Knowledge, attitudes and practices regarding the Pap test among women in northeastern Brazil
Keywords:
Papillomavirus infections, Uterine cervical neoplasms, Vaginal smears, Women’s health, Socioeconomic factorsAbstract
CONTEXT AND OBJECTIVE: The Papanicolaou (Pap) test has been shown to be effective in preventing cervical cancer. However, both the national and international literature shows that Pap testing has not reached the level of coverage desired. The objective of this study was to assess women’s knowledge, attitudes and practices regarding the Pap test and to investigate whether there are any associations between these three factors and the women’s sociodemographic characteristics. DESIGN AND SETTING: Cross-sectional descriptive study conducted in Floriano, Piauí. METHODS: The study was conducted among 493 women between November 2009 and December 2010. A questionnaire with precoded questions was used, and the responses were analyzed in terms of appropriateness in relation to the Pap test. RESULTS: The degrees of adequacy of knowledge, attitudes and practices regarding the Pap test were 36.7%, 67.2% and 69.6%, respectively. Among the main barriers against testing, absence of symptoms and a sense of embarrassment were the most notable. CONCLUSIONS: Women who visit doctors periodically had the most appropriate practices regarding the Pap test, but their knowledge of the procedure was poor. This suggests that these women were not receiving adequate information about the benefits of periodic testing.
Downloads
References
International Agency for Research on Cancer. Centre International de Recherche sur le Cancer. Press release no 151. IARC confirms efficacy of cervix cancer screening for women 25-65 in reducing mortality. Available from: http://www.iarc.fr/en/media-centre/pr/2004/pr151.html. Accessed in 2013 (Mar 12).
Villa LL. Vaccines against papillomavirus infections and disease. Salud Publica Mex. 2003;45 Suppl 3:S443-8.
Instituto Nacional de Câncer José Alencar Gomes da Silva. Coordenação Geral de Ações Estratégicas. Coordenação de Prevenção e Vigilância. Estimativa 2012: incidência de câncer no Brasil. Rio de Janeiro: INCA; 2011. Available from: http://www.inca.gov.br/estimativa/2012/estimativa20122111.pdf. Accessed in 2013 (Mar 13).
Hackenhaar AA, Cesar JA, Domingues MR. Exame citopatológico de colo uterino em mulheres com idade entre 20 e 59 anos em Pelotas, RS: prevalência, foco e fatores associados à sua não realização [Pap smears of 20 – 59 year-old women in Pelotas, Southern Brazil: prevalence, approach and factors associated with not undergoing the test]. Rev Bras Epidemiol. 2006;9(1):103-11.
Entiauspe LG, Teixeira, LO, Mendoza-Sassi RA, et al. Papilomavírus humano: prevalência e genótipos encontrados em mulheres HIV positivas e negativas, em um centro de referência no extremo Sul do Brasil [Human papillomavirus: prevalence and genotypes found among HIV-positive and negative women at a reference center in the far south of Brazil]. Rev Soc Bras Med Trop. 2010;43(3):260-3.
Oliveira LHS, Ferreira MDPL, Augusto EF, et al. Genótipos de papilomavírus humanos em mulheres jovens assintomáticas de escolas públicas do Rio de Janeiro, Brasil [Human papillomavirus genotypes in asymptomatic young women from public schools in Rio de Janeiro, Brazil]. Rev Soc Bras Med Trop. 2010;43(1):4-8.
Muñoz M, Castellsagué X, de González AB, Gissmann L. Chapter 1: HPV in the etiology of human cancer. Vaccine. 2006;24 Suppl 3:S3/1-10.
Steenbergen RD, de Wilde J, Wilting SM, et al. HPV-mediated transformation of the anogenital tract. J Clin Virol. 2005;32 Suppl 1:S25-33.
Trottier H, Franco EL. The epidemiology of genital human papillomavirus infection. Vaccine. 2006;24 Suppl 1:S1-15.
Greenwood SA, Machado MFAS, Sampaio NMV. Motivos que levam mulheres a não retornarem para receber o resultado de exame Papanicolau [Motives which lead women not to return to receive the results of their pap smear test]. Rev Latinoam Enferm. 2006;14(4):503-9.
