scholarly journals Facilitators and Barriers to Cervical Cancer Screening in Migori County, Kenya

2016 ◽  
Vol 2 (3_suppl) ◽  
pp. 82s-82s
Author(s):  
Holly Nishimura ◽  
Nelly Yatich ◽  
Megan Huchko
Keyword(s):  
Cervical Cancer ◽  
Focus Group ◽  
Cancer Prevention ◽  
Cervical Cancer Prevention ◽  
Sub Saharan Africa ◽  
Hpv Testing ◽  
Community Members ◽  
Screening Programs ◽  
Barriers To Screening ◽  
Incidence And Mortality

Abstract 77 Background: Cervical cancer, a disease that is largely preventable through organized screening programs, still impacts over 500,000 women every year. Sub-Saharan Africa has the highest global incidence and mortality, largely due to lack of screening coverage. Low-cost and simple-to-implement screening technologies can potentially impact the rates of cervical cancer, if they are acceptable and scalable. As part of a trial to evaluate implementation strategies for cervical cancer prevention in western Kenya, we sought to identify the barriers and facilitators of screening, as well as opinions on a strategy employing self-collection of specimens for human papillomavirus (HPV) testing. Methods: Providers and female community members were recruited for focus groups using purposive sampling. Two focus group discussions (FGDs) with community members (n=24) and one FGD with providers (n=12) and key stakeholders were held in Migori County, Kenya, using structured guides to assess and current cervical cancer knowledge, screening practices, barriers to screening and potential strategies to facilitate screening access and uptake, including self-collected HPV testing. Results: Participants in both groups assessed the education around HPV, cervical cancer, and screening as very low in the community, and identified this lack of education as the main barrier to screening. Community members reported fear of pain and embarrassment as significant barriers to a screening pelvic exam. They also reported that lack of knowledge and discomfort among providers were significant barriers. Having undergone screening themselves or talking to someone with experience increased willingness to screen. Providers reported workload and lack of supplies and trained staff as significant barriers. Most participants in both FGDs felt that self-collection would help address barriers. Women expressed willingness to self-collect if given adequate instructions and if knowledgeable counselors were present to discuss results. Conclusion: Cervical cancer prevention strategies employing effective educational components and self-collected HPV testing could address many of the identified barriers to screening. Key findings from analysis of the focus group transcripts will be used to inform the implementation of community health campaigns. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: No COIs from the authors.

Human Papillomavirus Selected Properties and Related Cervical Cancer Prevention Issues

2020 ◽  
Vol 26 (18) ◽  
pp. 2073-2086
Author(s):  
Saule Balmagambetova ◽  
Andrea Tinelli ◽  
Ospan A. Mynbaev ◽  
Arip Koyshybaev ◽  
Olzhas Urazayev ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cancer Prevention ◽  
Screening Program ◽  
Hpv Infection ◽  
Cervical Cancer Prevention ◽  
Point Of View ◽  
Prevention Strategies ◽  
Middle Income ◽  
Screening Programs

High-risk human papillomavirus strains are widely known to be the causative agents responsible for cervical cancer development. Aggregated damage caused by papillomaviruses solely is estimated in at least 5% of all malignancies of the human body and 16% in cancers that affect the female genital area. Enhanced understanding of the complex issue on how the high extent of carcinogenicity is eventually formed due to the infection by the Papoviridae family would contribute to enhancing current prevention strategies not only towards cervical cancer, but also other HPV associated cancers. This review article is aimed at presenting the key points in two directions: the current cervical cancer prevention and related aspects of HPV behavior. Virtually all applied technologies related to HPV diagnostics and screening programs, such as HPV tests, colposcopy-based tests (VIA/VILI), conventional and liquid-based cytology, currently available are presented. Issues of availability, advantages, and drawbacks of the screening programs, as well as vaccination strategies, are also reviewed in the article based on the analyzed sources. The current point of view regarding HPV is discussed with emphasis on the most problematic aspect of the HPV family concerning the observed increasing number of highly carcinogenic types. Present trends in HPV infection diagnostics throughout the human fluids and tissues are also reported, including the latest novelties in this field, such as HPV assay/self-sample device combinations. Besides, a brief outline of the related prevention issues in Kazakhstan, the leading country of Central Asia, is presented. Kazakhstan, as one of the post-soviet middle-income countries, may serve as an example of the current situation in those terrains, concerning the implementation of globally accepted cervical cancer prevention strategies. Along with positive achievements, such as the development of a nationwide screening program, a range of drawbacks is also analyzed and discussed.

