scholarly journals Immigration status and cervical test screening: more underscreening and inequality social health

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
J Sassenou ◽  
L Rigal ◽  
V Ringa

Abstract Introduction In France, public health authorities recommend cervical cancer screening (CCS) by a Pap test every 3 years for all sexually active women aged 25 to 65 years. Socioeconomic inequalities are observed in CCS and disparities in screening practices according to immigration status has been reported. The aim of this study was to compare income inequalities in cervical screening depending on immigration status. Methods The study was based on the 2012-2016 baseline data in the Constances cohort (N = 28905 women). Delayed CCS was defined by having last CCS for more 3 years. The main independant variables were monthly household income and immigration status. The women’s origin was divided into the following categories: French women born to two French parents (French origin), French women born to at least one foreign parent (immigrant origin), and women born to two foreign parent (immigrants). Immigrants were divided into two categories: women with French or not nationality (naturalized or foreign immigrant). The slope index inequality (SII) was computed to measure the income inequality in CCS non-adherence. Interaction test was used to compare SII depending on immigration status. We used imputation model. Results We confirmed the existence of a gradient with respect to migration origin for delaying CCS (21,9 % women of French origin, 26,5 % women of immigrant origin, 28,8 % immigrant, p < 10-4). More income inequalities were observed depending on immigration status (SII French origin= 0,17 [0,16-0,18], SII immigrant origin= 0,28 [0,24-0,32], SII immigrant = 0,27 [0,25-0,31], p interaction <0,001). Among immigrant women, we observed difference in social inequalities depending on French nationality (SII naturalized= 0,19 [0,15-0,23], SII foreign immigrant= 0,35 [0,30-0,40], p interaction <10-4). Conclusions French women of immigrant origin and immigrant women are underscreened and social inequalities are stronger among them than French women of French origin. Key messages French women of immigrant origin and immigrant women are less detected for cervical cancer screening than French women. French women of immigrant origin and immigrant women are detected for cervical cancer screening with more social inequalities than French women of french origin.

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Charlotte A. Brown ◽  
Johnannes Bogers ◽  
Shaira Sahebali ◽  
Christophe E. Depuydt ◽  
Frans De Prins ◽  
...  

Since the Pap test was introduced in the 1940s, there has been an approximately 70% reduction in the incidence of squamous cell cervical cancers in many developed countries by the application of organized and opportunistic screening programs. The efficacy of the Pap test, however, is hampered by high interobserver variability and high false-negative and false-positive rates. The use of biomarkers has demonstrated the ability to overcome these issues, leading to improved positive predictive value of cervical screening results. In addition, the introduction of HPV primary screening programs will necessitate the use of a follow-up test with high specificity to triage the high number of HPV-positive tests. This paper will focus on protein biomarkers currently available for use in cervical cancer screening, which appear to improve the detection of women at greatest risk for developing cervical cancer, including Ki-67,p16INK4a, BD ProEx C, and Cytoactiv HPV L1.


2005 ◽  
Vol 16 (3) ◽  
pp. 233-236 ◽  
Author(s):  
L C Chingang ◽  
U Bischof ◽  
G Andall-Brereton ◽  
O Razum

In many middle-income countries with a high incidence of cervical cancer, organized screening programmes with the Pap test are being planned. We assessed the knowledge of, and attitudes towards, cervical screening among 63 doctors and 102 randomly selected community members in Trinidad where screening is still opportunistic. Doctors were well informed about cervical cancer, but not all knew the approximate specificity of the Pap test. Many did not routinely discuss the benefits and disadvantages of screening with their clients. Most women had heard of the Pap test, but only 56% knew its purpose; 25% would not participate in screening, stating reasons such as being in menopause or not having symptoms. More information about the aim of screening and the purpose of the Pap test must be communicated. Doctors need to keep their knowledge on screening up-to-date, and offer counselling that helps women to make an informed decision whether or not to participate in screening.


2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 214s-214s
Author(s):  
C.J. Yong ◽  
L.L. Hong ◽  
K.Y. Lee ◽  
I. Krishnasamy ◽  
N.H. Binti Nasir ◽  
...  

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.


