Cervical cancer and the HPV link: identifying areas for education in Mexico City's public hospitals

Abstract

ResumenObjetivo. Evaluar el conocimiento y las prácticas de los proveedores de servicios de salud en la Ciudad de México sobre el cáncer cervicouterino y el virus del papiloma humano (VPH); comparar a este respecto a ginecoobstetras (GO) y médicos generales (MG). Material y métodos. En abril del 2003, 187 GO y MG empleados en 15 hospitales afiliados a la Secretaría de Salud del Distrito Federal (SSDF) completaron un cuestionario autoaplicado. Se utilizó la prueba de ji cuadrada de Pearson para evaluar las diferencias entre GO y MG. Resultados. Casi todos los participantes (93%) identificaron el VPH como la causa principal del cáncer cervicouterino. Los GO mostraron un conocimiento más detallado del VPH que los MG, con más probabilidad de haber escuchado de las cepas oncogénicas comunes del VPH (p= 0.000). Un 16% de los médicos contestó incorrectamente que los exá-menes de Papanicolaou deben realizarse cada seis meses y 17% recomendó la histerectomía como una opción de tratamiento para displasia leve o moderada. Conclusiones. Los médicos que se desempeñan en el SSDF demostraron conocimiento básico acerca de la relación entre el cáncer cervicouterino y el VPH. Sin embargo, las normas relativas al tamizaje y manejo son áreas prioritarias para las intervenciones educativas dirigidas a esta población. AbstractObjective. To assess Mexico City physicians' knowledge and practices regarding cervical cancer and human papillomavirus (HPV) to compare obstetricians/gynecologists (ob/gyns) and general practitioners (GPs) on these variables. Material and Methods. In April 2003, 187 ob/gyns and GPs working in 15 hospitals affiliated with the Federal District Secretary of Health (SSDF) completed a self-administered questionnaire. Pearson's chi-square tests were used to compare ob/ gyns and GPs on outcome variables. Results. Nearly all providers (93%) identified HPV as the principal cause of cervical cancer. Ob/gyns had more detailed knowledge about HPV than GPs and were more likely to have heard of common oncogenic strains (p=.000). Sixteen percent of all physicians incorrectly stated that Pap tests should be performed every six months regardless of previous results, and 17% recommended hysterectomy as an option for treating mild or moderate dysplasia. Conclusions. While SSDF physicians had basic knowledge about the cervical cancer-HPV link, screening and management norms are priority areas for educational interventions.

Knowledge about cervical cancer prevention and psychosocial barriers to screening among Mexican women

“…This finding highlights the need to improve preventive health programs which should include information both about the importance of Pap and about the timing of when women should have Pap tests performed. In a previous study conducted with Mexican gynecologists and general practitioners, some confusion was found concerning the appropriate periodicity of Pap smears as well as the recommended age for a woman's first Pap smear [21]. Since many women have the screening done following the advice of their physicians, it is also necessary to promote educational interventions directed toward physicians to improve the quality of medical care.…”