scholarly journals Canadian cancer screening disparities: a recent historical perspective

2015 ◽  
Vol 22 (2) ◽  
pp. 156 ◽  
Author(s):  
J. Kerner ◽  
J. Liu ◽  
K. Wang ◽  
S. Fung ◽  
C. Landry ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Low Income ◽  
Cancer Mortality ◽  
Pap Test ◽  
Screening Programs ◽  
Screening Services

Across Canada, introduction of the Pap test for cervical cancer screening, followed by mammography for breast cancer screening and, more recently, the fecal occult blood test for colorectal cancer screening, has contributed to a reduction in cancer mortality. However, another contribution of screening has been disparities in cancer mortality between certain populations. Here, we explore the disparities associated with breast and cervical cancer screening and preliminary data concerning disparities in colorectal cancer screening.Although some disparities in screening utilization have been successfully reduced over time (for example, mammography and Pap test screening in rural and remote populations), screening utilization data for other populations (for example, low-income groups) clearly indicate that disparities have existed and continue to exist across Canada. Organized screening programs in Canada have been able to successfully engage 80% of women for regular cervical cancer screening and 70% of women for regular mammography screening, but of the women who remain to be reached or engaged in regular screening, those with the least resources, those who are the most isolated, and those who are least culturally integrated into Canadian society as a whole are overrepresented. Population differences are also observed for utilization of colorectal cancer screening services.The research literature on interventions to promote screening utilization provides some evidence about what can be done to increase participation in organized screening by vulnerable populations. Adaption and adoption of evidence-based screening promotion interventions can increase the utilization of available screening services by populations that have experienced the greatest burden of disease with the least access to screening services.

scholarly journals Role of Protein Biomarkers in the Detection of High-Grade Disease in Cervical Cancer Screening Programs

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Charlotte A. Brown ◽  
Johnannes Bogers ◽  
Shaira Sahebali ◽  
Christophe E. Depuydt ◽  
Frans De Prins ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Cervical Screening ◽  
False Negative ◽  
Pap Test ◽  
Developed Countries ◽  
Protein Biomarkers ◽  
Ki 67 ◽  
Screening Programs

Since the Pap test was introduced in the 1940s, there has been an approximately 70% reduction in the incidence of squamous cell cervical cancers in many developed countries by the application of organized and opportunistic screening programs. The efficacy of the Pap test, however, is hampered by high interobserver variability and high false-negative and false-positive rates. The use of biomarkers has demonstrated the ability to overcome these issues, leading to improved positive predictive value of cervical screening results. In addition, the introduction of HPV primary screening programs will necessitate the use of a follow-up test with high specificity to triage the high number of HPV-positive tests. This paper will focus on protein biomarkers currently available for use in cervical cancer screening, which appear to improve the detection of women at greatest risk for developing cervical cancer, including Ki-67,p16INK4a, BD ProEx C, and Cytoactiv HPV L1.

scholarly journals Temporal trend in socioeconomic inequalities in the uptake of cancer screening programmes in France between 2005 and 2010: results from the Cancer Barometer surveys

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e016941 ◽  
Author(s):  
David Mark Kelly ◽  
Carla Estaquio ◽  
Christophe Léon ◽  
Pierre Arwidson ◽  
Hermann Nabi
Keyword(s):  
Colorectal Cancer ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Socioeconomic Inequalities ◽  
Secondary Outcome ◽  
Participation Rates ◽  
Cervical Smear ◽  
Screening Uptake

