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Yong, C. J., L. L. Hong, K. Y. Lee, I. Krishnasamy, N. H. Binti Nasir, P. Gravitt, Y. K. Lee, and Y. L. Woo. "Healthcare Providers´ Views on Cervical Screening: A Qualitative Study of Barriers to Cervical Screening in Malaysia." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 214s. http://dx.doi.org/10.1200/jgo.18.86300.
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Background: Cervical cancer is the third most common cancer affecting Malaysian women despite being highly preventable through screening. A national cervical cancer screening program has been established since 1969 to ensure early detection of cervical cancer. Nonetheless, the prevalence of cervical cancer in Malaysia remains high. Malaysia has been offering Pap tests for free in community health clinics since 1995, however only 47.3% of women have been screened. It has also been reported that nearly 40% of patients with cervical cancer presented at advanced stages of the disease. Government community healthcare professionals are the main stakeholders in the national cervical screening program. Therefore, understanding these healthcare professionals’ perspective of barriers associated with underutilization of cervical cancer screening is key to increase overall screening uptake. Aim: This study aimed to explore healthcare professionals’ views on perceived barriers to cervical screening in Malaysia. Methods: Qualitative in-depth semistructured interviews were carried out with 44 primary healthcare professionals consisting of family medicine specialists (N = 5), medical officers (N = 9), matrons and nurses (N = 20), laboratory technician (N = 5), registration staff and IT technicians (N = 5) involved in the cervical screening program at 5 different urban government healthcare clinics in Petaling district. The interviews were transcribed verbatim and analyzed using a thematic analysis approach. Results: Themes emerged were individual and system barriers. Individual barriers include knowledge/risk perception (lack of knowledge and awareness of cervical screening, low perceived risk), distress (Pap test is embarrassing or painful, previous negative Pap test experience and fear of a cancer diagnosis) and coping skills (remembering the appointment, managing responsibilities such as getting child care/elder care/coverage at work, ability to get transportation), social-cultural barrier (family support); while system barriers highlight the long waiting time for cervical screening, poor documentation, no national call-recall system, patient overload, lack of resources and manpower, lack of educational materials and problems with opportunistic screening. Conclusion: Sustainable screening interventions require approaches that address and resolve both individual and system barriers, such as exploring new methods and delivery of cervical screening, and providing education for the public and healthcare providers.
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Chisale Mabotja, Mantwa, Jonathan Levin, and Mary Kawonga. "Beliefs and perceptions regarding cervical cancer and screening associated with Pap smear uptake in Johannesburg: A cross-sectional study." PLOS ONE 16, no. 2 (February 10, 2021): e0246574. http://dx.doi.org/10.1371/journal.pone.0246574.
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Background Cervical cancer is a major global public health concern, with 85% of cases occurring in low- and middle-income countries. In South Africa, it is the second most common cancer amongst women. Screening and treatment of cervical cancer precursor lesions is associated with a lower incidence and mortality. This research determines the associations between women’s beliefs about cervical cancer and screening and the uptake of Papanicolaou (Pap) smears in Johannesburg, where cervical screening uptake is suboptimal. Methods This research was approved by the University of Witwatersrand Human Research Ethics Committee (Medical), clearance certificate number: M170243 and the Johannesburg District Heath Research Committee prior to conducting the study. All participants signed a consent form prior to participating in this study. This cross-sectional analytical study used an interviewer-administered validated measurement scale based on the Health Belief Model (HBM) to describe health beliefs regarding cervical cancer and screening among 280 women aged 30 years and older, attending Johannesburg primary care facilities in 2017. Logistic regression models, with robust estimation of variance to account for clustering of women within clinics, were fitted to identify health beliefs (perceived susceptibility, severity, barriers and benefit, cues to action, and self-efficacy) associated with ever having had a Pap smear (screening uptake), while controlling for knowledge of screening and potential confounders. Results Of the 280 women, 177 (63.2%) had ever been screened, 180 (64.3%) were never married, 199 (71.1%) attained secondary education and 133 (47.5%) were employed full time. Women of older age (AOR = 1.6 for a 5-year increase in age; CI: 1.3–1.9; P<0.001), with higher knowledge scores (AOR = 2.5 for a 5-point increase in knowledge score; 95% CI:1.0–6.3;P = 0.051), with lower perceived barriers scores (AOR = 0.4 for a 5-point increase in barriers score; 95% CI:0.3–0.5; P<0.001) and higher perceived severity scores (AOR = 1.3 for a 5-point increase in severity score; 95% CI:1.0–1.6; P = 0.017) were more likely to have had a Pap smear. Conclusions This study shows that women who take up screening are older, more knowledgeable regarding cervical cancer and screening, less likely to perceive screening barriers, and more likely to perceive cervical cancer as a severe disease. This highlights that for public health interventions to increase screening uptake, the focus should include tailored behaviour change communication strategies that address women’s beliefs regarding screening barriers and emphasize the severity of cervical cancer.
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Binka, Charity, Samuel H. Nyarko, Kofi Awusabo-Asare, and David T. Doku. "Barriers to the Uptake of Cervical Cancer Screening and Treatment among Rural Women in Ghana." BioMed Research International 2019 (November 3, 2019): 1–8. http://dx.doi.org/10.1155/2019/6320938.
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Background. This study sought to explore the barriers to the uptake of cervical cancer screening and treatment in the North Tongu district of Ghana. Methods. Twenty-five in-depth interviews were conducted, while three focus group discussions were held among respondents. The data were analysed with the R package for qualitative data analysis using a thematic analytical approach. Results. Low level of knowledge about the disease and screening services, personal or psychological convictions, and cost of screening and treatment coupled with a low level of income were the barriers at the individual level. Perceived health personnel attitude, perceived lack of privacy, and misdiagnosis were the barriers at the institutional level while the sociocultural belief system of the communities about the etiology of the disease was the barrier at the community level. Inadequate education about the disease, lack of funding and access to screening facilities also constrained screening and treatment at the policy level. Conclusions. Cervical cancer screening and treatment are constrained at multiple levels in rural Ghana. This study underscores the need to address the low uptake of cervical cancer screening and treatment at the individual, community, institutional, and policy levels simultaneously.
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Roux, Amandine Noemie, Bruno Kenfack, Alexandre Ndjalla, Jessica Sormani, Ania Wisniak, Karoline Tatrai, Pierre Vassilakos, Patrick Petignat, and Nicole Schmidt. "Barriers to cervical cancer prevention in rural Cameroon: a qualitative study on healthcare providers’ perspective." BMJ Open 11, no. 6 (June 2021): e043637. http://dx.doi.org/10.1136/bmjopen-2020-043637.
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ObjectiveCervical cancer in Cameroon ranks as the second most frequent cancer among women and the leading cause of cancer-related deaths, mainly due to the lack of prevention. Our principal objective was to explore potential barriers to an human papillomavirus (HPV)-based cervical cancer screening from a healthcare provider (HCP) perspective in a low-income context. Second, we aimed to explore the acceptability of a single-visit approach using HPV self-sampling.SettingsThe study took place in the District hospital of Dschang, Cameroon.ParticipantsFocus groups (FGs) involved HCPs working in the area of Dschang and Mbouda.Primary and secondary outcome measuresAll FGs were audiorecorded, transcribed and coded independently by two researchers using the ATLAS.ti software. A qualitative methodology was used to capture insights related to the way people perceive their surroundings. Discussion topics focused on perceived barriers, suggestions to improve cervical cancer screening uptake, and acceptability.ResultsA total of 16 HCPs were interviewed between July and August 2019. The identified barriers were (1) lack of basic knowledge on cervical cancer among most women and men and (2) lack of awareness of the role and existence of a screening programme to prevent it. Screening for cervical cancer prevention using HPV self-sampling was considered as an acceptable approach for patients according to HCPs. Traditional chiefs were identified as key entry points to raise awareness because they were perceived as essential to reach not only women, but also their male partners.ConclusionsAwareness campaigns about cervical cancer, its prevention and the availability of the screening programmes are crucial. Furthermore, involving male partners, as well as key community leaders or institutions was identified as a key strategy to encourage participation in the cervical cancer screening programme.Trial registrationEthical Cantonal Board of Geneva, Switzerland (CCER, N°2017-0110 and CER-amendment n°2) and Cameroonian National Ethics Committee for Human Health Research (N°2018/07/1083/CE/CNERSH/SP).
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Agurto, I., A. Bishop, G. Sánchez, Z. Betancourt, and S. Robles. "Perceived barriers and benefits to cervical cancer screening in Latin America." Preventive Medicine 39, no. 1 (July 2004): 91–98. http://dx.doi.org/10.1016/j.ypmed.2004.03.040.
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Abotchie, Peter N., and Navkiran K. Shokar. "Cervical Cancer Screening Among College Students in Ghana: Knowledge and Health Beliefs." International Journal of Gynecologic Cancer 19, no. 3 (March 2009): 412–16. http://dx.doi.org/10.1111/igc.0b013e3181a1d6de.
