scholarly journals Smartphone-Enhanced Training, QA, Monitoring, and Evaluation of a Platform for Secondary Prevention of Cervical Cancer: Opportunities and Challenges to Implementation in Tanzania

2020 ◽  
pp. 1114-1123
Author(s):  
Karen Yeates ◽  
Erica Erwin ◽  
Zac Mtema ◽  
Frank Magoti ◽  
Simoni Nkumbugwa ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Visual Inspection ◽  
Screening Program ◽  
Cervical Screening ◽  
Monitoring And Evaluation ◽  
Visual Assessment ◽  
Cervical Cancer Prevention ◽  
Supportive Supervision ◽  
Health Providers

PURPOSE Until human papillomavirus (HPV)–based cervical screening is more affordable and widely available, visual inspection with acetic acid (VIA) is recommended by the WHO for screening in lower-resource settings. Visual inspection will still be required to assess the cervix for women whose screening is positive for high-risk HPV. However, the quality of VIA can vary widely, and it is difficult to maintain a well-trained cadre of providers. We developed a smartphone-enhanced VIA platform (SEVIA) for real-time secure sharing of cervical images for remote supportive supervision, data monitoring, and evaluation. METHODS We assessed programmatic outcomes so that findings could be translated into routine care in the Tanzania National Cervical Cancer Prevention Program. We compared VIA positivity rates (for HIV-positive and HIV-negative women) before and after implementation. We collected demographic, diagnostic, treatment, and loss-to-follow-up data. RESULTS From July 2016 to June 2017, 10,545 women were screened using SEVIA at 24 health facilities across 5 regions of Tanzania. In the first 6 months of implementation, screening quality increased significantly from the baseline rate in the prior year, with a well-trained cadre of more than 50 health providers who “graduated” from the supportive-supervision training model. However, losses to follow-up for women referred for further evaluation or to a higher level of care were considerable. CONCLUSION The SEVIA platform is a feasible, quality improvement, mobile health intervention that can be integrated into a national cervical screening program. Our model demonstrates potential for scalability. As HPV screening becomes more affordable, the platform can be used for visual assessment of the cervix to determine amenability for same-day ablative therapy and/or as a secondary triage step, if needed.

scholarly journals Knowledge and perceptions regarding triage among human papillomavirus–tested women: A qualitative study of perspectives of low-income women in Argentina

2020 ◽  
Vol 16 ◽  
pp. 174550652097601
Author(s):  
Sánchez Antelo Victoria ◽  
Kohler Racquel E ◽  
Szwarc Lucila ◽  
Paolino Melisa ◽  
Kasisomayajula Viswanath ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cancer Prevention ◽  
Low Income ◽  
Economic Cost ◽  
Cervical Cancer Prevention ◽  
Attitudes And Beliefs ◽  
Health Providers ◽  
Pap Screening

Objectives: Among cancer prevention studies, little is known about knowledge, attitudes, and beliefs toward triage adherence in the context of the human papillomavirus self-collection test. This formative research aims to identify knowledge, attitudes, and beliefs related to human papillomavirus and cervical cancer prevention specifically about adherence to Pap triage among women residing in a low-income province in Argentina. Methods: We conducted six focus groups, stratified by residence and age. All participants were aged 30 or older and had performed human papillomavirus self-collection. Data collection and thematic analysis were carried out using constructs from the Health Belief Model. Results: Misinformation regarding human papillomavirus and cervical cancer was common and was a source of distress. Women could not distinguish Pap screening from triage; human papillomavirus risk perception was limited but cervical cancer was perceived as a threatening disease. Women were willing to follow-up after receiving an abnormal screening result. Negative views about clinician-collected screening/triage were common, defined as painful and shameful, and comes with an economic cost (transport/time). Lack of help from family/friends was an obstacle to adhering to triage. Health issues in the family’s records and a physician’s recommendation were a cue to adhere to triage. Conclusion: Lack of knowledge or misinformation of the causes of cervical cancer, human papillomavirus, and the multi-step screening and triage process are barriers to follow-up adherence. Interventions to improve communication between women and health providers about screening results and follow-up are needed. Also, health services should be organized to respond to women’s needs and reduce access barriers to follow-up.

scholarly journals Cervical Cancer Screening Program by Visual Inspection: Acceptability and Feasibility in Health Insurance Companies

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Apollinaire G. Horo ◽  
Judith Didi-Kouko Coulibaly ◽  
Abdoul Koffi ◽  
Boris Tchounga ◽  
Konan Seni ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Health Insurance ◽  
Cancer Screening ◽  
Diagnostic Accuracy ◽  
Cervical Cancer Screening ◽  
Visual Inspection ◽  
Screening Program ◽  
Cervical Screening ◽  
Screening Method ◽  
Insurance Company

