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Bridging the Gaps in Gynecologic Cancers: Prevention and Survival
Bridging the Gaps in Gynecologic Cancers: Prevention and Survival
Bridging the Gaps in Gynecologic Cancers: Prevention and Survival

상세정보

자료유형  
 학위논문 서양
최종처리일시  
20260202105213
ISBN  
9798291564745
DDC  
614
저자명  
Khoja, Lilah.
서명/저자  
Bridging the Gaps in Gynecologic Cancers: Prevention and Survival
발행사항  
[Sl] : University of Michigan, 2025
발행사항  
Ann Arbor : ProQuest Dissertations & Theses, 2025
형태사항  
196 p
주기사항  
Source: Dissertations Abstracts International, Volume: 87-02, Section: B.
주기사항  
Advisor: Pearce, Celeste Leigh.
학위논문주기  
Thesis (Ph.D.)--University of Michigan, 2025.
초록/해제  
요약This dissertation examines prevention strategies for two types of gynecologic cancers: cervical and ovarian. It delves into secondary prevention of cervical cancer through both qualitative and quantitative methods and investigates tertiary prevention of ovarian cancer using quantitative approaches. For cervical cancer, research was conducted under the Human Papillomavirus (HPV) component of the Study of Arab American Health Attitudes (SAHA). In Aim 1, focus groups were held in Michigan with Arab American and Chaldean women (n=19). The study revealed low cervical cancer screening rates in this population, attributed to negative perceptions of screening, scheduling challenges, and lack of awareness about cancer prevention. Participants had mixed feelings about HPV self-collection outside medical settings, like at home. Aim 2 involved both qualitative and quantitative methods in an expanded SAHA-HPV study that included Arab American and Chaldean women from Southern California, Chicago, Illinois, and the New York City metropolitan area. Focus groups were conducted in these areas, and a broader quantitative survey was available to Arab and Chaldean women in all these regions and Michigan. This survey included questions about demographics, health behaviors, attitudes towards cancer screening, and knowledge about cervical cancer and HPV. The study found moderate awareness of HPV and cervical cancer risk factors but a lack of tailored health education and interventions for Arab American women. Focus group participants (n=22) showed some knowledge about cervical cancer and HPV, with mixed feelings about HPV self-sampling. Among questionnaire respondents (n=25), 94% were current with screening. While 59% favored self-sampling at home, concerns about the accuracy were prevalent. The disparity in screening rates between Arab American women and other groups indicates an urgent need for culturally tailored health education and interventions. Aim 3 evaluated the acceptability and feasibility of HPV self-sampling in Bangladesh, where cervical cancer is a significant health risk. Women at a health clinic in Araihazar Upazila participated in the study (n=164). High levels of cervical cancer awareness were observed, but specific knowledge about causes was low. Over 95% of participants expressed willingness to self-sample again, highlighting an opportunity to improve screening rates and early detection through increased education and awareness. Although secondary prevention is critical in reducing cervical cancer burden, there is no effective screening for invasive epithelial ovarian cancer. Therefore, tertiary prevention is vital. In Aim 4, factors affecting long-term survival (10+ years) compared to short-term survival (2-4.99 years) in advanced-stage high-grade serous ovarian cancer were analyzed using data from the Multidisciplinary Ovarian Cancer Outcomes Group. The study identified pathogenic variants in BRCA2 and related genes, immunologic markers, and optimal primary cytoreductive surgery as factors independently associated with long-term survival. Non-smoking history also correlated with better outcomes, laying the groundwork for improving survival rates. Overall, this dissertation highlights strategies to lessen the burden of these gynecologic cancers. In Arab and Chaldean American populations, culturally tailored cervical cancer education shows promise in reducing disease burden. HPV self-sampling emerged as a practical strategy for overcoming screening barriers in Bangladesh. Identifying factors associated with long-term survival in ovarian cancer could lead to improved outcomes for affected women.
일반주제명  
Public health
일반주제명  
Epidemiology
일반주제명  
Oncology
일반주제명  
Obstetrics
일반주제명  
Immunology
키워드  
Arab American health
키워드  
Cancer epidemiology
키워드  
Cervical cancer
키워드  
Ovarian cancer
키워드  
Human Papillomavirus
기타저자  
University of Michigan Epidemiological Science
기본자료저록  
Dissertations Abstracts International. 87-02B.
전자적 위치 및 접속  
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MARC

