scholarly journals A descriptive analysis of health practices, barriers to healthcare and the unmet need for cervical cancer screening in the Lower Napo River region of the Peruvian Amazon

2019 ◽  
Vol 15 ◽  
pp. 174550651989096 ◽  
Author(s):  
Joseph H Collins ◽  
Diana Bowie ◽  
Geordan Shannon

Objectives: To undertake an descriptive analysis of the health needs, healthcare practices and barriers to accessing healthcare faced by women in Lower Napo River Region, Peru, and to understand health literacy regarding cervical cancer and the need for more effective cervical cancer screening services. Methods: We performed a community-based needs assessment adapting Demographic and Health survey methodology with additional questions determining female health literacy on cervical cancer and assessing the availability and need for cervical cancer screening services. We surveyed women (N = 121) across all households in six communities along the Lower Napo River, Loreto, Peru, in May 2015. Data were collected as part of the larger Amazon Community Based Participation Cervical Cancer Screen-and-Treat Programme. Survey data were compared to national results from ENDES 2014. Results: Comparison between our findings and the ENDES 2014 survey highlighted considerable inequality between indigenous or mixed indigenous, rural populations in Loreto, Peru, and national population data averages over level of formal education, literacy, barriers to accessing healthcare and maternal and sexual health. Even though only 5.9% (N = 7/117) of women had no formal health insurance coverage, money was reported as the leading barrier accessing healthcare (N = 88/117, 75.2%). Health literacy regarding cervical and breast cancer was poor. A high proportion of women highlighted fear of screening processes (70.8%, N = 80/113) and lack of available services (53.6%, N = 60/112) as barriers to cervical cancer screening. Conclusion: Although progress has been made in improving healthcare access in Peru, such gains have not been experienced equitably and women living in remote communities face persistent marginalization regarding their health. There is a significant need for education related to and screening for cervical cancer in this region that is tailored to the reality of women’s lives in remote communities in Loreto.

2021 ◽  
Author(s):  
Mandana Vahabi ◽  
Aisha K Lofters ◽  
Gauravi Mishra ◽  
Sharmila Pimple ◽  
Josephine Pui-Hing Wong

BACKGROUND Human papillomavirus (HPV) is the primary cause of cervical cancer, which is preventable through screening and early treatment. The Papanicolaou (Pap) test and visual inspection with acetic acid (VIA), traditionally performed at the clinical setting, have been used effectively to screen for cervical cancer and pre-cancerous changes, and reduce cervical cancer mortality in high-income countries for many decades. However, these screening methods are not easily accessible to women living in low- and middle- income countries (LMIC), especially women living in rural areas. OBJECTIVE Preventing Cervical Cancer in India through Self-Sampling (PCCIS) is a community-based family-centered research project that aims to reduce avoidable cervical cancer disparities in rural area in India. The project will use HPV self-sampling, supported by a sexual health literacy intervention to increase rural women’s participation in cervical cancer screening. The objectives are to determine the effectiveness of this program in: (a) increasing sexual health literacy; (b) reducing gendered stigma of HPV and cervical cancer; (c) promoting cervical cancer screening using HPV self-sampling. METHODS We will recruit 120 women aged 30-69, who are under or never screened (UNS) for cervical cancer along with 120 supportive male relatives or friends from 3 impoverished rural / tribal villages in Palghar district in the state of Maharashtra, India. Participants will attend gender-specific sexual health education (SHE) followed by a Movie Matinee. Data will be collected though an interviewer-administered questionnaire before and after SHE. The questionnaire will include items on social demographics, medical history, attitudes, sexual health stigma, cervical cancer knowledge, and screening practices. Women will self-select whether to use HPV self-sampling. Those who do not may or may not undergo Pap test/VIA. Participants’ views regarding barriers and facilitators and suggestions to improve access and uptake will also be elicited. RESULTS PCCIS was funded in January 2020 for 15 months. Due to the COVID19 pandemic, the project was extended by one year. The protocol was approved by the research ethics boards of Ryerson University (REB 2020-104) and Tata Memorial Center (OIEC/3786/2021 /00003). Study outcome measures will include changes in knowledge/attitudes about cervical cancer screening, proportion of participants who self-select into each cohort, proportion of positive test result in each cohort- and proportion of participants with confirmed cervical cancer. Women’s experiences related to barriers and facilitators associated with the screening uptake will be captured. CONCLUSIONS This multi-faceted work could lead to reduced cervical cancer mortality and morbidity, and increased community capacity in sexual health promotion and cervical cancer prevention. Insights and lessons learned from this project can be used to inform the adaptation and scale-up of HPV self-sampling among women across India and in other countries, promote collective commitment to family-centred wellness, and support women to make healthful, personalized cervical screening decisions. CLINICALTRIAL Not Applicable


