Barriers to Cervical Cancer Screening in Geneva (DEPIST Study)

Catarino, Rosa; Vassilakos, Pierre; Royannez-Drevard, Isabelle I.; Guillot, Cécile; Alzuphar, Stéphanie S.; Fehlmann, Aurore; Meyer-Hamme, Ulrike; Petignat, Patrick

doi:10.1097/lgt.0000000000000173

Cited by 15 publications

(15 citation statements)

References 18 publications

(20 reference statements)

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“…This study also revealed that women irregularly or never received a pap smear mainly because of lack of knowledge about pap smears, difficult access to healthcare facilities, lack of time, discomfort and anxiety of pap smear results 21. A study performed in Switzerland revealed that the main reasons for non-participation in cervical cancer screening were practical barriers, such as lack of time and the cost of screening 22. The two aforementioned studies and our study support the idea that convenience and accessibility may be major obstacles in achieving a greater degree of cervical cancer screening in the population.…”

Section: Discussionsupporting

confidence: 82%

Impact of family physicians on cervical cancer screening: cross-sectional questionnaire-based survey in a region of southern Poland

et al. 2019

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BackgroundDespite worldwide efforts in encouraging routine pap smears for early detection of cervical cancer, Poland’s screening rate lags behind the rest of the European Union at 20.2%. Family physicians (FPs) in Poland rarely perform pap smears, and little is known about the experiences and attitudes of Polish patients regarding pap smear screening in a primary healthcare (PHC) setting.MethodsA cross-sectional questionnaire-based survey was performed. Questionnaires were distributed among 43 FPs and 418 of their patients in one Polish region. The data from patients were associated with the doctors’ characteristics. Descriptive statistics, the χ2test and the Mann-Whitney U test were used for analysis.ResultsNearly two-thirds of patients (66%) declared willingness to undergo free pap smear screening by their FPs, with the most common reason being time saved. Among those objecting to receive pap smears from their FPs, immediate specialist care provided by gynaecologists in case of adverse results was the main concern. The factors that positively influenced the patients’ decision to undergo cervical cancer screening in PHC were: (1) living in a city with more than 100 000 inhabitants, (2) being single, (3) having a female FP or (4) a physician with specialty training in family medicine.ConclusionThere is high level of acceptance for pap smears performed in PHC offices among patients in Poland. They are more likely to comply with the screening due to easy access. Establishing a solid physician–patient relationship is also crucial in encouraging screening.

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Section: Discussionsupporting

confidence: 82%

Impact of family physicians on cervical cancer screening: cross-sectional questionnaire-based survey in a region of southern Poland

et al. 2019

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“…Considering that one of the main obstacles to screening participation is its cost, this aspect may have influenced the higher loss to follow-up rate in the IG, where an additional clinical step was required (Loerzel and Bushy, 2005; Catarino et al , 2015). Furthermore, as another barrier to screening attendance is lack of time, the time-consuming aspect of an additional clinical visit may explain the higher dropout rate in the IG (Catarino et al , 2016). This concept is reinforced by the finding that the majority of participants who dropped out between the baseline screening results and colposcopy were working women, who may have lacked the time to undergo multiple clinical visits.…”

Section: Discussionmentioning

confidence: 99%

“…The detailed results of this analysis are reported in two previously published articles (Catarino et al , 2015, 2016). …”

Section: Methodsmentioning

confidence: 99%

“…Women from lower socioeconomic groups and living in rural areas are less likely to undergo screening, which exposes them to a higher risk of developing CC (Rodriguez et al , 2005; Bischoff et al , 2009). The main obstacles to screening participation include absence of insurance coverage, low income, lack of time, and human/emotional factors, such as lack of knowledge about CC and fear of a positive test result (Catarino et al , 2016). One of the aims of the Swiss National Cancer Control Program 2011–2015 is the implementation of a CC screening system across the nation, together with the maximisation of the screening coverage rate (National Cancer Programme for Switzerland, 2011–2015).…”