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Background:Cervical cancer is the most incident cancer and the leading cause of cancer mortality in women in Ghana. Currently, little is known about Ghanaian women's knowledge and beliefs about cervical cancer screening, yet this information is essential to the success of cervical cancer screening programs. Therefore, the purpose of this study was to describe the knowledge and beliefs of female university college students in Ghana.Methods:A cross-sectional survey among college women in a university in Ghana elicited information about sociodemographics, knowledge and beliefs, and acceptability of cervical cancer screening, screening history, and sexual history. Bivariate analyses were conducted to identify factors associated with screening.Results:One hundred forty women were recruited; the age range was 20 to 35 years. The prior Papanicolaou (Pap) screening rate was 12.0%. The women were unaware of local screening initiatives, and only 7.9% were aware of the link between human papillomavirus and cervical cancer. The most prevalent barriers were lack of awareness that the purpose of Pap screening is to diagnose cancer, concerns about what others may think, and lack of information about how to obtain screening services. Although women perceived the benefits of screening, only about half perceived themselves to be at risk. Women received few screening cues. Three barriers were negatively associated with screening in bivariate analyses: lack of belief that cancer is diagnosed by cervical screening, belief that Pap test is painful, and belief that the test will take away virginity.Conclusion:New screening programs in Ghana should address these barriers and increase screening cues to the public.
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HosseAbedelAzim Mohamedin, Hoda, and Yosria El-sayed Hossein. "Impact of counseling on cervical cancer and its screening on women knowledge, health beliefs and protective practices." International Journal of Advanced Nursing Studies 7, no. 2 (August 4, 2018): 85. http://dx.doi.org/10.14419/ijans.v7i2.12989.
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Background: Cervical cancer can be preventable or detected early especially with a series of regular screening with Pap tests.Aim of the study: The aim of this study were to evaluate the impact of counseling on cervical cancer and its screening on women knowledge, health beliefs and protective practices.Subjects and Methods: A quasi-experimental design was used. A convenient ample of 120 women were randomly divided into experimental and control groups, each group consisted of 60 women were recruited from outpatient clinic at Obstetrics and Gynecology Department at Minia General Hospital.Results It can be observed that, 86% of the women in the intervention group had good knowledge compared to only 17% of the control group and the difference is statistically significant. The mean score of perceived susceptibility and barriers in both groups was reduced but the decrease was significantly higher in the intervention group (P<0.004). The mean score of perceived severity and benefits in both groups were increased, but the increased mean score in the intervention group was higher. A highly statistical significant difference was observed between groups regarding protective practices (p = .001).Conclusion: It can be concluded that there was a highly statistical significant improvement in women knowledge was observed and the higher positive beliefs about perceived benefits of preventive health practices, susceptibility, severity, health motivation and reduced the barriers of pap smear this can influence women’s willingness to take preventive test and higher participation in regular Pap smear test in the intervention group. The most commonly barriers to screening cited in our study are lack of knowledge.Recommendations: on the light of this findings it is recommended that, women should be encouraged to take responsibility for their own health and be active participants in the screening program, More educational intervention is needed to encourage adherence to routine cancer screening with raising women’s awareness about cervical cancer, The barriers to Pap smear test are considered by the health authorities in order to overcome barriers of cervical cancer screening.
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Costa, Sebastiano, Nadia Barberis, Rosalba Larcan, and Francesca Cuzzocrea. "The incremental role of trait emotional intelligence on perceived cervical screening barriers." Psychology, Health & Medicine 23, no. 7 (February 13, 2018): 880–90. http://dx.doi.org/10.1080/13548506.2018.1437278.
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Raddi, Sudha A., Anita Dalal, and Rohini B. Castillino. "Assessment of Knowledge and Perceived Barriers to Prevention of Cervical Cancer among Women Attending Gynecology OPD at KLE's Dr Prabhakar Kore Hospital and Medical Research Center, Belgaum, Karnataka, with a View to Develop an Information Booklet." Journal of South Asian Federation of Obstetrics and Gynaecology 4, no. 3 (2012): 169–71. http://dx.doi.org/10.5005/jp-journals-10006-1206.
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ABSTRACT Background Globally, cervical cancer is the second most common type of cancer among women leading to rise in death toll among women. Without urgent action, deaths due to cervical cancer are projected to rise by almost 25% over the next 10 years. Objectives To assess the knowledge and perceived barriers to prevention of cervical cancer among women attending gynecology outpatient department (OPD) and to find an association between knowledge and perceived barriers with sociodemographic variables. Methods This descriptive study at a tertiary care teaching hospital in India, enrolled 200 women attending gynecology OPD between 30 and 55 years. The research approach for the study was correlational and the subjects were selected by purposive sampling technique. The data on knowledge was collected using a structured knowledge questionnaire and perceived barriers by using 5 point Likert scale. Results The analysis demonstrated majority of women (65%) had an average knowledge regarding prevention of cervical cancer and their perceived barriers toward prevention of cervical cancer were neutral (70.5%). Chi-square test yielded p value < 0.05 suggesting a significant association between the sociodemographic variables with knowledge and perceived barriers. Interpretation and conclusion The study concluded that the level of knowledge among the women was average. The general attitude, even though is showing positivity, there are still women out there who have a more negative attitude toward cervical cancer and Pap smear screening and these women need to be targeted planning to start. How to cite this article Castillino RB, Raddi SA, Dalal A. Assessment of Knowledge and Perceived Barriers to Prevention of Cervical Cancer among Women Attending Gynecology OPD at KLE's Dr Prabhakar Kore Hospital and Medical Research Center, Belgaum, Karnataka, with a View to Develop an Information Booklet. J South Asian Feder Obst Gynae 2012;4(3):169-171.
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Liebermann, Erica J., Nancy VanDevanter, Taraneh Shirazian, Natalia Frías Gúzman, Mimi Niles, Cheryl Healton, and Danielle Ompad. "Barriers to Cervical Cancer Screening and Treatment in the Dominican Republic: Perspectives of Focus Group Participants in the Santo Domingo Area." Journal of Transcultural Nursing 31, no. 2 (May 3, 2019): 121–27. http://dx.doi.org/10.1177/1043659619846247.
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Introduction: Cervical cancer is the second leading cause of cancer death among women in the Dominican Republic, and high rates persist despite existing Pap smear screening programs. The purpose of this study was to explore Dominican women’s knowledge and attitudes regarding human papillomavirus (HPV) and cervical cancer, cervical cancer screening practices, and perceived barriers and facilitators to early detection of cervical cancer. Method: Six focus groups ( N = 64) were conducted in Spanish in urban, suburban, and rural locations, in private and public school settings, community and workplace settings, in or near Santo Domingo, as part of a larger study on barriers and facilitators to HPV vaccine implementation. Audio recordings were transcribed verbatim and translated from Spanish to English. Qualitative data analysis used inductive and deductive approaches. Results: Knowledge regarding HPV and cervical cancer varied across groups, but all agreed there was significant stigma and fear regarding HPV. Most women reported having Pap screening at least yearly. Follow-up of abnormal Pap testing was less consistent, with cost and uncertainty about provider recommendations identified as barriers. Discussion: Broader examination of provider-level and health system barriers and facilitators to cervical cancer prevention in the Dominican Republic is essential, in order to inform interventions to improve the effectiveness of cervical cancer screening and treatment programs and reduce preventable deaths.
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Al-amro, Suzanne Q., Muntaha K. Gharaibeh, and Arwa I. Oweis. "Factors Associated with Cervical Cancer Screening Uptake: Implications for the Health of Women in Jordan." Infectious Diseases in Obstetrics and Gynecology 2020 (March 21, 2020): 1–9. http://dx.doi.org/10.1155/2020/9690473.
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Purpose. The existing factors that influence cervical cancer screening uptake worldwide do not necessarily reflect the situation in Jordan. Therefore, the aim of this study was to determine the factors associated with cervical cancer screening uptake among Jordanian women. Methods. In this cross-sectional study, 500 married Jordanian women aged 21 to 65 years were recruited from eight nongovernmental organisations and community settings in Amman. Data were collected with a self-administered questionnaire regarding sociodemographic and reproductive data, a health utilisation data form, and scales on the perceived benefits of screening, perceived barriers to screening, perceived susceptibility to cervical cancer, and perceptions regarding the severity of cervical cancer. Descriptive statistics, multivariate logistic regressions, and independent t-tests were used in the data analysis. Results. Among the 500 age-eligible women, only 156 (31.2%) had been screened for cervical cancer. Healthcare provider encouragement, years of marriage (odds ratio OR=5.24, confidence interval CI=95%, p=0.00), and use of the private healthcare sector (OR=2.20, CI=95%, p=0.012) were significant predictors of cervical cancer screening. Conclusion. Cervical cancer screening uptake among Jordanian women is significantly low; determining factors for the decision to undergo screening include encouragement from the healthcare provider, the number of years of marriage, and use of the private healthcare sector. To improve uptake, structured screening programmes need to be implemented in collaboration with national partners and institutions to decrease the incidence of cervical cancer in Jordan.
