1
|
Urwin S, Gillibrand S, Davies JC, Crosbie EJ. Factors associated with cervical screening coverage: a longitudinal analysis of English general practices from 2013 to 2022. J Public Health (Oxf) 2024; 46:e43-e50. [PMID: 38148290 PMCID: PMC10939411 DOI: 10.1093/pubmed/fdad275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Indexed: 12/28/2023] Open
Abstract
BACKGROUND Cervical cancer remains an important global public health concern. Understanding the factors contributing to a decline in screening uptake in high-income countries is fundamental to improving screening rates. We aimed to identify general practice and patient characteristics related to cervical screening coverage in England between 2013 and 2022. METHODS We analyzed a panel of 59 271 General Practice (GP)-years from 7881 GP practices. We applied correlated random effects regression to examine the association between cervical screening uptake and a rich set of GP practice workforce, size, quality and patient characteristics. RESULTS Our results show a decline in overall screening rates from 2013/14 to 2021/22 from 77% to 72%. We find GP workforce and list size characteristics are strongly related to screening rates. An increase in 1 FTE Nurse per 1000 patients is related to a 1.94 percentage point increase in cervical screening rates. GP practices located in more deprived areas have lower screening rates. CONCLUSIONS GP workforce and patient characteristics need to be considered by decision-makers to increase screening rates. The implementation of self-sampling screening methods could help address some of the current barriers to screening, including lack of healthcare staff and facilities.
Collapse
Affiliation(s)
- Sean Urwin
- Health Organisation, Policy and Economics Group, School of Health Sciences, University of Manchester, Manchester M13 9PL, UK
| | - Stephanie Gillibrand
- Health Organisation, Policy and Economics Group, School of Health Sciences, University of Manchester, Manchester M13 9PL, UK
| | - Jennifer C Davies
- Gynaecological Oncology Research Group, Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK
- Department of Obstetrics and Gynaecology, St Mary's Hospital, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK
| | - Emma J Crosbie
- Gynaecological Oncology Research Group, Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK
- Department of Obstetrics and Gynaecology, St Mary's Hospital, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK
| |
Collapse
|
2
|
Waite F, Marlow LAV, Nemec M, Waller J. The impact of age-relevant and generic infographics on knowledge, attitudes and intention to attend cervical screening: A randomized controlled trial. Br J Health Psychol 2024; 29:204-220. [PMID: 37770383 PMCID: PMC10952565 DOI: 10.1111/bjhp.12695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/10/2023] [Accepted: 09/11/2023] [Indexed: 09/30/2023]
Abstract
OBJECTIVES Cervical screening uptake in England is falling. Infographics could strengthen intention to attend, increase positive attitudes and improve knowledge. Age targeting could improve these outcomes further. We tested the impact of generic and age-targeted infographics. DESIGN A randomized controlled trial using an age-stratified, parallel-group design. METHODS Women aged 25-64 (n = 2095) were recruited through an online panel and randomized to see one of the three infographics. We tested: (i) impact of a generic cervical screening infographic compared to a control infographic on an unrelated topic with all screening age women and (ii) impact of an age-targeted infographic compared to a generic cervical screening infographic with older women (50-64 years). Intentions, knowledge and attitudes were measured. RESULTS Women aged 25-64 years who viewed the generic infographic had significantly higher intentions [F(1, 1513) = 6.14, p = .013,η p 2 = .004], more accurate beliefs about the timeline of cervical cancer development (OR: 5.18, 95% CI: 3.86-6.95), more accurate social norms (OR: 3.03, 95% CI: 2.38-3.87) and more positive beliefs about screening benefits (OR: 2.23, 95% CI: 1.52-3.28) than those viewing the control infographic. In the older age group, there was no significant difference in intention between those viewing the generic versus age-targeted versions [F(1, 607) = .03, p = .853,η p 2 < .001], but the age-targeted version was more engaging [F(1, 608) = 9.41, p = .002,η p 2 = .015]. CONCLUSIONS A cervical screening infographic can result in more positive attitudes and better knowledge and may have a small impact on intentions. Although age targeting did not affect intention, it had a positive impact on engagement and may therefore be useful in encouraging women to read and process materials.
