• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.15
• /
• pp.6151-6154
• /
• 2014

A growing body of literature is evidence that identifying subtypes of high-risk human papillomavirus (HR-HPV) has impacted on various steps of cervical cancer prevention.Thus, it is mandatory to determine the background prevalence and distribution of HPV subtypes for designing and implementing area-specific management. The present study was conducted to evaluate prevalence and distribution of HPV subtypes among women aged 30-70 years living in Lampang, an area with a high incidence of cervical cancer, through use of a mobile screening unit. Of 2,000 women recruited in this study, 108 (5.40%, 95%CI: 4.45-6.48) were found to have HR-HPV infection. Risk was significantly correlated with age and number of partners. Singly or in combination, the most common genotype was HPV 52 (17.6%), followed by HPV 16 (14.81%), HPV 58 (13.89%), HPV 33 (11.11%), HPV 51 (11.11%), and HPV 56 (9.26%). HPV 18 was found in only 5.6% of cases. Together, HPV 16/18 were noted in approximately 20.4% of cases. Eighteen(16.67%) women were positive with multiple subtypes of HR-HPV. Co-infection most frequently involved HPV 16 or HPV 58. These findings have obvious implications for vaccine policy.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.6
• /
• pp.2991-2995
• /
• 2012

Background: India shows some of the highest rates of cervical cancer worldwide, and more than 70% of the population is living in rural villages. Prospective cohort studies to determine the risk factors for cervical cancer are very rare from low and medium resource countries. The aim of this study was to quantify the effect of risk factors related to cervical cancer in a rural setting in South India. Material and methods: Sociodemographic and reproductive potential risk factors for cervical cancer were studied using the data from a cohort of 30,958 women who constituted the unscreened control group in a randomised screening trial in Dindigul district, Tamilnadu, India. The analysis was accomplished with the Cox proportional hazard regression model. Results: Women of increasing age (HR=2.4; 95% CI: 1.6, 3.8 in 50-59 vs 30-39), having many pregnancies (HR=7.1; 1.0, 52 in 4+ vs 0) and no education (HR=0.6; 0.2, 0.7 in high vs none) were found to be at significantly increased risk of cervical cancer. Conclusion: This cohort study gives very strong evidence to say that education is the fundamental factor among the sociodemographic and reproductive determinants of cervical cancer in low resource settings. Public awareness through education and improvements in living standards can play an important role in reducing the high incidence of cervical cancer in India. These findings further stress the importance of formulating public health policies aimed at increasing awareness and implementation of cervical cancer screening programmes.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.17
• /
• pp.7085-7090
• /
• 2014

Objective: To make the clinical evaluation of a solid-state human papillomavirus (HPV) sampling medium in combination with an economical HPV testing method ($careHPV^{TM}$) for cervical cancer screening. Methods: 396 women aged 25-65 years were enrolled for cervical cancer screening, and four samples were collected. Two samples were collected by woman themselves, among which one was stored in DCM preservative solution (called "liquid sample") and the other was applied on the Whatman Indicating FTA $Elute^{(R)}$ card (FTA card). Another two samples were collected by physician and stored in DCM preservative solution and FTA card, respectively. All the samples were detected by $careHPV^{TM}$ test. All the women were administered a colposcopy examination, and biopsies were taken for pathological confirmation if necessary. Results: FTA card demonstrated a comparable sensitivity of detecting high grade Cervical Intraepithelial Neoplasia (CIN) with the liquid sample carrier for self and physician-sampling, but showed a higher specificity than that of liquid sample carrier for self-sampling (FTA vs Liquid: 79.0% vs 71.6%, p=0.02). Generally, the FTA card had a comparable accuracy with that of Liquid-based medium by different sampling operators, with an area under the curve of 0.807 for physician &FTA, 0.781 for physician &Liquid, 0.728 for self & FTA, and 0.733 for self &Liquid (p>0.05). Conclusions: FTA card is a promising sample carrier for cervical cancer screening. With appropriate education programmes and further optimization of the experimental workflow, FTA card based self-collection in combination with centralized $careHPV^{TM}$ testing can help expand the coverage of cervical cancer screening in low-resource areas.

