scholarly journals Working towards a comprehensive understanding of HPV and cervical cancer among Indigenous women: a qualitative systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e050113
Author(s):  
Sneha Sethi ◽  
Brianna Poirier ◽  
Karen Canfell ◽  
Megan Smith ◽  
Gail Garvey ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Prevention ◽  
Ecological Model ◽  
Cervical Screening ◽  
Hpv Infection ◽  
Cervical Cancer Prevention ◽  
Social Ecological Model ◽  
Indigenous Women ◽  
Indigenous Populations ◽  
Social Ecological

RationaleIndigenous peoples carry a disproportionate burden of infectious diseases and cancers and are over-represented among the socially disadvantaged of most countries. Human papillomavirus (HPV) is a risk factor and causative agent of cervical, oropharyngeal and other cancers. Recent literature shows evidence of Indigenous populations being at increased risk of HPV infections and its associated cancers.ObjectiveThis is a qualitative systematic review. The objective of this study was to explore the experiences and barriers Indigenous women face in relation to HPV awareness, knowledge and cervical screening, in order to better understand factors that may mitigate against or facilitate prevention efforts for HPV infection and associated cancers.MethodsTwo investigators independently searched MEDLINE, PubMed, SCOPUS and Web of Science databases (for articles published from inception until 30 June 2020) using a prespecified search strategy to identify qualitative studies on narratives of Indigenous women regarding HPV infection awareness, knowledge and cervical screening, across all geographic and income-level settings. Using a ‘meta-study’ approach, a social ecological model of cervical screening, infection and associated cancer prevention among Indigenous populations was formulated.ResultsFive core themes were identified and formulated within the social ecological model; intrapersonal factors, interpersonal factors, institutional/organisational factors, sociocultural/community factors and public policy. These collectively formed the proposed social ecological model of HPV infection awareness and cervical cancer prevention among Indigenous women. This model has been synthesised by taking into account personal stories of Indigenous women and healthcare workers, thus offering a more nuanced, organised, structured and culturally sensitive approach to policy translation.ConclusionThe social ecological model of HPV infection awareness and cervical cancer prevention among Indigenous women offers a holistic and practical approach for Indigenous health policy makers. It clearly addresses the high risk of Indigenous populations at a global level in experience of both HPV infection and HPV-related cancers.PROSPERO registration numberCRD42020207643.

Human Papillomavirus Selected Properties and Related Cervical Cancer Prevention Issues

2020 ◽  
Vol 26 (18) ◽  
pp. 2073-2086
Author(s):  
Saule Balmagambetova ◽  
Andrea Tinelli ◽  
Ospan A. Mynbaev ◽  
Arip Koyshybaev ◽  
Olzhas Urazayev ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cancer Prevention ◽  
Screening Program ◽  
Hpv Infection ◽  
Cervical Cancer Prevention ◽  
Point Of View ◽  
Prevention Strategies ◽  
Middle Income ◽  
Screening Programs

High-risk human papillomavirus strains are widely known to be the causative agents responsible for cervical cancer development. Aggregated damage caused by papillomaviruses solely is estimated in at least 5% of all malignancies of the human body and 16% in cancers that affect the female genital area. Enhanced understanding of the complex issue on how the high extent of carcinogenicity is eventually formed due to the infection by the Papoviridae family would contribute to enhancing current prevention strategies not only towards cervical cancer, but also other HPV associated cancers. This review article is aimed at presenting the key points in two directions: the current cervical cancer prevention and related aspects of HPV behavior. Virtually all applied technologies related to HPV diagnostics and screening programs, such as HPV tests, colposcopy-based tests (VIA/VILI), conventional and liquid-based cytology, currently available are presented. Issues of availability, advantages, and drawbacks of the screening programs, as well as vaccination strategies, are also reviewed in the article based on the analyzed sources. The current point of view regarding HPV is discussed with emphasis on the most problematic aspect of the HPV family concerning the observed increasing number of highly carcinogenic types. Present trends in HPV infection diagnostics throughout the human fluids and tissues are also reported, including the latest novelties in this field, such as HPV assay/self-sample device combinations. Besides, a brief outline of the related prevention issues in Kazakhstan, the leading country of Central Asia, is presented. Kazakhstan, as one of the post-soviet middle-income countries, may serve as an example of the current situation in those terrains, concerning the implementation of globally accepted cervical cancer prevention strategies. Along with positive achievements, such as the development of a nationwide screening program, a range of drawbacks is also analyzed and discussed.

