Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Factors Associated with Delayed Diagnosis of Cervical Cancer in Iran - a Survey in Isfahan City

  • Behnamfar, Fariba (Depatment of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences) ;
  • Azadehrah, Mahboobeh (Depatment of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences)
  • Published : 2015.02.25
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Abstract

Background: In the absence of routine screening program for cervical cancer in Iran and high rate of diagnosed cancer in its advanced stage, recognition of sociodemographic factors related to delayed diagnosis of cancer in Iran could be helpful in reducing the burden of disease in our community. The aim of this study was to determine the stage of cervical cancer at diagnosis and factors related to delayed diagnosis of cervical cancer in Isfahan, Iran. Materials and Methods: In this cross sectional study women diagnosed with cervical cancer for the first time by histo-pathological examination were enrolled. According to the clinical and paraclinical findings and staging of the cancer, they were classified into early and delayed diagnosis of cervical cancer. Sociodemographic factors were compared in the two groups. Results: In this study of 55 women mean age was $48.3{\pm}12.0.$ According to our classification 6/55 (10.9%) and 49/55 (89.1%) of them had early and delayed diagnosis of cervical cancer. Delayed diagnosis of the cancer was significantly higher in patients with lower degree of education, lower socioeconomic status, having smoker and addict husband and those who did not have a history of Pap smear test (p<0.05). Conclusions: The results of this study indicated risk factors related to delayed diagnosis of cervical cancer. The affected women should be targeted for implementation of specialized educational programmes for improving knowledge and screening test.

