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1.
Arq. ciências saúde UNIPAR ; 26(3): 794-808, set-dez. 2022.
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-2205383

ABSTRACT

O câncer do colo do útero é considerado um dos cânceres mais comuns entre mulheres, representando um grande problema de saúde global, sendo a quarta causa mais frequente de morte por câncer na população feminina. Mediante a um estudo quantitativo e retrospectivo de dados pré- analíticos e analíticos das requisições do exame citopatológico do colo do útero, objetivou-se avaliar os resultados de exames citopatológicos de mulheres usuárias do SUS de um município do oeste do Paraná, realizados no período antes da pandemia COVID-19, de março de 2019 a fevereiro de 2020 e durante a pandemia COVID-19, de março de 2020 a fevereiro de 2021, dos exames citopatológicos alterados. Foram utilizadas as requisições de exames citopatológicos do Programa Nacional de Controle do CCU e o sistema eletrônico SISCAN como ferramentas de busca. Dentre os resultados, totalizaram-se 20.425 amostras processadas no período antes da pandemia, sendo 19.908 consideradas satisfatórias para análise oncótica, onde 1.148 (5,76%) amostras apresentaram alteração citológica. No período da pandemia, totalizaram-se 11.315 amostras processadas, sendo 11.149 amostras satisfatórias para análise oncótica, das quais 721 (6,47%) apresentaram alteração citológica. No período da pandemia, o estudo demostra que metade da população de mulheres usuárias do SUS em um município do oeste do Paraná encontra-se na faixa etária da população-alvo preconizada pelo MS, sendo que a maioria delas realizou seu exame citopatológico por motivo de rastreamento. Contudo, mesmo com a interrupção dos atendimentos eletivos, as mulheres continuaram realizando seus exames citopatológicos, sendo elucidado um discreto aumento de 0,71% das alterações citológicas no período da pandemia, quando comparado ao período anterior, demonstrando o cenário deste programa na pandemia COVID-19.


Cervical cancer is considered one of the most common cancers among women, representing a major global health problem, being the fourth most frequent cause of cancer death in the female population. Through a quantitative and retrospective study of pre-analytical and analytical data of requests for cervical cytopathological examination, the objective was to evaluate the results of cytopathological examinations of women using the SUS in a city in western Paraná, carried out in the period before during the COVID-19 pandemic, from March 2019 to February 2020, and during the COVID-19 pandemic, from March 2020 to February 2021, from the altered cytopathological exams. Requests for cytopathological exams from the National Control Program of the CCU and the SISCAN electronic system were used as search tools. Among the results, a total of 20.425 samples were processed in the period before the pandemic, 19.908 of which were considered satisfactory for oncotic analysis, where 1.148 (5,76%) samples showed cytological alterations. During the pandemic period, a total of 11.315 samples were processed, of which 11.149 were satisfactory for oncotic analysis, of which 721 (6,47%) showed cytological alterations. During the pandemic period, the study shows that half of the population of women using the SUS in a municipality in western Paraná is in the target population age group recommended by the MS, and most of them underwent their cytopathological examination due to tracking. However, even with the interruption of elective care, women continued to perform their cytopathological exams, with a slight increase of 0,71% in cytological changes during the pandemic period, when compared to the previous period, demonstrating the scenario of this program in the COVID-19 pandemic.


El cáncer de cuello uterino se considera uno de los cánceres más comunes entre las mujeres, representando un importante problema de salud mundial, siendo la cuarta causa más frecuente de muerte por cáncer en la población femenina. Mediante el estudio cuantitativo y retrospectivo de los datos preanalíticos y analíticos de los requisitos del examen citopatológico del útero, se evaluaron los resultados de los exámenes citopatológicos de las usuarias del SUS de un municipio del oeste de Paraná, realizados en el período anterior a la pandemia COVID-19, de marzo de 2019 a febrero de 2020, y durante la pandemia COVID-19, de marzo de 2020 a febrero de 2021, de los exámenes citopatológicos alterados. Se utilizaron como herramientas de búsqueda las requisiciones de exámenes citopatológicos del Programa Nacional de Control de UCC y el sistema electrónico SISCAN. Entre los resultados, un total de 20.425 muestras fueron procesadas en el período anterior a la pandemia, de las cuales 19.908 fueron consideradas satisfactorias para el análisis oncológico, donde 1.148 (5,76%) muestras presentaron alteración citológica. En el periodo de la pandemia, se procesaron un total de 11.315 muestras, de las cuales 11.149 fueron satisfactorias para el análisis oncológico, y 721 (6,47%) presentaron alteraciones citológicas. En el período de la pandemia, el estudio demuestra que la mitad de la población de mujeres usuarias del SUS en una ciudad del oeste de Paraná está en la franja de edad de la población objetivo recomendada por el MS, y la mayoría de ellas se sometió a un examen citopatológico con fines de cribado. Sin embargo, aún con la interrupción de la atención electiva, las mujeres continuaron realizando sus exámenes citopatológicos, siendo dilucidado un leve aumento de 0,71% de alteraciones citológicas en el período pandémico, cuando comparado con el período anterior, demostrando el escenario de este programa en la pandemia COVID-19.


