• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8541-8551
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• 2016

Background: The coverage of breast and cervical cancer screening has only slightly increased in the past decade in Thailand, and these cancers remain leading causes of death among women. This study identified socioeconomic and contextual factors contributing to the variation in screening uptake and coverage. Materials and Methods: Secondary data from two nationally representative household surveys, the Health and Welfare Survey (HWS) 2007 and the Reproductive Health Survey (RHS) 2009 conducted by the National Statistical Office were used. The study samples comprised 26,951 women aged 30-59 in the 2009 RHS, and 14,619 women aged 35 years and older in the 2007 HWS were analyzed. Households of women were grouped into wealth quintiles, by asset index derived from Principal components analysis. Descriptive and logistic regression analyses were performed. Results: Screening rates for cervical and breast cancers increased between 2007 and 2009. Education and health insurance coverage including wealth were factors contributing to screening uptake. Lower or non-educated and poor women had lower uptake of screenings, as were young, unmarried, and non-Buddhist women. Coverage of the Civil Servant Medical Benefit Scheme increased the propensity of having both screenings, while the universal coverage scheme increased the probability of cervical screening among the poor. Lack of awareness and knowledge contributed to non-use of both screenings. Women were put off from screening, especially Muslim women on cervical screening, because of embarrassment, fear of pain and other reasons. Conclusions: Although cervical screening is covered by the benefit package of three main public health insurance schemes, free of charge to all eligible women, the low coverage of cervical screening should be addressed by increasing awareness and strengthening the supply side. As mammography was not cost effective and not covered by any scheme, awareness and practice of breast self examination and effective clinical breast examination are recommended. Removal of cultural barriers is essential.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8473-8477
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• 2016

Background: High risk human papilloma virus (HPV) types 16 and 18 have been proven as central causes of cervical cancer and safety and immunogenicity of HPV vaccines are sufficiently established. Knowledge and practices of HPV vaccination among medical and paramedical students is vital as these may strongly determine intention to recommend vaccination to others in the future. The present study was therefore undertaken to assess the knowledge, attitude and practices regarding cervical cancer screening and HPV vaccination among medical and paramedical students and to analyze factors influencing them. Materials and Methods: The present cross sectional study, conducted in a tertiary care teaching hospital in south India, included undergraduate students aged 18 years and above, belonging to medical, dental and nursing streams, after informed written consent. Results: Out of 957 participants, only 430 (44.9%) displayed good knowledge and only 65 (6.8%) had received HPV vaccination. Among the unvaccinated, 433 (48.54%), were not willing to take the vaccine. Concerns regarding the efficacy (30.5%), safety (26.1%) and cost of the vaccine (21.7%) were responsible for this. Age, gender, family history of malignancy and mother's education had no influence on knowledge. Compared to medical students, nursing students had better knowledge (OR-1.49, 95% CI 0.96 to 2.3, p = 0.072) and students of dentistry had poor knowledge (OR-0.50 95% CI 0.36 to 0.70, p<0.001). Conclusions: The knowledge and uptake of HPV vaccination among medical and paramedical students in India is poor. Targeted health education interventions may have huge positive impact not only on the acceptance of vaccination among them, but also on their intention to recommend the vaccine in future.

• The Korean Journal of Cytopathology
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• v.4 no.2
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• pp.87-92
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• 1993

The effect of Roentgen rays on carcinoma of the cervix has long been of great interest to both radiologists and gynecologists. Since most cervical carcinomas are treated by irradiation, any additional knowledge either concerning the radiosensitivity of cervical tumors or their ultimate prognosis would be of value. The vaginal smear is considered to be one of convenient and rapid methods to study the effects of radiation on cervical malignancy. We observed morphologic changes in 297 cytologic preparations obtained from 60 patients who had underwent irradiation for cancer of the cervix. With the morphologic parameters such as cytoplasmic vacuolization, cytoplasmic basophilia, multinucleated giant cell formation, polymorphonuclear leucocytes (PMNL) sticking and postradiation dysplasia, we analyzed the findings in relation to the follow up time interval. The most common effect was the cytoplasmic vacuolization with basophilia of basaloid cells, which were noted in more than 90% of followed patients. The multinucleated giant ceil formation and PMNL stickering were noted in 38 cases(63%) and 48 cases(80% ) respectively. The differential diagnosis of postradiation dysplasia from recurrent or persistent carcinoma, reparative atypical cells, and regressing tumor cells was difficult and further study seems to be needed to clarify the more accurate morphologic features and biologic behavior.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.11
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• pp.5687-5690
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• 2012

