scholarly journals Awareness and Attitude of Women towards Cervical Cancer Screening in Abakaliki, South East Nigeria

2021 ◽  
Vol 13 (4) ◽  
pp. 115
Author(s):  
J. O. Egede ◽  
L. O. Ajah ◽  
U. M. Agwu ◽  
M. I. Ajah ◽  
F. O. Edegbe ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Willingness To Pay ◽  
Cervical Cancer Screening ◽  
Cervical Screening ◽  
Sub Saharan Africa ◽  
University Teaching ◽  
High Risk Population ◽  
Cross Sectional ◽  
Screening Services

INTRODUCTION: Cervical cancer screening has significantly contributed to the detection of premalignant and malignant lesions of the cervix and prevention of the morbidity and mortality associated with the disease. In the developing countries, especially sub-Saharan Africa where the burden of cervical cancer is highest, the high-risk population may not know the screening schedules or be able to pay for the services, and so fail to benefit. OBJECTIVE: To determine the level of awareness of cervical cancer screening schedule and willingness to pay for cervical screening services among women in Abakaliki, southeast Nigeria. METHOD: The study design was a descriptive cross-sectional questionnaire-based and the population comprised 800 participants who came for free cervical cancer screening at well women centre, Alex Ekwueme Federal University Teaching Hospital, Abakaliki between January and December 2017. Data were analyzed using the Statistical Package for Sciences version 20.0. RESULT: Of the 756 (94.5%) questionnaires analyzed, the mean age was 41.4 years, modal parity 4; 83.6% had prior knowledge of cervical cancer while 81.0% knew that cervical cancer screening is a diagnostic tool. Surprisingly, only 32% of those aware of cervical cancer had previously done cervical cancer screening, while 10.8% knew the interval for cervical cancer screening. On screening for cervical cancer in future, 89.2% of the respondents were willing to repeat the test while 54.2% would be willing to pay for the screening services. Being 40 years of age or less, married, educated, of high socio-economic class and having first sexual intercourse at 18 years or less were associated with willingness to pay for screening. CONCLUSION: Although the knowledge of cervical cancer is high, cervical cancer screening uptake is low, many women are aware of the interval for cervical cancer screening, and many will not be willing to pay for cervical cancer screening out of their pockets. 

scholarly journals Women’s perceived susceptibility to and utilisation of cervical cancer screening services in Malawi

2014 ◽  
Vol 19 (1) ◽  
Author(s):  
Melanie Y. Hami ◽  
Valerie J. Ehlers ◽  
Dirk M. Van der Wal
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Cervical Screening ◽  
Hpv Infection ◽  
Screening Tests ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Perceived Susceptibility ◽  
Screening Services

