Cervical Cancer Screening Rate and Willingness among Female Migrants in Shenzhen, China: Three-Year Changes in Citywide Surveys

Background:Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that carries an increased risk for both viral illnesses and malignancies, including a greater risk for both human papilloma virus (HPV) infection and cervical cancer. Due to this increased risk, the American Society of Colposcopy and Cervical Pathology guidelines for SLE patients recommend more frequent cervical cancer screening. Few studies have examined patient characteristics associated with decreased cervical cancer screening in patients with autoimmune disease, specifically SLE.Objectives:To estimate cervical cancer screening rates in women with recently diagnosed SLE, and to identify characteristics associated with decreased screening.Methods:We identified women with an initial diagnosis of SLE in the United States MarketScan Commercial Claims and Encounter (CCAE, age 18-64) administrative claims database. We included patients with at least three claims with a lupus diagnosis (first and last at least >90 days apart), no lupus claims within the year before initial claim, and who had been on antimalarial drugs for at least 90 days. We excluded all patients with a previous claim for hysterectomy.Cervical cancer screening was ascertained using diagnosis and procedure codes within 1 year before and 2 years after the first SLE claim. Our covariates included the year of first SLE claim (2001-2014), age at first SLE claim, comorbidity score, insurance type, geographical region, and prescriptions for multiple types of corticosteroids. Control patients included age-matched females without autoimmune disease. Univariate comparison and multivariate logistic regression models were built to evaluate determinants of screening.Results:We included 4,316 SLE patients (median age 45) and 86,544 control patients. The screening rate in SLE patients was 73.4% vs 58.5% in the controls (P < 0.001). The screening rate was 71% in 2001, increased to 75% in 2004, then decreased to 70% in 2014 (trend P =0.005). In the multivariate model the following factors were associated with decreased cervical cancer screening: year of first SLE claim 2012-2014 versus 2001-2005 (odds ratio (OR) 0.67, 95% confidence interval (CI) 0.53 – 0.84, P < 0.001); older age 61-64 versus 21-30 (OR 0.27, 95% CI 0.19 – 0.39, P < 0.001); comorbidity score of ≥2 versus <2 (OR 0.71, 95% CI 0.6 – 0.83, P < 0.001); and use of corticosteroids for ≥ 90 days versus <90 days (OR 0.73, 95% CI 0.59 – 0.9, P = 0.003). Insurance type and geographical region were not associated with cervical cancer screening.Conclusion:About three quarters of women with SLE underwent cervical cancer screening within 3 years of their first lupus claim, at higher rates than controls. However, there was a concerning downward trend in screening rates in recent years. In addition, higher risk populations for cervical cancer (older age, increased comorbidities, and longer duration of corticosteroids) had lower screening rates. These findings highlight the need to enhance education for healthcare providers to improve utilization of screening in women with SLE at high risk of cervical cancer.Disclosure of Interests:Sebastian Bruera: None declared, Richard Zogala: None declared, Xiudong Lei: None declared, Xerxes Pundole: None declared, Hui Zhao: None declared, Sharon Giordano: None declared, Jessica Hwang Grant/research support from: MERCK grant funding unrelated to SLE., Maria Suarez-Almazor: None declared

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Knowledge, utilization and barriers of cervical cancer screening among women attending selected district hospitals in Kigali - Rwanda

Canadian Oncology Nursing Journal ◽

10.5737/23688076313266274 ◽

2021 ◽

Vol 31 (3) ◽

pp. 266-274

Author(s):

Gaudence Niyonsenga ◽

Darius Gishoma ◽

Ruth Sego ◽

Marie Goretti Uwayezu ◽

Bellancille Nikuze ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Knowledge Utilization ◽

Sub Saharan Africa ◽

Eastern Africa ◽

Screening Rate ◽

Effective Prevention ◽

District Hospitals ◽

Screening Services

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.

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What Messaging Best Promotes a 20-year-old Women’s Intention to have Cervical Cancer Screening?