2019 ◽  
Vol 1 (1) ◽  
pp. 55-65
Author(s):  
Jude Egwurugwu ◽  
S.D. Ejikunle ◽  
E.I. Dike ◽  
M.C. Ohamaeme ◽  
Jude Egwurugwu ◽  
...  

Background: Cervical cancer is the 2nd commonest cancer among women worldwide and the most common cancer among women in developing countries like Nigeria. Though preventable by screening for premalignant and early cervical lesions, this is predicated on the knowledge and practice of a cervical screening. Objective: To assess the knowledge and practice of cervical cancer screening among women in Orlu, Local Government Area(LGA) Imo State, Nigeria. Materials & Methods: A community based cross-sectional study with the use of 502 interviewer – administered questionnaires was conducted among women in Orlu LGA of Imo State. All the women in the communities attending the annual August Meeting who consented were recruited for this study. Results: The study showed that the mean age of the respondents was 42±2.8years. Furthermore, 82.3% of respondents attained postsecondary school educational level, 61.8% & 21.1% were multiparous and grand multiparous respectively. Also, 80.5% of respondents have heard about cervical cancer screening. Majority (67.5%) of these respondents heard it from health care providers. There was a positive statistically significant relationship between educational status and the likelihood of having knowledge of cervical cancer screening, (p< 0.01). The level of practice of cervical cancer screening was very low among the respondents(13.5%).Though majority of the respondents have high level of educational attainment this did not reflect their practice of cervical cancer screening. Conclusion: There was high knowledge of cervical cancer and cervical screening modalities among women in Orlu but their practice of cervical cancer screening was very low. There is an urgent need to educate and encourage women on the benefits of cervical cancer screening. Key words: cervical cancer, knowledge, Practice, Orlu women, Screening.


2006 ◽  
Vol 8 (1) ◽  
pp. 67-84 ◽  
Author(s):  
Melanie R. Wasserman ◽  
Deborah E. Bender ◽  
Shoou-Yih Lee ◽  
Joseph P. Morrissey ◽  
Ted Mouw ◽  
...  

2018 ◽  
Vol 5 ◽  
pp. 233339361878363 ◽  
Author(s):  
Brianne Wood ◽  
Virginia L. Russell ◽  
Ziad El-Khatib ◽  
Susan McFaul ◽  
Monica Taljaard ◽  
...  

In this study, we examine from multiple perspectives, women’s shared decision-making needs when considering cervical screening options: Pap testing, in-clinic human papillomavirus (HPV) testing, self-collected HPV testing, or no screening. The Ottawa Decision Support Framework guided the development of the interview schedule. We conducted semi-structured interviews with seven screen-eligible women and five health care professionals (three health care providers and two health system managers). Women did not perceive that cervical screening involves a “decision,” which limited their knowledge of options, risks, and benefits. Women and health professionals emphasized how a trusted primary care provider can support women making a choice among cervical screening modalities. Having all cervical screening options recommended and funded was perceived as an important step to facilitate shared decision making. Supporting women in making preference-based decisions in cervical cancer screening may increase screening among those who do not undergo screening regularly and decrease uptake in women who are over-screened.


2021 ◽  
Author(s):  
Nigus Bililign Yimer ◽  
Mohammed Akibu Mohammed ◽  
Kalkidan Solomon ◽  
Mesfin Tadese ◽  
Stephanie Grutzmacher ◽  
...  

AbstractBackgroundCervical cancer screening and prevention programs have been given considerable attention in high-income countries, while only receiving minimal effort in many African countries. This meta-analytic review aimed to estimate the pooled uptake of cervical cancer screening uptake and identify its predictors in Sub-Saharan Africa.MethodsPubMed, EMBASE, CINAHL, African Journals Online, Web of Science and SCOPUS electronic databases were searched. All observational studies conducted in Sub-Saharan Africa and published in English language from January 2000 to 2019 were included. The Newcastle-Ottawa Scale was applied to examine methodological quality of the studies. Inverse variance-weighted random-effects model meta-analysis was done to estimate the pooled uptake and odds ratio of predictors with 95% confidence interval. I2 test statistic was used to check between-study heterogeneity, and funnel plot and Egger’s regression statistical test were used to check publication bias. To examine the source of heterogeneity, subgroup analysis based on sample size, publication year and geographic distribution of the studies was carried out.ResultsOf 3,537 studies identified, 29 studies were included with 36,374 women. The uptake of cervical cancer screening in Sub-Saharan Africa was 12.87% (95% CI: 10.20, 15.54; I2= 98.5%). Meta-analysis of seven studies showed that knowledge about cervical cancer increased screening uptake by nearly 5-folds (OR: 4.81; 95% CI: 3.06, 7.54). Other predictors include educational status, age, HIV status, contraceptive use, perceived susceptibility, and awareness about screening locations.ConclusionCervical screening uptake is low in Sub-Saharan Africa and influenced by several factors. Health outreach and promotion targeting identified predictors are needed to increase uptake of screening service in the region.sProtocol registrationCRD42017079375


