Non-adherence to cervical cancer screening recommendations among women in Eswatini: a cross-sectional study

Healthcare-seeking behaviors and factors influencing non-adherence among cervical cancer patients attending Bugando Oncology Clinic in Mwanza, Tanzania: A qualitative Phenomenological study

BACKGROUND

In low- and middle-income countries, particularly in Tanzania, most patients with cervical cancer present with advanced-stage disease and exhibit non-adherence which results in increased numbers of patients with cancer-related deaths. The current study explores the health-seeking behavior of cervical cancer patients and the factors that influence their non-adherence to cancer care.

OBJECTIVE

To explore the healthcare-seeking behaviors and identify factors influencing non-adherence among cervical cancer patients attending Bugando Medical Center's Oncology Clinic in Mwanza, Tanzania.

METHODS

A qualitative phenomenological design was adopted to explore the lived experiences of 15 households with non-adherent cervical cancer patients, after obtaining patients' information from the chemo radiation treatment registries of Bugando Oncology Clinic in Mwanza, Tanzania. Data were generated through in-depth interviews with patients, and NVivo 12 qualitative computer software was used to aid analysis. Thematic content analysis was conducted to uncover underlying meanings and patterns in the data, providing valuable insights into the phenomena under investigation.

FINDINGS

The study revealed poor adherence to treatment-seeking by most of the study informants in the form of delayed health-seeking at nearby health facilities. The limited capacity for correct cervical cancer diagnosis also pushed some of the informants to turn to self-medication including traditional remedies. The findings revealed delayed healthcare-seeking behavior and poor adherence to most of the study participants seeking medical care at nearby health facilities with limited capacity for correct cervical cancer diagnosis. Some turned to self-medications including traditional remedies. Financial constraints emerged as a major obstacle, affecting the affordability of treatments, transportation, and accommodation. Moreover, the malfunctioning radiotherapy machine posed a significant barrier to effective treatment. Limited comprehensive information on their condition, treatment options, and schedules further hindered adherence.

CONCLUSION

There is a need for improved access to an appropriate healthcare system and interventions to improve non-adherence to treatment of cervical cancer services, as well as increase public awareness, initiation of tools for good adherence of chemotherapy treatment and mass screening of cervical cancer risk factors and earlier diagnosis for better survival from the disease in Tanzania.

Cervical cancer screening uptake and its predictors among women aged 30-49 in Ghana: Providing evidence to support the World Health Organization's cervical cancer elimination initiative

INTRODUCTION

Cervical cancer remains a global health challenge, disproportionately affecting women in low- and middle-income countries, including Ghana. Hence, this study examined the regional variations and predictors of cervical cancer screening uptake among women aged 30-49 in Ghana.

METHODS

Data for this study was obtained from the 2022 Ghana Demographic and Health Survey, comprising 7,124 women aged 30-49. The regional variations in women's uptake of cervical cancer screening was presented using spatial map. A mixed-effect multilevel binary logistic regression was used to examine the factors associated with cervical cancer screening uptake. The results were presented using adjusted odds ratios (aORs) with 95% confidence intervals (CIs).

RESULTS

The uptake of cervical cancer screening was 7.27% [6.33, 8.35] in Ghana. Significant variations in cervical cancer screening existed across regions, with the lowest uptake in Western, Oti, Savannah, and North East regions. Women in rural areas had lower odds of being screened for cervical cancer [aOR = 0.46; 95% CI = 0.28, 0.76] compared to those in urban areas. Women living in the Central, Greater Accra, Volta, Eastern, Ashanti, Ahafo, Bono East, Oti, Northern, North East, Upper East, and Upper West regions all had higher odds of undergoing cervical cancer screening compared to those in the Western region. Women with higher education [aOR = 2.71; 95% CI = 1.23, 5.94] were more likely to be screened for cervical cancer compared to those with no formal education. Women who visited a health facility in the past year had higher odds of being screened for cervical cancer [aOR = 1.48; 95% CI = 1.02, 2.15] relative to those who did not. Reading newspapers or magazines increased the odds of cervical cancer screening uptake [aOR = 1.80; 95% CI = 1.10, 2.92] . Women who belonged to the middle [aOR = 2.19; 95% CI = 1.07, 4.49], richer [aOR = 2.85; 95% CI = 1.28, 6.38], and richest [aOR = 3.08; 95% CI: 1.25, 7.59] wealth indices were more likely to be screened for cervical cancer compared to those in the poorest wealth index.

CONCLUSIONS

Our findings highlight critical disparities in cervical cancer screening uptake in Ghana, particularly emphasizing the need for targeted interventions to address the lower screening rates among women in the Western, Oti, Savannah, and North East regions. The significant association between cervical cancer screening uptake and healthcare access, media exposure, and wealth underscores the importance of enhancing healthcare infrastructure and outreach in underserved regions. To improve screening rates, it is recommended that public health initiatives focus on increasing awareness through community education programs, promoting health facility visits, and leveraging media platforms to disseminate information about cervical cancer screening. Additionally, policies should aim to reduce geographical and socioeconomic barriers, ensuring equitable access to screening services across all regions, especially for women in lower wealth quintiles.

Knowledge, attitudes, behaviors, and information needs of women vaccinated with the HPV vaccine regarding cervical cancer prevention: a cross-sectional study

Background

Cervical cancer poses a serious threat to women's health globally, especially in China. HPV vaccination and screening are crucial prevention and control measures. However, the screening coverage among Chinese women remains low, and there is a need to better understand the knowledge, attitudes, behaviors, and information needs of Chinese HPV-vaccinated women regarding cervical cancer prevention to optimize prevention and control strategies.

