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Objectives: Although commonly practiced, the accuracy, effectiveness, and safety of screening patients for COVID-19 at hospital entrances is not well documented. Material and Methods: We performed a retrospective analysis of single institution data involving screening patients for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection at hospital entrances by trained health personnel, with thermal scanning and administration of a standard questionnaire eliciting risk factors and symptoms of COVID-19. SARS-CoV-2 positivity among patients screened positive and negative and among personnel involved in screening were estimated. Results: Between May 22, 2020, and July 4, 2020, a total of 20152 patients involving 54955 hospital visits were screened at hospital entrances of whom 668 (3.31%, 95% CI 3.07-3.57) were screened positive for suspected COVID-19 and 19484 (96.69%, 95% CI 96.44-96.93) were screened negative. Among patients screened positive, of the 638 patients with available records, 109 (17.08%, 95% CI 14.24-20.23) were confirmed to be SARS-CoV-2 positive by polymerase chain reaction test, 288 (45.14%, 95% CI 41.23-49.10) were negative, 71 (11.13%, 95% CI 8.79-13.83) were not tested after secondary assessment, and 170 (26.65%, 95% CI 23.25-30.26) patients declined the test. Among screen negative patients, 162 (0.83%, 95% CI 0.71-0.97) were SARS-CoV-2 positive. Of the 104 personnel involved in screening, 03 (2.88%, 95% CI 0.60-8.20) were confirmed to be SARS-CoV-2 positive during study period. Conclusion: Screening patients with a combination of thermal scanning and a standard questionnaire for COVID-19 has a high positive predictive value for detecting this infection with low risk of SARS-COV-2 transmission to the involved health personnel. [ABSTRACT FROM AUTHOR]

Low- and middle-income countries (LMICs) have limited financial resources and proportionately smaller portions allocated for health budget. With competing health priorities, treatment of the diagnosed cases and establishment of treatment facilities are the main concerns in LMICs. Infectious diseases, reducing infant, child and maternal mortality may seem crucial as compared to early cancer detection. LMICs that are committed to providing comprehensive cancer care, will need to judiciously choose the screening tool depending on specifics of how the tool is expected to perform in the population and the cost-effectiveness with respect to the number of lives expected to be saved. Increasing awareness about breast health in general and common cancers and non-communicable diseases (NCDs), in particular, may lead to symptomatic women approaching the healthcare facilities at an earlier stage. When the limited available resources are mobilized towards cancer screening, increasing awareness would lead to greater acceptability of the programme. The reach of the programme to achieve good population coverage, the establishment of the diagnostic referral linkages and the availability and accessibility of treatment facilities, will all decide the outcome of the screening programme. [ABSTRACT FROM AUTHOR]

Background: The use of tobacco, especially smokeless variety, is common and culturally accepted among Indian women. Hence, oral cavity cancers rank as the fourth most common cancers among Indian women. Objectives: The objectives of this study were to study factors determining compliance of women for oral cancer screening in a population-based program in Mumbai and to create awareness among women regarding ill effects of tobacco and importance of oral cancer screening. Materials and Methods: This is a community-based organized service program for awareness and screening of oral cavity cancers among women residing in low socioeconomic areas of Mumbai, India. Screening was conducted by oral visual inspection by trained primary health workers (PHWs). Univariate and multivariate logistic regression analyses were conducted to identify predictors of participation in oral cancer screening. Results: 138,383 population was surveyed, out of which 13,492 eligible women were enlisted for oral cancer screening. Among these, 12,495 were contacted and 11,895 (95.12%) women participated in a cancer awareness program and 11,768 (94.18%) participated in oral cancer screening. According to results of multivariate logistic regression analysis, women belonging to Hindu religion 94.57%, with mother tongue Marathi 94.76%, and with family history of cancer 95.84% complied significantly higher to oral cancer screening as compared to other women. Conclusion: This program has assisted in identifying predictors of compliance to oral cavity screening. Furthermore, it demonstrates that good compliance can be achieved through multiple household visits, personal invitation during camps, organizing well-planned Health Education Program, and the use of simple, low-cost visual inspection test performed by trained PHWs. [ABSTRACT FROM AUTHOR]

Byline: Gauravi. Mishra, Parishi. Majmudar, Subhadra. Gupta, Pallavi. Rane, Pallavi. Uplap, Surendra. Shastri Context: This paper describes the follow-up interventions and results of the work place tobacco cessation study. Aims: [...]