Collapse
Affiliation(s)
- Frances Waite
- Cancer Prevention Group, School of Cancer & Pharmaceutical SciencesKing's College LondonLondonUK
| | - Laura A. V. Marlow
- Cancer Prevention Group, School of Cancer & Pharmaceutical SciencesKing's College LondonLondonUK
| | - Martin Nemec
- Cancer Prevention Group, School of Cancer & Pharmaceutical SciencesKing's College LondonLondonUK
- Behavioural Science and Health, Institute of Epidemiology & HealthUniversity College LondonLondonUK
| | - Jo Waller
- Cancer Prevention Group, School of Cancer & Pharmaceutical SciencesKing's College LondonLondonUK
| |
Collapse
|
3
|
Wilding S, O'Connor DB, Conner M. Social Norms in Cervical Cancer Screening. Psychol Rep 2023:332941231219943. [PMID: 38048215 DOI: 10.1177/00332941231219943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
Cancer screening aims to check the body for cancer before symptoms develop. Social norms theory suggests people falsely perceive the attitudes and/or behaviours of similar others to be different from their own and correcting these perceptions can lead to behaviour change. Across two studies, we tested if women underestimate peer levels of cervical screening behaviour and whether a social norms manipulation increases intention to attend cervical cancer screening. In study 1, participants completed a survey on cervical cancer screening norms. In study 2, participants were randomised to receive no norm information, norm information, or norm information plus statement on value of norms in decision making. In study 1, participant estimates of peer level of cervical screening behaviour were significantly lower than nationally reported levels. In study 2, a social norm plus value statement intervention led to stronger intentions to attend screening. This effect was consistent across demographic factors and screening status. Participants significantly underestimate rates of cervical screening behaviour in their peers. A brief, online social norms plus values manipulation increased intentions to attend cervical cancer screening across all groups.
Collapse
Affiliation(s)
- Sarah Wilding
- School of Psychology, University of Leeds, Leeds, UK
| | | | - Mark Conner
- School of Psychology, University of Leeds, Leeds, UK
| |
Collapse
|
4
|
Bermúdez PC, Arrivillaga M, Torres Poveda K, Castrillón Libreros DM, Castillo Castillo LE, Neira Acevedo D. Barriers to adherence to cytology exam: a case study in low-income Colombian women. BMC Health Serv Res 2023; 23:796. [PMID: 37491282 PMCID: PMC10369816 DOI: 10.1186/s12913-023-09700-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 06/14/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Cervical cytology is essential for the early detection of cervical cancer. However, in Colombia, only 50% of women with subsidized health insurance were screened in 2019, compared to 100% of women with contributory insurance. This disparity highlights significant barriers that must be addressed. This study aimed to identify the factors that contribute to or hinder adherence to cervical cytology screening among low-income women with subsidized health insurance in a public primary care network in Cali, Colombia, from 2014 to 2018. METHODS In a qualitative case study, the experience of women and health care and administrative personnel was recovered. Forty-seven women participated in seven focus group discussions. Five other women using the program participated in in-depth interviews. Finally, we interviewed eight people from the healthcare area and the health services administration. The qualitative data collected underwent content analysis, guided by the theoretical framework of Social Determinants of Health. Within this framework, five interconnected dimensions that influence adherence were incorporated. RESULTS Adherence is a multifactorial phenomenon, and in relation to attendance at cervical cytology, the analysis delved into the mechanisms that affect it in a low-income context. Barriers to adherence were identified across multiple dimensions, including social and economic factors, health conditions, and patient-related factors, among both adherent and non-adherent women. Among adherent women, barriers and facilitators related to the healthcare team and system, as well as patient-related factors, were identified. CONCLUSIONS The findings of this research can be useful in developing personalized interventions and strategies to improve adherence and screening outcomes in low-income settings. It is necessary to increase the resources of health insurance entities to establish effective communication channels with women who attend the cervical cancer prevention program.
