scholarly journals Cervical cancer screening uptake in Sub-Saharan Africa: a systematic review and meta-analysis

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

Public Health ◽  
2021 ◽  
Vol 195 ◽  
pp. 105-111
Author(s):  
N.B. Yimer ◽  
M.A. Mohammed ◽  
K. Solomon ◽  
M. Tadese ◽  
S. Grutzmacher ◽  
...  

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Birye Dessalegn Mekonnen

Background. Women living with human immunodeficiency virus (HIV) are more likely to develop an increased risk of invasive cervical cancer. Morbidity and mortality due to cervical cancer could be reduced with early detection through cervical screening. Though uptake of cervical screening was investigated in Ethiopia, inconsistent findings were reported. Therefore, this systematic review and meta-analysis was designed to estimate the pooled prevalence of cervical cancer screening uptake among HIV-positive women and its associated factors in Ethiopia. Methods. A comprehensive search of PubMed/MEDLINE, Scopus, EMBASE, CINAHL, Google Scholar, Science Direct, and Cochrane Library was conducted. The data were extracted using a standardized data extraction format. Statistical analysis was done using the STATA, version 14, software. The heterogeneity of the studies was assessed using the I2 test. Funnel plots and Egger’s test were used to check publication bias. A random effects model was computed to estimate the pooled prevalence of cervical cancer screening uptake. Moreover, pooled odds ratios with 95% confidence intervals were used to determine the association of identified determinant factors with cervical cancer screening uptake. Results. A total of 10358 studies were retrieved, and 7 studies were included in the meta-analysis. The pooled prevalence of cervical cancer screening uptake among HIV-positive women in Ethiopia was 18.17% (95% CI : 11.23, 25.10) with exhibited heterogeneity (I2 = 96.6%; p<0.001). Educational status of women (AOR = 3.50; 95% CI : 1.85, 6.07), knowledge of women on cervical cancer (AOR = 3.26; 95% CI : 2.50, 4.43), and perceived susceptibility (AOR = 3.26; 95% CI : 2.26, 4.26) were significantly associated with cervical cancer screening uptake among HIV-positive women. Conclusion. The uptake of cervical cancer screening among HIV-positive women in Ethiopia was low. The findings of this study suggest the need to improve the existing national strategies of cervical cancer screening so as to strengthen reproductive health education and promotion, in addition to providing screening services. Furthermore, cervical screening service should be integrated to the routine care and treatment, so that HIV-positive women can get counseling services in every clinical contact.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Hanna Amanuel Tesfahunei ◽  
Michael Solomon Ghebreyesus ◽  
Dawit Getachew Assefa ◽  
Eden Dagnachew Zeleke ◽  
Joan Acam ◽  
...  

Abstract Background Human papillomavirus (HPV) infection remains a major health threat in sub-Saharan Africa (SSA). HPV self-sampling could help find and treat cervical cancer at an early stage. We aimed to evaluate the effectiveness of HPV self-sampling over the standard health facility-based clinician-sampling for cervical cancer screening through a systematic review and meta-analysis of available randomized controlled trials. Method We searched PubMed, Cochrane Central Register of Controlled Trials, ClinicalTrial.gov, and the WHO Global Health Library for articles in SSA published as of 31 May 2020. We followed the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) 2015 guidelines for the design and reporting of the results. We included randomized control trials that compared HPV self-sampling with the standard of care. The primary endpoint was uptake of cervical cancer screening service. The secondary endpoints were linkage to care, acceptability, screening frequency, and adverse events. We used RevMan V.5.3 software for statistical analysis. We computed random-effect model to provide pooled estimates of available data and I-squared (I2) test to assess heterogeneity. Result Of 77 citations, we included four trials from Nigeria, Ethiopia, Kenya, and Uganda, encompassing 8200 participants with age ranging from 25 to 65 years. The pooled analysis showed significantly higher uptake of cervical cancer screening in women who used HPV self-sampling (risk ratio [RR] 1.72, 95% CI 1.58–1.87; p = 0.01), while this had a considerable heterogeneity as explained by subgroup analysis. Uptake was higher in women who were offered sampling kit at home or work (RR 2.05, 95% CI 1.80–2.33) and those who’s kit was mailed to or invited to a nearby health center (RR 1.65, 95% CI 1.58–1.72, I2 = 0%) than those screened with the standard of care. There was no difference between the two groups in the rate of linkage to care of positive cases (RR 1.30, 95% CI 0.90–2.74, I2 = 91%). HPV self-sampling was acceptable and easy to use. None of the trials compared the frequency of screening or adverse events. Conclusion HPV self-sampling is an effective and feasible alternative to the standard health facility-based clinician-sampling for cervical cancer screening in SSA. It could improve the uptake of cervical cancer screening and harness the global strategy towards elimination of cervical cancer by 2030.