Background: Malawi provides cervical cancer screening services free of charge at some public health facilities. Few women make use of these cancer screening services in Malawi and many women continue to be diagnosed with cervical cancer only during the late inoperable stages of the condition. Objectives: The purpose of this study was to discover whether the perceived susceptibility to cervical cancer, amongst Malawian women aged 42 and older, influenced their intentions to utilise the available free cervical cancer screening services.Method: A quantitative, cross-sectional descriptive study design was adopted. Structured interviews were conducted with 381 women who visited 3 health centres in the Blantyre District of Malawi.Results: A statistically-significant association existed between women’s intentions to be screened for cervical cancer and their knowledge about cervical cancer (X² = 8.9; df = 1; p = 0.003) and with having heard about HPV infection (X² = 4.2; df = 1; p = 0.041) at the 5% significance level. Cervical cancer screening services are provided free of charge in government health institutions in Malawi. Nevertheless, low perceived susceptibility to cervical cancer amongst women, aged 42 and older, might contribute to limited utilisation of cervical screening services, explaining why 80% of cervical cancer patients in Malawi were diagnosed during the late inoperable stages.Conclusion: Malawian women lacked awareness regarding their susceptibility to cervical cancer and required information about the available cervical cancer screening services. Malawi’s women, aged 42 and older, must be informed about the advantages of cervical cancer screening and about the importance of effective treatment if an early diagnosis has been made. Women aged 42 and older rarely attend antenatal, post-natal, well baby or family-planning clinics, where health education about cervical cancer screening is often provided. Consequently, these women aged 42 and older should be informed about cervical screening tests when they utilise any health services.Vroue se vermeende vatbaarheid en benutting van servikale kanker dienste in Malawi Agtergrond: Malawi verskaf gratis servikale kanker siftings dienste by sommige openbare gesondheids instansies. Min vrouens maak gebruik van die kanker siftings dienste in Malawi en baie vrouens word steeds gediagnoseer met servikale kanker tydens die laat onopereerbare fases van die toestand.Doelwitte: Die doel van die studie was was om te bepaal of Malawiese vrouens wat 42 en ouer is se waargenome vatbaarheid vir servikale kanker hulle beïnvleod om beskikbare gratis servikale siftingsdienste te gebruik. ’n Kwantitatiwe, deursnee beskrywende navorsingsontwerp was gekies.Metode: Gestruktureerde onderhoude is met 381 vrouens gevoer wat drie gesondheidsdiensentrums in die Blantyre Distrik van Malawi besoek het.Resultate: ’n Statistiese beduidende verhouding het bestaan tussen vrouens se voornemens om vir servikale kanker getoets te word en hulle kennis oor servikale kanker (X² = 8.9; df = 1; p = 0.003) en dat hulle al gehoor het van MPV infeksies (X² = 4.2; df = 1; p = 0.041) op die 5% vlak van beduidenis. Servikale kanker siftingsdienste is gratis beskikbaar in openbare gesondheidsdiensinrigtings in Malawi. Desnieteenstaande was daar ’n lae waargenome risiko van servikale kanker onder vrouens wat 42 jaar oud en ouer was en dit het bygedra tot die beperkte benutting van siftingsdienste, wat verduidelik waarom 80% van servikale kankergevalle in Malawi gedurende die laat onopereerbare fases gediagnoseer is.Gevolgtrekkings: Malawiese vrouens was onbewus van hulle vatbaarheid vir servikale kanker en het inligting benodig oor servikale kanker siftingsdienste. Malawi se vrouens wat 42 jaar oud en ouer is, moet ingelig word aangaande die voordele van servikale sifting en die belangrikheid van effektiewe behandeling indien ’n vroë diagnose gemaak is. Vrouens van 42 of ouer benut selde voorgeboorte, nageboorte gesonde baba, of gesinsbeplanningsklinieke waar voorliging aangaande servickale kanker verskaf word. Gevolglik behoort die vrouens ingelig te word oor servikale siftingstoetse wanneer hulle enige gesondheidsdienste benut.

scholarly journals Utilization of Cervical Cancer Screening Services among Women in Vhembe District, South Africa: A Cross-Sectional Study

2018 ◽  
Vol 11 (1) ◽  
pp. 451-463
Author(s):  
Elisa N. Vhuromu ◽  
Daniel T. Goon ◽  
Maria S. Maputle ◽  
Rachel T. Lebese ◽  
Benedine U. Okafor
Keyword(s):  
South Africa ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Pap Smear ◽  
Cervical Screening ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Screening Services ◽  
Vhembe District

Aim:Screening for early detection and treatment of cervical cancer is a cornerstone of prevention. The purpose of this study was to assess the awareness in women about the utilization of cervical cancer screening services in Vhembe District, South Africa.Methods:This cross-sectional study involved a random selection of 500 women aged 20-59 years in Vhembe District, Limpopo Province, South Africa. Data was collectedviaa self-structured questionnaire on the demographic variables, provision, utilization and awareness of cervical cancer screening services.Results:The majority of the participants agreed to have cervical cancer screening services in their clinics (79.2%), and never had a Pap smear (58.6%). Most women would not go for cervical cancer screening, mainly because of a lack of facilities (30.0%), fear of pain (24.4%), and embarrassment (15.2%). Most participants indicated that Pap smear test meant scraping the cervix to detect abnormal cancerous cells (39.2%) and 34.2% did not know a Pap smear. Majority of the participants indicated Pap smears should be done every 10 years (65.8%); Pap smears could detect cervical cancer earlier (66.8%), and had heard about cervical cancer (71.6%). The majority of the participants considered cervical cancer as a serious problem to warrant considerable attention (59.4%); and some perceived cervical cancer as transmittable through multiple sexual partners (22.2%). The majority of the participants were aware of a vaccine against cervical cancer for girls at school (69.0%), and it was indicated that government should use health education to encourage women to attend cervical screening services (51.6%).Conclusion:Despite the free availability of cervical cancer screening services and awareness, the utilization of cervical cancer screening services is low. There is a need to intensify cervical screening health talks and campaigns, and to provide alternative accessible options for screening services for women in rural areas.

