Mexican physicians' knowledge and attitudes about the human papillomavirus and cervical cancer: a national survey

Abstract

Objective: To assess Mexican physicians' knowledge about the human papillomavirus (HPV) and cervical cancer and their opinions and practices related to screening, managing, and counselling women on these topics. Methodology: In August 2002 we surveyed 1206 general practitioners (GPs) and obstetriciansgynaecologists (Ob-Gyns) working in a nationally representative sample of public and private facilities in urban Mexico. Eligible physicians completed a self administered questionnaire. We conducted a weighted analysis and used x 2 tests to compare GPs and Ob-Gyns on outcome variables. Results: 76% of recruited physicians responded to the survey. 43% of Ob-Gyns had performed a hysterectomy in the last year to treat a case of CIN I or II. With respect to HPV, while 80% of respondents identified the virus as the principal cause of cervical cancer, many lacked detailed knowledge about this association. Ob-Gyns were more likely than GPs to have heard about specific oncogenic strains of HPV (p,0.001). Nearly all respondents thought that women should be informed that HPV causes cervical cancer; nevertheless, physicians believed that positioning cervical cancer as a sexually transmitted infection (STI) could cause problems in partner relationships (60%), confusion (40%), and unnecessary anxiety among women (32%). Conclusions: Mexican physicians support patient education on the HPV-cervical cancer link. However, findings suggest the need to present clear messages to women (emphasising, for example, that only certain types of HPV are oncogenic), to consider the conflicts such information might create for couples, and to further educate physicians about this topic and about overall cervical cancer screening and treatment protocols. C ervical cancer is the second most common cancer in women, with an estimated 500 000 new cases and 231 000 deaths annually worldwide.1 2 Latin America has among the highest incidence rates in the world, and unlike the United States and Canada, most of the region has seen little improvement in the past 30 years. In Mexico, cervical cancer remains a leading cause of death among women of reproductive age with a stable mortality rate of around 17/100 000 despite a national screening programme since 1974.3 Several factors contribute to cervical cancer rates in Mexico, including low coverage of Papanicolaou (Pap) smears especially among high risk women such as those in rural areas with limited contact with the health system, poor quality of cytology services, and lack of follow up for women with abnormal Pap results. One study found that only 64% of women aged 15-49 in Mexico City and 30% in the state of Oaxaca had ever had a Pap test in their lifetime. 4 Since the mid-1990s, clinical evidence has established the human papillomavirus (HPV) as a necessary cause of cervical cancer.5 Knowledge of this association has spurred research on HPV based strategies for cervical cancer prevention, including primary prevention of HPV, HPV vaccines, and the use of HPV testing for follow up of women with abnormal Pap ...

Parental Knowledge and Attitudes about Human Papilloma Virus in Iran

“…Moreover, a study among Mexican physicians showed that only 19% knew that HPV types 16, 18, 31, 38 and 45 do not cause genital warts. This study showed the importance of services leading to increase of knowledge about HPV infection (Aldrich et al, 2005). There was a converse relation between the age and knowledge of parents in our study; the older parents, had less knowledge, but in the study of Stefanie et al (2010), age was not a predictor of knowledge about HPV infection (Klug et al, 2008).…”

Factors Associated With Intention-to-Recommend Human Papillomavirus Vaccination Among Physicians in Mysore, India

“…An overwhelming majority of studies on acceptability of HPV vaccination among physicians have been carried out in developed countries [9][10][11][12][13][14][15][16][17][18][19]. Studies that investigated knowledge of HPV and cervical cancer have shown that awareness varies widely by specialty and training [9][10][11][12]19].…”

Utilization of Cervical Cancer Screening and Associated Factors among Female Health Workers in Governmental Health Institution of Arba Minch Town and Zuria District, Gamo Gofa Zone, Arba Minch, Ethiopia, 2016

“…Screening even once in a lifetime will be beneficial to avoid advanced cancer but the intervals may vary [9,10]. According to the WHO, United States Preventive Services Task Force and the American Cancer Society women should start cervical cancer screening at the age of 21 at least once every three-five year interval.…”