Cervical Cancer (Research Paper)
| Citation | Conceptual Framework | Design/Method | Sample/Setting | Variables | Measurement | Data analysis | Findings | Appraisal/Worth to Practice |
Vamos, C. A., Calvo, A. E., Daley, E. M., Giuliano, A. R., & López Castillo, H. (2015). Knowledge, behavioral, and sociocultural factors related to human papillomavirus infection and cervical cancer screening among inner-city women in Panama
|
Social cognitive theory (SCT), which relates to the person, social/physical environment and their behavior | Design: The research utilized a quantitative study design.
Methods: Creation of a community advisory board (CAB), which guided the development of the research instrument |
San Miguelito is the study setting where men and women of the working class and aged between 18-44 years were recruited to this study. The socio-demographic database of the population census was the source of the sample size (365). 10% of the population failed to participate in the study | Independent variables: Knowledge, sociocultural and behavioral factors
Dependent variable: Human papillomavirus infection and cervical cancer |
The survey instrument used in this study was based on an earlier conducted qualitative study in Panama City | The data was analyzed through descriptive statistics in which questionnaires were critically analyzed | 324 study participants had low HPV knowledge,which translates to low cervical cancer awareness and the importance of having the Pap smear test. Key sources of information about cancer and HPV infection identified in the research were television, newspapers/magazines, and family/friends/neighbors | The study enables one to understand that community assessment is necessary before the introduction of educational interventions for enhancement of community awareness and cervical cancer prevention methods. Such a reduction in Panama will significantly decrease global burden of disease significantly |
| Hills, R. L., Kulbok, P. A., & Clark, M. (2015). Evaluating a Quality Improvement Program for Cervical Cancer Screening at an Urban Safety Net Clinic. Health promotion practice, 16(5), 631-641. | Diffusion of innovations | Design: Descriptive comparison study design
|
Fan Free Clinic is the study area of interest, which offers services to the uninsuredpersons residing in Richmond, Virginia, and surrounding counties.
1032 out of the 1846 patient records was the final sample size after application of the exclusion criteria |
Prior screening tests performed, date of last test, laboratory results of last screening, providerrecommendation for next screening, and history of hysterectomy secondary to benign condition
|
Patient chart review | Descriptive statistics through the IBM SPSS version 21 | The number of patients screened according to the guidelines increased by almost half whereas the proportion of underscreened patients also reduced by almost half. Likewise, the number of patients screened more frequently than recommended reducedby three times.
|
The study forms a basis for primary care settings’clinical administrators, quality improvement specialists, and health care providers seeking to implement continuous quality
improvement initiatives for cervical cancer screening |
| Elfström, K. M Johansson, A. L. V., Eklund, C., Nauclér, P., Arnheim-Dahlström, L., & Dillner, J. (2014). Long term duration of protective effect for HPV negative women: Follow-up of primary HPV screening randomized controlled trial. | Faye Abdellah’s Nursing Problems theory | Design: A quantitative study design
Methods: Follow-up of Swedes that took part in a primary HPV screeninglasting for thirteen years |
The follow-up involved 12527 women aged 32-38 who had taken part in a cervical screening program in Sweden | Independent variable: HPV screening
Dependent variable: CIN2+ and CIN3+ cumulative incidences
|
The study utilized Kaplan Meier curves in measuring the CIN2+ and CIN3+’s cumulative incidence, the main outcome measures | Statistical analysis using 1 minus the Kaplan-Meier curves to establish the cumulative incidences of CIN2+ and CIN3+ | The sensitivity of a cytology-based screening after three years is similar to the sensitivity of an HPV screening after five years.
|
These results affirm HPV screening is a cost-effective alternative that does not require short intervals given its increased sensitivity over long periods |
| Twinomujuni, C., Nuwaha, F., & Babirye, J. N. (2015). Understanding the Low level of cervical cancer screening in Masaka Uganda using the ASE model: a community-based survey. PloS one, 10(6), e0128498. | Attitude, social influence and self-efficacy (ASE) model | Design: Quantitative study design (Community-based survey)
Method: Pretested semi-structured questionnaire was administered during an interview that lasted for 60minutes |
Out of the 510 accessible women, only 416 were includedin the final sample | Independent Variables: Attitudinal, social influence and self-efficacy factors associated with intention to screen for cervical cancer
Dependent variable: Cervical cancer screening |
Use of pretested semi-structured questionnaire to establish the factors associated with intention to screen for cervical cancer | STATA version 12 software | Only 7%of study respondents had undergone screening while 63% had the intention of screening. The intention was higher among those who:
· at risk of developing cervical cancer · they would refer other women for screening · unafraid of being diagnosed with cervical cancer · reported discussions on cervical cancer with health care providers · formally employed |
Based on the study findings,pioneers of newcervical cancer screening intervention have a benchmark of what they need to do for them to succeed. In this case, increasing awareness of these interventions is necessary. |
| Wolwa, M., Blavo, C., Shah, R., Fleisher, J. M., & Espinal, T. (2013). Cervical cancer knowledge and prevention among college women | Dorothea Orem Self-care model | Design: Quantitative study design
Method: Administration of self-administered questionnaire to the college women for establishment of their attitudes and acceptance of cervical cancer screenings and the HPV vaccine Research approval was by the University institutional review board and the community centre research committee |
The sample size, 410, constituted of 217 college women and 193 women from a local
community health centre |
Independent Variables: Level of education, race, and age
Dependent variable: Cervical cancer knowledge and prevention |
Survey tool that measured cervical cancer knowledge and prevention practices | The SAS version 9.2 was used in the data analysis | College women utilized HPV vaccination more than community women (36% and 5% respectively)
College women also reported higher cervical cancer knowledge than community women
|
Women of different backgrounds have variable cervical cancer knowledge and preventive practices. As such, this study acts as a basis for tailoring interventions per the needs of the target groups. |
Cervical Cancer
In the contemporary medical world, cervical cancer is the second most common type of cancer among women after breast cancer. The proportion of women suffering from cervical cancer in the recent past has been on the rise despite the use of already institutionalized preventive measures. For instance, according to Twinomujuni, Nuwaha, and Babirye, (2015), 500000 is the estimated number of new cases diagnosed every year while a further 270000 die of this condition annually. With such a high proportion of new cervical cancer cases coupled with the high number of women with undetected cervical cancer, it is beyond doubt that there is need for analyzing this condition for the determination of its practical details. Central to the analysis are various aspects of cervical cancer noted in the reviewed literature. They include the risk factors, preventive measures and treatment options for cervical cancer. With such an analysis, development of insights of new ways of approaching cervical cancer management is inevitable.