Subject(s)
Humans , Female , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/prevention & control , Mass Screening/statistics & numerical data , Pandemics , COVID-19/diagnosis , Women , World Health Organization/organization & administration , Unified Health System , Uterine Cervical Neoplasms/complications , Causality , Retrospective Studies
2.
N Z Med J ; 135(1565): 83-94, 2022 Nov 11.
Article in English | MEDLINE | ID: covidwho-2112071

ABSTRACT

AIM: To determine the feasibility and acceptability of a telehealth offer and contactless delivery of human papillomavirus (HPV) cervical screening self-test during the 2021 COVID-19 Level 4 lockdown in Auckland, New Zealand. METHODS: A small proof-of-concept study was undertaken to test telehealth approaches in never-screened, due or overdue Maori and Pacific women enrolled in a local Primary Health Organisation (PHO). Study invitation, active follow-up, nurse-led discussions, result notification and a post-test questionnaire were all delivered through telehealth. RESULTS: A sample of 197 eligible Maori and Pacific women were invited to take part, of which 86 women were successfully contacted. Sixty-six agreed to take part. Overall uptake was 61 samples returned (31.8%) and uptake of all contactable women was 70.9%. Six of the 61 HPV self-tests (9.8%) were positive, all for non 16/18 types, and were referred for cytology. Three had negative cytology results, and three with positive cytology results were referred for colposcopy. CONCLUSION: The offer of HPV self-testing during COVID-19 lockdown was both feasible and highly acceptable for Maori and Pacific women. Importantly, HPV self-testing via telehealth and mail-out, alongside other options, offers a potential pro-equity approach for addressing the impact of deferred screens due to COVID-19 and other longstanding coverage issues.


Subject(s)
Alphapapillomavirus , COVID-19 , Papillomavirus Infections , Telemedicine , Uterine Cervical Neoplasms , Female , Humans , Pregnancy , Papillomavirus Infections/diagnosis , Papillomavirus Infections/epidemiology , Papillomavirus Infections/prevention & control , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/prevention & control , Uterine Cervical Neoplasms/epidemiology , Self-Testing , Early Detection of Cancer/methods , Native Hawaiian or Other Pacific Islander , Feasibility Studies , COVID-19/diagnosis , COVID-19/epidemiology , New Zealand/epidemiology , Communicable Disease Control , Papillomaviridae , Colposcopy , Mass Screening , Disease Outbreaks , Vaginal Smears
3.
Int J Environ Res Public Health ; 19(21)2022 Oct 28.
Article in English | MEDLINE | ID: covidwho-2090159

ABSTRACT

The burden of disease caused by cervical cancer ranked second among female tumors in China. The HPV vaccine has been proven to be a cost-effective measure to prevent cervical cancer, but the vaccination rate remained low to date among university students. This study aimed to understand the status quo of HPV vaccine hesitancy among university students across China during the COVID-19 pandemics and systematically analyze determinants of HPV vaccine hesitancy based on the WHO 3Cs model. Cross-sectional data were collected using an online survey of female university students in four cities across China in June 2022. Multinomial logistic regression was adopted to determine factors influencing vaccine hesitancy based on the 3Cs model with three dimensions, namely complacency, convenience, and confidence. Among 1438 female university students surveyed in this study, 89.7% did not hesitate to vaccinate against HPV, only 8.9% hesitated to some extent, and 1.4% refused to vaccinate. The actual vaccination rate for the HPV vaccine was 34.2%. Based on the 3Cs model, this study found that the trust on the efficacy of vaccines, risk perception of being infected by HPV, price, and distance/time were influencing factors of vaccine hesitancy. Knowledge of the HPV vaccine and sociodemographic characteristics, such as education levels, were also statistically relevant. Therefore, it is recommended that relevant scientific knowledge on cervical cancer and the HPV vaccine should be spread on campus, the vaccination appointment procedure should be simplified, and the affordability of vaccination should be increased through strategic purchasing or providing subsidies, so as to reduce HPV vaccine hesitancy.


Subject(s)
COVID-19 , Papillomavirus Infections , Papillomavirus Vaccines , Uterine Cervical Neoplasms , Female , Humans , Papillomavirus Vaccines/therapeutic use , Papillomavirus Infections/prevention & control , Cross-Sectional Studies , Uterine Cervical Neoplasms/prevention & control , Universities , Vaccination Hesitancy , Health Knowledge, Attitudes, Practice , Vaccination , China , Students
4.
Prev Med ; 164: 107264, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2086854

