• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.5053-5058
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• 2015

Background: Cervical cancer is one of the commonest cancers among women all over the world. The association of cervical cancer with human papilloma virus (HPV) is well established. Knowledge about the causal relationship between HPV and cervical cancer is important to make appropriate, evidence-based health care choices. In this context we conducted a community based study among women about the knowledge, attitude and practice about HPV infections and their health effects. Materials and Methods: A cross sectional interview based house to house survey was conducted with a validated data collection tool covering sociodemographic factors, knowledge, attitude and practice about HPV and its health effects, among 1020 women from a rural village, Perdoor, in Udupi district, Karnataka, India in 2013-14. Results: The mean age of participants was 38.9 years (SD=12.6). Study participants showed a high literacy rate (85.7%). Only 2.4% of sexually exposed women had undergone Pap smear testing. Partners of 4.4%women had undergone circumcision and they belonged to the Muslim community. Male condom usage was reported by 26 women (2.6%). However, none of the participants had heard of HPV and its health effects. Conclusions: This community based study found complete ignorance about HPV among rural South Indian women in spite of a high literacy level.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5869-5873
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• 2015

Background: Breast and cervical cancers are among the most frequent and most fatal cancers in women. Life span of patients may be increased and quality of life improved through early diagnosis and treatment. This investigation was performed in order to determine knowledge and practices of female health personnel working at a university hospital regarding breast and cervical cancers. Materials and Methods: This descriptive investigation was performed in Erciyes University Hospitals in 2014. A total of 524 female health personnel were included in the study. Data were collected through a questionnaire of 36 questions prepared by the researchers. The Chi square test and logistic regression were used for statistical analyses. Results: The mean age of the study group was $32.8{\pm}6.9$ years, 18.3% being doctors and 81.7% nurses. Of the study group, 60.5% stated that they performed self breast-examination, 4.4% underwent HPV testing, 26.3% thought about taking an HPV test, 34.7% of those who are 40 years and over had mammography regularly and 19.5% of those who were married had a Pap smear conducted regularly. Most important causes of not performing the methods for early diagnosis of breast and cervical cancers are "forget and neglect". Conclusions: It was concluded that female doctors and nurses do not pay sufficient attention to screening programs for breast and cervical cancers. The importance of early diagnosis and treatment should be emphasized during the undergraduate education and in-service training programs. Health condition of personnel and their utilization of preventive health care should be followed by occupational physicians.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.5753-5759
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• 2013

Curcumin and curcumin containing polyherbal preparations have demonstrated anti-microbial and antiviral properties in pre-clinical studies. Till date no therapeutic intervention has been proved to be effective and safe in clearing established cervical human papillomavirus (HPV) infection. The present study evaluated the efficacy of Basant polyherbal vaginal cream (containing extracts of curcumin, reetha, amla and aloe vera) and of curcumin vaginal capsules to eliminate HPV infection from cervix. Women were screened by Pap smear and HPV DNA test by PCR. HPV positive women without high grade cervical neoplasias (N=287) were randomized to four intervention arms to be treated with vaginal Basant cream, vaginal placebo cream, curcumin vaginal capsules and placebo vaginal capsules respectively. All subjects were instructed to use one application of the assigned formulation daily for 30 consecutive days except during menstruation and recalled within seven days of the last application for repeat HPV test, cytology and colposcopy. HPV clearance rate in Basant arm (87.7%) was significantly higher than the combined placebo arms (73.3%). Curcumin caused higher rate of clearance (81.3%) than placebo though the difference was not statistically significant. Vaginal irritation and itching, mostly mild to moderate, was significantly higher after Basant application. No serious adverse events were noted.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.8
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• pp.4877-4881
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• 2013