ObjectivesCancer screening is a form of secondary prevention for a disease which is now the leading cause of death in France. Various socioeconomic indicators have been identified as potential factors for disparities in breast, cervical and colorectal cancer screening uptake. We aimed to identify the socioeconomic inequalities, which persisted in screening uptake for these cancers, and to quantify these disparities over a 5-year period.SettingThe Cancer Barometer was a population-based-survey carried out in 2005 and 2010 in France.ParticipantsA randomly selected sample of participants aged 15–85 years (n=3820 in 2005 and n=3727 in 2010) were interviewed on their participation in breast, cervical and colorectal cancer screening-programmes and their socioeconomic profile.Primary and secondary outcome measuresFor each type of screening programme, we calculated participation rates, OR and relative inequality indices (RII) for participation, derived from logistic regression of the following socioeconomic variables: income, education, occupation, employment and health insurance. Changes in participation between 2005 and 2010 were then analysed.ResultsParticipation rates for breast and colorectal screening increased significantly among the majority of socioeconomic categories, whereas for cervical cancer screening there were no significant changes between 2005 and 2010. RIIs for income remained significant for cervical smear in 2005 (RII=0.25, 95% CI 0.13 to 0.48) and in 2010 (RII=0.31, 95% CI 0.15 to 0.64). RIIs for education in mammography (RII=0.43, 95% CI 0.19 to 0.98) and cervical smear (RII=0.36, 95% CI 0.21 to 0.64) were significant in 2005 and remained significant for cervical smear (RII=0.40, 95% CI 0.22 to 0.74) in 2010.ConclusionsThere was a persistence of socioeconomic inequalities in the uptake of opportunistic cervical cancer screening. Conversely, organised screening programmes for breast and colorectal cancer saw a reduction in relative socioeconomic inequalities, even though the results were not statistically significant. The findings suggest that organised cancer screening programmes may have the potential to reduce socioeconomic disparities in participation.

Mapping Population Health Management Roadmap into Cervical Cancer Screening Programs

2015 ◽  
Vol 4 (3) ◽  
pp. 1-18 ◽  
Author(s):  
Anastasius Moumtzoglou ◽  
Abraham Pouliakis
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Population Health ◽  
Cervical Cancer Screening ◽  
Health Management ◽  
Pap Test ◽  
Population Health Management ◽  
Personalized Care ◽  
Screening Programs ◽  
Care Gaps

Population Health Management (PHM) aims to provide better health outcomes for preventing diseases, closing care gaps and providing more personalized care. Since the inception of the Pap test, cervical cancer (CxCa) decreased in countries applying cervical cancer programs, involving both prevention and treatment. In this article, the authors map the PHM roadmap to the design of cervical cancer screening programs and examine the effect on the supporting information technology systems. Notwithstanding screening programs have a tight relation to PHM; the mapping reveals numerous interventions involving additional data sources, and timeless reconfiguration.

scholarly journals Methodologies of Primary HPV Testing Currently Applied for Cervical Cancer Screening

Life ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 290
Author(s):  
Andreas C. Chrysostomou ◽  
Leondios G. Kostrikis
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Pap Test ◽  
Population Based ◽  
World Health ◽  
Hpv Testing ◽  
Screening Programs ◽  
European Guidelines ◽  
Health Organization

The human papillomavirus is one of the most common sexually transmitted viruses, and an infection from this virus may become persistent, leading to diseases such as cervical cancer. In the past, cytology-based methods such as the Papanicolaou (Pap) test were imperative to identify the disease at a stage where it can be treated. However, since the 1980s where the etiological association of HPV and cervical cancer was identified, new tests began emerging directed towards identifying the virus. Furthermore, as the biology of HPV along with the relationships with its host are elucidated, these tests and treatments further advance. Recently in Europe, there is a movement towards the implementation of HPV testing methodologies in national screening programs to precede cytological testing. These screening strategies are recommended by the European guidelines and the World Health Organization. This review presents the current HPV testing methodologies, their application in organized population-based cervical cancer screening programs based on the most recent European guidelines, and their implementation status in countries in Europe.

scholarly journals Measuring colposcopy quality in Canada: development of population-based indicators

2019 ◽  
Vol 26 (3) ◽  
Author(s):  
K. Decker ◽  
N. Baines ◽  
C. Muzyka ◽  
M. Lee ◽  
M. H. Mayrand ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Quality Indicators ◽  
Pap Test ◽  
Population Based ◽  
Low Grade ◽  
Treatment Rate ◽  
Treatment Frequency ◽  
Screening Programs