scholarly journals Cervical cancer screening uptake in Sub-Saharan Africa: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Nigus Bililign Yimer ◽  
Mohammed Akibu Mohammed ◽  
Kalkidan Solomon ◽  
Mesfin Tadese ◽  
Stephanie Grutzmacher ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Meta Analysis ◽  
Cervical Screening ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Screening Uptake ◽  
Analytic Review ◽  
Sub Saharan

AbstractBackgroundCervical cancer screening and prevention programs have been given considerable attention in high-income countries, while only receiving minimal effort in many African countries. This meta-analytic review aimed to estimate the pooled uptake of cervical cancer screening uptake and identify its predictors in Sub-Saharan Africa.MethodsPubMed, EMBASE, CINAHL, African Journals Online, Web of Science and SCOPUS electronic databases were searched. All observational studies conducted in Sub-Saharan Africa and published in English language from January 2000 to 2019 were included. The Newcastle-Ottawa Scale was applied to examine methodological quality of the studies. Inverse variance-weighted random-effects model meta-analysis was done to estimate the pooled uptake and odds ratio of predictors with 95% confidence interval. I2 test statistic was used to check between-study heterogeneity, and funnel plot and Egger’s regression statistical test were used to check publication bias. To examine the source of heterogeneity, subgroup analysis based on sample size, publication year and geographic distribution of the studies was carried out.ResultsOf 3,537 studies identified, 29 studies were included with 36,374 women. The uptake of cervical cancer screening in Sub-Saharan Africa was 12.87% (95% CI: 10.20, 15.54; I2= 98.5%). Meta-analysis of seven studies showed that knowledge about cervical cancer increased screening uptake by nearly 5-folds (OR: 4.81; 95% CI: 3.06, 7.54). Other predictors include educational status, age, HIV status, contraceptive use, perceived susceptibility, and awareness about screening locations.ConclusionCervical screening uptake is low in Sub-Saharan Africa and influenced by several factors. Health outreach and promotion targeting identified predictors are needed to increase uptake of screening service in the region.sProtocol registrationCRD42017079375

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

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.

scholarly journals Intimate Stories: Aboriginal Women’s Lived Experiences of Health Services in Northern British Columbia and the Potential of Creative Arts to Raise Awareness About HPV, Cervical Cancer, and Screening

2013 ◽  
Vol 8 (1) ◽  
pp. 18 ◽  
Author(s):  
Virginia L. Russell ◽  
Sarah De Leeuw
Keyword(s):  
Cervical Cancer ◽  
British Columbia ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Health Care Services ◽  
Formal Education ◽  
Cervical Screening ◽  
Sexual Health Care ◽  
Wide Range ◽  
Screening Services

Guided by feminist and community-based participatory methodologies and by efforts to decolonize health research practices, and undertaken with qualitative research methods (interviews, open-ended questionnaires, and analysis of arts-based expressions like storytelling, journaling, and picture-making), this research identified challenges and barriers that (predominantly Aboriginal) women in northern British Columbia faced when trying to access sexual health care services related to HPV and cervical cancer screening. The research also examined the possible effectiveness of creative or arts-based strategies to promote cervical health and screening awareness among young and/or traditionally underserved or marginalized women. We review findings from data gathered over six months during multiple interactions with 22 women from a wide range of ethnic backgrounds. Results confirm that ethnicity, finances, and formal education are determinants in women’s awareness about, access to, and use of cervical screening services, and that experiences of gendered victimization, feelings of disempowerment, and life circumstances all influenced women’s comfort levels with, access to, and use of cervical cancer screening services.