Objective. To assess willingness to participate and diagnostic accuracy of visual inspection for early detection of cervical neoplasia among women in a health insurance company.Patients and Method. Cervical cancer screening was systematically proposed to 800 women after consecutive information and awareness sessions. The screening method was visual inspection with acetic acid (VIA) or Lugol’s iodine (VILI).Results. Among the 800 identified women, 640 (82%) have accepted the screening, their mean age was 39 years, and 12.0% of them were involved in a polygamist couple. 28.2% of women had prior cervical screening. VIA has been detected positive in 5.9% of women versus 8.6% for VILI. The sensitivity was 72.9% and specificity was 95.2% for VIA versus 71.2% and 97.3% for VILI respectively. The histological examination highlighted a nonspecific chronic cervicitis in 4.6%, CIN1 lesions in 5.91%, and CIN2/3 in 1.2% of the cases.Conclusion. Cervical cancer screening by visual inspection showed appropriate diagnostic accuracy when used to detect early cervical lesions. It is a simple and easy to perform method that could be introduced progressively in the health insurance policy while waiting for a national screening program.

scholarly journals “Human Papilloma Virus Vaccination for cervical cancer prevention. Is it safe and effective?”

2018 ◽  
Vol 17 (3) ◽  
pp. 329-336
Author(s):  
Damitha Asanga Gunawardane
Keyword(s):  
Cervical Cancer ◽  
High Risk ◽  
Reproductive Tract ◽  
Screening Program ◽  
Cervical Screening ◽  
Hpv Vaccination ◽  
Medical Science ◽  
Hpv Infection ◽  
Cervical Cancer Prevention ◽  
Hpv Vaccines

Human papillomavirus (HPV) causes cervical cancer, which is the fourth most common cancer in women. Most of the cervical cancers are linked to genital infection with HPV and it is the most common viral infection of the reproductive tract. At present, there are three types of HPV vaccines available. Even though HPV vaccination is a primary prevention tool, that does not eliminate the need for routine cervical screening, since the vaccines do not protect against all high-risk HPV types. Ninety percent of HPV infections have no clinical consequences at all whether they are high-risk or low-risk subtypes of HPV. All three types of HPV vaccines have very high vaccine efficacy for prevention of HPV infection among females aged 14 to 26 years. Proper assessment of the safety of HPV vaccine is a problem even after proper systematic review since the most of the clinical trials on the safety of the vaccines were used Hepatitis A vaccine or high immunogenicity enhancing aluminium adjuvant as their placebo. HPV vaccination would be very cost effective for the countries when there is no cervical screening program or if the programme coverage is very poor.Bangladesh Journal of Medical Science Vol.17(3) 2018 p.329-336

scholarly journals Bolivian Health Providers' Attitudes Toward Alternative Technologies for Cervical Cancer Prevention: A Focus on Visual Inspection with Acetic Acid and Cryotherapy

2012 ◽  
Vol 21 (8) ◽  
pp. 801-808 ◽  
Author(s):  
Analía Romina Stormo ◽  
Victor Conde Altamirano ◽  
Macarena Pérez-Castells ◽  
David Espey ◽  
Haydee Padilla ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Cancer Prevention ◽  
Visual Inspection ◽  
Cervical Cancer Prevention ◽  
Health Providers ◽  
Alternative Technologies

scholarly journals Predictors of default from follow-up care in a cervical cancer screening program using direct visual inspection in south-western Nigeria

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Oliver Chukwujekwu Ezechi ◽  
Karen Odberg Petterson ◽  
Titilola A Gabajabiamila ◽  
Ifeoma Eugenia Idigbe ◽  
Olutunmike Kuyoro ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Visual Inspection ◽  
Screening Program ◽  
Cancer Screening Program ◽  
Follow Up Care ◽  
Cervical Cancer Screening Program

Human Papillomavirus Selected Properties and Related Cervical Cancer Prevention Issues

2020 ◽  
Vol 26 (18) ◽  
pp. 2073-2086
Author(s):  
Saule Balmagambetova ◽  
Andrea Tinelli ◽  
Ospan A. Mynbaev ◽  
Arip Koyshybaev ◽  
Olzhas Urazayev ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cancer Prevention ◽  
Screening Program ◽  
Hpv Infection ◽  
Cervical Cancer Prevention ◽  
Point Of View ◽  
Prevention Strategies ◽  
Middle Income ◽  
Screening Programs

High-risk human papillomavirus strains are widely known to be the causative agents responsible for cervical cancer development. Aggregated damage caused by papillomaviruses solely is estimated in at least 5% of all malignancies of the human body and 16% in cancers that affect the female genital area. Enhanced understanding of the complex issue on how the high extent of carcinogenicity is eventually formed due to the infection by the Papoviridae family would contribute to enhancing current prevention strategies not only towards cervical cancer, but also other HPV associated cancers. This review article is aimed at presenting the key points in two directions: the current cervical cancer prevention and related aspects of HPV behavior. Virtually all applied technologies related to HPV diagnostics and screening programs, such as HPV tests, colposcopy-based tests (VIA/VILI), conventional and liquid-based cytology, currently available are presented. Issues of availability, advantages, and drawbacks of the screening programs, as well as vaccination strategies, are also reviewed in the article based on the analyzed sources. The current point of view regarding HPV is discussed with emphasis on the most problematic aspect of the HPV family concerning the observed increasing number of highly carcinogenic types. Present trends in HPV infection diagnostics throughout the human fluids and tissues are also reported, including the latest novelties in this field, such as HPV assay/self-sample device combinations. Besides, a brief outline of the related prevention issues in Kazakhstan, the leading country of Central Asia, is presented. Kazakhstan, as one of the post-soviet middle-income countries, may serve as an example of the current situation in those terrains, concerning the implementation of globally accepted cervical cancer prevention strategies. Along with positive achievements, such as the development of a nationwide screening program, a range of drawbacks is also analyzed and discussed.

scholarly journals Working towards a comprehensive understanding of HPV and cervical cancer among Indigenous women: a qualitative systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e050113
Author(s):  
Sneha Sethi ◽  
Brianna Poirier ◽  
Karen Canfell ◽  
Megan Smith ◽  
Gail Garvey ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Prevention ◽  
Ecological Model ◽  
Cervical Screening ◽  
Hpv Infection ◽  
Cervical Cancer Prevention ◽  
Social Ecological Model ◽  
Indigenous Women ◽  
Indigenous Populations ◽  
Social Ecological

RationaleIndigenous peoples carry a disproportionate burden of infectious diseases and cancers and are over-represented among the socially disadvantaged of most countries. Human papillomavirus (HPV) is a risk factor and causative agent of cervical, oropharyngeal and other cancers. Recent literature shows evidence of Indigenous populations being at increased risk of HPV infections and its associated cancers.ObjectiveThis is a qualitative systematic review. The objective of this study was to explore the experiences and barriers Indigenous women face in relation to HPV awareness, knowledge and cervical screening, in order to better understand factors that may mitigate against or facilitate prevention efforts for HPV infection and associated cancers.MethodsTwo investigators independently searched MEDLINE, PubMed, SCOPUS and Web of Science databases (for articles published from inception until 30 June 2020) using a prespecified search strategy to identify qualitative studies on narratives of Indigenous women regarding HPV infection awareness, knowledge and cervical screening, across all geographic and income-level settings. Using a ‘meta-study’ approach, a social ecological model of cervical screening, infection and associated cancer prevention among Indigenous populations was formulated.ResultsFive core themes were identified and formulated within the social ecological model; intrapersonal factors, interpersonal factors, institutional/organisational factors, sociocultural/community factors and public policy. These collectively formed the proposed social ecological model of HPV infection awareness and cervical cancer prevention among Indigenous women. This model has been synthesised by taking into account personal stories of Indigenous women and healthcare workers, thus offering a more nuanced, organised, structured and culturally sensitive approach to policy translation.ConclusionThe social ecological model of HPV infection awareness and cervical cancer prevention among Indigenous women offers a holistic and practical approach for Indigenous health policy makers. It clearly addresses the high risk of Indigenous populations at a global level in experience of both HPV infection and HPV-related cancers.PROSPERO registration numberCRD42020207643.

Cervical neoplasia

2019 ◽  
pp. 357-364
Keyword(s):  
Cervical Cancer ◽  
Screening Program ◽  
Cervical Screening ◽  
Hpv Vaccination ◽  
Invasive Cervical Cancer ◽  
Intraepithelial Neoplasia ◽  
Cervical Neoplasia ◽  
Women Living With Hiv ◽  
The Bethesda System ◽  
Common Malignancy

Cervical neoplasia provides an overview of the 4th most common malignancy in women worldwide, including the premalignant phase. Specific terminology used in cytology and histology (including atypia, dyskaryosis, cervical intraepithelial neoplasia (CIN), cervical glandular intraepithelial neoplasia (CGIN) and invasive cervical cancer (ICC) are explained, and the epidemiology and risk factors (with an emphasis on human papilloma virus (HPV)) for this common malignancy are included. Clinical presentation is outlined. Cervical screening is discussed, including the role of HPV testing, and both the British Association for Cytopathology/NHS cervical screening program 2013 classification of cervical cytology and the Bethesda system (used more widely worldwide) are explained. Diagnosis includes colposcopic examination of the cervix, and the management of both CIN and cervical cancer are included. HPV vaccination, pregnancy, and women living with HIV (including ICC as AIDS-defining) are discussed.

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