Simon, Gregory E; Rohde, Paul; Arterburn, David; Operskalski, Belinda H; Linde, Jennifer A; Jeffery, Robert W

    2010-03-01

    Obesity and depression may each be associated with lower rates of cervical and breast cancer screening. Studies have examined obesity or depression alone, but not together, despite the established link between them. This article aims to disentangle the effects of depression and obesity on receipt of breast and cervical cancer screening. A stratified sampling design was used to recruit women aged 40-65 years with information on BMI from an integrated health plan in Washington State in 2003-2005. A telephone survey included the Patient Health Questionnaire-9 for depression, weight, and height. Automated data assessed Paps for 3097 women over a 3-year period and screening mammograms over a 2-year period for 2163 women aged > or =51 years. Logistic regression models (conducted in 2008) examined the association between obesity and depression and receipt of screening tests. In univariate logistic regression models, women were less likely to receive a Pap if they were obese (OR=0.53, 95% CI=0.41, 0.69) or depressed (OR=0.60, 95% CI=0.42, 0.87). Further, women were less likely to receive a screening mammogram if they were depressed (OR=0.45, 95% CI=0.30, 0.67). In multivariable models, only obesity remained significantly associated with a lower likelihood of Pap screening (OR=0.67, 95% CI=0.0.49, 0.93), and only depression remained significantly associated with lower rates of screening mammography (OR=0.49, 95% CI=0.31, 0.76). Obesity and depression did not interact significantly in either model. Obesity and depression appear to have specific effects on receipt of different cancer-screening tests. Copyright (c) 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  18. A cost-utility analysis of cervical cancer screening and human papillomavirus vaccination in the Philippines.

    Science.gov (United States)

    Guerrero, Anna Melissa; Genuino, Anne Julienne; Santillan, Melanie; Praditsitthikorn, Naiyana; Chantarastapornchit, Varit; Teerawattananon, Yot; Alejandria, Marissa; Toral, Jean Anne

    2015-07-30

    Cervical cancer is the second leading cause of cancer cases and deaths among Filipino women because of inadequate access to screening and treatment services. This study aims to evaluate the health and economic benefits of HPV vaccination and its combination with different screening strategies to find the most optimal preventive strategy in the Philippines. A cost-utility analysis was conducted using an existing semi-Markov model to evaluate different screening (i.e., Pap smear, visual inspection with acetic acid) and vaccination strategies against HPV infection implemented alone or as part of a combination strategy at different coverage scenarios. The model was run using country-specific epidemiologic, cost and clinical parameters from a health system perspective. Sensitivity analysis was performed for vaccine efficacy, duration of protection and costs of vaccination, screening and treatment. Across all coverage scenarios, VIA has been shown to be a dominant and cost-saving screening strategy with incremental cost-effectiveness ratio (ICER) ranging from dominant to Php 61,059 (1443 USD) per QALY gained. VIA can reduce cervical cancer cases and deaths by 25%. Pap smear screening was found to be not cost-effective due to its high cost in the Philippines. Adding HPV vaccination at a cost of 54 USD per vaccinated girl on top of VIA screening was found to be potentially cost-effective using a threshold of 1 GDP per capita (i.e., Php 120,000 or 2835 USD/ QALY) with the most favorable assumption of providing lifelong immunity against high-risk oncogenic HPV types 16/18. The highest incremental QALY gain was achieved with 80% coverage of the combined strategy of VIA at 35 to 45 years old done every five years following vaccination at 11 years of age with an ICER of Php 33,126 (783 USD). This strategy may result in a two-thirds reduction in cervical cancer burden. HPV vaccination is not cost-effective when vaccine protection lasts for less than 20 years. High VIA coverage

  19. Cervical cancer screening and Chinese women: Insights from focus groups

    Directory of Open Access Journals (Sweden)