Cervical Cancer Screening in Tuscany: A Survey of the Actual State of Cervical Cancer Prevention in the Local Sanitary Units of the Tuscan Region

1988 ◽  
Vol 74 (3) ◽  
pp. 253-256 ◽  
Author(s):  
Silvia Cecchini ◽  
Grazia Grazzini ◽  
Stefano Ciatto
Keyword(s):  
Cervical Cancer ◽  
Quality Control ◽  
Data Collection ◽  
Cancer Prevention ◽  
Screening Program ◽  
Cost Benefit ◽  
Cervical Cancer Prevention ◽  
Actual State ◽  
Quality Of Data ◽  
Screening Programs

Every Local Sanitary Unit (USL) of the Tuscan Region was contacted to define screening variables, such as adequacy of the staff involved in prevention, smear technique, data collection and evaluation, laboratory quality control, and modalities of invitations to screening. The reported data show that 21 of 40 USL, but only 9 of 28 USL outside the Florence province (where a common screening program is performed), are performing active invitations to screening. The most serious staff inadequacies concern data evaluation and personnel performing the test. Sixteen of 28 USL outside Florence suggest an annual rescreening, which causes overcrowding of services and a poor availability for the unscreened population. Moreover, the poor quality of data collection makes it impossible to evaluate the benefit offered by the screening programs in the 28 USL outside Florence. Cytologic quality control is often lacking, and the smear technique is inadequate in 10 of 28 USL outside Florence. The lack in the USL of epidemiologic competence and of cost/benefit considerations and the need for political decisions about cancer prevention programs are stressed.

scholarly journals Prevention of Cervical Cancer in Sub-Saharan Africa: The Advantages and Challenges of HPV Vaccination

Vaccines ◽  
2018 ◽  
Vol 6 (3) ◽  
pp. 61 ◽  
Author(s):  
Eleanor Black ◽  
Robyn Richmond
Keyword(s):  
Cervical Cancer ◽  
Hpv Vaccination ◽  
Sub Saharan Africa ◽  
Current Status ◽  
Public Health Issue ◽  
Successful Implementation ◽  
Screening Programs ◽  
Incidence And Mortality ◽  
Sub Saharan ◽  
Ssa Countries

Cervical cancer is a critical public health issue in sub-Saharan Africa (SSA), where it is the second leading cause of cancer among women and the leading cause of female cancer deaths. Incidence and mortality rates are substantially higher than in high-income countries with population-based screening programs, yet implementing screening programs in SSA has so far proven to be challenging due to financial, logistical, and sociocultural factors. Human Papillomavirus (HPV) vaccination is an effective approach for primary prevention of cervical cancer and presents an opportunity to reduce the burden from cervical cancer in SSA. With a number of SSA countries now eligible for Global Alliance for Vaccines and Immunization (GAVI) support for vaccine introduction, it is timely to consider the factors that impede and facilitate implementation of vaccine programs in SSA. This article describes epidemiological features of cervical cancer in SSA and the current status of HPV vaccine implementation in SSA countries. Rwanda’s experience of achieving high vaccination coverage in their national HPV immunization program is used as a case study to explore effective approaches to the design and implementation of HPV vaccination programs in SSA. Key factors in Rwanda’s successful implementation included government ownership and support for the program, school-based delivery, social mobilization, and strategies for reaching out-of-school girls. These findings might usefully be applied to other SSA countries planning for HPV vaccination.