Collapse
Affiliation(s)
- Paula C Bermúdez
- Departamento de Salud Pública y Epidemiología, Pontificia Universidad Javeriana Cali, Cali, Colombia.
| | - Marcela Arrivillaga
- Oficina de Investigación, Pontificia Universidad Javeriana Cali, Cali, Colombia
| | - Kirvis Torres Poveda
- Chronic Infections and Cancer Division, National Institute of Public Health, Cuernavaca, Morelos, México
| | | | | | - Daniela Neira Acevedo
- Hospital de Siloé Siglo XXI, Red de Salud Ladera Empresa Social del Estado, Cali, Colombia
| |
Collapse
|
5
|
Oike T, Osu N, Yoshimoto Y, Obinata H, Yoshikawa K, Harris CC, Ohno T. Pilot study of plasma creatine riboside as a potential biomarker for cervical cancer. Heliyon 2023; 9:e16684. [PMID: 37292314 PMCID: PMC10245246 DOI: 10.1016/j.heliyon.2023.e16684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 05/19/2023] [Accepted: 05/24/2023] [Indexed: 06/10/2023] Open
Abstract
This pilot study aimed primarily to evaluate plasma levels of a novel metabolite, creatine riboside, in patients with cervical cancer (discovery and validation cohorts, n = 11 for each) compared with non-cancer subjects (controls, n = 30). We found that the pre-treatment plasma creatine riboside level was significantly higher in the discovery cohort than in controls. The cut-off value determined from the discovery cohort distinguished 90.9% of the patients in the validation cohort from controls. Unbiased principal component analysis of plasma metabolites in high-creatine riboside samples demonstrated enrichment of pathways involved in arginine and creatine metabolism. These data indicate the potential utility of plasma creatine riboside as a biomarker of cervical cancer.
Collapse
Affiliation(s)
- Takahiro Oike
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma, 371-8511, Japan
- Gunma University Heavy Ion Medical Center, 3-39-22, Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Naoto Osu
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Yuya Yoshimoto
- Department of Radiation Oncology, School of Medicine, Fukushima Medical University, 1, Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan
| | - Hideru Obinata
- Laboratory for Analytical Instruments, Education and Research Support Center, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Kazuhiro Yoshikawa
- Division of Research Creation and Biobank, Research Creation Support Center, Aichi Medical University, 1-1, Yazako-karimata, Nagakute, Aichi, 480-1103, Japan
| | - Curtis C. Harris
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 37 Convent Dr, Bethesda, MD, 20814, USA
| | - Tatsuya Ohno
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma, 371-8511, Japan
- Gunma University Heavy Ion Medical Center, 3-39-22, Showa-machi, Maebashi, Gunma, 371-8511, Japan
| |
Collapse
|
6
|
Wilding S, Wighton S, West R, Conner M, O'Connor DB. A randomised controlled trial of volitional and motivational interventions to improve cervical cancer screening uptake. Soc Sci Med 2023; 322:115800. [PMID: 36858020 DOI: 10.1016/j.socscimed.2023.115800] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 01/18/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023]
Abstract
OBJECTIVE Cervical cancer is the fourth most common cancer to occur in women worldwide. In the UK, the NHS cervical screening programme invites eligible individuals to take part in screening every 3-5 years. At present, around 70% of individuals attend screening when invited. The present study aimed to test the effectiveness of a volitional and a motivational intervention alone and in combination on screening uptake at 16-week follow up. METHODS 14,536 participants were recruited from the list of eligible participants invited for screening in Yorkshire, Humber and the North East regions of England in December 2021. They were randomised to a social norm-based motivational intervention (SNA); implementation intention-based Volitional Help Sheet (VHS); combined intervention (SNA + VHS); or treatment as usual control. The primary outcome was screening uptake measured via patient screening records at 16 weeks. RESULTS Of the 14,466 participants with eligible data for analysis, 5793 (40.0%) attended for cervical cancer screening in the 16 weeks after the intervention mailing. Both age and deprivation influenced screening uptake, with lower uptake in the youngest individuals and those from more deprived areas. Compared to control, there was no evidence of any benefit from the VHS implementation intervention alone (Adj.OR = 0.99, 95% CI 0.90 to 1.10), the SNA motivational intervention alone (Adj.OR = 0.89; 95% CI: 0.80 to 0.99), or the combined intervention (Adj.OR = 0.96, 95% CI 0.86 to 1.06). CONCLUSION The study did not support any benefit of either VHS or SNA interventions alone or in combination on cervical cancer screening uptake. It did demonstrate alarmingly low levels of screening uptake at 16 weeks which were well below the average rate. Future research needs to urgently investigate and understand the barriers to uptake following on from the COVID-19 pandemic.
