• Asian Pacific Journal of Cancer Prevention
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• 제16권4호
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• pp.1565-1570
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• 2015

Background: In Aotearoa/New Zealand cervical screening programmes have reduced cervical cancer; however, half of cervical cancer cases among Pacific women are found among clients who had not attended cervical screening. Hence, we set out to determine health provider perspectives on barriers that prevent their services reaching Pacific women within Aotearoa/New Zealand. Materials and Methods: Twenty semi-structured interviews were conducted with health care providers, Pap smear takers and community workers in the Wellington region. Participants were asked their views on factors that enabled and/or constrained the participation of Pacific women in their cervical screening services. Results: Six interrelated themes influencing participation in cervical screening among Pacific women in the Wellington region were apparent: the funding and practice of service delivery; family always coming first; the cost of screening services; type of employment; the appropriateness of information; and attitudes to self and screening. Conclusions: Determining specific ethnic group actual health needs and meeting them contributes to overall improvement in New Zealand's health status. The results identified the need for improvements to the delivery of screening services including adapting cervical screening services to the requirements of Pacific women through more outreach services at alternate clinic hours; culturally appropriate practitioners; the ability to take up opportunities for health checks and foster long-term relationships; as well as appropriate monitoring and evaluation of approaches. Funding and reporting relationships also need to be compatible with the goal of improving outcomes for Pacific women. Further research into client voices for their particular needs to compliment the service provider perspective as well as minority groups is called for.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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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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• 제17권1호
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• pp.239-247
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• 2016

Background: The overall cervical cancer incidence rate is low in Iran; however, because of a higher risk of death for cervical cancer, a disease that kills women in middle age, a cervical cancer control program is needed. The aim of this study was to provide consensus recommendation for cervical cancer prevention in Iran and other Muslim societies with low incidences of cervical cancer. Materials and Methods: Through a practical guideline development cycle, we developed six questions that were relevant to produce the recommendation. We reviewed 190 full text records of cervical cancer in Iran (1971 to 2013) of which 13 articles were related to the data needed to answer the recommendation questions. We also reviewed World Health Organization, IARC, GLOBOCAN report, Iran Ministry of Health cancer registry report and 8 available foreign countries guidelines. Lastly, we also evaluated the Pap smear results of 825 women who participated in the Iranian HPV survey, of whom 328 were followed-up after a 5-year interval. Results: The obtained data highlighted the burden of HPV and cervical cancer situation in Iran. Experts emphasized the necessity of a cervical cancer screening program for Iranian women, and recommended an organized screening program with a cytological evaluation (Pap smear) that would start at the age of 30 years, repeated every 5 years, and end at the age of 69 years. Meanwhile, there is no need for screening among women with a hysterectomy, and screening should be postponed to post-partum among pregnant women. Conclusions: An organized cervical cancer screening is a necessity for Iran as more than 500-900 women in middle age diagnosed with an invasive cervical cancer every year cannot be ignored. This recommendation should be taken into account by the National Health System of Iran and Muslim countries with shared culture and behavior patterns. CUBA HPV test could be consideration in countries Muslim country with appropriate budget, resources and facility.

• 대한간호학회지
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• 제32권6호
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• pp.832-843
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• 2002

The aim of this study was to describe women's embarrassability and embarrassment during cervical screening. Method: The subjects of this study were 82 women who had a cervical screening at a National University Hospital. The data were collected through personal interview using a questionnaire from February 4, 2001 to February 22, 2002. The questionnaire consisted of embarrassability scale, embarrassment Scale, and demographic data. Result: 1) The mean scores of situational embarrassability was 82.6 and that of dispositional embarrassability was 106.7. 2) The mean scores of subject's embarrassment was 54.3 and 48.7 in 10 stages of cervical screening. The following three situations of 10 stages of cervical screening were highly ranked as to be embarrassing: 'during the examination', 'waiting for a doctor', and 'climbing up the exam chair and positioning her thigh for a exam'. 3) There was a positive correlation between dispositional embarrassability and embarrassment of 10 stages of cervical screening. 4) There were significant differences in situational embarrassability of subjects according to education and the locations of service. There were significant differences in dispositional embarrassability of subjects with regard to frequencies of pregnancy. 5) There were significant differences in embarrassment of subjects during cervical screening with respect to age, age at the time of first smear and gender of the examiner. Conclusion: The finding of this study indicates that women experienced a high level of embarrassment during cervical screening, assuming a need for nursing intervention reduces women's embarrassment. Also, there is a positive correlation between embarrassability and embarrassment of cervical screening, suggesting a need for further research identifying the effect of nursing intervention on embarrassment according to embarrassability.