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■24510▼aBridging  the  Gaps  in  Gynecologic  Cancers:  Prevention  and  Survival
■260    ▼a[Sl]▼bUniversity  of  Michigan▼c2025
■260  1▼aAnn  Arbor▼bProQuest  Dissertations  &  Theses▼c2025
■300    ▼a196  p
■500    ▼aSource:  Dissertations  Abstracts  International,  Volume:  87-02,  Section:  B.
■500    ▼aAdvisor:  Pearce,  Celeste  Leigh.
■5021  ▼aThesis  (Ph.D.)--University  of  Michigan,  2025.
■520    ▼aThis  dissertation  examines  prevention  strategies  for  two  types  of  gynecologic  cancers:  cervical  and  ovarian.  It  delves  into  secondary  prevention  of  cervical  cancer  through  both  qualitative  and  quantitative  methods  and  investigates  tertiary  prevention  of  ovarian  cancer  using  quantitative  approaches.    For  cervical  cancer,  research  was  conducted  under  the  Human  Papillomavirus  (HPV)  component  of  the  Study  of  Arab  American  Health  Attitudes  (SAHA).  In  Aim  1,  focus  groups  were  held  in  Michigan  with  Arab  American  and  Chaldean  women  (n=19).  The  study  revealed  low  cervical  cancer  screening  rates  in  this  population,  attributed  to  negative  perceptions  of  screening,  scheduling  challenges,  and  lack  of  awareness  about  cancer  prevention.  Participants  had  mixed  feelings  about  HPV  self-collection  outside  medical  settings,  like  at  home.  Aim  2  involved  both  qualitative  and  quantitative  methods  in  an  expanded  SAHA-HPV  study  that  included  Arab  American  and  Chaldean  women  from  Southern  California,  Chicago,  Illinois,  and  the  New  York  City  metropolitan  area.  Focus  groups  were  conducted  in  these  areas,  and  a  broader  quantitative  survey  was  available  to  Arab  and  Chaldean  women  in  all  these  regions  and  Michigan.  This  survey  included  questions  about  demographics,  health  behaviors,  attitudes  towards  cancer  screening,  and  knowledge  about  cervical  cancer  and  HPV.    The  study  found  moderate  awareness  of  HPV  and  cervical  cancer  risk  factors  but  a  lack  of  tailored  health  education  and  interventions  for  Arab  American  women.  Focus  group  participants  (n=22)  showed  some  knowledge  about  cervical  cancer  and  HPV,  with  mixed  feelings  about  HPV  self-sampling.  Among  questionnaire  respondents  (n=25),  94%  were  current  with  screening.  While  59%  favored  self-sampling  at  home,  concerns  about  the  accuracy  were  prevalent.  The  disparity  in  screening  rates  between  Arab  American  women  and  other  groups  indicates  an  urgent  need  for  culturally  tailored  health  education  and  interventions.  Aim  3  evaluated  the  acceptability  and  feasibility  of  HPV  self-sampling  in  Bangladesh,  where  cervical  cancer  is  a  significant  health  risk.  Women  at  a  health  clinic  in  Araihazar  Upazila  participated  in  the  study  (n=164).  High  levels  of  cervical  cancer  awareness  were  observed,  but  specific  knowledge  about  causes  was  low.  Over  95%  of  participants  expressed  willingness  to  self-sample  again,  highlighting  an  opportunity  to  improve  screening  rates  and  early  detection  through  increased  education  and  awareness.  Although  secondary  prevention  is  critical  in  reducing  cervical  cancer  burden,  there  is  no  effective  screening  for  invasive  epithelial  ovarian  cancer.  Therefore,  tertiary  prevention  is  vital.  In  Aim  4,  factors  affecting  long-term  survival  (10+  years)  compared  to  short-term  survival  (2-4.99  years)  in  advanced-stage  high-grade  serous  ovarian  cancer  were  analyzed  using  data  from  the  Multidisciplinary  Ovarian  Cancer  Outcomes  Group.  The  study  identified  pathogenic  variants  in  BRCA2  and  related  genes,  immunologic  markers,  and  optimal  primary  cytoreductive  surgery  as  factors  independently  associated  with  long-term  survival.  Non-smoking  history  also  correlated  with  better  outcomes,  laying  the  groundwork  for  improving  survival  rates.  Overall,  this  dissertation  highlights  strategies  to  lessen  the  burden  of  these  gynecologic  cancers.  In  Arab  and  Chaldean  American  populations,  culturally  tailored  cervical  cancer  education  shows  promise  in  reducing  disease  burden.  HPV  self-sampling  emerged  as  a  practical  strategy  for  overcoming  screening  barriers  in  Bangladesh.  Identifying  factors  associated  with  long-term  survival  in  ovarian  cancer  could  lead  to  improved  outcomes  for  affected  women.
■590    ▼aSchool  code:  0127.
■650  4▼aPublic  health
■650  4▼aEpidemiology
■650  4▼aOncology
■650  4▼aObstetrics
■650  4▼aImmunology
■653    ▼aArab  American  health
■653    ▼aCancer  epidemiology
■653    ▼aCervical  cancer
■653    ▼aOvarian  cancer
■653    ▼aHuman  Papillomavirus
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■71020▼aUniversity  of  Michigan▼bEpidemiological  Science.
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■792    ▼a2025
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■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17359783▼nKERIS▼z이  자료의  원문은  한국교육학술정보원에서  제공합니다.

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