Collapse
Affiliation(s)
- Sarah Wilding
- School of Psychology, University of Leeds, Leeds, UK
| | - Sarah Wighton
- NHS England and NHS Improvement (North East & Yorkshire), UK
| | - Robert West
- Leeds Institute of Health Sciences, University of Leeds, UK
| | - Mark Conner
- School of Psychology, University of Leeds, Leeds, UK.
| | | |
Collapse
|
7
|
Guliashvili G, Taboridze I, Mebonia N, Alibegashvili T, Kazakhashvili N, Imnadze P. Evaluation of barriers to cervical cancer screening in Georgia. Cent Eur J Public Health 2023; 31:9-18. [PMID: 37086415 DOI: 10.21101/cejph.a7621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 02/24/2023] [Indexed: 04/23/2023]
Abstract
OBJECTIVES The Cervical Cancer (CC) Screening Programme in Georgia provides insufficient coverage of the target population. The aim of the study is to identify the barriers to cervical cancer screening for women in Georgia in order to plan and implement adequate measures to increase the screening effectiveness. METHODS The study is based on the results of a survey of 582 women aged 25-60 years (mean age 42.11 + 12.17). Respondents were selected in out-patient clinics. The questionnaire included questions related to the place of residence, ethnicity, religion, marital status, education, employment, cervical cancer awareness and screening, screening participation practices, and barriers to participation. RESULTS The following factors reliably increase the chance of participating in the screening: residing in Tbilisi, OR = 1.84 (95% CI: 1.10-3.07); higher education, OR = 1.87 (95% CI: 1.09-3.19); being employed as a nurse, OR = 3.42 (95% CI: 1.49-7.85); receiving screening-related information from medical staff, OR = 2.43 (95% CI: 1.42-4.15); and from television, OR = 2.57 (95% CI: 1.47-4.50). The chance of participating in the screening is reduced due to incomplete secondary education, OR = 0.10 (95% CI: 0.01-0.77); single marital status, OR = 0.49 (95% CI: 0.28-0.87); employment in public service, OR = 0.39 (95% CI: 0.17-0.89); and receiving screening-related information from friends, OR = 0.26 (95% CI: 0.09-0.77). Women with higher education are undoubtedly more informed about screening, screening procedures and free programmes than those without higher education. The common barrier to participation in the screening was "fear of the manipulation-related pain" but the most frequent answer was "I'm afraid that the test will detect cancer (36.3%)." Women with a lower level of education are more likely to believe that "Pap testing is appropriate for the women who have active sexual life", and/or "have multiple sexual partners", and/or "have children," and "it is not necessary if a woman has no complaints". CONCLUSION Screening participation among women in Georgia depends on screening availability, formal education and awareness of CC, sources of information, and employment type.