• 여성건강간호학회지
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• 제17권5호
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• pp.463-473
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• 2011

Purpose: Cervical cancer can be prevented by regular cervical screening. Embarrassment has been reported as one important barrier to cervical screening uptake. The absence of appropriate instrumentation, however, has limited our understanding of the links between embarrassment and health care outcomes. The purpose of this study was to evaluate psychometric attributes of the uterine cervical cancer screening embarrassment questionnaire. Methods: A convenience sample for field study was recruited from four gynecological clinics in Gyeongju, Korea. Within a cross-sectional descriptive design, 339 women who had cervical screening completed self-administered measures of embarrassment including a visual analogue, general medical embarrassment, dispositional embarrassment, and Pap smear related negative emotion. Results: Rasch analysis of items demonstrated the evidence of one-dimensional construct and good 7-point rating scales functioning. Factor analysis revealed that uterine cervical cancer screening embarrassment was comprised of two domains-bodily manifestations and perceiving an undesirable social face. Construct validity was demonstrated by a high subscale-to-subscale correlation. Convergent and discriminant validity was evidenced by significant correlations with a 100 mm VAS scale, general medical embarrassment, and Pap smear related negative emotion. Known-group validity was established by comparing women with high versus low trait embarrassment. Both two sub-scales and overall scale demonstrated good internal reliability. Conclusion: The Uterine uterine cervical cancer screening questionnaire is a reliable and valid instrument suited to assessing the manifestations of embarrassment during screening. The use of instrument can be extended to understand the client's embarrassment undergoing health examinations which require the exposure of their private parts.

• Asian Pacific Journal of Cancer Prevention
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• 제15권12호
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• pp.4903-4907
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• 2014

Background: This study aimed to identify factors associated with women's decisions to attend cervical cancer screening and to explore those linked with intention to attend in the coming year and to continue regular screening. Materials and Methods: A community based case-control study was conducted among woman 30-60 years of age in catchment area of Chatapadung Contracting Medical Unit (CCMU), networking of Khon Kaen Center Hospital, Thailand. Self-administered questionnaires were used to collect data, and in-depth interviews were then performed to explore in greater detail. Results: There were 195 participants. Only one third (32.3 %) had been screened for cervical cancer within the past 5 years. Some 67.7% reported that they had not been screened because they had no abnormal symptoms, single marital status, and no children. Only 10.6% of those never had screening intent to be screened within the next 12 months. High family income (adjusted OR=2.16, 95%CI=1.13-4.14), good attitude towards a Pap test (OR=1.87, 95%CI=1.09-4.23), and having received a recommendation from health care providers were important factors associated with decisions to attend cervical cancer screening (OR=1.73, 95%CI=1.01-4.63). From in-depth interviews, there were five reasons of their decisions to attend cervical cancer screening including yearly check-up, postpartum check-up, having abnormal symptom, encouragement by health care providers, and request from workplace. Conclusions: High family income, good attitude towards a Pap test, and receiving proper recommendation by health care providers, were important factors associated with decision to have cervical cancer screening among women 30-60 years old. Trying to enhance these factors and reduce barriers regarding screening, may increase the coverage rate for cervical cancer screening in Thailand.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7693-7699
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• 2013

Aims: A main reason for increasing incidence of cervical cancer worldwide is the lack of regular cervical cancer screening. Coverage and uptake remain major challenges and it is crucial to determine the perceived susceptibility to cervical cancer, as well as the benefits of, and barriers to, cervical cancer screening among women. Materials and Methods: A cross-sectional survey was conducted among 369 women attending an outpatient centre in Malaysia and data were collected by administering a self-report questionnaire. Results: The majority of the participants (265, 71.8%) showed good level of perception of their susceptibility to cervical cancer. Almost all responded positively to four statements about the perceived benefits of cervical cancer screening (agree, 23.1% or strongly agree, 52.5%), whereas negative responses were received from most of the participants (agree, 29.9%or strongly agree, 14.6 %) about the eleven statements on perceived barriers. Significant associations were observed between age and perceived susceptibility($x^2$=9.030, p=0.029); between employment status (p<0.001) as well as ethnicity and perceived benefits (p<0.05 [P=0.003]); and between education and perceived barriers to cervical cancer screening (p<0.001). Conclusions: Perceived susceptibility, including knowledge levels and personal risk assessment, should be emphasized through education and awareness campaigns to improve uptake of cervical cancer screening in Malaysia.

