研究动态
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喀麦隆宫颈癌筛查计划的差异:对实施和接受筛查的促进因素与障碍的范围审查。

Disparities in cervical cancer screening programs in Cameroon: a scoping review of facilitators and barriers to implementation and uptake of screening.

发表日期:2023 Aug 17
作者: Namanou Ines Emma Woks, Musi Merveille Anwi, Taal Bernard Kefiye, Dohbit Julius Sama, Angel Phuti
来源: TROPICAL MEDICINE & INTERNATIONAL HEALTH

摘要:

宫颈癌是全球第四常见的癌症。组织筛查在许多高收入国家(HICs)中取得了显著的宫颈癌发病率和死亡率降低。但是,HIC与低中等收入国家(LMICs)之间的差距仍然很大,因为该疾病的最高负担在LMICs。喀麦隆是一个LMIC,宫颈癌是女性癌症相关死亡的主要原因,只有3-5%的合格女性进行了筛查,且没有有效的全国宫颈癌预防计划。识别喀麦隆现有宫颈癌筛查计划的实施和接受度的促进因素和障碍,以综合指导全面国家计划的实施。我们使用“系统评价和荟萃分析的首选报告项目,拓展范围评价”(PRISMA-ScR)进行范围性综述。从2012年至2022年,我们系统地搜索了Google Scholar和五个电子数据库(PubMed,CINAHL,Embase,Cochrane library和Web of Science)。符合条件的文章是关于喀麦隆宫颈癌筛查计划的。两位评审人员独立筛选搜索结果并提取相关数据。我们的搜索策略共确定了182篇文章,并纳入其中的20篇。喀麦隆的北部、南部和东部地区的发文较少。发现的障碍和促进因素使用世界卫生组织的卫生系统框架进行了描述。横向性的障碍包括:(1)缺乏国家筛查提供者的培训课程,没有明确、协调的宫颈癌前病变筛查和治疗算法;(2)女性缺乏关于宫颈癌筛查活动的信息。相反,在一些计划中为妇女提供低费用或无费用的筛查服务以及使用新的现场筛查方法如人乳头瘤病毒DNA检测的可行性被确定为促进因素。这项范围性综述表明喀麦隆的某些地区在宫颈癌筛查服务方面存在知识和研究空白。此外,它强调了有必要推行综合癌症控制政策和实践,整合所有六个卫生系统建设领域,以减少喀麦隆不同地区和城乡之间的差异。©2023年。Springer Nature旗下BioMed Central Ltd.
Cervical cancer is the fourth most common cancer worldwide. Organized screening has achieved significant reductions in cervical cancer incidence and mortality in many high-income countries (HICs). But the gap between HICs and low-and-middle-income countries (LMICs) is still substantial as the highest burden of the disease is in LMICs. Cameroon is a LMIC, where cervical cancer is the leading cause of cancer-related deaths among women, only 3-5% of eligible women have been screened and there is no effective national cervical cancer prevention program.Identify facilitators and barriers to the implementation and uptake of existing cervical cancer screening programs in Cameroon to inform the implementation of a comprehensive national program.We conducted a scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-analysis, extension for Scoping Reviews (PRISMA-ScR). Google Scholar and five electronic databases (PubMed, CINAHL, Embase, Cochrane library and Web of Science) were searched systematically from 2012 to 2022. Articles on cervical cancer screening programs in Cameroon were eligible for inclusion. Two reviewers independently screened search results and extracted relevant data.A total of 182 articles were identified using our search strategy, and 20 were included. There was scarcity of publications from the North, Adamawa, East and South regions of Cameroon. Barriers and facilitators found were presented using the World Health Organisation framework for health systems. Cross-cutting barriers were: (1) the lack of a national training curriculum for screening providers with no elaborate, harmonized screening and treatment algorithm for cervical precancers; and (2) women's lack of information about cervical cancer screening activities. Conversely, provision of screening services at a low or no cost to women in some programs and the feasibility of using novel point of care screening methods like the Human Papillomavirus DNA test were identified as facilitators.This scoping review indicates that there are knowledge and research gaps concerning the state of cervical cancer screening services in some regions of Cameroon. Moreover, it underlines the need for comprehensive cancer control policies and practices integrating all six-health system building blocks to reduce disparities between regions, and rural versus urban areas in Cameroon.© 2023. BioMed Central Ltd., part of Springer Nature.