scholarly journals Onsite training of clinicians on new techniques to improve cervical cancer prevention in sub-Saharan Africa

2019 ◽  
Vol 30 (4) ◽  
pp. 551-552 ◽  
Author(s):  
Joel Fokom Domgue ◽  
Florence Manjuh ◽  
Kathleen Nulah ◽  
Thomas Welty ◽  
Alan Waxman
Keyword(s):  
Cervical Cancer ◽  
Cancer Prevention ◽  
Cervical Cancer Prevention ◽  
Sub Saharan Africa ◽  
New Techniques ◽  
Sub Saharan

scholarly journals HPV Testing of Self-Collected Vaginal Swabs for Cervical Cancer Prevention in South Africa

2016 ◽  
Vol 2 (3_suppl) ◽  
pp. 65s-66s ◽  
Author(s):  
Louise Kuhn ◽  
Rakiya Saidu ◽  
Cecilia Svanholm-Barrie ◽  
Ana Tergas ◽  
Rosalind Boa ◽  
...  
Keyword(s):  
South Africa ◽  
Health Care ◽  
Cervical Cancer ◽  
Conflicts Of Interest ◽  
Vaginal Swab ◽  
Cervical Cancer Prevention ◽  
Hpv Testing ◽  
Cervical Sample ◽  
Screening Programs ◽  
Vaginal Swabs

Abstract 33 Background: Cervical cancer screening programs in Low and Middle Income Countries (LMIC) need to be strengthened. One of the challenges is insufficient health care personnel to achieve optimal coverage. We evaluated the potential of human papillomavirus (HPV) testing using self-collected vaginal swabs to improve screening. Methods: As part of a larger NCI-supported study in Cape Town, South Africa, we recruited 261 HIV-uninfected and 237 HIV-infected women aged 30-60 years, at one primary health care site. All women were instructed to self-collect a vaginal swab on site immediately prior to a gynecologic exam, during which a cervical sample was collected. Both self- and clinician-collected samples were tested for high risk HPV types (16, 18, 45, 31, 33, 35, 52, 58, 51, 59, 39, 56, 66, 68) using Cepheid GeneXpert (HPV XpertTM). All women underwent at least one colposcopy with histological sampling. Classification of endpoint was based on expert pathology review. Results: The HPV prevalence using the cervical vs. self sample, respectively, was 14% vs. 25% among HIV-uninfected and 50% vs. 62% among HIV-infected women. Among women who were diagnosed with grade 2 or 3 cervical intraepithelial neoplasia (CIN) or cervical cancer, 94% were positive on HPV Xpert on the cervical and 88% on the vaginal swab, ignoring HIV status. However, specificity was poor for HPV tests done on self samples, 78% in HIV-uninfected and 52% in HIV-infected women. On a patient preference questionnaire, >90% of women stated they would be prepared to collect a sample at home and two-thirds expressed a preference to be examined by a clinician. Conclusion: Even in self-collected vaginal samples, HPV Xpert has excellent sensitivity for detecting cervical cancer precursor lesions. In LMIC settings where the ratio of health care workers to the population is low, HPV testing of self-collected samples could successfully triage women who require further evaluation and treatment. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: Louise Kuhn No relationship to disclose Rakiya Saidu No relationship to disclose Cecilia Svanholm-Barrie No relationship to disclose Ana Tergas Consulting or Advisory Role: Helomics Rosalind Boa No relationship to disclose Jennifer Moodley No relationship to disclose Thomas C. Wright No relationship to disclose David Persing No relationship to disclose Scott Campbell No relationship to disclose Lynette Denny No relationship to disclose

scholarly journals Implementation strategies to improve cervical cancer prevention in sub-Saharan Africa: a systematic review

