Patient factors affecting successful linkage to treatment in a cervical cancer prevention program in Kenya: A prospective cohort study

English version

Autoři: Charlotte M. Page ^aff001; Saduma Ibrahim ^aff002; Lawrence P. Park ^aff003; Megan J. Huchko ^aff001
Působiště autorů: Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina, United States of America ^aff001; Kenya Medical Research Institute, Nairobi, Kenya ^aff002; Department of Medicine, Division of Infectious Diseases, Duke University, Durham, North Carolina, United States of America ^aff003; Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America ^aff004
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0222750

Souhrn

Objective

To identify patient factors associated with whether women who screened positive for high-risk human papillomavirus (hrHPV) successfully accessed treatment in a cervical cancer prevention program in Kenya.

Methods

A prospective cohort study was conducted as part of a trial of implementation strategies for hrHPV-based cervical cancer screening in western Kenya from January 2018 to February 2019. In this larger trial, women underwent hrHPV testing during community health campaigns (CHCs), and hrHPV+ women were referred to government facilities for cryotherapy. For this analysis, we looked at rates of and predictors of presenting for treatment and presenting within 30 days of receiving positive hrHPV results (“timely” presentation). Data came from questionnaires completed at the time of screening and treatment. Multivariable logistic regression was used to identify factors associated with each outcome.

Results

Of the 505 hrHPV+ women, 266 (53%) presented for treatment. Cryotherapy was performed in 236 (89%) of the women who presented, while 30 (11%) were not treated: 15 (6%) due to gas outage, six (2%) due to pregnancy, five (2%) due to concern for cervical cancer, and four (2%) due to an unknown or other reason. After adjusting for other factors in the multivariable analysis, higher education level and missing work to come to the CHC were associated with presenting for treatment. Variables that were associated with increased likelihood of timely presentation were missing work to come to the CHC, absence of depressive symptoms, told by someone important to come to the CHC, and shorter distance to the treatment site.

Conclusion

The majority of hrHPV+ women who did not get treated were lost at the stage of decision-making or accessing treatment, with a small number encountering barriers at the treatment sites. Patient education and financial support are potential areas for intervention to increase rates of hrHPV+ women seeking treatment.

Klíčová slova:

Biology and life sciences – Organisms – Engineering and technology – Social sciences – Sociology – People and places – Population groupings – Medicine and health sciences – Microbiology – Medical microbiology – Microbial pathogens – Pathology and laboratory medicine – Pathogens – Diagnostic medicine – Viral pathogens – Viruses – Oncology – Cancer treatment – Cancers and neoplasms – DNA viruses – Education – Transportation – Age groups – Children – Families – Papillomaviruses – Human papillomavirus – Cancer detection and diagnosis – Cancer screening – Gynecological tumors – Cervical cancer – Educational attainment – Cancer prevention

Zdroje

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