Evidence map›Paper›PMID 31685510›Full record

ArticleBMJ open2019

Barriers to cervical cancer screening and acceptability of HPV self-testing: a cross-sectional comparison between ethnic groups in Southern Thailand.

Anna Gottschlich, Thanatta Nuntadusit, Katie R Zarins, Manila Hada, Nareerat Chooson, Surichai Bilheem, Raphatphorn Navakanitworakul, Kesara Nittayaboon, Shama Virani, Laura Rozek and 2 more

Abstract readComparative Study
In one paragraph

Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Prevalence of Cervical Cancer Screening in Asia: A Systematic Review and Meta-Analysis.Asian Pacific journal of cancer prevention : APJCP · 2025
    Pooled it
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  5. Barriers to and Facilitators of Cervical Cancer Screening among Women in Southeast Asia: A Systematic Review.International journal of environmental research and public health · 2021
    Pooled it
  6. Comparison of Human Papillomavirus Genotyping by Research vs. Clinical Assay for Two Self-Collection Devices.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025
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  16. Cervical cancer in Thailand: 2023 update.Obstetrics & gynecology science · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Anna GottschlichDepartment of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
Thanatta NuntadusitEpidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.
Katie R ZarinsDepartment of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, United States.
Manila HadaDepartment of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
Nareerat ChoosonEpidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.
Surichai BilheemEpidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.
Raphatphorn NavakanitworakulDepartment of Biomedical Sciences, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.
Kesara NittayaboonDepartment of Biomedical Sciences, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.
Shama ViraniEpidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.
Laura RozekDepartment of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, United States.
Hutcha Sriplung *Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand rmeza@umich.edu hutcha.s@gmail.com.
Rafael Meza *Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA rmeza@umich.edu hutcha.s@gmail.com.

Funding

XenograftP30CA046592 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI THEODORE S LAWRENCE · 1988 to 2026
$178.2M
University of Michigan ERC-supplement (TRT)T42OH008455 · OH · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI NEITZEL, RICHARD L · 2005 to 2025
$32.3M
Northern/Pacific Universities Global Health Research Training ConsortiumR25TW009345 · FIC · UNIVERSITY OF WASHINGTON · PI KOLARS, JOSEPH C., NERURKAR, VIVEK RAMCHANDRA · 2012 to 2016
$5.9M
FIC NIH HHS R25 TW009345NCI NIH HHS P30 CA046592NIOSH CDC HHS T42 OH008455
6 · The paper itself

Abstract

backgroundCervical cancer rates are higher in low-resourced countries than high, partly due to lower rates of screening. Incidence in Thailand is nearly three times higher than in the USA (16.2 vs 6.5 age-standardised incidence), even with Thailand's universal health coverage, which includes screening, suggesting that alternative methods are needed to reduce the burden. We investigated barriers to screening, as well as acceptability of self-collection human papillomavirus (HPV) testing as a primary form of cervical cancer screening among Buddhist and Muslim communities in Southern Thailand.

methods267 women from the Buddhist district of Ranot and Muslim district of Na Thawi, Songkhla were recruited to complete a survey assessing knowledge and risk factors of HPV and cervical cancer. Participants were offered an HPV self-collection test with a follow-up survey assessing acceptability. Samples were processed at Prince of Songkhla University and results were returned to participants.

results267 women participated in the study (132 Buddhist, 135 Muslim), 264 (99%) self-collecting. 98% reported comfort and ease, and 70% preferred it to doctor-facilitated cytology. The main predictor of prior screening was religion (92% Buddhist vs 73% Muslim reporting prior Pap). After adjustment with multivariate logistic models, Muslim women had an OR of prior Pap of 0.30 compared with Buddhist (95% CI: 0.12 to 0.66).

conclusionsSelf-collection HPV testing was highly acceptable across religious groups, suggesting that it could be beneficial for cervical cancer reduction in this region. Focus should be put into educating women from all backgrounds about the importance of screening to further improve screening rates among Thai women.

Indexed as

AdultBuddhismCross-Sectional StudiesEarly Detection of CancerEthnicityFemaleHealth Services AccessibilityHumansIslamMiddle AgedPapillomavirus InfectionsPatient Acceptance of Health CareSelf CareSpecimen HandlingThailandUterine Cervical Neoplasmscervical cancerepidemiologyHPVpublic healthself-collection testing

Identifiers

PMID31685510
PMCPMC6858097

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.