`With the best of reasons': cervical cancer prevention policy and the suppression of sexual risk factor information
Social Science & MedicinePublished 1 May 1999
Virginia Braun, Nicola Gavey
Citations43
SJR quartileQ1
SJR score2.10
SNIP2.01
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TL;DR
This work examines key policy documents and interview 18 key informants on cervical cancer prevention in New Zealand, and identifies and discusses two discourses which inform positions on whether or not women should be provided with information regarding sexual risk factors for cervical cancer.
Abstract
Cervical cancer is a very common but largely preventable cancer. Despite considerable medical knowledge of risk and even causal factors, possible social-behavioural strategies for the primary prevention of cervical cancer have rarely been explored as a viable addition to cervical screening. We examine key policy documents and interview 18 key informants on cervical cancer prevention in New Zealand. Using a discourse analytic approach we identify and discuss two discourses (which we have labelled 'protectionism' and 'right to know') which inform positions on whether or not women should be provided with information regarding sexual risk factors for cervical cancer. Cervical cancer prevention policy in New Zealand, which largely reflects a protectionist discourse, suppresses sexual risk factor information and focuses exclusively on cervical screening. The right to know discourse informs an alternative position, which contends that women have a right to be informed about risk factors. We discuss these positions in relation to questions about women's rights, the principle of informed choice, and attempts to judge what is in women's 'best interests.'
Keywords
Social SciencesMedicineHealth Professions
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CancerThe epidemiology of cervical carcinogenesis
352 Citations1995Mark H. Schiffman, L A Brinton
The steps in cervical carcinogenesis appear to be fundamentally the same everywhere, with a central role for HPV infection, however, the importance of etiologic cofactors like smoking may vary by region.
BMJOrganisation and results of the cervical cytology screening programme in British Columbia, 1955-85
230 Citations1988George Anderson, D. A. Boyes +7 more
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American Journal of Obstetrics and GynecologyPrimary prevention of gynecologic cancers
207 Citations1995David A. Grimes, Katherine E. Economy
Although women have a range of practical, effective measures available to reduce their risk of these cancers, few are aware of them and without this information, women cannot make fully informed decisions about their health.
Pediatric ResearchHuman Papillomavirus Infection Sexually Active Adolescent Females: Prevalence and Risk Factors
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Sexually Transmitted DiseasesPrevalence, Incidence, and Estimated Life-time Risk of Cervical Human Papillomavirus Infections in a Nonselected Finnish Female Population
151 Citations1990Karí Syrjänen, Matti Hakama +6 more
Estimates for the life‐time risk and prevalence and incidence figures for cervical human papillomavirus (HPV) infections in an unselected Finnish population of women aged 22 indicate that factors exist that regulate the development of an invasive carcinoma from a CIS lesion.
JNCI Journal of the National Cancer InstituteRisk Factors for Invasive Cervical Cancer Among Latinas and Non-Latinas in Los Angeles County<xref ref-type="fn" rid="FN2">2</xref>
149 Citations1986Ruth Peters, Duncan C. Thomas +3 more
Education, presumably a correlate of an inadequately measured etiologic risk factor (possibly papillomavirus infection), was responsible for the greatest difference in risk between the Spanish- and English-speaking cases.
American Journal of EpidemiologySEXUAL ACTIVITY, CONTRACEPTION, GENITAL INFECTIONS, AND CERVICAL CANCER: SUPPORT FOR A SEXUALLY TRANSMITTED DISEASE HYPOTHESIS
125 Citations1989Martha L. Slattery, James C. Overall +4 more
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Sexually Transmitted DiseasesPrevalence, Incidence, and Estimated Life-time Risk of Cervical Human Papillomavirus Infections in a Nonselected Finnish Female Population
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Journal of women's healthGenital Human Papillomavirus Infections: Knowledge, Perception of Risk, and Actual Risk in a Nonclinic Population of Young Women
114 Citations1997J. de Juan Ramirez, Dionei Ramos +3 more
The majority of women have little knowledge of HPV infections and have attributed many negative emotions associated with infectivity, which appear to influence women's decision making concerning HPV testing.
Journal of American College HealthRisk Level, Knowledge, and Preventive Behavior for Human Papillomaviruses among Sexually Active College Women
110 Citations1992Karen Vail‐Smith, David M. White
This study surveyed 263 sexually active college women and concluded that they are at considerable risk for contracting HPV, they lack awareness of HPV, and they are not practicing preventive behaviors that could reduce their risk of HPV and its serious consequences.
Journal of Community HealthPerceptions of cervical cancer and pap smear screening behavior by women's sexual orientation
99 Citations1996James H. Price, Alyssa Easton +2 more
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Social Science & MedicineAttendance for cervical screening—Whose problem?
91 Citations1985A Eardley, Andrea Knopf Elkind +4 more
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American Journal of EpidemiologyTHE ROLE OF CONTRACEPTIVE USE IN CERVICAL CANCER: THE MARYLAND CERVICAL CANCER CASE-CONTROL STUDY
87 Citations1987David D. Celentano, Ann C. Klassen +2 more
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PubMedHPV and cervical neoplasia: review of case-control and cohort studies.
84 Citations1992Núbia Muñóz, F. Xavier Bosch
Direct evidence suggests that HPV DNA detected in cancer cells is a good marker of HPV infection occurring before cancer development, and a dose-response relationship has been reported between increasing estimated viral load and risk of cervical cancer.
