Factors Associated with Cervical Cancer Screening Amongst Women of Reproductive Age from Yucatan, Mexico

Abstract

This study aimed to analyse the participation of women of reproductive age in a cancer screening program, and survey reasons for non-screening in a region from Mexico with high cervical cancer mortality. A total of 281 obstetric patients from a previous HPV study in a social security hospital during 2008-2009 were included. Reasons for not participating in the screening were directly asked. HPV positive patients were invited to participate in an informative workshop, and they filled in a knowledge questionnaire. The women ranged in age from 14-47 years; 123 (43.8%) had never participated in screening, of which 97 (78.9%) had their first sexual intercourse 2 to 10 years ago, resulting in 25% HPV positive. Screening history was strongly associated with 2 or more gestations (OR= 10.07, p=0.00) and older age (OR=6.69 p=0.00). When 197 women were contacted and interviewed, reasons referred for non-screening were ignorance, lack of interest or time, recent sexual onset, shame and fear. More than 50% of the workshop participants showed knowledge of HPV, while 38.9% and 25% knew about Pap smear and cervical cancer. A high percentage of women of reproductive age have never had a Pap smear. Promoting the screening program in medical facilities seems to be important in this population. New approaches to inform vulnerable individuals on the benefits of screening need to be implemented, especially for young women.

The challenge of cancer in middle-income countries with an ageing population: Mexico as a case study

“…Fear of a cancer diagnosis, lack of knowledge or interest and anxiety regarding physical examination have all been cited as reasons for not attending cervical and mammographic screening appointments in the adult population [ 76 , 77 ]. Elderly men are potentially vulnerable.…”

Factors associated with attitudes of rural women toward cervical cancer screening

“…A clear role of husbands in permitting their wives to undergo pelvic examination for cancer is positive in the context of screening uptake. The studies conducted elsewhere( 4 5 6 7 8 9 10 11 ) described several factors in association with screening uptake.…”

“…The associated reasons found were ignorance, lack of interest, recent sexual onset, shame and fear. The study( 9 ) recommended the need of promoting screening program in medical facilities for their population. The factor of acceptability of conducting screening program in existing government health facility was also studied by the present study.…”

“…Studies have shown non-suitable screening clinic time and place could be a factor negatively influencing women to undergo cervical screening. ( 2 8 9 ) The awareness about cancer prevention by screening is needed because many studies found it to be an important factor for non-participation. A study was conducted on how the husbands in general would take care of their wife's health.…”

Cobertura do exame de Papanicolaou no município de Manaus, Amazonas: um estudo de base populacional

“…Mais pesquisas são necessárias para esclarecer esta relação, uma vez que é bem estabelecida a associação entre o câncer do colo do útero com comportamento sexual da mulher, em virtude da exposição ao vírus HPV, sendo mais propensa a esta neoplasia as mulheres com elevado número de parceiros sexuais, início precoce da atividade sexual e com alta paridade.Quanto a história reprodutiva, evidenciou-se a associação estatisticamente significativa entre a realização do exame de Papanicolaou e o número de gestações, sendo observado que as mulheres com uma ou duas gestações apresentaram menor risco de frequência inadequada do exame em relação às que engravidaram seis ou mais vezes. Alguns autores têm mostrado que a gestação é um fator relacionado a prática de realização do exame, e a chance de realizá-lo pode aumentar a medida que a mulher apresenta mais gestações(CECHINEL et al, 2009;AREIAS, 2011; GONÇALVES et al 2011;CONDE-FERRÁEZ et al, 2012;KARABULUTLU, 2013). Em consonância com este argumento,Nygard et al (2007), ao estudarem o efeito do exame de Papanicolaou antes do parto na cobertura de um programa de rastreamento do câncer do colo do útero, observaram que as mulheres grávidas eram quase cinco vezes mais propensas de terem realizado o exame de Papanicolaou no último ano comparadas às mulheres não grávidas.…”