Cervical cancer screening utilization and predictors among eligible women in Ethiopia: A systematic review and meta-analysis.
Cervical cancer screening utilization and predictors among eligible women in Ethiopia: A systematic review and meta-analysis.
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DOI：
10.1371/journal.pone.0259339
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Yeshitila YG
中科院分区：
文献类型：
--
作者：
Desta M;Getaneh T;Yeserah B;Worku Y;Eshete T;Birhanu MY;Kassa GM;Adane F;Yeshitila YG
尽管在降低全球孕产妇死亡率方面取得了显著进展，但宫颈癌已被确定为孕产妇发病和死亡的主要原因，特别是在撒哈拉以南非洲国家。子宫颈癌普查服务一直被证明能有效降低子宫颈癌的发病率和死亡率。尽管如此，在埃塞俄比亚进行的评估宫颈癌筛查及其预测因素的研究有限，这些研究显示出不一致和不确定的结果。因此，本系统性综述和荟萃分析旨在评估埃塞俄比亚符合条件的妇女的合并宫颈癌筛查利用率及其预测因素。系统检索PubMed、Web of Science、SCOPUS、CINAHL、Psychinfo、Google Scholar、Science Direct和科克伦图书馆等数据库。纳入了埃塞俄比亚所有报告宫颈癌筛查利用率和/或其预测因素的观察性研究。两位作者使用标准化数据提取格式独立提取了所有必要的数据。患病率研究的质量评估标准改编自纽卡斯尔渥太华质量评估量表。采用科克伦Q检验和I2检验进行异质性分析。采用随机效应分析模型估计宫颈癌筛查利用率和相关因素的汇总患病率及其95%置信区间（CI）。从850篇潜在相关文章中，25项研究共纳入18，067名合格女性。汇总的全国宫颈癌筛查利用率为14.79%（95% CI：11.75，17.83）。宫颈癌筛查的利用率最高的是南方民族和人民地区（SNNPR），最低的是阿姆哈拉地区（13.62%）。亚组分析显示，艾滋病毒阳性妇女的合并宫颈癌筛查率最高（20.71%）。这项荟萃分析还显示，缺乏妇女的正规教育使宫颈癌筛查利用率降低了67% [POR = 0.33，95%CI：0.23，0.46]。对宫颈筛查有良好认识的女性[POR = 3.01，95%CI：2.2.6，4.00]，对宫颈癌的敏感性[POR = 4.9，95%CI：3.67，6.54]，宫颈癌的严重程度[POR = 6.57，95%CI：有性传播感染史者[POR = 5.39，95%CI：1.41，20.58]更有可能进行宫颈癌筛查。此外，认为自己健康（48.97%）和缺乏宫颈癌筛查信息（34.34%）是利用宫颈癌筛查的主要障碍。这项荟萃分析发现，符合条件的妇女接受宫颈癌筛查的比例远低于世卫组织的建议。在埃塞俄比亚，每七名妇女中只有一名接受宫颈癌筛查。根据地理区域和妇女的特点，宫颈癌筛查存在显著差异。受教育程度、对宫颈癌筛查的了解、对宫颈癌的易感性和严重性以及性传播感染史显著增加了筛查实践的采用。因此，增强妇女权能、提高对子宫颈癌筛查的认识、提高对癌症的易感性和严重性的认识以及确定妇女的既往病史是改善子宫颈癌筛查实践的重要策略。
Despite a remarkable progress in the reduction of global rate of maternal mortality, cervical cancer has been identified as the leading cause of maternal morbidity and mortality, particularly in sub-Saharan African countries. The uptake of cervical cancer screening service has been consistently shown to be effective in reducing the incidence rate and mortality from cervical cancer. Despite this, there are limited studies in Ethiopia that were conducted to assess the uptake of cervical cancer screening and its predictors, and these studies showed inconsistent and inconclusive findings. Therefore, this systematic review and meta-analysis was conducted to estimate the pooled cervical cancer screening utilization and its predictors among eligible women in Ethiopia. Databases like PubMed, Web of Science, SCOPUS, CINAHL, Psychinfo, Google Scholar, Science Direct, and the Cochrane Library were systematically searched. All observational studies reporting cervical cancer screening utilization and/ or its predictors in Ethiopia were included. Two authors independently extracted all necessary data using a standardized data extraction format. Quality assessment criteria for prevalence studies were adapted from the Newcastle Ottawa quality assessment scale. The Cochrane Q test statistics and I2 test were used to assess the heterogeneity of studies. A random effects model of analysis was used to estimate the pooled prevalence of cervical cancer screening utilization and factors associated with it with the 95% confidence intervals (CIs). From 850 potentially relevant articles, twenty-five studies with a total of 18,067 eligible women were included in this study. The pooled national cervical cancer screening utilization was 14.79% (95% CI: 11.75, 17.83). The highest utilization of cervical cancer screening (18.59%) was observed in Southern Nations Nationalities and Peoples’ region (SNNPR), and lowest was in Amhara region (13.62%). The sub-group analysis showed that the pooled cervical cancer screening was highest among HIV positive women (20.71%). This meta-analysis also showed that absence of women’s formal education reduces cervical cancer screening utilization by 67% [POR = 0.33, 95% CI: 0.23, 0.46]. Women who had good knowledge towards cervical screening [POR = 3.01, 95%CI: 2.2.6, 4.00], perceived susceptibility to cervical cancer [POR = 4.9, 95% CI: 3.67, 6.54], severity to cervical cancer [POR = 6.57, 95% CI: 3.99, 10.8] and those with a history of sexually transmitted infections (STIs) [POR = 5.39, 95% CI: 1.41, 20.58] were more likely to utilize cervical cancer screening. Additionally, the major barriers of cervical cancer screening utilization were considering oneself as healthy (48.97%) and lack of information on cervical cancer screening (34.34%). This meta-analysis found that the percentage of cervical cancer screening among eligible women was much lower than the WHO recommendations. Only one in every seven women utilized cervical cancer screening in Ethiopia. There were significant variations in the cervical cancer screening based on geographical regions and characteristics of women. Educational status, knowledge towards cervical cancer screening, perceived susceptibility and severity to cervical cancer and history of STIs significantly increased the uptake of screening practice. Therefore, women empowerment, improving knowledge towards cervical cancer screening, enhancing perceived susceptibility and severity to cancer and identifying previous history of women are essential strategies to improve cervical cancer screening practice.
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影响因子：
2.5
作者：
Ebu, Nancy Innocentia;Ogah, Joseph Kwesi
通讯作者：
Ogah, Joseph Kwesi
57个国家 /地区的宫颈癌筛查覆盖范围：平均水平低和较大的不平等。
影响因子：
15.8
作者：
Gakidou, Emmanuela;Nordhagen, Stella;Obermeyer, Ziad
通讯作者：
Obermeyer, Ziad
影响因子：
4.8
作者：
Birhanu, Zewdie;Abdissa, Alemseged;Russell, Fiona M.
通讯作者：
Russell, Fiona M.
DOI：
10.2147/ijwh.s132202
发表时间：
2017
期刊：
International journal of women's health
影响因子：
--
作者：
Dulla D;Daka D;Wakgari N
通讯作者：
Wakgari N
影响因子：
2.8
作者：
Assefa, Abiyu Ayalew;Astawesegn, Feleke Hailemichael;Eshetu, Bethlehem
通讯作者：
Eshetu, Bethlehem