Cervical cancer screening among reproductive-aged women: a crossectional survey in Tabanan Regency

2017 ◽  
pp. 18
Author(s):  
Desak Gede Yenny Apriani ◽  
N.L.P. Suariyani ◽  
Mangku Karmaya
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Cervical Screening ◽  
Breast Cancers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Factors Associated ◽  
Screening Uptake ◽  
Reproductive Aged Women

Background and purpose: Cervical and breast cancers are the most common malignancies among women in Indonesia. The prevalence of cervical cancer in Bali was 0.6% in 2013. Screening coverage for cervical cancer in Tabanan district varies from 37% to 67%. This study aims to determine factors associated to cervical cancer screening uptake among reproductive-aged women.Methods: A cross-sectional survey was conducted at Baturiti Subdistrict, Tabanan Regency, Bali Province. This study involved 188 reproductive-aged women. Samples were randomly selected from all reproductive-aged women from two villages of Baturiti and Angseri. Data were collected using home interviews by a standardised questionaire. Multivariate analysis was conducted using poisson regression model to determine factors associated to cervical cancer screening uptake.Results: This study showed that the proportion of cervical cancer screening was 38.83%. Variables associated to the uptake of cervical cancer screening were comprehensive knowledge about cervical cancer (APR=10.16; 95%CI: 4.33-24.76), insurance holder (APR=2.95; 95%CI: 1.38-6.64) and aged of ?40 years (APR=1.26; 95%CI: 1.01-1.59). Education level, employment status and perceived benefits were not associated with the screening uptake among reproductive-aged women.Conclusions: Level of knowledge about cervical cancer, insurance ownership and aged over 40 years increase the cervical screening uptake among reproductive-aged women

scholarly journals Uptake and determinants of cervical cancer prevention services among female college students in Kenya: A cross-sectional survey

2020 ◽  
Author(s):  
Elisha Ngetich ◽  
Irene Nzisa ◽  
Alfred Osoti
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cancer Prevention ◽  
Cervical Cancer Screening ◽  
Cervical Cancer Prevention ◽  
Female College Students ◽  
Cross Sectional ◽  
Prevention Services ◽  
Parametric Data ◽  
Screening Services

AbstractIntroductionCervical cancer is the leading cause of cancer death in women in low- and middle-income countries. In Kenya, cervical cancer incidence and prevalence have been increasing and in 2018 alone, there were 3286 deaths from cervical cancer. Previously, studies on cervical cancer prevention strategies have focused on women above 30 years old. However, as the risk factors for cervical cancer are acquired as early as in the teen years, an understanding of the awareness, uptake and determinants of screening services among college female students will help inform prevention strategies. This study sought to determine the awareness, uptake, determinants and barriers to cervical cancer screening services among colleges students in Kenya.MethodsThis was a multicenter cross-sectional study conducted in eight universities spread all over Kenya. Participants were interviewed using a self-administered structured questionnaire on sociodemographics, reproductive history, awareness on cervical cancer including screening practices, and attitude towards cervical cancer prevention services. Descriptive statistics were summarized using means and standard deviation (SD) for parametric data and median and interquartile range (IQR) for non-parametric data. Univariable and multivariable logistic regression analyses were done to determine odds ratios of factors associated with uptake of cervical cancer screening services. P-value of <0.05 was considered statistically significant.ResultsBetween January 2017 and Sept 2017, we screened 800 and enrolled 600 female colleges students from eight universities in Kenya. In total, 549 of the 600 (92%) participants completed the questionnaire. The median age (IQR) was 21(20,22) years. Nearly two-thirds 338(62.7%) were sexually active, while 54(16%) had concurrent sexual partners. The main form of contraception was oral postcoital emergency pills 123(64.7%). Only 76(14.4%) had screened for cervical cancer, and the commonest approach was a Pap smear 47(61.8%). About one half 40(54.1%) did not like their experience due to pain, discomfort and bleeding. Four out of five participants (439, 80.7%) had poor knowledge on cervical cancer screening. On bivariate analysis, increased level of awareness (odds ratio [OR] 1.08 95% Confidence Interval [CI] 1.03,1.18, p = 0.004), knowledge of someone with cervical cancer(OR 0.43 CI 0.23,0.78 p=0.006) and a perception of self-risk (OR2.6 CI 1.38,4.98 p=0.003) were associated with increased odds of uptake of cervical cancer screening. In the multivariate analysis, high awareness was significantly associated with increased odds of cervical cancer screening (OR 1.12 CI 1.04, 1.20 p=0.002).ConclusionsFemale college students in Kenya had low levels of awareness on cervical cancer and had very low uptake of cervical cancer screening. However, high perception of self-risk and perceived benefit was associated with increased odds of cervical cancer screening.RecommendationsSince female colleges students are generally thought to be more knowledgeable and have better access to information compared to the general population, the low levels of knowledge and uptake of cervical cancer screening, calls for a rethink of strategies that focus on the younger population including those in primary, high school and universities. Such strategies include HPV vaccination and incorporation of cancer prevention in school curriculum.