ABSTRACT

Worldwide, the COVID-19 pandemic disrupted healthcare services, including cervical cancer management, and an increased burden for this condition is expected. This systematic review synthetizes the available evidence on the impact of the pandemic on prevention, diagnosis and treatment of cervical cancer. Searches were performed on PubMed, Embase, and Scopus for relevant studies on these topics with the purpose of comparing service access and care delivery before and during COVID-19 pandemic. Due to the methodological heterogeneity among the studies, findings were narratively discussed. Of the 715 screened titles and abstracts, 33 articles were included, corresponding to 42 reports that covered the outcomes of interest: vaccination against human papillomavirus (HPV) (6 reports), cancer screening (19), diagnosis (8), and treatment (8). Seven studies observed reductions in HPV vaccination uptake and coverage during COVID-19. Reports on cervical screening and cancer diagnosis activities showed a substantial impact of the pandemic on access to screening services and diagnostic procedures. All but one study that investigated cervical cancer treatment reported changes in the number of women with cervical lesions who received treatments, as well as treatment delay and interruption. With a major impact during the first wave in 2020, COVID-19 and restriction measures resulted in a substantial disruption in cervical cancer prevention and management, with declines in screening and delays in treatment. Taken together, findings from this systematic review calls for urgent policy interventions for recovering cervical cancer prevention and care.


Subject(s)
COVID-19 , Papillomavirus Infections , Papillomavirus Vaccines , Uterine Cervical Neoplasms , Female , Humans , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/prevention & control , Papillomavirus Infections/diagnosis , Papillomavirus Infections/prevention & control , Papillomavirus Infections/epidemiology , COVID-19/diagnosis , COVID-19/prevention & control , Early Detection of Cancer/methods , Pandemics/prevention & control , Patient Care
5.
BMC Public Health ; 22(1): 1914, 2022 10 14.
Article in English | MEDLINE | ID: covidwho-2079403

ABSTRACT

BACKGROUND: Quests for the global elimination of cervical cancer and its related SDG goals by 2030 are achievable if realistic approaches for improving outcomes in LMICs are entrenched. Targeting teenage high schoolers in these countries, which largely lack universally-affordable anti-cervical cancer measures, can be a game-changer. This paper evaluates a 2019 Harvard-endorsed measure that integrated relevant teachings into the curricula of some Nigerian high schools, in what was a global-first. METHOD: A 12-month, quasi-experimental (pre-and-post-tests) research that evaluated the impact of the above initiative on three public schools randomly selected from a pool of 261 in South-east Nigeria. The intervention was "exposure" to anti-cervical teachings, which included "repetitions" and "examination/assessments" designed to enhance "engagement". Both genders were among the 2,498 recruited participants. Data collections with questionnaires were at three different intervals over 12 months. RESULTS: At Phase-1 (baseline), there were 1,699 (68.0%) responses, while Phases 2 (one-month post-intervention) and 4 (12-month post-intervention) had 1,797 (71.9%) and 500 (20.0%) responses, respectively. COVID-19 lockdowns washed out Phase-3 (six-month post-intervention). The majority in all groups were aged 15-19 years. Males dominated in phases 1 (55.9%) and 2 (67.3%), and females (65.6%) in Phase 4. Overall, there were increased knowledge on "General Awareness", "HPV Vaccinations", "Risk Factors" and "Symptoms", particularly between Phases 2 and 1. Levels at Phase-4 were higher than at Phase-2, with the exception of "Pap Smears", as knowledge gained in half of its assessing items became negative (reversed) at Phase-4. These observed changes were non-different between gender, age groups, and classes of high schools. Relative to Phase 2, knowledge changes at Phase-4 for questions associated with established myths ("spiritual attacks"; OR 0.39; CI 0.29-0.52 and "enemy poisons"; OR 0.49; CI 0.37-0.65) were reversed, even though they were originally increased significantly between Phases 2 and 1. CONCLUSION: Anti-cervical cancer enlightenment interventions to teenage high school students were largely effective, but appears guaranteed if engagement-enhancing measures are maintained over time. Extra efforts should be put into debunking prevailing myths.


Subject(s)
COVID-19 , Poisons , Uterine Cervical Neoplasms , Adolescent , Communicable Disease Control , Curriculum , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Nigeria , Surveys and Questionnaires , Uterine Cervical Neoplasms/prevention & control
6.
Curr Oncol ; 29(10): 7379-7387, 2022 Oct 02.
Article in English | MEDLINE | ID: covidwho-2065745

ABSTRACT

Program ROSE (removing obstacles to cervical screening) is a primary HPV-based cervical screening program that incorporates self-sampling and digital technology, ensuring that women are linked to care. It was developed based on the principles of design thinking in the context of Malaysia. The program illustrates the importance of collaborative partnerships and addressing the multi-faceted barriers from policy changes, and infrastructure readiness to the implementation of a radically new cervical screening program in communities. The paradigm shift in cervical cancer requires a monumental and concerted effort in educating both the healthcare providers and the general public. In this short review, we highlight how Pilot Project ROSE incorporated evidence-based tools that rapidly scaled up to Program ROSE. These ideas and solutions can be adapted and adopted by other countries. Notwithstanding the impact of COVID-19, it is incumbent on countries to pave the road towards the elimination of cervical cancer with pre-existing footpaths.