Background: The aim of the study was to assess the knowledge about HPV and HPV vaccines and attitudes towards vaccination among the females aged 9-24 years in Turkey. Materials and Methods: Self-administered questionnaires were filled out individually by the participants covering demographic information, knowledge about HPV infection and HPV vaccines, attitudes towards vaccination, and the perceptions of them about their parental attitudes about vaccination. Results: Of the 408 subjects participating in the study, 41.6% (n=170) had heard of HPV. Thirty-three percent (n=136) knew the causal relationship between HPV and cervical cancer. Only 27.9% (n=114) of them knew that HPV vaccines can prevent cervical cancer. Eleven percent (n=46) of the females participating in the study were willing to be vaccinated, and only 1.4% (n=6) were already vaccinated at the current time. The main reason listed among the participants who were not willing to be vaccinated was lack of information. Conclusions: Awareness and knowledge of Turkish female adolescents and young women about HPV, relation with cervical cancer and prevention of cervical cancer by Pap smear and vaccine are still limited. If the most important barrier to vaccination, which is reported as lack of information, were to be addressed, it would greatly impact the decision-making and vaccine acceptance.

• Women's Health Nursing
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• v.9 no.4
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• pp.351-358
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• 2003

Purpose: The aim of this study was to examine the effect of Desexualization Care guided by dramaturgical interaction on women's embarrassment during cervical cancer screening. Method: This study was carried out in a nonequivalent control group non-synchronized post-test only design. 62 women who had cervical cancer screening were' conveniently recruited from a university hospital health promotion center. Embarrassment was measured under four distinctive sub-dimensions by the method of self-reported questionnaire and blood pressure and pulse rates monitoring. The data of control group had a conventional pap smear were collected in advance and then those of experimental group were gathered after completing data collection in the control group. Women in experimental group were provided with a newly developed cervical cancer screening programme in which interdisciplinary team conducted dramaturgical interaction. Result: There was no significant difference in the scores of VAS between the two groups. The score of physiological response of Embarrassment Measurement Scale was significantly lower in experimental group than in the control group (p <.05), while no significant difference was found in cognitive-emotional, non-verbal and verbal behavioral responses between the two groups. There was also no significant difference in blood pressure and pulse rates between the two groups during cervical s creening. Conclus ion: Desexualization Care guided by dramaturgical interaction during cervical screening was found to have positive effect on physiological response of women's embarrassment. Further research for identifying other main variables which might have influenced on women's embarrassment is needed.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.4
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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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• v.14 no.5
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• pp.3269-3274
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• 2013

Background: The aim was to determine the lifestyle behaviors and the practices for early diagnosis of cancer of cancer patients. Materials and Methods: A descriptive cross-sectional design was used for this study. The sample consisted of 222 patients with a diagnosis of cancer (non-random sample method). Ethical permission was obtained of the Non-interventional Research Ethics Committee of our Institution. Values of p<0.05 were accepted as statistically significant. Results: It was observed that 54.4% of the patients had never performed breast self-examination, 60.8% had never had a mammography, and 71.2% had never had a Pap smear. Sixty-six point two percent of patients had never had screening for colon cancer within the past ten years. GIS cancers were higher in smokers and ex-smokers (p=0.005), in drinkers and in ex-drinkers (p=0.000). The breast cancer rate was higher in obese people (p=0.019). Conclusions: The results of this study provide information on the healthy lifestyle behavior of cancer patients before their diagnosis, and their use of early diagnosis practices. The important aspect of this study is to extend cancer patients' period of life after the diagnosis and treatment process, to make them conscious of risky lifestyle and nutritional behavior so that they can maintain a high quality of life, and to start initiatives in this direction that would ensure changes in behavior.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.3029-3035
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• 2013

