scholarly journals Barriers and Facilitators to Integrating Clinical Breast Examinations With Cervical Cancer Screening Programs in Outpatient Clinics in Western Kenya

2021 ◽  
pp. 1722-1729
Author(s):  
Prisca C. Diala ◽  
Magdalene Randa ◽  
Jackline Odhiambo ◽  
Gregory Ganda ◽  
Craig R. Cohen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Patient Education ◽  
Cervical Cancer Screening ◽  
Clinical Training ◽  
Barriers And Facilitators ◽  
Screening Programs ◽  
Clinical Breast ◽  
Clinical Breast Examinations

PURPOSE Nearly half of Kenyan women with breast cancer present with advanced disease—owing partially to limited patient education and screening limitations in low- and middle-income countries. With increasing access to nurse-led cervical cancer screening (CCS) in government clinics in Kenya, we investigated provider-perceived barriers and facilitators to integrating clinical breast examinations (CBEs) with ongoing CCS programs in Kisumu County, Kenya. METHODS CCS providers within the Ministry of Health Clinics in Kisumu County, Kenya, were recruited to participate in a two-phase, sequential, mixed methods study. Knowledge of CBE guidelines was assessed with a questionnaire. Providers with significant CCS and CBE experience then completed a one-on-one interview discussing barriers and facilitators to integration. RESULTS Sixty-nine providers from 20 randomly selected facilities participated in the survey. Providers all agreed that breast cancer screening was very important. Although 93% said that they routinely offered CBEs, only 22% of these providers screened at least eight of their last 10 patients. Forty-four percent identified four or more of five signs and symptoms of breast cancer, and 33% identified four to five risk factors. Although providers showed enthusiasm for integration of CBEs into their practices, barriers were identified and grouped into four themes: (1) fragmentation of services, (2) staffing shortage and inadequate on-the-job training, (3) limited space and referral system challenges, and (4) limited patient awareness on need for cancer screening. CONCLUSION Addressing providers' concerns by providing routine on-the-job clinical training, improving staffing shortages, strengthening the diagnostic and treatment referral pathway, and increasing patient education are some of the first steps in facilitating integration of CBEs with CCS services in primary care clinics in Kenya.

Barriers to Cervical Cancer Screening and Treatment in the Dominican Republic: Perspectives of Focus Group Participants in the Santo Domingo Area

2019 ◽  
Vol 31 (2) ◽  
pp. 121-127 ◽  
Author(s):  
Erica J. Liebermann ◽  
Nancy VanDevanter ◽  
Taraneh Shirazian ◽  
Natalia Frías Gúzman ◽  
Mimi Niles ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Dominican Republic ◽  
Cervical Cancer Screening ◽  
Pap Smear ◽  
Barriers And Facilitators ◽  
Santo Domingo ◽  
Pap Screening ◽  
Screening Programs ◽  
Pap Smear Screening

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.

scholarly journals Barriers to and Facilitators of Cervical Cancer Screening among Women in Southeast Asia: A Systematic Review

2021 ◽  
Vol 18 (9) ◽  
pp. 4586
Author(s):  
Brandon Chua ◽  
Viva Ma ◽  
Caitlin Asjes ◽  
Ashley Lim ◽  
Mahsa Mohseni ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Southeast Asia ◽  
Cervical Cancer Screening ◽  
The Philippines ◽  
Barriers And Facilitators ◽  
Pap Smears ◽  
Screening Programs ◽  
Education Status ◽  
Low Coverage

