Screening for cervical cancer in developing countries.

Soe, Myint Myint

doi:10.1136/bmj.304.6832.983-c

Cited by 6 publications

(4 citation statements)

References 10 publications

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“…The recommended 3‐dose course costs approximately US $360 (MYR 1200) and is unaffordable for many, especially women of lower socioeconomic status. These women have the highest risk of cervical cancer but often lack access to preventive care such as cervical screening [19]. To ensure wide coverage, the vaccine may need to be subsidized or incorporated into the vaccination program in Malaysia [20].…”

Section: Discussionmentioning

confidence: 99%

Young multiethnic women's attitudes toward the HPV vaccine and HPV vaccination

Wong

2008

Intl J Gynecology & Obste

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Section: Discussionmentioning

confidence: 99%

Young multiethnic women's attitudes toward the HPV vaccine and HPV vaccination

Wong

2008

Intl J Gynecology & Obste

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“…The risk of developing CC increases with early start of sexual activity, number of sexual partners, prolonged use of oral contraceptives and smoking [ 4 ]. In Mexico it is associated with poverty related factors such as low schooling, unemployment, residence in rural areas and lack of access to health services [ 5 - 7 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of high-risk human papillomavirus types in Mexican women with cervical intraepithelial neoplasia and invasive carcinoma

López‐Revilla

Martínez-Contreras

Sánchez-Garza

2008

Infect Agents Cancer

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Background: Prevalence of high risk (HR) human papillomavirus (HPV) types in the states of San Luis Potosí (SLP) and Guanajuato (Gto), Mexico, was determined by restriction fragment length-polymorphism (RFLP) analysis on the E6 ~250 bp (E6-250) HR-HPV products amplified from cervical scrapings of 442 women with cervical intraepithelial neoplasia and invasive carcinoma (280 from SLP and 192 from Gto). Fresh cervical scrapings for HPV detection and typing were obtained from all of them and cytological and/or histological diagnoses were performed on 383.

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“…However, while these methods may prove feasible in a developed country's national screening program, they remain highly laboratory‐dependent and are not yet applicable in most developing countries. Direct visual inspection and immediate referral for treatment is another approach that is less laboratory‐dependent19 but requires new training of clinical staff 20–22. Thus, technical, financial and personnel constraints provide formidable challenges to implementing effective national CC screening programs in many developing countries in the near future.…”

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confidence: 99%

Determinants of cervical cancer rates in developing countries

Drain

Holmes

Hughes

et al. 2002

Intl Journal of Cancer

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Although cervical cancer (CC) is a leading cause of cancerrelated deaths in developing countries, incidence rates vary considerably, ranging from 3 to 61 per 10 5 females. Identifying determinants of high vs. low rates may suggest population-level prevention strategies. CC rates for 175 countries were obtained from the IARC. Country-specific behavioral, health, economic and demographic measures were obtained from United Nations agencies and other international organizations. Regression analyses performed for 127 low or medium developed countries identified both geography and religion as independently associated with high CC rates. Among behavioral measures, high fertility rates, early age at birth of first child and high teenage birthrates were significantly associated with high CC rates. Countries with high CC rates had fewer doctors per capita, less immunization coverage, more HIV infections and shorter life expectancies. CC rates also tended to be higher in countries with more spending on health and younger, less educated populations. Patterns of CC rates suggest that programmatic approaches, such as promoting delayed childbearing and sexual monogamy, may be appropriate interventions. Key words: cervical cancer; human papillomavirus; epidemiology; developing countries; ecologic analysis; sexual behaviorIn developing countries, cervical cancer (CC) ranks second to breast cancer in incidence 1 but represents the leading cause of cancer-related deaths among women. 2 Of the estimated 470,000 CC cases around the world each year, 380,000 (81%) occur in the developing world. 3 Several studies have conclusively determined that HPV plays an etiologic role in the development of invasive CC. 4 -6 Genital HPV is transmitted through sexual contact, 7 and estimates suggest that at least 50% of sexually active adults have had a genital HPV infection. 8 Currently, over 120 different HPV types have been identified, of which at least 38 primarily infect the genitalia. Four high-risk types ) account for about 80% of invasive CCs collected from around the world. 9 Among developed countries, CC incidence and mortality rates have markedly decreased through active screening and effective treatment. 10,11 However, national CC prevention programs are expensive and laborious and rely on delicate laboratory procedures. Screening programs have rarely been implemented and virtually never sustained in most developing countries. [12][13][14] Among the screening programs that have been introduced, many have had very poor quality and low coverage rates, with little financial support. 15,16 As a result, the less developed countries have CC mortality rates more than twice those of the developed countries with national CC prevention programs. 3 Relatively new screening methods, such as HPV DNA testing, now offer a viable alternative or adjunct to conventional Pap smears. 17,18 However, while these methods may prove feasible in a developed country's national screening program, they remain highly laboratory-dependent and are not yet applicable ...

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Screening for cervical cancer in developing countries.

Cited by 6 publications

References 10 publications

Young multiethnic women's attitudes toward the HPV vaccine and HPV vaccination

Young multiethnic women's attitudes toward the HPV vaccine and HPV vaccination

Prevalence of high-risk human papillomavirus types in Mexican women with cervical intraepithelial neoplasia and invasive carcinoma

Determinants of cervical cancer rates in developing countries

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