scholarly journals Organised Versus Opportunistic Cervical Cancer Screening in Urban and Rural Regions of Lithuania

Medicina ◽  
2019 ◽  
Vol 55 (9) ◽  
pp. 570 ◽  
Author(s):  
Justina Paulauskiene ◽  
Rugile Ivanauskiene ◽  
Erika Skrodeniene ◽  
Janina Petkeviciene

Background and Objectives: In 2004, Lithuania started the Nationwide Cervical Cancer Screening Programme. However, screening is more opportunistic than population-wide and the programme’s coverage is insufficient. The aim of this study was to assess the effect of systematic personal invitation on coverage of cervical cancer (CC) screening in urban and rural regions of Lithuania. Materials and Methods: The study was conducted in an urban primary healthcare centre (PHCC) and in a rural PHCC, where prevailing CC screening practice was highly opportunistic. Over the first year, all women aged 25–60 who had not received a Pap smear test within the last three years in urban (n = 1591) and rural (n = 1843) PHCCs received a personal invitation letter to participate in the screening. Over the second year, the reminder letter was sent to the non-attendees (n = 1042 in urban and n = 929 in rural PHCCs). A random sample of women (n = 93), who did not attend for screening after two letters, was contacted by phone in order to identify the barriers of non-attendance. Results: Before the study, only 9.6% of the target population in urban and 14.7% in rural PHCCs participated in CC screening. After the first invitation letter, the participation in CC screening increased up to 24.6% in urban and 30.8% in rural areas (p < 0.001). After the reminder letter, the attendance was 16.4% in urban and 22.2% in rural PHCCs (p < 0.001). The most common barriers for the non-attendance were lack of time, long waiting time for family doctor’s appointment, worries that a Pap test might be unpleasant and preventive gynaecological examination outside of the screening program. Conclusions: A systematic personal invitation with one reminder letter significantly increased the coverage of CC screening and was more effective in rural regions than in urban regions. The assessed barriers for non-attendance can be used to improve the coverage of screening.

Author(s):  
Parth H. Vyas ◽  
Kanchan Dhadwe ◽  
Harsha A. Shah ◽  
Hiral M. Dave ◽  
Ashwin A. Shah

Background: Carcinoma of the uterine cervix is a major health problem faced by the Indian women. Regular cervical cytological examination by all sexually active women can prevent the occurrence of carcinoma cervix. Early detection of cervical cancer is possible with Pap smear tests. Methods: Women above 25 years of age, living in study area and want to participate in study were included. Total 2352 women were enrolled in study. House to house visits were conducted in all the village area by using simple random sampling method. Information about cervical cancer was given. Pap test for cervical cancer screening was carried out by gynaecologist. Cytological examination and confirmation was done by pathologists.Results: A total of 3001 women had attended village level IEC session and out that, 2352 (78.4%) women took part in the screening program. Out of these 2352 women, 2007 women (85.3% compliance) had given consent for physical cervical examination and Pap smear. The incidence of cervical cancer was 0.2% on the basis of clinical examination and biopsy.Conclusions: Higher compliance for undergoing vaginal examination and Pap test shows the positive health seeking behaviour of the women but for that, strong IEC and sensitization about the disease must be done to improve the participation. Sensitivity of Pap test was poor and couldn’t find true positive cases.


2020 ◽  
Vol 7 (2) ◽  
pp. 239-246
Author(s):  
J. S. Misra ◽  
A. N. Srivastava ◽  
Shivani Singh

Carcinoma cervix is a major health problem faced by Indian women and situation is very alarming in rural population because of illiteracy and poverty. There is urgent need of creating awareness regarding the risk factors of cervical cancer such as early marriage and multiparity in the rural women and the importance of early detection of the cervical cancer. With aim for providing single life time Pap smear cover to the rural women, cervical cancer screening program was initiated in May 2013 by Era's Lucknow, Medical College and Hospital, Lucknow, through organizing camps in the villages of Lucknow ,west. Till December 2019, a total of 183 camps have been organized and 5209 women attended these camps (28.5%). Pap smear examination could be done in only 2912 women (55.9%). The incidence of squamous intraepithelial lesions of cervix (SIL) was found to be very high in these women (17.1%) though majority of SIL were of low grade (LSIL). This may be related to the poor personal genital hygiene prevailing in rural women due to illiteracy. In the present review, the SIL incidence has been extensively analyzed in relation to different predisposing factors of cervical carcinogenesis and problems faced during camp organization and the benefits derived from these camps to rural women have been highlighted.