In Southeast Asia, cervical cancer is the second most common cancer in women. Low coverage for cervical cancer screening (CCS) becomes a roadblock to disease detection and treatment. Existing reviews on CCS have limited insights into the barriers and facilitators for SEA. Hence, this study aims to identify key barriers and facilitators among women living in SEA. A systematic literature review was conducted on Pubmed, Embase, PsycINFO, CINAHL, and SCOPUS. Primary qualitative and quantitative studies published in English that reported barriers and facilitators to CCS were included. The Mix Methods Appraisal Tool was used for the quality assessment of the included studies. Among the 93 included studies, pap smears (73.1%) were the most common screening modality. A majority of the studies were from Malaysia (35.5%). No studies were from Timor-Leste and the Philippines. The most common barriers were embarrassment (number of articles, n = 33), time constraints (n = 27), and poor knowledge of screening (n = 27). The most common facilitators were related to age (n = 21), receiving advice from healthcare workers (n = 17), and education status (n = 11). Findings from this review may inform health policy makers in developing effective cervical cancer screening programs in SEA countries.

Systematic review of cervical cancer prevalence and determinants of early detection in Sub-Saharan Africa

2018 ◽  
Vol 1 (1) ◽  
pp. 32-36
Author(s):  
Eleazar Ndabarora ◽  
Dariya Mukamusoni ◽  
Clarte Ndikumasabo ◽  
Védaste Ngirinshuti
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Early Detection ◽  
Cervical Cancer Screening ◽  
Sub Saharan Africa ◽  
Extensive Literature ◽  
Early Management ◽  
Screening Programs ◽  
Mesh Terms ◽  
Sub Saharan

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.

Cancer screening. Current state of the problem

2020 ◽  
pp. 4-12
Author(s):  
Marina Kochiyeva
Keyword(s):  
Breast Cancer ◽  
Cervical Cancer ◽  
Colon Cancer ◽  
Cancer Screening ◽  
Target Population ◽  
Evidence Based ◽  
Screening Programs ◽  
Current State ◽  
Methodological Approaches ◽  
Based Medicine

Data on modern methodological approaches that are used in screening for cancer are summarized. General principles of organizing screening studies are examined from the perspective of evidence-based medicine, target population, research methods, and effectiveness of the implemented screening programs for breast cancer, cervical cancer, and colon cancer are determined.

scholarly journals Automated Quantitative Cytology Imaging Analysis System in Cervical Cancer Screening in Shanxi Province, China

2017 ◽  
Vol 6 (2) ◽  
pp. 51 ◽  
Author(s):  
Yan Dong ◽  
Jigeng Bai ◽  
Yuping Zhang ◽  
Guangjie Shang ◽  
Yan Zhao ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Population Based ◽  
Shanxi Province ◽  
Detection Rates ◽  
Screening Programs ◽  
Quantitative Cytology ◽  
Automated Platform

Purpose: In China the number of pathologists is far from being enough to meet the demands of ongoing population based cervical cancer screening programs. This article aims to present our experience with automated quantitative cytology imaging platform, a reading system with an artificial intelligence that we currently use routinely for cervical cancer screening in Shanxi province.Methods: From 2012-2016 a total of 40 178 women were screened. Women were divided into three groups and each group had two subgroups. Smear and liquid based technique were compared using manual and automated platform.Results: Detection rates of CIN2 + and positive rates of CIN2 were higher in all three groups when automated quantitative cytology platform was used compared with groups where reading was done by the pathologist using conventional microscope. Operator’s costs associated with automated quantitative cytology platform vs. conventional reading using light microscope were compared too. The overall costs of operations based on automated platform were proven to be lower.Conclusion: The use of automated platform and artificial intelligence as a means to overcome the lack of cytotechnologists and pathologists and to implement proper quality control in the large scale population based cervical cancer screening seems very promising.

scholarly journals Role of Protein Biomarkers in the Detection of High-Grade Disease in Cervical Cancer Screening Programs

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Charlotte A. Brown ◽  
Johnannes Bogers ◽  
Shaira Sahebali ◽  
Christophe E. Depuydt ◽  
Frans De Prins ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Cervical Screening ◽  
False Negative ◽  
Pap Test ◽  
Developed Countries ◽  
Protein Biomarkers ◽  
Ki 67 ◽  
Screening Programs

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.

Sign in / Sign up

Export Citation Format

Share Document