|LETTERS TO EDITOR
|Year : 2021 | Volume
| Issue : 1 | Page : 159-160
Lost-to-follow-up for cervical cancer screening
Geetu Bhandoria1, Vijay Ahuja2, SP Somashekhar2
1 Department of Gyn-Oncology and Obstetrics, Command Hospital, Kolkata, West Bengal, India
2 Manipal Comprehensive Cancer Center, Manipal Hospital, Bengaluru, Karnataka, India
|Date of Submission||24-Feb-2021|
|Date of Decision||01-Mar-2021|
|Date of Acceptance||01-Mar-2021|
|Date of Web Publication||26-Mar-2021|
S P Somashekhar
Manipal Comprehensive Cancer Center, Manipal Hospital, Bengaluru, Karnataka
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Bhandoria G, Ahuja V, Somashekhar S P. Lost-to-follow-up for cervical cancer screening. Cancer Res Stat Treat 2021;4:159-60
Screening is a proven strategy to decrease the burden of cervical cancer. Most developed nations have been able to significantly reduce the incidence of cervical cancer with the effective implementation of screening programs, along with widespread vaccination against the human papillomavirus infection. However, low- and middle-income countries like India are still struggling to achieve acceptable rates of screening for cervical cancer. Vidhubala et al. performed a small qualitative study to identify the barriers to follow-up of women who tested positive on initial screening for cervical cancer. This study brings out interesting perspectives from the patients' point of view. The authors have also interviewed the health-care staff involved in the screening program as they tend to echo the patients' concerns.
However, the authors have not described the size of the cohort from which this study sample was selected. It is also not clear whether the reported non-compliance is only for the initial follow-up or includes patients who did not return for a follow-up for the specific treatments offered after a positive result. It would have been useful to include questions related to the “see-and-treat” strategy to understand the acceptance of this concept in the screened population.
Thus, despite the interesting perspectives offered by Vidhubala et al.'s study, the inherent drawbacks of a qualitative study persist. Hence, their results must be replicated in other similar studies before they can be applied to a larger population. Moreover, the study presents the opinions of a very small proportion of women in the population, and a small sample size can make it difficult to obtain statistically significant results. The “fear of screening” and “fear of being diagnosed with cancer” have also been identified in other similar qualitative studies recently.,,,
The authors have suggested some solutions to reduce the loss to follow-up, such as repeated phone calls and home visits. However, most participants had expressed concerns about such repeated phone calls and home visits by health-care workers.
The key barriers identified in this study can be overcome by effective communication and by explaining the benefits of screening and follow-up to the community women. In addition, gaining their trust and involving their family members, especially their husbands, can also help to overcome these barriers.
Integration of other members of their community and properly explaining the entire screening process in the native language using audiovisual aids seem to be more viable options to enhance the receptivity of the community women for screening opportunities.
Screening and follow-up can be challenging in a developing country like ours. Although Vidhubala et al.'s study is a good initiative, more well-structured and robust studies are required in the future to derive any meaningful outcomes.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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