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      Beliefs and Utilization of Cervical Cancer Screening by Female Health Care Workers in Saudi Arabia Using the Health Belief Model: A Nationwide Study

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          Abstract

          Purpose

          Epidemiologically, cervical cancer is the fourth most commonly diagnosed cancer among females globally and the third most commonly diagnosed gynecological cancer in Saudi Arabia. Screening is an important measure to prevent it. The current study aimed to assess, epidemiologically, female healthcare workers’ (HCWs) utilization of cervical cancer screening services and its association with their beliefs about cervical cancer and the screening test, as well as their personal characteristics.

          Methods

          This cross-sectional study included female HCWs in Saudi Arabia. A predesigned, self-administered survey was used to collect data, and it included questions about sociodemographic and reproductive characteristics, self-utilization of cervical cancer screening services, and the Health Belief Model (HBM) scale. Regression analyses were conducted to identify predictors of cervical cancer screening service utilization.

          Results

          A total of 1857 females participated. The cervical cancer screening test uptake was 24.6% of ever-married females. However, 45% of the participants were willing to have the test. The odds of utilizing a screening were significantly higher among older participants, those with a higher level of education, and those with a higher number of pregnancies. Furthermore, HCWs with a history of HPV infection, cervical cancer in the family, hormonal contraception, or immunocompromised diseases were more likely to have the screening. An increase in the mean scores of the perceived benefits and motives subscales of HBM was associated with an increase in the uptake of screening. However, an increase in perceived barrier scores was significantly associated with a lower likelihood of cervical cancer screening uptake.

          Conclusion

          Low cervical screening uptake and slightly higher intentions to have the test exist among HCWs. Certain personal factors and health beliefs significantly affect the utilization of the screening test. Approaches that target perceived benefits, health motivation, and perceived barriers to improve the screening rates of cervical cancer among HCWs are recommended.

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          Most cited references38

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          Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

          This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.
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            Screening for Cervical Cancer

            The number of deaths from cervical cancer in the United States has decreased substantially since the implementation of widespread cervical cancer screening and has declined from 2.8 to 2.3 deaths per 100 000 women from 2000 to 2015.
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              • Article: not found

              Instrument development for health belief model constructs.

              V Champion (1984)
              Research was conducted to develop valid and reliable scales to test the Health Belief Model (HBM). The dependent variable chosen for scale development was frequency of breast self-examination. Independent variables were constructs related to the HBM: susceptibility, seriousness, benefits, barriers, and health motivation. Analyses for construct validity and theory testing included factor analysis and multiple regression. Chronbach Alpha and Pearson r were used to compute reliabilities. Scales that were judged valid and reliable were susceptibility, seriousness, benefits, barriers, and health motivation.
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                Author and article information

                Journal
                Int J Womens Health
                Int J Womens Health
                ijwh
                International Journal of Women's Health
                Dove
                1179-1411
                07 August 2023
                2023
                : 15
                : 1245-1259
                Affiliations
                [1 ]Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University , Dammam, Saudi Arabia
                [2 ]College of Medicine, Imam Abdulrahman Bin Faisal University , Dammam, Saudi Arabia
                [3 ]College of Medicine, Fakeeh College of Medical Sciences , Jeddah, Saudi Arabia
                Author notes
                Correspondence: Nouf A AlShamlan, Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University , Dammam, Saudi Arabia, Tel +966 504901406, Email nashamlan@iau.edu.sa
                Author information
                http://orcid.org/0000-0002-8049-237X
                http://orcid.org/0000-0003-4899-7965
                http://orcid.org/0000-0002-9842-894X
                http://orcid.org/0000-0002-8852-361X
                http://orcid.org/0000-0001-8501-2649
                http://orcid.org/0000-0003-4596-5159
                http://orcid.org/0000-0002-7434-7432
                Article
                415924
                10.2147/IJWH.S415924
                10417788
                37576181
                5ebed345-9954-4060-8996-005109ea3325
                © 2023 AlShamlan et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 06 April 2023
                : 29 July 2023
                Page count
                Figures: 0, Tables: 6, References: 39, Pages: 15
                Categories
                Original Research

                Obstetrics & Gynecology
                cervical cancer screening,health belief model,pap smear,healthcare worker,utilizations,saudi arabia

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