Byline: Gauravi. Mishra, Surendra. Shastri, Pallavi. Uplap, Parishi. Majmudar, Pallavi. Rane, Subhadra. Gupta Background: Tobacco use is highly prevalent and culturally accepted in rural Maharashtra, India. Aims: To study the [...]

Background: The objective of the study is to comparatively evaluate performance of human papillomavirus (HPV) hybrid capture 2 (HC2) and cytology as triage tests among visual inspection after application of 3-5% acetic acid (VIA) screen positive women, thus aiming to reduce the referral burden. Methods: The community-based cross sectional cervical cancer screening with VIA was conducted among women aged between 30 and 65, residing in selected low socio-economic areas of Mumbai, India, during October 2010-March 2017. After obtaining informed consent, delivering health education and collecting socio-demographic data, participants were offered VIA screening by trained primary health workers. The VIA screen positive women underwent cytology, HPV HC2 and diagnostic colposcopy at nodal hospital. Women with positive colposcopy underwent cervical biopsies. Results: 231 VIA positive women underwent cytology and HPV HC2 test, followed by colposcopy. Cervical biopsies were obtained in 83 cases. The sensitivity and specificity in detecting ≥ CIN 2 were 77.8 and 92.3 for HC2 and 66.7 and 98.2 for cytology. The false positivity and negativity rates were 7.7 and 22.2 for HC2 and 1.8 and 33.3 for cytology. Conclusions: HPV HC2 reduces referrals to larger extent and misses fewer cases compared to cytology, thus appearing a better triage test among VIA positive women. [ABSTRACT FROM AUTHOR]

Background: Breast cancer (BC) is the most common cancer among women globally and also in India. Early detection by screening is likely to reduce mortality and improve survival. To study the determinants of compliance to BC screening and referral by women in a community based BC screening programme in urban India. Methods: A community-based one-time cancer screening programme, implemented in the urban slums of Mumbai, India. The programme involves screening for breast cancer by Clinical Breast Examination (CBE) performed by trained primary health workers (PHWs), referral of screen-positive women to the nodal hospital for further investigations, confirmation of diagnosis and treatment. Univariate and multivariate logistic regression analysis in SPSS version 16 was used. Results: The compliance to screening, referral and treatment were 90.58%, 74.22% and 100% respectively. The results of multivariate logistic regression analysis demonstrate literate women, having family history of cancer, with tobacco habit, being treated for breast abnormalities, being ever pregnant and having history of contraceptive use were positive predictors while, women belonging to Muslim religion or speaking mother-tongue other than Marathi or Hindi were negative predictors of participation to screening. Educational status was the only significant predictor of compliance to referral. Screen-positive women with education of secondary school level or more were more likely to comply with referral. Conclusions: The programme ensured good compliance with screening, referral and treatment indicating feasibility and acceptability of CBE based BC screening programme by the community. [ABSTRACT FROM AUTHOR]