Bosch FX, Lorincz A, Muñoz N, Meijer CJ, Shah KV. The causal relation between human papillomavirus and cervical cancer. J Clin Pathol. 2002;55(4):244-65.
Villa LL. Prophylactic HPV vaccines: reducing the burden of HPV- related diseases. Vaccine. 2006;24 Suppl 1:S23-8.
Martins LFL, Thuler LCS, Valente JG. Cobertura do exame de Papanicolaou no Brasil e seus fatores determinantes: uma revisão sistemática da literatura [Coverage of the Pap smear in Brazil and its determining factors: a systematic literature review]. Rev Bras Ginecol Obstet. 2005;27(8):485-92.
von Zuben MV, Derchain SF, Sarian LO, et al. The impact of a community intervention to improve cervical cancer screening uptake in the Amazon region of Brazil. Sao Paulo Med J. 2007;125(1):42-5.
Ramos AS, Palha PF, Costa Júnior ML, Sant’Anna SC, Lenza NFB. Perfil de mulheres de 40 a 49 anos cadastradas em um núcleo de saúde da família, quanto à realização do exame preventivo de Papanicolaou [Pap smear realization profile of women between 40 and 49 years registered at a family health center]. Rev Latinoam Enferm. 2006;14(2):170-4.
Amorim VM, Barros MB, César CL, Carandina L, Goldbaum M. Fatores associados à não realização do exame de Papanicolaou: um estudo de base populacional no Município de Campinas, São Paulo, Brasil [Factors associated with women’s failure to submit to Pap smears: a population-based study in Campinas, São Paulo, Brazil]. Cad Saude Publica. 2006;22(11):2329-38.
Pinho AA, França-Júnior I. Prevenção do câncer de colo do útero: um modelo teórico para analisar o acesso e a utilização do teste de Papanicolaou [Cervical cancer prevention: a theoretical framework to analyze Papanicolaou test access and use]. Rev Bras Saúde Matern Infant. 2003;3(1):95-112.
Oliveira MMHN, Silva AAM, Brito LMO, Coimbra LC. Cobertura e fatores associados à não realização do exame de Papanicolaou em São Luis, Maranhão [Coverage and factors associated with not performing Pap smear screening tests in São Luís, Maranhão, Brazil]. Rev Bras Epidemiol. 2006;9(3):325-34.
Fernandes JV, Rodrigues SH, Costa YG, et al. Knowledge, attitudes, and practices related to Pap test by women, Northeastern Brazil. Rev Saude Publica. 2009;43(5):851-8.
Szwarcwald CL, Viacava F, Vasconcellos MTL, et al. Pesquisa Mundial de Saúde 2003: o Brasil em números. RADIS. 2004;23:14-33. Available from: http://www.ensp.fiocruz.br/radis/sites/default/files/radis_23.pdf. Accessed in 2013 (Mar 12).
Quadros CAT, Victora CG, Costa JSD. Coverage and focus of a cervical cancer prevention program in southern Brazil. Rev Panam Salud Publica. 2004;16(4):223-32.
Muller DK, Dias-da-Costa JS, Luz AM, Olinto MT. Cobertura do exame citopatológico do colo do útero na cidade de São Leopoldo, Rio Grande do Sul, Brasil [Coverage of Pap smear tests in the city of São Leopoldo, Rio Grande do Sul State, Brazil]. Cad Saude Publica. 2008;24(11):2511-20.
Lartey M, Joubert G, Cronje HS. Knowledge, attitudes and practices of rural women in South Africa regarding the Pap smear. Int J Gynaecol Obstet. 2003;83(3):315-26.
Gamarra CJ, Paz EP, Griep RH. Conhecimentos, atitudes e prática do exame de Papanicolaou entre mulheres argentinas [Knowledge, attitudes and practice related to Papanicolaou smear test among Argentina’s women]. Rev Saude Publica. 2005;39(2):270-6.
Racho D, Vargas VRA. Análise da prática e atitude sobre o exame preventivo de câncer de colo de útero em uma comunidade universitária [Analyses of practice and behaviors about the pap semear of feminine university population]. Rev Bras Anal Clin. 2007;39(4):259-63.