Objectives

To explore the knowledge, attitudes, behaviors, and information needs of women vaccinated with the HPV vaccine regarding cervical cancer prevention.

Methods

This cross-sectional study was conducted using a convenience sampling method from October 1 to December 30, 2023. A questionnaire survey was administered to 439 women vaccinated with the HPV vaccine at the Shu Shan District Community Health Service Center in Hefei, Anhui Province. The survey tool was self-designed. Data were analyzed using descriptive statistics, chi-square tests, and binary logistic regression.

Results

The average age of the 439 participants was 27.82 ± 6.42 years. The average cervical cancer prevention knowledge score was 35.01 ± 5.76. 434 (98.9%) women held a positive attitude towards cervical cancer screening, and 320 (72.9%) women had undergone cervical cancer screening after receiving the HPV vaccine. Educational levels such as college (OR = 2.995, 95%CI: 1.233-7.279, p = 0.015), bachelor's degree (OR = 3.694, 95%CI: 1.718-7.943, p = 0.001), and postgraduate and above (OR = 4.826, 95%CI: 2.176-10.707, p < 0.001), as well as occupation as medical workers (OR = 4.660, 95%CI: 2.292-9.474, p < 0.001), were associated with higher knowledge of prevention and treatment scores. Individuals aged 26-35 years (OR = 7.431, 95%CI: 2.856-19.331, p < 0.001), 36-45 years (OR = 11.466, 95%CI: 2.279-57.694, p = 0.003), married individuals (OR = 4.307, 95%CI: 1.455-12.750, p = 0.008), and participants who had received health education related to cervical cancer prevention (OR = 2.125, 95%CI: 1.169-3.863, p = 0.013) and possessed good knowledge of prevention (OR = 16.770, 95%CI: 8.667-32.451, p < 0.001) were more inclined to undergo cervical cancer screening. Among the 254 participants who had received health education, 34.2% still had unmet information needs regarding cervical cancer prevention, and 29.5% hoped to receive health education services from professionals.

Conclusion

Chinese HPV-vaccinated women have a good understanding of cervical cancer prevention and a positive attitude and behavior towards cervical cancer screening. However, their knowledge of cervical cancer screening is not sufficient, and their information needs have not been fully met.

Cervical cancer screening knowledge and associated factors among Eswatini women: A cross-sectional study

BACKGROUND

Over recent years, cervical cancer incidence and related mortality have steadily increased in Eswatini. Low cervical cancer screening uptake partly explains the situation. Cervical cancer screening-related knowledge is positively associated with screening uptake. Little is known about women's cervical cancer screening-related knowledge in Eswatini.

OBJECTIVE

This study aimed to assess cervical cancer screening knowledge and associated factors among Eswatini women eligible for screening.

METHODS

A cross-sectional study involving three hundred and seventy-seven women aged 25 to 59 selected from four primary healthcare clinics in Eswatini was conducted. A paper and pen survey assessed knowledge about cervical cancer risk factors, benefits of screening, the meaning of screening results, recommended screening intervals, and socio-demographics. Descriptive analyses were performed to assess participants' sociodemographic characteristics. Linear regression was applied to examine associations between cervical cancer screening-related knowledge and participants' sociodemographic characteristics.

RESULTS

Two hundred and twenty-nine (61%) participants answered 80% or more knowledge questions correctly. Compared to HIV-positive participants, HIV-negative participants had 0.61 times lower cervical cancer screening knowledge scores (β = -0.39, 95% CI: -0.56, -0.19, p = 0.03). Participants who travelled more than 30 minutes to the clinic had 0.3 times lower cervical cancer screening knowledge scores (β = -0.70, 95% CI: -1.15, -0.25, p < 0.01) compared to participants who travelled less than 30 minutes to the clinic.

CONCLUSIONS

Relatively high overall cervical cancer screening knowledge levels were observed among the study participants. Findings from the current study may inform future educational programs to create and sustain an accurate understanding of cervical cancer screening in Eswatini communities.

What rate of Iranian women perform Pap smear test? Results from a meta-analysis

In this study, an attempt was made to estimate the aggregated proportion of Pap smear test uptake among women in Iran from 2012 to 2022 using meta-analysis. The data collection process involved reviewing records registered in databases between January 1, 2012, and September 11, 2022. The final data was analyzed using random effects models, and potential heterogeneity was assessed using the I2 index. To examine publication bias, Egger's test and Funnel Plot were employed. Sensitivity analysis, specifically single study exclusion Meta-analysis, was conducted to assess the influence of each individual study on the aggregated percentage of Pap smear test uptake. A total of 28,754 women were included across the 33 articles analyzed. The pooled percentage of Pap smear test uptake for both one-time and regular screenings was found to be 46.52% (95% CI: 40.91 to 52.14) and 17.80% (95% CI: 12.42 to 23.18), respectively. No significant evidence of publication bias was detected, although the influence of smaller studies was confirmed. Sensitivity analysis indicated that the overall rate of Pap smear test uptake was not highly sensitive to the results of individual studies. The findings emphasize the low rate of regular Pap smear testing among Iranian women and suggest that tailored interventions considering cultural and geographical factors specific to different provinces in Iran could help increase the utilization of this screening service.