Spatial evaluation of prevalence, pattern and predictors of cervical cancer screening in India

Nilima, Nilima; Puranik, Amitha; Shreenidhi, S.M.; Rai, Shesh

doi:10.1016/j.puhe.2019.09.008

Cited by 18 publications

(14 citation statements)

References 30 publications

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“…The study findings revealed that age of the respondent, BMI, religion, years of schooling, awareness of STI, contraception use, lifetime number of sex partners, number of children, and wealth index had a significant direct impact on the CCS. Previously, an ecological spatial study on CCS in India reported country-wide hot spots and cold spots of screening along with the factors associated [5]. Incorporating the component of geography, the factors related to CCS were the percentage of women-with poor wealth index, not using a modern method of contraception, residing in rural areas, and being aware of STIs [5]-which is in line with the present study findings.…”

Section: Discussionsupporting

confidence: 90%

“…Previously, an ecological spatial study on CCS in India reported country-wide hot spots and cold spots of screening along with the factors associated [5]. Incorporating the component of geography, the factors related to CCS were the percentage of women-with poor wealth index, not using a modern method of contraception, residing in rural areas, and being aware of STIs [5]-which is in line with the present study findings. To the best of our knowledge, the present study is the first to investigate the mediation effect of factors on the CCS percentage in India.…”

Section: Discussionsupporting

confidence: 90%

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Cervical Cancer Screening and Associated Barriers among Women in India: A Generalized Structural Equation Modeling Approach

Nilima

Kalaivani

Kaushik

et al. 2022

Cancers

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Exploring the barriers and facilitators of cervical cancer screening (CCS) is essential to reduce the incidence and mortality, particularly in low and middle-income countries. The present study investigates the direct, indirect, and total effects of the barriers and facilitators on CCS in India through the generalized structural equation modeling using data from women files of the fourth round of the National Family Health Survey (NFHS-4). Generalized structural equation models were used to quantify the hypothetical pathway via fitting a series of regression equations. Age, body mass index, religion, years of schooling, awareness of sexually transmitted infection, contraception use, lifetime number of sex partners, number of children, and wealth index were shown to have significant direct effects on the CCS. Older women had 1.16 times the odds of getting screened for cervical cancer as compared to their younger counterpart. The odds of CCS among the women in richest wealth quintile is 2.50 times compared to the poorest. Those who are aware of STIs have 1.39 times the odds of getting screened for cervical cancer. Wealth index, years of schooling, and religion have a substantial indirect and total impact on the CCS. The findings will aid in policy formulations for enhancing the CCS in India.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%

Cervical Cancer Screening and Associated Barriers among Women in India: A Generalized Structural Equation Modeling Approach

Nilima

Kalaivani

Kaushik

et al. 2022

Cancers

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“…According to the American Cancer Society, the malignancy originates in the cellular lining of the cervix, and most cases can be classified as being squamous cell carcinomas, with adenocarcinoma/adenosquamous carcinomas following the list ( 3 , 4 ). Epidemiological studies have reported a high incidence of cervical cancer (almost 40%) ( 5 , 6 ), and the World Health Organization acknowledges that almost 310,000 women worldwide perish annually due to cervical cancer ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

Survival of Patients With Cervical Cancer Treated With Definitive Radiotherapy or Concurrent Chemoradiotherapy According to Histological Subtype: A Systematic Review and Meta-Analysis

