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 Using photovoice to understand the context of cervical cancer screening for underserved communities in rural India

2020 ◽  
Vol 27 (4) ◽  
pp. 50-58
Author(s):  
Prajakta Adsul ◽  
Shivamma Nayaka ◽  
Rashmi Pramathesh ◽  
Savitha Gowda ◽  
Poornima Jaykrishna ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Cultural Beliefs ◽  
Target Population ◽  
Healthcare Services ◽  
Future Research ◽  
Underserved Communities ◽  
Screening Programs ◽  
The Social

Cervical cancer is the second most common cancer diagnosed among women in India and current estimates indicate low screening rates. To implement successful population-based screening programs, there is an urgent need to explore the social and cultural beliefs among women residing in underserved communities. An innovative, community-based participatory approach called photovoice was used with 14 women aged between 30–51 years, residing in rural and tribal villages around Mysore, Karnataka, India. Each participant was trained in photovoice techniques, provided with a digital camera, and asked to photo document their everyday realities that could influence their intentions to undergo cervical cancer screening. Over 6 months, participants took a total of 136 photos and participated in 42 individual interviews and two group discussions. These data helped identify specific beliefs prevalent in the target population and were organized according to the Integrated Behavior Model. Some women reported a lack of perceived susceptibility to cervical cancer whereas others mentioned the fatal nature of cancer as a disease and believed that no screening exam could prevent death if they were destined to get cancer. Husbands, mothers-in-law, and their peers in the community had an important influence on the social identity of women and influenced their intentions to participate in the screening exams. Seeking healthcare was associated with an economic burden, not only in terms of out-of-pocket expenses for healthcare services but also in missing daily labor wages or taking unpaid leave from work to seek healthcare when they were asymptomatic. Several action steps were proposed including: identifying community liaisons or champions, repeated community activities to raise awareness of cervical cancer, and educating men and other family members about women’s health issues. Study findings can conceptually help design and develop educational efforts for mobilizing women to undergo screening and inform future research to help understand disparities.

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.

Cancer screening in France: 3rd edition of the EDIFICE survey.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1568-1568
Author(s):  
Jérôme Viguier ◽  
Francois Eisinger ◽  
Yvan Coscas ◽  
Jean F. Morere ◽  
Jean-Yves Blay ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Screening Test ◽  
Prostate Cancer Screening ◽  
Age Groups ◽  
Target Population ◽  
Screening Programs

1568 Background: The EDIFICE survey program started in 2005 and was aimed at providing a better understanding of the participation of the French population in cancer screening programs and assess the evolution over time. The EDIFICE 3 survey was conducted in 2011, following EDIFICE 1 (2005) and EDIFICE 2 (2008), and focused on colorectal, breast and prostate cancer. Methods: This third nationwide observational study, EDIFICE 3, was conducted by phone interviews among a representative sample of 1603 subjects aged between 40 and 75 years, using the quota method. The analysis focused on the target population of the national screening programs for breast and colorectal cancer (50-74 years). The same population was analysed for prostate cancer screening behaviours. Results: For breast cancer, the rate of women attending at least one screening test was 93%/94%/95% in 2005/2008/2011 respectively. A mammography had been performed as recommended within the last two years for 75%/83%/83% among them. We observed an increase in timing compliance between 2005 and 2011, significant for women aged 65-74. For colorectal cancer, the rate of subjects attending at least one screening test was 25%/38%/59%. A fecal test or colonoscopy had been performed according to the recommended timing for NA/30%/51% among them. Colorectal cancer screening has increased significantly in all age groups, especially between 65 and 69 years, and for both genders. For prostate cancer, the rate of men having performed at least one screening test (PSA and/or rectal examination) was 36%/49%/50%.This rate have significantly decreased in men aged 50-59 between 2008 and 2011(44% vs 37%, p<0.05). Conclusions: For National Programs, the attendance rate remains high for breast cancer screening and is improving for colorectal cancer screening. However, the European guideline objective rate of participation for colorectal cancer screening has not yet been reached. Despite the absence of recommendations, prostate cancer screening is frequently carried out and stable overall.

