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The Medical Clinics of North America Mar 2023Cervical cancer screening is an essential component of preventative health care. Although rates of cervical cancer have decreased over the last 50 years, survival has... (Review)
Review
Cervical cancer screening is an essential component of preventative health care. Although rates of cervical cancer have decreased over the last 50 years, survival has not changed dramatically, and there are significant discrepancies in disease detection by race. Multiple national organizations contribute to the recommendations for cervical cancer screening timing, testing modalities, and management. This article aims to summarize the current understanding of cervical cancer pathogenesis, options for cervical cancer screening, and the shift in guidelines toward risk-based clinical management.
Topics: Female; Humans; Uterine Cervical Neoplasms; Early Detection of Cancer; Papillomavirus Infections; Delivery of Health Care; Mass Screening; Papanicolaou Test; Papillomaviridae
PubMed: 36759096
DOI: 10.1016/j.mcna.2022.10.006 -
European Review For Medical and... Oct 2021Cervical cancer is largely preventable. Although routine Pap smear screening has reduced cervical cancer-related mortality by 70-80% in all countries and by... (Review)
Review
OBJECTIVE
Cervical cancer is largely preventable. Although routine Pap smear screening has reduced cervical cancer-related mortality by 70-80% in all countries and by approximately 90% in developing countries, the gynecologist is still confronted with women in advanced stages of the disease. The eradication of cervical cancer depends on identifying the disease early and removing barriers to its timely detection. Given the significant burden of cervical cancer in Asian countries, we investigated factors related to its screening in Asia.
MATERIALS AND METHODS
A comprehensive search was carried out in databases such as Medline, Web of Science and Scopus for articles published until September 2020. The following keywords were used: vaginal smear, Pap smear, cervical cancer screening, barriers, obstacles, challenge, early detection, the name of each Asian country, and a combination of these words.
RESULTS
Seventy-five articles were included in the study. The investigation revealed various factors related to cervical cancer screening in Asian women, including sociodemographic factors, awareness, attitudes and beliefs, perceived risk, psychological factors, self-efficacy, previous experiences, time, household, culture, fatalism, social support, access, cost, safety, insurance and health system-related factors.
CONCLUSIONS
Several barriers hinder the efficacy of a screening program. Its success requires the use of educational interventions, professional and inter-professional cooperation, allocation of sufficient resources, and policymakers focusing on the elimination of barriers.
Topics: Asian People; Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Humans; Mass Screening; Papanicolaou Test; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 34661271
DOI: 10.26355/eurrev_202110_26889 -
The New England Journal of Medicine Jul 2021
Topics: District of Columbia; Female; Humans; International Planned Parenthood Federation; Middle Aged; Papanicolaou Test; Patient-Centered Care
PubMed: 34265191
DOI: 10.1056/NEJMp2109001 -
PloS One 2021The knowledge of Pap smear and uptake of preventive behaviors to prevent cervical cancer are the most important contributors to the advanced stage of the disease....
BACKGROUND
The knowledge of Pap smear and uptake of preventive behaviors to prevent cervical cancer are the most important contributors to the advanced stage of the disease. Knowledge is one of the most leading factors to predict the health behaviors and a helpful factor in performing screening procedures. This study aimed to investigate Saudi Arabian women knowledge of Pap testing in relation to their intention to undergo the test.
METHODS
An online survey including demographic characteristics (3 questions), knowledge (13 questions), and intentions (3 questions) towards Pap smear was completed by 467 Saudi Arabian women. Data were analyzed through SPSS version 22, using descriptive statistics and correlation to measure the relationship between knowledge, demographic factors, and intention.
RESULTS
The study found that average level of knowledge was 1.3 which is between high and moderate knowledge, and the average score for the intention was 2.88, to indicate that the intentions to uptake Pap smear among the participants were above the average. The study revealed a significant correlation between demographic factors and intention (p<0.01).
CONCLUSION
Findings from the current study can inform health care providers about Saudi Arabian women knowledge of Pap smear and the intention to uptake the test. Strategies to motivate women to undergo Pap screening should be introduced.
Topics: Adolescent; Adult; Aged; Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Humans; Middle Aged; Papanicolaou Test; Patient Acceptance of Health Care; Saudi Arabia; Uterine Cervical Neoplasms; Vaginal Smears; Young Adult
PubMed: 34166452
DOI: 10.1371/journal.pone.0253850 -
BMC Women's Health Apr 2021Cervical cancer is a leading cause of death among Peruvian women. Barriers at multiple levels impact effective screening and treatment, including a lack of knowledge...