scholarly journals Utilisation and Perceptions of Cervical Cancer Screening Services

2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Mercy Kokuro ◽  
Abigail Kusi-Amponsah Diji
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Sampling Technique ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Reproductive Age ◽  
Cross Sectional ◽  
Screening Services ◽  
Study Sites

Cervical cancer is the second most frequently diagnosed and the fourth commonest cause of cancer death among women worldwide. Even though cervical cancer is preventable, its screening rate has been reported to be low in Ghana. To the best of our knowledge, no study has focused on the utilisation and perceptions of cervical cancer among women in their reproductive age in Ghana. The present study aimed at assessing the utilisation and perceptions of cervical cancer screening services among women who seek reproductive healthcare services. A descriptive cross-sectional study was carried out among women aged 18 years and above. Using a two-stage sampling technique, 369 participants were selected from 2 out of 4 eligible study sites. Data on the perceptions and utilisation of cervical cancer screening services were collected following ethical approval. The data were collected using both English and Twi versions of the questionnaire. The data were descriptively and inferentially analysed. A few of the participants had been previously screened for cervical cancer (n = 69; 18.7%), while a greater proportion of the participants appropriately perceived the screening benefits (> 70%), and an equally greater percentage of them harboured negative perceptions which prevented them from engaging in such endeavours (> 80%). Significant differences in perception were, however, observed in two-fifths of the studied areas (6/14) among the screened and unscreened participants. Cervical cancer screening services were not utilised by the majority of the participating women. Screening was associated with socio-demographic characteristics such as marital status, parity, education, and employment status. Inappropriate perceptions on cervical cancer screening may account for the low utilisation of cervical cancer screening. Therefore, all-inclusive health education on the benefits of cervical cancer screening for both women and men should be a priority for stakeholders and all health organisations.

scholarly journals Knowledge, attitudes, and practices regarding cervical cancer screening among women in metropolitan Lima, Peru: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Michelle M. Pieters ◽  
Rae Jean Proeschold-Bell ◽  
Emily Coffey ◽  
Megan J. Huchko ◽  
Lavanya Vasudevan
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Barriers To Screening ◽  
Screening Services ◽  
Knowledge And Attitude ◽  
Screening Behaviors

Abstract Background Cervical cancer is a leading cause of cancer deaths among women of reproductive age in Peru. Screening and early identification of pre-cancerous lesions are a cornerstone of the cervical cancer prevention strategy. Yet, there is limited literature on barriers to screening among Peruvian women. In this cross-sectional study, we aimed to examine Peruvian women’s knowledge, attitudes, and practices regarding cervical cancer screening and identify possible reasons for the gap between knowledge and screening. Methods The study was conducted in metropolitan Lima from June–August 2019. We purposefully recruited 12 women who had previously been screened, and 12 who had never been screened for cervical cancer. The women completed a 40-question knowledge and attitude survey and an in-depth interview about barriers to screening. Descriptive analysis was used to calculate a knowledge and attitude score and qualitative analysis was guided by the Health Belief Model constructs. Results Previously screened participants had greater knowledge of cervical cancer symptoms, risk factors, and prevention (mean score = 28.08, S.D. = 4.18) compared to participants who had never been screened (mean score = 21.25, S.D. = 6.35). Both groups described lack of priority and embarrassment as barriers to cervical cancer screening. For participants who had never been screened before, major barriers included the fear of a cancer diagnosis and lack of information about screening services. Pregnancy, unusual gynecological symptoms and encouragement from friends and family were cues to action for participants seeking screening. Most participants in both groups recognized the benefits of getting screened for cervical cancer. Being previously screened increased participants’ self-efficacy for engaging in screening behaviors again. Misconceptions regarding screening procedures and cervical cancer were also noted as barriers for participants accessing screening services. Conclusions Improving knowledge and awareness about cervical cancer and screening programs may improve screening behaviors among women. Targeting women who have never been screened before and addressing their fears and concerns around embarrassment may be other areas for intervention. Misconceptions that deter women from screening services are an important issue that should be addressed in order to increase the number of women who get timely screenings.

Sign in / Sign up

Export Citation Format

Share Document