Objective. The purpose of this study was to assess the knowledge level about HPV and screening of cervical cancer in women from the metropolitan region of Natal, Brazil. Materials and Methods. A descriptive cross-sectional study involving sexually active women was conducted. The participants were submitted to a face-to-face interview, using a structured questionnaire that permitted the quantification of data and opinions of the respondents. Results. Most participants (70.9%) had poor knowledge about HPV and also the Pap test (53.0%). The high level of knowledge about HPV was associated with age, education, marital status, household income, and pregnancy, while the high level of knowledge about the Pap test proved to be associated only with education and household income. Conclusion. The results highlight the need for performing educational campaigns emphasizing the role of HPV in the etiology of cervical lesions of different degrees, including cervical cancer, as well as the importance of having a Pap test regularly to prevent these diseases. 1. Introduction Cervical cancer is the third most common cancer affecting women, after nonmelanoma skin cancer and breast cancer, and is the third leading cause of death by cancer among women worldwide, with higher incidence in developing countries [1, 2]. It is estimated that about 500,000 new cases are reported every year, with approximately 230,000 deaths worldwide. In Brazil, the crude incidence rates per 100,000 women, estimated for the year 2012, were 17 for the country and 14 for the Rio Grande do Norte State. The incidence of the disease starts from the age of 20 and the risk gradually increases with age, reaching its peak generally at age 50 to 60 [3]. The natural history of cervical cancer reveals that, despite its high incidence, this malignant neoplasm stands out among those with the greatest potential for prevention and cure in view of their infectious nature [4]. Cervical cytology is one of the most efficient methods for the screening of cervical cancer and is the most commonly used method worldwide [5]. Despite its benefits, many women in developing countries have never been screened or are not screened at regular intervals, so that this screening program does not have the desired impact on women’s health [6]. Reasons for the lack of effectiveness of these screening programs in developing countries include low screening coverage and participation rates among women, lack of quality control, poor ability of the health care system to offer proper followup and access to colposcopy, and inappropriate
References
[1]
D. M. Parkin and F. Bray, “Chapter 2: the burden of HPV-related cancers,” Vaccine, vol. 24, supplement 3, pp. S11–S25, 2006.
[2]
J. Ferlay, H. R. Shin, F. Bray, D. Forman, C. Mathers, and D. M. Parkin, “Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008,” International Journal of Cancer, vol. 127, no. 12, pp. 2893–2917, 2010.
[3]
Instituto Nacional de Cancer José Alencar Gomes da Silva, Coordena？？o Geral de A？？es Estratégicas—Coordena？？o de Preven？？o e Vigilancia. Estimate/2012—Cancer Incidence in Brazil, 2011, http://www.inca.gov.br/estimativa/2012/.
[4]
M. Kyrgiou, G. Valasoulis, C. Founta et al., “Clinical management of HPV-related disease of the lower genital tract,” Annals of the New York Academy of Sciences, vol. 1205, pp. 57–68, 2010.
[5]
D. Kobayashi, O. Takahashi, C. Hikosaka, T. Okubo, and T. Fukui, “Optimal cervical cytology mass screening interval for cervical cancer,” Archives of Gynecology and Obstetrics, vol. 287, no. 3, Article ID 136034, pp. 549–554, 2013.
[6]
P. N. Aniebue and U. U. Aniebue, “Awareness and practice of cervical cancer screening among female undergraduate students in a Nigerian University,” Journal of Cancer Education, vol. 25, no. 1, pp. 106–108, 2010.
[7]
R. Hanisch, J. Gustat, M. E. Hagensee et al., “Knowledge of Pap screening and human papillomavirus among women attending clinics in Medellín, Colombia,” International Journal of Gynecological Cancer, vol. 18, no. 5, pp. 1020–1026, 2008.
[8]
V. M. S. L. Amorim, M. B. D. A. Barros, C. L. G. César, L. Carandina, and M. Goldbaum, “Factors associated with women's failure to submit to Pap smears: a population-based study in Campinas, S？o Paulo, Brazil,” Cadernos de Saúde Pública, vol. 22, no. 11, pp. 2329–2338, 2006.
