Views of Irish general practitioners on screening for cervical cancer

McDonald, P.; Herity, B.; Johnson, Z.; O'Kelly, Fergus Desmond

doi:10.1007/bf03173887

Cited by 7 publications

(6 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In order to keep equal access, one possible solution may be for gynecologists to share screening work with general physicians in regional areas. In several countries, medical systems that permit general physicians and midwives to take smears for cervical cancer screening are now seeing the benefit (Yabroff et al, 2009;McDonald et al, 2001;Ideström et al, 2007;Cooper and Saraiya, 2014;Poncet et al, 2016). These systems can help improve access to cancer screening programs, although they can also serve as a barrier to referring abnormal results to gynecologists.…”

Section: Discussionmentioning

confidence: 99%

National Data Analysis and Systematic Review for Human Resources for Cervical Cancer Screening in Japan

Hamashima

Sasaki

Hosono³

et al. 2021

Asian Pac J Cancer Prev

View full text Add to dashboard Cite

Background: Although cervical cancer screening has been performed as a national program since 1983 in Japan, the participation rate has remained below 20%. Equity of access is a basic requirement for cancer screening. However, taking smears from the cervix has been limited to gynecologists or obstetricians in Japan and it might be a barrier for accessibility. We examined the current access and its available human resources for cervical cancer screening in Japan. Methods: We analyzed the number of gynecologists and obstetricians among 47 prefectures based on a national survey. A systematic review was performed to clarify disparity and use of human resources in cervical cancer screening, diagnosis, and treatment for cervical cancers in Japan. Candidate literature was searched using Ovid-MEDLINE and Ichushi-Web until the end of January 2020. Then, a systematic review regarding accessibility to cervical cancer screening was performed. The results of the selected articles were summarized in the tables. Results: Although the total number of all physicians in Japan increased from 1996 to 2016, the proportion of gynecologists and obstetricians has remained at approximately 5% over the last 2 decades. 43.6% of municipalities have no gynecologists and obstetricians in 2016. Through a systematic review, 4 English articles and 1 Japanese article were selected. From these 5 articles, the association between human resources and participation rates in cervical cancer screening was examined in 2 articles. Conclusions: The human resources for taking smears for cervical cancer screening has remained insufficient with a huge disparity among municipalities in Japan. To improve accessibility for cervical cancer screening another option which may be considered could be involving general physicians as potential smear takers.

show abstract

Section: Discussionmentioning

confidence: 99%

National Data Analysis and Systematic Review for Human Resources for Cervical Cancer Screening in Japan

Hamashima

Sasaki

Hosono³

et al. 2021

Asian Pac J Cancer Prev

View full text Add to dashboard Cite

show abstract

“…However, although family and general physicians were more likely to follow the speci ed guidelines used by gynecologists [26], some nonexpert physicians feel that there are some barriers in accurately taking Pap smears, such as the lack of a training system [30]. Similar problems have been suggested in studies conducted in European countries [28,29,31]. On the other hand, even if general physicians have no constraint in taking Pap smears, they often hesitate to perform them because they believe that women are better served if Pap smears are taken by gynecologists [30,31].…”

Section: Consent Publicationmentioning

confidence: 97%

“…To increase the participation rate and improve treatment results, sharing various screening works with other health professionals, particularly taking Pap smears, should be considered in Japan. In several countries, medical systems that permit general physicians and midwives to take Pap smears for cervical cancer screening are now seeing the bene t [27][28][29][30][31]. These systems can help improve access to cancer screening programs, although they can also serve as a barrier to referring abnormal results to gynecologists.…”

Section: Consent Publicationmentioning

confidence: 99%

National data analysis and systematic review for human resources for cervical cancer screening in Japan: Who should take Pap smears for cervical cancer screening?

Hamashima¹,

Sasaki²,

Hoshi³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Although cervical cancer screening has been performed as a national program since 1983 in Japan, taking Pap smears from the cervix has usually been performed by gynecologists and obstetricians in their offices. Conventionally, general physicians and midwives cannot take Pap smears of cervical cancer screening in Japan. Accessibility is one of the important factors to consider when planning to increase the participation rate in cancer screening programs. Gynecologists also play a primary role in the diagnosis and treatment of cervical cancers. Discussions regarding the needed human resources for cancer screening programs have remained scared in Japan. Methods: We examined the number of gynecologists and obstetricians based on a national survey. Candidate literature was searched using Ovid-MEDLINE and Ichushi-Web until the end of January 2019. Then, a systematic review regarding accessibility to cervical cancer screening was performed. The results of the selected articles were summarized in the tables.Results: Although the total number of all physicians in Japan increased from 1996 to 2016, the proportion of gynecologists and obstetricians has remained at approximately 5% over the last 2 decades. However, 43.6% of municipalities have no gynecologists and obstetricians in 2016. Five articles identified from Ovid-MEDLINE and Ichushi-Web were eligible and assessed. Two Japanese studies showed consistent results regarding the association of resources as gynecologists and obstetricians with participation rates in cervical cancer screening. Another article reported on the national distribution of gynecological oncologists and compared the treatment outcomes between hospitals with and without certified gynecologists. The number of certified gynecological oncologists has remained insufficient with a biased distribution. Thus, the survival rate of cervical cancer patients was different between hospitals with and without accreditation by academic society. Although the perspectives of selected articles were different, the results suggested the burden to access to cervical cancer screening and consequent diagnosis and treatment.Conclusions: The human resources for taking Pap smears for cervical cancer screening has remained insufficient with a huge disparity among municipalities in Japan. Enabling general physicians to take Pap smears or the introduction of self-sampling HPV testing may be considered to augment the limited access to cervical cancer screening.

show abstract

“…Being a woman [14, 15] and working in a group practice [16] are examples of individual characteristics associated with GP’s provision of screening. Some other characteristics such as age [13, 17, 18] are inconsistently associated with the performance of CCS, and others such as practicing complementary and alternative medicine (CAM) have never been studied.…”

Section: Introductionmentioning

confidence: 99%

“…Besides individual characteristics, the contextual aspects of the physicians’ office, like the density of gynaecologists, could also shape GPs’ gynaecological activities. The most frequently tested contextual characteristics, working in a rural area, is inconsistently associated with GP’s involvement in the screening [16, 19]. Even if the socio-economic level of the neighbourhood and the primary care supplies of the physician office could also modify GPs’ gynaecological activities, very few studies focusing on contextual aspects have been conducted and only two used a representative nationwide sample [20, 21].…”

Section: Introductionmentioning

confidence: 99%

General practitioners who never perform Pap smear: the medical offer and the socio-economic context around their office could limit their involvement in cervical cancer screening

et al. 2019

View full text Add to dashboard Cite

Background In France, with the growing scarcity of gynecologists and a globally low and socially differentiated coverage of cervical cancer screening (CCS), general practitioners (GPs) are valuable resources to improve screening services for women. Still all GPs do not perform Pap smears. In order to promote this screening among GPs, the characteristics of physicians who never perform CCS should be more precisely specified. Besides already-known individual characteristics, the contextual aspects of the physicians’ office, such as gynecologist density in the area, could shape GPs gynecological activities. Methods To analyze county ( département ) characteristics of GPs’ office associated with no performance of CCS, we used a representative sample of 1063 French GPs conducted in 2009 and we constructed mixed models with two levels, GP and county. Results Almost 35% ( n = 369) of the GPs declared never performing CCS. GPs working in counties with a poor GP-density per inhabitants were more likely to perform CCS (odds ratio (OR) = 0.52 for each increase of density by 1 GP per 10,000 inhabitants, 95% confidence interval (CI) = 0.37–0.74). On the contrary, GPs working in counties with an easier access to a gynecologist were more likely not to perform CCS (OR = 1.06 for each increase of density by 1 gynecologist per 100,000 women, 95%CI = 1.03–1.10 and OR = 2.02 if the first gynecologist is reachable in less than 15 min, 95%CI = 1.20–3.41) as well as GPs working in areas with a poverty rate above the national average (OR = 1.66, 95%CI = 1.09–2.54). These contextual characteristics explain most of the differences between counties concerning rates of not performing CCS. Conclusions Specific programs should be developed for GPs working in contexts unfavorable to their involvement in CCS.

show abstract

Views of Irish general practitioners on screening for cervical cancer

Abstract: GPs will support a national cervical screening programme but a number of organisational issues must be discussed with them to ensure a successful programme.

Cited by 7 publications

References 1 publication

National Data Analysis and Systematic Review for Human Resources for Cervical Cancer Screening in Japan

National Data Analysis and Systematic Review for Human Resources for Cervical Cancer Screening in Japan

National data analysis and systematic review for human resources for cervical cancer screening in Japan: Who should take Pap smears for cervical cancer screening?

General practitioners who never perform Pap smear: the medical offer and the socio-economic context around their office could limit their involvement in cervical cancer screening

Contact Info

Product

Resources

About