Family physicians' knowledge of risk factors for cervical cancer

Predictors of human papillomavirus awareness and knowledge in 2013: gaps and opportunities for targeted communication strategies

BACKGROUND

Nearly 80 million people in the U.S. are currently infected with at least one of two strains of human papillomavirus (HPV), which is associated with 70% of cervical cancers. Greater cervical cancer mortality has been observed among women of lower SES and those living in rural, versus urban, areas. African American and Hispanic women are significantly more likely to die from cervical cancer than non-Hispanic white women.

PURPOSE

To assess current population awareness of and knowledge about HPV and the HPV vaccine, as well as the contribution of sociodemographic characteristics to disparities in HPV awareness and knowledge.

METHODS

Cross-sectional data were obtained from the National Cancer Institute's 2013 Health Information National Trends Survey (HINTS; N=3,185). Multivariable logistic regression was employed to identify gaps in awareness and knowledge by sex, education, income, race/ethnicity, geographic area, and other important sociodemographic characteristics. Analyses were conducted in 2014.

RESULTS

Sixty-eight percent of Americans had heard of HPV and the HPV vaccine. Consistent with the Knowledge Gap Hypothesis, awareness and knowledge were patterned by sex, age, education, and other important sociodemographic factors. Those in rural areas were less likely than those in urban areas to know that HPV causes cervical cancer. Less than 5% of Americans were aware that HPV often clears on its own without treatment.

CONCLUSIONS

Although awareness and knowledge of HPV is increasing, there are opportunities to target communication with populations for whom knowledge gaps currently exist, in order to promote dialogue about the vaccine among patients and their providers.

Attitudes and beliefs of women about the factors responsible for the development of cervical carcinoma

Background: To determine the level of knowledge among women about factors responsible for the development of cervix carcinoma and the necessity of education and health promotion. Methods: Three groups of women were interviewed according to measuring instruments by the specially created questionnaire for this research. The statistically significant difference in answers was determined by the ANOVA test. Results: In most of the investigated factors (7 of 11) statistically significant differences in answers were observed among the groups. Only six participants in all groups indicated human papillomavirus as the factor responsible for the development of cervix carcinoma. Conclusion: In all three groups of the interviewed women, bacterial and viral causes of the disease were highly ranked in comparison to other risk factors. Only a small number of participants indicated human papillomavirus as an etiological factor. There is need to improve the knowledge about risk factors through health promotion and health education in order to change the epidemiological situation concerning cervical carcinoma.

Knowledge of human papillomavirus: differences by self-reported treatment for genital warts and sociodemographic characteristics

The aim of this study was to evaluate knowledge about human papillomavirus (HPV) in individuals with genital warts compared with women from the general population without genital warts. Human papillomavirus (HPV) knowledge among women reporting treatment for genital warts compared with HPV knowledge in women reporting no treatment was assessed using data from the population-based 2005 Health Information National Trends Survey (HINTS). Three percent (N = 97) of women answered "yes" and 97% (N = 3,450) "no" to "Have you ever been treated for venereal warts or condyloma?" Women who reported treatment for genital warts, were more likely to have heard of HPV (odds ratio (OR): 2.4, 95% confidence interval (CI): 1.4-4.2 vs. no or don't know), to have been told they had HPV (OR: 24.5, 95% CI: 11.4-52.8), and to have accurate information about HPV, such as HPV causes cancer (OR: 2.7, 95% CI: 1.8-4.3). A large proportion (41%) of women who reported treatment for genital warts, however, had not heard of HPV. These women tended to be older, poorer, less educated, non-Hispanic Black, less likely to have had a recent Pap test, and divorced, widowed, or separated. Women with genital warts are learning about HPV, but socioeconomically disadvantaged groups may need to be targeted.

Use of cervical cancer screening among insured women: the extent of missed opportunities

The objective of the study is to identify opportunities to improve cervical cancer screening among privately insured women. From MedStat's Marketscan database, we identified 735,181 women aged 21-64 years who remained in the same insurance plan during the entire period of 2000-2002. We obtained the percentages of women who had a Papanicolaou (Pap)-test reimbursement claim and any health-related claim during the 3-year period. For women without a Pap-test claim, we obtained information about the frequency of insurance claims, type of health-care provider, and type of insurance plan in which the women were enrolled. The multivariate logistic regression model was used to identify factors independently associated with not having a Pap test. Of the total sample, in the 3-year period, 96% had at least one health insurance reimbursement claim and 69% had at least one claim for a Pap test. Approximately, 87% of the women who had no Pap-test claim had a health claim; 44% of such claims were from primary care providers. In the multiple logistic regression model, factors that were independently associated with having no Pap test were old age, being dependents of employees, and enrollment in comprehensive insurance plans. Efforts to increase the use of cervical cancer screening service should consider additional risk factors besides lack of insurance coverage. Concerted efforts by insurance and health-care providers are needed to improve adherence to the recommended cervical cancer screening guidelines, both by consumers and service providers.