Subject(s)
COVID-19 , Papillomavirus Infections , Uterine Cervical Neoplasms , Female , Humans , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/prevention & control , Papillomavirus Infections/diagnosis , Papillomavirus Infections/prevention & control , Early Detection of Cancer , Self-Testing , Pilot Projects , Malaysia
7.
Arthritis Res Ther ; 24(1): 211, 2022 09 01.
Article in English | MEDLINE | ID: covidwho-2038859

ABSTRACT

BACKGROUND: Systemic lupus erythematosus (SLE) is a disease that can lead to damage of multiple organs and, along with certain treatments, increase the risk of developing cancer, cardiovascular disease, diabetes, osteoporosis, and infections. Preventive services are particularly important in patients with SLE to mitigate the aforementioned risks. We aimed to evaluate the trends of preventive services utilization in patients with systemic lupus erythematosus, compared with non-SLE population. METHODS: All ≥19-year-old patients in the Lupus Midwest Network (LUMEN) registry, a population-based cohort, with SLE on January 1, 2015, were included and matched (1:1) by sex, age, race, and county to non-SLE comparators. Among both groups, we compared the rates of screenings for breast and cervical cancer, hypertension, hyperlipidemia, diabetes mellitus, and osteoporosis as well as immunizations. RESULTS: We included 440 SLE patients and 430 non-SLE comparators. The probability of breast cancer screening among women with SLE was similar to comparators (hazard ratio [HR] 1.09, 95% CI 0.85-1.39), while cervical cancer screening was lower (HR 0.75, 95% CI 0.58-0.96). Hypertension screening was higher among patients with SLE (HR 1.35, 95% CI 1.13-1.62); however, hyperlipidemia screening was similar to comparators (HR 1.16, 95% CI 0.96-1.41). Diabetes and osteoporosis screenings were more likely to be performed for SLE patients than for comparators (HR 2.46, 95% CI 2.11-2.87; and HR 3.19, 95% CI 2.31-4.41; respectively). Influenza and pneumococcal immunizations were higher among SLE patients (HR 1.31, 95% CI 1.12-1.54; and HR 2.06, 95% CI 1.38-3.09; respectively), while zoster vaccination was similar (HR 1.17, 95% CI 0.81-1.69). CONCLUSIONS: The trends of utilization of preventive services by SLE patients vary according to screening or vaccine compared with the general population. Considering these differences, we demonstrate an opportunity for improvement, particularly in cervical cancer, hyperlipidemia, and osteoporosis screenings and vaccinations.


Subject(s)
Hyperlipidemias , Hypertension , Lupus Erythematosus, Systemic , Osteoporosis , Uterine Cervical Neoplasms , Adult , Early Detection of Cancer , Female , Humans , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/diagnosis , Lupus Erythematosus, Systemic/epidemiology , Risk Factors , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/epidemiology , Uterine Cervical Neoplasms/prevention & control , Young Adult
8.
Epidemiol Health ; 44: e2022053, 2022.
Article in English | MEDLINE | ID: covidwho-2024880

ABSTRACT

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has affected the utilization of healthcare services, including participation in cancer screening programs. We compared cancer screening participation rates for colorectal, gastric, breast, and cervical cancers among participants in the National Cancer Screening Program (NCSP) in 2019 and 2020 to address the potential distraction effect of COVID-19 on cancer screening. METHODS: Data from the NCSP for 4 cancer types (stomach, colorectal, breast, and cervical) in 2019 and 2020 were used to calculate cancer screening participation rates by calendar month, gender, age group, and geographical region. Monthly participation rates were analyzed per 1,000 eligible individuals. RESULTS: The screening participation rate decreased in 2020 compared to 2019 for all 4 cancers: colorectal (40.5 vs. 35.3%), gastric (61.9 vs. 54.6%), breast (63.8 vs. 55.8%), and cervical (57.8 vs. 52.2%) cancers. Following 2 major COVID-19 waves in March and December 2020, the participation rates in the 4 types of cancer screening dropped compared with those in 2019. The highest decline was observed in the elderly population aged 80 years and older (percentage change: -21% for colorectal cancer; -20% for gastric cancer; -26% for breast cancer; -20% for cervical cancer). CONCLUSIONS: After the 2 major COVID-19 waves, the screening participation rate for 4 types of cancer declined compared with 2019. Further studies are needed to identify the indirect effects of the COVID-19 pandemic on cancer patients, such as delayed diagnoses of cancer or excess cancer deaths.


