Cervical cancer in Tanzania: A systematic review of current challenges in six domains

Cervical cancer is the most common cancer in Tanzania. After excluding human immunodeficiency virus, lower respiratory infections, malaria, diarrheal diseases, and tuberculosis, cervical cancer kills more women than any other form of illness in the country. Unfortunately, Tanzania has a low doctor-t...

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Main Authors: Ava S. Runge, Megan E. Bernstein, Alexa N. Lucas, Krishnansu S. Tewari
Format: Article
Language:English
Published: Elsevier 2019-08-01
Series:Gynecologic Oncology Reports
Online Access:http://www.sciencedirect.com/science/article/pii/S2352578919300554
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spelling doaj-2395a759f3854f08a88fb3b700369fbc2020-11-25T00:43:59ZengElsevierGynecologic Oncology Reports2352-57892019-08-01294047Cervical cancer in Tanzania: A systematic review of current challenges in six domainsAva S. Runge0Megan E. Bernstein1Alexa N. Lucas2Krishnansu S. Tewari3Department of Medical Education, University of California, Irvine School of Medicine, Irvine, CA, USA; Corresponding author at: University of California, Irvine School of Medicine, 1001 Health Sciences Rd, Irvine, CA 92617, USA.Department of Medical Education, University of California, Irvine School of Medicine, Irvine, CA, USADepartment of Medical Education, University of California, Irvine School of Medicine, Irvine, CA, USADivision of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of California, Irvine Medical Center, Orange, CA, USACervical cancer is the most common cancer in Tanzania. After excluding human immunodeficiency virus, lower respiratory infections, malaria, diarrheal diseases, and tuberculosis, cervical cancer kills more women than any other form of illness in the country. Unfortunately, Tanzania has a low doctor-to-patient ratio (1:50,000) and nearly 7000 women die each year from this disease. The clinical problem is further magnified by the country's lack of resources and prevailing poverty, sporadic cervical cancer screening, prevalence of high-risk oncogenic human papillomavirus subtypes, and relatively high rates of human immunodeficiency virus co-infection. In recent years, addressing the cervical cancer problem has become a priority for the Tanzanian government. In this systematic review of 39 peer-reviewed publications that appeared in the PubMed/MEDLINE (NCBI) database from 2013 to 2018, we synthesize the growing body of literature to capture current trends in Tanzania's evolving cervical cancer landscape. Six domains were identified, including risk factors, primary prevention, barriers to screening, treatment, healthcare worker education, and sustainability. In addition to traditional risk factors associated with sexual behavior, acetowhite changes observed during visual inspection of the cervix with acetic acid, lower education, rural setting, and HIV positivity also have a noteworthy clinical impact. Keywords: Visual inspection with acetic acid, VIA, Tanzania, Cervical cancer, HPV, HIVhttp://www.sciencedirect.com/science/article/pii/S2352578919300554
collection DOAJ
language English
format Article
sources DOAJ
author Ava S. Runge
Megan E. Bernstein
Alexa N. Lucas
Krishnansu S. Tewari
spellingShingle Ava S. Runge
Megan E. Bernstein
Alexa N. Lucas
Krishnansu S. Tewari
Cervical cancer in Tanzania: A systematic review of current challenges in six domains
Gynecologic Oncology Reports
author_facet Ava S. Runge
Megan E. Bernstein
Alexa N. Lucas
Krishnansu S. Tewari
author_sort Ava S. Runge
title Cervical cancer in Tanzania: A systematic review of current challenges in six domains
title_short Cervical cancer in Tanzania: A systematic review of current challenges in six domains
title_full Cervical cancer in Tanzania: A systematic review of current challenges in six domains
title_fullStr Cervical cancer in Tanzania: A systematic review of current challenges in six domains
title_full_unstemmed Cervical cancer in Tanzania: A systematic review of current challenges in six domains
title_sort cervical cancer in tanzania: a systematic review of current challenges in six domains
publisher Elsevier
series Gynecologic Oncology Reports
issn 2352-5789
publishDate 2019-08-01
description Cervical cancer is the most common cancer in Tanzania. After excluding human immunodeficiency virus, lower respiratory infections, malaria, diarrheal diseases, and tuberculosis, cervical cancer kills more women than any other form of illness in the country. Unfortunately, Tanzania has a low doctor-to-patient ratio (1:50,000) and nearly 7000 women die each year from this disease. The clinical problem is further magnified by the country's lack of resources and prevailing poverty, sporadic cervical cancer screening, prevalence of high-risk oncogenic human papillomavirus subtypes, and relatively high rates of human immunodeficiency virus co-infection. In recent years, addressing the cervical cancer problem has become a priority for the Tanzanian government. In this systematic review of 39 peer-reviewed publications that appeared in the PubMed/MEDLINE (NCBI) database from 2013 to 2018, we synthesize the growing body of literature to capture current trends in Tanzania's evolving cervical cancer landscape. Six domains were identified, including risk factors, primary prevention, barriers to screening, treatment, healthcare worker education, and sustainability. In addition to traditional risk factors associated with sexual behavior, acetowhite changes observed during visual inspection of the cervix with acetic acid, lower education, rural setting, and HIV positivity also have a noteworthy clinical impact. Keywords: Visual inspection with acetic acid, VIA, Tanzania, Cervical cancer, HPV, HIV
url http://www.sciencedirect.com/science/article/pii/S2352578919300554
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