#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Patient factors affecting successful linkage to treatment in a cervical cancer prevention program in Kenya: A prospective cohort study


Autoři: Charlotte M. Page aff001;  Saduma Ibrahim aff002;  Lawrence P. Park aff003;  Megan J. Huchko aff001
Působiště autorů: Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina, United States of America aff001;  Kenya Medical Research Institute, Nairobi, Kenya aff002;  Department of Medicine, Division of Infectious Diseases, Duke University, Durham, North Carolina, United States of America aff003;  Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America aff004
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0222750

Souhrn

Objective

To identify patient factors associated with whether women who screened positive for high-risk human papillomavirus (hrHPV) successfully accessed treatment in a cervical cancer prevention program in Kenya.

Methods

A prospective cohort study was conducted as part of a trial of implementation strategies for hrHPV-based cervical cancer screening in western Kenya from January 2018 to February 2019. In this larger trial, women underwent hrHPV testing during community health campaigns (CHCs), and hrHPV+ women were referred to government facilities for cryotherapy. For this analysis, we looked at rates of and predictors of presenting for treatment and presenting within 30 days of receiving positive hrHPV results (“timely” presentation). Data came from questionnaires completed at the time of screening and treatment. Multivariable logistic regression was used to identify factors associated with each outcome.

Results

Of the 505 hrHPV+ women, 266 (53%) presented for treatment. Cryotherapy was performed in 236 (89%) of the women who presented, while 30 (11%) were not treated: 15 (6%) due to gas outage, six (2%) due to pregnancy, five (2%) due to concern for cervical cancer, and four (2%) due to an unknown or other reason. After adjusting for other factors in the multivariable analysis, higher education level and missing work to come to the CHC were associated with presenting for treatment. Variables that were associated with increased likelihood of timely presentation were missing work to come to the CHC, absence of depressive symptoms, told by someone important to come to the CHC, and shorter distance to the treatment site.

Conclusion

The majority of hrHPV+ women who did not get treated were lost at the stage of decision-making or accessing treatment, with a small number encountering barriers at the treatment sites. Patient education and financial support are potential areas for intervention to increase rates of hrHPV+ women seeking treatment.

Klíčová slova:

Medicine and health sciences – Oncology – Cancers and neoplasms – Gynecological tumors – Cervical cancer – Cancer treatment – Cancer prevention – Diagnostic medicine – Cancer detection and diagnosis – Cancer screening – Pathology and laboratory medicine – Pathogens – Social sciences – Sociology – Education – Educational attainment – Biology and life sciences – Organisms – Viruses – DNA viruses – Papillomaviruses – Human papillomavirus – Microbiology – Medical microbiology – Microbial pathogens – Viral pathogens – Engineering and technology – Transportation – People and places – Population groupings – Age groups – Children – Families


Zdroje

1. International Agency for Research on Cancer. Cancer fact sheets: Cervix uteri: Globocan; 2018 [cited 2019 January 26]. https://gco.iarc.fr/today/data/factsheets/cancers/23-Cervix-uteri-fact-sheet.pdf.

2. Bruni L, Barrionuevo-Rosas L, Albero G, Serrano B, Mena M, Gómez D, et al. Human Papillomavirus and Related Diseases Report: Kenya. ICO Information Centre on HPV and Cancer, 2017.

3. Denny L, Kuhn L, Hu C-C, Tsai W-Y, Wright TC. Human Papillomavirus–Based Cervical Cancer Prevention: Long-term Results of a Randomized Screening Trial. JNCI: Journal of the National Cancer Institute. 2010;102:1557–67. doi: 10.1093/jnci/djq342 20884893

4. Sankaranarayanan R, Bhagwan N, Shastri S, Jayant K, Muwonge R, Budukh A, et al. HPV screening for cervical cancer in rural India. New England Journal of Medicine. 2009;360:1385–94. doi: 10.1056/NEJMoa0808516 19339719

5. Geng EH, Bansberg DR, Musinguzi N, Emenyonu N, Bwana MB, Yiannoutsos CT, et al. Understanding Reasons for and Outcomes of Patients Lost to Follow-Up in Antiretroviral Therapy Programs in Africa Through a Sampling-Based Approach. J Acquir Immune Defic Syndr. 2010;53:405–11. doi: 10.1097/QAI.0b013e3181b843f0 19745753

6. Geng EH, Odeny TA, Lyamuya R, Nakiwogga-Muwanga A, Diero L, Bwana M, et al. Retention in care and patient-reported reasons for undocumented transfer or stopping care among HIV-infected patients on antiretroviral therapy in Eastern Africa: Application of a sampling-based approach. Clinical Infectious Diseases. 2016;62:935–44. doi: 10.1093/cid/civ1004 26679625

7. Huchko MJ, Kahn JG, Smith JS, Hiatt RA, Cohen CR, Bukusi E. Study protocol for a cluster-randomized trial to compare human papillomavirus based cervical cancer screening in community-health campaigns versus health facilities in western Kenya. BMC Cancer. 2017;17:1–12.

8. World Health Organization. Comprehensive cervical cancer prevention and control: a healthier future for girls and women. World Health Organization; 2013.

9. Arbyn M, Verdoodt F, Snijders PJF, Verhoef VMJ, Suonio E, Dillner L, et al. Accuracy of human papillomavirus testing on self-collected versus clinician-collected samples: A meta-analysis. The Lancet Oncology. 2014;15:172–83. doi: 10.1016/S1470-2045(13)70570-9 24433684

10. Santesso N, Schünemann H, Blumenthal P, De Vuyst H, Gage J, Garcia F, et al. World Health Organization Guidelines: Use of cryotherapy for cervical intraepithelial neoplasia. International journal of gynaecology and obstetrics. 2012;118:97–102. doi: 10.1016/j.ijgo.2012.01.029 22727415

11. Kenya Ministry of Health. Kenya National Cancer Screening Guidelines. Nairobi, 2018. http://www.health.go.ke/wp-content/uploads/2019/02/National-Cancer-Screening-Guidelines-2018.pdf.

12. Rosser JI, Njoroge B, Huchko MJ. Changing knowledge, attitudes, and behaviors regarding cervical cancer screening: The effects of an educational intervention in rural Kenya. Patient Education and Counseling. 2015;98:884–9. doi: 10.1016/j.pec.2015.03.017 25858634


Článek vyšel v časopise

PLOS One


2019 Číslo 9
Nejčtenější tento týden
Nejčtenější v tomto čísle
Kurzy

Zvyšte si kvalifikaci online z pohodlí domova

plice
INSIGHTS from European Respiratory Congress
nový kurz

Současné pohledy na riziko v parodontologii
Autoři: MUDr. Ladislav Korábek, CSc., MBA

Svět praktické medicíny 3/2024 (znalostní test z časopisu)

Kardiologické projevy hypereozinofilií
Autoři: prof. MUDr. Petr Němec, Ph.D.

Střevní příprava před kolonoskopií
Autoři: MUDr. Klára Kmochová, Ph.D.

Všechny kurzy
Kurzy Podcasty Doporučená témata Časopisy
Přihlášení
Zapomenuté heslo

Zadejte e-mailovou adresu, se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.

Přihlášení

Nemáte účet?  Registrujte se

#ADS_BOTTOM_SCRIPTS#