Objective: The study was planned with the purpose of examining the attitude of women who have pap-smear test for the early diagnosis of cervical cancer, factors affecting their decisions and their feelings and experiences during this period. Materials and Methods: A phenomenological method was used. Data were collected between March 2012 and April 2012 using standard and purposive samplings from 17 women. A detailed interview with women were held in their houses and recorded. The data collection tool consisted of two parts, one of which is information form with 17 questions identifying sociodemographic and cervical cancer risk factors of women and the second part is made up of semi-structured interview form with 15 alternative questions taking literature and the pap-smear test into consideration. Collected data were put into a written document. Content analysis was held by loading the documents into NVIVO 8 Statistical Programme. Results: The study comprised themes such as cervical risk factor, decision of taking pap-smear test, taking pap-smear test, knowledge about pap-smear test, relieving factors during pap-smear test, obstructive factors during pap-smear test, gynecological examination and feelings of women during and after pap-smear test while waiting for the results. Conclusions: As women perceive gynaecological examinations differently from other examinations, they have different feelings in each process of the Pap smear test. Medical staff should advise women more clearly on the nature and advantages of the Pap-smear test.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4651-4654
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• 2012

Organized introduction of prophylactic human papillomavirus (HPV) vaccination can reduce the burden of cervical cancer in developing countries. One of the most effective ways is through a national school-based program. Information on teachers is therefore important since this group may have a disproportionate influence in the success of any implementation. Objective: To assess teachers' knowledge and perception of HPV, cervical cancer and HPV vaccine prior to commencing a school-based HPV vaccination program in a multiethnic, predominantly Muslim country. Factors associated with acceptability of the vaccine were identified. Method: A bilingual questionnaire was applied to 1,500 secondary school teachers from 20 urban schools in Malaysia. Data collected were analyzed using SPSS version 17. Results: 1,166 questionnaires were returned. From this group, 46.1% had never heard of HPV while 50.9% had never had a pap smear. However, 73.8% have heard of the HPV vaccine with 75% agreeing to have it. 96% considered themselves religious with 79.8% agreeing to have the vaccine. Conclusions: A national school-based HPV immunization program can be implemented effectively in a multiethnic, cultural and religious country despite limited knowledge of HPV-related pathology among teachers. In addition, the perception that religion has a negative influence on such a program is unwarranted.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.6
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• pp.2913-2921
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• 2012

Introduction: The impact of cervical cancer prevention programs depends on persuading women to go for screening and, if needed, treatment. As part of an evaluation of a pilot project in Indonesia, qualitative research was conducted to explore the factors that influence women's decisions regarding screening and treatment and to generate practical recommendations to increase service coverage and reduce loss to follow up. Methods: Research was conducted at 7 of the 17 public health centers in Karawang District that implemented the pilot project. Interviews and focus group discussions were held with 20 women, 20 husbands, 10 doctors, 18 midwives, 3 district health officials, and 16 advocacy team members. Results: Free services and mobile outreach events encouraged women to go for screening, along with promotional efforts by community health workers, advocacy teams, and the mass media. Knowledge and perceptions were the most important barriers to screening: women were not aware of cervical cancer risks, did not know the disease was treatable, and were fatalistic. Factors facilitating treatment were social support from husbands, relatives, and friends and the encouragement and role modeling of health workers. Barriers to prompt treatment included limited access to services and the requirement for husband's consent for cryotherapy. Conclusion: As cervical cancer prevention services are scaled up throughout Indonesia, the findings suggest three strategies to expand screening coverage and ensure prompt treatment: strengthening community mobilization and advocacy activities, modifying the service delivery model to encourage a single visit approach to screening and treatment, and working to gain men's support.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6095-6098
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• 2014

Background:Cervical cancer is potentially the most preventable and treatable cancer. Despite the known efficacy of cervical screening, a significant number of women do not avail themselves of the procedure due to lack of awareness. Objectives: This study was conducted to elicit information on the knowledge, attitude and practice (KAP) regarding screening (Pap test) and vaccination for carcinoma cervix among female doctors and nurses in a tertiary care hospital in Bangalore and to assess barriers to acceptance of the Pap test. Materials and Methods: A cross-sectional, descriptive study was conducted with semi-structured, self-administered questionnaire among female health professionals. The study subjects were interviewed for KAP regarding risk factors for cancer cervix, Pap test and HPV vaccination for protection against carcinoma cervix. Results: Higher proportion of doctors 45 (78.9%) had very good knowledge as compared to only 13 (13.3%) of the nurses, about risk factors for cancer cervix and Pap test (p=0.001). As many as 138(89.6%) of the study subjects had favorable attitude towards Pap test and vaccination, but 114 (73.6%) of the study subjects never had a Pap test and the most common reason 35 (31%) for not practicing was absence of disease symptoms. Conclusions: In spite of good knowledge and attitudes towards cancer cervix and Pap test being good, practice remained low among the study subjects and most common reasons for not undergoing Pap test was absence of disease symptoms. The independent predictors of ever having a Pap test done was found to be the occupation and duration of married life above 9yrs. Hence there is a strong need to improve uptake of Pap test by health professionals by demystifying the barriers.

