Linking cervical cancer to the human papillomavirus: findings from a qualitative study with Mexican women

Cervical cancer is an important cause of mortality for women in developing countries. Researchers have established a link between cervical cancer and the human papillomavirus (HPV). We explored Mexican women's beliefs about cervical cancer and sexually transmitted infections (STIs), including HPV, to better understand the social implications of this linkage. We conducted eight focus groups with middle-aged and young women in Mexico City. Cervical cancer elicited different social and emotional responses than STIs; participants generally attached less culpability to it and saw it as more life threatening. Information campaigns should take into account differences in lay conceptions of these illnesses.     

宫颈癌流行病学研究与调查

宫颈癌在全球妇女恶性肿瘤中居第二位,近20年发病明显呈年轻化趋势,如能早期发现是可以治愈的恶性肿瘤。该文就近年来有关宫颈癌的流行病学特点及危险因素作一综述。     

Predictors of cervical cancer screening in Mexican American women of reproductive age

Several barriers impede cancer prevention in the Mexican American population. This study identified sociocultural factors that could be used to increase screening rates for cervical cancer in women of reproductive age. A survey was conducted in 1991 of 366 Mexican American women ages 18 to 40 in Tucson, Arizona, to assess current compliance with cervical cancer screening guidelines and several psychological, social, and cultural variables. Women who had never been screened (13 percent of the sample) had a knowledge deficit, no gynecological care, and no sexual activity. Women not screened annually (16 percent) lacked preventive care, imperfectly understood the Pap test, had lower self-efficacy expectations for understanding physicians, experienced higher emotional stress about the test, and were older and less acculturated. Women who have never been screened require basic education on cancer and cancer screening and policy changes increasing access to care. For women with less routine screening, preventive care, supportive attitudes, and health care skills must be encouraged.     

An epidemiological study of familial neurocysticercosis in an endemic Mexican community

Neurocysticercosis (NC) caused by Taenia solium is a frequent parasitic disease of the central nervous system. It is highly endemic in many developing countries, where many people are exposed but few become infected. Here, the relevance of age, gender, and genetic and exposure factors on NC susceptibility was studied in 649 inhabitants of a rural community of Mexico. Endemicity was confirmed by the high prevalence of pig cysticercosis (32.8%) and human seroprevalence (43.8%). Human NC cases were diagnosed by computerised tomography scans. A questionnaire to evaluate risk factors was applied and familial relationships between participants were registered. An overall NC frequency of 9.1% (59/649) was found. NC frequency increased with age but did not associate with gender. Most NC cases were asymptomatic. None of the evaluated risk factors were associated with NC. No familial aggregation was detected when studying all cases, although a significant relationship between mother and child in cases with multiple parasites was found. These findings point to the fact that human NC in high exposure conditions is not simply related to exposure factors and they do not support the participation of a major gene in single-cyst NC. Rather, our results point to a complex interaction of genetic and environmental factors involved in NC.     

Breast and cervical cancer screening among Mississippi Delta women

The purpose of the study was to determine breast and cervical cancer screening among women living in the Mississippi Delta region. Using data from the Behavioral Risk Factor Surveillance System for 1999--2000, we determined the prevalence of mammography (women 40 years and older, n = 6,028) and Pap testing (women 18 years and older, n = 6,502) within the past 2 or 3 years, respectively. We examined predictors of testing and compared results with those for women living elsewhere in the United States. Among Delta women, 69.4% (95% confidence interval [CI] 67.9% to 70.9%) had a mammogram and 85.5% (95% CI 84.3% to 86.6%) a Pap test. Mammography prevalence was lower among black and white Delta women than among black and white women elsewhere. Pap testingwas lower among older (65 years and older) Delta women or women who did not visit a doctor within the past year than among their counterparts elsewhere. Additional interventions are needed to meet the goals of Healthy People 2010 for all women.     

Breast cancer prevention with older women: a gender-focused intervention study

Breast cancer continues to be the most frequently diagnosed cancer in American women, with older women at highest risk (American Cancer Society [ACS], 2007). In this study, the researcher explored whether an educational intervention using feminist pedagogical methods would affect the use of breast cancer screening methods (mammography and breast self-exam) by older women. At 6-month follow-up, those women receiving the education intervention were found to have significantly increased their use of screening methods in comparison with a control group of women of similar age from the same community. The results of this study indicate support for the use of gender-focused educational methods with an emphasis on empowerment to increase the cancer screening practices of older women.     

