Title: Clinical Audit: Exploring barriers to Cervical Cancer Screening Compliance
Authors: Omar Kasmieh, Mustafa Salah, Raed Azzam
DOI: https://dx.doi.org/10.18535/jmscr/v12i11.02
Abstract
Background
Human papillomavirus (HPV) DNA is detected in 99% of cervical cancer cases; however, the infection alone in individuals with a healthy immune system does not lead to the development of invasive cervical cancer (Gates et al., 2021).
The development of cervical cancer is influenced by several other risk factors beyond HPV infection, including: Pre-cancerous cervical lesions, history of HPV-related vulval or vaginal dysplasia, Immunosuppression, Infrequent participation in cervical screening programs, lower socioeconomic status, an earlier onset of sexual activity, an increasing number of sexual partners or engagement with high-risk sexual partners, history of sexually transmitted infections, prolonged use of oral contraceptives, a young age at first full-term pregnancy, high number of full-term pregnancies, smoking, in utero exposure to diethylstilboestrol (DES), and family history of cervical cancer due to the association with some rare genetic disorders (Cohen et al., 2019; Okunade, 2019; Stumbar et al., 2019).
Cervical cancer can be effectively prevented through HPV vaccination and cervical screening programs. As a result of these initiatives, there has been a decrease in the number of individuals being diagnosed with cervical cancer. Nevertheless, there continues to be an average of 171 new cases (from 2015 – 2020) and 53 fatalities (from 2015 – 2018 due to cervical cancer in New Zealand annually ( Health New Zealand. Te Whatu Ora, 2022).
References
- Cohen, Paul A, et al. “Cervical Cancer.” The Lancet, vol. 393, no. 10167, Jan. 2019, pp. 169–182, pubmed.ncbi.nlm.nih.gov/30638582/, https://doi.org/10.1016/s0140-6736(18)32470-x . Accessed 10 Aug. 2024.
- Gates, Allison, et al. “Screening for the Prevention and Early Detection of Cervical Cancer: Protocol for Systematic Reviews to Inform Canadian Recommendations.” Systematic Reviews, vol. 10, no. 1, 2 Jan. 2021, pp. 2–3, https://doi.org/10.1186/s13643-020-01538-9 . Accessed 10 Aug. 2024.
- Health New Zealand. Te Whatu Ora (2022).Historical Cancer Data 14 Nov. 2022, Available at: www.tewhatuora.govt.nz/for-health-professionals/data-and-statistics/nz-health-statistics/health-statistics-and-data-sets/cancer-data-and-statistics/historical-cancer/ . Accessed 10 Aug. 2024.
- Health New Zealand. Te Whatu Ora (2024). Immunisation Handbook 19 Aug. 2024, Available at: www.tewhatuora.govt.nz/for-health-professionals/clinical-guidance/immunisation-handbook . Accessed 24 Aug. 2024.
- O’Hallahan, J, et al. Clinical Practice Guidelines for Cervical Screening in Aotearoa New Zealand. June 2023. https://www.tewhatuora.govt.nz/assets/Our-health-system/Screening/HPV-Primary-Screening/clinical_practice_guidelines_final_version_1.1.pdf . Accessed 10 Aug. 2024.
- Okunade, Kehinde Sharafadeen. “Human Papillomavirus and Cervical Cancer.” Journal of Obstetrics and Gynaecology, vol. 40, no. 5, 10 Sept. 2019, pp. 602–608, https://doi.org/10.1080/01443615.2019.1634030. Accessed 10 Aug. 2024.
- Stumbar SE, Stevens M, Feld Z. Cervical Cancer and Its Precursors: A Preventative Approach to Screening, Diagnosis, and Management. Prim Care. 2019 Mar;46(1):117-134. doi: 10.1016/j.pop.2018.10.011. Epub 2018 Dec 22. PMID: 30704652 .