Epidemiology of HPV infection and current status of cervical cancer prevention in Greece

2014 ◽  
Vol 23 (5) ◽  
pp. 425-431 ◽  
Author(s):  
Theodoros Agorastos ◽  
Kimon Chatzistamatiou ◽  
Menelaos Zafrakas ◽  
Vagia Siamanta ◽  
Taxiarchis Katsamagkas ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Prevention ◽  
Hpv Infection ◽  
Cervical Cancer Prevention ◽  
Current Status

scholarly journals Precision Prevention: The 2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors

2021 ◽  
Vol 2 (3) ◽  
pp. 274-280
Author(s):  
Ritu Nayar
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cancer Prevention ◽  
Cervical Cancer Screening ◽  
Hpv Vaccination ◽  
Management Strategies ◽  
Hpv Infection ◽  
Cervical Cancer Prevention ◽  
Screening Tests ◽  
Consensus Guidelines

The approach to cervical cancer prevention has evolved significantly over the past two decades. HPV immunization has decreased the specificity of screening modalities and HPV-based testing has been replacing our previously successful morphology-only approach. Additionally, there is much more emphasis on providing precision prevention, rather than the previously used “one-fits-all” management strategies. A number of new biomarkers are entering clinical practice and being integrated into cervical cancer screening and management in order to enable a more personalized assessment of the risk for precancer/cancer for an individual patient. The 2019 ASCCP Risk-Based Management Consensus Guidelines expand on the concept of “equal management for equal risk”. They consider a patient’s history in addition to current test results to provide recommendations for increased surveillance/treatment in patients at higher risk for CIN3+ while minimizing interventions for lower-risk patients who have new versus persistent HPV infection. Clinical management decisions are based on immediate risk and 5-year risk estimates for CIN3+, which are determined by referencing an extensive risk table compiled by the National Cancer Institute (NCI). The course of action for a given patient is recommended by comparison of the risk in the risk database, to the predetermined clinical action thresholds. These guidelines address the need for simplification and offer some stability for the provider while being conducive to the incorporation of anticipated continued technologic advances in methods for cervical cancer prevention. Their enduring nature will allow for changes needed based on risk reduction as HPV vaccination uptake increases and vaccinated women reach screening age. Similarly, the design allows for the addition of new tests into the risk assessment calculations after their approval by applicable regulatory agencies and review/consensus approval by the ASCCP new technology and enduring guidelines workgroups. As cytopathologists, we must be familiar with the scientific advancements in primary and secondary prevention, evolving screening and management guidelines, and participate actively in the multidisciplinary approach for the prevention of cervical cancer.

scholarly journals Knowledge, attitudes, and practices of cervical cancer prevention and pap smears in two low-income communities in Lima, Peru

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Thomas T. Miles ◽  
Amy R. Riley-Powell ◽  
Gwenyth O. Lee ◽  
Esther E. Gotlieb ◽  
Gabriela C. Barth ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Prevention ◽  
Low Income ◽  
Pap Smear ◽  
Hpv Infection ◽  
Cervical Cancer Prevention ◽  
Infection Prevalence ◽  
Pap Smears ◽  
Attitudes And Practices ◽  
Knowledge Attitudes And Practices