• Journal of Korean Academy of Nursing
• /
• v.51 no.6
• /
• pp.769-781
• /
• 2021

Purpose: Health literacy is a significant determinant of health and health behaviors such as cancer screening. Despite its significance, there are limited instruments available to assess health literacy targeting Koreans. The purpose of this study was to test the psychometric properties of Korean translation of a validated health literacy instrument in cancer screening-Korean version of assessment of health literacy in breast and cervical cancer screening (K-AHL-C). Methods: A total of 555 women aged 20~65 participated in the online survey study. Of 52 items addressing five domains included in the original version, we focused on 36 items addressing three key domains closely associated with cancer screening: familiarity, health navigation, and comprehension. Results: During content validation, two items from the health navigation domain were removed, yielding 34 items. Using Rasch analysis and confirmatory factor analysis, we found the evidence of construct validity of K-AHL-C. The Korean version was also significantly correlated with measures of Functional Health Literacy scale, cancer prevention behaviors, and subjective health status, suggesting convergent validities respectively. Finally, K-AHL-C had acceptable reliability coefficients (α) ranging from 0.71 to 0.92 for each domain and the total scale. Conclusion: These psychometric properties support the K-AHL-C is a valid and reliable instrument for measuring Koreans' health literacy in cancer screening. Also it is expected to use the instrument to detect breast and cervical cancer early and improve the screening rate, and ultimately to contribute to the promotion of women's health and women's health nursing practice.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.11
• /
• pp.4837-4844
• /
• 2016

Objectives: To describe the survival experience of cervix cancer patients in a screened rural population in India. Methods: Included 558 cervical cancer patients diagnosed in 2000-2013 in a cohort of 100,258 women invited for screening during 2000-2003. The primary end point was death from cervical cancer. We used the Kaplan-Meier method to estimate cumulative observed survival and Cox proportional hazards regression to assess the effect of patient characteristics on survival after diagnosis. Results: Of the 558 cases included, 143 (26%) and 114 (20%) were diagnosed in stages IA and IB respectively; 252 (45.2%) were dead, and 306 (54.8%) were alive at the last follow-up. The overall 5-year observed survival was 60.5%. The 5-year survival of stage IA patients was 95.1% and 5.3% for stage IV patients. All surgically treated stage IA patients, 94.1% of stage IB patients receiving intracavitary radiotherapy, 62% of stage IIB, 49% of stage III and 25% of stage IV patients receiving radiotherapy survived for 5 years. Conclusion: Higher 5-year survival in our study than elsewhere in India is due to the high proportion of early stage cancers detected by screening combined with adequate treatment, resulting into a favourable prognosis.

• Journal of Digital Convergence
• /
• v.16 no.7
• /
• pp.337-343
• /
• 2018

The purpose of this study is to conduct a systematical survey about the recognition by Korean women's age groups on the cervical cancer screening, of which screening age has expanded to include 20 years of age as of January 2016. An online survey was conducted between July 26th to 31st 2017, and 332 answers in total were collected. 332 sets of survey were used to conduct frequency analysis, chi-square test. According to the result, only 116(34.9%) answered that they recognized the current system of cervical cancer screening. Additionally, most of the subjects, namely 298(89.8%), had the intention to take the cancer screening, but the number of subjects who actually received the test was low with 209(63.0%). Therefore, it is necessary to educate and publicize the importance of screening to increase the screening participation.

