Knowledge about cervical cancer screening among family physicians: cross-sectional survey

Background  Cervical cancer (CC) is an important public health problem worldwide. In Mexico, there has been a National Cervical Cancer Screening Program (NCCSP) since 1974. Mexican Social Security Institute attended Mexican workers and family physicians are responsible of the primary care of patients.
Objective  To evaluate knowledge about the aetiology and prevention of CC among family physicians working in Yucatan, Mexico, at Mexican Social Security Institute.
Methods  A questionnaire was applied to 187 family doctors. Self-administer questionnaire with 10 item previously used by ours and other researchers, was used for the evaluation. Each correctly answered item was given a point. The maximum grade was 10 and the minimum 0.
Results  The knowledge mean was 6.93 points. Fewer than 50% knew what to do with women who are human papillomavirus (HPV) positive without a precancerous cervical lesion and the appropriate age range for Pap smears. A total of 61.1% identified CC as an important health problem in Mexico; however, 95.1% identified CC as a preventive cause of deaths among Mexican women and recognized that HPV is the main CC aetiological agent, and 90.3% mentioned the Pap smear as the main method of diagnosis of CC.
Conclusion  The family doctors need to have an adequate knowledge of the practical elements of the NCCSP to give an efficient attention to their patients.     

Challenges in providing breast and cervical cancer screening services to Vietnamese Canadian women: the healthcare providers' perspective

Breast cancer and cervical cancer are major contributors to morbidity and mortality among Vietnamese Canadian women. Vietnamese women are at risk because of their low participation rate in cancer-preventative screening programmes. Drawing from the results of a larger qualitative study, this paper reports factors that influence Vietnamese women's participation in breast and cervical cancer screening from the healthcare providers' perspectives. The women participants' perspective was reported elsewhere.
Semistructured interviews were conducted with six healthcare providers. Analysis of these interviews reveals several challenges which healthcare providers encountered in their clinical practice. These include the physicians' cultural awareness about the private body, patient's low socioeconomic status, the healthcare provider–patient relationship, and limited institutional support.
This is the first Canadian study to identify the healthcare providers' perspective on giving breast and cervical cancer preventive care to the Vietnamese immigrant women. The insight gained from these healthcare providers' experiences are valuable and might be helpful to healthcare professionals caring for immigrant women of similar ethno-cultural backgrounds. Recommendations for the promotion of breast cancer and cervical cancer screening among Vietnamese women include: (i) effort should be made to recruit Vietnamese-speaking female healthcare professionals for breast and cervical health-promotion programmes; (ii) reduce woman–physicians hierarchical relationship and foster effective doctor–patient communication; (iii) healthcare providers must be aware of their own cultural beliefs, values and attitudes that they bring to their practice; and (iv) more institutional support and resources should be given to both Vietnamese Canadian women and their healthcare providers.     

Role of cervical cancer screening during prenatal checkups for infectious diseases: A retrospective,descriptive study

ObjectiveThis study was conducted to evaluate the status and role of cervical cytology affected by human papillomavirus infection and other infectious diseases screened during routine prenatal checkups.MethodsWe retrospectively examined medical records containing the screening results for infectious diseases and cervical cancer in women who delivered neonates in our hospital from 2014 to 2017.ResultsAmong 3393 deliveries, 18.8% of women underwent a regular cervical cancer screening within 1 year of becoming pregnant, and 2641 women underwent a cervical cytology screening during this pregnancy. The cytological diagnostic results showed that 2562 women (97.0%) were negative for intraepithelial lesions or malignancy, whereas 79 (3.0%) had abnormal results. Of those with abnormal cytology results, 70 had abnormal cytology that was newly detected in this pregnancy, and 42 had grade ≥1 cervical intraepithelial neoplasia lesions. Spatulas were the most frequently used cytological sampling instruments, followed by cotton swabs. Cervical cytology revealed no major adverse reactions during these pregnancies.ConclusionsOur results confirm the importance of screening for infectious diseases during pregnancy. Only 20% of the women underwent a regular pre-pregnancy cervical cytology screening. Cervical cytology screening during pregnancy may currently be playing a crucial role in preventing cervical cancer in Japan.     

Behavioral intention to prevent cervical cancer and related factors among female high school students in Japan

Aim

This study aimed to examine female high school students’ behavioral intention to prevent cervical cancer and related factors.

Methods

The participants were 2158 female high school students at 16 high schools in A prefecture in the Tohoku region in Japan. A self‐administered questionnaire was carried out that was developed based on a conceptual framework comprising the Health Belief Model and Theory of Reasoned Action.

Results

The responses were obtained from 2072 students (96.0%). Of these, the answers of 2028 respondents were analyzed after excluding those participants who did not complete the behavioral intention item (effective response rate: 97.0%). A factor analysis and covariance structure analysis yielded a model with strong goodness‐of‐fit that explained the behavioral intentions based on an “Awareness of the importance and effectiveness of cervical cancer screening,” “Obstacles to cervical cancer prevention behavior,” “Subjective norms for adopting cervical cancer prevention behavior,” and “The behavior of someone close that encourages cervical cancer prevention behavior.”

Conclusion

The statistical analysis yielded a model with strong goodness‐of‐fit that explained female high school students’ behavioral intentions, which were related to four factors, including “the awareness of the importance and effectiveness of cervical cancer screening.”

     

女性宫颈癌早期筛查认知程度的调查分析

目的 了解妇科门诊就诊女性对宫颈癌早期筛查的认知程度.方法 选取1 590例门诊就诊女性,采用自设问卷进行认知程度调查.结果 知道宫颈癌的占96.60％.城市女性对宫颈癌知识的认知程度高于农村;文化程度越高的女性对宫颈癌知识的认知程度越高,差异均具有统计学意义(P＜0.01).结论 女性对宫颈癌早期筛查重要性的认知程度...     