2013 ◽  
Vol 12 (1) ◽  
pp. 18-20 ◽  
Author(s):  
M Joshi ◽  
SR Mishra

Cervical cancer screening is a process using the Pap smear to identify precancerous and potentially precancerous changes in cervical cells and tissue. Cervical cancer acts as the biggest killer and most preventable cancer in Nepalese women. This paper tries to give a brief overview of cervical cancer screening program in Nepal. Various published and unpublished literatures were obtained and reviewed from international journals, local newspapers and books. All literatures were systematically reviewed and analyzed. Human papilloma virus (HPV) infection is chiefly the reason for cervical cancer. In majority cases, early exposure to sexual intercourse, multiple sex partners and addiction are considered as risk factor. In Developing country like Nepal, screening for cervical cancers is not easily available to people at risk. A vaccine is available which reduces the risk of HPV. The vaccine will be effective if received before the onset of sexual activities 9-13 years. Cervical cancer screening program has many difficulties in terms of limited medical services, difficult geographical terrain creating difficulties in delivering health services. Special programs needs to be designed and delivered to population focusing on reducing burden of cervical cancer. DOI: http://dx.doi.org/10.3126/hprospect.v12i1.8723 Health Prospect: Journal of Public Health Vol.12(1) 2013: 18-20


Author(s):  
Justina Paulauskiene ◽  
Mindaugas Stelemekas ◽  
Rugile Ivanauskiene ◽  
Janina Petkeviciene

In Lithuania, cytological screening of cervical cancer (CC) is largely opportunistic. Absence of standardized systematic invitation practice might be the reason for low participation rates. The study aimed to assess the cost-effectiveness of systematic invitation approach in CC screening programme from the perspective of a healthcare provider. A decision tree was used to compare an opportunistic invitation by a family doctor, a personal postal invitation letter with appointment time and place, and a personal postal invitation letter with appointment time and place with one reminder letter. Cost-effectiveness was defined as an incremental cost-effectiveness ratio (ICER) per one additionally screened woman and per one additional abnormal Pap smear test detected. The ICER of one personal postal invitation letter was €9.67 per one additionally screened woman and €55.21 per one additional abnormal Pap smear test detected in comparison with the current screening practice. The ICER of a personal invitation letter with an additional reminder letter compared to one invitation letter was €13.47 and €86.88 respectively. Conclusions: A personal invitation letter approach is more effective in increasing the participation rate in CC screening and the number of detected abnormal Pap smears; however, it incurs additional expenses compared with current invitation practice.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Alida Manoëla Datchoua Moukam ◽  
Muriel Samartha Embolo Owono ◽  
Bruno Kenfack ◽  
Pierre Vassilakos ◽  
Patrick Petignat ◽  
...  

Abstract Background Cervical cancer is the second leading cause of cancer-related death among women in sub-Saharan countries, constituting a major public health concern. In Cameroon, cervical cancer ranks as the second most common type of cancer among women and the leading cause of cancer-related deaths, mainly due to the lack of prevention. Objectives Our first and main objective was to understand the barriers affecting women’s decision-making process regarding participation in a cervical cancer screening program in the Dschang district (West Cameroon). Second, we aimed to explore the acceptability and perception of a single-visit approach (screen and treat). Methods A qualitative study using focus groups (FGs) was conducted from February to March 2020. Female participants aged between 30 and 49 years and their male partners were invited to participate. Thematic analysis was used, and barriers were classified according to the three-delay model of Thaddeus and Maine. Results In total, six FGs with 43 participants (31 women and 12 men) were conducted. The most important barriers were lack of health literacy, low accessibility of the program (in respect to cost and distance), and disrespectful treatment by healthcare workers. Conclusions Our study identified three needs: (1) enhancing health literacy; (2) improving the delivery of cervical cancer screening in rural areas; and (3) providing training for healthcare providers and community healthcare workers to improve patient-provider-communication. Trial registration Ethical Cantonal Board of Geneva, Switzerland (CCER, N°2017-0110 and CER-amendment n°3) and Cameroonian National Ethics Committee for Human Health Research (N°2018/07/1083/CE/CNERSH/SP). NCT: 03757299