Collapse
Affiliation(s)
- Gvantsa Guliashvili
- Faculty of Medicine, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia
- Georgian National Screening Centre, Tbilisi, Georgia
| | - Iamze Taboridze
- David Aghmashenebeli University of Georgia, Tbilisi, Georgia
| | - Nana Mebonia
- National Centre for Disease Control and Public Health, Tbilisi, Georgia
| | | | - Nata Kazakhashvili
- Faculty of Medicine, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia
| | - Paata Imnadze
- Faculty of Medicine, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia
- National Centre for Disease Control and Public Health, Tbilisi, Georgia
| |
Collapse
|
8
|
Wilding S, Prudenzi A, Conner M, O'Connor DB. Do reasoned action approach variables mediate relationships between demographics and cervical cancer screening intentions or behaviour? An online study of women from the UK. Soc Sci Med 2022; 313:115354. [PMID: 36191387 DOI: 10.1016/j.socscimed.2022.115354] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 08/05/2022] [Accepted: 09/03/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVE In the UK, approximately 3,200 women are diagnosed with cervical cancer each year. Regular screening is one of the best ways to prevent cervical cancer from developing, yet screening rates are declining and vary by sociodemographic variables. The present stratified online study aimed to investigate relationships between sociodemographic factors and screening intentions and past behaviour. Reasoned Action Approach (RAA) variables were assessed as potential mediators. METHODS In total, 500 women living in the UK were recruited via an online research recruitment website to an online cross-sectional survey. Participant recruitment was stratified by age, socioeconomic status and ethnicity to ensure adequate representation of each strata. Participants completed measures on RAA variables (affective attitudes, cognitive attitudes, injunctive norms, descriptive norms, capability, autonomy, and intention) as well as screening past behaviour. RESULTS Among the demographic variables, age, ethnicity and deprivation were significantly related to screening intention. Younger women, those from less deprived areas, along with white women were more likely to report higher intentions to attend screening. Past behaviour was significantly negatively predicted by deprivation only, indicating that individuals from less deprived areas were more likely to be up to date with their screening. Both intention and past behaviour were significantly positively correlated with all RAA variables. Capability and cognitive attitude partially mediated the relationship between age and intention and fully mediated the relationship between ethnicity and intention. Capability fully mediated the relationships between deprivation and intention and between deprivation and past behaviour. CONCLUSION Intentions toward attending cervical cancer screening are related to age, ethnicity, and level of deprivation, with older women and those from areas of greater deprivation and ethnic minority groups reporting lower intentions. Capability (confidence engaging in cervical screening) and cognitive attitudes (how useful/beneficial screening is seen to be) are key variables to target to promote cervical screening attendance and reduce potential inequalities.
Collapse
Affiliation(s)
- Sarah Wilding
- School of Psychology, University of Leeds, LS2 9JT, Leeds, UK
| | - Arianna Prudenzi
- School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Mark Conner
- School of Psychology, University of Leeds, LS2 9JT, Leeds, UK.
| | | |
Collapse
|
9
|
Osei EA, Appiah S, Oti-Boadi E, Hammond D, Awuah DB, Menlah A, Garti I, Baidoo M. Experiences of women awaiting cervical CANCER screening results from selected hospitals in Accra, Ghana. BMC Public Health 2022; 22:1467. [PMID: 35915420 PMCID: PMC9342593 DOI: 10.1186/s12889-022-13874-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 07/26/2022] [Indexed: 11/10/2022] Open
Abstract
Background The rate at which cervical cancer is diagnosed among women worldwide is alarming, nevertheless, millions of women have never undergone cervical cancer screening, and many more with cervical cancer die prematurely without accessibility to quality healthcare or effective treatment. Women’s experiences following cervical cancer screening have not been extensively studied especially in advancing countries like Ghana. Hence, the researchers aim to explore the experiences of women awaiting cervical cancer results at selected hospitals in Accra. Methods An exploratory-descriptive qualitative design was adopted to purposively sample 48 participants engaged in face-face in-depth interviews, which were audio-taped and transcribed verbatim after. The interviews were guided by semi-structured interviews. Findings The findings revealed 3 themes and 10 subthemes. The themes were pre-screening experience, intra-screening experience, and post-screening experience. Participants narrated the challenges they face before the screening, during the screening, and as they waited for their results to get ready. Despite some challenges reported, most of the participants indicated that they were willing to come for a retesting if recommended. Conclusion In conclusion, participants who have undergone CCS have several experiences that may either motivate or discourage them from subsequent screening. Being aware of such experiences could help the nurses address them in order to increase the interest of the women in CCS.
