Cervical Cancer-Related Knowledge, Attitudes, and Practices of Health Professionals Working in Brazil's Network of Primary Care Units

Abstract

Introduction. Brazil's national strategy for cervical cancer screening includes using the Papanicolaou (Pap) test every 3 years among women aged 25–64 years. Comprehensive primary care services are provided through a network of primary health units, but little is known about cervical cancer‐related knowledge, attitudes, and practices among health professionals and coordinators working in these facilities. Methods. In 2011, we conducted a cross‐sectional nationally representative phone survey of 1,600 primary health care units to interview one unit coordinator and one health care professional per unit (either nurse, physician, or community health worker). Responses were obtained from 1,251 coordinators, 182 physicians, 347 nurses, and 273 community health workers. Questionnaires were administered to assess health units’ characteristics and capacity for cervical cancer‐related services as well as health professionals’ perceived effectiveness of the Pap test, preparedness to talk to women about cervical cancer, adherence with screening guidelines, and willingness to recommend human papillomavirus (HPV) vaccination to females. Results. Most units conducted screening (91.9%), used home visits to conduct recruitment and outreach (83.4%), and provided follow‐up to women who did not return to discuss Pap test results (88.1%). Approximately 93% of health professionals stated that Pap testing was effective in decreasing death rates from cervical cancer and 65% stated that national guidelines for cervical cancer screening are very influential; 93% of nurses and physicians reported screening women annually and 75% reported beginning to screen women younger than 25 years old. Regarding HPV vaccination, almost 90% of nurses and physicians would recommend the HPV vaccine to their females patients if it were available. A larger proportion of physicians and nurses recommended the HPV vaccine to older girls (13–18 years) and women (19–26 years and even older than 26 years) than to younger girls (12 years or younger). Conclusion. Although Brazil's network of primary care units has significantly increased access to cervical cancer screening, effective strategies are needed to ensure that women get screened at the appropriate ages and intervals. Additionally, this study's baseline data on HPV vaccination may be useful as Brazil embarks on a national HPV vaccination program in 2014.

Role of Interleukin-18 and Associated Risk Factors in Cervical Cancer in North Indian Population

“…As result shows that awareness about health is significantly varied with the level of educational attainment, this is also supported by many studies. [13][14][15][16] This study provides useful information that could be utilized by both researchers and those involved in public health programs.…”

Sağlık Çalışanlarının Kanser Taramaları Hakkındaki Bilgi, Tutum ve Davranışlarının Değerlendirilmesi

“…19 Stormo ve arkadaşlarının Brezilya'da birinci basamak sağlık merkezlerinde yaptığı çalışmasında Pap-smear testinin yapılma oranı %91,9 olup sağlık çalışanlarının %93'ü Pap-smear testininin serviks kanserine bağlı ölümleri azaltmada etkili olduğunu düşünmekteyken, hekimlerin %17,9'u serviks kanseri taraması yapmadığını belirtmiştir. 20 Jemal ve arkadaşlarının çalışmasında; American Cancer Society (ACS), Centers for Disease Control and Prevention (CDC), National Cancer Institute (NCI) ve North American Association of Central Cancer Registries (NAACCR) verileri değerlendirildiğinde 3 yıl içinde 21-65 yaş arasındaki kadınların %86,7 sine Papsmear testi yapıldığı bildirilmiştir. 21 Çalışmamızda testin uygulanma oranı değerlendirilememekle birlikte bilgi düzeyinin düşük olduğu görülmüştür.…”

Cervical Cancer Screening: The Complex Interplay of Medical Infrastructure, Society, and Culture

“…Using standardized telephone surveys, Stormo et al [2] and Townsend et al [3] report on the screening knowledge and practices of two separate regions with extremely high cervical cancer rates: Brazil and the U.S. Affiliated Pacific Island Jurisdictions (USAPIJ).…”

“…Both surveys took place in 2011, prior to the institution of the new combined American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology guidelines for cervical cancer screening (Table 1) [4]. In Brazil, national guidelines recommend a focus on women aged 25-59 years with Papanicolaou (Pap) tests every 3 years after two consecutive yearly normal results [2]. In the USAPIJ, the older annual Pap test screening guidelines were generally followed [3].…”

“…Stormo et al showed that community health workers have been used effectively to both educate the community and to follow up with home visits when women do not return to the clinic [2]. A 1998 landmark report on community workers identified key roles to facilitate access and care in health care systems [17].…”