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南亚宫颈癌常规筛查证据的范围综述:调查影响采用和实施的因素

A scoping review of evidence on routine cervical cancer screening in South Asia: investigating factors affecting adoption and implementation.

作者信息

Rajkhowa Priyobrat, Mathew Mebin, Fadra Razeena, Saha Soumyajit, Rakshitha K, Narayanan Prakash, Brand Helmut

机构信息

Department of Health Policy, Prasanna School of Public Health (PSPH), Manipal Academy of Higher Education (MAHE), Manipal, 576104, Karnataka, India.

Department of International Health, Care and Public Health Research Institute - CAPHRI, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.

出版信息

Cancer Causes Control. 2025 Jan;36(1):67-79. doi: 10.1007/s10552-024-01923-y. Epub 2024 Oct 7.

Abstract

UNLABELLED

NEED: Cervical cancer is a major global public health issue, particularly affecting low and middle-income countries, distinctly in the South Asian region. This geographical region lacks a well-organized routine cervical screening program. Consequently, this scoping review aimed to investigate the evidence on factors influencing the adoption and implementation of routine cervical cancer screening in South Asia.

METHODS

Adopting the "Arksey and O'Malley and Levac et al." methodology, databases such as PubMed, CINAHL, Web of Science, and Scopus were scrutinized in the pursuit of relevant studies. Subsequently, the collected data were synthesized by adopting the Consolidated Framework for Implementation Research (CFIR) model.

RESULTS

A total of 837 records were initially identified and screened for eligibility, including 55 studies. The successful adoption and implementation of cervical cancer screening in South Asia encounter numerous obstacles within the health system, including the absence of a comprehensive program protocol for screening, inadequate health infrastructure, and the presence of multiple sociocultural factors, such as social stigma, low levels of education, and concerns related to modesty.

CONCLUSION

To optimize adoption and implementation, it is imperative to construct a customized policy framework that incorporates a risk communication strategy tailored to the specific contexts of these nations. Drawing insights from the experiences of South Asian countries in executing cervical cancer screening programs can inform the formulation of policies for similar healthcare initiatives aimed at facilitating the expansion of HPV vaccination efforts.

摘要

未标注

需求:宫颈癌是一个重大的全球公共卫生问题,尤其影响低收入和中等收入国家,在南亚地区表现得尤为明显。该地理区域缺乏一个组织完善的常规宫颈癌筛查项目。因此,本范围综述旨在调查影响南亚地区常规宫颈癌筛查采用和实施的因素的证据。

方法

采用“阿克西和奥马利以及莱瓦克等人”的方法,对诸如PubMed、CINAHL、科学网和Scopus等数据库进行审查以寻找相关研究。随后,采用实施研究综合框架(CFIR)模型对收集到的数据进行综合分析。

结果

最初共识别并筛选了837条记录以确定其 eligibility,其中包括55项研究。南亚地区宫颈癌筛查的成功采用和实施在卫生系统内面临众多障碍,包括缺乏全面的筛查项目方案、卫生基础设施不足以及存在多种社会文化因素,如社会耻辱感、教育水平低以及对端庄得体的担忧。

结论

为了优化采用和实施,必须构建一个定制的政策框架,其中纳入针对这些国家具体情况的风险沟通策略。借鉴南亚国家实施宫颈癌筛查项目的经验可为制定类似医疗保健举措的政策提供参考,以促进人乳头瘤病毒疫苗接种工作的扩大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81ef/11761498/53ecf3d8d6da/10552_2024_1923_Fig1_HTML.jpg

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