Factors affecting utilization of cervical cancer prevention services in low-resource settings

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Strategies for introducing or strengthening cervical cancer prevention programs must focus on ensuring that appropriate, cost-effective services are available and that women who most need the services will, in fact, use them. This article summarizes the experiences of research projects in Bolivia, Peru, Kenya, South Africa, and Mexico. Factors that affect participation rates in cervical cancer prevention programs are categorized in three sections. The first section describes factors that arise from prevailing sociocultural norms that influence women's views on reproductive health, well being, and notions of illness. The second section discusses factors related to the clinical requirements and the type of service delivery system in which a woman is being asked to participate. The third section discusses factors related to quality of care. Examples of strategies that programs are using to encourage women's participation in cervical cancer prevention services are provided.

Translated abstract

Las estrategias para introducir o fortalecer programas de prevención de cáncer cervical deben enfocarse hacia garantizar servicios costo-efectivos, que se encuentren disponibles para que las mujeres que los necesiten puedan utilizarlos. Este artículo resume la experiencia de proyectos de investigación realizados en Bolivia, Perú, Kenya, Sudáfrica y México. Los factores que afectan la tasa de participación en programas de prevención son categorizados en tres secciones. La primera describe los factores que surgen predominantemente por normas socioculturales que influyen en la visión que las mujeres tienen sobre la salud reproductiva. La segunda discute los factores relacionados con los requerimientos clínicos y el tipo de servicio ofrecido, así como el sistema mediante el cual las mujeres están siendo invitadas a participar. La tercera sección discute factores relacionados con la calidad de la atención. Finalmente, se proveen ejemplos de las estrategias sobre los programas que son utilizados para alentar la participación de las mujeres en los servicios de prevención del cáncer cervical.

Related collections

Most cited references 48

Record: found
Abstract: found
Article: found

Is Open Access

Effective screening programmes for cervical cancer in low- and middle-income developing countries

Rengaswamy Sankaranarayanan, Atul Budukh, Rajamanickam Rajkumar (2001)

Cervical cancer is an important public health problem among adult women in developing countries in South and Central America, sub-Saharan Africa, and south and south-east Asia. Frequently repeated cytology screening programmes -- either organized or opportunistic -- have led to a large decline in cervical cancer incidence and mortality in developed countries. In contrast, cervical cancer remains largely uncontrolled in high-risk developing countries because of ineffective or no screening. This article briefly reviews the experience from existing screening and research initiatives in developing countries. Substantial costs are involved in providing the infrastructure, manpower, consumables, follow-up and surveillance for both organized and opportunistic screening programmes for cervical cancer. Owing to their limited health care resources, developing countries cannot afford the models of frequently repeated screening of women over a wide age range that are used in developed countries. Many low-income developing countries, including most in sub-Saharan Africa, have neither the resources nor the capacity for their health services to organize and sustain any kind of screening programme. Middle-income developing countries, which currently provide inefficient screening, should reorganize their programmes in the light of experiences from other countries and lessons from their past failures. Middle-income countries intending to organize a new screening programme should start first in a limited geographical area, before considering any expansion. It is also more realistic and effective to target the screening on high-risk women once or twice in their lifetime using a highly sensitive test, with an emphasis on high coverage (>80%) of the targeted population. Efforts to organize an effective screening programme in these developing countries will have to find adequate financial resources, develop the infrastructure, train the needed manpower, and elaborate surveillance mechanisms for screening, investigating, treating, and following up the targeted women. The findings from the large body of research on various screening approaches carried out in developing countries and from the available managerial guidelines should be taken into account when reorganizing existing programmes and when considering new screening initiatives.

0 comments Cited 53 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Screening for cervical cancer: a review of women's attitudes, knowledge, and behaviour.

F Fylan (1998)

