In order to understand the level of knowledge of women about cervical cancer and contribute to reducing misinformation about the disease in Brazil, the Institute of Urology, Oncology and Robotic Surgery (IUCR) applied the questionnaire “What do women know about cervical cancer and HPV?”. The online questionnaire, applied to a convenience sample, was attended by 548 women from 18 years of age. Amid the impact of the Covid-19 pandemic, just over half (55.7%) of the interviewees went through at least one routine visit in the gynecologist in 2020. Among those who made an appointment, 58.4% were for supplementary health and 41.1% for the Unified Health System (THEIR).
Regarding the level of education presented in the sample, 41.6% have completed higher education (undergraduate, graduate, master’s or doctorate). The main occupation was liberal professional (19.6%), however 28.6% of the participants are unemployed. Mostly, the women interviewed are married (55.7%) and have children (74.6%). In the sample, 12% said they had been diagnosed with a type of cancer, the most common being breast and cervix.
“ The survey provides data that raise topics for reflection. Even among women, who are more zealous about their health, the demand for routine consultations was low. The pandemic continues and it is essential to strengthen the alert about the importance of preventing cervical cancer, a disease that, with the Pap test and the HPV vaccine, is preventable ”, highlights Andréa Gadêlha Guimarães, clinical oncologist at the Instituto de Urology, Oncology and Robotic Surgery (IUCR) and the ACCamargo Cancer Center.
Knowledge and adherence to the Pap smear
Among the interviewees, 85.2% recognize Pap smear as the main exam for the diagnosis of cervical cancer and 82% perform the routine exam, with an interval between one and three years. Among the 18% who do not perform the exam routinely or never did, the main causes pointed out were an uncomfortable exam and fear of feeling pain. When asked about signs and symptoms, 88% correctly answered that, in the initial stage, cervical cancer has no symptoms and that with the progression of the disease may occur: dark vaginal discharge; vaginal bleeding after intercourse; pain during sex; abnormal vaginal bleeding (after menopause or between menstrual periods) etc. In addition, 96% showed knowledge when stating that cervical cancer is a disease that can affect women of all ages and more than 90% pointed out that the most indicated specialist to treat the disease is the oncologist or gynecologist.
Among the points of attention, warns Andréa Gadêlha, is the fact that 1 in 4 women are unaware of infection by HPV as the main cause of cervical cancer. In the sample, 23.4% pointed out other causes (smoking, being over 40 years old, obesity, early onset of sexual life and sexual practice with many partners and without a condom). “Another question that we should be aware of is that half (50.1%) responded as false or I do not know for the statement that cervical cancer is one of the easiest types to be avoided”, notes the expert.
The HPV vaccine is indicated for boys and girls as a strategy to prevent cervical cancer, as well as to prevent cancer of the penis, anus and oropharynx. However, the majority of respondents (53.8%) answered “false” or “I don’t know” to the statement that HPV is related to cancer of the penis, anus and oropharynx in men. “It is an evidence of how important it is to talk to the population, more and more, about the importance of also immunizing boys,” says Andréa Gadêlha.
Among the myths, one that stands out is the fact that the majority (57.7%) believe that the use of condoms during sexual intercourse completely protects against HPV when, in fact, although condoms are an important ally to prevent this and other sexually transmitted infections, the virus may be in areas that condoms do not protect, such as the vulva, pubic, perineal region or scrotum and, therefore, it is essential, to avoid HPV, to associate the use of condoms with immunization by the vaccine.
Care during the pandemic
The survey also outlined the profile of health care in the time of Covid-19. The good news is that only 7.7% said that, during the pandemic, only those who already have a cancer diagnosis and are undergoing treatment should go to the doctor and only 3.5% said that cancer does not arise unexpectedly and that it is possible expect to pass this pandemic moment to get back to the exam routine. In turn, half of the respondents did not undergo a routine gynecologist consultation in 2020.
