Women´s knowledge about PAP Screening and HPV infection and its influence on screening uptake: a case-control study in Argentina"

PAOLINO M; ARROSSI S

Shenzen

Congreso; 2010 World Cancer Congress; 2010

Background: Assuring high levels of participation in screening is essential for effective cervical cancer prevention. In Argentina Pap coverage rates are relatively low (47% among women aged 35-64 without health coverage1). Knowledge about cervical cancer and preventive strategies play an important role in determining women’s participation in screening. However, in Argentina, little research has explored women’s knowledge regarding Pap test. Objectives: To describe women’s knowledge about Pap screening and HPV infection and vacctination and analyze how this knowledge influence Pap screening uptake.  Methods: This case control study was carried out in San Martin district in the Metropolitan Area of Buenos Aires. 200 women 18 years old and older (100 cases–100 controls), were recruited at the outpatient and emergency waiting rooms at the “Eva Perón” Hospital. Women attending gynecologic services were excluded from the study. Cases were women who have had a Pap test in the previous three years. Controls were women who have not had a Pap test in the previous three years or never had Pap tests. A face-to-face interview was performed using a structured questionnaire that also included questions about socio-demographic characteristics. Level of Pap knowledge was first categorized as “high”, “medium”, “low”, “inaccurate” and “do not know”. Secondly knowledge about Pap test was dichotomized in adequate (high/medium) or inadequate (low/inaccurate/do not know). Univariate and multivariate logistic regressions were used to evaluate the impact of women’s knowledge about Pap test in screening uptake. Crude and adjusted odds ratios (ORs) and 95% confidence intervals (95%CI) were calculated. Results: : 49% of cases and 73% of controls had inadequate knowledge about Pap test (P=0.001). 13% of cases and 31% of controls reported not knowing the purpose of the Pap test (P=0.001). In multivariate analysis (controlled for socio-demographic variables) women with adequate knowledge about the Pap test were 2.6 times more likely to have been screened than women with inadequate knowledge (95% CI: 1.4–4.8). 47% of cases and 30% of controls reported that they had ever heard about HPV infection (P=0.013); 17 cases and 3 controls had heard about HPV vaccination. Only 11 cases (11%) mentioned that HPV causes cervical cancer, all of whom had adequate knowledge about the Pap test. No women among controls knew that HPV causes cervical cancer. Conclusions: Lack of knowledge about Pap test is a potential barrier to screening, so increasing women’s knowledge about the preventive role of the test should be a key first step of any strategy to increase coverage. Women’s knowledge about HPV and its role on cervical cancer seems to be very limited, therefore before introducing new preventive technologies (HPV test/vaccination) culturally sensitive education activities addressed to the community should be carried out. Providing women with accurate information about cervical cancer prevention must be viewed as a key step to achieve Target 6 of the World Cancer Declaration. References: 1. Ministerio de Salud de la Nación. Primera Encuesta Nacional de Factores de Riesgo.  2006. Buenos Aires, 2006.