    Sabrina Chia Hsuan Chang

    2013-02-01

    Full Text Available Objective: Despite extensive efforts to raise awareness, Papanicolaou (Pap testing rates among Chinese women living in North America remain low compared with Euro-American women. Although the lower Pap testing rate and ensuing health repercussions among Chinese women are well characterized, mechanisms underlying such health disparities are not. The aim of this study was to use a qualitative approach to delineate such mechanisms. Qualitative approaches to understand constructs within the domain of sexual and reproductive health have been shown to be particularly appropriate, and offer a nuanced view of sexuality that is not afforded by traditional quantitative methods.Method: We carried out two focus groups aimed at exploring how Mandarin-speaking and English-speaking Chinese women experience Pap testing (N = 12. The women were invited to partake in the focus groups from having participated in a large-scale quantitative study. We used content analyses to analyze transcripts and extract themes. Results: The women heavily endorsed Chinese medicine philosophy, conceptualizing physical health holistically, and valuing preventative measures over screening and interceptive measures. Pap testing was described as qualitatively different from other screening procedures, such that women assigned a sexually charged meaning to Pap testing, often discussing it in relation to sexual activity and promiscuity. Women expressed their preference for the compulsory and depersonalized manner that Pap tests are performed in their home country of China, as this lessens the embarrassment associated with undergoing Pap testing. Conclusion: Three mechanisms may contribute to lower Pap testing among Chinese women: preference for Chinese medicine philosophy, perceived sexualization of Pap testing, and the institutionalization of medical care. Implications for improving the reproductive health of Chinese women are discussed.

  20. Cervical cancer screening and chinese women: insights from focus groups.

    Science.gov (United States)

    Chang, S C H; Woo, J S T; Yau, V; Gorzalka, B B; Brotto, L A

    2013-01-01

    Despite extensive efforts to raise awareness, Papanicolaou (Pap) testing rates among Chinese women living in North America remain low compared with Euro-American women. Although the lower Pap testing rate and ensuing health repercussions among Chinese women are well characterized, mechanisms underlying such health disparities are not. The aim of this study was to use a qualitative approach to delineate such mechanisms. Qualitative approaches to understand constructs within the domain of sexual and reproductive health have been shown to be particularly appropriate, and offer a nuanced view of sexuality that is not afforded by traditional quantitative methods. We carried out two focus groups aimed at exploring how Mandarin-speaking and English-speaking Chinese women experience Pap testing (N = 12). The women were invited to partake in the focus groups from having participated in a large-scale quantitative study. Participants were all first-generation immigrants and their average age was 53-years-old. We used content analyses to analyze transcripts and extract themes. The women heavily endorsed traditional Chinese medicine philosophy, conceptualizing physical health holistically, and valuing preventative measures over screening and interceptive measures. Pap testing was described as qualitatively different from other screening procedures, such that women assigned a sexually charged meaning to Pap testing, often discussing it in relation to sexual activity and promiscuity. Women expressed their preference for the compulsory and depersonalized manner that Pap tests are performed in their home country of China, as this lessens the embarrassment associated with undergoing Pap testing. Three mechanisms may contribute to lower Pap testing among middle-aged first-generation Chinese immigrants: preference for Chinese medicine philosophy, perceived sexualization of Pap testing, and the institutionalization of medical care. Implications for improving the reproductive health

  1. Mobile Phone Text Messaging Intervention for Cervical Cancer Screening: Changes in Knowledge and Behavior Pre-Post Intervention

    Science.gov (United States)

    2014-01-01

    Background Cervical cancer poses a significant threat to Korean American women, who are reported to have one of the highest cervical cancer mortality rates in the United States. Studies consistently report that Korean American women have the lowest Pap test screening rates across US ethnic groups. Objective In response to the need to enhance cervical cancer screening in this vulnerable population, we developed and tested a 7-day mobile phone text message-based cervical cancer Screening (mScreening) intervention designed to promote the receipt of Pap tests by young Korean American women. Methods We developed and assessed the acceptability and feasibility of a 1-week mScreening intervention to increase knowledge of cervical cancer screening, intent to receive screening, and the receipt of a Pap test. Fogg’s Behavior Model was the conceptual framework that guided the development of the mScreening intervention. A series of focus groups were conducted to inform the development of the intervention. The messages were individually tailored for each participant and delivered to them for a 7-day period at each participant’s preferred time. A quasi-experimental research design of 30 Korean American women aged 21 to 29 years was utilized with baseline, post (1 week after the completion of mScreening), and follow-up (3 months after the completion of mScreening) testing. Results Findings revealed a significant increase in participants’ knowledge of cervical cancer (Pcancer screening (P=.006). A total of 23% (7/30) (95% CI 9.9-42.3) of the mScreening participants received a Pap test; 83% (25/30) of the participants expressed satisfaction with the intervention and 97% (29/30) reported that they would recommend the program to their friends, indicating excellent acceptability and feasibilit