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      Knowledge, attitudes and practices regarding the Pap test among women in northeastern Brazil : Conhecimentos, atitudes e práticas sobre o exame de Papanicolaou em mulheres do nordeste brasileiro

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          Abstract

          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.

          Translated abstract

          CONTEXTO E OBJETIVO:

          O exame de Papanicolaou já mostrou efetividade na prevenção de câncer do colo do útero. A literatura nacional e internacional tem mostrado que o exame de Papanicolaou não tem alcançado o índice de cobertura desejado. O objetivo deste estudo foi avaliar os conhecimentos, atitudes e práticas entre mulheres em relação ao exame de Papanicolaou e verificar se existe associação entre esses comportamentos e as características sociodemográficas.

          TIPO DE ESTUDO E LOCAL:

          Estudo descritivo e transversal realizado em Floriano, Piauí.

          MÉTODOS:

          O estudo foi conduzido com 493 mulheres no período de novembro de 2009 a dezembro de 2010. Utilizou-se um questionário com perguntas precodificadas, cujas respostas foram analisadas quanto à adequação dos comportamentos em relação ao exame.

          RESULTADOS:

          Os graus de adequação dos conhecimentos, atitudes e práticas em relação ao exame foram de 36,7%, 67,2% e 69,6%, respectivamente. Dentre as principais barreiras para a sua realização, destacaram-se a ausência de sintomas e a vergonha.

          CONCLUSÃO:

          As mulheres que realizam consultas periodicamente apresentam prática mais adequada, porém com baixa adequação de conhecimentos frente ao procedimento, sugerindo que não estejam recebendo as informações adequadas sobre os benefícios da realização periódica do exame de Papanicolaou.

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          Most cited references43

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          The causal relation between human papillomavirus and cervical cancer.

          The causal role of human papillomavirus infections in cervical cancer has been documented beyond reasonable doubt. The association is present in virtually all cervical cancer cases worldwide. It is the right time for medical societies and public health regulators to consider this evidence and to define its preventive and clinical implications. A comprehensive review of key studies and results is presented.
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            Chapter 1: HPV in the etiology of human cancer.

            The causal role of human papillomavirus (HPV) in all cancers of the uterine cervix has been firmly established biologically and epidemiologically. Most cancers of the vagina and anus are likewise caused by HPV, as are a fraction of cancers of the vulva, penis, and oropharynx. HPV-16 and -18 account for about 70% of cancers of the cervix, vagina, and anus and for about 30-40% of cancers of the vulva, penis, and oropharynx. Other cancers causally linked to HPV are non-melanoma skin cancer and cancer of the conjunctiva. Although HPV is a necessary cause of cervical cancer, it is not a sufficient cause. Thus, other cofactors are necessary for progression from cervical HPV infection to cancer. Long-term use of hormonal contraceptives, high parity, tobacco smoking, and co-infection with HIV have been identified as established cofactors; co-infection with Chlamydia trachomatis (CT) and herpes simplex virus type-2 (HSV-2), immunosuppression, and certain dietary deficiencies are other probable cofactors. Genetic and immunological host factors and viral factors other than type, such as variants of type, viral load and viral integration, are likely to be important but have not been clearly identified.
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              • Record: found
              • Abstract: found
              • Article: not found

              The epidemiology of genital human papillomavirus infection.

              Clinical and subclinical human papillomavirus (HPV) infections are the most common sexually transmitted infections in the world, and most sexually-active individuals are likely to be exposed to HPV infection during their lifetimes. More than 40 genotypes of HPV infect the epithelial lining of the anogenital tract and other mucosal areas of the body; of these, 13-18 types are considered to be high-oncogenic risk HPV types (HR-HPV). Persistent infection with HR-HPVs is now unequivocally established as a necessary cause of cervical cancer and is likely to be responsible for a substantial proportion of other anogenital neoplasms and upper aero-digestive tract cancers. Low oncogenic risk HPV types (LR-HPV) are also responsible for considerable morbidity as the cause of genital warts. Youth and certain sexual characteristics are key risk factors for HPV acquisition and persistence of HPV infection, but other mediating factors include smoking, oral contraceptive (OC) use, other STIs (e.g. chlamydia, herpes simplex virus), chronic inflammation, immunosuppressive conditions including HIV infection, parity, dietary factors, and polymorphisms in the human leukocyte antigen system. Not surprisingly, these factors are also established or candidate cofactors identified in epidemiologic studies of cervical cancer. HPV transmissibility and molecular events in HPV-induced carcinogenesis have been the focus of recent multidisciplinary epidemiologic studies. This shift in research focus coincides with a shift in cancer prevention techniques towards immunization with HPV vaccines and HPV testing of precancerous lesions.
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                Author and article information

                Journal
                Sao Paulo Med J
                Sao Paulo Med J
                Sao Paulo Med J
                São Paulo Medical Journal
                Associação Paulista de Medicina - APM
                1516-3180
                1806-9460
                01 February 2014
                2014
                : 132
                : 1
                : 3-9
                Affiliations
                [I ] originalNursing Undergraduate, Department of Health Sciences, Universidade Federal do Piauí (UFPI), Floriano, Piauí, Brazil
                [II ] originalMSc. Professor, Department of Health Sciences, Universidade Federal do Piauí (UFPI), Floriano, Piauí, Brazil
                [III ] originalPhD. Professor, Department of Statistics, Universidade Federal do Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
                [IV ] originalPhD. Professor, Department of Parasitology and Microbiology, Universidade Federal do Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
                Author notes
                Address for correspondence: Humberto Medeiros Barreto. BR 343, KM 3,5. Meladão - Floriano (PI). CEP 64800-000. Tel. (+55 89) 3522-0136. Cel. (+ 55 89) 9928-2467. E-mail: hmbarreto@ 123456ufpi.edu.br

                Conflict of interest: None

                Article
                10.1590/1516-3180.2014.1321551
                10889457
                24474073
                5fb0cff0-f160-45c4-9ffa-62aef1627d90

                This is an open access article distributed under the terms of the Creative Commons license.

                History
                : 21 December 2012
                : 15 March 2013
                Page count
                Figures: 4, Tables: 0, Equations: 1, References: 25, Pages: 7
                Categories
                Original Article

                papillomavirus infections,uterine cervical neoplasms,vaginal smears,women's health,socioeconomic factors,infecções por papillomavirus,neoplasias do colo do útero,esfregaço vaginal,saúde da mulher,fatores socioeconômicos

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