Barriers to cervical cancer screening and acceptability of HPV self-testing: a cross-sectional comparison between ethnic groups in Southern Thailand
Background Cervical cancer rates are higher in low-resourced countries than high, partly due to lower rates of screening. Incidence in Thailand is nearly three times higher than in the USA (16.2 vs 6.5 age-standardised incidence), even with Thailand’s universal health coverage, which includes screen...
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| Format: | Article |
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BMJ Publishing Group
2019-11-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/11/e031957.full |
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| author | Anna Gottschlich Rafael Meza Thanatta Nuntadusit Katie R Zarins Manila Hada Nareerat Chooson Surichai Bilheem Raphatphorn Navakanitworakul Kesara Nittayaboon Shama Virani Laura Rozek Hutcha Sriplung |
| author_facet | Anna Gottschlich Rafael Meza Thanatta Nuntadusit Katie R Zarins Manila Hada Nareerat Chooson Surichai Bilheem Raphatphorn Navakanitworakul Kesara Nittayaboon Shama Virani Laura Rozek Hutcha Sriplung |
| author_sort | Anna Gottschlich |
| collection | DOAJ |
| description | Background Cervical cancer rates are higher in low-resourced countries than high, partly due to lower rates of screening. Incidence in Thailand is nearly three times higher than in the USA (16.2 vs 6.5 age-standardised incidence), even with Thailand’s universal health coverage, which includes screening, suggesting that alternative methods are needed to reduce the burden. We investigated barriers to screening, as well as acceptability of self-collection human papillomavirus (HPV) testing as a primary form of cervical cancer screening among Buddhist and Muslim communities in Southern Thailand.Methods 267 women from the Buddhist district of Ranot and Muslim district of Na Thawi, Songkhla were recruited to complete a survey assessing knowledge and risk factors of HPV and cervical cancer. Participants were offered an HPV self-collection test with a follow-up survey assessing acceptability. Samples were processed at Prince of Songkhla University and results were returned to participants.Results 267 women participated in the study (132 Buddhist, 135 Muslim), 264 (99%) self-collecting. 98% reported comfort and ease, and 70% preferred it to doctor-facilitated cytology. The main predictor of prior screening was religion (92% Buddhist vs 73% Muslim reporting prior Pap). After adjustment with multivariate logistic models, Muslim women had an OR of prior Pap of 0.30 compared with Buddhist (95% CI: 0.12 to 0.66).Conclusions Self-collection HPV testing was highly acceptable across religious groups, suggesting that it could be beneficial for cervical cancer reduction in this region. Focus should be put into educating women from all backgrounds about the importance of screening to further improve screening rates among Thai women. |
| format | Article |
| id | doaj-art-9d41faa5cf3b4c7b9aa9ba24d9991b1a |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-9d41faa5cf3b4c7b9aa9ba24d9991b1a2024-11-29T02:00:10ZengBMJ Publishing GroupBMJ Open2044-60552019-11-0191110.1136/bmjopen-2019-031957Barriers to cervical cancer screening and acceptability of HPV self-testing: a cross-sectional comparison between ethnic groups in Southern ThailandAnna Gottschlich0Rafael Meza1Thanatta Nuntadusit2Katie R Zarins3Manila Hada4Nareerat Chooson5Surichai Bilheem6Raphatphorn Navakanitworakul7Kesara Nittayaboon8Shama Virani9Laura Rozek10Hutcha Sriplung111 Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA8 Cancer Epidemiology and Prevention Program, University of Michigan Rogel Cancer Center, Ann Arbor, United States2 Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand3 Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, United States1 Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA2 Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand2 Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand4 Department of Biomedical Sciences, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand4 Department of Biomedical Sciences, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand2 Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand3 Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, United States2 Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, ThailandBackground Cervical cancer rates are higher in low-resourced countries than high, partly due to lower rates of screening. Incidence in Thailand is nearly three times higher than in the USA (16.2 vs 6.5 age-standardised incidence), even with Thailand’s universal health coverage, which includes screening, suggesting that alternative methods are needed to reduce the burden. We investigated barriers to screening, as well as acceptability of self-collection human papillomavirus (HPV) testing as a primary form of cervical cancer screening among Buddhist and Muslim communities in Southern Thailand.Methods 267 women from the Buddhist district of Ranot and Muslim district of Na Thawi, Songkhla were recruited to complete a survey assessing knowledge and risk factors of HPV and cervical cancer. Participants were offered an HPV self-collection test with a follow-up survey assessing acceptability. Samples were processed at Prince of Songkhla University and results were returned to participants.Results 267 women participated in the study (132 Buddhist, 135 Muslim), 264 (99%) self-collecting. 98% reported comfort and ease, and 70% preferred it to doctor-facilitated cytology. The main predictor of prior screening was religion (92% Buddhist vs 73% Muslim reporting prior Pap). After adjustment with multivariate logistic models, Muslim women had an OR of prior Pap of 0.30 compared with Buddhist (95% CI: 0.12 to 0.66).Conclusions Self-collection HPV testing was highly acceptable across religious groups, suggesting that it could be beneficial for cervical cancer reduction in this region. Focus should be put into educating women from all backgrounds about the importance of screening to further improve screening rates among Thai women.https://bmjopen.bmj.com/content/9/11/e031957.full |
| spellingShingle | Anna Gottschlich Rafael Meza Thanatta Nuntadusit Katie R Zarins Manila Hada Nareerat Chooson Surichai Bilheem Raphatphorn Navakanitworakul Kesara Nittayaboon Shama Virani Laura Rozek Hutcha Sriplung Barriers to cervical cancer screening and acceptability of HPV self-testing: a cross-sectional comparison between ethnic groups in Southern Thailand BMJ Open |
| title | Barriers to cervical cancer screening and acceptability of HPV self-testing: a cross-sectional comparison between ethnic groups in Southern Thailand |
| title_full | Barriers to cervical cancer screening and acceptability of HPV self-testing: a cross-sectional comparison between ethnic groups in Southern Thailand |
| title_fullStr | Barriers to cervical cancer screening and acceptability of HPV self-testing: a cross-sectional comparison between ethnic groups in Southern Thailand |
| title_full_unstemmed | Barriers to cervical cancer screening and acceptability of HPV self-testing: a cross-sectional comparison between ethnic groups in Southern Thailand |
| title_short | Barriers to cervical cancer screening and acceptability of HPV self-testing: a cross-sectional comparison between ethnic groups in Southern Thailand |
| title_sort | barriers to cervical cancer screening and acceptability of hpv self testing a cross sectional comparison between ethnic groups in southern thailand |
| url | https://bmjopen.bmj.com/content/9/11/e031957.full |
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