Breast self-examination among college women: predictors for cancer control

Monthly breast self-examination (BSE) to aid in the early diagnosis of breast cancer is advocated for all adult women, but regular and competent practice is unusual. Our purpose was to explore the associations between young women's reported cancer history, BSE training, demographic variables (predictors), self-reported frequency of BSE, BSE skill level, breast lump detection ability, confidence, and anxiety (outcome variables). A general health history questionnaire was administered to 73 female university students, faculty, and staff. BSE skill and detection ability were measured by observation; confidence and anxiety ratings were obtained by interview. BSE frequency was predicted by employment status and cyclically enlarged breasts, while BSE skill was related to professional BSE training and the length of that training plus bra size. Surprisingly, BSE training was not found to be associated with self-reported BSE frequency. These analyses suggest that BSE training may result in more complete BSE (although well below acceptable standards) performed by women who are moderately confident and sensitive to the risk of breast cancer--but not in more frequent BSE.     

Barriers to cervical cancer screening: a qualitative study with women in Serbia

Serbia employs opportunistic approaches to cervical cancer screening, leading to inequitable health care access. To better understand the health care needs of women, we investigated their knowledge of and perceived barriers to cervical cancer screening. Data reported in the paper arise from nine focus group discussions with 62 women from diverse socio-economic backgrounds. They were recruited in two cities with contrasting social settings, Belgrade, the Serbian capital, and a regional town, Smederevo. Thematic analysis identified that the interplay of social and personal barriers influenced women's poor presentation for screening. Inadequate public health education, lack of patient-friendly health services, socio-cultural health beliefs, gender roles, and personal difficulties were the most salient barriers to screening. We suggest how within the context of opportunistic screening patient education may be employed. The introduction of compulsory cervical cancer screening, suggested by some participants, is also discussed.     

Breast and cervical cancer screening: exploring perceptions and barriers with Hmong women and men in Oregon

Background. Hmong women are reported to have very low rates of breast and cervical cancer screening compared to other Asian and White women in the USA. Reasons for low cancer screening rates among this population are not well understood.

Methods. This qualitative study (n=83) explored Hmong women and men's perceptions of breast and cervical cancer and cancer screening, women's experiences with breast and cervical cancer screening, and health care system barriers to screening.

Results. Hmong women and men perceived breast cancer to be more severe than other types of cancers. Participants believed that breast cancer is curable if detected early. Cervical cancer was not well understood and was of greater concern than breast cancer because of its location within the body and its consequences for reproduction. In general, few participants had personal experiences with breast and/or cervical cancer. Overall, women and men had positive things to say about screenings for breast and cervical cancer, expressing that screenings offered a ‘proof of illness.’ The majority of women did not report any concerns with the exams themselves, although some discussed embarrassment, pain, and discomfort. Barriers to screening included lack of health insurance, making co-payments, language, and issues related to scheduling appointments. Barriers differed for younger and older women.

Conclusion. Results of this study provide new insight into perceptions, experiences, and barriers to breast and cervical cancer screening among Hmong women and men. These findings have implications for developing culturally appropriate interventions to increase breast and cervical cancer screening in this population.     

Breast cancer in young women

This eighth article in our series on breast disease focuses on breast cancer in young women. There are several challenges in the diagnosis of breast cancer in young women, and special consideration must be given to the woman's fertility and body image issues. The difficulty in distinguishing benign from malignant lesions on clinical and imaging assessment in this group stresses the importance of the triple test of clinical examination, mammography or ultrasound, and biopsy.     

Breast cancer care compared with clinical Guidelines: an observational study in France

Background  

Great variability in breast cancer (BC) treatment practices according to patient, tumour or organisation of care characteristics has been reported but the relation between these factors is not well known. In two French regions, we measured compliance with Clinical Practice Guidelines for non-metastatic BC care management and identified factors associated with non-compliance at clinical and organisational levels.     

Quality of life measurement in women with cervical cancer: implications for Chinese cervical cancer survivors

Background  

Women with cervical cancer now have relatively good 5-year survival rates. Better survival rates have driven the paradigm in cancer care from a medical illness model to a wellness model, which is concerned with the quality of women's lives as well as the length of survival. Thus, the assessment of quality of life among cervical cancer survivors is increasingly paramount for healthcare professionals. The purposes of this review were to describe existing validated quality of life instruments used in cervical cancer survivors, and to reveal the implications of quality of life measurement for Chinese cervical cancer survivors.     