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Baezconde-Garbanati, Lourdes, Sheila T. Murphy, Meghan Bridgid Moran, and Victoria K. Cortessis. "Reducing the Excess Burden of Cervical Cancer among Latinas." Californian Journal of Health Promotion 11, no. 1 (May 1, 2013): 45–57. http://dx.doi.org/10.32398/cjhp.v11i1.1517.
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Purpose: Although deaths from cervical cancer are declining, Latinas are not benefiting equally in this decline. Incidence of invasive cervical cancer among Los Angeles’, California Latinas is much higher than among non-Latina Whites (14.7 versus 8.02 per 100,000). This paper examines cervical cancer screening among Latinas. Methods: Ninety-seven women of Mexican origin participated in 12 focus groups exploring barriers to screening. Saturation was reached. Results: All participants knew what a Pap test was and most knew its purpose. More acculturated participants understood the link between HPV and cervical cancer. More recent immigrants did not. There was confusion whether women who were not sexually active need to be screened. Most frequently mentioned barriers were lack of time and concern over missing work. Lower income and less acculturated women were less likely to be aware of free/lowcost clinics. Older and less acculturated participants held more fatalistic beliefs, were more embarrassed about getting a Pap test, were more fearful of being perceived as sexually promiscuous, and were more fearful of receiving disapproval from their husbands. Conclusions: Latinas are informed regarding cervical cancer screening; rather they encounter barriers such as a lack of time, money and support. Health promotion interventions can be enhanced via peer-to-peer education, by addressing barriers to cervical cancer screening with in-language, culturally tailored interventions, and working with clinics on systemic changes, such as extended clinic hours.
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Bukowska-Durawa, Alicja, and Aleksandra Luszczynska. "Review Cervical cancer screening and psychosocial barriers perceived by patients. A systematic review." Współczesna Onkologia 3 (2014): 153–59. http://dx.doi.org/10.5114/wo.2014.43158.
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Bennett, Kirsty F., Jo Waller, Amanda J. Chorley, Rebecca A. Ferrer, Jessica B. Haddrell, and Laura AV Marlow. "Barriers to cervical screening and interest in self-sampling among women who actively decline screening." Journal of Medical Screening 25, no. 4 (April 13, 2018): 211–17. http://dx.doi.org/10.1177/0969141318767471.
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Objectives Understanding why some women actively decline cervical screening could contribute to tailored intervention development. We explored reasons for non-participation in cervical screening among women who had made an active decision not to attend in the future. We also explored interest in human papillomavirus self-sampling. Methods In a population-based survey of women in Great Britain, home-based computer-assisted interviews were carried out with screening eligible women. Women reported their intention to attend for screening when next invited. They endorsed predefined barriers to screening and indicated their interest in human papillomavirus self-sampling. Results Women who had actively declined screening and those who intended to go but were currently overdue (n=543) were included in this analysis. Women who had made an active decision not to be screened in the future were more likely to endorse the barriers ‘I have other more important things to worry about’ and to perceive screening to be of low relevance based on their sexual behaviour. Most participants (70%) indicated that they would be interested in human papillomavirus self-sampling. Interest in self-sampling was greater among those who reported having had a bad experience of screening in the past, were too busy or embarrassed to attend, or would not want a man to carry out the test. Conclusions Women who had made an active decision not to attend screening felt it was of low relevance to them and that they had more important things to worry about. Shifting the perceived cost–benefit ratio for these women by offering human papillomavirus self-sampling might increase screening participation in this group.
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Abdullah, Nik Nairan, Waqar Al-Kubaisy, and Mazlin Mohamad Mokhtar. "Cervical Cancer Screening in Selangor, Malaysia." Asian Journal of Behavioural Studies 2, no. 6 (April 1, 2017): 1. http://dx.doi.org/10.21834/ajbes.v2i6.32.
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A total of 384 females aged 20 years and above from two urban health centres in Selangor were recruited to determine the cervical cancer screening behaviours.Researchers used a set of questionnaires to collect data. The prevalence of ever undergone Pap smear was 58.1%.Working commitment was a significant barrier to performing Pap smear among non-performers with higher educational level relative to those with lower educational level. Non- Malays were four times more likely to perceive cost as a barrier. Older women perceivedworry due to Pap smear less likely compared to those younger.Keywords: urban;cervicalcancer;screening;barriers.2398-4295 © 2017 The Authors. Published for AMER ABRA by e-International Publishing House, Ltd., UK. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, UniversitiTeknologi MARA, Malaysia.
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Sudenga, Staci L., Anne F. Rositch, Walter A. Otieno, and Jennifer S. Smith. "Knowledge, Attitudes, Practices, and Perceived Risk of Cervical Cancer Among Kenyan Women: Brief Report." International Journal of Gynecologic Cancer 23, no. 5 (June 2013): 895–99. http://dx.doi.org/10.1097/igc.0b013e31828e425c.
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ObjectivesEastern Africa has the highest incidence and mortality rates from cervical cancer worldwide. It is important to describe the differences among women and their perceived risk of cervical cancer to determine target groups to increase cervical cancer screening.MethodsIn this cross-sectional study, we surveyed women seeking reproductive health services in Kisumu, Kenya to assess their perceived risk of cervical cancer and risk factors influencing cervical cancer screening uptake. χ2 statistics and t tests were used to determine significant factors, which were incorporated into a logistic model to determine factors independently associated with cervical cancer risk perception.ResultsWhereas 91% of the surveyed women had heard of cancer, only 29% of the 388 surveyed women had previously heard of cervical cancer. Most had received their information from health care workers. Few women (6%) had ever been screened for cervical cancer and cited barriers such as fear, time, and lack of knowledge about cervical cancer. Nearly all previously screened women (22/24 [92%]) believed that cervical cancer was curable if detected early and that screening should be conducted annually (86%). Most women (254/388 [65%]) felt they were at risk for cervical cancer. Women with perceived risk of cervical cancer were older (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.02–1.10), reported a history of marriage (OR, 2.08; CI, 1.00–4.30), were less likely to feel adequately informed about cervical cancer by health care providers (OR, 0.76; CI, 0.18–0.83), and more likely to intend to have cervical cancer screening in the future (OR, 10.59; CI, 3.96–28.30). Only 5% of the women reported that they would not be willing to undergo screening regardless of cost.ConclusionsCervical cancer is a major health burden for women in sub-Saharan Africa, yet only one third of the women had ever heard of cervical cancer in Kisumu, Kenya. Understanding factors associated with women’s perceived risk of cervical cancer could guide future educational and clinical interventions to increase cervical cancer screening.
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Bigaard, J., J. H. Mortensen, and A. B. Kvernrød. "Barriers for Young Women to Participate in The Danish Cervical Screening Program." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 55s. http://dx.doi.org/10.1200/jgo.18.54600.
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Background: In Denmark, the coverage rate for cervical cancer screening is about 75% for women aged 23 to 64 years whereas the participation rate is 65%. The participation rate varies with age, and is between 47%-57% among women in their twenties. In 2005, a qualitative study among women between 23 and 39 years found a range of barriers for nonparticipation. Barriers were lack of knowledge about the aim of cervical screening (i.e., the possibilities for early detection and treatment of cervical dysplasia), lack of knowledge about HPV as a very common virus causing dysplasia and cervical cancer and finding the time to make an appointment with the GP. 10 years later a follow-up study among women aged 30 to 50 years found similar barriers (i.e., lack of knowledge about HPV and cervical screening as a preventative method). Despite the different barriers, most women wanted to take part in screening, but a busy everyday life meant that they forgot about the invitation or they did not book an appointment with their GP. Aim: We investigated barriers for participation in the first generation of HPV-vaccinated women in Denmark aged 23 to 29 years. Methods: Qualitative interviews (focus groups) with women aged 23 to 29 years, who had all received one or more invitations to partake in cervical cancer screening, but who had not participated. Results: A preliminary analysis of the first six focus groups identified a handful of interrelated barriers similar to older women. The most important barrier being insufficient knowledge or lack of knowledge about HPV as the cause of dysplasia/cervical cancer (i.e., the high incidence of HPV-infection in women under the age of 35). Furthermore, few women knew about the screening program being an important supplement to their HPV-vaccine, and therefore did not find the program of relevance to them. Conclusion: Surprisingly, the preliminary results suggest important barriers for participation in cervical screening for women aged 23 to 29 to be insufficient knowledge or lack of knowledge about HPV-infection and the importance of regular smear tests as a supplement to their HPV-vaccine. The women did not perceive the smear test relevant enough to exert action and book an appointment with their GP. Barriers remained similar across age groups within the last 12 years despite health campaigns.
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Moore de Peralta, Arelis, Bonnie Holaday, and Ida Mikisa Hadoto. "Cues to Cervical Cancer Screening Among U.S. Hispanic Women." Hispanic Health Care International 15, no. 1 (December 16, 2016): 5–12. http://dx.doi.org/10.1177/1540415316682494.