• Journal of Korean Academy of Nursing
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• v.12 no.1
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• pp.25-38
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• 1982

As technological civilization and medical science has developed, standards of living have imp-roved and human life expectancy has been extended. But the incidence and mortality rate of cancer have been gradually increasing due to the pollution of the environment. Even though cancer is still a great threat to human beings, the etiology and appropriate cure forcancerhavenotyetbeendiscovered. The early detection and treatment of cancer is urgently needed. This study concentrates on the health behavior of woman regarding the papanicolau smear for early detection of cervical cancer. It was done in order to provide a direction for scientific health education materials by investigating predictors of preventive health behavior. The subjects for this study were made up of 54 woman, who comply with preventive health practices(compliant) who attended the Cervical Cancer Center of Y University Hospital in order to have tests for early detection of cervical cancer and 54 woman who did not comply with preventive health practices (noncompliant) selected from 100 housewives of I apartment, Kang Nam Ku, Seoul. The study method used, was a questionnaire for the compliance group and an interview for the noncompliance group. The period for data collection was from October 13th to October 24th. 1981. Analysis of the data was done using percentages, T-test, Pearson Correlation and Stepwise Multiple Regression. The results of study were as follows: 1. The hypotheses tested were based on the health belief model; 1) The first hypothesis,“The compliant may have more knowledge of the cervical cancer than the noncompliant”was rejected(T=-1.86, p>.05) 2) The second hypothesis,“The compliant may have a higher severity of cervical cancer than the noncompliant”was accepted (T=5.41, p<.001) 3) The third hypothesis, “The compliant may have a higher susceptability to cervical cancer than the noncompliant”was accepted(T=3.51, p<.01). 4) The fourth hypothesis,“The compliant may have more beneHt than cost'from the cervical cancer tests than the noncompliant" was accepted(T=7.46, p<.001). 5) The fifth hypothesis,“The compliant may have more health concern than the noncompliant”. was accepted(T=3.39, p<.01). These results show that severity, susceptability, benefit(over cost) and health concern influence the preventive health behavior in this Study. 2. In the correlation among variables, it was found that the knowledge of cervical cancer and the benefit(over cost) of preventive health behavior were negatively correlated(r=-2.75, p<.01), Severity of cervical cancer and benefit (over cost) of preventive health behavior were positively correlated(r=.280, p＜.01), severity and susceptability of cervical cancer were positively correlated(r= .238, p<.01), benefit(over cost) and health concern were positively correlated(r= .299, p<.01). The benefit(over cost) may be raised by increasing the severity and health concern. Therefore the compliance rate of woman may be raised through health education by increasing the benefit(over cost) of the individual. 3. The Stepwise Multiple Regression between health behavior and predictors. 1) The factor“Benefit(over cost)”could account for preventive health behavior in 34.4％ of the sample(F=55.6204 P<.01). 2) When the factor“Severity”is added to this, it accounts for 44.3% of preventive health behavior(F=41.679, p<.01). 3) When the factor“Susceptability”is also included, it accounts for 46.7% of preventive health behavior(F=30.373, p<.01). 4) When the factor “Health concern”is included, it accounts for 48.1% of preventive health behavior(F=23859, p<.05). This means that other factors appear to influence preventive health behavior, since the combination of variables explains only 48.1％ of the Preventive health behavior. Therefore further study to investigate the predictors of preventive health behavior is necessary.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.7
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• pp.4212-4219
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• 2014

Purpose: The goal of this study is to assess the factors influencing the HPV vaccination of females in their twenties. Methods: The survey was conducted during 2013.11.11-28 with a convenience sample of 488 participants. Results: The mean score of their knowledge about cervical cancer shows 2.54 out of 7. 96.7% and 31.5% of respondents have heard about cervical cancer and HPV, respectively. Only 2.7% are vaccinated by the recommendations from the medical teams. The higher the knowledge scores, the more the subjects are vaccinated. The factors influencing HPV vaccination appear to be prior knowledge about the HPV. Conclusion: The knowledge level is low compared to previous studies. Despite this, the trend of vaccination rate is higher. Medical teams need to promote vaccination. Accordingly, education and promotion are needed for the unvaccinated.

• Women's Health Nursing
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• v.20 no.3
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• pp.225-233
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• 2014

Purpose: This study was to assess the intention of undergoing Pap testing and to identify influencing factors of HPV knowledge and their attitude related to Pap test by sexual activity among unmarried nurses. Methods: A cross sectional survey design was employed, utilizing a self-administered questionnaire amongst 343 unmarried nurses. Descriptive statistics was utilized to analyze data and inferential statistics used an independent-t test and ${\chi}^2$ test for the differences in measurement variables, and odds ratios for factors on intention of Pap testing by sexual activity. Results: Nurses not sexually active were significantly higher in intention of Pap testing (${\chi}^2$=40.15, p<.001) and influencing factors of HPV knowledge (t=3.93, p=.048) than did nurses who were sexually active. Factors influencing intention were regularity of the breast self-examination (Adjusted Odds Ratio [AOR]=4.20, 95% Confidence Interval [CI]=1.93~9.17), HPV knowledge (AOR=2.49, 95% CI=1.36~4.56), and attitudes toward the Pap test(AOR=2.33, 95% CI=1.25~4.34) amongst nurses who never had sexual experience. Conclusion: It is necessary to minimize negative attitudes of Pap testing and to increase HPV knowledge in order to improve intention of Pap testing for women who were not sexually active. More focus would be given to sexually active women to get Pap tested as a preventive measure for cervical cancer.