Pub Date : 2023-06-01DOI: 10.1158/1538-7755.asgcr23-abstract-40
Samantha Sadler, Erick Torio, Alexandra Golby
Abstract Background: Cancer surgery is a resource-intensive yet essential component of cancer care. In the face of projected increase in cancer burden, the present gap in cancer surgery care in low-resource settings with stressed healthcare and surgical infrastructure risks further exacerbation. Understanding the current state of global cancer surgery is essential to determining the best way forward. Purpose: The objectives of this report are to (1) describe the landscape of global cancer surgery literature and (2) characterize these findings through a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis. Methods: A literature review was performed of global cancer surgery studies involving low-resource settings published since the landmark 2015 Lancet Commission on Global Surgery and Global Cancer Surgery. Studies were summarized and evaluated for themes, which were further grouped into SWOT categories for analysis. Results: The online literature search yielded 123 articles, of which 46 articles met inclusion criteria for analysis. The majority of included studies were open access (n=34) and published between 2021 and 2022 (n=26). Conclusion: The body of published global cancer surgery literature is growing, perhaps reflecting increased research attention and valuation. From the reviewed literature, Strengths of the global cancer surgery field include a body of studies investigating important aspects of cancer surgery in low-resource settings: local cancer epidemiology, local surgical and technological innovation, quality-of-life as a key surgical outcome metric, and advancements in cancer surgery through interdisciplinary work. Weaknesses include systems-level limitations (i.e. resources, perioperative services, broader health system gaps) and a paucity of detailed economic analyses. Opportunities include diverse local cancer management strategies, successful inter-setting collaborations supporting research, education, and surgical skills training, and thoughtful research expansion for an inclusive future. Threats include large-scale stresses on local healthcare infrastructure (i.e. COVID-19) and the risk of widening disparities posed by unchecked technological. Conclusion: This SWOT analysis may inform local intervention strategies and action plans to help LMIC stakeholders achieve cancer surgery goals. Similar analyses are needed locally to help elucidate best practices that might be applied or tailored to similar settings globally. Citation Format: Samantha Sadler, Erick Torio, Alexandra Golby. Global Cancer Surgery in Low-Resource Settings: A Strengths, Weaknesses, Opportunities, and Threats Analysis [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 40.
背景:肿瘤手术是癌症治疗中资源密集型的重要组成部分。面对预计的癌症负担的增加，目前在低资源环境中，在医疗保健和手术基础设施紧张的情况下，癌症手术护理的差距有进一步加剧的风险。了解全球癌症手术的现状对于确定最佳的前进道路至关重要。目的:本报告的目的是(1)描述全球癌症手术文献的概况，(2)通过优势、劣势、机会和威胁(SWOT)分析来描述这些发现。方法:对具有里程碑意义的2015年柳叶刀全球外科和全球癌症外科委员会以来发表的涉及低资源环境的全球癌症外科研究进行文献综述。对研究主题进行总结和评估，并进一步分组为SWOT分类进行分析。结果:网络文献检索得到123篇，其中46篇符合纳入标准。大多数纳入的研究是开放获取的(n=34)，发表于2021年至2022年之间(n=26)。结论:全球发表的癌症外科文献数量正在增长，这可能反映了研究的关注度和价值的提高。从文献综述来看，全球癌症手术领域的优势包括在低资源环境下研究癌症手术的重要方面:当地癌症流行病学，当地手术和技术创新，作为关键手术结果指标的生活质量，以及通过跨学科工作在癌症手术方面的进展。弱点包括系统层面的限制(即资源、围手术期服务、更广泛的卫生系统差距)和缺乏详细的经济分析。机会包括多样化的当地癌症管理策略，成功的跨环境合作支持研究、教育和手术技能培训，以及为包容性未来进行深思熟虑的研究扩展。威胁包括对当地医疗基础设施的大规模压力(即COVID-19)以及不受控制的技术造成的差距扩大的风险。结论:SWOT分析可以为当地的干预策略和行动计划提供信息，帮助LMIC利益相关者实现癌症手术目标。需要在当地进行类似的分析，以帮助阐明可能适用于或适合于全球类似环境的最佳做法。引文格式:Samantha Sadler, Erick Torio, Alexandra Golby。低资源环境下的全球癌症手术:优势、劣势、机会和威胁分析[摘要]。第11届全球癌症研究年会论文集;缩小从研究到实施的差距;2023年4月4-6日。费城(PA): AACR;癌症流行病学杂志[j]; 2009;32(6 -增刊):摘要[40]。
{"title":"Abstract 40: Global Cancer Surgery in Low-Resource Settings: A Strengths, Weaknesses, Opportunities, and Threats Analysis","authors":"Samantha Sadler, Erick Torio, Alexandra Golby","doi":"10.1158/1538-7755.asgcr23-abstract-40","DOIUrl":"https://doi.org/10.1158/1538-7755.asgcr23-abstract-40","url":null,"abstract":"Abstract Background: Cancer surgery is a resource-intensive yet essential component of cancer care. In the face of projected increase in cancer burden, the present gap in cancer surgery care in low-resource settings with stressed healthcare and surgical infrastructure risks further exacerbation. Understanding the current state of global cancer surgery is essential to determining the best way forward. Purpose: The objectives of this report are to (1) describe the landscape of global cancer surgery literature and (2) characterize these findings through a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis. Methods: A literature review