Subject(s)
Breast Neoplasms , COVID-19 , Colorectal Neoplasms , Uterine Cervical Neoplasms , Aged , Breast Neoplasms/diagnosis , Breast Neoplasms/epidemiology , Breast Neoplasms/prevention & control , COVID-19/diagnosis , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/epidemiology , Early Detection of Cancer , Female , Humans , Mass Screening , Pandemics , Republic of Korea/epidemiology , Stomach , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/epidemiology , Uterine Cervical Neoplasms/prevention & control
10.
BMC Womens Health ; 22(1): 353, 2022 08 20.
Article in English | MEDLINE | ID: covidwho-2002163

ABSTRACT

BACKGROUND: Participation of culturally and linguistically diverse (CALD) women from migrant and refugee backgrounds in cervical screening is crucial to eliminate cervical cancer as a public health problem within the next 20 years. However, CALD women report low participation in cervical screening. Barriers to participation can be addressed with culturally tailored, community-based programs. There is a need for research to explore the process, feasibility, acceptability and barriers to cultural tailoring in the delivery and evaluation of cervical screening health education. METHODS: CALD community health workers took part in a 2 day training program then co-designed, culturally tailored and co-facilitated cervical screening health promotion forums within their communities. Forums were delivered to a total of seven groups, involving 12 sessions and 71 CALD women. The forums were evaluated for feasibility, acceptability, implementation and effectiveness using a survey, interviews and observations. Data were collected from CALD women, facilitators and researchers. RESULTS: The co-design and co-delivery of cervical screening health promotion forums was time and resource intensive however allowed for deeper cultural tailoring resulting in engagement with 'hard to reach' CALD women, improved health literacy and intention to screen. Flexibility in the intervention implementation was crucial to ensure forums were responsive to community interests and needs. Online delivery of the forums in response to the COVID-19 pandemic was acceptable to most groups. CONCLUSIONS: Co-designed, culturally tailored cervical screening health promotion forums are feasible and acceptable to CALD women, in both face-to-face and online formats. Adjustments to the intervention protocol were recommended to improve future implementation.


Subject(s)
COVID-19 , Refugees , Transients and Migrants , Uterine Cervical Neoplasms , Australia , Cultural Diversity , Early Detection of Cancer , Feasibility Studies , Female , Humans , Language , Pandemics , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/prevention & control
11.
BMC Public Health ; 22(1): 1611, 2022 08 24.
Article in English | MEDLINE | ID: covidwho-2002150

ABSTRACT

BACKGROUND: Over 80% of new cervical cancer cases occur in women living in low- and middle-income countries. It is the second highest cause of female cancer deaths in Nigeria. School based vaccination programs are an effective strategy for delivering the HPV vaccine to adolescent girls. This study aims to understand the challenges to implementing school-based HPV vaccination programs, particularly in a remote rural setting where vaccine hesitancy is high. METHODS: A 22- item interviewer administered questionnaire was used to evaluate HPV knowledge and willingness to get the HPV vaccinate among 100 female secondary school students as part of an HPV vaccination pilot in a rural community in Kebbi State, Nigeria. Additionally, semi-structured interviews were used to assess community knowledge and attitudes on cervical cancer and HPV vaccination. Data collected were analyzed thematically to understand challenges and generate lessons for vaccine delivery in the study setting. RESULTS: Knowledge of HPV and cervical cancer among junior secondary school aged girls was fair with a mean score of 66.05%. For senior secondary school aged girls, the knowledge score ranged from 70 to 100% with a mean of 96.25% indicating good knowledge of HPV and cervical cancer. All participants (n = 100) received the first vaccine dose but due to COVID-19, 33 participants were not able to complete the vaccine dosage within the recommended 6-month schedule. Of the parents who provided consent, none could afford the vaccine out of pocket. Challenges to vaccine delivery included operational costs exacerbated by lack of adequate health workforce and infrastructure in the study setting. CONCLUSION: An exploration of sociocultural perspectives and contextual realities is crucial to understanding the complexities of HPV vaccine introduction from the perspective of the target audience, and the local community. Strategies for introducing the HPV vaccine should address community concerns through effective communication, appropriate delivery, and targeted advocacy to make the vaccination program locally relevant. While school-based HPV immunization programs have been shown to be successful, adequate design, planning and monitoring is important. Additionally, considerations must be made to account for the high operational cost of vaccine delivery in rural, hard to reach areas where human resources and infrastructure are limited.


Subject(s)
Alphapapillomavirus , COVID-19 , Papillomavirus Infections , Papillomavirus Vaccines , Uterine Cervical Neoplasms , Adolescent , Child , Female , Health Knowledge, Attitudes, Practice , Humans , Immunization Programs , Nigeria , Papillomavirus Infections/prevention & control , Patient Acceptance of Health Care , Rural Population , Schools , Uterine Cervical Neoplasms/prevention & control , Vaccination
12.
Ginekol Pol ; 92(2): 165-173, 2021.
Article in English | MEDLINE | ID: covidwho-1964413

ABSTRACT

The Polish Society of Colposcopy and Cervical Pathophysiology (PTKiPSM) together with the Polish Society of Gynecologists and Obstetricians (PTGiP) issued a final summary of interim guidelines for secondary cervical cancer prevention during the SARS-CoV-2 pandemic based on the analysis of the latest directional publications and the authors' own experiences. The aim of the summary is to facilitate the implementation of the most effective possible screening of cervical precancerous lesions and cervical cancer due to temporary significant limitation of screening as a consequence of the ongoing epidemiological threat. These final guidelines are taking into account the 2020 call of the World Health Organization (WHO) for global epidemiological elimination of cervical cancer. The guidelines supplement the interim guidelines of PTKiPSM and PTGiP announced in March 2020 on the possible deferral of diagnostic and therapeutic procedures in patients with abnormal screening tests results in secondary prevention of cervical cancer in current pandemic.