Achieving quality: Comparing recommendations for cancer care between NCCN and ESMO.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6579-6579
Author(s):  
Jennifer Gao ◽  
Geoffrey Calkins ◽  
Michael J. Birrer ◽  
Don S. Dizon
Keyword(s):  
Breast Cancer ◽  
Colon Cancer ◽  
Evidence Based Medicine ◽  
B Cell Lymphoma ◽  
The United States ◽  
Treatment Recommendations ◽  
High Rate ◽  
Partial Breast Irradiation ◽  
Evidence Based ◽  
Based Medicine

6579 Background: Guidelines for the treatment of cancer are in place in both the United States and Europe. However, specific recommendations that can be utilized as measures of quality care have not been evaluated in either guideline set, nor have they have been compared against one another. Our aim was to delineate the number of concrete treatment recommendations made using the PICO model for evidence-based medicine. Methods: Three authors (JG, GC, DD) independently reviewed treatment guidelines of the National Comprehensive Cancer Network (NCCN) and the European Society for Medical Oncology (ESMO) for three common cancers: 1) breast cancer; 2) colon cancer; 3) non-Hodgkin lymphoma (specifically diffuse large B-cell lymphoma and follicular lymphoma). The primary objective was to differentiate the concordant versus discordant recommendations. Recommendations were identified by first identifying all category 1 and 2 guidelines in ESMO, then finding the equivalent NCCN recommendations, and finally assessing their fulfillment of the PICO model (Patient/Problem – Intervention – Comparison – Outcome). Each recommendation was separately analyzed by the three aforementioned authors of this abstract. The results reflect the unanimous agreement of all three reporters. Results: Using PICO criteria, we identified a total of 46 recommendations (10 colon cancer, 22 breast cancer, and 14 in NHL). Concordance between NCCN and ESMO was 80, 86, and 100 percent, respectively. Discordance between NCCN and ESMO were noted in first line chemotherapy regimens in localized colon cancer and fluoropyridine as maintenance therapy in unresectable colon cancer; patients who should receive partial breast irradiation and chemotherapy regimens in the elderly with breast cancer. Conclusions: The number of actual recommendations that meet the PICO evidence-based medicine criteria is relatively small. However, comparing NCCN and ESMO, there is a high rate of agreement between guidelines reviewed regarding treatment recommendations. Our data suggest that it may be possible to identify specific measures of quality treatment as defined by evidence based medicine criteria.

scholarly journals Cervical intraepithelial lesions in females attending Women's Health Clinics in Alexandria, Egypt

CytoJournal ◽  
2015 ◽  
Vol 12 ◽  
pp. 13 ◽  
Author(s):  
Mona Abdel-Hadi ◽  
Adel Khalaf ◽  
Hanaa Aboulkassem ◽  
Noha Naeem ◽  
Mohamed Abdel Baqy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Screening Program ◽  
Intraepithelial Neoplasia ◽  
Pap Smears ◽  
Cervical Lesions ◽  
Screening Programs ◽  
Life Saving ◽  
Egyptian Women

Background: Data from Egyptian studies provide widely varying estimates on the prevalence of preinvasive cervical lesions. The aim of this study was to estimate the rate of cervical intraepithelial neoplasia (CIN) in Egyptian women living in Alexandria to clarify the need for implementing a national organized screening program and a vaccination program in our community. Materials and Methods: The study was conducted over a 6 years period and covered the different socioeconomic levels to have a representative sample for women living in Alexandria. All women included did not have any cervical disorder related complaints. Conventional Pap smears were obtained and diagnosed using the Bethesda system. Women with abnormal Pap smears were managed according to the 2006 consensus guidelines within the available facilities. Persistent abnormal cytological results were referred for colposcopic biopsy. Histological results were grouped into: Reactive changes, CIN 1, CIN 2/CIN 3 and adenocarcinoma in-situ (AIS). Results: Out of the 6173 smears included in the study 6072 (98.36%) were normal and only 101 (1.63%) were abnormal. After colposcopic biopsies, 0.08% had CIN 1, 0.03% had CIN 2, 3 and 0.01% had AIS. Conclusion: We concluded that cervical cancer screening programs, although life-saving for a number of women, are not a sufficiently high priority in our community. Money for national health screening programs should preferably be directed more towards recruiting women for breast cancer screening, since breast cancer accounts for about 33% of all female cancers in Egypt ranking number one, while cervical cancer ranks number 13.

scholarly journals 325. Cancer Screening Disparities among Persons Living with HIV (PLWH)

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S172-S172
Author(s):  
Kristen Hysell ◽  
Wei He ◽  
Yuchiao Chang ◽  
Scott Dryden-Peterson ◽  
Virginia A Triant
Keyword(s):  
Breast Cancer ◽  
Cervical Cancer ◽  
Colon Cancer ◽  
Cancer Screening ◽  
Healthcare System ◽  
Colon Cancer Screening ◽  
Older Age ◽  
Research Network ◽  
Persons Living With Hiv ◽  
Living With Hiv