2018 ◽  
Vol 13 (1) ◽  
Author(s):  
Lauren G. Johnson ◽  
Allison Armstrong ◽  
Caroline M. Joyce ◽  
Anne M. Teitelman ◽  
Alison M. Buttenheim
Keyword(s):  
Systematic Review ◽  
Cervical Cancer ◽  
Cancer Prevention ◽  
Implementation Strategies ◽  
Cervical Cancer Prevention ◽  
Sub Saharan Africa ◽  
Sub Saharan

scholarly journals Prevention of Cervical Cancer in Sub-Saharan Africa: the Promises and Challenges of HPV Vaccination

2018 ◽  
Author(s):  
Eleanor Black ◽  
Robyn Richmond
Keyword(s):  
Cervical Cancer ◽  
Hpv Vaccination ◽  
Sub Saharan Africa ◽  
Current Status ◽  
Public Health Issue ◽  
Vaccination Programs ◽  
Screening Programs ◽  
Incidence And Mortality ◽  
Sub Saharan ◽  
Ssa Countries

In sub-Saharan Africa (SSA), cervical cancer is a critical public health issue; it is the second leading cause of cancer among women and the leading cause of female cancer deaths. Incidence and mortality rates are substantially higher than in high-income countries with population-based screening programs, yet implementing screening programs in SSA has so far proven to be challenging due to financial, logistical and sociocultural factors. Human Papillomavirus (HPV) vaccination is an effective approach for primary prevention of cervical cancer and presents an opportunity to reduce the burden from cervical cancer in SSA. With a number of SSA countries now eligible for GAVI support for vaccine introduction, it is timely to consider the factors that impede and facilitate implementation of vaccine programs in SSA. This article reviews the epidemiological and clinical features of cervical cancer in SSA and describes the current status of HPV vaccine implementation in SSA countries. The review considers the challenges that will need to be addressed, and effective approaches to the design and implementation of HPV vaccination programs, using Rwanda as a case study. The review aims to provide suggestions and guidance to those involved in the development and implementation of HPV vaccination programs in SSA.

scholarly journals Changing the paradigm of cervical cancer prevention through introduction of HPV-testing: evaluation of the implementation process of the Jujuy Demonstration Project in Argentina

2019 ◽  
Author(s):  
Silvina Arrossi ◽  
Melisa Paolino ◽  
Rosa Laudi ◽  
Laura Thouyaret
Keyword(s):  
Cervical Cancer ◽  
Screening Program ◽  
Implementation Process ◽  
Cervical Cancer Prevention ◽  
Political Support ◽  
Demonstration Project ◽  
Hpv Testing ◽  
Structured Interviews ◽  
Treatment Services ◽  
Incidence And Mortality

Abstract Background The Jujuy Demonstration Project (JDP) was a four-year implementation project (2011-2014) to develop, implement and evaluate the programmatic components of an HPV-based screening program in Argentina . The aim of this paper is present a qualitative evaluation of the context and implementation process of JDP. Methods We used an adaptation of the Health System Framework (HSF), which includes contextual interconnected factors that are considered key drivers for successful health interventions. We reviewed Secondary Documents, which included program reports, information sheets, power point presentations, and minutes of meetings and management round-tables. We also carried out semi-structured interviews to key informants to explore their views about technology acceptability. Results Key components of JDP implementation process were high level of political support and consensus among stakeholders, the demonstrated effectiveness of the technology and its acceptability by health authorities and providers, funding of tests and diagnosis/treatment services, implementation of an information system for monitoring and evaluation, and the reorganization of the network of screening diagnosis and treatment services. Conclusion This analysis has made explicit the policy context in which the JDP was implemented, and system components that were key for the demonstrated effectiveness of the strategy. Such analyses provide useful insights into core components of HPV-testing implementation that are needed to guarantee its potential effectiveness to reduce cervical cancer incidence and mortality .

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