Los signos de Curwen

This study was delimited to women who had already been diagnosed with cancer. It will be important to undertake a KAP (Knowledge Attitudes and Practices) study at the community level targeting all women and not necessarily those diagnosed with the disease. There is need to understand the reasons why most women do not go for regular checkups. Further research should also be done to understand why some women seek alternative medical care.

Further studies should include men to understand their awareness of the disease and understanding of HPV virus as a cause of cervical cancer. In addition, men provide the much needed support to their spouses when diagnosed with the disease.

There is also need for a detailed study on treatment regimes and response to treatment among women with cervical cancer. Such a study will go a long way in revealing if the same factors impeding diagnosis apply in impeding treatment. Further, there is need to carry out studies targeting diagnosis and treatment of other types of cancers such as breast, ovarian and uterine which mostly affect women.

Finally, the potential for integrating cervical cancer education and screening services within the existing HIV Testing and Counseling Centres (HTCs) should be investigated with a view to establish how feasible it would be.

REFERENCES

Abdullahi, A., Copping, J., Kessel, A., Luck, M., Bonell, C.(2009). Cervical screening: Perceptions and barriers to uptake among Somali women in Camden. Public Health, Vol.123, No.10, (Oct 2009),.pp.680-5.

Adewole IF, Benedict JL, Brian TC, Fallen M. (2005). Evolving a strategic approach to cervical cancer control in Africa. Gynecologic Oncology Vol 99, Issue 3, Suppl 1, Dec 2005, pages S209-S212.

Ahmedin J. Freddie Bray, et al. (2011) Global Cancer Statistics Ca Cancer J Clin 2011;61:69–90

Alliance for Cervical Cancer Prevention. (2003) “Effectiveness, Safety, and Acceptability of Cryotherapy: A Systematic Literature Review,” Cervical Cancer Prevention Issues in Depth, No. 1 (Seattle: ACCP, 2003).

American Cancer Society (2007). Detailed Guide: Cervical Cancer. American Cancer Society: http://www.cancer.org/

Anorlu RI, Orakwue CO, Oyeneyin L, (2004). Late presentation of cervical cancer in Lagos: what is responsible? European Journal of Gynaecological Oncology; 25(6):729–32.

Barnes L, Moss-Morris R, Kaufusi M, (2004): Illness, beliefs and adherence in diabetes mellitus: a comparison between Togan and European Patients. New Zealand Medical Journal; 117(1188):U743

Brouha XD. et al. (2005). Oral and pharyngeal cancer: analysis of patient delay at different tumor stages. Head Neck; 27: 939-945

Cancer facts and figures (2009). A publication of The America Cancer Society. Retrieved:http://www.cancer.org/research/cancerfactsstatistics/cancerfactsfigure s2009/index

Carrie Kingsley, et.al. (2010). Cultural and Socioeconomic Factors Affecting Cancer Screening, Early Detection and Care in the Latino Population. EthnoMED. http://ethnomed.org/clinical/cancer).

Centers for Disease Control and Prevention. (2008). CDC features: people without health insurance coverage, by race and ethnicity. Retrieved from http://www.cdc.gov/Features/dsHealthInsurance/

Chavez L. et al. (2001). “Beliefs Matter: Cultural Beliefs and Use of Cervical Cancer Screening Tests” Medical Anthropology, 103(4)1114-1129.

Chirenje ZM. (2005). HIV and cancer of the cervix. Best Pract Res Clin Obstet Gynaecol 2005;19:269–276.

Chung H. et al., (2006). Cervical cancer incidence and survival in Korea: 1993–2002. International Journal of Gynecological Cancers;16:1833–1838.

Davis GE., Bryson CL., Yueh B., McDonell MB., Micek MA. Fihn SD., (2006). Treatment delay associated with alternative medicine use among veterans with head and neck cancer. DOI: 10.1002/hed.20420. Vol. 28, Issue 10, pages 926–931 del Carmen and Diaz-Montez, 2009. H.K. Koh (ed.) Toward the Elimination of Cancer Disparities. DOI 10.1007/978-0-387-89443-0_9 @ Springer Science + Business Media, LLC 2009.

del Carmen MG, Findley M, Muzikansky A, Roche M, Verrill CL, Horowitz N, Seiden MV.(2007) Demographic, risk factor, and knowledge differences between Latinas and non-Latinas referred to colposcopy. Gynecol Oncol;104:70–6.

