Lifetime Prevalence of Cervical Cancer Screening in 55 Low- and Middle-Income Countries.

Journal: JAMA

Volume: 324

Issue: 15

Year of Publication: 2020

Affiliated Institutions:  Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany. Department of Applied Tumor Biology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany. Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Department of Economics and Centre for Modern Indian Studies, University of Goettingen, Göttingen, Germany. RWI-Leibniz Institute for Economic Research, Essen (Berlin office), Germany. Eswatini Ministry of Health, Mbabane, Eswatini. Non-Communicable Disease Department, National Center for Disease Control and Public Health, Tbilisi, Georgia. Division of Non-Communicable Diseases, Kenya Ministry of Health, Nairobi, Kenya. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Faculty of Medicine and Health Sciences, Universidade Nacional Timor Lorosa'e, Rua Jacinto Candido, Dili, Timor-Leste. Laboratory of Epidemiology of Chronic and Neurological Diseases, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin. Health Research and Epidemiology Unit, Ministry of Health, Thimphu, Bhutan. Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. MRC/Wits Rural Public Health and Health Transitions Research Unit, University of Witwatersrand School of Public Health, Johannesburg, South Africa. Department of Global Health and Population at the Harvard T.H. Chan School of Public Health, Boston, Massachusetts.

Abstract summary 

The World Health Organization is developing a global strategy to eliminate cervical cancer, with goals for screening prevalence among women aged 30 through 49 years. However, evidence on prevalence levels of cervical cancer screening in low- and middle-income countries (LMICs) is sparse.To determine lifetime cervical cancer screening prevalence in LMICs and its variation across and within world regions and countries.Analysis of cross-sectional nationally representative household surveys carried out in 55 LMICs from 2005 through 2018. The median response rate across surveys was 93.8% (range, 64.0%-99.3%). The population-based sample consisted of 1 136 289 women aged 15 years or older, of whom 6885 (0.6%) had missing information for the survey question on cervical cancer screening.World region, country; countries' economic, social, and health system characteristics; and individuals' sociodemographic characteristics.Self-report of having ever had a screening test for cervical cancer.Of the 1 129 404 women included in the analysis, 542 475 were aged 30 through 49 years. A country-level median of 43.6% (interquartile range [IQR], 13.9%-77.3%; range, 0.3%-97.4%) of women aged 30 through 49 years self-reported to have ever been screened, with countries in Latin America and the Caribbean having the highest prevalence (country-level median, 84.6%; IQR, 65.7%-91.1%; range, 11.7%-97.4%) and those in sub-Saharan Africa the lowest prevalence (country-level median, 16.9%; IQR, 3.7%-31.0%; range, 0.9%-50.8%). There was large variation in the self-reported lifetime prevalence of cervical cancer screening among countries within regions and among countries with similar levels of per capita gross domestic product and total health expenditure. Within countries, women who lived in rural areas, had low educational attainment, or had low household wealth were generally least likely to self-report ever having been screened.In this cross-sectional study of data collected in 55 low- and middle-income countries from 2005 through 2018, there was wide variation between countries in the self-reported lifetime prevalence of cervical cancer screening. However, the median prevalence was only 44%, supporting the need to increase the rate of screening.

Authors & Co-authors:  Lemp De Neve Bussmann Chen Manne-Goehler Theilmann Marcus Ebert Probst Tsabedze-Sibanyoni Sturua Kibachio Moghaddam Martins Houinato Houehanou Gurung Gathecha Farzadfar Dryden-Peterson Davies Atun Vollmer Bärnighausen Geldsetzer

Study Outcome 

Source Link: Visit source

Statistics
Citations :  Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424. doi:10.3322/caac.21492
Authors :  25
Identifiers
Doi : 10.1001/jama.2020.16244
SSN : 1538-3598
Study Population
Women
Mesh Terms
Adult
Other Terms
Study Design
Study Approach
Country of Study
Kenya
Publication Country
United States