Abstract
Background: Cervical cancer, although largely preventable, remains the most common cause of cancer mortality among women. Objective: The objective of this study was to evaluate primary care physicians’ knowledge regarding cervical cancer occurrence, screening and vaccination as well as HPV. Methods: This study was a cross-sectional survey that was conducted in the Capital primary health care centers in Kuwait. An anonymous self-administered questionnaire was distributed to all currently working physicians in the selected centers.It included data related to personal characteristics as well as physicians’ knowledge regarding cervical cancer epidemiology, risk factors, clinical features, screening and causative agents. Results: The response rate in this study was thus 60.7% with an overall percentage knowledge score of 63.4% ± 8.9% .The mean percentage knowledge score for different domains ranged from 58.5%±15.1 % to 69.2%±17.5%. Conclusion: Physicians’ knowledge regarding cervical cancer was fair. However, certain aspects of knowledge need enhancement.
Highlights
There are two types of Human papillomavirus (HPV) vaccine that have received regulatory approval for use in cervical cancer prevention programs worldwide.The vaccines are best administered prior to exposure to the virus, ideally during preadolescence.(WHO,2009)It is hoped that the available HPV vaccines will markedly reduce the burden of cervical cancer and other HPV-related diseases in developing countries.Several studies, mostly from developed countries, have shown that the knowledge of HPV infection and vaccines and the acceptability of these vaccines among health care providers and the general public vary from low to high.(Jain et al, 2009;Dursun et al, 2009; Christian et al, 2009) Causal role of infection with high risk HPV strains in cervical cancer has been targeted in the past two decades
On the basis of these findings it can be expected that considering the knowledge about this disease in health professionals, the knowledge in general population of Kuwait will be even less.All participants in the current study were aware that HPV infection can lead to cervical cancer
These results show sufficient knowledge of HPV infection being the cause of cervical cancer among primary health care (PHC) physicians in Kuwait as 98% of cervical cancer in our part of the world is due to HPV infection, as reported in a study done in India (Lee et al, 2007)
Summary
Cancer of the cervix uteri is the second most common cancer in women and is the most common gynecologic malignancy worldwide.There were about 530,232 new cases in 2008 alone, and 85.5% of these occurred in developing countries.(Ferlay et al, 2010)Cervical cancer is a major public health problem and it is second most common cancer in women worldwide and the leading cause of cancer deaths in developing countries.(Anorlu,2008)A major discovery in human cancer etiology has been the recognition that cervical cancer is a rare consequence of an infection by some mucosatropic types of Human papillomavirus (HPV).By the year 2000, the epidemiological evidence included a large and consistent body of studies indicating, beyond any reasonable doubt, strong and specific associations relating HPV infections to cervical cancer.(Thomas et al, 2001)HPV is one of the most common sexually transmitted infections.(Cates, 1999; Baseman and Koutsky, 2005). High income countries have successfully reduced the cervical cancer burden by over 70 percent using one such approach of organized cytological based pap smears.A number of preventive strategies are currently being practiced in developed countries including use of two novel prophylactic vaccines and a number of secondary preventive strategies. Most of these interventions are currently not feasible in low income countries because of the already limited health care infrastructure (Das et al, 2008).
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