Inequities in cervical cancer care in indigenous Peruvian women

Nevin, Paul E.; García, Patricia J.; Blas, Magaly M.; Rao, Deepa; Molina, Yamilé

doi:10.1016/s2214-109x(19)30044-0

Cited by 20 publications

(22 citation statements)

References 5 publications

(7 reference statements)

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“…The rainforest has a high density of indigenous women [ 32 ]. A study in Latin American indigenous women [ 33 ] showed a higher risk of death from cervical cancer, which could be explained by the lower detection rate of early-stage cervical cancer and barriers to access treatment [ 10 , 33 – 35 ]. In addition, the socioeconomic disparities, lack of access to health care services, and low education in the rainforest region [ 36 ], have and continue to create a setting with a lack of knowledge, and poor education on cancer prevention, resulting in poor adherence to treatment and even rejection of screening [ 34 , 35 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

“…Despite the efforts of Plan Esperanza to provide comprehensive coverage of cervical cancer screening, treatment, and medical care, this strategy is still restricted to urban areas [ 10 ]. Given the high and variability of the mortality rates among the Peruvian departments, we aimed to examine the overall and regional trends of cervical cancer mortality in Peru between 2008 and 2017.…”

Section: Introductionmentioning

confidence: 99%

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Cervical cancer mortality in Peru: regional trend analysis from 2008–2017

et al. 2021

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Background Cervical cancer is the third leading cause of cancer-related death among Latin American women. Peru has the sixth highest mortality rate for cervical cancer in the region with regional variations. We aimed to determine overall and regional cervical cancer mortality rates and trends in Peru between 2008 and 2017. Methods We performed an ecological study on the number of deaths by cervical cancer in Peru. Deaths were extracted from the Peruvian Ministry of Health mortality database. Age-standardized mortality rates (ASMR) were estimated per 100,000 women-years using the world standard Segi population. We computed mortality trends using the Joinpoint regression program, estimating the annual percent change (APC). For spatial analysis, GeoDA software was used. Results Peru showed downward trends in the last decade (from 11.62 in 2008 to 9.69 in 2017 (APC = − 2.2, 95% CI: − 4.3, − 0.1, p < 0.05). According to regional-specific analysis, the highest ASMR was in the rainforest region, although this declined from 34.16 in 2008 to 17.98 in 2017 (APC = − 4.3, 95% CI: − 7.2, − 1.3, p < 0.01). Concerning spatial analysis and clustering, the mortality rates from 2008 to 2017 showed a positive spatial autocorrelation and significant clustering (Moran’s I: 0.35, p < 0.001) predominantly in the neighboring North-East departments (Loreto, Ucayali, and San Martin). Conclusions Although mortality trends in the entire population are decreasing, mortality rates remain very high, mainly in the rainforest region. Our results encourage a need for further development and improvement of the current health care delivery system in Peru.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cervical cancer mortality in Peru: regional trend analysis from 2008–2017

et al. 2021

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“…These outcomes were poorly predicted by epidemiological models ( Pacheco-Barrios et al, 2020 ). Some potential related factors are socioeconomic inequities, high rate of informal business, difficulties to the access of supplies ( Herrera Romero and Reys, 2020 ) and health services ( Nevin et al, 2019 ), on the basis of a fragile and fragmented health care system ( World Health Organization, 2003 ; Sánchez-Moreno, 2014 ). The governmental Peruvian response for mental health preservation during COVID-19 had been insufficient too and the technical guidelines proposed were logistically unrealistic in terms of implementation ( Giraldo, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Explanatory Model of Perceived Stress in the General Population: A Cross-Sectional Study in Peru During the COVID-19 Context