was performed of global cancer surgery studies involving low-resource settings published since the landmark 2015 Lancet Commission on Global Surgery and Global Cancer Surgery. Studies were summarized and evaluated for themes, which were further grouped into SWOT categories for analysis. Results: The online literature search yielded 123 articles, of which 46 articles met inclusion criteria for analysis. The majority of included studies were open access (n=34) and published between 2021 and 2022 (n=26). Conclusion: The body of published global cancer surgery literature is growing, perhaps reflecting increased research attention and valuation. From the reviewed literature, Strengths of the global cancer surgery field include a body of studies investigating important aspects of cancer surgery in low-resource settings: local cancer epidemiology, local surgical and technological innovation, quality-of-life as a key surgical outcome metric, and advancements in cancer surgery through interdisciplinary work. Weaknesses include systems-level limitations (i.e. resources, perioperative services, broader health system gaps) and a paucity of detailed economic analyses. Opportunities include diverse local cancer management strategies, successful inter-setting collaborations supporting research, education, and surgical skills training, and thoughtful research expansion for an inclusive future. Threats include large-scale stresses on local healthcare infrastructure (i.e. COVID-19) and the risk of widening disparities posed by unchecked technological. Conclusion: This SWOT analysis may inform local intervention strategies and action plans to help LMIC stakeholders achieve cancer surgery goals. Similar analyses are needed locally to help elucidate best practices that might be applied or tailored to similar settings globally. Citation Format: Samantha Sadler, Erick Torio, Alexandra Golby. Global Cancer Surgery in Low-Resource Settings: A Strengths, Weaknesses, Opportunities, and Threats Analysis [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 40.","PeriodicalId":9488,"journal":{"name":"Cancer Epidemiology, Biomarkers & Prevention","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135727421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Purpose: For a population of over 201 million, Nigeria has only 4 doctors per 10,000 patients and 16.1 nurses, midwives per 10,000 patients, and less than 100 clinical oncologists for over 100,000 cancer patients. While Nigeria has one of the worst disease burdens in the world and a workforce shortage; 9 in 10 Nigerian physicians are seeking opportunities to leave for the USA, UK, and Canada. To improve oncology care in Nigeria, it may be important to understand the push and pull factors contributing to the migration of the clinical oncology (CO) workforce. Mathew (2018), Vanderpuye, et al., (2019), Balogun, et al., (2017), and Adebayo, (2016) have done research on CO; however, their studies were vastly focused on the African continent and not country-specific nor focused on the CO workforce in Nigeria.The aim of this study is to explore the push and pull factors to stay or leave the clinical oncology workforce in Nigeria. Methods: Using a mixed-method research approach, 80 participants completed the questionnaire and 9 participants responded to semi-structured interviews. Multiple linear regression and Grounded theory were used for the data analysis. Results: The results show that CO workload and satisfaction were significantly related to turnover intention. The qualitative results showed that CO as a new area of specialization, mentorship, career growth, and attractiveness of radiation science are the pull factors. While, high CO workload, poor healthcare system, poor remuneration, corruption in the public sector, and a few other themes are push factors. Empathy for patients, patriotism and a sense of fulfillment unexpectedly emerged as retention factors in the study. Conclusion: Nigeria can improve patient treatment outcomes by the reduction of CO workload through the employment of more CO. More CO can be available for employment when they are attracted, and their training is optimized. Those employed can be retained by improving working conditions and introducing work benefits. Our recommendations are that health leaders should create more CO training and awareness of CO in Nigeria. Citation Format: Runcie C.W. Chidebe, Tochukwu C. Orjikor, Onyinye Balogun, Adedayo Joseph, Samantha Toland, Alison Simons. Leaving Cancer Patients Behind for Greener Pastures: The Clinical Oncology Workforce in Nigeria [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 58.