BACKGROUND
Cervical cancer is a leading cause of death among Peruvian women. Barriers at multiple levels impact effective screening and treatment, including a lack of knowledge about cervical cancer and how regular screening can reduce morbidity and mortality through earlier detection. The aim of this study is to assess knowledge, attitudes, and practices regarding cervical cancer and its prevention in the peri-urban communities of Oasis and Pampas in southern Lima, Peru that can be used to inform future campaigns about cervical cancer prevention.
METHODS
A cross-sectional survey that included several open-ended questions was administered to women in Pampas and Oasis between 2015 and 2016 to evaluate the knowledge, attitudes, and practices regarding cervical cancer and Pap smears.
RESULTS
In total, 224 women were interviewed. Knowledge about cervical cancer and Pap smears was high, and attitudes were predominantly positive among most participants. Most participants knew how often they should get Pap smears (89.7%), when to begin seeking screening (74.6%), knew the price of a Pap smear (61.9%), and felt Pap smears were important for their health (70.1%). About one third (29.5%) of premenopausal women reported receiving a Pap smear in the last year. However, open ended questions revealed some knowledge gaps around Pap smears, as well as some stigma associated to Human Papilloma Virus (HPV) infection.
CONCLUSION
Although knowledge of cervical cancer prevention was generally high and perceptions were positive among women in peri-urban Peruvian communities, our findings revealed there is a need for education on HPV infection prevalence among sexually active individuals to reduce stigma. Future research should focus on exploring experiences with follow-up and treatment associated with abnormal Pap smears, as well as perspectives from health authorities and professionals about barriers in the early detection and treatment process for cervical cancer.
Topics: Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; Humans; Mass Screening; Papanicolaou Test; Peru; Surveys and Questionnaires; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 33882904
DOI: 10.1186/s12905-021-01291-8 -
JAAPA : Official Journal of the... Mar 2022For women ages 21 to 65 years who have not had a hysterectomy, the US Preventive Services Task Force (USPSTF) recommends cervical cancer screening with cytology (Pap... (Review)
Review
For women ages 21 to 65 years who have not had a hysterectomy, the US Preventive Services Task Force (USPSTF) recommends cervical cancer screening with cytology (Pap smear) every 3 years or a combination of cytology and human papillomavirus (HPV) testing every 5 years. However, foreign-born women were less likely to have received a Pap smear compared with US-born women. This article reviews barriers to cervical cancer screening for foreign-born women.
Topics: Adult; Aged; Early Detection of Cancer; Emigrants and Immigrants; Female; Humans; Mass Screening; Middle Aged; Papanicolaou Test; Papillomavirus Infections; Uterine Cervical Neoplasms; Vaginal Smears; Young Adult
PubMed: 35120364
DOI: 10.1097/01.JAA.0000819564.35151.0a -
Journal of Immigrant and Minority Health Feb 2022Although multiple studies have shown that resettled refugee women are less likely to receive preventative cancer screenings like pap smears and mammograms, a small...
Although multiple studies have shown that resettled refugee women are less likely to receive preventative cancer screenings like pap smears and mammograms, a small number have demonstrated the opposite. This retrospective chart review, conducted between January 2017 and October 2018, compares pap smear and mammogram rates of patients seen in a refugee-specific OB/GYN clinic with patients from the general OB/GYN clinic at the same institution. Data from 298 patients (149 refugee and 149 general clinic patients matched by age and date-of-visit) were analyzed. Pap smear screening rates were 90.60% in the refugee group and 73.83% in the general group [p < 0.009, aOR 3.46 (1.36-8.81)], while mammogram screening rates were 36.84% and 38.60%, respectively (p = 0.46). The provision of holistic services meeting refugee women's unique needs can effectively increase pap smear screening rates.
Topics: Female; Humans; Mass Screening; Papanicolaou Test; Refugees; Retrospective Studies; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 34714467
DOI: 10.1007/s10903-021-01297-2 -
Journal of Cancer Education : the... Oct 2023In Morocco, cervical cancer is the second most common cancer affecting women after breast cancer. Encouraging more women to practice cervical cancer screening remains a...
