Prevalence and Risk Factors for Cervical and Breast Cancer Screening among Women in the General Population in Indonesia

By Pengpid, Supa; Peltzer, Karl | Gender & Behaviour, December 2018 | Go to article overview

Prevalence and Risk Factors for Cervical and Breast Cancer Screening among Women in the General Population in Indonesia


Pengpid, Supa, Peltzer, Karl, Gender & Behaviour


Introduction

Cervical and breast cancers are the most prevalent types of cancer among women in low- and middle-income countries as well as globally (Sankaranarayanan, 2014). In Indonesia, the incidence rate of breast cancer among women at all ages is 39.9 (estimates for 2012) (Ferlay et al., 2013), and among women 15 years and above the cervical cancer age-standardized incidence rate (per 100,000/year) was 17.3 (Bruni et al., 2017).Cervical and breast cancer screening is critical in early detection and treatment (Sankaranarayanan, 2014). Uptake of cancer screening remains low in all regions in Southeast Asia, including Indonesia (Domingo et al., 2008). In Indonesia, the early detection programme is primarily done with cervical and breast cancer, which are the highest types of cancer in Indonesia (Ministry of Health Republic of Indonesia, 2017). In Indonesia, until 2013, early detection of cervical and breast cancer has been conducted in 717 out of the 9500 health centres, with 1.75% of the total number of women aged 30-50 years screened (Ministry of Health of Indonesia, 2014). The coverage of cervical and breast cancer screening increased to 5.1% of women 30-50 years in 2016 compared to 2015 coverage of 3.4%, with a target of 50% (Ministry of Health Republic of Indonesia, 2017). In a community-based cervical cancer prevention programme in Indonesia of 22040 women (20-60 years) 92.7% had never been screened for cervical cancer (Vet et al., 2012).

There is a lack of national population-based studies on the uptake of cervical and breast cancer screening in Indonesia (Kim et al., 2013). In recent national population-based surveys, e.g., in Brazil 78.8% of women 25-64 years had had Pap tests performed in the last 3 years and among women 5069 years old 54.5% had a mammogram performed in the last 2 years (Theme Filha, Leal, Oliveira, Esteves-Pereira & Gama, 2016). In Jordan among women (15-49 years) the rate of Breast-SelfExamination (BSE) was 31.5% in the past year, Clinical Breast Examination (CBE) was 19.3% in the past year and that of Pap smear examination at least once in life was 25.5% (Al Rifai & Nakamura, 2015). In Mongolia in women 30 years and older, 25.7% self-rated their "knowledge of breast and cervical cancers as none", 56.4% had BSE in the past 3 years and 22.9 CBE in the past 3 years (Yerramilli, Dugee, Enkhtuya, Knaul & Demaio, 2015). In Thailand in women 30-59 years, 23.5% ever had BSE, ever CBE 20.3%, ever mammogramme 29.0%, ever Pap smear 68.4% (Chongthawonsatid, 2017), and in Turkey in women 30 years and older, 22.0% ever a Pap smear test and 19.0% ever had a mammography (Sözmen et al., 2016).

Factors positively associated with cervical and breast screening uptake may include higher socioeconomic position (education, occupation and income) (Chongthawonsatid, 2017; Islam, Billah, Hossain & Oldroyd, 2017; Narayan et al., 2017; Sözmen et al., 2016; Theme Filha et al., 2016; Williams-Brennan, Gastaldo, Cole & Paszat, 2012), urban living (Islam et al., 2017), increased access to health care (Narayan et al., 2017), having chronic conditions (Heflin, Oddone, Pieper, Burchett & Cohen, 2002), positive lifestyle behaviours such as physical activity, fruit and vegetable consumption, and not smoking (Lin, 2008; Sözmen et al., 2016; Theme Filha et al., 2016), and social support (Documet et al., 2015; Jensen, Pedersen, Andersen & Vedsted, 2016). Further, having mental distress or illness or having depressive symptoms (Mitchell et al., 2015; Vigod, Kurdyak, Stewart, Gnam & Goering, 2011), having obesity (Maruthur, Bolen, Brancati & Clark, 2009) and poor self-rated health status (Doumit, Fares & Arevian, 2017) have been found to be negatively associated with cancer screening uptake among women.

There is a lack of knowledge about the prevalence of cervical and breast cancer screening and its correlates in adult women in Indonesia. The study aimed at estimating the prevalence of and factors associated with cervical and breast cancer screeningamong women in the general population in Indonesia. …

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