et al. 2022

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BackgroundCervical cancer is a leading cause of morbidity and mortality for women worldwide. Different histopathological cervical cancer subtypes (i.e., adenocarcinoma/adenosquamous carcinoma, and squamous cell carcinoma) are all treated similarly with definitive radiotherapy or concurrent chemoradiotherapy, but studies have reported differing survival prognoses. In this review and meta-analysis, we compared the disease-free and overall survivals of patients with cervical cancer treated with definitive radiotherapy or concurrent chemoradiotherapy according to the histopathological subtypes.ObjectiveTo compare the disease-free and overall survivals of patients with adenocarcinoma/adenosquamous carcinoma and squamous cell carcinoma cervical cancer treated with definitive radiotherapy or concurrent chemoradiotherapy.MethodsWe systematically searched the Web of Science, EMBASE, CENTRAL, Scopus, and MEDLINE academic databases following PRISMA guidelines. We identified publications to conduct a random-effects meta-analysis to evaluate the disease-free and overall survivals of patients with cervical adenocarcinoma/adenosquamous carcinoma and squamous cell carcinoma treated with definitive radiotherapy or concurrent chemoradiotherapy.ResultsFrom 963 studies, we found eight eligible ones with 13,859 patients with cervical cancer (mean age, 52.2 ± 7.9 years). Our meta-analysis revealed a poorer outcome of disease-free (hazard ratio, 1.51; 95% CI, 1.28–1.79) and overall (hazard ratio 1.41; 95% CI, 1.26–1.57) survivals for patients with adenocarcinoma/adenosquamous carcinoma undergoing definitive radiotherapy or concurrent chemoradiotherapy than for those with squamous cell carcinoma undergoing similar treatments. We also observed that larger tumor size and advanced tumor stage are also significant prognostic factors that adversely impact survival outcomes in cervical cancer patients undergoing definitive radiotherapy or concurrent chemoradiotherapy.ConclusionOur results show poor disease-free and overall survivals for patients with cervical cancer and adenocarcinoma/adenosquamous carcinoma than for those with squamous cell carcinoma after treatment with definitive radiotherapy or concurrent chemoradiotherapy. Our findings clarify the risks associated with the conventional management of cervical cancer according to the histological type.

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“…Multiple studies from other countries have demonstrated positive associations between cervical cancer screening and sexual health history and contraceptive usage factors; so, our results are concordant with those findings. [14][15][16][17][18] Since these associations remained after multivariable adjustment, we hypothesize that individuals who use contraception are more likely to have more positive attitudes and opinions about preventative health care that also leads them to seek cervical cancer screening. Although this hypothesis requires further study, if confirmed through qualitative analysis, it may lead to important insights into what motivates individuals to seek care that could lead to more effective public health messaging.…”

Section: Discussionmentioning

confidence: 99%

Loss to Follow-Up and the Care Cascade for Cervical Cancer Care in Rural Guatemala: A Cross-Sectional Study

García¹,

Juarez²,

Sacuj³

et al. 2022

JCO Global Oncology

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PURPOSE More than 80% of cervical cancer cases and deaths occur in low- and middle-income countries. Here, we analyze a large geographically extensive cross-sectional data set from the Western rural highlands of Guatemala. Our objective is to better characterize weak points in care along the cervical cancer care continuum and investigate sociodemographic and clinical correlates of loss to follow-up. METHODS We conducted a retrospective review of electronic health records data from July 21, 2015, through December 10, 2020 for a cytology-based screening and cervical cancer treatment program. We used a care cascade analysis to characterize the progression of individuals through screening, confirmatory testing, and treatment. We examined demographic and clinical factors correlated with screening and loss to follow-up using multivariate logistic regression. RESULTS A total of 8,872 individuals were included in the analysis. Five thousand nine hundred thirteen cervical cancer screenings were conducted. 4.1% of all screening tests were abnormal, including 0.61% cervical intraepithelial neoplasia or overt cervical cancer. Care cascade analysis showed that 67% of eligible women accepted screening. Of those requiring confirmatory testing or treatment, 73% completed recommended follow-up. In adjusted multivariable analysis, prior history of sexual transmitted infection, prior experience with cervical cancer screening, older age, and current contraceptive use were associated with accepting screening. Age and contraceptive use were also associated with retention in care after a positive first screen. CONCLUSION In a large rural Guatemalan retrospective cohort, a care continuum analysis showed that both declining the opportunity to receive cervical cancer screening as well as declining confirmatory testing after a first positive screen were both important weak points along the care continuum. These data support the need for comprehensive and culturally appropriate initiatives to improve screening uptake and retention in care.

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Spatial evaluation of prevalence, pattern and predictors of cervical cancer screening in India

Cited by 18 publications

References 30 publications

Cervical Cancer Screening and Associated Barriers among Women in India: A Generalized Structural Equation Modeling Approach

Cervical Cancer Screening and Associated Barriers among Women in India: A Generalized Structural Equation Modeling Approach

Survival of Patients With Cervical Cancer Treated With Definitive Radiotherapy or Concurrent Chemoradiotherapy According to Histological Subtype: A Systematic Review and Meta-Analysis

Loss to Follow-Up and the Care Cascade for Cervical Cancer Care in Rural Guatemala: A Cross-Sectional Study

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