2021 ◽  
Author(s):  
Agani Afaya ◽  
Kennedy Diema Konlan ◽  
Eugenia Mensah ◽  
Amos Nawunimali Suuk ◽  
Damata Issahaku Kombat ◽  
...  

Abstract Introduction: Cervical cancer is the second most common cancer among women and approximately 500,000 new cases are diagnosed yearly. It is increasingly imperative to use effective methods of early detection and initialization of treatment for cervical cancer especially among women from vulnerable poor communities through the initiation of effective health promotion interventions. This study will coalesce the sporadic, and uncoordinated interventions that have been used by researchers to give a single unit that describes and assess the most effective means of health promotion interventions. Methods: The PRISMA Extension for Scoping Reviews (PRISMA-ScR) and Joanna Briggs Institute (JBI) scoping review methodology will be used to guide the reporting of this scoping review. The three-step search strategy for scoping reviews will be adopted to electronically search databases such as PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL via EBSCOhost), Web of Science, and EMBASE. After search completion, the citations of the articles will be imported to EndNote X9 (version 1.19.6) reference manager for screening, removal of duplicates, and storage. Two of the researchers (AA, KDK) will independently screen the titles and abstracts in accordance with the inclusion criteria specified in this protocol. The proposed review will consider primary published peer-review articles published articles in English language from 2010-2021. Data extracted from selected studies will include author(s), publication year, country, research design and aim, study population, interventions, outcome measure, and major findings. The JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses will be used to assess the quality of the included articles.Discussion: We envisage that the findings from this review will firstly identify the various types of interventions implemented in the sub-Saharan African countries to increase the uptake of cervical cancer screening. Secondly, the findings will provide an overview of the outcome measures and identify effective interventions implemented in all the studies to increase cervical cancer uptake in SSA. Finally, the review will guide future research in developing, implementing, and evaluating appropriate health promotion interventions tailored towards increasing cervical cancer screening uptake.Scoping review registration: The review has been registered in the Open Science Framework with the registration number (osf.io/yad46)


2018 ◽  
Vol 1 (1) ◽  
pp. 32-36
Author(s):  
Eleazar Ndabarora ◽  
Dariya Mukamusoni ◽  
Clarte Ndikumasabo ◽  
Védaste Ngirinshuti

Cervical cancer is one of the leading causes of morbidity and mortality globally and in Sub-Saharan Africa in particular. There is evidence that early detection and early management of cases are the best strategies to prevent and control this health threat, since treatment of the later stages of the diseases are very expensive. The objectives of the review were: (1) to identify and review studies on the prevalence of cervical cancer and determinants of early detection in Sub-Saharan Africa, and (2) to recommend further studies and interventions based on the findings of this review. Extensive literature search was conducted using the MeSH terms. Articles on cervical cancer and/or determinants of early detection which fulfilled inclusion criteria were reviewed independently by three reviewers. The prevalence of cervical cancer in Sub-Saharan Africa is increasing. Although there are evidences that cervical cancer screening programs are practical and feasible even in resource-limited settings in Sub-Saharan Africa, there is a very low uptake of cervical cancer screening and there are key factors that need to be addressed in order to make these programs established and effective.


