Background

Cervical cancer is the second-leading cause of death among all cancers in Ethiopia. Ethiopia plans to eliminate cervical cancer as a public health problem by 2030, following the World Health Organization's call for action. A scoping review was conducted on the status of the cervical cancer continuum towards elimination in Ethiopia.

Methods

We searched articles in PubMed, Scopus, and Google Scholar. All studies conducted on cervical cancer in Ethiopia, from first date of publication to March 15, 2023, type of article, or language of publication, were included. However, conference abstracts, commentaries, and letters to the editors were excluded. We used EndNote X9 software to merge articles from different databases and automatically remove duplicates. Screening of titles, abstracts, and full texts was performed independently by two co-authors. The cancer care continuum was employed as a framework to guide data synthesis and present the findings.

Results

Of the 569 retrieved articles, 159 were included in the review. They found that most of the articles focused on knowledge, attitude, and practice. However, there were few studies on health-seeking behavior, perception and acceptability of cervical cancer services, as well as the availability and readiness of a screening program. The review identified inadequate knowledge, attitude, and perception about cervical cancer, and highlighted that screening for cervical cancer is not widely utilized in Ethiopia. Knowledge, attitude, education status, and income were repeatedly reported as precursors influencing cervical cancer screening. Most studies concluded that there is a high prevalence of precancerous lesions and cervical cancer, as well as high mortality rates or short survival times. The review also identified significant heterogeneity in findings across time and geographic settings within each component of the cancer care continuum.

Conclusions

Overall, there is inadequate knowledge, perception, health-seeking behavior, screening, and treatment services, indicating that the country is falling behind its targets in eliminating cervical cancer, despite the availability of effective interventions and tools. We argue that implementation research is necessary to identify implementation issues, challenges, and strategies to scale up both primary and secondary prevention services. By doing so, Ethiopia can address cervical cancer as a public health problem and work towards its elimination.

中文翻译：

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改善埃塞俄比亚宫颈癌的连续护理以消除宫颈癌：范围界定审查

背景

宫颈癌是埃塞俄比亚所有癌症中第二大死亡原因。响应世界卫生组织的号召，埃塞俄比亚计划到 2030 年消除宫颈癌这一公共卫生问题。对埃塞俄比亚消除宫颈癌的持续状况进行了范围审查。

方法

我们在 PubMed、Scopus 和 Google Scholar 中搜索了文章。从首次发表之日到 2023 年 3 月 15 日，在埃塞俄比亚进行的所有关于宫颈癌的研究、文章类型或发表语言均包含在内。然而，会议摘要、评论和给编辑的信被排除在外。我们使用EndNote X9软件来合并来自不同数据库的文章并自动删除重复项。标题、摘要和全文的筛选由两位合著者独立进行。癌症护理连续体被用作指导数据合成和呈现研究结果的框架。

结果

检索到的 569 篇文章中，有 159 篇被纳入评论。他们发现大多数文章都侧重于知识、态度和实践。然而，关于求医行为、对宫颈癌服务的认知和可接受性以及筛查计划的可用性和准备情况的研究很少。该审查发现对宫颈癌的认识、态度和认知不足，并强调宫颈癌筛查在埃塞俄比亚并未得到广泛应用。知识、态度、教育状况和收入被多次报道为影响宫颈癌筛查的前兆。大多数研究得出的结论是，癌前病变和宫颈癌的患病率很高，死亡率很高或生存时间很短。该综述还发现，癌症护理连续体各个组成部分中不同时间和地理环境的研究结果存在显着异质性。

结论

总体而言，知识、观念、求医行为、筛查和治疗服务不足，这表明尽管有有效的干预措施和工具，但该国在消除宫颈癌方面仍落后于其目标。我们认为，实施研究对于确定实施问题、挑战和扩大初级和二级预防服务的战略是必要的。通过这样做，埃塞俄比亚可以将宫颈癌作为一个公共卫生问题来解决，并努力消除它。