Abstract Background Cancer is now the leading cause of mortality for persons living with HIV (PLWH) in the United States, but it is uncertain whether PLWH access cancer screening that could lower this burden. We sought to assess cancer screening for breast, cervical, and colon cancer among PLWH compared with the HIV-uninfected population at a multicenter healthcare system over the past two decades. Methods Data were obtained from a prospective, observational HIV clinical care cohort comprised of PLWH engaged in care in the Partners Healthcare System. Patients eligible for cancer screening between the years 2002 and 2016 were included. Patients were matched in a maximum of 1:4 ratio with HIV-uninfected patients from the Massachusetts General Primary Care Practice-Based Research Network based on age, sex, race, year of study entry, and length of follow-up. The mean proportion of time in which eligible patients were guideline concordant for cervical, breast, and colon cancer screening was assessed. Non-parametric tests were used to compared screening rates between PLWH and HIV-infected and on the basis of multiple clinical and sociodemographic factors. Results During the observation period, a total of 495 PLWH were eligible for breast cancer screening, 1011 for cervical cancer screening, and 1965 for colon cancer screening. For each screening group, the majority of PLWH were on antiretroviral therapy (ART) and had relatively high CD4 cell counts (Table 1). Screening rates for PLWH compared with controls were 67.3% vs. 82.8% (P < 0.0001) for breast cancer, 49.0% vs. 73.3% (P < 0.0001) for cervical cancer, and 92.7% vs. 91.2% (P = 0.96) for colon cancer (Figure 1). Among PLWH, factors significantly associated with lower rates of screening guideline concordance were older age, lower CD4 count, HIV-1 RNA >1000 copies/mL, and HIV duration < 5 years for breast cancer, and older age, white race, English language, and lack of ART use for cervical cancer. Conclusion Among patients engaged in longitudinal care, PLWH had significantly lower rates of screening for breast and cervical cancer than HIV-uninfected. Disparity is not explained by racial or primary language differences. Further work to improve access to cancer screening for PLWH is needed. Disclosures All authors: No reported disclosures.

Promoting Participation in a Population Screening Program for Breast and Cervical Cancer: A Randomized Trial of Different Invitation Strategies

1998 ◽  
Vol 84 (3) ◽  
pp. 348-353 ◽  
Author(s):  
Nereo Segnan ◽  
Carlo Seriore ◽  
Livia Giordano ◽  
Antonio Ponti ◽  
Guglielmo Ronco
Keyword(s):  
Breast Cancer ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Screening Program ◽  
Block Design ◽  
Population Screening ◽  
Screening Programs ◽  
Group A ◽  
Group B ◽  
Group D

Aims and background Attendance level has been identified as a major determinant of cost-effectiveness of organized screening programs. We tested the effectiveness of 4 different invitation systems in the context of an organized population screening program for cervical and breast cancer. Methods Women eligible for invitation - 8385 for cervical and 8069 for breast cancer screening - listed in the rosters of 43 and 105 general practitioners (GP), respectively, who had accepted to collaborate in the program, were randomized to 4 invitation groups: Group A - letter signed by the GP, with a prefixed appointment; Group B - open-ended invitation, signed by the GP, prompting women to contact the screening center to arrange an appointment; Group C - letter (same as for group A), signed by the program coordinator, with a prefixed appointment; Group D - extended letter (highlighting the benefits of early cancer detection) signed by the GP, with a prefixed appointment. Assignment to the interventions was based on a randomized block design (block=GP). Results Assuming Group A as the reference, the overall compliance with cervical cancer screening was reduced by 39% in Group B (RR=0.61; 95% CI, 0.56-0.68) and by 14% in Group C (RR=0.86; 95% CI, 0.78-0.93); no difference was observed for Group D (RR=1.03; 95% CI, 0.95-1.1). The response pattern was similar for breast screening (Group B: RR=0.71; 95% CI, 0.65-0.76; Group C: RR=0.87; 95% CI, 0.81-0.94; Group D: RR=1.01; 95% CI, 0.94-1.08). Conclusions Personal invitation letters signed by the woman's GP, with preallocated appointments, induce a significant increase in compliance with screening. Efficiency can be ensured through the adoption of overbooking, provided that attendance levels are regularly monitored.

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