2021

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BackgroundThe COVID-19 pandemic had negatively impact mental health worldwide. High prevalence of stress had been previously reported in populations during this context. Many theoretical frameworks had been proposed for explaining the stress process, we aim to proposed and explanatory model for the genesis of perceived stress in Peruvian general population.MethodWe conducted an online survey in Peruvian general population assessing sociodemographic variables and evaluating mental health conditions by using The Perceived Stress Scale (PSS-10), Positive Affect and Negative Affect Scale (PANAS), Generalized Anxiety Disorder scale (GAD-7), Patient Health Questionnaire (PHQ-9), and a numerical rating scale (NRS) for fear of COVID-19. Correlation analysis was conducted for the variables of interest. Two regression models were constructed to explore related factor to the dimensions of perceived stress. Finally, a structural regression model was performed with the independent variables.ResultsData of 210 individuals was analyzed. Ages ranged from 15 to 74 years and 39% were women. Additionally, 65.2% of the participants had at least one mental health conditions (depression, anxiety, or stress symptoms). Perceived self-efficacy and positive affect (PA) were correlated, as perceived helplessness with anxious symptoms and negative affect (NA). Regression analysis showed that sex, anxiety symptoms, and NA explained perceived helplessness while positive and NA explained self-efficacy. The structural regression model analysis identified that fear of COVID-19 (composed of fear of infecting others and fear of contagion), predicted mental health conditions (i.e., depressive or anxiety symptoms); also, mental health conditions were predicted by PA and NA. Perceived helplessness and Perceived self-efficacy were interrelated and represented the perceived stress variable.ConclusionWe proposed an explanatory model of perceived stress based on two correlated dimensions (self-efficacy and helplessness) in the Peruvian general population during the context of the COVID-19 pandemic, with two out of three individuals surveyed having at least one mental health condition.

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“…All experiments were repeated in triplicate. The χ 2 test was used to analyze clinicopathological characteristics. The survival Kaplan-Meier analysis was applied by log-rank analysis.…”

Section: Lentiviral Production and Stable Cell Line Constructionmentioning

confidence: 99%

“…Cervical cancer (CC) is one of the most common gynecological carcinomas worldwide with an incidence rate of ~3.2% in 2018 (1). Although advancements in radiotherapy and immunotherapy have been applied (2), ~50% of patients with late FIGO stage CC, a clinical stage system based on the location and metastasis of Tumor (3), remain to suffer from recurrence and metastasis. A previous study demonstrated that the overactivation of oncogene pathways such as Wnt/β-catenin was associated with the progression of CC (4).…”

Section: Introductionmentioning

confidence: 99%

Long non‑coding RNA RP11‑480I12.5 promotes cervical carcinoma progression by regulating the Wnt/β‑catenin signaling pathway

Zhang¹,

Sona³

2019

Oncol Lett

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T he long non-coding R NA (lncR NA), RP11-480I12.5 is one of the most dysregulated lncRNAs, which is believed to contribute to the progression of cervical carcinoma (CC); however, the exact function of RP11-480I12.5 in human CC remains unknown. The present study aimed to investigate the function and underlying molecular mechanism of RP11-480I12.5 in CC. First, reverse transcription-quantitative PCR was implemented in order to detect differences in the expression of RP11-480I12.5 between normal and CC tissues. The present study used in vitro analysis to establish RP11-480I12.5 stable knockdown and overexpressing cell lines, in order to investigate the function and potential molecular mechanism of RP11-480I12.5 in the progression of CC. RP11-480I12.5 was upregulated in CC tissue compared with normal tissue. Furthermore, RP11-480I12.5 was associated with clinical stage, tumor size and lymph node metastasis. RP11-480I12.5 promoted the proliferation, migration and invasion of CC cell lines. Subsequently, the present study investigated the association between RP11-480I12.5 and the epithelial-to-mesenchymal transition (EMT) and Wnt/β-catenin pathways. RP11-480I12.5 promoted EMT through the Wnt/β-catenin pathway. Overall, the results of the present study demonstrate that RP11-480I12.5 promotes cercical cancer cell migration, invasion and EMT through the Wnt/β-catenin pathway.

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Inequities in cervical cancer care in indigenous Peruvian women

Cited by 20 publications

References 5 publications

Cervical cancer mortality in Peru: regional trend analysis from 2008–2017

Cervical cancer mortality in Peru: regional trend analysis from 2008–2017

Explanatory Model of Perceived Stress in the General Population: A Cross-Sectional Study in Peru During the COVID-19 Context

Long non‑coding RNA RP11‑480I12.5 promotes cervical carcinoma progression by regulating the Wnt/β‑catenin signaling pathway

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