Subject(s)
Colposcopy , Early Detection of Cancer/methods , Mass Screening/methods , Secondary Prevention , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/prevention & control , Algorithms , COVID-19/epidemiology , Female , Humans , Pandemics , Poland , Precancerous Conditions/diagnosis , Precancerous Conditions/prevention & control , Precancerous Conditions/surgery , SARS-CoV-2 , Uterine Cervical Neoplasms/surgery
14.
Sci Rep ; 12(1): 11380, 2022 07 05.
Article in English | MEDLINE | ID: covidwho-1921722

ABSTRACT

The coronavirus disease (COVID-19) pandemic significantly declined cancer screening rates worldwide. Its impact on the South Korean population is unclear, depending on socioeconomic status (SES), residence, and history of chronic disease. This study utilized data (2018-2020) from the Korean National Cancer Screening Survey, an annual cross-sectional study employing nationally representative random sampling. Cancer screening rates were defined as the proportion of the eligible population who received respective cancer screening within the last 1 year and investigated four major cancers (stomach, colorectal, breast, and cervical). Screening rates every year were compared with screening rate ratios (SRRs) and the corresponding 95% confidence intervals (CIs). Between 2019 and 2020, screening rates declined significantly by 23%, 17%, 12%, and 8% for colorectal cancer (SRR 0.77; 95% CI 0.73-0.82), stomach cancer (SRR 0.83; 95% CI 0.79-0.87), breast cancer (SRR 0.88; 95% CI 0.82-0.93), and cervical cancer (SRR 0.92; 95% CI 0.87-0.97), respectively. Regardless of cancer type, screening was significantly lower in metropolitan residents, those with higher SES, and, interestingly, those without a history of chronic diseases. The significant decline in cancer screening during the pandemic requires urgent political intervention to reduce the burden of future cancer incidence and mortality.


Subject(s)
COVID-19 , Uterine Cervical Neoplasms , COVID-19/diagnosis , COVID-19/epidemiology , Cross-Sectional Studies , Early Detection of Cancer , Female , Humans , Republic of Korea/epidemiology , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/epidemiology , Uterine Cervical Neoplasms/prevention & control
15.
JMIR Mhealth Uhealth ; 10(6): e32089, 2022 06 27.
Article in English | MEDLINE | ID: covidwho-1910856

ABSTRACT

BACKGROUND: Despite the availability and accessibility of free Papanicolaou (Pap) smear as a screening tool for cervical cancer, the uptake of Pap smear in Malaysia has not changed in the last 15 years. Previous studies have shown that the high uptake of Pap smear reduces the mortality rate of patients with cervical cancer. The low uptake of Pap smear is multifactorial, and the problem could be minimized through the use of mobile technologies. Nevertheless, most intervention studies focused on individual factors, while other important aspects such as mobile technologies, especially WhatsApp, have not been investigated yet. OBJECTIVE: This study aims to determine the effects of a theory-based educational intervention and WhatsApp follow-up (Pap smear uptake [PSU] intervention) in improving PSU among postnatal women in Seremban, Negeri Sembilan, Malaysia. METHODS: A 2-arm, parallel single-blind cluster randomized controlled trial was conducted among postpartum women from the Seremban district. Twelve health clinics were randomly assigned to the intervention and control groups. At baseline, both groups received a self-administered questionnaire. The intervention group received standard care and PSU intervention delivered by a researcher. This 2-stage intervention module was developed based on Social Cognitive Theory, where the first stage was conducted face-to-face and the second stage included a WhatsApp follow-up. The control group received standard care. Participants were observed immediately and at 4, 8, and 12 weeks after the intervention. The primary endpoint was PSU, whereas the secondary endpoints were knowledge, attitude, and self-efficacy scores for Pap smear screening self-assessed using a Google Forms questionnaire. A generalized mixed model was used to determine the effectiveness of the intervention. All data were analyzed using IBM SPSS (version 25), and P value of .05 was considered statistically significant. RESULTS: We analyzed 401 women, of whom 76 (response rate: 325/401, 81%) had withdrawn because of the COVID-19 pandemic, with a total of 162 respondents in the intervention group and 163 respondents in the control group. The proportion of Pap smears at the 12-week follow-up was 67.9% (110/162) in the intervention group versus 39.8% (65/163) in the control group (P<.001). Significant differences between the intervention and control groups were found for Pap smear use (F4,1178; P<.001), knowledge scores (F4,1172=14.946; P<.001), attitude scores (F4,1172=24.417; P<.001), and self-efficacy scores (F1,1172=10.432; P<.001). CONCLUSIONS: This study demonstrated that the PSU intervention is effective in increasing the uptake of Pap smear among postnatal women in Seremban district, Malaysia. This intervention module can be tested in other populations of women. TRIAL REGISTRATION: Thai Clinical Trials Registry TCTR20200205001; https://www.thaiclinicaltrials.org/show/TCTR20200205001.


