Barriers to Cancer Screening Uptake in Women: A Qualitative Study from Tamil Nadu, India

Mahalakshmi, S.; Sundaram, Suresh

doi:10.31557/apjcp.2020.21.4.1081

Cited by 35 publications

(53 citation statements)

References 24 publications

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“…Apart from socio-economic barriers, knowledge, and health literacy, participation in cervical screening is also influenced by psychosocial variables [56]. These variables can be better understood and accounted for by utilizing theoretical models.…”

Section: Psychosocial Determinants Of Cervical Screeningmentioning

confidence: 99%

A comparison of behavioural models explaining cervical cancer screening uptake

et al. 2022

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Background Cervical cancer represents a very high burden of disease, especially in Low- and Middle-income economies. Screening is a recommended prevention method in resource-poor settings. Cervical cancer screening (CCS) uptake is influenced by various psycho-social factors, most of which are included in behavioural models. Unlike demographic characteristics, these factors are modifiable. While few studies have compared these models in terms of their capacity to predict health behaviour, this study considers three health behaviour theories to assess and compare the predictors of CCS behaviour and intention. Methods A survey was conducted among 607 sexually active women in the South Indian state of Karnataka. Data was collected regarding socio-demographic factors, health literacy, knowledge on CCS, and the socio-cognitive factors related to CCS that are represented in the Health Belief Model (HBM), Theory of Planned Behaviour (TPB) and Theory of Care-Seeking Behaviour (TCSB). Logistic regression analyses tested to what extent each of the theoretical models explained cervical cancer screening (CCS) intention and regular screening behaviour, comparing the variance explained by each of the models. Results CCS intention was best explained by the TPB, followed by the HBM. Of the constructs included in these models, positive attitude towards the screening procedure and perceived benefits contributed most significantly to screening intention, followed by fear, anxiety or embarrassment related to the disease or screening procedure, and context specific barriers. Conclusion Health behavioural models such as the TPB and HBM can help to identify the main socio-cognitive factors explaining the intention of women to participate in CCS. As such, they can inform interventions to target specific determinants of screening intention and behaviour, and enhance their effectiveness by addressing women’s screening attitude, perceived benefits, and emotions as well as reducing context specific barriers to screening.

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Section: Psychosocial Determinants Of Cervical Screeningmentioning

confidence: 99%

A comparison of behavioural models explaining cervical cancer screening uptake

et al. 2022

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“…The rise in morbidity and mortality due to cervical cancer urges the step towards prevention which includes activities at three tier of action at primary, secondary and tertiary 7 Vaccination for HPV infection and health education regarding, Increasing knowledge about cervical cancer are the primary level of activities, the secondary prevention includes early diagnosis and screening, and tertiary care includes palliative care and management for diagnosed cancer 2 The HPV vaccine licensed in India is not very advantageous due to dominant socioeconomic factors and the enormous cost of vaccination 8 The study done in the Kancheepuram district regarding the awareness and knowledge about cervical screening among married rural women indicates there existed a positive association between the variables of knowledge and awareness of cervical cancer prevention with restricted to only higher levels of educational, socio -economic and occupational status. 9 The study conducted in the tribal population of Madhya Pradesh in the year 2020 shows that lack of awareness about cervical cancer accounts for about 25.06% which holds the one of the important criteria for poor utilization of cervical cancer screening services 10 The research paper on knowledge about cervical cancer and Human Papiloma Virus among medical students of second and third year conducted in Belagavi states that knowledge regarding risk factors and prevention techniques were lacking 11 Screening not only helps to diagnose for cervical cancer even benefit the asymptomatic women by diagnosing the cancer in the Pre-cancer stage before it gets advanced in to invasive cancer for getting proper treatment and care 12 The data from the National family health survey fourth round reveals, the percentage of women ever screened for cervical cancer in tamilnadu among the age group of 15-49 were 24.4% only 13 The factors associated with the poor screening rate were absence of awareness, cultural ideologies, economic obstacle, and other health care system related factors,Psychosocial factors, fear of screening procedure and fear of being diagnosed with cancer 14 In India, Tamilnadu and Sikkim are the two locations where cervical cancer screening has been used in primary healthcare 15 Indeed, conspicuously the endeavor of the cervical cancer screening pilot project in tamilnadu towards the attempt for mobilization to screen for cervical cancer was restrained due to paucity in health education about cervical cancer 16 Effective health education is required to promote the cervical cancer screening and to address the factors associated with poor screening rate in rural India, the mass health education conducted in various parts of rural villages of Uttar Pradesh increased the screening rate to 39% included both cervical and breast cancer 17 The health education in the design of face to face reciprocated discussion and audio-visual media application was found to be effective in rural parts of tamilnadu 18 Regarding the screening procedures in India, visual inspection with acetic acid, Pap smear HPV are two common laboratory investigation procedure available for cancer detection…”