2019 ◽  
Vol 4 (3) ◽  
pp. e001351 ◽  
Author(s):  
Ping Teresa Yeh ◽  
Caitlin E Kennedy ◽  
Hugo de Vuyst ◽  
Manjulaa Narasimhan

IntroductionHuman papillomavirus (HPV) self-sampling test kits may increase screening for and early detection of cervical cancer and reduce its burden globally. To inform WHO self-care guidelines, we conducted a systematic review and meta-analysis of HPV self-sampling among adult women on cervical (pre-)cancer screening uptake, screening frequency, social harms/adverse events and linkage to clinical assessment/treatment.MethodsThe included studies compared women using cervical cancer screening services with HPV self-sampling with women using standard of care, measured at least one outcome, and were published in a peer-reviewed journal. We searched PubMed, the Cumulative Index to Nursing and Allied Health Literature (CNIAHL), Latin American and Caribbean Health Sciences Literature (LILACS) and Embase through October 2018. Risk of bias was assessed using the Cochrane tool for randomised controlled trials (RCTs) and the Evidence Project tool for non-randomised studies. Meta-analysis was conducted using random-effects models to generate pooled estimates of relative risk (RR).Results33 studies in 34 articles with 369 017 total participants met the inclusion criteria: 29 RCTs and 4 observational studies. All studies examined HPV self-sampling; comparison groups were standard of care (eg, Pap smear, visual inspection with acetic acid, clinician-collected HPV testing). 93% of participants were from high-income countries. All 33 studies measured cervical cancer screening uptake. Meta-analysis found greater screening uptake among HPV self-sampling participants compared with control (RR: 2.13, 95% CI 1.89 to 2.40). Effect size varied by HPV test kit dissemination method, whether mailed directly to home (RR: 2.27, 95% CI 1.89 to 2.71), offered door-to-door (RR: 2.37, 95% CI 1.12 to 5.03) or requested on demand (RR: 1.28, 95% CI 0.90 to 1.82). Meta-analysis showed no statistically significant difference in linkage to clinical assessment/treatment between arms (RR: 1.12, 95% CI 0.80 to 1.57). No studies measured screening frequency or social harms/adverse events.ConclusionA growing evidence base, mainly from high-income countries and with significant heterogeneity, suggests HPV self-sampling can increase cervical cancer screening uptake compared with standard of care, with a marginal effect on linkage to clinical assessment/treatment.Systematic review registration numberPROSPERO CRD42018114871.


2019 ◽  
Author(s):  
Zita Aleyo Nodjikouambaye ◽  
Damtheou Sadjoli ◽  
Ralph Sydney Mboumba Bouassa ◽  
Hélène Péré ◽  
David Veyer ◽  
...  

Author(s):  
Desak Gede Yenny Apriani ◽  
N.L.P. Suariyani ◽  
Mangku Karmaya

Background and purpose: Cervical and breast cancers are the most common malignancies among women in Indonesia. The prevalence of cervical cancer in Bali was 0.6% in 2013. Screening coverage for cervical cancer in Tabanan district varies from 37% to 67%. This study aims to determine factors associated to cervical cancer screening uptake among reproductive-aged women.Methods: A cross-sectional survey was conducted at Baturiti Subdistrict, Tabanan Regency, Bali Province. This study involved 188 reproductive-aged women. Samples were randomly selected from all reproductive-aged women from two villages of Baturiti and Angseri. Data were collected using home interviews by a standardised questionaire. Multivariate analysis was conducted using poisson regression model to determine factors associated to cervical cancer screening uptake.Results: This study showed that the proportion of cervical cancer screening was 38.83%. Variables associated to the uptake of cervical cancer screening were comprehensive knowledge about cervical cancer (APR=10.16; 95%CI: 4.33-24.76), insurance holder (APR=2.95; 95%CI: 1.38-6.64) and aged of ?40 years (APR=1.26; 95%CI: 1.01-1.59). Education level, employment status and perceived benefits were not associated with the screening uptake among reproductive-aged women.Conclusions: Level of knowledge about cervical cancer, insurance ownership and aged over 40 years increase the cervical screening uptake among reproductive-aged women


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