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Introduction: Hispanic women’s cervical cancer rates are disproportionately high. Cues to cervical cancer screening (Cues to Action) are strategies to activate the decision-making process to get screened for cervical cancer. This study used the health belief model to examine which cues prompt Hispanic women to undergo cervical cancer screening and how perceptions could be potentiated by cues to cervical cancer screening. Method: A cross-sectional survey was conducted among Hispanic women 18 to 65 years old ( n = 220). Generalized linear modeling was used. Results: Spanish media and reminders by mother and doctors were relevant cues. Generalized linear modeling showed cues to action modified significantly the predictive effect of Perceived Threats (i.e., Susceptibility, Severity), benefits, barriers, and self-efficacy on Hispanic women’s cervical cancer screening behavior. “Mother told me” and Spanish media messages were significant covariates. Conclusion: Cues to Action influenced Hispanic’s women participation in cervical cancer screening. Cues to Action increased the strength of the health belief model as an explanatory model, and must be considered in designing culturally appropriate cervical cancer screening interventions.
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Hong, L. L., J. C. Yong, K. Y. Lee, N. H. Binti Nasir, P. Gravitt, Y. K. Lee, and Y. L. Woo. "Understanding Barriers to Cervical Screening Follow-Up and Treatment Compliance in Malaysia: A Qualitative Study of Provider Perspectives." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 214s. http://dx.doi.org/10.1200/jgo.18.86200.
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Background: Cervical cancer is a leading cause of women mortality in Malaysia. In Malaysia, system of care remain fragmented despite the increased uptake of cervical screening. Thus, it is important to better understand factors that affect loss to follow-up and treatment along the care continuum. The ability of a patient to attend a cervical screening clinic, to return for possible treatment, and to return to clinic for follow-up evaluation (“the patient factor”) is a major component to the success of a screening program. Women diagnosed with early or local (stage 1) cervical cancer have a 92% chance of survival 5 years after diagnosis whereas survival rates decrease to 17% for women with late cancer diagnoses. Due to this, a better understanding of barriers to cervical cancer treatment can inform initiatives to address therapeutic delays, which is vitally important to providing optimal care. Aim: To explore, from the perspectives of healthcare professionals, the perceived barriers of cervical screening follow-up and treatment compliance in Malaysia. Methods: In-depth semistructured interviews with 45 government health clinic staffs comprise of clinicians, nurses, front desk staffs, medical laboratory technicians and IT support engineers were conducted from 5 government health clinics in Petaling District. Qualitative content analysis through an inductive approach was used to identify barriers of cervical cancer care continuum and treatment compliance in public health clinics settings. Results: Participants identified various potential barriers to seeking follow-up care and treatment after receiving a positive Pap test results or invalid test results at 2 levels: the structural level, and the patient level. Long waiting time, lack of transport to healthcare providers, fear of treatment, poor documentation, absence of cervical screening registry, as well as unsystematic referral or treatment procedures are some of the major reasons affecting follow-up and treatment compliance. Conclusion: The results highlight the need of structural and personal interventions that eliminate barriers to follow-up and treatment compliance along the care continuum.
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Chapola, John, Fan Lee, Agatha Bula, Clement Mapanje, Billy Rodwell Phiri, Nenani Kamtuwange, Mercy Tsidya, Jennifer H. Tang, and Lameck Chinula. "Barriers to follow-up after an abnormal cervical cancer screening result and the role of male partners: a qualitative study." BMJ Open 11, no. 9 (September 2021): e049901. http://dx.doi.org/10.1136/bmjopen-2021-049901.
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IntroductionCervical cancer is the leading cause of cancer deaths among women in Malawi, but preventable through screening. Malawi primarily uses visual inspection with acetic acid (VIA) for screening, however, a follow-up for positive screening results remains a major barrier, in rural areas. We interviewed women who underwent a community-based screen-and-treat campaign that offered same-day treatment with thermocoagulation, a heat-based ablative procedure for VIA-positive lesions, to understand the barriers in accessing post-treatment follow-up and the role of male partners in contributing to, or overcoming these barriers.MethodsWe conducted in-depths interviews with 17 women recruited in a pilot study that evaluated the safety and acceptability of community-based screen-and-treat programme using VIA and thermocoagulation for cervical cancer prevention in rural Lilongwe, Malawi. Ten of the women interviewed presented for post-treatment follow-up at the healthcare facility and seven did not. The interviews were analysed for thematic content surrounding barriers for attending for follow-up and role of male partners in screening.ResultsTransportation was identified as a major barrier to post-thermocoagulation follow-up appointment, given long distances to the healthcare facility. Male partners were perceived as both a barrier for some, that is, not supportive of 6-week post-thermocoagulation abstinence recommendation, and as an important source of support for others, that is, encouraging follow-up attendance, providing emotional support to maintaining post-treatment abstinence and as a resource in overcoming transportation barriers. Regardless, the majority of women desired more male partner involvement in cervical cancer screening.ConclusionDespite access to same-day treatment, long travel distances to health facilities for post-treatment follow-up visits remained a major barrier for women in rural Lilongwe. Male partners were identified both as a barrier to, and an important source of support for accessing and completing the screen-and-treat programme. To successfully eliminate cervical cancer in Malawi, it is imperative to understand the day-to-day barriers women face in accessing preventative care.
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Parajuli, Jamuna, Dell Horey, and Maria-Irini Avgoulas. "Perceived barriers to cervical cancer screening among refugee women after resettlement: A qualitative study." Contemporary Nurse 56, no. 4 (July 3, 2020): 363–75. http://dx.doi.org/10.1080/10376178.2020.1806089.
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Nagendiram, Archana, Hannah Bougher, Jennifer Banks, Leanne Hall, and Clare Heal. "Australian women’s self‐perceived barriers to participation in cervical cancer screening: A systematic review." Health Promotion Journal of Australia 31, no. 3 (August 7, 2019): 343–53. http://dx.doi.org/10.1002/hpja.280.
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Nguyen-Truong, Connie Kim Yen, Dena Hassouneh, Frances Lee-Lin, Chiao-Yun Hsiao, Tuong Vy Le, Joannie Tang, Margret Vu, and Anthony My Truong. "Health Care Providers’ Perspectives on Barriers and Facilitators to Cervical Cancer Screening in Vietnamese American Women." Journal of Transcultural Nursing 29, no. 5 (December 3, 2017): 441–48. http://dx.doi.org/10.1177/1043659617745135.
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Introduction: Vietnamese American women (VAW) are diagnosed and die at twice the rate than White non-Hispanic American women (16.8/100,000 vs. 8.1/100,000 and 4.4/100,000 vs. 2.4/100,000, respectively). Despite efforts to increase cervical cancer (CC) screening among VAW, the participation rates are persistently low (69% to 81%). The purpose of this study was to explore health care providers’ (HCPs) perspectives on barriers and facilitators to CC screening in VAW. Method: This qualitative descriptive pilot study, used open-ended semistructured interviews with 10 HCPs. Results: The HCPs had two to 23 years treating VAW. Major barriers and facilitators identified by the HCPs were as follows: VAW’s decision making about CC screening; sexual health divide; language discordance, relying on interpreters; breaking suspicion; VAW’s exposure to health sources of CC screening; sustainable trust; and motivated health care practices. Discussion: HCPs perceived the reasons for VAW not being screened or delaying CC screening were due to their lack of knowledge, cultural barriers, language, and issues related to trust.
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Wong, Choi, Law, Chan, and So. "Effects of a Community Health Worker-Led Multimedia Intervention on the Uptake of Cervical Cancer Screening among South Asian Women: A Pilot Randomized Controlled Trial." International Journal of Environmental Research and Public Health 16, no. 17 (August 23, 2019): 3072. http://dx.doi.org/10.3390/ijerph16173072.
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The utilization rate of cervical cancer screening services among South Asian women is low. Multimedia interventions conducted by community health workers (CHWs) could potentially enhance the cervical cancer screening uptake among these individuals. This study aimed to investigate the feasibility and preliminary effects of a CHW-led multimedia intervention on cervical cancer screening uptake among this underprivileged group. This pilot study utilized a randomized wait-list controlled trial design. Forty-two South Asian women were recruited at six ethnic minority associations. Randomization of each organization into either the intervention arm or wait-list control arm was then performed. The intervention was conducted by the CHWs from the associations where the participants were recruited. Outcome measures, were assessed and compared at baseline and immediately post-intervention. We demonstrated that the intervention was feasible as evidenced by the high consent rate and low withdrawal and attrition rates. The intervention arm showed a statistically significant improvement in perceived benefits (p = 0.001) and perceived barriers (p = 0.02). However, no significant difference was noted in screening uptake and screening intention between arms. Our findings support the feasibility of CHW-led multimedia intervention and provide preliminary evidence of its effectiveness on enhancing the cervical cancer screening beliefs among South Asian women.
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Wong, J. P. H., M. Vahabi, J. Miholjcic, V. Tan, M. Owino, A. T. W. Li, and M. K. L. Poon. "Knowledge of HPV/cervical cancer and acceptability of HPV self-sampling among women living with HIV: A scoping review." Current Oncology 25, no. 1 (February 28, 2018): 73. http://dx.doi.org/10.3747/co.25.3855.