Primarily, cervical cancer mainly develops due to human papilloma virus (HPV) infection, whose spread is through sexual contact. Several risk factors are responsible for increased vulnerability to this condition and one must understand if the prevention of this condition is at heart. Such predisposing factors include but not limited to sexually active women aged between 30-45years, multiple sex partners, early age at first coitus, short interval between menarche and first coitus, sexual contact with men whose partners have had cervical cancer, exposure to the HPV virus, and smoking(Nadarzynski, Waller, Robb, & Marlow, 2012).
Secondly, the current preventive measures against cervical cancer are also worth mention given multiple studies acknowledge their existence and efficacy. Befitting examples of commonly studied preventive strategies evident in the reviewed literature include HPV vaccination among women aged 13-26 years and cervical cancer screening.Wolwa, Blavo, Shah, Fleisher, and Espinal, (2013) in their study highlighted that HPV vaccination as a preventive strategy is an effective weapon against cervical cancer given the reduced mortality and incidence rates due to HPV-related cervical cancer. In another research, the use of cervical cancer screening intervention resulted in early detection HPV infection and effective treatment of the same. Other preventive measures are mainly safe sex practices, which include sticking to a single sexual partner, use of condoms during sexual encounters and avoidance of unprotected sexual contact with commercial sex workers (Wolwa, et al., 2013).
Lastly,the treatment options for newly diagnosed cervical cancer patients are also noteworthy given their contribution to improve the quality of life. For precursor or pre-invasive lesions,conservative treatment is the approach of choice. The conservative management entails careful monitoring by frequent pap smears, cryotherapy, laser therapy and loop electrocautery excision procedure (LEEP) for the management of the precancerous cervical lesions. On the contrary, treatment of invasive cervical cancer depends on the stage of cancer, patient’s age and physician’s judgment. Surgery and radiation are beneficial options for invasive cancer(Buttaro, Trybulski, Polgar-Bailey, & Sandberg-Cook, 2013).
In closure, this analysis aimed at illustrating the disease burden, risk factors, preventive measures and treatment options for cervical cancer. Based on the discussion, a key implication that is worth highlighting relates to the need of reinforcing the agenda of preventing cervical cancer through interventions such as cervical cancer screening whose efficacy is beyond question. By such a campaign, the enormous financial burden imposed by this condition is likely to become minimal on the global circle. However, in the absence of such a consideration, the cost burden will remain or even increase, which is no good for already struggling health sector.
References
Buttaro, T., Trybulski, J., Bailey, P., Sandberg-Cook, J. (2013). Primary care a collaborative practice (4th ed.). [VitalSource Bookshelf Online]. Retrieved from https://digitalbookshelf.southuniversity.edu/#/books/978-0-323-07501-5/
Elfström, K. M., Smelov, V., Johansson, A. L. V., Eklund, C., Nauclér, P., Arnheim-Dahlström, L., & Dillner, J. (2014). Long-term duration of protective effect for HPV negative women: Follow-up of primary HPV screening randomized controlled trial. BMJ (Clinical Research Ed.), 348(jan16 1), g130-g130. doi:10.1136/bmj. g130
Hills, R. L., Kulbok, P. A., & Clark, M. (2015). Evaluating a Quality Improvement Program for Cervical Cancer Screening at an Urban Safety Net Clinic. Health promotion practice, 16(5), 631-641.
Nadarzynski, T., Waller, J., Robb, K. A., & Marlow, L. A. V. (2012). Perceived risk of cervical cancer among pre-screening age women (18-24 years): The impact of information about cervical cancer risk factors and the causal role of HPV. Sexually Transmitted Infections, 88(6), 400-406. doi:10.1136/sextrans-2012-050482
Twinomujuni, C., Nuwaha, F., & Babirye, J. N. (2015). Understanding the Low level of cervical cancer screening in Masaka Uganda using the ASE model: a community-based survey. PloS one, 10(6), e0128498.
Vamos, C. A., Calvo, A. E., Daley, E. M., Giuliano, A. R., & López Castillo, H. (2015). Knowledge, behavioral, and sociocultural factors related to human papillomavirus infection and cervical cancer screening among inner-city women in panama. Journal of Community Health, 40(6), 1047-1056. doi: http://dx.doi.org.southuniversity.libproxy.edmc.edu/10.1007/s10900-015-0030-4
Wolwa, M., Blavo, C., Shah, R., Fleisher, J. M., & Espinal, T. (2013). Cervical cancer knowledge and prevention among college women. Journal of Community Health, 38(6), 997-1002. doi: http://dx.doi.org.southuniversity.libproxy.edmc.edu/10.1007/s10900-013-9707-8
