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Identifying the Cause of Young Women Diagnosed with Locally Advanced Cervical Cancer Despite Routine Screening
Author(s) -
Jewlal Elizabeth,
D'Souza David,
Shaddick Heather,
Patel Nikhilesh,
Leung Eric,
Sugimoto Akira,
McGee Jacob,
Prefontaine Michael
Publication year - 2018
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.2018.32.1_supplement.504.10
Subject(s) - medicine , cervical cancer , feeling , health care , disease , cervical screening , cancer , family medicine , gynecology , psychology , social psychology , economics , economic growth
Background Screening programs for cervical cancer in developed countries have led to a marked reduction in mortality given their ability to detect early stage disease. Despite this success, there remains a concerning number of women compliant with regular screening that are diagnosed with advanced disease – a particularly devastating diagnosis for young women given the sexual and reproductive consequences. To explore the reasons behind this shortcoming, the present study sought to identify diagnostic commonalities amongst young women compliant with screening who presented to a tertiary cancer hospital with locally advanced cervical cancer (LACC). Methods A review of all women (age<50) with LACC receiving definitive chemoradiation between Sept/10‐Dec/12 at our institution was performed to identify those with a routine Pap test done ≤2y prior to diagnosis. Eligible women were offered semi‐structured, face‐to‐face interviews focusing on 4 areas: presenting symptoms, experience with the health care system, feelings after diagnosis, and perception of their future. Interviews were audiotaped, transcribed and a constant comparison analysis was performed to identify key themes. Thirteen out of 38 women (34%) with LACC were compliant with screening prior to diagnosis and met the other study criteria (median age: 38 (27–49)). All had a normal Pap, except one, completed 11 months prior to diagnosis. Ten consented to participate in an interview. Results Several key themes were identified: a lack of understanding about the symptoms/diagnosis of cervical cancer and a belief that LACC does not occur in those compliant with screening, reluctance from health care providers to perform pelvic examinations, the emotional burden of diagnosis on both the patient and their families and lessons learned with a different outlook for the future. Conclusions There is a need to educate physicians and the public about cervical cancer, even where screening is available. Delay in diagnosis has detrimental effects on quality of life and likely prognosis. This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal .