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To achieve higher coverage and effectiveness in limited‐resource settings, World Health Organization (WHO) guidelines for cervical cancer prevention recommend a screen‐and‐treat strategy with high‐risk human papillomavirus (HPV) testing. We piloted a real‐word project to examine the feasibility of this approach in rural Cameroon. Nurses from the Women's Health Program (WHP) of the Cameroon Baptist Convention Health Services (CBCHS) educated women in remote villages on cervical cancer prevention. At a follow‐up visit, they explained to nonpregnant women aged 30–65 how to self‐collect vaginal specimens for HPV testing with the careHPV assay. The cytobrush specimens were transported in coolers to a CBCHS laboratory for analysis. The nurses returned to villages to inform women of their results, examined HPV‐positive women in the primary health centers (PHCs) using visual inspection with acetic acid and Lugol's iodine (VIA/VILI) enhanced by digital cervicography (DC) to guide treatment. Of the 1,270 eligible women screened (mean age: 44.7 years), 196 (15.4%) were HPV‐positive, of whom 185 (94.4%) were examined, 16 (8.6%) were VIA/VILI‐positive, 8 (4.3%) were VIA/VILI‐inadequate, one (0.5%) was VIA/VILI‐uncertain and 161 (87.0%) were treated with thermal ablation. One woman had LEEP, and another woman with invasive cancer was treated at a referral facility. The cytobrushes broke off in the vaginas of two women (removed in the village) and in the bladder of another (surgically removed). Community‐based cervical cancer screening with self‐collected specimens for HPV testing is feasible in rural Cameroon. Education on the proper sampling procedure and follow‐up of women who are HPV‐positive are essential. What's new? In Africa, the continent with the highest burden of cervical cancer globally, nearly three quarters of cases occur in rural areas. Per the World Health Organization, HPV‐based screen‐and‐treat is a preferred strategy for cervical cancer secondary prevention in limited resource settings. However, the successful implementation of this recommendation in rural and remote areas of Africa remains uncertain. Here, the authors designed and piloted a culturally appropriate screening strategy with self‐collected HPV testing, and found that community engagement is critical to achieve success. In particular, education on the proper sampling procedure and follow‐up of women who are HPV positive are essential. [ABSTRACT FROM AUTHOR]

Although the burden of cervical cancer has significantly declined in high-income settings, this preventable disease has remained a public health priority in most developing countries, where it is still among the commonest and deadliest women's cancers.[1] Despite the huge number of resources that have been invested over the past decades, the incidence of cervical cancer has continued to increase in limited-resource settings, and projections for the coming years confirm that this tendency[2] will remain until high-impact interventions (including vaccination against human papilloma virus [HPV], which is the main factor leading to cervical cancer [referred to as primary prevention]) are widely and effectively implemented. Indeed, molecular screening based on the detection of high-risk HPV in exfoliated cervico-vaginal cells (referred to as HPV testing) has made a lot of progress and is nowadays considered the most accurate screening method for cervical cancer. In settings where a VIA-based program is already implemented, HPV testing should be introduced for screening and VIA used to manage women whose screens were positive. [Extracted from the article]

Introduction: Evidence suggests that advice from health care professionals (HCP) increases the likelihood of quit attempts and successful quitting of tobacco use. However, previous studies primarily focussed on cigarette smoking and did not include all forms of tobacco products. This study aimed to investigate the prevalence and disparities in receiving HCP's advice to quit tobacco use (combustible or noncombustible) in the US adult population., Methods: Using the 2022 National Health Information Survey (NHIS) data, we examined 4,424 adults who reported (i) any tobacco product use within the past 12 months and (ii) having seen an HCP within the past 12 months. The outcome variable included the receipt of advice to quit tobacco use from an HCP, and predictors included sociodemographic variables. Weighted prevalence estimates were calculated, and multivariable regression analyses were conducted., Results: Over 38% of tobacco users who visited an HCP were advised to quit. The odds of receiving such advice were lower among Hispanics (AOR: 0.625; 95% confidence interval (CI) [0.464-0.843]; p  = 0.002), males (AOR: 0.767; 95% CI [0.659-0.893], p  = 0.001), those above the poverty level (AOR: 0.795; 95% CI [0.641-0.987]; p  = 0.037), foreign-born (AOR: 0.664; 95% CI [0.496-0.888]; p  = 0.006), those with a bachelor's degree or higher educational level (AOR: 0.477; 95% CI [0.349-0.653]; p < 0.001) and those aged less than 45 years (AOR: 0.404; 95% CI: [0.344-0.473]; p  < 0.001)., Conclusion: The prevalence of receiving HCP's advice to quit tobacco use remains suboptimal and disparate among sociodemographic groups. Our findings call for strategic implementation of the USPHS's recommendation on treating tobacco use and taking further actions to equip HCPs with the training and resources needed to provide appropriate advice to quit tobacco., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Chandra, Talluri, Fokom Domgue and Shete.)

Background: Cigarette smoking is the major preventable cause of premature deaths in the United States. Attempting to quit smoking is an important step toward smoking cessation. Although it has been studied extensively, limited information on the association between attempts to quit smoking and neighborhood air quality problems is available. Therefore, we examined the association between attempts to quit smoking in the past year and perceived neighborhood air quality problems among adult Texans who smoke., Methods: In 2018, a cross-sectional multistage area probability design-based survey was administered to collect sociodemographic, behavioral, and health-related information from a representative sample of 2050 Texas residents. The current study included 486 adult respondents who reported smoking within the past 12 months. The association between attempts to quit smoking and perceived neighborhood air quality (measured by self-reported problems with neighborhood air quality) was examined using a population-weighted multivariable logistic regression analysis., Results: Overall, 60.7% of the 486 respondents attempted to quit cigarette smoking. The prevalence of attempting to quit was 74.6% for those reporting perceived neighborhood air quality problems. In the multivariable analysis, a higher likelihood of attempting to quit smoking was found among individuals with perceived neighborhood air quality problems (AOR: 1.906 [1.104-3.289]) and those who were married or living as married (AOR: 1.876 [1.161-3.033]). The likelihood of attempts to quit smoking was lower among males (AOR: 0.629 [0.397-0.995]) and decreased with age (AOR: 0.968 [0.951-0.984])., Discussion: The perceived neighborhood air quality problems were found to independently predict attempts to quit cigarette smoking in Texas. To encourage quitting smoking among individuals living in neighborhoods with poor air quality, such neighborhoods should receive tailored and evidence-based interventions to improve community education, social support, and healthcare professionals' assistance to quit smoking., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Chandra, Fokom Domgue, Yu and Shete.)

Background: Cancer is a rapidly rising cause of morbidity and mortality in sub-Saharan Africa. Cervical cancer, in particular, is still one of the leading causes of mortality for women in this setting. The uptake of healthcare services is in part influenced by patients' belief systems. We sought to better understand the perception of cancer in the Kom tribe of Northwest Cameroon., Methods: A qualitative research study was completed using a semi-structured interview guide and one-on-one interviews with 45 parents of girls aged 9-14 years. These girls were candidates for free HPV vaccination to prevent cervical cancer. The interviews were recorded, transcribed, and analyzed using ATLAS.ti 9., Results: Thirty-five mothers and ten fathers with a median age of 42 yo were interviewed from Mbingo, Belo, Njinikom, and Fundong. Half of the parents were farmers, with three being herbalists or traditional medicine doctors. Seventy-seven percent had either no or only primary school education. None had had cancer. All knew at least one person with cancer. The most common word for cancer in the Kom language is " ngoissu ". It can refer to a bad infection or cancer. The occurrence of ngoissu is the result of either a curse placed on you, ancestral retribution, or transgressing the ngoulatta (snail shell spoken over and usually placed in a garden). The implications are that treatment of ngoissu must involve the traditional doctor who determines the spiritual issue and prescribes a remedy (like a herb or tea) and/or an incantation. Within the context of cancer, this can lead to a delay in diagnosis until the disease is no longer curable by conventional therapies., Conclusion: Ways to bridge biomedical healthcare services and traditional medicine are needed, especially in tribal contexts where the latter is an integral part of daily life.

Competing Interests: We declare no competing interests.

Amid subpar uptake of HPV vaccination in the United States, gender-generated disparities in HPV vaccination uptake have the potential to perpetuate existing disparities in HPV-associated cancers. Yet few studies have investigated the influence of parent-child gender on intentions to refuse HPV vaccination due to safety concerns/side effects. This study used nationally representative data, spanning 2010-2019, from the National Immunization Survey-Teen (NIS-Teen). NIS-Teen respondents are parents/guardians or primary caregivers of adolescents 13-17 years old living in the United States. Over the study period, intentions to refuse HPV vaccination due to safety concerns rose among all parent-child gender pairings but were highest among respondent mothers regarding their unvaccinated daughters. The results revealed a statistically significant increased likelihood of having intentions to refuse HPV vaccination due to safety concerns among all parent-child combinations compared with father-son pairs. These odds were consistently highest among mother-daughter pairs. In 2019, compared with father-son pairs, fathers were 1.94 (95% CI: 1.21-3.12) times more likely to report the intention to not vaccinate against HPV for their daughters, while mothers were 2.23 (95% CI: 1.57-3.17) and 2.87 (95% CI: 2.02-4.09) times more likely to report intentions to refuse HPV vaccination for their sons and daughters, respectively. These findings were persistent and constantly increased over the 10-year study period. Interventions aimed at correcting gender-based misperceptions and countering misinformation about the safety of the HPV vaccine are warranted.

Background: Human papilloma virus (HPV) vaccination is essential for the WHO cervical cancer elimination initiative. In Cameroon, HPV vaccine uptake is currently 5%. To assess the knowledge, beliefs and attitudes of parents of young girls aged 9-14 years about HPV vaccines within rural communities in the Northwest Region of Cameroon., Methods: During January-May 2022, we conducted 45 one-on-one interviews using a semistructured interview guide in the localities of Mbingo, Njinikom and Fundong. Participants were parents of girls aged 9-14 years who speak English or Pidgin English. Healthcare workers were excluded. The interviews were recorded, transcribed and analysed using ATLAS.ti V.9. Member checking was conducted presenting our findings and getting feedback from a focus group of parents., Results: Thirty-five mothers and 10 fathers were interviewed with a mean age of 42 years. Ninety-one per cent of parents had ever been vaccinated. Seventy-seven per cent had no or only primary school education. Thirty-two parents (71.12%) had daughters who had not been vaccinated against HPV. The themes identified include: perceived effectiveness of the HPV vaccine, affective behaviour (how they feel about the vaccine), accessibility (ability to get the vaccine), intervention coherence, ethicality (including parental informed consent), opportunity cost (future potential financial implications of cancer prevention), decision-making in the home (predominantly paternalistic), self-efficacy (extent to which education initiatives were effective) and quality initiatives (use of village infrastructure including fons/qwifons, village crier, healthcare worker presenting at the njangi house, schools and churches). Member checking with 30 women from two other communities confirmed our findings., Conclusions: Lack of awareness concerning the availability and purpose of the HPV vaccination was prevalent. Use of mainstream media and top-down health education activities are not effective. Novel approaches should engage local community health workers and use established community social and leadership structures., Trial Registration Number: ClinicalTrials.gov Registry (NCT05325138)., Competing Interests: Competing interests: This is an investigator-initiated research project which has been funded by Merck. Merck does not have access to any of the original material but will be provided with any manuscripts that result from this work for review prior to publication., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Tackling cancer is a major challenge right on the global level. Europe is only the tip of an iceberg of cancer around the world. Prosperous developed countries share the same problems besetting Europe-and the countries and regions with fewer resources and less propitious conditions are in many cases struggling often heroically against a growing tide of disease. This paper offers a view on these geographically wider, but essentially similar, challenges, and on the prospects for and barriers to better results in this ceaseless battle. A series of panels have been organized by the European Alliance for Personalised Medicine (EAPM) to identify different aspects of cancer care around the globe. There is significant diversity in key issues such as NGS, RWE, molecular diagnostics, and reimbursement in different regions. In all, it leads to disparities in access and diagnostics, patients' engagement, and efforts for a better understanding of cancer.