Follow the complete results:
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AGE |
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|
8 – 24 |
30 (5,5%) |
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|
25 – 34 |
89 (16,2%) |
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|
25 – 44 |
171 (31,3%) |
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|
45 – 54 |
171 (31,3%) |
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|
55 – 64 |
57 (10,4%) |
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|
65 – 74 |
29 (5,3%) |
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|
75 or + |
0 |
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|
WHAT IS YOUR CURRENT OCCUPATION? |
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|
Self-employed professional, entrepreneur |
107 (19,6%) |
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|
CLT Professional |
83 (15,2%) |
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|
Retired |
69 (12,6%) |
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|
Unemployed |
157 (28,6%) |
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|
Intern |
26 (4,7%) |
|||
|
Public agent |
106 (9,3%) |
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WHAT IS YOUR SCHOOL DEGREE? |
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|
Complete or incomplete elementary school |
48 (8,8%) |
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|
Complete or incomplete high school |
211 (38,5%) |
|||
|
Incomplete higher education |
61 (11,1%) |
|||
|
Complete higher education |
137 (25%) |
|||
|
Post-graduate, master’s or doctorate |
91 (16,6%) |
|||
|
WHAT IS YOUR MARITAL STATUS? |
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|
Married |
305 (55,7%) |
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|
Single |
149 (27,2%) |
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|
Divorcee |
44 (8%) |
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|
Others |
50 (9,1%) |
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|
DO YOU HAVE KIDS? |
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|
Sim |
409 (74,6%) |
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|
No |
139 (25,4%) |
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|
IF YES, HOW MANY CHILDREN DO YOU HAVE? |
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|
a |
143 (35,6%) |
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|
Two |
178 (35,1%) |
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|
Three or more |
87 (21,3%) |
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|
YOU PASSED IN ROUTINE CONSULTATION |
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|
Sim |
305 (55,7%) |
|||
|
No |
243 (44,3%) |
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|
HAVE YOU HAD ANY TYPE OF CANCER? |
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|
Sim |
66 (12%) |
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|
No |
482 (88%) |
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RESPONSE AFFIRMATIVELY TO THE QUESTION PREVIOUS, WHAT KIND OF CANCER DID YOU HAVE?
|
ABOUT Cervix Cancer, choose |
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|
It is a disease that affects only |
2 (0,4%) |
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|
It is a tumor that can affect |
526 (96%) |
|||
|
Cervical cancer has no treatment or cure. |
5 (0,9%) |
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|
It is a disease that cannot be prevented |
15 (2,7%) |
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|
ABOUT CIRCUS CANCER SIGNS AND SYMPTOMS, |
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|
In the initial stage, cervical cancer has constant vaginal bleeding. In addition, headache, difficulty sleeping, lack of appetite, high fever for more than three days, change in libido, pain when urinating etc. |
42 (7,7%) |
|||
|
In the initial stage, cervical cancer has no symptoms. As the disease progresses, there may be: vaginal discharge of a dark color; vaginal bleeding after intercourse; pain during sex; abnormal vaginal bleeding (after menopause or between menstrual periods) etc. |