International Journal of CancerCase‐control study of risk factors for cervical neoplasia in Denmark. I: Role of the “male factor” in women with one lifetime sexual partner
80 Citations1991Susanne K. Kjær, Ethel‐Michele de Villiers +6 more
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British Journal of CancerOral contraceptives and cervical cancer - further findings from the Oxford Family Planning Association contraceptive study
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A possible effect of OC use on later stages of cervical carcinogenesis is suggested, although residual confounding due to sexual factors or human papillomavirus (HPV) infection cannot be ruled out.
The Journal of Infectious DiseasesThe Prevalence of Cervical Infection with Human Papillomaviruses and Cervical Dysplasia in Alaska Native Women
67 Citations1994Michael Davidson, P. G. Schnitzer +11 more
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Baillière s Clinical Obstetrics and Gynaecology1 Epidemiology of cervical intraepithelial neoplasia: the role of human papillomavirus
64 Citations1995J. Thomas Cox
The evidence implicating specific HPV types in the aetiology of cervical cancer is now strong enough to establish a causative role, and epidemiological studies indicating that HPV infection with oncogenic viral types is far more common than cervical neoplasia suggest the necessity of cofactors in cervical carcinogenesis.
American Journal of EpidemiologyProstitution, Condom Use, and Invasive Squamous Cell Cervical Cancer in Thailand
59 Citations1996D. B. Thomas, Roberta M. Ray +10 more
Regular use of condoms by customers of prostitutes could reduce the number of invasive cervical cancer cases in the general population of Thailand by at least one fourth.
Obstetrical & Gynecological SurveyEtiology of Cervical Cancer
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The data on the etiological factors presented here may enable us to suggest a synergism between the various factors associated with the pathogenesis of cervical cancer, and cigarette smoking, hormones, and other infections causing local inflammation and the production of free radicals.
Clinical PediatricsSexually Transmitted Diseases
53 Citations1994Paula K. Braverman, Victor C. Strasburger
The biological, psychological, and social factors that place adolescents at increased risk for STDs are reviewed and major sequelae of STDs — including pelvic inflammatory disease, perihepatitis, Reiter's syndrome, and disseminated gonorrhea infection are discussed.
Journal of Clinical EpidemiologyThe relationship between contraceptives, sexual practices, and cervical human papillomavirus infection among a college population
48 Citations1992Barbara J. Burkett
Alcohol use was significantly more frequent in all groups, underscoring this variable as a risk factor for both HPV DNA positivity and related disease in young women.
International Journal of Health ServicesWomen and Health Care: A Comparison of Theories
47 Citations1975Elizabeth Fee
There are three distinct approaches to the analysis of women's position in society, and thus of women’s relation to the health care system; liberal feminists, Marxist-feminists and radical feminists.
International Journal of Health ServicesThe Women's Health Movement
44 Citations1975Helen I. Marieskind
It is shown that health issues are seen by the Movement as suspended in the larger social context from which they arise.
EpidemiologyBarrier and Spermicidal Contraceptive Methods and Risk of Invasive Cervical Cancer
43 Citations1990Allan Hildesheim, Louise A. Brinton +5 more
After adjustment for relevant confounders, diaphragm and condom use were found not to be significantly associated with risk of cervical cancer, and the potential ability of spermicides to reduce cervical cancer risk by neutralizing viral agents warrants further attention.
JAMAThe New Our Bodies, Ourselves: A Book by and for Women
42 Citations1993Charlea T. Massion
The 1992 New The authors' Bodies, Ourselves (OBOS) is a motherlode of information and resources for the client/consumer and the physician, which can better understand the social, political, and cultural context of women's health.
Journal of Advanced NursingOlder women's attitudes to cervical screening and cervical cancer: a New Zealand experience
34 Citations1995Gillian E. White
The study highlights cognitive, emotional, socio-economic and ego integrity barriers to regular cervical screening in healthy older women and provides a useful background for developing strategies to increase the uptake of cervical smears amongst older Caucasian women.
The Medical Journal of AustraliaCervical cancer — what role for human papillomavirus?
26 Citations1992Suzanne M. Garland, Beverly E. Faulkner-Jones +2 more
The role of human papillomavirus (HPV) as a causative agent of cancer of the cervix is reviewed to assess its role in women's cervix cancer.
DigitalGeorgetown (Georgetown University Library)Second opinion: The politics of women's health in New Zealand
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Journal of Public HealthImproving the coverage and quality of cervical screening: women's views
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PubMedPeriodic health examination, 1995 update: 1. Screening for human papillomavirus infection in asymptomatic women. Canadian Task Force on the Periodic Health Examination.
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Current Opinion in Obstetrics & GynecologyContraception choice and sexually transmitted disease
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Individuals at high risk for both an unwanted pregnancy and an STD should be counseled to use both a hormonal and barrier contraceptive.
Seminars in Oncology NursingCervix cancer prevention and detection update
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The incidence of cervical cancer varies among ethnic and racial groups in the United States, and black, Native American, and Hispanic women are diagnosed at a more advanced stage than whites, and Native Americans and Hispanics are less likely to receive treatment than whites.
JNCI Journal of the National Cancer InstituteCervical Cancer: Following the HPV Pathway
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Health Care For Women InternationalWomen and power: How can we change the system?
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