2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Sunday Joseph Ayamolowo ◽  
Lydia Feyisayo Akinrinde ◽  
Monisola Omoyeni Oginni ◽  
Love Bukola Ayamolowo

The global incidence of cancer is rising, and low-income and lower-middle-income countries have the worst figures. However, knowledge of cervical cancer prevention and cervical cancer screening practices remains poor in these regions. This study assessed the concept of health literacy as a potential determinant of knowledge of cervical cancer prevention and screening practices among female undergraduates. A descriptive cross-sectional study was conducted among 385 female undergraduates at a university in southwest Nigeria. A validated questionnaire composed of subscales on nine components of health literacy, knowledge of cervical cancer prevention, and cervical cancer screening practices was used for data collection. The majority of the respondents obtained a high score on most of the components of health literacy and 66% had good knowledge of cervical cancer prevention. Only 11% demonstrated good practices of Pap smear testing. Of all the components of health literacy, “feeling understood and supported by healthcare providers” (OR = 0.075; 95% CI [0.036–0.115]; p = 0.015) and “understanding health information well enough to know what to do” (OR = 0.055; 95% CI [0.006–0.104]; p = 0.029) were significantly associated with knowledge of cervical cancer prevention. Out of the major challenges related to cervical cancer screening among undergraduates, the feeling of being at risk (OR = 4.71; p < 0.05) and uncomfortable experiences from past screening (OR = 0.12; p < 0.05) were significantly associated with going for cervical cancer screening. The study concluded that levels of health literacy influenced knowledge of cervical cancer prevention among female undergraduates, but it did not affect their engagement in cervical cancer screening practices.


Author(s):  
Alejandra Castanon ◽  
Matejka Rebolj ◽  
Francesca Pesola ◽  
Peter Sasieni

Abstract Background The COVID-19 pandemic has disrupted cervical cancer screening services. Assuming increases to screening capacity are unrealistic, we propose two recovery strategies: one extends the screening interval by 6 months for all and the other extends the interval by 36/60 months, but only for women who have already missed being screened. Methods Using routine statistics from England we estimate the number of women affected by delays to screening. We used published research to estimate the proportion of screening age women with high-grade cervical intraepithelial neoplasia and progression rates to cancer. Under two recovery scenarios, we estimate the impact of COVID-19 on cervical cancer over one screening cycle (3 years at ages 25–49 and 5 years at ages 50–64 years). The duration of disruption in both scenarios is 6 months. In the first scenario, 10.7 million women have their screening interval extended by 6 months. In the second, 1.5 million women (those due to be screened during the disruption) miss one screening cycle, but most women have no delay. Results Both scenarios result in similar numbers of excess cervical cancers: 630 vs. 632 (both 4.3 per 100,000 women in the population). However, the scenario in which some women miss one screening cycle creates inequalities—they would have much higher rates of excess cancer: 41.5 per 100,000 delayed for screened women compared to those with a 6-month delay (5.9 per 100,000). Conclusion To ensure equity for those affected by COVID-19 related screening delays additional screening capacity will need to be paired with prioritising the screening of overdue women.


2021 ◽  
pp. 106801
Author(s):  
Raúl Murillo ◽  
Oscar Gamboa ◽  
Gustavo Hernández ◽  
Mauricio González ◽  
Peter Olejua ◽  
...  

2017 ◽  
Vol 138 (2) ◽  
pp. 194-200 ◽  
Author(s):  
Bari Laskow ◽  
Ruben Figueroa ◽  
Karla M. Alfaro ◽  
Isabel C. Scarinci ◽  
Elizabeth Conlisk ◽  
...  

