PDF(Pubmed)
Abstract：
Background and objective Cervical cancer is the second most common malignancy among Indian women. In 2018, the World Health Organization (WHO) called for global action toward the elimination of cervical cancer through the triple-intervention strategy. One of its pillars is ensuring 70% screening coverage of eligible women with a high-performance test at least twice in their lifetime. Various factors contribute to the delayed diagnosis of cervical cancer, increasing the burden of the disease. In this study, we aimed to determine the healthcare provider (HCP)-related factors in the diagnostic delay of advanced cervical cancer. Methods This prospective cross-sectional study was conducted over two months in the cancer clinic of the Department of Obstetrics and Gynecology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India. We interviewed 384 women diagnosed with advanced cervical cancer [the International Federation of Gynecology and Obstetrics (FIGO) stage IB3-IVB] by using a questionnaire to capture data inputs regarding the various healthcare services they had received in the past 10 years along with details of HCPs. The collected data were analyzed using the software STATA version 17.0. Results Among 384 participants, 185 (48.1%) had interacted with an HCP in the past 10 years; 157 (40.8%) of them had visited a healthcare facility. Among these 185 women, only 22.16% had been advised to undergo screening, and only 15.18% had been tested despite several having access to primary health centers within 10 km of their residence. The lack of screening guidance by HCPs accounted for 78% of delayed diagnoses of cervical cancer. Conclusions Based on our findings, a deficiency in screening guidance in the asymptomatic period by healthcare providers across various levels of our healthcare system contributed significantly to the delayed diagnosis of cervical cancer.
摘要：
背景与目的宫颈癌是印度女性中第二常见的恶性肿瘤。2018年，世界卫生组织（WHO）呼吁采取全球行动，通过三重干预战略消除宫颈癌。它的支柱之一是确保70％的合格妇女一生中至少两次进行高性能测试的筛查覆盖率。各种因素导致宫颈癌的延迟诊断，增加疾病的负担。在这项研究中,我们旨在确定晚期宫颈癌诊断延迟的医疗保健提供者(HCP)相关因素.方法这项前瞻性横断面研究在妇产科肿瘤门诊进行了两个月，Jawaharlal研究生医学教育与研究学院（JIPMER），Puducherry,印度。我们采访了384名被诊断为晚期宫颈癌的妇女[国际妇产科联合会（FIGO）IB3-IVB阶段]，方法是使用问卷调查来获取有关他们在过去10年中接受的各种医疗保健服务的数据输入以及HCP的详细信息。使用STATA软件17.0版分析收集的数据。结果在384名参与者中，在过去的10年中，有185人（48.1％）与HCP进行了互动；其中157人（40.8％）去过医疗机构。在这185名女性中，只有22.16%被建议接受筛查，尽管有几个人可以进入其居住地10公里范围内的初级保健中心，但只有15.18％的人接受了测试。HCP缺乏筛查指导占宫颈癌延迟诊断的78％。结论根据我们的发现，我们各级医疗保健系统的医疗保健提供者在无症状期的筛查指导不足导致了宫颈癌的延迟诊断。