Collapse
Affiliation(s)
- Evans Appiah Osei
- School of Nursing and Midwifery, Department of Midwifery, Valley View University, P.O. Box DT, 595, Oyibi, Ghana.
| | - Stella Appiah
- Head of the Department of Nursing, Valley View University, Box AF 595, Adentan, Accra, Ghana.
| | - Ezekiel Oti-Boadi
- School of Nursing and Midwifery, Valley View University, Oyibi, Ghana.
| | | | | | - Awube Menlah
- School of Nursing and Midwifery, Valley View University, Oyibi, Ghana.
| | | | | |
Collapse
|
10
|
Vallone F, Lemmo D, Martino ML, Donizzetti AR, Freda MF, Palumbo F, Lorenzo E, D'Argenzio A, Caso D. Factors Promoting Breast, Cervical and Colorectal Cancer Screenings participation: A Systematic Review. Psychooncology 2022; 31:1435-1447. [PMID: 35793430 PMCID: PMC9541457 DOI: 10.1002/pon.5997] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/29/2022] [Accepted: 07/04/2022] [Indexed: 12/05/2022]
Abstract
Objective The present study aims at systematically reviewing research conducted on factors promoting breast, cervical and colorectal cancer screenings participation. Methods A literature search in MEDLINE/PubMed and PsycInfo from January 2017 to October 2021 was performed. Data extraction, researchers' full agreement and the inclusion criteria produced 102 eligible studies. Data were narratively synthesized and critically interpreted. Results Multiple factors favoring or hindering breast, cervical and colorectal cancer screenings were identified and summarized as factors operating at the individual level (background information, individual characteristics, emotions related to screening procedure and to cancer, knowledge and awareness), at the relational level (relationships with healthcare staff, significant others, community members), and at the healthcare system level (systems barriers/policy, lack of staff). A critical appraisal of studies revealed a fragmentation in the literature, with a compartmentalization of studies by type of cancer screening, country and specific populations of destination. Conclusions Overall findings indicated that greater integration of research results obtained independently for each cancer diagnosis and within the different countries/populations could foster a more comprehensive understanding of factors potentially enhancing the participation in breast, cervical and colorectal cancer screenings worldwide. This review, which is grounded in the current context of globalization and superdiversification in population, can help to enhance a better integration between research and practices, by supporting the development of more effective and inclusive evidence‐based interventions and health‐promotion campaigns worldwide. Research and practical implications are highlighted and discussed.
Collapse
Affiliation(s)
- Federica Vallone
- University of Naples Federico II, Department of Humanities, Napoli, Italy.,Dynamic Psychology Laboratory, Department of Political Sciences, University of Naples Federico II, Napoli, Italy
| | - Daniela Lemmo
- University of Naples Federico II, Department of Humanities, Napoli, Italy
| | | | | | | | - Francesco Palumbo
- Department of Political Sciences, University of Naples Federico II, Napoli, Italy
| | - Elvira Lorenzo
- Regione Campania, Direzione Generale per la Tutela della Salute ed il Coordinamento del Sistema Sanitario Regionale, Napoli, Italy
| | - Angelo D'Argenzio
- Regione Campania, Direzione Generale per la Tutela della Salute ed il Coordinamento del Sistema Sanitario Regionale, Napoli, Italy
| | - Daniela Caso
- University of Naples Federico II, Department of Humanities, Napoli, Italy
| |
Collapse
|
11
|
Young B, Robb KA. Understanding patient factors to increase uptake of cancer screening: a review. Future Oncol 2021; 17:3757-3775. [PMID: 34378403 DOI: 10.2217/fon-2020-1078] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Early detection of cancer through organized screening is a central component of population-level strategies to reduce cancer mortality. For screening programs to be effective, it is important that those invited to screening participate. However, uptake rates are suboptimal in many populations and vary between screening programs, indicating a complex combination of patient factors that require elucidation to develop evidence-based strategies to increase participation. In this review, the authors summarize individual-level (sociodemographic and psychosocial) factors associated with cancer screening uptake and evidence for the effectiveness of behavioral interventions to increase uptake. The authors reflect on current trends and future directions for behavioral cancer screening research to overcome challenges and address unmet needs in reducing cancer mortality.