Breast cancer trends of black women compared with white women

OBJECTIVE: To investigate why breast cancer mortality rates have decreased in the 1990's for white women but not for black women. DESIGN: Racial differences in breast cancer incidence, survival, and mortality rates were examined using regression methods and age-period-cohort models. SETTING: United States breast cancer mortality rates from 1970 through 1995, breast cancer incidence rates from 1980 through 1995, and 3-year survival rates from 1980 through 1993. The incidence and survival data are from the Surveillance, Epidemiology, and End Results Program, representing 11% of the US population, of the National Cancer Institute, Bethesda, Md. RESULTS: For both white and black women aged 30 to 39 years, breast cancer mortality rates began decreasing in 1987. For white women aged 40 to 79 years, breast cancer mortality rates declined after 1989, and for black women aged 40 to 69 years, mortality rates ceased increasing in the middle to late 1980s. Birth cohort trends were similar by race, but calendar period trends and survival rates differed. CONCLUSIONS: Declines in mortality rates in women younger than 40 years reflect a favorable birth cohort trend for women born after 1948 and likely reflect changes in risk factors. The increased early detection of breast cancer by mammography and improvements in breast cancer treatment appear to be contributing to the improving mortality trends in older women, although black women appear to have benefited less than white women from early detection and treatment advances. In addition, substantial increases in survival rates for white women with regional disease have contributed to their declining mortality rates and likely reflect an increasing use of beneficial adjuvant therapy.     

Breast and cervical cancer screening in older women: the San Diego Medicare Preventive Health Project.

BACKGROUND. This study presents rates and correlates of cancer screening, including mammography, clinical breast exam, breast self-examination, and Pap tests, in older women. Age was the predictor of main interest. RESULTS. Among a sample of female Medicare beneficiaries ages 65 and older, who were members of a health maintenance organization, there was a significant, inverse relationship between age and mammography adherence, while controlling for health status, physician utilization, education, and income. The proportions of subjects ages 65-74 and 75+ never having had a mammogram were 17 and 32%, respectively, and the proportions having had annual mammograms were 40 and 28%, respectively. Pap test frequency showed a trend toward an inverse relationship with age, controlling for demographic and health-related variables. In the youngest age group (65-69), 52% had annual Pap tests, whereas in the oldest group (80+), only 36% had annual Pap tests. Age did not predict frequency of clinical breast exam, and the relationship of age to breast self-examination was inconclusive. The role of the physician in promoting cancer screening is discussed.     

北京地区子宫颈癌发病相关因素分析——1∶3病例-对照流行病学调查

目的:了解近年北京地区宫颈癌流行病学情况,探讨现阶段宫颈癌的预防措施。方法:2004年6～12月采用1∶3病例-对照研究方法,对北京地区经病理确诊的286例宫颈癌患者和858例按年龄和地区匹配的健康对照进行一般情况、饮食与生活方式、月经婚育史、激素使用、既往病史及家族史和妇女病普查知识等因素的调查。结果:宫颈癌患者年龄最小24岁,最大87岁,中位发病年龄45岁。多因素分析显示采用避孕措施是宫颈癌的保护因素,子宫颈癌家族史、子宫癌家族史、既往滴虫性阴道炎和吸烟为宫颈癌的高危因素。结论:提倡使用安全套、戒烟、便前便后洗手、积极防治生殖道炎症,对子宫恶性肿瘤家族史、早婚等高危人群加强监测,将有助于降低宫颈癌的发病率。     

Breast and cervical cancer screening: sociodemographic predictors among White,Black, and Hispanic women

OBJECTIVES: We evaluated the relationship between breast and cervical cancer screening and a variety of variables across race/ethnicity groups. METHODS: Using logistic regression models, we analyzed data from the 1998 National Health Interview Survey to assess the relative importance of the independent variables in predicting use of cancer screening services. RESULTS: Having a usual source of care was the most important predictor of cancer screening use for all race/ethnicity groups. Health insurance was associated with an increased likelihood of cancer screening. Smoking was associated with a decreased likelihood of cancer screening. CONCLUSIONS: Regardless of race/ethnicity, most women follow mammography and cervical cancer screening guidelines. The identification of specific factors associated with adherence to cancer screening guidelines may help inform screening campaigns.