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Barriers and facilitators to cervical cancer screening among under-screened women in Cuenca, Ecuador: the perspectives of women and health professionals

BACKGROUND: Cervical cancer screening is a cost-effective method responsible for reducing cervical cancer-related mortality by 70% in countries that have achieved high coverage through nationwide screening strategies. However, there are disparities in access to screening. In Ecuador, although cervic...

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Autores principales: Vega Crespo, Bernardo, Neira, Vivian Alejandra, Ortíz Segarra, José, Andrade, Andrés, Guerra, Gabriela, Ortiz, Stalin, Flores, Antonieta, Mora, Lorena, Verhoeven, Veronique, Gama, Ana, Dias, Sónia, Verberckmoes, Bo, Vermandere, Heleen, Michelsen, Kristien, Degomme, Olivier
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9682802/
https://www.ncbi.nlm.nih.gov/pubmed/36414955
http://dx.doi.org/10.1186/s12889-022-14601-y
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author Vega Crespo, Bernardo
Neira, Vivian Alejandra
Ortíz Segarra, José
Andrade, Andrés
Guerra, Gabriela
Ortiz, Stalin
Flores, Antonieta
Mora, Lorena
Verhoeven, Veronique
Gama, Ana
Dias, Sónia
Verberckmoes, Bo
Vermandere, Heleen
Michelsen, Kristien
Degomme, Olivier
author_facet Vega Crespo, Bernardo
Neira, Vivian Alejandra
Ortíz Segarra, José
Andrade, Andrés
Guerra, Gabriela
Ortiz, Stalin
Flores, Antonieta
Mora, Lorena
Verhoeven, Veronique
Gama, Ana
Dias, Sónia
Verberckmoes, Bo
Vermandere, Heleen
Michelsen, Kristien
Degomme, Olivier
author_sort Vega Crespo, Bernardo
collection PubMed
description BACKGROUND: Cervical cancer screening is a cost-effective method responsible for reducing cervical cancer-related mortality by 70% in countries that have achieved high coverage through nationwide screening strategies. However, there are disparities in access to screening. In Ecuador, although cervical cancer is the second most common cancer in women, only 58.4% of women of reproductive age have ever been screened for cervical cancer. METHODOLOGY: A qualitative study was performed to understand the current barriers to screening and to identify strategies that could increase uptake in Azuay province, Ecuador. Seven focus group discussions (FGDs) were conducted with under-screened women and health professionals (HPs). The FGDs were recorded and transcribed. Content analysis was done using the socio-ecological framework to categorize and analyse the data. RESULTS: Overall, 28 women and 27 HPs participated in the study. The two groups perceived different barriers to cervical cancer screening. The HPs considered barriers to be mainly at the policy level (lack of a structured screening plan; lack of health promotion) and the individual level (lack of risk perception; personal beliefs). The women identified barriers mainly at organizational level, such as long waiting times, lack of access to health centres, and inadequate patient–physician communication. Both groups mentioned facilitators at policy level, such as national campaigns promoting cervical cancer screening, and at community and individual level, including health literacy and women’s empowerment. CONCLUSIONS: The women considered access to health services the main barrier to screening, while the HPs identified a lack of investment in screening programmes and cultural patterns at the community level as major obstacles. To take an integrated approach to cervical cancer prevention, the perspectives of both groups should be taken into account. Additionally, new strategies and technologies, such as self-administered human papillomavirus (HPV) testing and community participation, should be implemented to increase access to cervical cancer screening.
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spelling pubmed-96828022022-11-24 Barriers and facilitators to cervical cancer screening among under-screened women in Cuenca, Ecuador: the perspectives of women and health professionals Vega Crespo, Bernardo Neira, Vivian Alejandra Ortíz Segarra, José Andrade, Andrés Guerra, Gabriela Ortiz, Stalin Flores, Antonieta Mora, Lorena Verhoeven, Veronique Gama, Ana Dias, Sónia Verberckmoes, Bo Vermandere, Heleen Michelsen, Kristien Degomme, Olivier BMC Public Health Research BACKGROUND: Cervical cancer screening is a cost-effective method responsible for reducing cervical cancer-related mortality by 70% in countries that have achieved high coverage through nationwide screening strategies. However, there are disparities in access to screening. In Ecuador, although cervical cancer is the second most common cancer in women, only 58.4% of women of reproductive age have ever been screened for cervical cancer. METHODOLOGY: A qualitative study was performed to understand the current barriers to screening and to identify strategies that could increase uptake in Azuay province, Ecuador. Seven focus group discussions (FGDs) were conducted with under-screened women and health professionals (HPs). The FGDs were recorded and transcribed. Content analysis was done using the socio-ecological framework to categorize and analyse the data. RESULTS: Overall, 28 women and 27 HPs participated in the study. The two groups perceived different barriers to cervical cancer screening. The HPs considered barriers to be mainly at the policy level (lack of a structured screening plan; lack of health promotion) and the individual level (lack of risk perception; personal beliefs). The women identified barriers mainly at organizational level, such as long waiting times, lack of access to health centres, and inadequate patient–physician communication. Both groups mentioned facilitators at policy level, such as national campaigns promoting cervical cancer screening, and at community and individual level, including health literacy and women’s empowerment. CONCLUSIONS: The women considered access to health services the main barrier to screening, while the HPs identified a lack of investment in screening programmes and cultural patterns at the community level as major obstacles. To take an integrated approach to cervical cancer prevention, the perspectives of both groups should be taken into account. Additionally, new strategies and technologies, such as self-administered human papillomavirus (HPV) testing and community participation, should be implemented to increase access to cervical cancer screening. BioMed Central 2022-11-22 /pmc/articles/PMC9682802/ /pubmed/36414955 http://dx.doi.org/10.1186/s12889-022-14601-y Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Vega Crespo, Bernardo
Neira, Vivian Alejandra
Ortíz Segarra, José
Andrade, Andrés
Guerra, Gabriela
Ortiz, Stalin
Flores, Antonieta
Mora, Lorena
Verhoeven, Veronique
Gama, Ana
Dias, Sónia
Verberckmoes, Bo
Vermandere, Heleen
Michelsen, Kristien
Degomme, Olivier
Barriers and facilitators to cervical cancer screening among under-screened women in Cuenca, Ecuador: the perspectives of women and health professionals
title Barriers and facilitators to cervical cancer screening among under-screened women in Cuenca, Ecuador: the perspectives of women and health professionals
title_full Barriers and facilitators to cervical cancer screening among under-screened women in Cuenca, Ecuador: the perspectives of women and health professionals
title_fullStr Barriers and facilitators to cervical cancer screening among under-screened women in Cuenca, Ecuador: the perspectives of women and health professionals
title_full_unstemmed Barriers and facilitators to cervical cancer screening among under-screened women in Cuenca, Ecuador: the perspectives of women and health professionals
title_short Barriers and facilitators to cervical cancer screening among under-screened women in Cuenca, Ecuador: the perspectives of women and health professionals
title_sort barriers and facilitators to cervical cancer screening among under-screened women in cuenca, ecuador: the perspectives of women and health professionals
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9682802/
https://www.ncbi.nlm.nih.gov/pubmed/36414955
http://dx.doi.org/10.1186/s12889-022-14601-y
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