Integrative review of cervical cancer screening in Western Asian and Middle Eastern Arab countries

Population‐based screening programs have resulted in minimizing mortality and morbidity from cervical cancer. The aim of this integrative review was to explore the factors influencing access of women from Western Asian and Middle Eastern Arab countries to cervical cancer screening. A systematic search for studies conducted in Arab countries in those regions, and published in English between January 2002 and January 2017, was undertaken. Thirteen papers were selected and subjected to quality appraisal. A three step analysis was used, which involved a summary of the evidence, analysis of both quantitative and qualitative data, and integration of the results in narrative form. Few population‐based cervical cancer screening programs had been implemented in the relevant countries, with low knowledge of, and perceptions about, cervical screening among Arab women, the majority of whom are Muslim. Factors affecting the uptake of cervical cancer screening practices were the absence of organized, systematic programs, low screening knowledge among women, healthcare professionals’ attitudes toward screening, pain and embarrassment, stigma, and sociocultural beliefs. Policy changes are urgently needed to promote population‐based screening programs. Future research should address the promotion of culturally‐sensitive strategies to enable better access of Arab Muslim women to cervical cancer screening.     

液基薄层细胞学在宫颈癌筛查中的应用

目的探讨液基薄层细胞学(LBP)在宫颈癌筛查中的应用价值。方法选取2010年1月至2014年9月于广东省第二人民医院行宫颈LBP检查的8 017例受检者为研究对象,根据年龄进行分组,观察结果阳性且愿意接受阴道镜及病理组织活检者的细胞学结果与组织学诊断的符合率。结果共有阳性人数703例,占8.8%,年龄17~70岁,40~49岁年龄组阳性率最高,达13.9%,各组间阳性率差异有统计学意义(χ2=25.741,P=0.000);共有566例患者随后接受了阴道镜检查和病理组织活检,占80.5%,细胞学与组织学结果总符合率为62.5%,高级别病变符合率100.0%。结论 LBP检查在宫颈癌筛查中具有操作简便、准确率高等优点,适合作为大范围宫颈癌筛查的首选方法。     

农村适龄妇女“两癌”筛查中的组织管理方法与效果

目的探讨农村适龄妇女两癌筛查中的组织管理方法及效果,为更好地开展农村女性群体健康服务提供科学依据。方法坚持政府主导、采取筛查前对适龄妇女人群进行摸底、对筛查对象实施健康教育、培训筛查人员、合理布局和体检现场管理,结合耐心的问卷调查和对调查对象进行心理疏导。结果符合本次筛查年龄段的妇女共64 357人,完成对48 946人调查及两癌筛查,完善各项体检并完整收回问卷调查表46 981份,有效收回率为95.99%,筛查率为73.00%。结论政府主导及科学地组织管理是农村适龄妇女妇科病调查及两癌筛查顺利实施的保障。     

A decision theory perspective on why women do or do not decide to have cancer screening: systematic review

Title.  A decision theory perspective on why women do or do not decide to have cancer screening: systematic review.
Aim.  This paper is a report of a review in which decision theory from economics and psychology was applied to understand why some women with access to care do not seek cancer screening.
Background.  Mammography and cervical smear testing are effective modes of cancer screening, yet many women choose not to be screened. Nurses need to understand the reasons behind women's choices to improve adherence.
Data sources.  Research papers published between January 1994 and November 2008 were identified using the Cumulative Index to Nursing and Allied Health Literature, MEDLINE and PsycINFO data bases. The search was performed using the following terms: cervical cancer screening, breast cancer screening, decision, choice, adherence and framing. Forty-seven papers were identified and reviewed for relevance to the search criteria.
Methods.  Nineteen papers met the search criteria. For each paper, reasons for obtaining or not obtaining cancer screening were recorded, and organized into four relevant decision theory principles: emotions, Prospect Theory, optimism bias and framing.
Findings.  All women have fears and uncertainty, but the sources of their fears differ, producing two main decision scenarios. Non-adherence results when women fear medical examinations, providers, tests and procedures, do not have/seek knowledge about risk and frame their current health as the status quo. Adherence is achieved when women fear cancer, but trust care providers, seek knowledge, understand risk and frame routine care as the status quo.
Conclusion.  Nurses need to address proactively women's perceptions and knowledge about screening by openly and uniformly discussing the importance and benefits.     

Women's lay knowledge of cervical cancer/cervical screening: accounting for non-attendance at cervical screening clinics

An assessment of women’s knowledge of cervical screening and cervical cancer was considered important as up to 92% of those dying from this form of cancer had never been tested. What were the reasons which determined their non-attendance? Issues to be addressed were reactions to invitation, women’s knowledge of screening, and the possible factors which they envisaged as being associated with cervical cancer. Other issues to be considered were practical problems associated with attendance, and preference for the sex and professional status of the health professionals involved; 187 women in a general practitioner practice in Lothian, Scotland were targeted by questionnaire. As with other studies in this field 50% of those contacted were ineligible for a variety of reasons. Seventy-two women completed the questionnaire, providing a mix of qualitative and quantitative data. Although the majority of women felt the invitation to attend screening was clear and easy to understand, there was a lack of knowledge with regard to both the screening itself and the possible causes of cervical cancer. The main ‘causes’ were seen as higher sexual activity among those aged under 37 and smoking and a virus by those over 37. The majority of women showed preference for a female professional to take the smear. Practical problems of time and venue were not considered insurmountable. The main reasons cited for non-compliance were the fear and dislike of the test itself.