{"title":"Abstract 58: Leaving Cancer Patients Behind for Greener Pastures: The Clinical Oncology Workforce in Nigeria","authors":"Runcie C.W. Chidebe, Tochukwu C. Orjikor, Onyinye Balogun, Adedayo Joseph, Samantha Toland, Alison Simons","doi":"10.1158/1538-7755.asgcr23-abstract-58","DOIUrl":"https://doi.org/10.1158/1538-7755.asgcr23-abstract-58","url":null,"abstract":"Abstract Purpose: For a population of over 201 million, Nigeria has only 4 doctors per 10,000 patients and 16.1 nurses, midwives per 10,000 patients, and less than 100 clinical oncologists for over 100,000 cancer patients. While Nigeria has one of the worst disease burdens in the world and a workforce shortage; 9 in 10 Nigerian physicians are seeking opportunities to leave for the USA, UK, and Canada. To improve oncology care in Nigeria, it may be important to understand the push and pull factors contributing to the migration of the clinical oncology (CO) workforce. Mathew (2018), Vanderpuye, et al., (2019), Balogun, et al., (2017), and Adebayo, (2016) have done research on CO; however, their studies were vastly focused on the African continent and not country-specific nor focused on the CO workforce in Nigeria.The aim of this study is to explore the push and pull factors to stay or leave the clinical oncology workforce in Nigeria. Methods: Using a mixed-method research approach, 80 participants completed the questionnaire and 9 participants responded to semi-structured interviews. Multiple linear regression and Grounded theory were used for the data analysis. Results: The results show that CO workload and satisfaction were significantly related to turnover intention. The qualitative results showed that CO as a new area of specialization, mentorship, career growth, and attractiveness of radiation science are the pull factors. While, high CO workload, poor healthcare system, poor remuneration, corruption in the public sector, and a few other themes are push factors. Empathy for patients, patriotism and a sense of fulfillment unexpectedly emerged as retention factors in the study. Conclusion: Nigeria can improve patient treatment outcomes by the reduction of CO workload through the employment of more CO. More CO can be available for employment when they are attracted, and their training is optimized. Those employed can be retained by improving working conditions and introducing work benefits. Our recommendations are that health leaders should create more CO training and awareness of CO in Nigeria. Citation Format: Runcie C.W. Chidebe, Tochukwu C. Orjikor, Onyinye Balogun, Adedayo Joseph, Samantha Toland, Alison Simons. Leaving Cancer Patients Behind for Greener Pastures: The Clinical Oncology Workforce in Nigeria [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 58.","PeriodicalId":9488,"journal":{"name":"Cancer Epidemiology, Biomarkers & Prevention","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135728373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Purpose: Cervical cancer is the fourth most common cancer in women around the globe. It has been identified as the most common cancer in Tanzania, resulting in about 9772 new cases and 6695 deaths each year. Several research studies have identified the importance of adequate and timely policies and guidelines to optimize the cervical cancer prevention and treatment pathway in the nation. However, there is scant literature on the perspectives of all stakeholders (e.g., patients, key informants, healthcare providers, and non-healthcare providers). Our study aims to better understand the recommendations from important stakeholders to inform current and upcoming policies and guidelines, and overall, improve the cervical cancer screening and treatment cascade in rural Tanzania and other African countries. Methods: We leveraged a framework for conducting a health systems assessment to identify healthcare providers’ perspectives on effective cervical cancer screening, prevention and control in Tanzania. We adapted interview topic guides for cervical cancer screening using the health systems assessment framework conceptualized by Risso-Gill and colleagues designed initially for evaluating hypertension