Background: Most developing countries have been unable to implement well-organized health care systems, especially comprehensive Pap smear screening-based programs. One of the reasons for this is regional differences in medical services, and a low-cost portable cervical screening system is necessary. To improve regional discrepancies in cervical screening systems, we investigated the usefulness and acceptability of cervical selfsampling by liquid-based cytology (LBC) for 290 volunteers in the Lao PDR. Materials and Methods: Following health education with comprehensive documents, cervical self-sampling kits by LBC were distributed in three provincial, district, and village areas to a total of 290 volunteers, who were asked to take cytology samples by themselves. Subsequently, the acceptability of self-sampling was evaluated using a questionnaire. Results: The documents were well understood in all three regions. Regarding the acceptability of self-sampling, the selections for subsequent screening were 62% self-sampling, 36% gynecologist-sampling, 1% either method, and 1% other methods. The acceptability rates were higher in the district and the village than in the province. For the relationship between acceptability and pregnancy, the self-sampling selection rate was higher in the pregnancy-experienced group (75%) than in the pregnancy-inexperienced group (60%). For the relationship between selection of self-sampling and experience of screening, the self-sampling selection rate was higher in the screening-inexperienced group (62%) than in the screening-experienced group (52%). Conclusions: Our data show that this new way forward, involving a combination of self-sampling and LBC, is highly acceptable regardless of age, educational background, and residence in rural areas in a developing country.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3489-3494
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• 2016

Background: A major problem with cervical cancer screening in countries which have no organized national screening program for cervical cancer is sub-optimal participation. Implementation of self-sampling method may increase the coverage. Objective: We determined the agreement of cytological diagnoses made on samples collected by women themselves (self-sampling) versus samples collected by physicians (Physician sampling). Materials and Methods: We invited women volunteers to undergo two procedures; cervical self-sampling using the Evalyn brush and physician sampling using a Cervex brush. The women were shown a video presentation on how to take their own cervical samples before the procedure. The samples taken by physicians were taken as per routine testing (Gold Standard). All samples were subjected to Thin Prep monolayer smears. The diagnoses made were according to the Bethesda classification. The results from these two sampling methods were analysed and compared. Results: A total of 367 women were recruited into the study, ranging from 22 to 65 years age. There was a significant good agreement of the cytological diagnoses made on the samples from the two sampling methods with the Kappa value of 0.568 (p=0.040). Using the cytological smears taken by physicians as the gold standard, the sensitivity of self-sampling was 71.9% (95% CI:70.9-72.8), the specificity was 86.6% (95% CI:85.7-87.5), the positive predictive value was 74.2% (95% CI:73.3-75.1) and the negative predictive value was 85.1% (95% CI: 84.2-86.0). Self-sampling smears (22.9%) allowed detection of micro-organisms better than physicians samples (18.5%). Conclusions: This study shows that samples taken by women themselves (self-sampling) and physicians have good diagnostic agreement. Self-sampling could be the method of choice in countries in which the coverage of women attending clinics for screening for cervical cancer is poor.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.24
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• pp.10809-10812
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• 2015

Background: Human papillomavirus (HPV) DNA testing is an effective method to screen for precancerous changes in the cervix. Samples from self-collection rather than Pap smear can potentially be used to test for HPV as they are more acceptable and preferred for use in certain settings. The objective of this study was to compare HPV DNA testing from self-collected vaginal swabs and physician-collected cervical swabs. Materials and Methods: A total of 101 self-collected vaginal and physician-collected cervical swabs of known cytology from Thai women were tested by electrochemical DNA chip assay. The specimens were divided into 4 groups: 29 with normal cytology, 14 with atypical squamous cells of undetermined significance (ASCUS), 48 with low-grade squamous intraepithelial lesion (LSIL), and 10 with high-grade squamous intraepithelial lesion (HSIL). Results: Positive detection rates of HPV from self-collected swabs were similar to those from physician-collected swabs. Among specimens with abnormal cytology, HPV was found in 50% of self-collected swabs and 47.2% of physician-collected swabs. In specimens with normal cytology, 17.2% of self-collected swabs and 24.1% of physician-collected swabs were positive for HPV. Concordance was relatively high between results from self-collected and physician-collected samples. The most common HPV genotype detected was HPV 51. Conclusions: HPV DNA testing using self-collected swabs is a feasible alternative to encourage and increase screening for cervical cancer in a population who might otherwise avoid this important preventive examination due to embarrassment, discomfort, and anxiety.