Discipline of Public Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4000, South Africa.
Burden of Disease Research Unit, South African Medical Research Council, Cape Town 7505, South Africa.
Int J Environ Res Public Health. 2022 Jul 28;19(15):9207. doi: 10.3390/ijerph19159207.
Cervical cancer (CC) is the most common viral infection of the reproductive tract and in Sub-Saharan Africa (SSA), its morbidity and mortality rates are high. The aim of this review was to map evidence on CC management in SSA. The scoping review was conducted in accordance with Arksey and O'Malley's scoping review framework. The review included studies on different aspects of CC management. The review was also done following the steps and guidelines outlined in the PRISMA-Extension for Scoping Reviews (PRISMA-ScR) checklist. The following databases were searched: PubMed, EBSCOhost, Scopus and Cochrane Database of Systematic Review. A total of 1121 studies were retrieved and 49 which were eligible for data extraction were included in the review. The studies were classifiable in 5 groups: 14 (28.57%) were on barriers to CC screening, 10 (20.41%) on factors associated with late-stage presentation at diagnosis, 11 (22.45%) on status of radiotherapy, 4 (8.20%) on status of chemotherapy and 10 (20.41%) on factors associated with high HPV coverage. High HPV vaccine coverage can be achieved using the class school-based strategy with opt-out consent form process. Barriers to CC screening uptake included lack of knowledge and awareness and unavailability of screening services. The reasons for late-stage presentation at diagnosis were unavailability of screening services, delaying whilst using complementary and alternative medicines and poor referral systems. The challenges in chemotherapy included unavailability and affordability, low survival rates, treatment interruption due to stock-outs as well as late presentation. Major challenges on radiotherapy were unavailability of radiotherapy, treatment interruption due to financial constraints, and machine breakdown and low quality of life. A gap in understanding the status of CC management in SSA has been revealed by the study implying that, without full knowledge of the extent of CC management, the challenges and opportunities, it will be difficult to reduce infection, improve treatment and palliative care. Research projects assessing knowledge, attitude and practice of those in immediate care of girls at vaccination age, situational analysis with health professionals and views of patients themselves is important to guide CC management practice.
宫颈癌（CC）是生殖道最常见的病毒感染，在撒哈拉以南非洲（SSA），其发病率和死亡率都很高。本综述的目的是绘制 SSA 中 CC 管理的证据图。该范围综述是根据 Arksey 和 O'Malley 的范围综述框架进行的。该综述包括了关于 CC 管理各个方面的研究。该综述还按照 PRISMA-扩展范围综述（PRISMA-ScR）清单中概述的步骤和指南进行。以下数据库进行了检索：PubMed、EBSCOhost、Scopus 和 Cochrane 系统评价数据库。共检索到 1121 项研究，其中 49 项符合数据提取标准纳入综述。这些研究可分为 5 组：14 项（28.57%）研究与 CC 筛查障碍相关，10 项（20.41%）研究与诊断时晚期表现相关的因素相关，11 项（22.45%）研究与放射治疗状况相关，4 项（8.20%）研究与化疗状况相关，10 项（20.41%）研究与与高 HPV 覆盖率相关的因素相关。使用具有选择退出同意书流程的班级为基础的策略，可以实现 HPV 疫苗的高覆盖率。CC 筛查接受率低的原因包括缺乏知识和意识以及缺乏筛查服务。诊断时晚期表现的原因是缺乏筛查服务，在使用补充和替代药物时会推迟，以及转诊系统差。化疗面临的挑战包括缺乏可及性和可负担性、生存率低、由于缺货而中断治疗以及晚期出现。放疗的主要挑战包括缺乏放疗、由于财务限制中断治疗、机器故障以及生活质量低。研究揭示了对 SSA 中 CC 管理状况缺乏了解的情况，这意味着，如果没有对 CC 管理的范围、挑战和机遇有全面的了解，将难以减少感染、改善治疗和姑息治疗。评估直接照顾女孩接种疫苗年龄的人知识、态度和实践的研究项目、对卫生专业人员的情况分析以及患者自身的意见对于指导 CC 管理实践非常重要。