• Women's Health Nursing
• /
• v.16 no.4
• /
• pp.390-398
• /
• 2010

Purpose: The purpose of this study was to analyze periodic screening behaviors for breast cancer and factors affecting the screening behaviors among hospital nurses. Methods: A total of 461 nurses were recruited from 15 hospitals located in two southern areas of Korea. The Champion's Health Beliefs Model Scale-Korean version and a structured study questionnaire were used for data collection. Data were collected during July and August 2008. Results: Nurses who performed periodic mammography accounted for 15.6% of the total, while 22.8% performed periodic breast self-examination (BSE). Among married nurses, the rates of periodic mammography and BSE were significantly different by age, menopausal status, delivery experience, family history of breast cancer, and experiences of cervical cancer screening. Significant factors affecting periodic mammography were family history of breast cancer, experiences of cervical cancer screening, age above 40, and performance of periodic BSE. For health beliefs, levels of severity, confidentiality and barrier were significant factors for periodic BSE. Conclusion: Nurses, who are role models for health promoting behaviors, did not adequately performing periodic BSE and mammography. A health promotion program for breast cancer designed for hospital nurses is needed to improve performance rates for periodic screening behaviors for breast cancer.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.2
• /
• pp.635-639
• /
• 2015

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.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.5
• /
• pp.2267-2272
• /
• 2014

Background: Cancer is one of the most common causes of death in Turkey. Nurses are essential providers of preventive care for patients, especially breast, cervical and colorectal cancer screening as part of routine preventive practice. The aim of this study was to assess knowledge of these cancers among nurses in Karabuk State Hospital. Materials and Methods: This cross-sectional and descriptive study was performed from April 1 to July 30, 2013. The study sample consisted of 226 nurses working in Karabuk State Hospital. Results: Mean age of the nurses was $32.07{\pm}8.39$. 62.4% of nurses practiced breast self examination when they remembered it, while 39.8% of them did not take a Pap smear test since they did not think it was necessary. 64.2% of nurses would like to receive information about cancer and screening tests. Majority of them had given true answers to questions on breast, cervical and colorectal cancer. There were significant relationships between cancer knowledge scores and marital status, working experience, and level of education. Conclusions: Nurses possess adequate knowledge about breast cancer but they need more information on cancer risk estimation. Awareness may be raised in nurses by establishing continuing education programs regarding the risk factors, symptoms, protection methods, early diagnosis, and scanning of breast, cervix and colon cancers.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.12
• /
• pp.7607-7611
• /
• 2013

Background: Cervical cancer continues to be a major problem in Bangladesh with approximately 18,000 new cases annually of which over 10,000 women die from it. Visual inspection of the cervix after 3-5% acetic acid (VIA) application is a simple and easy to learn method for cervical cancer screening, although cytology-based screening is more often applied in developed countries where it has successfully reduced the prevalence of cervical cancer. Objective: To compare the efficacy of VIA and cytology-based primary methods for cervical cancer screening in Bangladesh. Materials and Methods: This hospital based comparative study was conducted at the VIA centre and Colposcopy Clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU) from October 2008 to October 2010. Results: Among 650 women, 74 (11.4%) were VIA+ve and 8 (1.2%) had abnormalities in their Pap smear reports. During colposcopy, 38 (7.7%) women had different grades of CIN and 4 (0.6%) had cervical cancer. The gold standard histology findings proved 20 women had CIN I, 14 had CIN II/II and 4 had cervical cancer. Among the 38 histology diagnosed abnormalities, VIA test could identify 30 abnormalities including two cervical cancers. However, Pap smear could detect only 8 cases of histological abnormalities (2 low grade and 6 had high grade lesion) and it missed all the cervical cancer cases. The sensitivity and specificity of VIA were 88.9% and 52.1%. The positive predictive value (PPV) and negative predictive value (NPV) were 41.0%, and 92.6% respectively. Moreover, the sensitivity, specificity, PPV and NPV of Pap smear were 33.3%, 95.8%, 75.0% and 79.3%, respectively. Conclusions: VIA test should be used as the primary screening tool even with its low sensitivity and specificity in low resource countries like Bangladesh. False positive results may be greater, but overtreatment can be minimized by colposcopy evaluation of the VIA positive women.