Dataset Information

Beliefs and perceptions regarding cervical cancer and screening associated with Pap smear uptake in Johannesburg: A cross-sectional study.

ABSTRACT:

Background

Cervical cancer is a major global public health concern, with 85% of cases occurring in low- and middle-income countries. In South Africa, it is the second most common cancer amongst women. Screening and treatment of cervical cancer precursor lesions is associated with a lower incidence and mortality. This research determines the associations between women's beliefs about cervical cancer and screening and the uptake of Papanicolaou (Pap) smears in Johannesburg, where cervical screening uptake is suboptimal.

Methods

This research was approved by the University of Witwatersrand Human Research Ethics Committee (Medical), clearance certificate number: M170243 and the Johannesburg District Heath Research Committee prior to conducting the study. All participants signed a consent form prior to participating in this study. This cross-sectional analytical study used an interviewer-administered validated measurement scale based on the Health Belief Model (HBM) to describe health beliefs regarding cervical cancer and screening among 280 women aged 30 years and older, attending Johannesburg primary care facilities in 2017. Logistic regression models, with robust estimation of variance to account for clustering of women within clinics, were fitted to identify health beliefs (perceived susceptibility, severity, barriers and benefit, cues to action, and self-efficacy) associated with ever having had a Pap smear (screening uptake), while controlling for knowledge of screening and potential confounders.

Results

Of the 280 women, 177 (63.2%) had ever been screened, 180 (64.3%) were never married, 199 (71.1%) attained secondary education and 133 (47.5%) were employed full time. Women of older age (AOR = 1.6 for a 5-year increase in age; CI: 1.3-1.9; P<0.001), with higher knowledge scores (AOR = 2.5 for a 5-point increase in knowledge score; 95% CI:1.0-6.3;P = 0.051), with lower perceived barriers scores (AOR = 0.4 for a 5-point increase in barriers score; 95% CI:0.3-0.5; P<0.001) and higher perceived severity scores (AOR = 1.3 for a 5-point increase in severity score; 95% CI:1.0-1.6; P = 0.017) were more likely to have had a Pap smear.

Conclusions

This study shows that women who take up screening are older, more knowledgeable regarding cervical cancer and screening, less likely to perceive screening barriers, and more likely to perceive cervical cancer as a severe disease. This highlights that for public health interventions to increase screening uptake, the focus should include tailored behaviour change communication strategies that address women's beliefs regarding screening barriers and emphasize the severity of cervical cancer.

SUBMITTER: Chisale Mabotja M

PROVIDER: S-EPMC7875386 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Beliefs and perceptions regarding cervical cancer and screening associated with Pap smear uptake in Johannesburg: A cross-sectional study.

Chisale Mabotja Mantwa M Levin Jonathan J Kawonga Mary M

PloS one 20210210 2

<h4>Background</h4>Cervical cancer is a major global public health concern, with 85% of cases occurring in low- and middle-income countries. In South Africa, it is the second most common cancer amongst women. Screening and treatment of cervical cancer precursor lesions is associated with a lower incidence and mortality. This research determines the associations between women's beliefs about cervical cancer and screening and the uptake of Papanicolaou (Pap) smears in Johannesburg, where cervical ...[more]

PMID: 33566798

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Project description:Cervical intraepithelial neoplasia (CIN) and cervical cancer are major health problems faced by women worldwide. The conventional Papanicolaou (Pap) smear analysis is an effective method to diagnose cervical pre-malignant and malignant conditions by analyzing swab images. Various computer vision techniques can be explored to identify potential precancerous and cancerous lesions by analyzing the Pap smear image. The majority of existing work cover binary classification approaches using various classifiers and Convolution Neural Networks. However, they suffer from inherent challenges for minute feature extraction and precise classification. We propose a novel methodology to carry out the multiclass classification of cervical cells from Whole Slide Images (WSI) with optimum feature extraction. The actualization of Conv Net with Transfer Learning technique substantiates meaningful Metamorphic Diagnosis of neoplastic and pre-neoplastic lesions. As the Progressive Resizing technique (an advanced method for training ConvNet) incorporates prior knowledge of the feature hierarchy and can reuse old computations while learning new ones, the model can carry forward the extracted morphological cell features to subsequent Neural Network layers iteratively for elusive learning. The Progressive Resizing technique superimposition in consultation with the Transfer Learning technique while training the Conv Net models has shown a substantial performance increase. The proposed binary and multiclass classification methodology succored in achieving benchmark scores on the Herlev Dataset. We achieved singular multiclass classification scores for WSI images of the SIPaKMed dataset, that is, accuracy (99.70%), precision (99.70%), recall (99.72%), F-Beta (99.63%), and Kappa scores (99.31%), which supersede the scores obtained through principal methodologies. GradCam based feature interpretation extends enhanced assimilation of the generated results, highlighting the pre-malignant and malignant lesions by visual localization in the images.

Project description:BACKGROUND:In Nicaragua, cervical cancer is the leading cause of cancer-related death for women ages 15-44, yet access to the HPV vaccine is limited to those with financial resources to pay for it. Cervical cytology is provided free of charge in public clinics; however, only 10% of women receive Pap smears at the nationally recommended frequency. Previous studies have not investigated how beliefs regarding cervical cancer screening may differ for urban and rural populations in Nicaragua. Furthermore, no investigation has assessed Nicaraguan women's beliefs about a potential HPV immunization campaign. Given beliefs' influence on health behavior, we investigated the structural, sociocultural, and knowledge-based factors influencing women's beliefs regarding cervical cancer screening among urban and rural women in León, Nicaragua, and assessed acceptance of a potential HPV immunization program. METHODS:Our sequential explanatory mixed-methods study consisted of two phases: (1) a close-ended questionnaire, followed by (2) a qualitative, in-depth interview. Our quantitative sample contained 117 urban and 112 rural participants aged 18-49. We assessed beliefs regarding cervical cancer screening using a 22-item scale, with higher scores indicating screening-promoting beliefs in simple linear and multiple linear regressions. Twenty qualitative interviews, exploring the sociocultural dimensions of knowledge and attitudes indicated by our quantitative findings, were conducted with a sample of 13 urban and 7 rural women aged 19-46. RESULTS:The multiple linear regression indicates that greater knowledge of Pap smears, HPV, and cervical cancer is significantly associated with screening-promoting beliefs after adjusting for other relevant factors. There was no significant difference in screening knowledge and beliefs for urban and rural women. Four recurrent themes representing determinants of knowledge, beliefs, and attitudes regarding cervical cancer screening arose from interviews and built on quantitative findings: (1) women's embarrassment due to the intimate nature of the Pap smear and male gender of exam provider discourages screening; (2) women believe Pap smears and cervical cancer are associated with sexual promiscuity, and this association stigmatizes women with the disease; (3) knowledge of cervical cancer prevention is limited to those who regularly attend health centers; and (4) women find screening inconvenient, believing understaffed clinics increase patient wait time, limit time patients spend with clinicians, and delay Pap results. A fifth theme indicates (5) participants' acceptance of a potential HPV immunization program. DISCUSSION:Future interventions should focus on increasing access to information about cervical cancer prevention for women who do not regularly attend health centers. Furthermore, our results suggest that if funding were allocated to make the HPV vaccine accessible in Nicaragua, it would be well received.

Dataset Information

Beliefs and perceptions regarding cervical cancer and screening associated with Pap smear uptake in Johannesburg: A cross-sectional study.

Background

Methods

Results

Conclusions

Publications

Beliefs and perceptions regarding cervical cancer and screening associated with Pap smear uptake in Johannesburg: A cross-sectional study.

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