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References

  1. Allgar VL, Neal RD (2005). Delays in the diagnosis of six cancers: analysis of data from the National Survey of NHS Patients: Cancer. Br J Cancer, 92, 1959-70. https://doi.org/10.1038/sj.bjc.6602587
  2. Arbyn M, Castellsague X, de Sanjose S, et al (2011). Worldwide burden of cervical cancer in 2008. Ann Oncol, 22, 2675-86. https://doi.org/10.1093/annonc/mdr015
  3. Augusto EF, Rosa ML, Cavalcanti SM, Oliveira LH (2013). Barriers to cervical cancer screening in women attending the family medical program in Niteroi, Rio de Janeiro. Arch Gynecol Obstet, 287, 53-8. https://doi.org/10.1007/s00404-012-2511-3
  4. Bebis H, Reis N, Yavan T, et al (2012). Effect of health education about cervical cancer and papanicolaou testing on the behavior, knowledge, and beliefs of Turkish women. Int J Gynecol Cancer, 22, 1407-12. https://doi.org/10.1097/IGC.0b013e318263f04c
  5. Benedet JH, Bender H, Jones H 3rd, Ngan HY, Pecorelli S (2000). FIGO staging classifications and clinical practice guidelines in management of gynecologic cancer. FIGO committee on gynecologic oncology. Int J Gynaecol Obstet, 70, 209-62. https://doi.org/10.1016/S0020-7292(00)90001-8
  6. Berraho M, Obtel M, Bendahhou K, et al (2012). Sociodemographic factors and delay in the diagnosis of cervical cancer in Morocco. Pan Afr Med J, 12, 14.
  7. Brewer N, Pearce N, Jeffreys M, White P, Ellison-Loschmann L (2009). Demographic differences in stage at diagnosis and cervical cancer survival in New Zealand, 1994-2005. J Womens Health (Larchmt), 18, 955-63. https://doi.org/10.1089/jwh.2008.1163
  8. California Office of Environmental Health Hazard Assessment (1997). Health effects of exposure to environmental tobacco smoke. California environmental protection agency. Sacramento, CA.
  9. Chigbu CO, Aniebue U (2011). Why southeastern Nigerian women who are aware of cervical cancer screening do not go for cervical cancer screening. Int J Gynecol Cancer, 21, 1282-6. https://doi.org/10.1097/IGC.0b013e31822bd139
  10. Devi BC, Tang TS, Corbex M (2007). Reducing by half the percentage of late-stage presentation for breast and cervix cancer over 4 years: a pilot study of clinical downstaging in Sarawak, Malaysia. Ann Oncol, 18, 1172-6. https://doi.org/10.1093/annonc/mdm105
  11. Ferlay J, Shin HR, Bray F, et al (2010). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer, 127, 2893-917. https://doi.org/10.1002/ijc.25516
  12. Franceschi S, Plummer M, Clifford G, et al (2009). International agency for research on cancer multicentric cervical cancer study groups; international agency for research on cancer human papillomavirus prevalence surveys study group. differences in the risk of cervical cancer and human papillomavirus infection by education level. Br J Cancer, 101, 865-70. https://doi.org/10.1038/sj.bjc.6605224
  13. Galobardes B, Shaw M, Lawlor DA, Lynch JW, Davey Smith G (2006). Indicators of socioeconomic position (part 2). J Epidemiol Community Health, 60, 95-101. https://doi.org/10.1136/jech.2004.028092
  14. Gyenwali D, Khanal G, Paudel R, et al (2014). Estimates of delays in diagnosis of cervical cancer in Nepal. BMC Women's Health, 14, 29. https://doi.org/10.1186/1472-6874-14-29
  15. Gyenwali D, Pariyar J, Onta SR (2013). Factors associated with late diagnosis of cervical cancer in Nepal. Asian Pac J Cancer Prev, 14, 4373-7. https://doi.org/10.7314/APJCP.2013.14.7.4373
  16. Hansen RP, Olesen F, Sorensen HT, Sokolowski I, Sondergaard J (2008). Socioeconomic patient characteristics predict delay in cancer diagnosis:a Danish cohort study. BMC Health Serv Res, 8, 49. https://doi.org/10.1186/1472-6963-8-49
  17. IARC (2004). Tobacco smoking and involuntary smoking. Lyon, France: IARC.
  18. Ibfelt E, Kjaer SK, Johansen C, et al (2012). Socioeconomic position and stage of cervical cancer in Danish women diagnosed 2005 to 2009. Cancer Epidemiol Biomarkers Prev, 21, 835-42. https://doi.org/10.1158/1055-9965.EPI-11-1159
  19. Ibrahim A, Rasch V, Pukkala E, Aro AR (2011). Predictors of cervical cancer being at an advanced stage at diagnosis in Sudan. Int J Womens Health, 3, 385-9.
  20. Jemal A, Bray F, Center MM, et al (2011). Global cancer statistics. CA Cancer J Clin, 61, 69-90. https://doi.org/10.3322/caac.20107
  21. Khorasanizadeh F, Hassanloo J, Khaksar N, et al (2013). Epidemiology of cervical cancer and human papilloma virus infection among Iranian women-analyses of national data and systematic review of the literature. Gynecol Oncol, 128, 277-81. https://doi.org/10.1016/j.ygyno.2012.11.032
  22. Lindau ST, Tomori C, Lyons T, et al (2002). The association of health literacy with cervical cancer prevention knowledge and health behaviors in a multiethnic cohort of women. Am J Obstet Gynecol, 186, 938-43. https://doi.org/10.1067/mob.2002.122091
  23. Louie KS, Castellsague X, de Sanjose S, et al (2011). International agency for research on cancer multicenter cervical cancer study group. smoking and passive smoking in cervical cancer risk: pooled analysis of couples from the IARC multicentric case-control studies. Cancer Epidemiol Biomarkers Prev, 20, 1379-90. https://doi.org/10.1158/1055-9965.EPI-11-0284
  24. Lourenco AV, Fregnani CM, Silva PC, Latorre MR, Fregnani JH (2012). Why are women with cervical cancer not being diagnosed in preinvasive phase? an analysis of risk factors using a hierarchical model. Int J Gynecol Cancer, 22, 645-53. https://doi.org/10.1097/IGC.0b013e318246a1af
  25. Ma J, Zhu Q, Han S, Zhang Y, Ou W, Wang H, Zhao J, Liu Z (2012). Effect of socio-economic factors on delayed access to health care among Chinese cervical cancer patients with late rectal complications after radiotherapy. Gynecol Oncol, 124, 395-8. https://doi.org/10.1016/j.ygyno.2011.11.040
  26. Maar M1, Burchell A, Little J, et al (2013). A qualitative study of provider perspectives of structural barriers to cervical cancer screening among first nations women. Womens Health Issues, 23, 319-25. https://doi.org/10.1016/j.whi.2013.06.005
  27. McCarthy AM, Dumanovsky T, Visvanathan K, Kahn AR, Schymura MJ (2010). Racial/ethnic and socioeconomic disparities in mortality among women diagnosed with cervical cancer in New York City, 1995-2006. Cancer Causes Control, 21, 1645-55. https://doi.org/10.1007/s10552-010-9593-7
  28. Mitchell JB, McCormack LA (1997). Time trends in late stage diagnosis of cervical cancer. Differences by race-/ethnicity and income. Med Care, 35, 1220-4. https://doi.org/10.1097/00005650-199712000-00006
  29. Tanturovski D, Zafirova E, Stojovski M, Basheska N, Jovanovska V (2013). Impact of socio-demographic factors on the delayed diagnosis and advanced stage presentation of patients with invasive cervical cancer in Macedonia. Prilozi, 34, 71-8.
  30. Thomson C, Forman D (2009). Cancer survival in England and the influence of early diagnosis: what can we learn from recent EUROCARE results and quest. Br J Cancer, 101, 102-9. https://doi.org/10.1038/sj.bjc.6605399
  31. U.S. Department of Health and Human Services (2006). the health consequences of involuntary exposure to tobacco smoke: a report of the surgeon general. u.s. department of health and human services, centers for disease control and prevention, coordinating center for health promotion, national center for chronic disease prevention and health promotion, office on smoking and health. Atlanta, GA.
  32. Vinh-Hung V, Bourgain C, Vlastos G, et al (2007). Prognostic value of histopathology and trends in cervical cancer: a SEER population study. BMC Cancer, 7, 164. https://doi.org/10.1186/1471-2407-7-164
  33. World Health Organization (2010). Gender, women, and the tobacco epidemic. Geneva, Switzerland: World Health Organization.
  34. Yu CK, Chiu C, McCormack M, Olaitan A (2005). Delayed diagnosis of cervical cancer in young women. J Obstet Gynaecol, 25, 367-70. https://doi.org/10.1080/01443610500118814

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