Cervical cancer is the second most common cancer, with about 500 000 new cases per year among women worldwide. With a well-organized screening programme the number of cases can be reduced by more than 50%. In spite of having such a screening programme there are still around 450 new cases yearly in Sweden. The majority of these cases occur in non-attendees. There is thus a need to improve the Swedish cervical cancer screening programme in order to further reduce the number of cases of cervical cancer. Cervical cancer and high-grade cervical dysplasia are caused by sexually transferred high-risk human papillomaviruses (HR-HPVs). In cases of persistent HR-HPV infection there is a risk of development of dysplasia and in some cases subsequent progress to cervical cancer. HR-HPV testing shows high sensitivity as regards the detection of cervical dysplasia. Self-sampling of vaginal fluid for the analysis of HR-HPV has many advantages, since a woman can perform the sampling herself in a private setting, whenever suitable, without the need to travel to a clinic. Our studies have shown that sensitivity in the detection of precancerous lesions is about twice as great with the HR-HPV self-test compared with cytology-based tests.  If a woman was HR-HPV-positive in two consecutive tests, the specificity of the HR-HPV test increased to about 98%. Among women with short-term persistent HR-HPV infection, the prevalence of CIN 2+ was over 40%. There was good concordance in sensitivity as regards the detection of CIN 2+ between self-obtained and physician-obtained samples, although self-sampling was associated with slightly lower specificity. The prevalence of HR-HPV from day to day in premenopausal women was not influenced by hormonal changes during the menstrual cycle. Neither were there significant day-to-day changes in postmenopausal women. A single self-test thus provides reliable information on whether or not a woman has an HR-HPV infection. In conclusion, self-sampling combined with the analysis of HR-HPV appears to be a powerful alternative as a primary screening method for the prevention of cervical cancer. Self-sampling for HR-HPV testing is a suitable, safe and accepted strategy for cervical cancer prevention among women.

Background: Cervical cancer may be fatal to women if not identified and treated early. In Iraq, cervical cancer ranks as the 10th most frequent cancer among women between 15-44 years of age, with about 291 new cervical cancer cases diagnosed annually. Cervical cancer can be prevented in two ways: primary prevention aimed at preventing HPV infection through prophylactic HPV vaccinations; and secondary prevention aimed at preventing precancerous lesions from progressing into invasive lesions through screening. Cervical cancer screening is under researched in Iraq. It is clear that Iraq’s years of isolation and disorder has resulted in a loss of research capacity. Aim: To provide evidence–based strategies to establish population based cervical cancer screening services in Iraq. Methods: A mixed methods sequential exploratory design was used; an iterative mixed method approach which included the triangulation of qualitative, quantitative and systematic review methods. Results of all phases were used to develop an emergent theory around the barriers for establishing cervical screening programme and to provide evidence to enhance cervical cancer screening services to be established in Iraq. Findings: The findings from the systematic review indicated significant health inequalities for Arab Muslim women, in that no population-based cervical cancer screening programmes have been implemented in most of Western Asian and Middle Eastern Arab countries. Findings from the qualitative phase revealed gap in theoretical and practical knowledge among the health care professionals regarding cervical cancer screening programmes with a lack of the capacity and infrastructure to establish population based cervical screening programme in Kirkuk, Iraq. Also, results suggest that the health behaviour of women living in Kirkuk is influenced by cultural ‘stigma’ around the word ‘cancer’, in addition to women’s lack of awareness in relation to smear test and cervical screening. Conclusion: Women in Iraq are more likely to be diagnosed at an advanced, rather than early stage of cervical cancer. These women should be targeted by cervical cancer screening and health education programmes. Policy makers need to improve the cervical screening infrastructure and make the cervical screening service more accessible to women. The current opportunistic cervical screening services are insufficient; there is an urgent need to developing cervical cancer intervention programmes.