control. Study participants (71) were interviewed between 2014-2018. This included key stakeholders, patients, healthcare providers and non-healthcare providers. Results: Through the interviews and focus group discussions that were conducted, three major themes emerged: 1) policies and guidelines, 2) burden of disease in relation to policies, and 3) treatment and follow-up. Sub-themes relating to policies and guidelines included health policies, governmental influence, data collection, and revision of HPV vaccination guidelines. Sub-themes for burden of disease included the rise in overall cases of cervical cancer. Subthemes for treatment and follow-up included quality of care, dissatisfaction with care, and patient safety and well-being. Conclusion: It is evident that significant changes must be made to existing policies and guidelines to improve many aspects of the cervical cancer screening and treatment pathway, to benefit healthcare providers and patients alike in rural Tanzania. There is also a critical need to implement new initiatives and programs to increase uptake and allow for informed-decision making among women. Citation Format: Melinda Chelva, Sanchit Kaushal, Nicola West, Erica Erwin, Prisca Dominic Marandu, Safina Yuma, Donna Shelley, Karen Yeates. Examining Policies and Guidelines to Improve the Cervical Cancer Prevention and Treatment Pathway for Patients and Health Providers in Tanzania: A Qualitative Study [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 36.
{"title":"Abstract 36: Examining Policies and Guidelines to Improve the Cervical Cancer Prevention and Treatment Pathway for Patients and Health Providers in Tanzania: A Qualitative Study","authors":"Melinda Chelva, Sanchit Kaushal, Nicola West, Erica Erwin, Prisca Dominic Marandu, Safina Yuma, Donna Shelley, Karen Yeates","doi":"10.1158/1538-7755.asgcr23-abstract-36","DOIUrl":"https://doi.org/10.1158/1538-7755.asgcr23-abstract-36","url":null,"abstract":"Abstract Purpose: Cervical cancer is the fourth most common cancer in women around the globe. It has been identified as the most common cancer in Tanzania, resulting in about 9772 new cases and 6695 deaths each year. Several research studies have identified the importance of adequate and timely policies and guidelines to optimize the cervical cancer prevention and treatment pathway in the nation. However, there is scant literature on the perspectives of all stakeholders (e.g., patients, key informants, healthcare providers, and non-healthcare providers). Our study aims to better understand the recommendations from important stakeholders to inform current and upcoming policies and guidelines, and overall, improve the cervical cancer screening and treatment cascade in rural Tanzania and other African countries. Methods: We leveraged a framework for conducting a health systems assessment to identify healthcare providers’ perspectives on effective cervical cancer screening, prevention and control in Tanzania. We adapted interview topic guides for cervical cancer screening using the health systems assessment framework conceptualized by Risso-Gill and colleagues designed initially for evaluating hypertension control. Study participants (71) were interviewed between 2014-2018. This included key stakeholders, patients, healthcare providers and non-healthcare providers. Results: Through the interviews and focus group discussions that were conducted, three major themes emerged: 1) policies and guidelines, 2) burden of disease in relation to policies, and 3) treatment and follow-up. Sub-themes relating to policies and guidelines included health policies, governmental influence, data collection, and revision of HPV vaccination guidelines. Sub-themes for burden of disease included the rise in overall cases of cervical cancer. Subthemes for treatment and follow-up included quality of care, dissatisfaction with care, and patient safety and well-being. Conclusion: It is evident that significant changes must be made to existing policies and guidelines to improve many aspects of the cervical cancer screening and treatment pathway, to benefit healthcare providers and patients alike in rural Tanzania. There