10.21203/rs.3.rs-449362/v1 ◽

2021 ◽

Author(s):

Ai Miyoshi ◽

Yutaka UEDA ◽

Asami YAGI ◽

Toshihiro KIMURA ◽

Eiji KOBAYASHI ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Educational Intervention ◽

Young Women ◽

Online Survey ◽

Japanese Women ◽

Information Sheet ◽

Cancer Screening Rate ◽

Positive Intention

Abstract Background: Because they have not been HPV-vaccinated, the vast majority of women in Japan are defenseless against HPV-caused cervical cancer. Cervical cancer screening has become their only means for intervention early enough to save their uterus and often, their lives. Unfortunately, the cervical cancer screening rate in Japan has dropped recently to 10.2% for 20-25-year-olds. We need to recommend earlier, more frequent, and more effective screening for them. We have assessed several factors that could promote the intention of Japanese women toward having cervical cancer screening. Method: We conducted an online survey of 412 Japanese women. Half of the respondents were given an information sheet concerning cervical cancer, the remaining half wasn’t. After this educational intervention, we quizzed them about their knowledge concerning cervical cancer, about their and their family’s cervical cancer screening practices, about having talks with their family about cervical cancer, and their intentions for having cervical cancer screening. Among the 127 women who admitted having had a sexual relationship, we evaluated their intention toward having cervical cancer screening. We assessed several factors that were likely to influence their intention to have cervical cancer screening. Results: We determined that an education with an information sheet, whether or not they had ever talked with their family about cervical cancer, and whether members of their family had ever had cervical cancer screening, were associated with an effective impact on the women's positive intention to have cervical cancer screening. Knowing that cervical cancer is becoming more common among young women, that cervical cancer could influence their fertility, and that cervical cancer screening could prevent any lesions from advancing to become invasive cancer, 3 were also associated with an effective impact on the women's positive intention. Conclusion: Personal educational intervention, talking with their family about cervical cancer, and the general health consciousness of their family, were all associated with an effective impact on the women's positive intentions toward cervical cancer screening. It is likely that the messaging for the need for cervical cancer screening for 20-year-olds targeting their innate desire to preserve their fertility would most effectively resonate with these young women.

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Disparities in Cervical Cancer Screening Among Women With Disabilities: A National Database Study in South Korea

Journal of Clinical Oncology ◽

10.1200/jco.2018.77.7912 ◽

2018 ◽

Vol 36 (27) ◽

pp. 2778-2786 ◽

Cited By ~ 12

Author(s):

Dong Wook Shin ◽

Jeong-Won Lee ◽

Jin Hyung Jung ◽

Kyungdo Han ◽

So Young Kim ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Severe Disabilities ◽

National Database ◽

Screening Rate ◽

Women With Disabilities ◽

Factors Associated ◽

Screening Participation ◽

Cancer Screening Participation

Purpose Using the linked administrative database in Korea, we investigated (1) whether cervical cancer screening participation differed by the presence of varying degrees and types of disability; (2) trends in the cervical cancer screening rate relative to disabilities over time; and (3) factors associated with cervical cancer screening. Methods We linked national disability registration data with national cancer screening program data. Age-standardized participation rates were analyzed for each year during the period 2006 to 2015, according to the presence, type, and severity of disabilities. Factors associated with undergoing cervical cancer screening were examined by multivariate logistic regression with the most current data (ie, 2014 to 2015). Results The age-adjusted screening rate for cervical cancer screening in women with disabilities increased from 20.8% in 2006% to 42.1% in 2015 (change, +21.3%); however, among women without disabilities, it increased from 21.6% to 53.5% (change: +31.9%) during that time. Disability was associated with a lower screening rate (adjusted odds ratio [aOR], 0.71; 95% CI, 0.71 to 0.72). Screening rates were markedly lower in women with severe disabilities (aOR, 0.42; 95% CI, 0.42 to 0.42) and women with autism (aOR, 0.06; 95% CI 0.03 to 0.11), intellectual disability (aOR, 0.25; 95% CI, 0.25 to 0.26), brain injury (aOR, 0.311; 95% CI, 0.31 to 0.32), ostomy (aOR, 0.36; 95% CI, 0.33 to 0.38), or mental disorder (aOR, 0.43; 95% CI, 0.42 to 0.44). Conclusion Despite the availability of free screening, a significant disparity was found in cervical cancer screening participation, especially in women with severe disabilities and those with mental disabilities. The identification of barriers associated with decreased screening rates in women with disabilities has important implications for the design of tailored interventions and health care policies to improve cervical cancer screening and outcomes in this vulnerable population.

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