A conservative strategy for women with a low-grade abnormal cervical smear is continued cytological surveillance by repeat Papinacolaou testing, but there is surprisingly little information on the management of such follow-up. Our objectives were to investigate such management pathways, their determinants, and psychological implications using data from the cytological surveillance arm of the Trial of Management of Borderline and Other Low-grade Abnormal cervical smears. A substantial proportion of participants had ongoing unresolved cytology at last follow-up (42.7%); a policy of following women solely though cytological surveillance to manage these women may be inefficient. A high-risk human papillomavirus test, smoking and age were significantly associated with the management pathways (p-value <0.05). While there were some limitations, our results were reassuring with respect to this group of women with ongoing unresolved cytology, since there were no differences in anxiety and depression scores across the management pathways after thirty months of follow-up.

Minority women groups in the United States have the highest incidence and mortality rates of cervical cancer. Hispanic women have the highest incidence rate and the second highest mortality rate of the disease. Researchers have examined the lower rates of cervical cancer screening among Hispanic women, as compared to other groups of U.S. women, but researchers have not examined the extent to which socioeconomic status, acculturation, and sexual activity impact Hispanic women's compliance with screening. The purpose of this study was to examine the association between compliance with cervical cancer screening and acculturation, socioeconomic status, and sexual activity among U.S. Hispanic women. The framework for investigating the extent of association between these identified barriers and willingness to comply with screening was the behavioral model for vulnerable populations. Chi-square tests and logistic regression were used to analyze data from the National Health Interview Survey for 2011, 2012, and 2013, focusing on U.S. Hispanic women ages 21 - 65 (N = 739). The findings from this study revealed that educational level was significantly associated with U.S. Hispanic women's cervical cancer screening; however, no statistically significant associations were found for socioeconomic status, acculturation, and sexual activity and screening rates for this group. Findings from this study can better inform researchers and others of the lower rate of screening for cervical cancer among U.S. Hispanic women. The findings will also promote positive social change by targeting U.S. Hispanic women and other minority women groups for programs that promote cervical cancer screening.

No description available.

No description available.

Cervical cancer remains the leading cause of cancer mortality among women worldwide, a burden in the developing countries and commonly detected through symptoms at later invasive stages. The study aimed at establishing knowledge and awareness of the importance of cervical cancer screening in the Makhuduthamaga Sub-district by exploring the perceptions of women and professional nurses and through the review of the National Cervical Cancer Screening Policy (2013). Recommendations to address the gap in knowledge and to inform the National Cervical Cancer Screening Policy were developed based on the study findings. A mixed-method approach was used in this study through a sequential explanatory design, which is quantitatively driven was used. Quantitative data were obtained by using a researcher developed checklist. The checklist was developed from variables stated in the National Cervical Cancer Screening Policy and was used to review its implementation. Qualitative data was obtained through in-depth interviews with individual women and focus group discussions with professional nurses. The study was conducted in ten randomly selected clinics of Makhuduthamaga Sub-district. Purposive sampling was done to obtain qualitative data. An average score of 9.7 was obtained for all ten clinics that participated in the study with regard to the evaluation of the implementation of the National Cervical Cancer Screening Policy. Only 6 (60%) clinics implemented the policy whereas 4 (40%) clinics did not implement the policy. Women and professional nurses perceived cervical cancer screening as important. Lack of knowledge among women regarding cervical cancer screening contributed to the majority of women not screening for cervical cancer. Lack of resources, the 10 year interval of normal cervical cancer screening, the use of disposable vaginal speculums and brushes, lack of standardized cervical cancer screening training, centralization of cytology laboratories came out as factors that negatively influence the uptake of cervical cancer screening. Cervical cancer screening awareness campaigns, availability of resources and standardized in-service trainings on cervical cancer screening were recommended to enhance the cervical cancer screening uptake. / Health Studies / D. Litt. et Phil. (Health Studies)

