Gynecological Health Concerns in Women with Schizophrenia and Related Disorders: A Narrative Review of Recent Studies

Sex and age are important factors influencing physical and mental health in schizophrenia. Our goal was to review the recent literature for associations between gynecological conditions and psychotic illness and to propose integrated strategies for their management in order to improve overall health outcomes in women. We addressed the following questions: What are the prevalence and risk factors of gynecological disorders in women with schizophrenia or delusional disorder (DD)? What are the rates of uptake of gynecological cancer screening and mortality in this population? What role does menopause play? We found an increased incidence of breast cancer in women with schizophrenia. Other gynecological comorbidities were less frequent, but the field has been understudied. Low rates of breast and cervical cancer screening characterize women with schizophrenia. Menopause, because of endocrine changes, aging effects, and resultant comorbidity is associated with high rates of aggressive breast cancer in this population. Uterine and ovarian cancers have been less investigated. Psychosocial determinants of health play an important role in cancer survival. The findings lead to the recommendation that primary care, psychiatry, gynecology, oncology, and endocrinology collaborate in early case finding, in research into etiological links, and in improvement of prevention and treatment.

Analysis of the malignant ovarian tumors incidence in the Sumy region in 2014-2018.

Background. Ovarian cancer is a very important pathology of the female reproductive system and tends to increase in incidence and mortality rates around the world. Despite the fact that ovarian cancer prevalence is lower than that of breast and cervical cancer, its mortality rate is three times higher. Aim. To analyze the incidence of ovarian cancer in the female population of Ukraine and the Sumy region in 2014–2018. Methods. Data from the National Cancer Register of Ukraine were used for this work. A statistical analysis of the incidence rates of ovarian cancer in the population of Ukraine and Sumy region was carried out. Results. The highest incidence of ovarian cancer in the Sumy region was detected in 2018 (12.5 cases per 100,000 women), and the lowest - in 2017 (10.4 cases per 100,000 women). This pathology occurs most often in women 60-79 years old. 91% of the tumors were epithelial-stromal tumors, of which 75% were serous ovarian adenocarcinomas. Ovarian cancer in most cases was diagnosed at the third stage of the disease (47% of cases), which indicates a low level of early diagnosis of this tumor. Conclusion. In the Sumy region, a high incidence rate of ovarian cancer was revealed, which exceeds the national one and has a significant age dependence. Serous ovarian adenocarcinoma is the most common type of ovarian cancer. This pathology is diagnosed mainly at the 3rd stage.

Knowledge, awareness, attitudes and screening practices towards breast and cervical cancer among women in Nepal: a scoping review

Aim Breast and cervical cancers have emerged as major global health challenges and disproportionately affect women in low- and middle-income countries, including Nepal. This scoping review aimed to map the knowledge, attitudes and screening practices for these cancers among Nepali women to improve cancer outcomes and reduce inequality. Methods Five electronic databases (CINAHL, Embase, Global Health, PsycINFO and PubMed), grey literature, and reference and citation lists were searched for articles published in English up to June 2021. Articles were screened against inclusion/exclusion criteria, and data from eligible studies were extracted. Results were summarised narratively. Results The search yielded 615 articles, 38 of which were included in this scoping review (27 cervical cancer, 10 breast cancer, 1 both cancers). Levels of knowledge regarding breast and cervical varied widely. The main knowledge gaps were misconceptions about symptoms and risk factors, and poor understanding of screening behaviours. Screening practices were mostly inadequate due to socio-cultural, geographical or financial barriers. Positive attitudes towards cervical screening were associated with higher education and increased knowledge of screening modalities. Higher levels of knowledge, (health) literacy and participation in awareness campaigns facilitated breast cancer screening. Conclusion Knowledge and screening practices for breast and cervical cancer among Nepali women were poor and highlight the need for awareness and education programmes. Future research should explore community health worker-led awareness and screening interventions for cervical cancer, and programmes to increase the practice of breast self-examination and clinical breast examinations to support early diagnosis of breast cancer.

Knowledge of Breast Self-Examination, Breast and Cervical Cancer Screening among Indian Women

The burden of breast and cervical cancer in terms of incidence and mortality in low- and mid-income countries is increasing daily due to late diagnosis, unhealthy lifestyle choices, late presentation, and poor attitude to screening. Early detection increases the chances of survival. This present study assessed Assam women’s breast and cervical cancer screening (CCS) awareness, the practice of breast self-examination (BSE), and uptake of human papillomavirus vaccines. An internet-based cross-sectional questionnaire was utilized to obtain 251 consenting respondents. The mean age of respondents was 27.8 ± 6.91. Only 205 (81.7%) and 110 (43.8%) respondents have satisfactory levels of BCS, and CCS knowledge, respectively. While only 76 (30.3%) respondents had satisfactory BSE practice. Age range (26 – 32 years), tertiary education, and being single were demographic characteristics that influenced knowledge and practice. Though the respondents had a satisfactory knowledge level, screening uptake among respondents is very poor as only 32 (12.7 %) had ever been screened and only 19 (7.6 %) ever been vaccinated. The major reasons for poor screening uptake were “no symptoms” and “not aware of screening location”. Most respondents (227, 90.4 %) are willing to go for screening if well oriented. This presents an opportunity to enhance awareness about screening and vaccination among Assam women. The media/internet and health practitioners can be leveraged to promote the uptake and utilization of screening services and BSE practice. Doi: 10.28991/SciMedJ-2021-0304-5 Full Text: PDF