NURS 8310 Discussion: Screening for Disease Discussion: Screening for Disease

NURS 8310 Discussion: Screening for Disease Discussion: Screening for Disease

The article I chose was:

Kessler, T. A. (2017). Cervical cancer: Prevention and early detection. Seminars in Oncology Nursing, 33(2), 172–183. https://doi.org/10.1016/j.soncn.2017.02.005

Cervical cancer affects women worldwide as the fourth most common female malignancy (Kessler, 2017).  In the United States, cervical cancer ranks 14th among all cancers (Kessler, 2017).  Cervical cancer remains more prevalent in for women in less developed countries such as Africa, Latin America, and the Caribbean (Kessler, 2017). North America has one of the lowest incidences of cervical cancer (Kessler, 2017).

Cervical cancer is almost always caused by the human papillomavirus (HPV), which ranks as the most prevalent sexually transmitted infection worldwide (Kessler, 2017).  HPV is the cause in 99.7% of the United States cases of cervical cancer (Kessler, 2017).  HPV does not usually exhibit signs and symptoms and most women are unaware they have HPV (Kessler, 2017).  Early detection or vaccination against HPV drastically reduces women’s risk of developing cervical cancer (Kessler, 2017).

Recommendations, Evidence & Population

            The Kessler article recommended women be screened for cervical cancer beginning at 21 years of age, regardless of whether they are sexually active or not (2017).  This screening would continue every 3 years until 29 years of age and then reduce to every 5 years between the ages of 30 and 65 years of age (Kessler, 2017).  After 65, cervical cancer screening is not recommended if prior exam results have been negative (Kessler, 2017).  Prior to these recommendations, screening was recommended annually (Kessler, 2017).  This was reduced to the above recommendations based on the incidence of false positive results (Kessler, 2017).

            The recommendations are great for women with access to medical care, but leave a gap for those women with little to no access for the screenings, as well as those living in third world countries.  There seems to be some selection bias in that the recommendations are not feasible for all (Friis & Sellers, 2021).  There is some confounding in the article due to distortion of the estimated effect and extraneous factors (Friis & Sellers, 2021).

            The article is population based as it focuses on all women and not just women at high risk for cervical cancer.  The article leaves you thinking that everyone has HPV and will eventually get cervical cancer without the HPV vaccination or some type of cervical screening.  Better understanding could have been portrayed by looking at one particular population, such as women in the United States or women in Latin America.  Instead, the author combined all groups of women (Kessler, 2017).

Improving Population Health

             “Cervical cancer is the leading cause of cancer deaths among women of reproductive age in Peru” (Pieters et al., 2021).  In 2013, I was able to go to Peru on a mission trip to the villages and communities.  During this time, I taught women, along with their husbands about the risk of HPV and the need for cervical cancer screenings.  It was important to include their husbands, as they often made the decisions for the household and decided if the wife could have the cervical cancer screening or vaccine.  Cervical cancer screening exams were then conducted by appropriate providers if wanted.

            Focusing on a population, such as the one in Peru, could drastically impact and reduce cervical cancer in Peruvian women.  Understanding the barriers and misconceptions about cervical cancer and why women do not seek out the screening through their scfeening programs, could help to provide appropriate education and improve awareness (Pieters et al., 2021).