The United Kingdom (UK) cervical screening programme has been successful in securing participation of a high proportion of targeted women, and has seen a fall in mortality rates of those suffering from cervical cancer. There remains, however, a significant proportion of unscreened women and, of women in whom an abnormality is detected, many will not attend for colposcopy. The present work reviews the psychological consequences of receiving an abnormal cervical smear result and of secondary screening and treatment, and examines reasons for women's non-participation in the screening programme. Psychological theories of screening behavior are used to elucidate women's reactions and to suggest methods of increasing participation, of improving the quality of the service, and of reducing women's anxiety. A literature search identified studies that examine factors influencing women's participation in the screening programme, their psychological reaction to the receipt of an abnormal cervical smear result, and experiences of colposcopy. Reasons for non-participation include administrative failures, unavailability of a female screener, inconvenient clinic times, lack of awareness of the test's indications and benefits, considering oneself not to be at risk of developing cervical cancer, and fear of embarrassment, pain, or the detection of cancer. The receipt of an abnormal result and referral for colposcopy cause high levels of distress owing to limited understanding of the meaning of the smear test; many women believe the test aims to detect existing cervical cancer. The quality of the cervical screening service can be enhanced by the provision of additional information, by improved quality of communication, and by consideration of women's health beliefs. This may result in increased participation in, and satisfaction with, the service.

0 comments Cited 45 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Evaluation of alternative methods of cervical cancer screening for resource-poor settings.

Misty Kuhn, L Denny, Peter Wright … (2000)

Noncytologic methods of screening for cervical carcinoma and its precursor lesions are needed for resource-poor settings in which cervical carcinoma continues to be an important cause of morbidity and mortality. Two thousand nine hundred forty-four women ages 35-65 years were recruited from Cape Town, South Africa and screened using a combination of a Papanicolaou (Pap) smear, human papillomavirus (HPV) DNA testing, direct visual inspection after the application of a 5% acetic acid solution (DVI), and cervicography. Cervicography was considered primarily as a method with which to quality control the DVI examinations. Women with squamous intraepithelial lesions (SIL) or carcinoma on Pap smear, positive DVI examination (acetowhite lesion or cervical ulcer/growth), high levels of high risk HPV DNA (relative light units [RLU] > 10x positive control), or positive Cervigramtrade mark were referred for colposcopy and cervical biopsy. Pap smears were positive in 8.1% of all women screened and identified 65 (78%) of all cases of biopsy confirmed high grade disease (high grade SIL or invasive carcinoma). DVI and cervicography were classified as positive in 18.1% and 10.5%, respectively, of women screened and identified 58 (67%) and 46 (58%) of all cases of high grade disease, respectively. The results of HPV DNA testing varied depending on the cutoff value used to define a positive result. At the standard cutoff level (RLU > 1x positive control), 16.2% of women screened were classified as high risk HPV DNA positive, as were 63 women with high grade disease (73%). DVI and HPV DNA testing identified similar numbers of high grade SIL (cervical intraepithelial neoplasia Grade 2,3) and invasive carcinoma cases as Pap smears. However, both classify considerably more women without cervical disease as being test positive. Copyright 2000 American Cancer Society.

0 comments Cited 45 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (publisher-id): spm

Title: Salud Pública de México

Abbreviated Title: Salud pública Méx

Publisher: Instituto Nacional de Salud Pública (Cuernavaca, Morelos, Mexico )

ISSN (Print): 0036-3634

Publication date (Print and electronic): 2003

Volume: 45

Issue: suppl 3

Pages: 408-416

Affiliations

[01] Seattle orgnameProgram for Appropriate Technology in Health France

[02] orgnameEngenderHealth Bolivia

[03] orgnamePan American Health Organization USA

Article

Publisher ID: S0036-36342003000900015 Publisher ID: S0036-3634(03)04500015

DOI: 10.1590/s0036-36342003000900015

PubMed ID: 14746034

SO-VID: 4bf87423-c6e0-4013-90d1-71c23062c6af

License:

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

History

Date accepted : 17 February 2003

Date received : 02 October 2002

Page count

Figures: 0, Tables: 0, Equations: 0, References: 1, Pages: 9

Product

SciELO Public Health

Self URI: Full text available only in PDF format (EN)

Comments

Comment on this article

scite_

Cited by 36

See all cited by

Most referenced authors 18

See all reference authors

- Version 1
- Version 1

Factors affecting utilization of cervical cancer prevention services in low-resource settings Translated title: Factores determinantes de utilización de programas de detección oportuna de cáncer cervical en población de bajos recursos

Read this article at

Abstract

Translated abstract

Related collections

SciELO Public Health

Most cited references 48

Effective screening programmes for cervical cancer in low- and middle-income developing countries

Screening for cervical cancer: a review of women's attitudes, knowledge, and behaviour.

Evaluation of alternative methods of cervical cancer screening for resource-poor settings.

Author and article information

Journal

Affiliations

Article

History

Page count

Product

Categories

Comments

Comment on this article

Similar content 313

Cited by 36

Most referenced authors 18