Devi BCR, Tang TS & Corbex M., (2007) “Reducing by half the percentage of late stage presentation for breast and cervix cancer over 4 years: A pilot study of clinical downstaging in Sarawak, Malaysia” Annals of Oncology, 2007; 18: 1172- 1176.

Evans J et al. (2007). Minimizing delays in ovarian cancer diagnosis: An expansion of Andersen‟s model of „total patient delay‟. Family Practice 2007; 24: 48-55

Ferlay J, Shin HR, (2010). GLOBOCAN 2008, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10. Lyon, France: International Agency for Research on Cancer; Year. Available at: http://globocan.iarc.fr. 2010.

Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. (2014). GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11. Lyon, France: International Agency for Research on Cancer; 2013. Available from: http://globocan.iarc.fr, accessed on 20/01/2014.

Gakidou E, Nordhagen S, Obermeyer Z (2008). Coverage of cervical cancer screening in 57 countries: Low average levels and large inequalities. PLoS Med. 5(6):e132, 10.1371/journal. Pmed.0050132.

Gatune J.W. and Nyamongo I.K. (2005). An ethnographic study of cervical cancer among women in rural Kenya: Is there a folk causal model? International Journal of Gynecological Cancers 2005, 15, 1049-1059

Gichangi P., Estambale B., Bwayo J. (2003). Knowledge and Practice about cervical cancer and Pap smear testing among patients at Kenyatta National Hospital, Nairobi, Kenya. International Journal of Gynecological Cancers, 13, 827-833 Glenngård, A.H., and T.M. Maina. (2007). Reversing the trend of weak policy

implementation in the Kenyan health sector? – A study of budget allocation and spending of health resources versus set priorities. Health Res Policy Sys. 5(1):3. doi: 10.1186/1478-4505-5-3.

Global Forum for Health Research (2005). Poverty, equity and health research, Geneva Switzerland. Global Forum for Health Research.

Gyenwali, Pariyar, Raj Onta (2012). Factors Associated with Late Diagnosis of Cervical Cancer in Nepal. Asian Pac J Cancer Prev,14 (7), 4373-4377

Heard I, et al (2005). High rate of recurrence of cervical intraepithelial neoplasia after surgery in HIV-positive women. J Acquir Immune Defic Syndr; 39:412–418. Heard I. (2009). Prevention of cervical cancer in women with HIV. Current Opinion in

HIV and AIDS; PubMed 4(1):68- 73.

Huchko MJ, et al, (2011). Building capacity for cervical cancer screening in outpatient HIV clinics in the Nyanza province of western Kenya, Int J Gynecol Obstet (2011), doi:10.1016/j.ijgo.2011.02.009

IARC 2007. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Human Papillomaviruses. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Vol. 90, Lyon, IARC. 670 p.

Kalyango J, Owino E, Nambuya P (2008). Non-adherence to diabetes treatment at Mulago Hospital, Uganda: Prevalence and associated factors. Makerere University. African Health Science Vol. 8 (2) 2008: pp. 67-73

Kanavos P. (2006). The rising burden of cancer in the developing world. Annals of Oncology 17 (Supplement 8): viii15–viii23. doi:10.1093/annonc/mdl983

Kenya National Bureau of Statistics (KNBS) and ICF Macro (2010). Kenya Demographic and Health Survey 2008-09. Calverton, Maryland: KNBS and ICF Macro.

Liu Y, Rao K. (2006). Providing health insurance in rural China: from research to policy. Journal of Health Policy Law; 31: 71-92.

Love G.D.,Mouttapa M., Tanjasiri S.P (2009). Everybody‟s talking: using entertainment-education video to reduce barriers to discussion of cervical cancer screening among Thai women. Health Education Research.;Vol.24 no.5, Pages 829-838

Mitchell ED. et al. (2008). Influences on pre-hospital delay in the diagnosis of colorectal cancer: a systematic reviewed. British J Cancer; 98: 60-70

Mugenda A.G and Mugenda O.M (1999) Research Methods: Quantitative and qualitative approaches. ACTS. Publ. Nairobi Kenya.

Mutyaba T., Faxelid E., Mirembe F. and Weiderpass E. (2007). Influences on uptake of reproductive health services in Nsangi community of Uganda and their implications for cervical cancer screening. Reproductive Health 2007, 4:4 doi:10.1186/1742-4755-4-4

Nairobi Cancer Registry Report (2006). Cancer incidence report 2000 to 2002.