482 (88%) |
|||
|
Cervical cancer presents among the symptoms of the initial phase mental confusion due to hormonal changes. With advanced disease, there is pain in the abdomen and intense and continuous vaginal bleeding. |
24 (4,3%) |
|||
|
ALL FOLLOWING ALTERNATIVES REFER TO RISK FACTORS |
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|
Smoking |
17 (3,1%) |
|||
|
Being over 40 |
19 (3,5%) |
|||
|
Obesity |
9 (1,6%) |
|||
|
Sexual practice with many partners / without using a condom (condom) |
76 (13,9%) |
|||
|
Early onset of sexual life |
7 (1,3%) |
|||
|
Human Papillomavirus (HPV) infection |
420 (76,6%) |
|||
|
YOU GO TO THE DOCTOR TO PERFORM EXAMS |
||||
|
Yes, once a year |
361 (65,9%) |
|||
|
Yes, every six months |
43 (7,8%) |
|||
|
Yes, eventually |
54 (9,9%) |
|||
|
Only when I have any symptoms |
76 (13,9%) |
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|
I never was. I don’t think it’s necessary |
14 (2,5%) |
|||
|
WITH WHICH PERIODICITY DO YOU PERFORM THE PAP SCAN? |
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|
Annually |
355 (64,8%) |
|||
|
Every two or three years |
94 (17,2%) |
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|
Never did |
40 (7,3%) |
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|
I do it only when I feel some discomfort |
38 (6,9%) |
|||
|
I did it over two years ago, but I don’t intend to repeat |
21 (3,8) |
|||
|
IF YOU ANSWERED IN THE PREVIOUS QUESTION |
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|
The exam is uncomfortable |
35 (17,9%) |
|||
|
Fear of feeling pain |
45 (23,1%) |
|||
|
I don’t know the exam |
25 (12,8%) |
|||
|
I did not find it necessary to repeat the test, since the result did not indicate cancer the last time it was performed. |
6 (3,1%) |
|||
|
I couldn’t get access to schedule the exam |
8 (4,1%) |
|||
|
Another motive |
76 (39%) |
|||
|
CURRENTLY, YOU MAKE AN APPOINTMENT BY |
||||
|
Supplementary Health (private or private insurance) |
320 (58,4%) |
|||
|
Single Health System (SUS) |
228 (41,6%) |
|||
|
FOR YOU, WHAT IS THE MEDICAL SPECIALIST WHO |
||||
|
Oncologist |
347 (63,3%) |
|||
|
Gynecologist |
155 (28,3%) |
|||
|
General practitioner |
1 (0,2%) |
|||
|
I do not know how to answer |
15 (2,7) |
|||
|
All of the above |
30 (5,5%) |
|||
|
MARK WHICH IS THE MAIN EXAMINATION FOR |
||||
|
Pap smear |
467 (85,2%) |
|||
|
Transvaginal ultrasound |
71 (13%) |
|||
|
Blood test |
7 (1,3%) |
|||
|
I do not know how to answer |
3 (0,5%) |
|||
|
ON HEALTH CARE DURING PANDEMIC |
||||
|
Cancer does not arise unexpectedly and I can |
19 (3,5%) |
|||
|
Everyone who has symptoms should, |
356 (65%) |
|||
|
Time does not stop. Neither is cancer. I must |
420 (76,6%) |
|||
|
You should only go to the doctor during the pandemic who has already |
42 (7,7%) |
|||
|
CONSIDERING THE AFFIRMATIONS BELOW ABOUT |
||||
|
I agree |
I disagree |
Do not know |
||
|
The HPV vaccine is the main form |
375 |
127 |
46 |
|
|
The HPV vaccine is available for free in the public system for girls between 9 and 14 years old, because cervical cancer is an exclusively female disease. Boys don’t need this immunization |
175 |
332 |
41 |
|
|
The HPV vaccine is available free of charge to girls, between 9 and 14 years old, and boys, between 11 and 14 years old. |
432 |
76 |
40 |
|
|
The HPV vaccine is not fully |
44 |
397 |
107 |
|
|
It is best to get the vaccine before the start |
447 |
52 |
49 |
|
|
HPV is related to cancer of the penis, |
253 |
155 |
140 |
|
|
MYTHS AND TRUTHS ABOUT Cervix Cancer |
||||
|
False |
True |
Do not know |
||
|
HPV is the leading cause of breast cancer |
85 |
382 |
81 |
|
|
Men do not develop HPV-related illnesses |
394 |
71 |
83 |
|
|
Cervical cancer is one of the types |
135 |
273 |
140 |
|
|
Condom use during intercourse |
167 |
316 |
65 |
|
|
All women with HPV will get cancer |
363 |
75 |
110 |
|
|
Pap smear is the gynecological exam |
96 |
424 |
28 |
|
|
With the early identification and treatment of changes that precede cervical cancer, it is possible to prevent 100% of the cases of the disease. |
368 |
110 |
70 |
|
.
Source link
https://medicinasa.com.br/ginecologista-2020/