[9]
S. de Sanjosé, M. Diaz, X. Castellsagué et al., “Worldwide prevalence and genotype distribution of cervical human papillomavirus DNA in women with normal cytology: a meta-analysis,” Lancet Infectious Diseases, vol. 7, no. 7, pp. 453–459, 2007.
[10]
J. V. Fernandes, R. de Vasconcellos Meissner, M. G. F. de Carvalho, T. A. A. de Medeiros Fernandes, P. R. M. de Azevedo, and L. L. Villa, “Prevalence of HPV infection by cervical cytologic status in Brazil,” International Journal of Gynecology and Obstetrics, vol. 105, no. 1, pp. 21–24, 2009.
[11]
P. K. S. Chan, A. R. Chang, M. Y. Yu et al., “Age distribution of human papillomavirus infection and cervical neoplasia reflects caveats of cervical screening policies,” International Journal of Cancer, vol. 126, no. 1, pp. 297–301, 2010.
[12]
X. Castellsagué, “Natural history and epidemiology of HPV infection and cervical cancer,” Gynecologic Oncology, vol. 110, no. 3, supplement 2, pp. 4–7, 2008.
[13]
F. X. Bosch, S. de Sanjosé, and X. Castellsagué, “HPV and genital cancer: the essential epidemiology,” in Vaccines for the Prevention of Cervical Cancer, P. L. Stern and H. C. Kitchener, Eds., chapter 4, Oxford University Press, Oxford, UK, 2008.
[14]
M. Stanley, “Pathology and epidemiology of HPV infection in females,” Gynecologic Oncology, vol. 117, supplement 2, pp. S5–S10, 2010.
[15]
M. Arbyn, S. de Sanjosé, M. Soraiya, et al., “EUROGIN 2011 roadmap on prevention and treatment of HPV-related disease,” International Journal of Cancer, vol. 131, no. 9, pp. 1969–1982, 2012.
[16]
J. V. Fernandes, S. H. L. Rodrigues, Y. G. A. S. da Costa et al., “Knowledge, attitudes, and practices related to Pap test in Northeastern Brazil,” Revista de Saude Publica, vol. 43, no. 5, pp. 851–858, 2009.
[17]
A. A. Hackenhaar, J. A. Cesar, and M. R. Dominuges, “Pap smears of 20–59 year-old women in Pelotas, Southern Brazil: prevalence, approach and factors associated with not undergoing the test,” Revista Brasileira de Epidemiologia, vol. 9, no. 1, pp. 103–111, 2006.
[18]
A. A. Pinho and I. Fran？a Jr., “Cervical cancer prevention: a theoretical framework to analyze Papanicolaou test access and use,” Revista Brasileira de Saúde Materno Infantil, vol. 3, no. 1, pp. 95–112, 2003.
[19]
L. A. Dahlstr？m, K. Sundstrom, C. Young, C. Lundholm, P. Sparén, and T. N. Tran, “Awareness and knowledge of human papillomavirus in the Swedish adult population,” Journal of Adolescent Health, vol. 50, no. 2, pp. 204–206, 2012.
[20]
F. S. Conti, S. Bortolin, and I. C. Külkamp, “Education and promotion to the health: behavior and knowledge of adolescents of public and particular college in relation to the human papillomavirus,” Jornal Brasileiro de Doen？as Sexualmente Transmissíveis, vol. 18, no. 1, pp. 30–35, 2006.
[21]
J. R. S. Bretas, C. V. S. Ohara, D. P. Jardim, and R. L. Muroya, “Knowledge of STD/AIDS among adolescent students,” Revista da Escola de Enfermagem da USP, vol. 43, no. 3, pp. 551–557, 2009.
[22]
H. Cerigo, M. E. Macdonald, E. L. Franco, and P. Brassard, “Awareness and knowledge about human papillomavirus among Inuit women in Nunavik, Quebec,” Journal of Community Health, vol. 36, no. 1, pp. 56–62, 2011.