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Cervical cancer rates are disproportionately high among women living with the human immunodeficiency virus (wlhiv). Cervical cancer is preventable through hpv screening, regular Pap tests, and early cancer detection. Evidence indicates that hpv and cervical cancer screening are suboptimal among wlhiv, who face a myriad of access barriers. Considering that screening is an effective first-line defense to cervical cancer, we conducted a scoping review with the aim of gaining a better understanding about: (1) the knowledge and perceptions of hpv and cervical cancer screening among wlhiv; and (2) the acceptability of self-sampling for hpv among wlhiv. We searched five electronic databases for peer-reviewed articles that were published in English within the last ten years, reported on studies with hiv-positive women who were aged 16 or older, and satisfied the topics of the review. A total of 621 articles were found. After accounting for duplicates and unmet criteria, 17 articles and 1 abstract, reporting on studies in the United States and Africa, were included in this review. The review highlighted that most wlhiv had inadequate knowledge of hpv transmission and cervical cancer prevention, which influenced their perceptions of risk and susceptibility. Screening barriers included misconceptions about Pap tests, fear of diagnosis of serious illness, perceived pain, embarrassment, bodily modesty, and limited access to female health care providers. This review also affirms that self-sampling is an acceptable and promising screening option for wlhiv. Implications for policy, research, and practice are discussed.
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Poudel, Kritika, and Naomi Sumi. "Analyzing Awareness on Risk Factors, Barriers and Prevention of Cervical Cancer among Pairs of Nepali High School Students and Their Mothers." International Journal of Environmental Research and Public Health 16, no. 22 (November 9, 2019): 4382. http://dx.doi.org/10.3390/ijerph16224382.
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Providing information on increased cancer risks associated with certain behaviors might encourage adolescents to initiate protective behaviors. This study firstly determined the knowledge of risk factors and prevention of cervical cancer. Secondly, it checked an association between mothers’ screening practice and student’s knowledge. A descriptive, cross sectional study was conducted among 253 pairs of high school students and their mothers. Knowledge on cervical cancer was significantly lower among students and mothers. While cancer screening tests, maintenance of hygiene were considered as major preventive measures for cervical cancer, human papilloma vaccine was the least considered preventive measure. Students who were female, attended discussions on cancer and had a healthy diet had better awareness of cancer. Mothers of female students had better knowledge about cervical cancer than mothers of male students. Less perceived susceptibility and lack of knowledge were major obstacles among mothers, limiting cervical cancer screening to 15%. Although association between knowledge of students and screening practice of mothers was not clear, it was observed that cancer communication increased awareness of cervical cancer in both groups. Our findings showed a strong need for school-based cancer education program to address the issues of human papillomavirus vaccinations, cervical cancer risk and screening.
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Tung, Wei-Chen, Minggen Lu, Michelle Granner, Jiani McDonough, and Susan Ervin. "Exploration of factors associated with perceived barriers to cervical cancer screening among Chinese American women." Journal of Public Health and Emergency 3 (September 2019): 11. http://dx.doi.org/10.21037/jphe.2019.08.01.
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Baskaran, Pryma, Pathmawathi Subramanian, Rasnah Abdul Rahman, Wong Li Ping, Nur Aishah Mohd Taib, and Roshaslina Rosli. "Perceived Susceptibility, and Cervical Cancer Screening Benefits and Barriers in Malaysian Women Visiting Outpatient Clinics." Asian Pacific Journal of Cancer Prevention 14, no. 12 (December 31, 2013): 7693–99. http://dx.doi.org/10.7314/apjcp.2013.14.12.7693.
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Tung, Wei-Chen, Minggen Lu, Michelle Granner, and Jeeyun Sohn. "Assessing perceived benefits/barriers and self-efficacy for cervical cancer screening among Korean American women." Health Care for Women International 38, no. 9 (May 4, 2017): 945–55. http://dx.doi.org/10.1080/07399332.2017.1326495.
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Unger-Saldaña, K., A. Alvarez-Meneses, and D. Isla-Ortiz. "Symptomatic Presentation, Diagnostic Delays and Advanced Stage Among Cervical Cancer Patients in Mexico." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 221s. http://dx.doi.org/10.1200/jgo.18.89600.
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Background: Even though cancer of the cervix uteri is a preventable and highly curable disease, in Mexico it is the second cause of cancer mortality among women. According to the last National Survey of Health and Nutrition (2012) , Papanicolaou test screening coverage in Mexico is estimated at 45%. Additionally, studies have revealed quality problems in the taking and interpretation of Papanicolaou test tests and a lack of follow-up in ∼60% of women with positive Pap smears. To date there is no information on the time intervals of care for cervical cancer patients in Mexico. Aims: To quantify the intervals of care from the detection of a possible cervical cancer to the beginning of cancer treatment, describe the form of presentation and identify perceived barriers to timely care. Methods: We surveyed 427 patients that received a new cervical cancer diagnosis between 6.01.16 and 5.31.17 in the 2 largest public hospitals located in Mexico City available for uninsured cancer patients. Approximately 2/3 patients reside in Mexico City metropolitan area and 1/3 in surrounding states. All patients signed informed consent. Participants' medical files were reviewed. We gathered data on: dates necessary to estimate the intervals of care, sociodemographic characteristics, form of cancer identification (symptoms vs screening), perceived barriers of care and cancer clinical stage. Results: Clinical stages at diagnosis were: 9.5% in situ, 16.9% stage I, 25.2% stage II, 20.2% stage III, 17.8% stage IV and 10.5% not known. The median duration of the patient interval (time between symptom discovery and first medical consultation) was 24 days (IQR = 5.5-72), in comparison with 175 days (IQR = 101-272) for the health system interval (time between first medical consultation and treatment start). The diagnosis interval (first consultation to diagnosis) had a median duration of 99 days (IQR = 43-204) and the treatment interval (time between diagnosis and treatment start) a median of 57 days (IQR = 37-78). Only 15% (64/427) patients identified the problem through screening. The most common symptom of presentation was vaginal bleeding in 65.9% (236/363) cases. The main perceived barriers of diagnostic delay were: lack of information of available health services (63%), long waiting times between appointments (52%) and diagnostic medical errors in the first services consulted (38%). Conclusion: The vast majority of cervical cancer cases among uninsured women in the Mexico City metropolitan area have symptomatic presentations. Additionally, these patients face delays of ∼6 months between the first medical consultation and the confirmation of cancer. Low coverage of screening and diagnostic delays are the most likely explanations of the high mortality rates of cervical cancer that persist in Mexico despite the 30-year implementation of the national screening program.
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Eiser, J. Richard, and Nicola Cole. "Participation in Cervical Screening as a Function of Perceived Risk, Barriers and need for Cognitive Closure." Journal of Health Psychology 7, no. 1 (January 2002): 99–105. http://dx.doi.org/10.1177/1359105302007001657.
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Victoria, Sánchez Antelo, Kohler Racquel E, Szwarc Lucila, Paolino Melisa, Kasisomayajula Viswanath, and Arrossi Silvina. "Knowledge and perceptions regarding triage among human papillomavirus–tested women: A qualitative study of perspectives of low-income women in Argentina." Women's Health 16 (January 2020): 174550652097601. http://dx.doi.org/10.1177/1745506520976011.
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Objectives: Among cancer prevention studies, little is known about knowledge, attitudes, and beliefs toward triage adherence in the context of the human papillomavirus self-collection test. This formative research aims to identify knowledge, attitudes, and beliefs related to human papillomavirus and cervical cancer prevention specifically about adherence to Pap triage among women residing in a low-income province in Argentina. Methods: We conducted six focus groups, stratified by residence and age. All participants were aged 30 or older and had performed human papillomavirus self-collection. Data collection and thematic analysis were carried out using constructs from the Health Belief Model. Results: Misinformation regarding human papillomavirus and cervical cancer was common and was a source of distress. Women could not distinguish Pap screening from triage; human papillomavirus risk perception was limited but cervical cancer was perceived as a threatening disease. Women were willing to follow-up after receiving an abnormal screening result. Negative views about clinician-collected screening/triage were common, defined as painful and shameful, and comes with an economic cost (transport/time). Lack of help from family/friends was an obstacle to adhering to triage. Health issues in the family’s records and a physician’s recommendation were a cue to adhere to triage. Conclusion: Lack of knowledge or misinformation of the causes of cervical cancer, human papillomavirus, and the multi-step screening and triage process are barriers to follow-up adherence. Interventions to improve communication between women and health providers about screening results and follow-up are needed. Also, health services should be organized to respond to women’s needs and reduce access barriers to follow-up.
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Biddell, Caitlin B., Lisa P. Spees, Jennifer S. Smith, Noel T. Brewer, Andrea C. Des Marais, Busola O. Sanusi, Michael G. Hudgens, et al. "Perceived Financial Barriers to Cervical Cancer Screening and Associated Cost Burden Among Low-Income, Under-Screened Women." Journal of Women's Health 30, no. 9 (September 1, 2021): 1243–52. http://dx.doi.org/10.1089/jwh.2020.8807.