Collapse
Affiliation(s)
- Ben Young
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, G12 0XH, UK
| | - Kathryn A Robb
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, G12 0XH, UK
| |
Collapse
|
12
|
Davies-Oliveira JC, Smith MA, Grover S, Canfell K, Crosbie EJ. Eliminating Cervical Cancer: Progress and Challenges for High-income Countries. Clin Oncol (R Coll Radiol) 2021; 33:550-559. [PMID: 34315640 DOI: 10.1016/j.clon.2021.06.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 06/21/2021] [Accepted: 06/29/2021] [Indexed: 11/26/2022]
Abstract
In 2020, the World Health Organization launched a major initiative to eliminate cervical cancer globally. The initiative is built around the three key pillars of human papillomavirus (HPV) vaccination, cervical screening and treatment, with associated intervention targets for the year 2030. The '90-70-90' targets specify that 90% of adolescent girls receive prophylactic HPV vaccination, 70% of adult women receive a minimum twice-in-a-lifetime cervical HPV test and 90% receive appropriate treatment for preinvasive or invasive disease. Modelling has shown that if these targets are met, the elimination of cervical cancer, defined as fewer than four cases per 100 000 women per annum, will be achieved within a century. Many high-income countries are well positioned to eliminate cervical cancer within the coming decades, but few have achieved '90-70-90' and many challenges must still be addressed to deliver these critical interventions effectively. This review considers the current status of cervical cancer control in relation to each of the three elimination pillars in high-income countries and discusses some of the developments that will assist countries in reaching these ambitious targets by 2030.
Collapse
Affiliation(s)
- J C Davies-Oliveira
- Gynaecological Oncology Research Group, Division of Cancer Sciences, University of Manchester, Faculty of Biology, Medicine and Health, Manchester, UK; Department of Obstetrics and Gynaecology, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - M A Smith
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - S Grover
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia; Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - K Canfell
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia.
| | - E J Crosbie
- Gynaecological Oncology Research Group, Division of Cancer Sciences, University of Manchester, Faculty of Biology, Medicine and Health, Manchester, UK; Department of Obstetrics and Gynaecology, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| |
Collapse
|
13
|
Groves S, Brooks J. What do young women below national screening age in England think about cervical cancer and cervical screening? A qualitative study. J Clin Nurs 2021; 31:1588-1597. [PMID: 34418192 DOI: 10.1111/jocn.16012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/05/2021] [Accepted: 08/10/2021] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To explore what women aged below the national screening age in the UK know and think about cervical cancer and cervical screening. BACKGROUND The efficacy of cervical cancer screening is well established. However, cervical screening attendance in the United Kingdom has decreased, with especially low rates at the first screening opportunity at age 25. Research has not yet explored knowledge and beliefs underpinning young women's intention to screen before first screening invitation. DESIGN Qualitative exploratory study. METHODS Qualitative email interviews were undertaken with 16 participants, using questions derived from the Health Belief Model. Data were analysed using template analysis. The COREQ were followed. RESULTS Analysis generated three themes; (1) Learning about cervical cancer and cervical screening: sources of information and (missed) opportunities; (2) Young women know screening is important - but they don't always know why; (3) Screening intentions: a cost/benefit analysis of the available information. CONCLUSIONS Young women had varied knowledge and beliefs about cervical cancer and screening which were underpinned by several sources of information available to them. Most women expressed an intention to attend screening when invited; however, some participants were unsure, with low screening-based knowledge and low perceived susceptibility of cervical cancer identified as key barriers. Social media, familial interactions and interventions within education were highlighted as being suited to interventions aimed at increasing cervical cancer- and screening-based knowledge in young women. RELEVANCE TO CLINICAL PRACTICE Findings suggest that women below screening age could be better informed about cervical cancer and screening. Tailored interventions addressing common concerns and misconceptions around screening may be acceptable to young women and could help to promote screening attendance at first invitation.