2017 ◽  
Vol 2 (4) ◽  
pp. 133-142 ◽  
Author(s):  
Connie Kim Yen Nguyen-Truong ◽  
Kim Quy Vo Nguyen ◽  
Thai Hien Nguyen ◽  
Tuong Vy Le ◽  
Anthony My Truong ◽  
...  

2021 ◽  
Vol 31 (3) ◽  
pp. 266-274
Author(s):  
Gaudence Niyonsenga ◽  
Darius Gishoma ◽  
Ruth Sego ◽  
Marie Goretti Uwayezu ◽  
Bellancille Nikuze ◽  
...  

Background: Cervical cancer is the third most common cancer attacking women globally, and the second in Eastern Africa where Rwanda is located. Regular screening is an effective prevention approach for cervical cancer. Despite that, the screening rate for cervical cancer in Africa is estimated between 10% and 70%, with a number of barriers. This is especially the case in sub-Saharan Africa. In Rwanda, there is limited literature on the rate of use of screening services or the barriers to cervical screening. Objective: To assess knowledge, utilization, and barriers of cervical cancer screening among women attending selected district hospitals in Kigali, Rwanda. Methods: A descriptive cross-sectional study with a structured questionnaire was used to collect data. Nominal ‘yes’ or ‘no’ questions were used to gather data on knowledge and utilisation of cervical cancer and its screening. Likert-type scale questions were used to identify different barriers to screening services. Data were analysed using descriptive and inferential statistics. Respondents were selected by systematic random sampling from the database of women attending gynaecology services at three district hospitals in Kigali, Rwanda. Results: Three hundred and twenty-nine women responded to the survey. Half of the respondents (n = 165) had high knowledge level scores on cervical cancer screening. The cervical cancer screening rate was 28.3%. Utilization of screening was associated with knowledge (P = 0.000, r = -0.392) and selected demographic factors (P = 0.000). Individual barriers included poor knowledge on availability of screening services, community barriers included living in a rural area, and health provider and systems barriers included lack of awareness campaigns, negative attitudes of healthcare providers toward clients, and long waiting times; all barriers limit the access to screening services. Conclusion: A low rate of cervical cancer screening was identified for women attending selected district hospitals in Kigali-Rwanda due to various barriers. On-going education on cervical cancer and its screening is highly recommended. It is important that trained health providers encourage their clients to have cervical cancer screening and work to reduce related barriers.


2020 ◽  
Author(s):  
Tegan Dutton ◽  
Jo Marjoram ◽  
Shellie Burgess ◽  
Laurinne Campbell ◽  
Anne Vail ◽  
...  

Abstract Background: Aboriginal women experience disproportionately higher rates of cervical cancer mortality yet are less likely to participate in screening for early detection. This study sought to determine whether a community-based HPV self-sampling service model can effectively recruit never-screened and under-screened Aboriginal women to participate in cervical cancer screening; assess the clinical outcomes; and explore the acceptability of the model from the perspective of the participants.Methods: Aboriginal women aged 25-69 years of age were recruited from eight rural and remote communities in New South Wales, Australia to participate in HPV self-sampling via a community-based service model. Outcome measures were: number of women screened by HPV self-sampling, their prior cervical screening status (under-screened or never-screened), clinical outcomes and participation in follow-up pathways of care, and satisfaction with the service model.Results: In total, 215 women conducted a HPV self-sampling test and 200 evaluation surveys were completed. One-fifth of participants (n=46) were never-screened and one-third (n=69) were under-screened. Many were unsure of their screening status. Nine women were HPV 16/18 positive and eight had completed all follow up by the conclusion of the study. A further 30 women tested positive for a high risk type other than HPV 16/18 (HPV other), of which 14 had completed follow up at the conclusion of the study. Satisfaction with the HPV self-sampling kit, the process of self-sampling and the service model was high (>92% satisfied on all items). Many women had difficulty understanding their official HPV results and placed high importance on the nurse explaining it to them.Conclusions: A community-based service model that respects Aboriginal Women’s Business can effectively recruit under-screened and never-screened Aboriginal women to complete cervical cancer screening. Furthermore, this service model supports them to complete recommended follow-up care and engage with their local existing health services.


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