is also a critical need to implement new initiatives and programs to increase uptake and allow for informed-decision making among women. Citation Format: Melinda Chelva, Sanchit Kaushal, Nicola West, Erica Erwin, Prisca Dominic Marandu, Safina Yuma, Donna Shelley, Karen Yeates. Examining Policies and Guidelines to Improve the Cervical Cancer Prevention and Treatment Pathway for Patients and Health Providers in Tanzania: A Qualitative Study [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 36.","PeriodicalId":9488,"journal":{"name":"Cancer Epidemiology, Biomarkers & Prevention","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135728171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1158/1538-7755.asgcr23-abstract-39
Leith León-Maldonado, Raul U. Hernández-Ramírez, Leticia Torres-Ibarra, Donna Spiegelman, Sangini S Sheth, Eduardo Lazcano-Ponce, José Damián Cadena-Fiscal, Jorge Salmerón
Abstract Purpose: Unlike in high-income countries, where cervical cancer (CC) screening programs have resulted in a dramatic decrease in incidence and mortality of this nearly fully preventable disease, in low- and middle-income countries, the impact of these programs has been limited. Poor follow-up to abnormal cancer screening tests lessens the benefit of CC screening. We sought to identify multilevel factors at the level of patient, provider, and healthcare system related to receipt of screening results and attendance to colposcopy among patients with positive screening results in a CC screening program in Mexico. Methods: We studied 1,351 patients who were scheduled for colposcopy after testing positive for high-risk human papillomavirus in two screening demonstration studies conducted in Mexico City’s Tlalpan District (2017-2018). Multilevel factors associated with receipt of screening results and with adherence to a colposcopy appointment were identified using multivariable logistic regression. Results: Participants had a median age of 40 years, 58% had less than high school education, and 74% had a Pap screening recently (i.e., in the last 5 years). Fifty-five percent of participants retrieved their screening results at the healthcare facility before being reminded to do so. Greater adherence to obtaining screening test results was associated with providing an email address as contact information (Odds Ratio 1.35 [95% Confidence Interval 1.03-1.77]), attending a facility with family medicine (1.54 [1.07-2.21]), and receiving care from experienced nurses (1.85 [1.30-2.70]). Fifty-seven percent of participants attended their first scheduled colposcopy appointment. Providing a phone number as contact information was linked to improved adherence to colposcopy (1.27 [1.01-1.59]), whereas longer travel time between the healthcare facility and the colposcopy clinic was associated with a decrease in colposcopy adherence (0.68 [0.49-0.94]). Having a Pap recently was positively associated with better compliance with both outcomes (1.36 [0.96-1.94] for receiving results; 1.59 [1.10-2.29] for colposcopy adherence). Conclusion: We identified multilevel factors associated with abnormal test follow-up in patients in Mexico City. Additional research is necessary to design and test components for a multilevel intervention to address these factors and enable successful implementation of the follow-up process for abnormal screens from screening to diagnosis and treatment. Citation Format: Leith León-Maldonado, Raul U. Hernández-Ramírez, Leticia Torres-Ibarra, Donna Spiegelman, Sangini S Sheth, Eduardo Lazcano-Ponce, José Damián Cadena-Fiscal, Jorge Salmerón. Factors Associated With Receiving Results and Attending Colposcopy in Patients With Positive HPV Screens in Mexico City [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol B