Background: Globally, about 80,000 to 1,00,000 adolescents start smoking daily. As adolescents get addicted to tobacco much faster than adults, sensitizing them regarding harms of tobacco and various tobacco control laws is essential. Objectives: To determine the knowledge about harms of tobacco among school children and understand their awareness about tobacco control laws in India. Materials and Method: A cross sectional survey was conducted among tenth grade students aged 14-16 years in six schools in Mumbai using a self administered questionnaire. Awareness regarding harms of tobacco and tobacco control legislation was given next day. Results: Among 505 participants, mean age of the students was 14.69 years. None of them were tobacco users. Many students knew about forms of tobacco and were aware that tobacco was harmful but could name only a few health hazards. About 76% knew that smoking is banned in public places, 87.7% knew about warning signs on tobacco products, 96.6% felt that tobacco should not be sold to minors and only 36% knew that sale of tobacco was banned within 100 yard of schools. Most important source of information was television (88.5%) followed by newspapers (78.4%). Majority students (89%) felt tobacco should be banned and 98.4% were sure that they won't use tobacco in future. Conclusions: There is a need to increase awareness among adolescents regarding various tobacco control policies and harmful effects of tobacco. [ABSTRACT FROM AUTHOR]

Background: While recommending a human papillomavirus (HPV) single-dose vaccination schedule in 2022, the World Health Organization highlighted the need for long-term follow-up studies to monitor waning of protection. We report on vaccine efficacy against HPV infections in 1-, 2-, and 3-dose schedules and protection against cervical precancers at a median follow-up of 12 years postvaccination., Methods: This randomized multicenter study in India was originally designed to vaccinate unmarried girls aged 10-18 years with either 2 or 3 doses of quadrivalent HPV vaccine. A ministerial decree to halt vaccination in trials resulted in the creation of cohorts receiving different doses, including just a single dose. Cohorts were assessed for incident and persistent infections by genotyping cervical samples collected yearly for 4 consecutive years after participants were married. Cervical screening with an HPV test was initiated at age 25 years for married participants. Age- and site-matched unvaccinated married women were recruited to be compared with vaccinated cohorts. Vaccine efficacy was assessed using proportional incidence ratios., Results: The number of participants in the 1-, 2- (at 0 and 6 months), and 3-dose cohorts was 4949, 4980, and 4348, respectively. Of the recipients, 71%-82% in the different cohorts were eligible to provide samples for genotyping. Vaccine efficacy against persistent HPV 16 and 18 infection was 92.0% (95% confidence interval [CI] = 87.0% to 95.0%) in 3022 recipients of the single dose; and comparable with that observed in the 2-dose arm (94.8%, 95% CI = 90.0% to 97.3%) and the 3-dose arm (95.3%, 95% CI = 90.9% to 97.5%). No high-grade precancer associated with HPV 16 and 18 was detected among vaccinated participants compared with 8 precancers detected among the unvaccinated women., Conclusion: This observational cohort study has established that a single dose of HPV vaccine provides high protective efficacy against persistent HPV 16 and 18 infections and associated neoplasia 15 years postvaccination., (© The Author(s) 2024. Published by Oxford University Press.)

India records one fifth of global cervical cancer burden. Unlike human papillomavirus (HPV) self-sampling, other screening methods may cause discomfort and embarrassment. This study aimed to investigate attitudes, acceptability, barriers, predictors, effective modality of instructions, and validity of HPV self-sampling among Indian women residing in varied settings and different literacy levels. This is community-based interventional study among Indian women 30-55 years, residing in urban slums (500), urban non-slums (500), and rural (600) settings with varied washroom facilities and privacy, to collect self-samples. Each group was subdivided into two arms; in one women received education with pamphlets and other with health education program (HEP). Study involved enlisting eligibles, obtaining informed consents and conducting personal interviews to collect baseline data. Self-samplers were distributed with instructions (pictorial pamphlets in one group and HEP in other) regarding usage, storage and return. Willingness to use self-samplers, refusals, experiences, and so forth were captured. Post-intervention knowledge, attitudes, practices was recorded. HPV reports were distributed. Women with positive result on either test were offered further management. Acceptance rate of self-sampling was 99.2%, 97%, and 98.8% and HPV positivity was 7%, 7.8%, and 8.5%, respectively among urban non-slum, urban slum and rural women. Agreement rate between health personnel collected and self-collected samples was 96.5% in pamphlet and 93.2% in HEP arm. Major barriers of self-sampling were lack of confidence about performing self-test correctly, fear that test would be painful and anxiety about test results. HPV self-sampling has good acceptability among Indian women and good agreement with health personnel collected samples., (© 2024 The Author(s). International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.)