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confidence: 99%

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Self-sampling to improve cervical cancer screening coverage in Switzerland: a randomised controlled trial

et al. 2017

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Background:The aim of this study is to evaluate whether self-sampling can increase screening attendance of women who do not attend regular screening in Switzerland.Methods:Participants were proactively recruited in Geneva between September 2011 and November 2015. Women (25–69 years) who had not undergone CC screening in the last 3 years were considered eligible. Through a 1 : 1 ratio randomisation, enrolled participants were invited to either undergo liquid-based cytology, which was performed by a health-care provider (control group, CG) or to take a self-sample for HPV-testing, which was mailed to their home (intervention group, IG).Results:A total of 331 and 336 women were randomised in the CG and in the IG, respectively. Overall, 7.3% (95% CI: 4.9–10.6) women in the CG and 5.7% (95% CI: 3.6–8.7) women in the IG did not undergo the initial screening (P=0.400). There were 1.95% (95% CI: 0.8–4.3) women in the CG and 5.05% (95% CI: 3.1–8.1) women in the IG with a positive screen who did not attend triage and colposcopy (P=0.036).Conclusions:The participation in CC screening in women offered self-sampling was not higher than among those offered specimen collection by a clinician. Compliance with further follow-up for women with a positive HPV test on the self-sample requires further attention.

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“…[1][2][3] Pap screening barriers include sociodemographic factors (e.g. race/ethnicity), 4 poor health status, 5,6 logistical difficulties, 7,8 embarrassment, 8,9 and fear of abnormal results. 8,9 Recently expanded United States cervical cancer screening guidelines include primary human papillomavirus (HPV) screening (i.e.…”

Section: Introductionmentioning

confidence: 99%

Reactions of women underscreened for cervical cancer who received unsolicited human papillomavirus self-sampling kits

et al. 2019

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Objectives To evaluate experiences and reactions after receiving a mailed, unsolicited human papillomavirus self-sampling kit and identify psychosocial correlates of using kits. Methods Survey participants were underscreened women aged 30–64 who were mailed human papillomavirus kits as part of a pragmatic trial at Kaiser Permanente Washington, a United States integrated health care system. Six months after the mailing, we invited kit returners and non-returners to complete a web survey that measured psychosocial factors (e.g. cervical cancer/human papillomavirus knowledge, attitudes toward screening), experiences, and reactions to kits. We compared responses between kit returners and non-returners. Results Comparing 116 kit returners (272 invited) and 119 non-returners (1083 invited), we found no clinically significant differences in psychosocial factors. Overall, survey respondents showed knowledge gaps in human papillomavirus natural history (82% did not know human papillomavirus infection can clear on its own) and interpreting human papillomavirus test results (37% did not know a human papillomavirus-negative result indicates low cancer risk). Kit returners found kits convenient and easy to use (>90%). The most common reason for non-return was low confidence in ability to correctly use a kit, although many non-returners (49%) indicated that they would consider future use. Women reported low trust in human papillomavirus testing to identify women at high risk for cervical cancer (52% in returners, 42% in non-returners). Conclusions Screening programs could improve uptake and acceptability of human papillomavirus self-sampling through outreach materials that emphasize the high efficacy of human papillomavirus testing for cervical cancer screening and educate patients about how to interpret results.

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Barriers to Cervical Cancer Screening in Geneva (DEPIST Study)

Abstract: Practical considerations seem to play a more important role in screening participation than emotional reasons and other beliefs. Particular attention should be paid to immigrant communities, where women seem more likely to skip cervical screening.

Cited by 15 publications

References 18 publications

Impact of family physicians on cervical cancer screening: cross-sectional questionnaire-based survey in a region of southern Poland

Impact of family physicians on cervical cancer screening: cross-sectional questionnaire-based survey in a region of southern Poland

Self-sampling to improve cervical cancer screening coverage in Switzerland: a randomised controlled trial

Reactions of women underscreened for cervical cancer who received unsolicited human papillomavirus self-sampling kits

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