Abstract Background Cervical cancer is a leading cause of death among Peruvian women. Barriers at multiple levels impact effective screening and treatment, including a lack of knowledge about cervical cancer and how regular screening can reduce morbidity and mortality through earlier detection. The aim of this study is to assess knowledge, attitudes, and practices regarding cervical cancer and its prevention in the peri-urban communities of Oasis and Pampas in southern Lima, Peru that can be used to inform future campaigns about cervical cancer prevention. Methods A cross-sectional survey that included several open-ended questions was administered to women in Pampas and Oasis between 2015 and 2016 to evaluate the knowledge, attitudes, and practices regarding cervical cancer and Pap smears. Results In total, 224 women were interviewed. Knowledge about cervical cancer and Pap smears was high, and attitudes were predominantly positive among most participants. Most participants knew how often they should get Pap smears (89.7%), when to begin seeking screening (74.6%), knew the price of a Pap smear (61.9%), and felt Pap smears were important for their health (70.1%). About one third (29.5%) of premenopausal women reported receiving a Pap smear in the last year. However, open ended questions revealed some knowledge gaps around Pap smears, as well as some stigma associated to Human Papilloma Virus (HPV) infection. Conclusion Although knowledge of cervical cancer prevention was generally high and perceptions were positive among women in peri-urban Peruvian communities, our findings revealed there is a need for education on HPV infection prevalence among sexually active individuals to reduce stigma. Future research should focus on exploring experiences with follow-up and treatment associated with abnormal Pap smears, as well as perspectives from health authorities and professionals about barriers in the early detection and treatment process for cervical cancer.

scholarly journals Knowledge of Cervical Cancer and Acceptability of Prevention Strategies Among HPV-Vaccinated and Nonvaccinated Adolescents in Eldoret, Kenya

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 196s-196s ◽  
Author(s):  
A. Mburu ◽  
P. Itsura
Keyword(s):  
Cervical Cancer ◽  
Public Schools ◽  
Cancer Prevention ◽  
Hpv Vaccine ◽  
Sexual Debut ◽  
Hpv Infection ◽  
Cervical Cancer Prevention ◽  
Prevention Strategies ◽  
Barrier Method ◽  
Cross Sectional

Background: Primary prevention of cervical cancer with the introduction of the human papilloma virus (HPV) vaccines is the next generation means to reduction of the disease burden in developing countries. Sexually active adolescents have the highest rates of prevalent and incident HPV infection rates with over 50%–80% having infections within 12 months of initiating intercourse. From May 2012 to March 2013, through the Gardasil Access Program, Eldoret received 9600 vaccine doses and vaccinated over 3000 girls aged 9-14. Despite this, there is little information on the knowledge of cervical cancer among adolescents and their amenability to accepting cervical cancer prevention strategies. Aim: To compare the knowledge of cervical cancer and acceptability of prevention strategies among vaccinated and nonvaccinated adolescents after an HPV vaccination initiative in Eldoret, Kenya. Methods: A cross-sectional comparative study carried out in 6 public schools which were clustered into 2 groups of 2. 60 vaccinated and 120 nonvaccinated adolescents were randomly selected from each of the schools by proportionate allocation. IREC approval obtained and signed consent got from the parents. Data collection was then carried out using interviewer-administered questionnaires. Results: The median age of the participants was 14.0 (IQR: 13.0-15.0). Of 60 vaccinated adolescents, 56 (93.3%) had heard of the HPV vaccine compared with 6 (5%) of unvaccinated participants ( P < 0.001). Fifty-eight (96.7%) of vaccinated participants heard of cervical cancer compared with 61 (50.8%) unvaccinated participants ( P < 0.001). The participants were not different in their knowledge of risk factors for developing cervical cancer or its symptoms but overall, the vaccinated participants had a significantly higher knowledge score compared with the unvaccinated participants 14.4 (95% CI: 12.2-16.7). Both cohorts identified the school as the commonest source of information for health matters as compared with social media or hospitals. The 2 groups also showed similarity in their selection of cervical cancer prevention strategies acceptable to them like delaying sexual debut until after the teenage years and frequency of using barrier method for protection against sexually transmitted infections. Similar proportions of participants from both cohorts showed high acceptability of screening modalities for cervical cancer (85% vs 86.7%, P = 0.940). Of the unvaccinated participants, 63.7% expressed willingness to be vaccinated. Conclusion: Exposure to the HPV vaccine was associated with a higher knowledge of cervical cancer. The adolescents predominantly rely on the school for their information. They show remarkable acceptability for cervical cancer prevention strategies but are limited by the dearth of information they have.

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