2006 ◽  
Vol 4 (2) ◽  
pp. 13-24 ◽  
Author(s):  
Myriam Leyva ◽  
Theresa Byrd ◽  
Patrick Tarwater

Pap smear testing continues to be the single most effective tool in reducing deaths due to cervical cancer (Watkins, Gabali, Winkleby, Gaona & Lebaron, 2002). Despite the creation of a national cervical cancer screening program, more than 4,000 women die every year in Mexico from this disease. This study explored the knowledge, attitudes, and behaviors of Mexican women regarding cervical cancer screening, and identified beliefs and barriers that may influence cervical health. All analyses compared women who had ever had a Pap test in their lives (“ever”) with women who had never had a Pap test (“never”). In bivariate analyses, the following variables were significantly associated (p


2015 ◽  
Vol 49 (0) ◽  
Author(s):  
Cibelli Navarro ◽  
Allex Jardim da Fonseca ◽  
Alexander Sibajev ◽  
Camila Iasmim de Andrade Souza ◽  
Daniela Souza Araújo ◽  
...  

OBJECTIVE To analyze the coverage of a cervical cancer screening program in a city with a high incidence of the disease in addition to the factors associated with non-adherence to the current preventive program.METHODS A cross-sectional study based on household surveys was conducted. The sample was composed of women between 25 and 59 years of age of the city of Boa Vista, RR, Northern Brazil who were covered by the cervical cancer screening program. The cluster sampling method was used. The dependent variable was participation in a women’s health program, defined as undergoing at least one Pap smear in the 36 months prior to the interview; the explanatory variables were extracted from individual data. A generalized linear model was used.RESULTS 603 women were analyzed, with an mean age of 38.2 years (SD = 10.2). Five hundred and seventeen women underwent the screening test, and the prevalence of adherence in the last three years was up to 85.7% (95%CI 82.5;88.5). A high per capita household income and recent medical consultation were associated with the lower rate of not being tested in multivariate analysis. Disease ignorance, causes, and prevention methods were correlated with chances of non-adherence to the screening system; 20.0% of the women were reported to have undergone opportunistic and non-routine screening.CONCLUSIONS The informed level of coverage is high, exceeding the level recommended for the control of cervical cancer. The preventive program appears to be opportunistic in nature, particularly for the most vulnerable women (with low income and little information on the disease). Studies on the diagnostic quality of cervicovaginal cytology and therapeutic schedules for positive cases are necessary for understanding the barriers to the control of cervical cancer.


Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1578
Author(s):  
Concetta P. Pelullo ◽  
Federica Cantore ◽  
Alessandra Lisciotto ◽  
Gabriella Di Giuseppe ◽  
Maria Pavia

The aims of this study were to evaluate the attendance to breast and cervical cancer screening and the related determinants in a low attendance area. A cross-sectional study was conducted among mothers of students attending secondary schools and university courses in Campania region, Southern Italy. Only 49.7% of the eligible women reported to have undergone mammography in the previous two years. Unemployed women, unsatisfied about their health status, with a family history of breast cancer, and having visited a physician in the previous 12 months were significantly more likely to have undergone mammography in the previous two years within an organized screening program. The attendance to cervical cancer screening in the interval of three years was reported to be 56.1% of women. Having a lower than graduation degree, being smokers, and having visited a physician in the previous 12 months were significant predictors of having had a Pap-smear in the previous three years in an organized screening program. In this study a very low attendance was found to both breast and cervical cancer organized screening programs. A strong commitment to their promotion is urgently needed, also to reduce inequalities of attendance of disadvantaged women.


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