CHARACTERIZING THE GEOSPATIAL FEATURES IN CERVICAL CANCER SCREENING UPTAKE AMONG AMAZONIAN PERUVIAN WOMEN

Cervical Cancer Screening;Peru;Geospatial Analysis;Epidemiology

Barrett, Benjamin

Johns Hopkins University

关键词: Cervical Cancer Screening;    Peru;    Geospatial Analysis;    Epidemiology;   

Others  :  https://jscholarship.library.jhu.edu/bitstream/handle/1774.2/59234/BARRETT-THESIS-2018.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: JOHNS HOPKINS DSpace Repository

【 摘 要 】

IntroductionCervical cancer is the most common and second-most deadly cancer among Peruvian women. Uptake of critical cancer prevention and care services has been demonstrated to depend on health facility accessibility. This study sought to identify and analyze the geospatial features that contribute to the utilization of cervical cancer screening among women in Amazonian Peru.MethodsA Knowledge, Attitudes, and Practice (KAP) survey was implemented across five study sites of varying urbanization levels in Iquitos, Peru during September and October, 2017. Cross-sectional cervical cancer screening history information was collected from 619 female interviewees aged 18 to 65 years. Standard regression models and semivariograms were used to characterize the degree to which uptake of cervical cancer screening is related to spatial location. Exposures identified to be spatially-related to cervical cancer screening use were analyzed in spatial generalized mixed-effects regression models. Furthermore, spatial statistics were employed within each of the Iquitos study sites to assess the spatial intensity and clustering of cervical cancer screening uptake on the household-level.ResultsUptake of cervical cancer screening among women in Amazonian Peru was shown to be spatially dependent. Number of live births, health insurance status, partner support of screening participation, and travel time to health facility usually attended were identified as exposures spatially-related to screening. Spatial regressions demonstrated that health insurance status and partner support of screening participation were statistically significantly associated with cervical cancer screening in univariate models, but not in a model including all spatially-related exposures. Finally, screened households generally clustered among each other and their public community health post more than unscreened households.DiscussionThis study demonstrated the spatial dependency of cervical cancer screening in Iquitos, Peru. These findings first suggest that geospatial analyses of cervical cancer screening uptake among women in Amazonian Peru are appropriate and necessary. Second, the relationship between screening and geographic location indicates that public health interventions implemented to improve screening rates should remain mindful of the particular challenges that characterize specific locations.