Introduction: Cervical cancer, mostly caused by human papilloma virus (HPV), has disproportionately high incidence in developing countries. HPV infection being essentially a sexually transmitted infection, high-risk behaviour women with multiple sexual contacts like female sex workers (FSWs) are at higher risk of co-infection with HPV and of developing cervical precancer and cancer., Objective: This study aimed to determine the prevalence and determinants of HPV infection and cervical intraepithelial neoplasia (CIN) among FSWs in Mumbai, India., Methods: A cross-sectional study was conducted among 448 FSWs, between the ages of 18-50 years, by collaborating with local non-government organizations working for the health and welfare of FSW communities at sexually transmitted diseases clinics. All FSWs were screened for HPV DNA by hybrid capture II followed by reference diagnosis of colposcopy and/or cervical biopsy., Results: The prevalence of HPV DNA positivity was 35.5% and CIN was 2.2%. Factors significantly associated with HPV DNA positivity were age group younger than 30 years odds ratio (OR = 2.098, 95% confidence interval (CI) 1.408-3.127), Illiteracy (OR = 2.015, 95% CI 1.305-3.112), being single (OR = 2.409, 95% CI 1.558-3.724), less than 18 years of age at time of initiating work as FSW (OR = 3.718, 95% CI 3.718-2.392), having more than five clients per day (OR = 2.078, 95% CI 1.301-3.318), been working as a FSW for more than 5 years (OR = 2.321, 95% CI 1.455-3.701), not using barrier contraception methods (OR = 5.155, 95% CI 3.395-7.827) and having no exposure to human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) education program (OR = 29.153, 95% CI 15.385-55.240). FSWs with a positive HPV DNA test are substantially more likely to have CIN compared to those with a negative test (OR = 7.6, 95% CI 1.59-36.25)., Conclusion: The prevalence of HPV infection and CIN was high among FSWs. FSWs with a positive HPV DNA test had a seven times higher risk of developing CIN. The persistence of HPV infection is expected to significantly raise the risk of cervical cancer in the future. It is suggested to have an integrated approach towards cervical cancer screening and HIV/AIDS control activities., Competing Interests: The authors declare no conflicts of interest in this work., (© the authors; licensee ecancermedicalscience.)

Background: The burden of cancer in India has been rising, yet testing for early detection remains low. This study explored inequalities in the uptake of breast cancer (BC) examination and cervical cancer (CC) among Indian women, focusing on socioeconomic, regional, and educational differences., Methods: Data from the 2019-21 National Family Health Survey (n=353,518) were used to assess the uptake of BC examination and CC testing. Inequalities were quantified using the slope index of inequality (SII), relative index of inequality (RII), and relative concentration index (RCI). SII measured absolute inequality, while RII and RCI assessed relative inequality between disadvantaged and advantaged groups., Results: The ever uptake of tests for early detection of BC and CC were low at 9 and 20 per 1,000 women, respectively. Higher uptake was observed among women from the richest households compared to the poorest (SII: 1.1 for BC and 1.8 for CC). The magnitude of relative socioeconomic inequalities was more pronounced in rural areas (RCI: 22.5 for BC and 21.3 for CC) compared to urban areas. Similarly, higher-educated women were 4.84 times (RII: 4.84) and 2.12 times (RII: 2.12) more likely to undergo BC examination and CC testing, respectively, compared to non-educated women. The northeastern region exhibited greater socioeconomic inequality, while the western region showed more education-based inequality., Conclusion: The lower uptake of BC examination and CC testing and the marked inequalities underscore the need for targeted interventions to improve access and utilization of testing services, especially among lower-educated women, and those in rural areas.