Background Colposcopy is a key part of cervical cancer control. As cervical cancer screening and prevention strategies evolve, monitoring colposcopy performance will become even more critical. In the present paper, we describe population-based colposcopy quality indicators that are recommended for ongoing measurement by cervical cancer screening programs in Canada.Methods The Pan-Canadian Cervical Cancer Screening Network established a multidisciplinary expert working group to identify population-based colposcopy quality indicators. A systematic literature review was conducted to ascertain existing population and program-level colposcopy quality indicators. A systems-level cervical cancer screening pathway describing each step from an abnormal screening test, to colposcopy, and back to screening was developed. Indicators from the literature were assigned a place on the pathway to ensure that all steps were measured. A prioritization matrix scoring system was used to score each indicator based on predetermined criteria. Proposed colposcopy quality indicators were shared with provincial and territorial screening programs and subsequently revised.Results The 10 population-based colposcopy quality indicators identified as priorities were colposcopy uptake, histologic investigation (biopsy) rate, colposcopy referral rate, failure to attend colposcopy, treatment frequency in women 18–24 years of age, re-treatment proportion, colposcopy exit-test proportion, histologic investigation (biopsy) frequency after low-grade Pap test results, length of colposcopy episode of care, and operating room treatment rate. Two descriptive indicators were also identified: colposcopist volume and number of colposcopists per capita.Summary High-quality colposcopy services are an essential component of provincial cervical cancer screening programs. The proposed quality and descriptive indicators will permit colposcopy outcomes to be compared between provinces and across Canada so as to identify opportunities for improving colposcopy services.

Quality Indicators for Cervical Cancer Screening Programs

2014 ◽  
Vol 3 (4) ◽  
pp. 19-37 ◽  
Author(s):  
Elena Athanasiadi ◽  
Abraham Pouliakis ◽  
Evripidis Bilirakis ◽  
Vassilis Fragoulakis ◽  
Constantinos Bilirakis ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Quality Assurance ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Quality Indicators ◽  
Performance Indicators ◽  
Screening Programs ◽  
European Guidelines ◽  
Screening Services ◽  
And Performance

Cervical cancer is the malignancy most succesfully monitored by screening programs. Although most counties offer screening services, outcomes differ. It is clear that incidence reduction is achieved when quality assurance is implemented. Quality indicators are essential audit tools when implementing screening policies. Uniform indicators are used to monitor general performance and to identify potential problems that may occur and jeopardise efforts. That way quality management is enabled and the assessment of deviation from goals is facilitated. In this paper the authors present the workflow of cervical cancer screening programs in respect to the quality and performance indicators required by the European Guidelines for Quality Assurance in Cervical Cancer Screening. The authors also propose the appropriate data structures and entities that are required for a computerised system to support their calculation. Additionally the authors highlight important interconnections of the computerised system with other systems; these interconnections are vital for the calculation of the proposed quality indicators.

Family-Centered Sexual Health Intervention to Promote Cervical Cancer Screening Uptake Among Low-income Rural Women in India: A Community-Based Protocol study (Preprint)

2021 ◽  
Author(s):  
Mandana Vahabi ◽  
Aisha K Lofters ◽  
Gauravi Mishra ◽  
Sharmila Pimple ◽  
Josephine Pui-Hing Wong
Keyword(s):  
Cervical Cancer ◽  
Health Literacy ◽  
Cancer Screening ◽  
Sexual Health ◽  
Cervical Cancer Screening ◽  
Cancer Mortality ◽  
Pap Test ◽  
Community Based ◽  
Cervical Cancer Mortality ◽  
Family Centered

BACKGROUND Human papillomavirus (HPV) is the primary cause of cervical cancer, which is preventable through screening and early treatment. The Papanicolaou (Pap) test and visual inspection with acetic acid (VIA), traditionally performed at the clinical setting, have been used effectively to screen for cervical cancer and pre-cancerous changes, and reduce cervical cancer mortality in high-income countries for many decades. However, these screening methods are not easily accessible to women living in low- and middle- income countries (LMIC), especially women living in rural areas. OBJECTIVE Preventing Cervical Cancer in India through Self-Sampling (PCCIS) is a community-based family-centered research project that aims to reduce avoidable cervical cancer disparities in rural area in India. The project will use HPV self-sampling, supported by a sexual health literacy intervention to increase rural women’s participation in cervical cancer screening. The objectives are to determine the effectiveness of this program in: (a) increasing sexual health literacy; (b) reducing gendered stigma of HPV and cervical cancer; (c) promoting cervical cancer screening using HPV self-sampling. METHODS We will recruit 120 women aged 30-69, who are under or never screened (UNS) for cervical cancer along with 120 supportive male relatives or friends from 3 impoverished rural / tribal villages in Palghar district in the state of Maharashtra, India. Participants will attend gender-specific sexual health education (SHE) followed by a Movie Matinee. Data will be collected though an interviewer-administered questionnaire before and after SHE. The questionnaire will include items on social demographics, medical history, attitudes, sexual health stigma, cervical cancer knowledge, and screening practices. Women will self-select whether to use HPV self-sampling. Those who do not may or may not undergo Pap test/VIA. Participants’ views regarding barriers and facilitators and suggestions to improve access and uptake will also be elicited. RESULTS PCCIS was funded in January 2020 for 15 months. Due to the COVID19 pandemic, the project was extended by one year. The protocol was approved by the research ethics boards of Ryerson University (REB 2020-104) and Tata Memorial Center (OIEC/3786/2021 /00003). Study outcome measures will include changes in knowledge/attitudes about cervical cancer screening, proportion of participants who self-select into each cohort, proportion of positive test result in each cohort- and proportion of participants with confirmed cervical cancer. Women’s experiences related to barriers and facilitators associated with the screening uptake will be captured. CONCLUSIONS This multi-faceted work could lead to reduced cervical cancer mortality and morbidity, and increased community capacity in sexual health promotion and cervical cancer prevention. Insights and lessons learned from this project can be used to inform the adaptation and scale-up of HPV self-sampling among women across India and in other countries, promote collective commitment to family-centred wellness, and support women to make healthful, personalized cervical screening decisions. CLINICALTRIAL Not Applicable