National AIDS and STI Control Programme, Ministry of Health, Kenya (2013). Kenya AIDS Indicator Survey 2012: Preliminary Report. Nairobi, Kenya.

Ngoma T., Muwonge R., Mwaiselage J., (2010). Bottom of Form Evaluation of cervical visual inspection screening in Dar es Salaam, Tanzania. Intern. J Gynecol & Ob. Volume 109, Issue 2 , Pages 100-104.

Okonofua F. (2007). HPV Vaccine and Prevention of Cervical Cancer in Africa. African Journal of Reproductive Health Vol 11 No. 2.

O‟Malley CD., Shema SJ., Perkins CI. (2006). Medicaid Status and Stage at Diagnosis of Cervical Cancer. Am J Public Health. 96 (12): 2179 – 2185.

Palefsky JM., Minkoff H., Kalish L., (2009). Cervicovaginal Human Papillomavirus Infection in Human Immunodeficiency Virus-1 (HIV)-Positive and High-Risk HIV-Negative Women. JNCI J Natl Cancer Inst.Volume 91, Issue 3 Pp. 226-236.

Parkin DM, Nambooze S. et.al. (2010). Changing cancer incidence in Kampala,

Uganda, 1991–2006. Int. J. Cancer: 126, 1187–1195 (2010) VC 2009 UICC)

Perkins R.B., Langrish S.M. et.al. (2010). Impact of patient adherence and test performance on the cost-effectiveness of cervical cancer screening in developing countries. The case of Honduras. Women’s Health Issues 20; 35- 42

Robinson K.M. et.al (2011) Socio-demographic factors, comorbidity and diagnostic delay among women diagnosed with cervical, endometrial or ovarian cancer. European Journal of Cancer Care 20, 653–661.

Sankaranarayanan R, Thara S, et.al (2008). Cervical cancer: screening and therapeutic perspectives. Medical Principal and Practice, Vol. 17, No.5; pp.351-64.

Sankaranarayanan and Boffetta (2010). Research on cancer prevention, detection and

management in low- and medium-income countries. Annals of Oncology 21: 1935–1943. Published online 15 March 2010Volume 21 | No. 10 | October 2010

Schultz T, Boshoff C, Weiss R (1996) HIV infection and neoplasia. Lancet 348: 587– 591.

Scott S. et al. (2009). Barriers and triggers to seeking help for potentially malignant oral symptoms: implications for interventions. J Public Health Dent.; 69: 1: 34-40 Sener SF, Gney N. (2005). The global burden of cancer. Journal for Surgical Oncology;

92: 1-3

Smith LK et al. (2005). Patient‟s help-seeking experiences and delay in cancer presentation:a qualitative synthesis. Lancet 2005; 366: 825-31

Target Ovarian Cancer Pathfinder Study (2009). Available from www.targetovarian.org.uk

Tebeu PM, Major AL, Rapiti E, Petignat P, et.al. (2008). The attitude and knowledge of cervical cancer by Cameroonian women; a clinical survey conducted in Maroua, the capital of Far North Province of Cameroon. Int J Gynecol Cancer. 2008; 18(4):761-5.

Tenge C.N., Kuremu R.T., Buziba N.G., Patel K. and Were P. A., 2009. Burden and pattern of cancer in Western Kenya. East African Medical Journal Vol. 86 No. 1 Tjalma (2006). Cervical cancer and prevention by vaccination: results from recent trials.

Annals of Oncology 17; (supplement 10): x217-x223.

Tsui J, Tanjasiri SP. (2008). Cervical cancer screening among Thai women in Northern California. J Womens Health.;17:393–401.

WHO/ICO HPV Information Centre (2010), on HPV and Cervical Cancer (HPV Information Centre). Human Papilomavirus and Related Cancers in Kenya. Summary Report 2010. Available at www.who.int/hpvcentre

World Health Organization, (2006). Bulletin: Controversial new vaccine to prevent cervical cancer. Bulletin; 84 (2).

Wringe A, Isingo R, et.al. (2008). Uptake of HIV voluntary counseling and testing services in rural Tanzania: implications for effective HIV prevention and equitable access to treatment. Tro. Med. Int. vol. 13 no 3 pp 319–327.

APPENDICES

Appendix 1 PATIENT CONSENT