In Morocco, cervical cancer is the second most common cancer affecting women after breast cancer. Encouraging more women to practice cervical cancer screening remains a major public health concern. There is a lack of data on awareness and of data concerning the determinants of the acceptability of Pap smear test in Morocco. To fill this gap, our study aims to assess the level of awareness of cervical cancer and human papillomavirus (HPV) infection among Moroccan women and to understand the determinants of the acceptability of Pap smear test. We conducted a cross-sectional study including 857 women in the following three Moroccan regions: Casablanca-settat, Marrakech-Safi, and Tanger-Tetouan-Al Hoceima, by using a structured interviewer-administered questionnaire between November 2019 and February 2020. Out of the total sample, 83.9% of participants were aware of cervical cancer, 87.2% of participants were unaware of HPV, and 51.8% of participants were aware of Pap smear test. The rate of women who had ever had a Pap smear test in our population was only 19.36%. Moreover, our study revealed that more than 78% of participants were willing to undergo Pap smear test regularly in the future. The study revealed parity, age, educational level, risk perception, and the belief that early screening improves the chances of successful treatment, as determinants of acceptability of Pap smear test. Our results have shown that there is an urgent need to implement a strategy to sensitize women on the prevention of cervical cancer. Furthermore, the results of this study should be taken into account in the development of strategic and action plans for the prevention of cervical cancer.
Topics: Female; Humans; Papanicolaou Test; Vaginal Smears; Uterine Cervical Neoplasms; Early Detection of Cancer; Cross-Sectional Studies; Papillomavirus Infections; Health Knowledge, Attitudes, Practice; Mass Screening; Surveys and Questionnaires
PubMed: 37418146
DOI: 10.1007/s13187-023-02317-5 -
Cancer Epidemiology Oct 2022Like many Eastern-European countries, Estonia struggles with ineffective cervical cancer (CC) screening. Despite a long-term organised screening programme and high...
BACKGROUND
Like many Eastern-European countries, Estonia struggles with ineffective cervical cancer (CC) screening. Despite a long-term organised screening programme and high overall Pap-smear coverage, CC incidence and mortality remain very high. The aim of the study was to examine the reasons for high CC incidence in Estonia by analysing the effect of Pap-smears and sociodemographic factors on CC risk.
METHODS
In this population-based case-control study, women aged ≥ 25 years with an in situ/invasive CC diagnosed in Estonia in 2011-2017 were defined as cases. Using a density sampling scheme, controls were randomly selected from general population. To estimate CC risk associated with having no Pap-smears during seven years before diagnosis (cases) or index date (controls), place of residence, interruption in health insurance, and several sociodemographic factors, multivariate logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals (CI). Individual-level data from three population-based registries were used.
RESULTS
Among 1439 cases and 4317 controls, proportion of women with no Pap-smears was 53% and 35%, respectively. Women with no Pap-smears were at higher risk for CC (OR=2.35; 95% CI: 1.85-2.98). CC risk was increased among women who were younger, living in more remote regions, lower-educated, or divorced/widowed. Interruption in health insurance was associated with a 23% risk increase. Regional differences in CC risk were observed among screened women.
CONCLUSION
To reduce the risk of CC in Estonia, efforts are necessary to increase screening coverage among high-risk women and ensure the quality of CC screening programme. Screening approaches and communication should be tailored to the needs of different population groups. Further studies are warranted to identify the reasons for regional differences in CC risk.
Topics: Case-Control Studies; Estonia; Female; Humans; Logistic Models; Mass Screening; Papanicolaou Test; Sociodemographic Factors; Uterine Cervical Neoplasms; Vaginal Smears; Uterine Cervical Dysplasia
PubMed: 35901623
DOI: 10.1016/j.canep.2022.102231 -
The Gulf Journal of Oncology Jan 2022The study aim is to determine the association of post-menopausal status with abnormal Pap smear cytology and cervical dysplasia detected by colposcopically-directed...
INTRODUCTION
The study aim is to determine the association of post-menopausal status with abnormal Pap smear cytology and cervical dysplasia detected by colposcopically-directed biopsy. We also study the association of biopsy-confirmed dysplasia with Pap smear results.
PATIENTS AND METHODS
This retrospective study included 480 women with abnormal Pap smear results who were referred for colposcopy. Covariates considered included demographic (age, race/ethnicity, smoking status), sexual activity (age first sexual intercourse, number lifetime partners, duration current partner), and disease (HIV, high-risk HPV, immunosuppression).
RESULTS
Post-menopausal status was not significantly associated with abnormal Pap smear cytology or cervical dysplasia. We found a statistically significant association of high-grade dysplasia with high-grade Pap smear results: ASC-H (B=3.43, SE=0.84, p< 0.001); HSIL (B=3.50, SE=0.84, p< 0.001) and AGC (B=3.47, SE=1.02, p< 0.01).
DISCUSSION AND CONCLUSION
Although clinicians may want to consider not requiring colposcopically-directed biopsy for certain post-menopausal patients, we recommend continuing with current cervical cancer guidelines of screening for all women regardless of menopausal status.
Topics: Female; Humans; Papanicolaou Test; Postmenopause; Retrospective Studies; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms; Vaginal Smears
PubMed: 35156642
DOI: No ID Found