Subject(s)
COVID-19 , Health Knowledge, Attitudes, Practice , Social Media , Uterine Cervical Neoplasms , Female , Follow-Up Studies , Humans , Malaysia , Pandemics , Papanicolaou Test , Psychological Theory , Self Efficacy , Single-Blind Method , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/prevention & control
16.
Hum Vaccin Immunother ; 18(5): 2045856, 2022 11 30.
Article in English | MEDLINE | ID: covidwho-1895719

ABSTRACT

PURPOSE: Vaccination of adolescent girls against human papillomavirus (HPV) significantly reduces the incidence of cervical cancer. HPV vaccines are available in Pakistan but plans to develop HPV vaccination program are at a nascent stage. We conducted a formative study to explore adolescent girls' knowledge and perspectives on HPV and cervical cancer and collect their recommendations for implementing an HPV vaccination program in their community. METHODS: Using qualitative exploratory study design, we conducted four focus group discussions (FGDs) with 12 adolescent girls per group in District West, Karachi. We recruited unmarried girls aged 16-19 years from schools and community settings between May-December 2020. Data analysis was done using NVivo. RESULTS: Overall, participants displayed a positive attitude toward HPV vaccine. However, they were unfamiliar with basic concepts related to female reproductive health. Female relatives were indicated as girls' preferred point of contact for discussions on HPV and cervical cancer, but fathers were portrayed as decision-making authority on vaccination. Participants indicated vaccine hesitancy among parents may affect HPV vaccination uptake. Girls suggested individual household visits and community-based camps as strategies for successful implementation of HPV vaccination program. A solid foundation of trust between girls' families, program managers, and other stakeholders emerged as a key asset for the program's success. CONCLUSION: Adolescent girls' suggestions of informing key decision-makers in the family (particularly fathers) of the benefits of HPV vaccination, establishing trust with vaccine providers, and increasing accessibility of vaccinations should be explored for successful implementation of an HPV vaccination program in Pakistan.


Subject(s)
Alphapapillomavirus , Papillomavirus Infections , Papillomavirus Vaccines , Uterine Cervical Neoplasms , Adolescent , Female , Health Knowledge, Attitudes, Practice , Humans , Pakistan , Papillomaviridae , Papillomavirus Infections/prevention & control , Patient Acceptance of Health Care , Uterine Cervical Neoplasms/prevention & control , Vaccination
17.
JCO Glob Oncol ; 8: e2100214, 2022 01.
Article in English | MEDLINE | ID: covidwho-1886972

ABSTRACT

In 2018, there were approximately 570,000 new cases of cervical cancer worldwide. More than 85% of cases occurred in low- and middle-income countries (LMICs), primarily because of poor access to screening and a limited number of medical providers trained to diagnose and treat cervical precancerous lesions. Our objective was to provide locally arranged, hands-on training courses for medical providers in LMICs to learn to perform cervical cancer screening, diagnosis, and treatment procedures. The courses included didactic lectures and hands-on training stations using low-cost simulation models developed by bioengineers and students at Rice University in Houston, TX, United States, and the Malawi Polytechnic in Blantyre, Malawi. The hands-on training stations included visual inspection with acetic acid (VIA), colposcopy, cervical biopsy, endocervical curettage, loop electrosurgical excision procedure (LEEP), and thermal ablation. Provider pre- and postcourse confidence levels in performing the procedures were evaluated. From February 2017 to January 2020, we arranged 15 hands-on training courses in seven cities across six countries (El Salvador, Mozambique, Trinidad and Tobago, Lesotho, Malawi, and Nepal). Overall, there were 506 participants. The average number of participants per course was 38 (range 19-92). The participants included doctors, nurses, and midwives. The course duration varied from 1 to 3 days. Increased confidence in performing VIA, colposcopy and cervical biopsy, ablation, and LEEP was reported by 69%, 71%, 61%, and 76% of participants, respectively. Our findings suggest that locally arranged, hands-on cervical cancer prevention training courses in LMICs can improve provider confidence in performing cervical cancer screening, diagnosis, and treatment procedures. These courses are part of a larger strategy to build local capacity for delivering and improving cervical cancer prevention services in LMICs.


Subject(s)
Uterine Cervical Neoplasms , Acetic Acid , Cervix Uteri , Colposcopy , Developing Countries , Early Detection of Cancer , Female , Humans , Pregnancy , United States , Uterine Cervical Neoplasms/prevention & control , Uterine Cervical Neoplasms/therapy
18.
JAMA Netw Open ; 5(6): e2215490, 2022 06 01.
Article in English | MEDLINE | ID: covidwho-1877536