目的:与高收入国家不同，宫颈癌(CC)筛查项目导致这种几乎完全可以预防的疾病的发病率和死亡率急剧下降，而在低收入和中等收入国家，这些项目的影响有限。对异常癌症筛查试验的不良随访减少了CC筛查的益处。在墨西哥的一个CC筛查项目中，我们试图在患者、提供者和医疗保健系统层面确定与接受筛查结果和参加阴道镜检查有关的多水平因素。方法:我们研究了在墨西哥城Tlalpan区(2017-2018)进行的两项筛查示范研究中高危人乳头瘤病毒检测阳性后计划进行阴道镜检查的1,351例患者。使用多变量逻辑回归确定与接受筛查结果和遵守阴道镜检查预约相关的多水平因素。结果:参与者的中位年龄为40岁，58%的人受教育程度低于高中，74%的人最近(即最近5年内)做过子宫颈抹片检查。55%的参与者在被提醒之前在医疗机构取回了他们的筛查结果。提供电子邮件地址作为联系信息(优势比1.35[95%置信区间1.03-1.77])、在家庭医疗机构就诊(优势比1.54[1.07-2.21])和接受经验丰富的护士护理(优势比1.85[1.30-2.70])与获得筛查结果的更强依从性相关。57%的参与者参加了第一次阴道镜检查预约。提供电话号码作为联系信息与提高阴道镜检查依从性相关(1.27[1.01-1.59])，而从医疗机构到阴道镜检查诊所之间的较长旅行时间与阴道镜检查依从性降低相关(0.68[0.49-0.94])。近期接受Pap检查与两种结果更好的依从性呈正相关(1.36 [0.96-1.94]);1.59[1.10-2.29]为阴道镜依从性)。结论:我们确定了与墨西哥城患者异常测试随访相关的多水平因素。需要进一步的研究来设计和测试多层次干预措施的组成部分，以解决这些因素，并使异常筛查从筛查到诊断和治疗的后续过程能够成功实施。引文格式:Leith León-Maldonado, Raul U. Hernández-Ramírez, Leticia Torres-Ibarra, Donna Spiegelman, Sangini S Sheth, Eduardo Lazcano-Ponce, jos Damián Cadena-Fiscal, Jorge Salmerón。墨西哥城HPV筛查阳性患者接受结果和参加阴道镜检查相关因素[摘要]。第11届全球癌症研究年会论文集;缩小从研究到实施的差距;2023年4月4-6日。费城(PA): AACR;癌症流行病学杂志[j]; 2009;32(6 -增刊):摘要第39期。
{"title":"Abstract 39: Factors Associated With Receiving Results and Attending Colposcopy in Patients With Positive HPV Screens in Mexico City","authors":"Leith León-Maldonado, Raul U. Hernández-Ramírez, Leticia Torres-Ibarra, Donna Spiegelman, Sangini S Sheth, Eduardo Lazcano-Ponce, José Damián Cadena-Fiscal, Jorge Salmerón","doi":"10.1158/1538-7755.asgcr23-abstract-39","DOIUrl":"https://doi.org/10.1158/1538-7755.asgcr23-abstract-39","url":null,"abstract":"Abstract Purpose: Unlike in high-income countries, where cervical cancer (CC) screening programs have resulted in a dramatic decrease in incidence and mortality of this nearly fully preventable disease, in low- and middle-income countries, the impact of these programs has been limited. Poor follow-up to abnormal cancer screening tests lessens the benefit of CC screening. We sought to identify multilevel factors at the level of patient, provider, and healthcare system related to receipt of screening results and attendance to colposcopy among patients with positive screening results in a CC screening program in Mexico. Methods: We studied 1,351 patients who were scheduled for colposcopy after testing positive for high-risk human papillomavirus in two screening demonstration studies conducted in Mexico City’s Tlalpan District (2017-2018). Multilevel factors associated with receipt of screening results and with adherence to a colposcopy appointment were identified using multivariable logistic regression. Results: Participants had a median age of 40 years, 58% had less than high school education, and 74% had a Pap screening recently (i.e., in the last 5 years). Fifty-five percent of participants retrieved their screening results at the healthcare facility before being reminded to do so. Greater adherence to obtaining screening test results was associated with providing an email address as contact information (Odds Ratio 1.35 [95% Confidence Interval 1.03-1.77]), attending a facility with family medicine (1.54 [1.07-2.21]), and receiving care from experienced nurses (1.85 [1.30-2.70]). Fifty-seven percent of participants attended their first scheduled colposcopy appointment. Providing a phone number as contact information was linked to improved adherence to colposcopy (1.27 [1.01-1.59]), whereas longer travel time between the healthcare facility and the colposcopy clinic was associated with a decrease in colposcopy adherence (0.68 [0.49-0.94]). Having a Pap recently was positively associated with better compliance with both outcomes (1.36 [0.96-1.94] for receiving results; 1.59 [1.10-2.29] for colposcopy adherence). Conclusion: We identified multilevel factors associated with abnormal test follow-up in patients in Mexico City. Additional research is necessary to design and test components for a multilevel intervention to address these factors and enable successful implementation of the follow-up process for abnormal screens from screening to diagnosis and treatment. Citation Format: Leith León-Maldonado, Raul U. Hernández-Ramírez, Leticia Torres-Ibarra, Donna Spiegelman, Sangini S Sheth, Eduardo Lazcano-Ponce, José Damián Cadena-Fiscal, Jorge Salmerón. Factors Associated With Receiving Results and Attending Colposcopy in Patients With Positive HPV Screens in Mexico City [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol B","PeriodicalId":9488,"journal":{"name":"Cancer Epidemiology, Biomarkers & Prevention","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135727417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：