Perception of cervical cancer screening among Immigrant African women residing in Houston, Texas Esther I. Orji M.Ed., University of Lagos, 2002 B. Ed, Abia State University, 1998 A.C. E. University of Benin, 1990 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University August 2016 Disparities in cervical cancer screening participation still exist especially among immigrant and minority women compared to non immigrant populations. Research investigators through multiple studies have explored reasons for non participation in cervical cancer screening among immigrant and minority women. However, there was limited research specifically on how immigrant women of African descent could be empowered to overcome barriers associated with cervical cancer screening in Houston Texas. The purpose of this study was to explore and understand the perceptions of factors which are barriers to perform cervical cancer screening tests among immigrant women of African descent, as well as their beliefs on preventive medicine, and how immigrant women could be empowered in order to overcome barriers associated with cervical cancer screening. The theoretical framework was based on the health belief model. The participants for the study were 20 immigrant women of African descent aged 21-65. A semi-structured interview schedule which comprised of open ended questions was used to collect data on the perspectives of immigrant women towards cervical cancer screening. Data was transcribed verbatim and analyzed thematically. The social change implications of the study can be that immigrant women could be more encouraged to seek access to the appropriate state of the art in cervical cancer screening which could contribute in reducing mortality, morbidity rate, and costs associated with cervical cancer.

Thesis (MPH.) --University of Limpopo, 2015 / Background Cervical cancer is the 2nd most common cancer in women globally representing 13% of female cancers and accounting for 11% of the total cancer deaths (Ahmedin et al.2011). Several studies demonstrated the association between HIV and HPV. In Zimbabwe the prevalence of HIV/AIDS is high and cervical cancer is the leading cause of cancer deaths among women of all age groups. The aim of the study was to determine the knowledge, attitude and practices of HIV infected women on cervical cancer and cervical cancer screening at Musiso Hospital, Masvingo Province, Zimbabwe. Methods 208 self administered questionnaires were used with a 100 per cent response rate. Quantitative data were analysed using STATA statistical package version 12 for descriptive and inferential statistics. Chi-squared tests were done for hypothesis testing at 5 per cent level of significance and 95 per cent confidence level. Multiple variable logistic regressions models were also used to assess association between outcomes of interest and socio-demographic characteristics. All open ended questions were analysed using qualitative methods. Results Out of the 208 participants, 45 (21.6 per cent) respondents claimed to know what cervical cancer is. About 55.3 per cent said cervical cancer is preventable. The majority (92.8 per cent) did not know any screening tests. Just above three quarters (77.3 per cent) of the respondents believed they were at risk of having cervical cancer. About 9 per cent (18) of all participants had screened for cervical cancer before and 95.8 per cent respondents reported would like to screen for cervical cancer in the future. Conclusion HIV infected women at Musiso mission hospital were found to be having inadequate knowledge, positive attitude and inadequate practices on cervical cancer and cervical cancer screening. There is need to equip these women with knowledge on cervical cancer and cervical cancer screening to increase cervical cancer screening uptake. Key Concepts: knowledge, attitude, practice, screening, cervical cancer

In Swaziland, cases of cervical cancer among Human Immunodeficiency Virus (HIV)-positive adolescent girls and young women (AGYW) are increasing, but there is low uptake of cervical cancer screening. This study was conducted using the systems thinking theory to explore the relationships between the uptake of cervical cancer screening among HIV-positive AGYW in Swaziland and the availability of trained health providers, cervical screening services, and the provision of referrals for cervical screening. The study also investigated any differences in uptake of cervical screening based on age group. For this quantitative cross-sectional study, secondary HIV program data that were collected routinely between January 2016 and March 2018 were accessed. Data were described with univariate analysis while relationships were tested using bivariate analysis and logistic regression. Most facilities (97%) had staff who had been trained; facilities with greater numbers of trained staff were more likely to have a higher uptake (OR: 30.3, p = 0.000). Facilities with cervical screening services were also more likely to have a higher uptake (x2 = 16.94, p = 0.000), and facilities with all the core components for screening had the highest uptake (p = 0.002). AGYW who had a positive screen were referred equally but the referral rate was low (20.45%). There was no difference in uptake by age group. The results of the study can increase knowledge of the institutional factors that contribute to the low uptake of cervical cancer screening among HIV-positive AGYW and has implications for social change by informing interventions for improving cervical cancer screening uptake in HIV-positive AGYW in similar settings, ultimately reducing the high costs, morbidity, and mortality related to cervical cancer in this population.