ABSTRACT

Importance: Health care was disrupted in the US during the first quarter of 2020 with the emergence of the COVID-19 pandemic. Early reports in selected samples suggested that cancer screening services decreased greatly, but population-based estimates of cancer screening prevalence during 2020 have not yet been reported. Objective: To examine changes in breast cancer (BC), cervical cancer (CC), and colorectal cancer (CRC) screening prevalence with contemporary national, population-based Behavioral Risk Factor Surveillance System (BRFSS) data. Design, Setting, and Participants: This survey study included respondents from the 2014, 2016, 2018, and 2020 BRFSS surveys who were eligible for BC (women aged 50-74 years), CC (women aged 25-64 years), and CRC (women and men aged 50-75 years) screening. Data analysis was performed from September 2021 to February 2022. Exposures: Calendar year. Main Outcomes and Measures: Self-reported receipt of a recent (defined as in the past year) BC, CC, and CRC screening test. Adjusted prevalence ratios (aPRs) comparing 2020 vs 2018 prevalence and 95% CIs were computed. Results: In total, 479 248 individuals were included in the analyses of BC screening, 301 453 individuals were included in CC screening, and 854 210 individuals were included in CRC screening, In 2020, among respondents aged 50 to 75 years, 14 815 (11.4%) were Black, 12 081 (12.6%) were Hispanic, 156 198 (67.3%) were White, and 79 234 (29.9%) graduated from college (all percentages are weighted). After 4 years (2014-2018) of nearly steady prevalence, past-year BC screening decreased by 6% between 2018 and 2020 (from 61.6% in 2018 to 57.8% in 2020; aPR, 0.94; 95% CI, 0.92-0.96), and CC screening decreased by 11% (from 58.3% in 2018 to 51.9% in 2020; aPR, 0.89; 95% CI, 0.87-0.91). The magnitude of these decreases was greater in people with lower educational attainment and Hispanic persons. CRC screening prevalence remained steady; past-year stool testing increased by 7% (aPR, 1.07; 95% CI, 1.02-1.12), offsetting a 16% decrease in colonoscopy (aPR, 0.84; 95% CI, 0.82-0.88) between 2018 and 2020. Conclusions and Relevance: In this survey study, stool testing increased and counterbalanced a decrease in colonoscopy during 2020, and BC and CC screening modestly decreased. How these findings might be associated with outcomes is not yet known, but they will be important to monitor, especially in populations with lower socioeconomic status, who experienced greater screening decreases during the COVID-19 pandemic.


Subject(s)
Breast Neoplasms , COVID-19 , Colorectal Neoplasms , Uterine Cervical Neoplasms , Behavioral Risk Factor Surveillance System , Breast Neoplasms/diagnosis , Breast Neoplasms/epidemiology , COVID-19/diagnosis , COVID-19/epidemiology , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/epidemiology , Early Detection of Cancer , Female , Humans , Male , Occult Blood , Pandemics , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/epidemiology , Uterine Cervical Neoplasms/prevention & control
19.
Medicina (Kaunas) ; 58(6)2022 May 29.
Article in English | MEDLINE | ID: covidwho-1869707

ABSTRACT

Background and Objectives: Cervical cancer (CC) is the fourth most common cause of cancer-related morbidity and mortality among women worldwide. CC prevention is based on screening and HPV vaccination. The COVID-19 pandemic has caused difficulties in implementing CC-preventative measures. The aim of this study was to collect data on the implementation of CC prophylaxis in Poland provided by public and private health care with a particular focus on the impact of the COVID-19 pandemic and attempt to estimate the level of CC-screening implementation by 2026 under public and private health care. Materials and Methods: Data on the implementation of privately funded (2016-2021) and publicly funded (2014-2021) CC-preventative measures in Poland were examined. The Prophet algorithm, which positions itself as an automatic forecasting procedure and represents a local Bayesian structural time-series model, was used to predict data. The correlation test statistic was based on Pearson's product moment correlation coefficient and follows a t distribution. An asymptotic confidence interval was given based on Fisher's Z transform. Results: In 2021, a significantly higher population screening coverage was observed in private health care (71.91%) than in the public system (12.6%). Our estimation assumes that the adverse downward trend of population coverage (pap smear CC screening) in the public system will continue to 5.02% and in the private health system to 67.92% in 2026. Correlation analysis showed that with the increase in the sum of HPV tests and LBC, the percentage of Pap smear coverage in the private healthcare sector decreases r = -0.62, p = 0.260 df = 3, CI = [-0.97, 0.57]. The amount of HPV vaccinations provided in private health care is steadily increasing. Immunization coverage of the population of girls aged 9-18 years under private health care at the end of the observation period was 4.3% (2021). Conclusions: It is necessary to reorganize the public CC-screening system in Poland based on a uniform reporting system for tests performed in both public and private health care using the model of action proposed by us. We recommend the introduction of a national free HPV vaccination program funded by the government and implemented in public and private health care facilities.


Subject(s)
COVID-19 , Papillomavirus Infections , Uterine Cervical Neoplasms , Bayes Theorem , COVID-19/epidemiology , COVID-19/prevention & control , Delivery of Health Care , Female , Humans , Pandemics/prevention & control , Papillomavirus Infections/epidemiology , Papillomavirus Infections/prevention & control , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/epidemiology , Uterine Cervical Neoplasms/prevention & control
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