Section: Introductionmentioning

confidence: 99%

Impact of health education intervention in promoting cervical cancer screening among rural women of Chengalpattu district - The community based interventional study

Logaraj

2021

Clinical Epidemiology and Global Health

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Background:The incidence and prevalence of cervical cancer is on rise among rural women in Tamil Nadu. The scientific community is lobbying strongly in providing health education as a pre-emptive measure in reducing morbidity and mortality due to cervical cancer. This research explores the effective way of health communication towards the promotion of cervical cancer prevention and screening. Materials and methods: The community based interventional study was carried out from, sample of 370 rural women from Chengalpattu district of tamilnadu selected using multistage sampling method.A baseline and endline data were collected using standard questionnaire "Cervical Cancer Awareness Measure tool kit 2.1".After baseline data collection, health education on cervical cancer was imparted using Audio-Visual sources depicting the signs and symptoms, preventive measures, and the significance of getting screened at regular intervals for cervical cancer were exhibited in the local language. Call for screening camp was announced at regular intervals. Descriptive statistics, Paired t-test and Mean difference with 95% CI and screening rate from the women attending the screening camp was calculated. Results: Women aged 40-49 with 44.5% was the major study participants The significant difference was found to the factors, warning sign(p-value = 0.03; MD = 7.59; CI = 3.27-3.29), Risk factors(p-value = 0.02; MD = 21.32; CI = 21.2-21.4) and attitude towards screening (p-value = 0.003; MD = 0.85; CI = 0.79-0.81).The percentage of Screening rate was 31.1% after health education. Conclusion: Thus, the above-mentioned health education model has proved to be efficacious on cervical cancer prevention Research can be further up-scaled by integrating the benefit incidence and comparing with other health education models.

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“…Women with higher education and engagement professional occupations are more likely to be aware of their health conditions as well as the necessity of adopting preventive measures. So far, there is not sufficient research evidence on the barriers to cancer screening uptake among Indian women [ 34 – 36 ]. Evidence from the available small-scale studies reveals that there is a lack of awareness regarding the services and the risk factors of cancer among women.…”

Section: Discussionmentioning

confidence: 99%

Sociodemographic correlates of cervix, breast and oral cancer screening among Indian women

Zhu

Bishwajit

et al. 2022

PLoS ONE

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Introduction Cervix, breast and oral cancers account for about one-third of all cancers in India which as a group is a major contributor to all non-communicable disease-related morbidity and mortality among women. Existing evidence suggests that early diagnosis plays a pivotal role in the prevention and intervention of these cancers, and many community-based early screening and awareness programs have been in place in developed countries. Currently, there is not enough research evidence regarding the sociodemographic correlates of cervix, breast and oral cancer screening among Indian women. In the present study, we aimed to assess the self-reported percentage and sociodemographic factors associated with the use of these three types of cancer screening services among Indian women aged 15–49 years. Methods Data were collected from National Family Health Survey conducted during 2015–16. Sample population was 699,686 women aged 15–49 years. Associations between self-reported cervical, breast and oral cancer screening status and the associated sociodemographic factors were analyzed using multivariable logistic regression methods. Results The percentage of screening for cervical (21%), breast (8.95%), and oral cancers (13.45%) varied significantly across the population sub-groups. Higher age, urban residence, higher education, having employment, health insurance, use of electronic media, higher household wealth quintile, having healthcare autonomy, showed a positive effect on taking screening services. Further analyses revealed that the strength of the associations varied considerably between urban and rural residents, denoting the need for region-specific intervention strategies. Sex of household head, age, watching TV, using radio, and having health insurance were the most significant contributors to the outcome effects. Conclusions The present study provides important insights regarding the current scenario of seeking cancer screening services among women in India. These findings could inform policy analysis and make an avenue for further in-depth analysis for future studies. Our findings conclude that cancer prevention policies should focus on leveraging the positive effects of better socioeconomic status, employment, health insurance ownership, exposure to electronic media, and better healthcare autonomy to improve the cancer screening service uptake among Indian women.

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Barriers to Cancer Screening Uptake in Women: A Qualitative Study from Tamil Nadu, India

Cited by 35 publications

References 24 publications

A comparison of behavioural models explaining cervical cancer screening uptake

A comparison of behavioural models explaining cervical cancer screening uptake

Impact of health education intervention in promoting cervical cancer screening among rural women of Chengalpattu district - The community based interventional study

Sociodemographic correlates of cervix, breast and oral cancer screening among Indian women

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