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Getahun, Tomas, Mirgissa Kaba, and Behailu Tariku Derseh. "Intention to Screen for Cervical Cancer in Debre Berhan Town, Amhara Regional State, Ethiopia: Application of Theory of Planned Behavior." Journal of Cancer Epidemiology 2020 (March 19, 2020): 1–8. http://dx.doi.org/10.1155/2020/3024578.
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Background. Cervical cancer is a major public health problem in many developing countries. Despite the value of screening to prevent morbidity and mortality from cervical cancer, little available literature shows early detection and treatment to be limited in Ethiopia. The aim of this study was to determine the magnitude of and identify factors associated with women’s intention to screen for cervical cancer using the theory of planned behavior. Methods. A community-based cross-sectional study design supplemented with a qualitative approach was employed. Using multistage sampling, a total of 821 women were used in the study. An interviewer-administered survey questionnaire was used to collect quantitative data, whereas purposively selected 12 female health care providers were included in in-depth interviews. Descriptive statistics and simple and multiple binary logistic regression analysis were used to determine the magnitude of women’s intention, identify associated factors, and explore barriers for intention to cervical cancer screening among Debre Berhan women, Ethiopia. The statistical association was determined at a P value of less than 0.05. Moreover, thematic analysis was used to search the hindrances of women’s intention to screen for cervical cancer. Results. The median age of women who participated in this study was 39 years with IQR of 35 to 42 years. Three hundred sixty-one (361, 45.3%) of women had an intention to screen for cervical cancer within three months from the date of the interview. Positive attitude towards cervical cancer screening (AOR=6.164; 95% CI: 4.048, 9.387), positive subjective norm (AOR=2.001; 95% CI: 1.342, 2.982), and higher perceived behavioral control (AOR=7.105; 95% CI: 4.671, 10.807) were predictors of the women’s intention to screen for cervical cancer. The qualitative finding revealed that women did not like to be screened for cervical cancer because they thought that procedure pinch the cervix and it may result in perforating the uterus that would expose them for infertility. In addition, the qualitative findings supported quantitative results, where the constructs of the theory of planned behavior play an essential role in the betterment of women’s intention. Conclusion. This study showed that women’s intention to screen for cervical cancer was low. Positive attitudes towards cervical cancer screening (CCS), subjective norms, and perceived behavioral control were predictors of women’s intention to screen for cervical cancer. Thus, efforts should be exerted to improve the attitude of women involving influential people, which could improve women’s intention for cervical cancer screening. Moreover, behavioral change communication focusing on the constructs of the theory of planned behavior is crucial.
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Cuschieri, Kate, Attila T. Lorincz, and Belinda Nedjai. "Human Papillomavirus Research: Where Should We Place Our Bets?" Acta Cytologica 63, no. 2 (2019): 85–96. http://dx.doi.org/10.1159/000493800.
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Background: Massive strides have been made with respect to primary and secondary prevention of human papillomavirus (HPV)-associated disease as a result of prophylactic vaccination and cervical screening based on molecular HPV testing. However, cervical cancer continues to be an important clinical and societal burden. Additionally, other HPV-associated cancers, for which there are no screening programmes, are rising. Finally, the optimal combination of vaccination and screening strategies will require careful thinking. Considering this unprecedented and important time, we were keen to solicit the views of the expert community to determine what they perceived were the key priorities for HPV research. Our objective was to identify consensus and key priorities for HPV-based research through provision of a questionnaire disseminated to a multidisciplinary group of key opinion leaders (KOLs). Summary: A structured survey composed of 46 HPV research “categories” was sent to 73 KOLs who were invited to “rank” the categories according to priority. The invitees represented clinical and public health disciplines as well as basic scientists. Scores were weighted according to the number of responses. Invitees also had the opportunity to comment on barriers to the research and suggest other research areas that required attention not reflected in the survey. We received 29 responses in total; overall, the 3 highest-ranked categories were “optimal cervical screening in low and middle-income countries (LMICs),” “primary disease prevention in LMICs” and “impact of vaccine on HPV infection and associated disease.” “HPV and the microbiome” and “mechanisms of transformation” were the highest-ranked categories with respect to basic research. Consistent barriers to research were around governance on the use of samples and data and funding, particularly in an era of vaccination. Key Messages: Research to support the management of disease in LMICs is clearly perceived as a priority in the international community in addition to other diverse areas which necessitate an improved basic understanding of viral mechanisms and interactions. International, multidisciplinary efforts which articulate the broader HPV research agenda will be important when seeking funding in addition to international endeavours to support the efficient use of existing samples and cohorts to facilitate such research.
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O'Brien, Sian, and Christina Lee. "Effects of a Videotape Intervention on Pap Smear Knowledge, Attitudes and Behaviour." Behaviour Change 7, no. 3 (September 1990): 143–50. http://dx.doi.org/10.1017/s0813483900007129.
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This study assessed the capacity of modelling videotapes to promote Pap smear screening. A total of 245 women watched videotapes modelling the process of Pap smear testing, and completed pre- and post-questionnaires which assessed knowledge and attitudes relating to Pap smears and cervical cancer. 186 also completed follow-up questionnaires five weeks later. Behavioural effects were strong. One third of those women identified as due for a Pap smear reported having had the test by follow-up. Initial levels of knowledge of Pap smears and of risk factors for cervical cancer were low, but increased significantly at post-test and follow-up. Health Belief Model variables, particularly perceived barriers, were associated with reported Pap smear behaviour, but a large proportion of the variance remained unexplained. The results suggest that modelling videotapes of this type, combined with appropriate encouragement and reassurance from medical practitioners, could significantly increase Pap smear rates and thus increase the detection and treatment of cervical cancer in its early stages.
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Moise, Rhoda K., Raymond Balise, Camille Ragin, and Erin Kobetz. "Cervical cancer risk and access: Utilizing three statistical tools to assess Haitian women in South Florida." PLOS ONE 16, no. 7 (July 6, 2021): e0254089. http://dx.doi.org/10.1371/journal.pone.0254089.
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Although decreasing rates of cervical cancer in the U.S. are attributable to health policy, immigrant women, particularly Haitians, experience disproportionate disease burden related to delayed detection and treatment. However, risk prediction and dynamics of access remain largely underexplored and unresolved in this population. This study seeks to assess cervical cancer risk and access of unscreened Haitian women. Extracted and merged from two studies, this sample includes n = 346 at-risk Haitian women in South Florida, the largest U.S. enclave of Haitians (ages 30–65 and unscreened in the previous three years). Three approaches (logistic regression [LR]; classification and regression trees [CART]; and random forest [RF]) were employed to assess the association between screening history and sociodemographic variables. LR results indicated women who reported US citizenship (OR = 3.22, 95% CI = 1.52–6.84), access to routine care (OR = 2.11, 95%CI = 1.04–4.30), and spent more years in the US (OR = 1.01, 95%CI = 1.00–1.03) were significantly more likely to report previous screening. CART results returned an accuracy of 0.75 with a tree initially splitting on women who were not citizens, then on 43 or fewer years in the U.S., and without access to routine care. RF model identified U.S. years, citizenship, and access to routine care as variables of highest importance indicated by greatest mean decreases in Gini index. The model was .79 accurate (95% CI = 0.74–0.84). This multi-pronged analysis identifies previously undocumented barriers to health screening for Haitian women. Recent US immigrants without citizenship or perceived access to routine care may be at higher risk for disease due to barriers in accessing U.S. health-systems.
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Akhagba, Omoye Mary. "Migrant women’s knowledge and perceived sociocultural barriers to cervical cancer screening programme: a qualitative study of African women in Poland." Health Psychology Report 3 (2017): 263–71. http://dx.doi.org/10.5114/hpr.2017.65238.
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Portillo, Erin M., Denise Vasquez, and Louis D. Brown. "Promoting Hispanic Immigrant Health via Community Health Workers and Motivational Interviewing." International Quarterly of Community Health Education 41, no. 1 (January 10, 2020): 3–6. http://dx.doi.org/10.1177/0272684x19896731.
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Hispanic immigrant health disparities are among the highest in the nation, especially related to obesity and access to health services. Healthy Fit (En Forma Saludable) is a health promotion program that leverages public health department infrastructure to address these disparities through the use of three key innovations explored in this article: community health workers (CHWs), motivational interviewing (MI), and vouchers for free preventative health services. CHWs trained in MI conduct a health screening and then distribute preventive service vouchers and health resources as needed based on screening results. Vouchers cover breast, cervical, and colorectal cancer screening, and several vaccinations including flu and human papillomavirus. Resources to support exercise, to support a healthy diet, to quit smoking, and to reduce risky drinking are also distributed as needed. CHWs then use MI to address perceived barriers and strengthen intrinsic motivation to make use of the health resources. Integrating these strategies provides a low-cost approach to promote healthy behavior in an underserved immigrant population.
