Exploring Women’s Challenge to Pap Smear Attendance and Colposcopy Referral: A Qualitative Study
Main Article Content
Abstract
Introduction: The greatest protection against cervical cancer can be achieved through the combination of cervical screening via repeated Pap tests and HPV vaccination before first sexual intercourse. This study aimed to explore women’s perceptions and experiences of Pap test and colposcopy examination to avoid advance stage of cervical cancer. Methods: An exploratory qualitative approach was carried out using face-to face semi-structured interviews with 22 women attending for their Pap test appointment or colposcopy examination in the main hospital in Kirkuk, Iraq. The study took place between October 2019 and March 2020. The collected data were analysed using induc- tive content analysis. Results: The findings revealed gap in knowledge regarding Pap test and colposcopy investiga- tion among participants. Overall, three main categories emerged during data analyses namely, women’s awareness of Pap test; challenges to access cervical screening and colposcopy services; women’s views and suggestions to improve their access to cervical screening cervices. Conclusion: Currently, women living in Iraq have no access to regular cervical screening due to unavailability of the cervical screening programme in Iraq. This study provides evidence to develop strategies to enhance the existing cervical cancer prevention services. Health policy makers should consider the establishment of regular population based cervical screening. Health promotion efforts and in- terventions should focus on challenges and barriers influence the screening behavior among women living in Iraq.
Downloads
Article Details
References
Aminisani N, Armstrong BK, Canfell K. Cervical cancer screening in Middle Eastern and Asian migrants to Australia: a record linkage study. Cancer epidemiology. 2012 Dec 1;36(6):e394-
doi:10.1016/j.canep.2012.08.009
Goddard M, Smith P. Equity of access to health care services: Theory and evidence from the UK. Social science & medicine. 2001 Nov 1;53(9):1149-62. doi:10.1016/s0277-9536(00)00415-9
Scarinci IC, Garcia FA, Kobetz E, Partridge EE, Brandt HM, Bell MC, Dignan M, Ma GX, Daye JL, Castle PE. Cervical cancer prevention: new tools and old barriers. Cancer: Interdisciplinary International Journal of the American Cancer Society. 2010 Jun 1;116(11):2531-42. doi:10.1002/cncr.25065
Bruni l, Barrionuevo-rosas L, albero G, Serrano B, Bosch fx, Mena M, Gomez D, Muñoz J & Desanjose,
S. ICO Information Centre on HPV and Cancer (HPV Information Centre). Human papillomavirus and Related Diseases in Iraq. Summary Report 15 December 2016; 5-20. Retrievedfrom http://www. hpvcentre.net/statistics/reports/XWX.pdf
Sankaranarayanan R, Budukh AM, Rajkumar R. Effective screening programmes for cervical cancer in low-and middle-income developing countries. Bulletin of the World Health Organization. 2001;79:954-62.
Al Meer FM, Aseel MT, Al Khalaf J, Al Kuwari MG, Ismail MF. Knowledge, attitude and practices regarding cervical cancer and screening among women visiting primary health care in Qatar. EMHJ- Eastern Mediterranean Health Journal (2011); 17
(11), 855-861. doi:10.26719/2011.17.11.856
Arbyn M, Castellsagué X, de Sanjosé S, Bruni L, Saraiya M, Bray F, Ferlay J. Worldwide burden of cervical cancer in 2008. Annals of oncology. 2011 Dec 1;22 (12):2675-86. doi:10.1093/annonc/ mdr015
Everett T, Bryant A, Griffin MF, Martin-Hirsch PP, Forbes CA, Jepson RG. Interventions targeted at women to encourage the uptake of cervical screening. Cochrane database of systematic reviews. 2011(5). doi:10.1002/14651858.
cd002834.pub2
Ibeanu, O. A. (2011) Molecular pathogenesis of cervical cancer. Cancer biology & therapy, 11, 295-306. doi:10.4161/cbt.11.3.14686
Guimond ME, Salman K. Modesty matters: cultural sensitivity and cervical cancer prevention in Muslim women in the United States. Nursing for women’s health. 2013 Jun 1;17(3):210-7. doi:10.1111/1751-486x.12034
Matin M, LeBaron S. Attitudes toward cervical cancer screening among Muslim women: a pilot
study. Women & health. 2004 Jun 30;39(3):63-77. doi:10.1300/j013v39n03_05
Galletta A. Mastering the semi-structured interview and beyond. New York University Press; 2013 Jun
doi:10.18574/nyu/9780814732939.001.0001
Ali S, Skirton H, Clark MT, Donaldson C. Integrative review of cervical cancer screening in Western Asian and Middle Eastern Arab countries. Nursing & health sciences. 2017 Dec;19(4):414-
doi:10.1111/nhs.12374
Olubunmi OA, Timothy IO, Alabi AO, Israel OT. Competitive strategies of selected quantity surveying firms in Nigeria. International Journal of Management, Information Technology and Engineering. 2014;2(11):1-8.
Castleberry A, Nolen A. Thematic analysis of qualitative research data: is it as easy as it sounds?. Currents in pharmacy teaching and learning. 2018 Jun 1;10(6):807-15. doi:10.1016/j. cptl.2018.03.019
Braun V, Clarke V. Using thematic analysis in psychology. Qualitative research in psychology. 2006 Jan 1;3(2):77-101 doi:10.1191/1478088706qp063oa
Corbin J, Strauss A. Basics of qualitative research: Techniques and procedures for developing
grounded theory. Sage publications; 2014 Nov 25. doi:10.4135/9781452230153.n1
Saadoon OZ, Amin RM, Jadoo SA. Factors influencing pap smear practice among primary school teachers in Diyala city, Iraq. Malays J Public Health Med. 2014 Jan 1;14(1):19-28.
Hweissa NA, Lim JN, Su TT. Health-care providers’ perceptions, attitudes towards and recommendation practice of cervical cancer screening. European journal of cancer care. 2016 Sep;25(5):864-70 doi:10.1111/ecc.12537.
Ali SM, Clark MT, Khedher Ghalib A, Skirton H, Donaldson C. “We don’t have up to date knowledge about the disease” Practical challenges encountered in delivery of cervical cancer screening in Iraq. European Journal of Cancer Care. 2021 May 1:e13457. doi:10.1111/ecc.13457
Khan S, Woolhead G. Perspectives on cervical cancer screening among educated Muslim women in Dubai (the UAE): a qualitative study. BMC women’s health. 2015 Dec;15(1):1-3. doi:10.1186/ s12905-015-0252-8
Sharma M. Theoretical foundations of health education and health promotion. Jones & Bartlett Learning; 2021 Jul 15.