In context of the ongoing multi-centric HPV vaccine study in India, unvaccinated married women (N = 1484) aged 18-23 years were recruited in 2012-2015 as age-matched controls to the vaccinated women and followed up yearly. We assess type-specific prevalence, natural history and potential determinants of human papillomavirus (HPV) infection in these unvaccinated women. Cervical samples were collected yearly for at least four consecutive years. A Multiplex Type-Specific E7-Based polymerase chain reaction assay was used to detect 21 HPV types. HPV prevalence was 36.4% during 6 years. Most common HPV types were 16 (6.5%) and 31 (6.1%). Highest persistence were observed for HPV 35 (62.5%) and 52 (25%). New HPV acquisition rate was 5.6/1000 person-months of observation (PMO), highest for HPV 16 (1.1/1000 PMO). Type-specific clearance rates ranged between 2.9-5.5/100 PMO. HPV 16 and/or 18 infections were 41% (95% CI 4-63%) lower among women with 2-<3 years between marriage and first cervical sample collection compared to those with <2 years. HPV prevalence and acquisition rates in young Indian women were lower than their Western counterparts. HPV 16 infections being most common shows the importance and potential impact of HPV vaccination in India. Women with 2-3 years exposure had reduced risk possibly due to higher infections clearance., Competing Interests: The corresponding authors, on behalf of all authors, declares the following potential competing interests: Neerja Bhatla has received research funding through her institute from GlaxoSmithKline and Merck. Smita Joshi has received funds from GlaxoSmithKline through the Jehangir Clinical Development Center to do an HPV vaccine study. Partha Basu has received research funding from GlaxoSmithKline through Chittaranjan National Cancer Institute, India during his previous position at the institute. This does not alter our adherence to PLOS ONE policies on sharing data and materials. The other authors declare no competing interests.

Background and Objectives: Preventable cancers like cancers of cervix, breast and oral cavity claim more than 142,500 lives of Indian women annually. Mobile cancer screening may help in early detection and successful treatment in vulnerable populations., Methods: This is a community based mobile cancer screening program in co-ordination with various non-governmental organizations. Participants included 182 women from low socio-economic background residing in Mumbai. Around twenty five consenting women were screened in each of the eight camps conducted. Health education programme (HEP) was given before screening. Tests included clinical breast examination (CBE) for breast , visual inspection with 5% acetic acid (VIA), visual inspection with lugols iodine (VILI) followed by colposcopic examination for cervix and oral visual examination (OVE) for oral cavity. Women requiring further diagnostic tests were referred to the nodal hospital. A satisfaction survey was carried out at the end of the examination., Results: Out of 182 women screened, 179 received health education. More than 90% of the participants were satisfied with the various aspects of screening. Majority (90%) of them found the mobile screening facility more convenient and accessible than static site screening. The variables age and income were found to be significantly associated with the overall satisfaction of the participants. The satisfaction level regarding information given during HEP was moderate (74%) compared to other factors., Interpretation and Conclusion: The overall acceptance and satisfaction levels were encouraging with the mobile cancer screening programme. Such a facility can act as an important tool in cancer prevention and control in low socio-economic women.

Background: Cancer, a major cause of morbidity and mortality in India can be prevented by early detection through screening, for which, awareness is essential., Aim: Determining cancer awareness among low socioeconomic women in Mumbai., Settings and Design: Community based cancer screening study using a mobile van., Materials and Methods: Data of consenting participants, collected using structured questionnaire, was differentiated into good and poor level of awareness using point based grading procedure. results: Mean age of 182 participants, majority (90.5%) belonging to lower socioeconomic strata, was 43.0∓8.8 years. Knowledge about cancer (84.6%) was good compared to knowledge of cancer screening (35.1%), awareness being higher among richer and more educated. Major sources of information were friends or relatives (46.1%) and media (35.2%). Only 6.6% had undergone prior screening., Conclusion: In spite of appreciable knowledge about cancer, creating awareness about screening, its availability, and motivating the general population for screening is necessary.