Factors Affecting Uptake of Cervical Cancer Screening among Clinic Attendees in Trelawny, Jamaica

2007 ◽  
Vol 14 (4) ◽  
pp. 396-404 ◽  
Author(s):  
Patricia Bessler ◽  
Maung Aung ◽  
Pauline Jolly
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Pap Smear ◽  
Pap Test ◽  
Preventive Measure ◽  
Developed Countries ◽  
Factors Affecting ◽  
Screening Programs ◽  
Attitudes And Practices

Background Use of the Pap test has resulted in a decline in cervical cancer mortality in developed countries. Yet, despite established cervical cancer screening programs, a significant portion of Jamaican women are not undergoing screening for cervical cancer. This study was carried out to identify factors that affect Jamaican women's decisions to screen for cervical cancer. Methods A population survey was administered to 367 clinic-attending women 25 to 54 years of age in the Parish of Trelawny from May to July of 2005. An interviewer-administered questionnaire assessed the women's knowledge, attitudes, and practices regarding cervical cancer and cervical cancer screening. Results Overall, 11% of the women had never had a Pap smear and only 38% had a Pap test within the last year. Annual visits to a health provider have a strong influence on women's decisions to regularly screen for cervical cancer. Provider recommendation also positively affected initial receipt of a Pap smear as well as continued regular screening. Conclusions Programs that promote annual health checkups, encourage consistent provider recommendations, and emphasize screening as a preventive measure might positively influence women's decisions to screen for cervical cancer.

scholarly journals Proposal to institutionalize criteria and quality standards for cervical cancer screening within a health care system

1998 ◽  
Vol 14 (suppl 3) ◽  
pp. S67-S75 ◽  
Author(s):  
Jorge Salmerón-Castro ◽  
Eduardo César Lazcano Ponce ◽  
Ricardo Pérez Cuevas ◽  
Iliana del Río Gómez ◽  
Irene Torres Torija ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Quality Control ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
New Technologies ◽  
Pap Test ◽  
Control Measures ◽  
Epidemiological Surveillance ◽  
Cancer Site ◽  
Screening Programs

The uterine cervix is the most common cancer site for females. Approximately 52,000 new cases occur annually in Latin America, thus the need to improve efficiency and effectiveness of Cervical Cancer Screening Programs (CCSP) is mandatory to decrease the unnecessary suffering women must bear. This paper is addressing essential issues to revamp the CCSP as proposed by the Mexican official norm. A general framework for institutionaling CCSP is outlined. Furthermore, strategies to strengthen CCSP performance through managerial strategies and quality assurance activities are described. The focus is on the following activities: 1) improving coverage; 2) implementing smear-taking quality control; 3) improving quality in interpretation of Pap test; 4) guaranteeing treatment for women for whom abnormalities are detected; 5) improving follow-up; 6) development of quality control measures and 7) development of monitoring and epidemiological surveillance information systems. Changes within the screening on cervical cancer may be advocated as new technologies present themselves and shortcomings in the existing program appear. It is crucial that these changes should be measured through careful evaluation in order to tally up potential benefits.

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