School of Public Health, Psychological Research Institute, UCLouvain University of Belgium, Louvain-la-neuve, Belgium.
Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Asian Pac J Cancer Prev. 2020 Aug 1;21(8):2209-2215. doi: 10.31557/APJCP.2020.21.8.2209.
Cervical cancer is a major reason for morbidity and mortality in Low and Middle income countries. The National Programme for Prevention and Control of Cancers, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) sets out broad national guideline to implement Cervical cancer screening. However, an implementation strategy for cervical cancer screening is not in place for districts. Although opportunistic screening takes place, implementation is hindered by psychological and physical barriers for women, as well as insufficient capacity on the part of implementers. This qualitative study aims to identify the specific barriers that prevent the uptake of cervical cancer screening.
Women who could benefit from cervical cancer program were interviewed to explore the factors that influenced their uptake of the cervical screening offered. Key informant interviews were conducted with implementers of the NPCDCS and with public health staff of three States (Himachal Pradesh, Meghalaya and Karnataka), to understand their perception of determinants of the utilization of screening services.
The general health concern among the participants was low, and routine check-ups were considered unimportant. Poor knowledge about cervical cancer, benefits of screening service availability, as well as a general sense of well-being, embarrassment or anxiety related to the screening procedure, fear of being judged for lack of modesty, and stigma were common barriers to screening uptake. In addition to a general unawareness of cervical cancer geographical inaccessibility of screening as a barrier to participate in cervical cancer screening, in certain regions.
It is essential to increase the knowledge on cervical cancer and on the benefits of screening among Indian women. Providing information and cues to action by health workers and professionals can facilitate the decision to participate. Implementers need to be involved to ensure context specific implementation of the National programme to overcome these barriers.
宫颈癌是中低收入国家发病率和死亡率的主要原因。国家癌症、糖尿病、心血管疾病和中风防控计划（NPCDCS）制定了广泛的国家准则，以实施宫颈癌筛查。然而，各地区尚未制定宫颈癌筛查实施策略。尽管有机会性筛查，但由于妇女的心理和身体障碍，以及实施者能力不足，实施受到阻碍。本定性研究旨在确定阻止宫颈癌筛查采用的具体障碍。
对可能受益于宫颈癌项目的妇女进行访谈，以探讨影响其接受提供的宫颈癌筛查的因素。对 NPCDCS 的实施者以及三个邦（喜马偕尔邦、梅加拉亚邦和卡纳塔克邦）的公共卫生工作人员进行了重点人物访谈，以了解他们对决定筛查服务利用的因素的看法。
参与者的一般健康关注度较低，常规检查被认为不重要。对宫颈癌的知识了解甚少、筛查服务的可用性的益处，以及一般的幸福感、与筛查程序相关的尴尬或焦虑、害怕因缺乏端庄而受到评判，以及污名化，是筛查采用的常见障碍。除了普遍缺乏对宫颈癌的认识以及对参与宫颈癌筛查的地理可达性的障碍外，某些地区的人还缺乏对宫颈癌的认识。
提高印度妇女对宫颈癌和筛查益处的认识至关重要。卫生工作者和专业人员提供信息和行动线索可以促进参与决策。实施者需要参与进来，以确保在特定情况下实施国家计划，以克服这些障碍。