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Bowman, Jenny, Rob Sanson-Fisher, Catherine Boyle, Stephanie Pope, and Sally Redman. "A Randomised Controlled Trial of Strategies to Prompt Attendance for a Pap Smear." Journal of Medical Screening 2, no. 4 (December 1995): 211–18. http://dx.doi.org/10.1177/096914139500200408.
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Objective – To assess the comparative efficacy, by randomised controlled trial, of three interventions designed to encourage “at risk” women to have a Pap smear: an educational pamphlet; letters inviting attendance at a women's health clinic; and letters from physicians. Methods – Subjects at risk for cervical cancer who had not been adequately screened were identified by a random community survey and randomly allocated to one of the intervention groups or a control group. Six months after intervention implementation, a follow up survey assessed subsequent screening attendance. Self report was validated by comparison with a national screening data base. Results – A significantly greater proportion of women (36.9%) within the group receiving a physician letter reported screening at follow up than in any other group (P =0.012). The variables most strongly predicting screening attendance were: age, perceived frequency of screening required, use of oral contraceptives, and allocation to receive the physician letter intervention. Conclusions – The relative efficacy of the GP letter in prompting screening attendance shows that this strategy is worthy of further investigation. There remains a need to examine the barriers to screening for older women, and to develop tailored strategies for this population.
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Bebis, Hatice, Nesrin Reis, Tulay Yavan, Damla Bayrak, Ayşe Unal, and Serkan Bodur. "Effect of Health Education About Cervical Cancer and Papanicolaou Testing on the Behavior, Knowledge, and Beliefs of Turkish Women." International Journal of Gynecologic Cancer 22, no. 8 (October 2012): 1407–12. http://dx.doi.org/10.1097/igc.0b013e318263f04c.
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BackgroundCervical cancer is the second most common form of cancer observed among women in Turkey. The participation of women in cervical cancer screening programs is strongly affected by Turkish attitudes, beliefs, and sociocultural structure.AimThis study was conducted to assess the effectiveness of health education that aimed to raise awareness about Papanicolaou testing and to emphasize the importance of the early diagnosis of cervical cancer.Materials and MethodsThe study was conducted as a prospective, randomized, controlled trial and was carried out in 148 women. Seventy-five women in the control group were asked to fill out questionnaire forms. A 45-minute conference-style training was given to 73 women in the study group, and all of the subjects were asked to fill out the forms after the training. The sociodemographic characteristics of the 2 groups and the mean “Health Belief Model Scale for Cervical Cancer and Pap Smear Test” scores of the 2 groups were statistically analyzed by Statistical Package of Social Sciences (SPSS), version 15.ResultsThere was no statistically significant difference noticed between the sociodemographic characteristics of the 2 groups (P> 0.05). The difference in test scores, which represented knowledge about cervical cancer and Papanicolaou testing, was statistically significant between the control group and the study group (t= 10.122,P< 0.05). In the Health Belief Model Scale for Cervical Cancer and Pap Smear Test, there were statistically significant differences in the following measures: lower levels of susceptibility to cervical cancer score (t= −2.035,P< 0.05), lower levels of perceived benefit from a Papanicolaou test score (t= 3.278,P< 0.05) and lower levels of perceived barriers to Papanicolaou test score (t= −3.182,P< 0.05).ConclusionNurses should be involved in educating women about cervical cancer and Papanicolaou testing. By doing so, they can change the attitudes, knowledge, and beliefs of the women.
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Wong, Eliza Lai-Yi, Annie Wai-Ling Cheung, Amy Yuen-Kwan Wong, and Paul Kay-Sheung Chan. "Acceptability and Feasibility of HPV Self-Sampling as an Alternative Primary Cervical Cancer Screening in Under-Screened Population Groups: A Cross-Sectional Study." International Journal of Environmental Research and Public Health 17, no. 17 (August 27, 2020): 6245. http://dx.doi.org/10.3390/ijerph17176245.
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Background: Cervical cancer is one of the most common cancers in women and about 90% of cervical cancer can be reduced by regular screening. The Pap smear has been well in place as a primary cervical screening method since 1950s; however, coverage is still not optimal. This study explored the feasibility of HPV self-sampling in two under-screened population groups in Hong Kong (HK): never screened and not regularly screened females, to estimate the uptake rate and preference rate in the future. Materials and Methods: This was a cross-sectional study to explore the acceptability and feasibility of HPV self-sampling in two age groups: aged 25–35 and aged ≥45, which were reported as the highest proportion of the under-screened population in HK between 2017 and 2018. The study invited eligible women from an HPV study cohort to perform HPV self-sampling at home by themselves. The number of specimens returned from participants was recorded and used to determine the feasibility of HPV self-sampling in the community. The participants were asked to fill in the questionnaires before and after HPV self-sampling to indicate their attitudes, acceptability, and future preference for HPV self-sampling as an acceptable alternative primary cervical cancer screening method. Results: A total of 177 subjects participated in the present study and have achieved a good overall uptake rate of 73% (129/177) who returned the self-collected cervicovaginal sample for HPV testing. Among the under-screened population, there was a higher response rate in aged ≥45 than those aged 25–35. The findings also revealed that women who were under-screened, including those who have never been screened, were more likely to prefer HPV self-sampling than those who had regular screening. This study found that the acceptability of HPV self-sampling was fairly positive among the respondents. The findings also indicated that HPV self-sampling was not only beneficial to enhance their health awareness but also to promote the cervical cancer screening uptake rate, especially among the under-screened or never screened populations. Conclusions: HPV self-sampling would be a solution to overcome the perceived barriers in clinician-based screening. The findings also indicated that it could be feasible to use as an alternative primary cervical cancer screening.
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Bahmani, Afshin, Mohammah Hossein Baghianimoghadam, Behnaz Enjezab, Seyed Saeed Mazloomy Mahmoodabad, and Mohsen Askarshahi. "Factors Affecting Cervical Cancer Screening Behaviors Based On the Precaution Adoption Process Model: A Qualitative Study." Global Journal of Health Science 8, no. 6 (November 17, 2015): 211. http://dx.doi.org/10.5539/gjhs.v8n6p211.
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<p>One of the most preventable cancers in women is cervical cancer. Pap smear test is an effective screening program; however, it is not conducted very frequently. The aim of this study is explaining the determinants affecting women's participation in the Pap smear test based on precaution adoption process model with a qualitative approach. This study was a qualitative approach using a Directed Content Analysis methodology which was conducted in 2014. Participants were 30 rural women who participated in this study voluntarily in sarvabad, Iran. Purposive sampling was initiated and continued until data saturation. Semi-structured interviews were the primary method of data collection. Data were analyzed using qualitative content analysis and continuous comparisons. Women`s information and awareness about cervical cancer and Pap smear is insufficient and most of them believed that they were not at risk; however, they perceived the severity of the disease. Some of them had no adequate understanding of the test benefits. They pointed to the lack of time, financial difficulties, fear of test result and lack of awareness as the main barriers against the Pap smear test; however, they did not say that they were not willing to do the test. Findings could help health policy makers to find the right area and purpose to facilitate the participation of women in the Pap smear test.</p>
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Hortence, Fouedjio Jeanne, Mawamba Sonfack Sophie, Wandji Brigitte, Fouelifack Ymélé Florent, Nangue Charlette, Ngaroua ., and Kemfang Ngowa Jean Dupont. "Knowledge, attitudes and practices of cervical cancer screening by health care providers in the Emana health area: Yaounde-Cameroon." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 5 (April 28, 2020): 2098. http://dx.doi.org/10.18203/2320-1770.ijrcog20201812.
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Background: Gynaecological cancers and more particularly those of the cervix cause many victims in our country despite the many prevention tools that exist. The objective of this study was to assess the knowledge, attitudes and practices of providers on cervical cancer in the Emana health area.Methods: To achieve this objective, we conducted a cross-sectional study form the period from April 2nd to June 10th, 2019 in the health facilities of the Emana health area.Results: A total of 64 healthcare providers participated in the study, 03 gynecologists and obstetricians, 10 General practitioners, 30 state-certified nurses, 09 midwives, 12 nursing assistants. The majority of these providers had poor knowledge of the causes of the disease (25%), risk factors (34.4%), and means of prevention (39.1%), especially among state nurses (SRN), midwives, nursing assistants. (87.5%) had good knowledge of the clinical signs of the disease and were almost unanimous on the curability of this disease when discovered early (78.1%). The severity of the cancer was perceived by all; however, the practice of screening was low (10.9%). As for their personal screening practices, 73.1% (38/52) of female staff had never been screened.Conclusions: Even though the participants perceive the grave nature of the cervical cancer, the subsequent attitude and screening practices remain poor. The possible barrier to this is the insufficient continuous training and recycling of the health personnel. Emphasis should be laid on the methods of prevention of cervical cancer in the curricula of nurses and midwives in Cameroon.
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Badre-Esfahani, Sara, Lone Kjeld Petersen, Camilla Rahr Tatari, Jan Blaakær, Berit Andersen, and Lene Seibæk. "Perceptions of cervical cancer prevention among a group of ethnic minority women in Denmark—A qualitative study." PLOS ONE 16, no. 6 (June 1, 2021): e0250816. http://dx.doi.org/10.1371/journal.pone.0250816.