• 융합정보논문지
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• 제10권5호
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• pp.42-50
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• 2020

본 연구의 목적은 간호대학생들의 자궁경부암 검진 여부를 파악하고, 자궁경부암 지식, 예방행위의도가 자궁경부암 검진에 미치는 영향을 확인하여. 이들의 자궁경부암 검진율 향상을 위한 효과적인 전략수립에 기초자료를 제공하기 위함이다. 연구대상은 G광역시와 J도에 소재한 대학교 3곳의 간호대학생 192명을 대상으로 하였다. 자료는 SPSS/WIN 23.0 프로그램을 이용하여 분석하였으며, 빈도분석, t-test, χ²-test, 로지스틱회귀분석을 시행하였다. 간호대학생의 자궁경부암 검진에 영향을 미치는 요인은 연령, 성경험 유무, 예방행위의도로 확인되었다. 자궁경부암 검진률을 향상시키기 위해, 건강전문가가 성경험이 시작되기 전인 학령기부터 대학생시기까지 학교와 의료기관에서 시행하는 단계적이며, 지속적인 자궁경부암 예방행위의도 증진 교육 및 프로그램 개발이 필요하다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.3887-3895
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• 2016

Background: In order to increase breast and cervical cancer screening uptake in Singapore, women's perceived barriers to screening need to be identified and overcome. Using data from both focus groups and surveys, we aimed to assess perceived barriers and motivations for breast and cervical cancer screening. Materials and Methods: We conducted 8 focus groups with 64 women, using thematic analysis to identify overarching themes related to women's attitudes towards screening. Based on recurring themes from focus groups, several hypotheses regarding potential barriers and motivations to screen were generated and tested through a national survey of 801 women aged 25-64. Results: Focus group participants had misconceptions related to screening, believing that the procedures were painful. Cost was an issue, as well as efficacy and fatalism. Conclusions: By identifying barriers to and motivators for screening through a mixed-method design that has both nuance and external validity, this study offers valuable suggestions to policymakers to improve breast and cervical cancer screening uptake in Singapore.

• Asian Pacific Journal of Cancer Prevention
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• 제14권5호
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• pp.2979-2982
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• 2013

Cervical cancer is a commonly-encountered malignant tumor in women. Cervical screening is particularly important due to early symptoms being deficient in specificity. The main purpose of the study is to assess the application value of cervical thinprep cytologic test (TCT) and human papillomavirus (HPV) detection in screening for cervical cancer and precancerous lesions. In the study, cervical TCT and HPV detection were simultaneously performed on 12,500 patients selected in a gynecological clinic. Three hundred patients with positive results demonstrated by cervical TCT and/or HPV detection underwent cervical tissue biopsy under colposcopy, and pathological results were considered as the gold standard. The results revealed that 200 out of 12,500 patients were abnormal by TCT, in which 30 cases pertained to equivocal atypical squamous cells (ASCUS), 80 cases to low squamous intraepithelial lesion (LSIL), 70 cases to high squamous intraepithelial lesion (HSIL) and 20 cases to squamous cell carcinoma (SCC). With increasing pathological grade of cervical biopsy, however, TCT positive rates did not rise. Two hundred and eighty out of 12,500 patients were detected as positive for HPV infection, in which 50 cases were chronic cervicitis and squamous metaplasia, 70 cases cervical intraepithelial neoplasia (CIN) I, 60 cases CIN II, 70 cases CIN III and 30 cases invasive cervical carcinoma. Two hundred and thirty patients with high-risk HPV infection were detected. With increase in pathological grade, the positive rate of high-risk HPV also rose. The detection rates of HPV detection to CIN III and invasive cervical carcinoma as well as the total detection rate of lesions were significantly higher than that of TCT. Hence, HPV detection is a better method for screening of cervical cancer at present.