Collapse
Affiliation(s)
- Samantha Groves
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, England
| | - Joanna Brooks
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, England
| |
Collapse
|
14
|
Stuart G, D'Lima D. Perceived barriers and facilitators to attendance for cervical cancer screening in EU member states: a systematic review and synthesis using the Theoretical Domains Framework. Psychol Health 2021; 37:279-330. [PMID: 34121540 DOI: 10.1080/08870446.2021.1918690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIMS To identify and synthesise peer-reviewed, published literature reporting perceived barriers and facilitators associated with cervical cancer screening attendance in EU member states with organised population-based screening programmes. METHODS Quantitative and qualitative studies reporting perceived barriers/facilitators to attendance for cervical cancer screening were searched for in databases Embase, HMIC, Medline and PsycInfo. Data were extracted and deductively coded to the Theoretical Domains Framework domains and inductive thematic analysis within domains was employed to identify specific barriers or facilitators to attendance for cervical cancer screening. RESULTS 38 studies were included for data extraction. Five theoretical domains ['Emotion' (89% of the included studies), 'Social influences' (79%), 'Knowledge' (76%), 'Environmental Context and Resources' (74%) and 'Beliefs about Consequences' (68%)] were identified as key domains influencing cervical cancer screening attendance. CONCLUSION Five theoretical domains were identified as prominent influences on cervical cancer screening attendance in EU member states with organised population-based screening programmes. Further research is needed to identify the relative importance of different influences for different sub-populations and to identify the influences that are most appropriate and feasible to address in future interventions.
Collapse
Affiliation(s)
- Gabriella Stuart
- Centre for Behaviour Change, Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Danielle D'Lima
- Centre for Behaviour Change, Department of Clinical, Educational and Health Psychology, University College London, London, UK
| |
Collapse
|
15
|
Chua B, Ma V, Asjes C, Lim A, Mohseni M, Wee HL. Barriers to and Facilitators of Cervical Cancer Screening among Women in Southeast Asia: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4586. [PMID: 33926019 PMCID: PMC8123618 DOI: 10.3390/ijerph18094586] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/24/2021] [Accepted: 04/24/2021] [Indexed: 01/27/2023]
Abstract
In Southeast Asia, cervical cancer is the second most common cancer in women. Low coverage for cervical cancer screening (CCS) becomes a roadblock to disease detection and treatment. Existing reviews on CCS have limited insights into the barriers and facilitators for SEA. Hence, this study aims to identify key barriers and facilitators among women living in SEA. A systematic literature review was conducted on Pubmed, Embase, PsycINFO, CINAHL, and SCOPUS. Primary qualitative and quantitative studies published in English that reported barriers and facilitators to CCS were included. The Mix Methods Appraisal Tool was used for the quality assessment of the included studies. Among the 93 included studies, pap smears (73.1%) were the most common screening modality. A majority of the studies were from Malaysia (35.5%). No studies were from Timor-Leste and the Philippines. The most common barriers were embarrassment (number of articles, n = 33), time constraints (n = 27), and poor knowledge of screening (n = 27). The most common facilitators were related to age (n = 21), receiving advice from healthcare workers (n = 17), and education status (n = 11). Findings from this review may inform health policy makers in developing effective cervical cancer screening programs in SEA countries.
Collapse
Affiliation(s)
- Brandon Chua
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, Singapore 117549, Singapore; (B.C.); (M.M.)
- Health Economics and Outcomes Research Centre of Excellence (Greater Asia), Becton, Dickinson and Company, 2 International Business Park Road, Singapore 609930, Singapore;
| | - Viva Ma
- Health Economics and Outcomes Research Centre of Excellence (Greater Asia), Becton, Dickinson and Company, 2 International Business Park Road, Singapore 609930, Singapore;
| | - Caitlin Asjes
- Government and Public Affairs, Becton, Dickinson and Company, 2 International Business Park Road, Singapore 609930, Singapore;
| | - Ashley Lim
- Department of Pharmacy, KK Women’s and Children’s Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore;
| | - Mahsa Mohseni
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, Singapore 117549, Singapore; (B.C.); (M.M.)
| | - Hwee Lin Wee
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, Singapore 117549, Singapore; (B.C.); (M.M.)
- Faculty of Science, Department of Pharmacy, National University of Singapore, 18 Science Drive 4, Singapore 117543, Singapore
| |
Collapse
|