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Background Cervical cancer screening (CCS) and human papillomavirus vaccination (HPVV) are effective measures against cervical cancer (CC). Attendance in HPVV and CCS provides the greatest protection, while combined non-attendance in HPVV and CCS provides little to no protection. It is hence concerning that some large ethnic minority groups show considerably lower HPVV and CCS attendance than other women–especially women from Middle-Eastern and North African (MENA) countries and Pakistan. Little is, however, known about the reasons for this low combined attendance pattern n. Aim To explore perceptions of and barriers to HPVV and CCS, among MENA and Pakistani women in Denmark. Method Focus group interviews were conducted. Data was transcribed verbatim, and analysed using systematic text condensation. Findings Seventeen long-term resident women originating from six major MENA countries and Pakistan were included. Mean age was 36 years. We found that these women, across different age groups and descent, had sparse knowledge and understanding about CC, and their perceived relevance of disease prevention was low. Compared to HPVV, their barriers to CCS were more fixed and often linked to socio-cultural factors such as taboos related to female genitals and sexuality. Moreover, they presented unmet expectations and signs of mistrust in the healthcare system. However, at the end of the interviews, participants became more attentive toward CC prevention, particularly toward HPVV. Conclusion Elements of insufficient knowledge and understanding of CC and its prevention were found among a group of MENA and Pakistani women. Their socio-cultural background further represents a barrier particularly towards CCS. Additionally, negative experiences and unmet expectations lessen their trust in the healthcare system. All of which underlines the need for new tailored CC preventive strategies for this group. Based on our findings we suggest that future studies develop and evaluate interventions aiming to improve HPVV and CCS, including user-involvement.
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Alsous, Mervat M., Ahlam Ali, Sayer Al-Azzam, Reema Karasneh, and Haneen Amawi. "Knowledge about cervical cancer and awareness about human papillomavirus vaccination among medical students in Jordan." PeerJ 9 (June 17, 2021): e11611. http://dx.doi.org/10.7717/peerj.11611.
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Objectives To assess the knowledge about cervical cancer and HPV infection and the awareness towards and perceived barriers of HPV vaccination amid medical students in Jordan. Methods The present study is a cross-sectional survey that was conducted for a period of three months in the College of Medicine at six different universities in Jordan. Third-year to sixth-year students from these medical colleges in Jordan were invited to participate in the study. Results There were 504 students that took part in the study with 42.3% being males and 57.7% females. The mean knowledge score of students in our survey was 21.4 ± 4.4 out of 34, which was categorized as a moderate level of knowledge regarding cervical cancer and HPV. Only 40.5% knew about the availability of the HPV vaccine in Jordan, and 65.9% accepted the idea that it is necessary to introduce the HPV vaccine for school girls in Jordan. Conclusions This study highlights that there is inadequate knowledge about cervical cancer and its screening among medical students in Jordan. Despite the limited awareness about the HPV vaccine among the study’s participants, there is a favorable opinion towards the introduction of the vaccine for school girls in Jordan. The data provide a benchmark on the level of knowledge about cervical cancer and awareness about HPV, which can be used to formulate an effective awareness program.
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REENA, VINCENT, JOY JUSTY, and SIMON RASNA. "ASSESS THE KNOWLEDGE, PRACTICE AND PERCEIVED BARRIERS OF SCREENING AMONG NON-PROFESSIONAL WORKING WOMEN ON PREVENTION OF CERVICAL CANCER IN A TERTIARY HOSPITAL." i-manager’s Journal on Nursing 10, no. 4 (2021): 15. http://dx.doi.org/10.26634/jnur.10.4.17411.
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Asgary, Ramin, Helen Cole, Philip Adongo, Ada Nwameme, Ernest Maya, Amanda Adu-Amankwah, Hannah Barnett, and Richard Adanu. "Acceptability and implementation challenges of smartphone-based training of community health nurses for visual inspection with acetic acid in Ghana: mHealth and cervical cancer screening." BMJ Open 9, no. 7 (July 2019): e030528. http://dx.doi.org/10.1136/bmjopen-2019-030528.
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ObjectiveTo explore acceptability and feasibility of smartphone-based training of low-level to mid-level health professionals in cervical cancer screening using visual inspection with acetic acid (VIA)/cervicography.DesignIn 2015, we applied a qualitative descriptive approach and conducted semi-structured interviews and focus groups to assess the perceptions and experiences of community health nurses (CHNs) (n=15) who performed smartphone-based VIA, patients undergoing VIA/cryotherapy (n=21) and nurse supervisor and the expert reviewer (n=2).SettingCommunity health centres (CHCs) in Accra, Ghana.ResultsThe 3-month smartphone-based training and mentorship was perceived as an important and essential complementary process to further develop diagnostic and management competencies. Cervical imaging provided peer-to-peer learning opportunities, and helped better communicate the procedure to and gain trust of patients, provide targeted education, improve adherence and implement quality control. None of the patients had prior screening; they overwhelmingly accepted smartphone-based VIA, expressing no significant privacy issues. Neither group cited significant barriers to performing or receiving VIA at CHCs, the incorporation of smartphone imaging and mentorship via text messaging. CHNs were able to leverage their existing community relationships to address a lack of knowledge and misperceptions. Patients largely expressed decision-making autonomy regarding screening. Negative views and stigma were present but not significantly limiting, and the majority felt that screening strategies were acceptable and effective.ConclusionsOur findings suggest the overall acceptability of this approach from the perspectives of all stakeholders with important promises for smartphone-based VIA implementation. Larger-scale health services research could further provide important lessons for addressing this burden in low-income and middle-income countries.
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Sultana, Farhana, Robyn Mullins, Michael Murphy, Dallas R. English, Julie A. Simpson, Kelly T. Drennan, Stella Heley, et al. "Women’s views on human papillomavirus self-sampling: focus groups to assess acceptability, invitation letters and a test kit in the Australian setting." Sexual Health 12, no. 4 (2015): 279. http://dx.doi.org/10.1071/sh14236.
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Background The study evaluated acceptability, invitation letters and the test kit for a trial of human papillomavirus (HPV) self-sampling among never- and under-screened women in Australia. Methods: Victorian women, 30–69 years, who had never had a Pap test or were overdue for one, participated. Four focus groups including eight to nine participants segmented by age (30–49 and 50–69 years) and screening history (never- and under-screened) were conducted in August 2013. Discussions were recorded and transcribed verbatim and data analysed using thematic content analysis. Results: The response to the concept of HPV self-sampling was positive. Decision-making was largely influenced by the content of a pre-invitation letter. Appealing features of self-sampling were cost (free), convenience (home-based) and anticipated less discomfort (with a swab) than a Pap test. Small kits that fit in mailboxes were preferred over post office parcel collection. The perceived barriers include concerns about test accuracy and lack of confidence that a home-based test would give the same results as a physician administered test. Women wanted information on the timing of receipt of the results and information about the organisation providing the test. Conclusion: HPV self-sampling is a possible alternative for Australian women who are reluctant to have a Pap test and may increase the likelihood of participation in cervical cancer screening if women’s concerns about it can be addressed. The findings of this study are relevant for researchers, policymakers and practitioners implementing self-sampling for under-screened women as part of cervical screening programs.
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Calderón-Mora, Jessica, Tamanna Ferdous, and Navkiran Shokar. "HPV Vaccine Beliefs and Correlates of Uptake Among Hispanic Women and Their Children on the US-Mexico Border." Cancer Control 27, no. 1 (January 1, 2020): 107327482096888. http://dx.doi.org/10.1177/1073274820968881.
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Introduction: Human Papilloma Virus (HPV) is the most common sexually transmitted infection nationally. Although preventable, uptake of the HPV vaccine is low. The purpose of this study was to describe HPV vaccine knowledge and beliefs and psychosocial correlates of vaccine uptake among adult females and their children in a US-Mexico border community. Materials and Methods: We conducted a survey of uninsured women aged 21-65 years living in Texas who were due for cervical cancer screening. We utilized descriptive statistics to report demographic and psychosocial variables. We used logistic regression analysis to identify correlates of prior vaccine uptake. Results: 599 women completed surveys: mean age was 44.69 years, 97.8%, were Hispanic and 86% were Spanish speaking; 5% had been vaccinated. Awareness of HPV infection & HPV vaccine was 81.6% & 68.6% respectively. Scores for mean perceived susceptibility was low and mean perceived benefits was high; the mean score for knowledge was 3.69 out of 6. Common parental barriers to child vaccination were cost, lack of accessibility and lack of information. Correlates of past HPV vaccine uptake among adult women were younger age, monthly income of $2,500-$5,000, full-time employment, US birth, and higher perceived severity of HPV. Older age was a correlate of vaccine uptake for daughters. Discussion and Conclusion: Findings revealed low HPV vaccine uptake among adult Hispanic women, but high vaccine acceptability for their sons and daughters. Culturally tailored educational interventions are needed to improve HPV knowledge and HPV vaccine uptake among adults and their children.