2020 ◽  
Vol 10 (1) ◽  
pp. 1639-1644
Author(s):  
Indrani Krishnappa ◽  
Kalyani R. ◽  
Raja Parthiban ◽  
Abhishek Agrawal

Background: Pap smear examination has been universally used as an effective screening tool for early detection of cervical carcinoma. The aim of this study was to assess the utility of Cervical Acid Phosphatase staining as an adjunct to routine Pap smear testing to improvethe sensitivity and specificity of routine Pap smear examination for cervical cancer detection. Materials and Methods: Cervical smears were taken from patients attending the gynecology department and a few cervical cancer screening programmes. One set of slides were alcohol fixed and stained with rapid pap stain and another set of slides were fixed in a special fixative and stained with Cervical Acid Phosphatase -Pap stain. The nuclear features of these Cervical Acid Phosphatase stained dysplastic cells was studied on Pap stain to diagnose cervical intraepithelial lesion/ malignancy. Results: Out of 489 cases included in the study 6 cases were diagnosed with intraepithelial lesion/ malignancy. On Cervical Acid Phosphatase -Pap stain 2 of the cases diagnosed as inflammatory smears on pap stain showed Cervical Acid Phosphatase positivity and thus were re evaluated. Mild nuclear atypia was observed in the Cervical Acid Phosphatase positive cells and these cases were diagnosed as Low grade squamous intraepithelial lesion and later biopsy proven to be Cervical intraepithelial Neoplasia I. Therefore Cervical Acid Phosphatase -Pap test was 100% sensitive and specific for cervical cancer detection. Conclusions: With 100% sensitivity Cervical Acid Phosphatase -Pap test satisfies the criteria of an efficient screening test.


2021 ◽  
Author(s):  
Karen Kieu Giang Chung

This paper was among the first to critically examine literature on factors that impede Southeast Asian immigrant women's access and utilization of cervical cancer screening services. 46 articles examining Southeast Asian women and their utilization of Pap testing were analyzed using the core concepts of the Health Belief Model. Individual perceptions, (i.e. Asian cultural beliefs and traditions), and cues to action (i.e. physician recommendations) were most influencing on Southeast Asian immigrant women's participation of cervical cancer screening services. Proposed recommendations from reviewed literature were examined, addressing solutions that can potentially minimize these factors. Providing Asian immigrant women with culturally and linguistically appropriate education materials, and increased physician education were the most frequent recommendations proposed in the literature. More field research is needed in this area, including the development of culturally-sensitive interventions and strategies for enhancing Southeast Asian women's participation in cervical cancer screening.


2013 ◽  
Vol 8 (1) ◽  
pp. 18 ◽  
Author(s):  
Virginia L. Russell ◽  
Sarah De Leeuw

Guided by feminist and community-based participatory methodologies and by efforts to decolonize health research practices, and undertaken with qualitative research methods (interviews, open-ended questionnaires, and analysis of arts-based expressions like storytelling, journaling, and picture-making), this research identified challenges and barriers that (predominantly Aboriginal) women in northern British Columbia faced when trying to access sexual health care services related to HPV and cervical cancer screening. The research also examined the possible effectiveness of creative or arts-based strategies to promote cervical health and screening awareness among young and/or traditionally underserved or marginalized women. We review findings from data gathered over six months during multiple interactions with 22 women from a wide range of ethnic backgrounds. Results confirm that ethnicity, finances, and formal education are determinants in women’s awareness about, access to, and use of cervical screening services, and that experiences of gendered victimization, feelings of disempowerment, and life circumstances all influenced women’s comfort levels with, access to, and use of cervical cancer screening services.


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