Abstract
ObjectiveWomen with high-grade cervical intraepithelial neoplasia (CIN) are at increased risk for developing cervical cancer. We examine how women with high-grade CIN perceive their own risk, and about pertinent knowledge concerning human high-risk papillomavirus (HPV), CIN and cervical cancer.MethodsAll patients who underwent first-time treatment of high-grade CIN (grade 2+) were followed-up at 6-months at the Karolinska University Hospital, Stockholm, Sweden and were invited to participate in the present study. This included completion of a questionnaire examining sociodemographic characteristics, self-perceived risk of cervical cancer without regular gynecologic follow-up, and 14 queries about HPV, CIN and cervical cancer knowledge, inter alia.ResultsThe participation rate was 96.6%, with 479 women enrolled in this study. Over 75% were age 40 or younger, over half had completed university education. Most were married or co-living with their partner and were gainfully employed. On a scale scored from 10 (highest self-perceived risk of cervical cancer without regular gynecologic follow-up) to 1 (lowest self-perceived risk), 64% rated their risk ≥ 7; almost 30% viewed their risk ≤ 6 and 7.5% did not rate their risk. A Specific Knowledge Scale with six of the queries explained 58.3% of the total variance. Nearly 30% of the women answered four or fewer of the six queries correctly. The Specific Knowledge Scale predicted self-perceived cervical cancer risk (Odds ratio = 11.3, 95% Confidence Interval 5.6 − 22.6) after adjusting for age, income and education. Most of the women with low self-perceived cervical cancer risk did not rate their HPV-related knowledge as good. However, 32 predominantly university-educated women, with low self-perceived cervical cancer risk, considered their HPV-related knowledge good.ConclusionIt is vital to effectively convey accurate information about these patients’ cervical cancer risk, needed preventive and follow-up measures, together with the relevant specific knowledge, for these women at increased risk for developing cervical cancer. Tailored programming to address these knowledge gaps is needed.
Highlights
Among women worldwide, cervical cancer is the fourth most common cause of cancer death [1]
Population-based cytology-based cervical cancer screening program has been in place in Sweden since 1967, with a participation rate of 73%, and cervical cancer mortality rate the 9th lowest in the European Union (EU) [3, 7]
The aim of the present study is to examine self-perceived risk of cervical cancer and pertinent knowledge about human papilloma virus (HPV), cervical intraepithelial neoplasia (CIN) and cervical cancer among women treated for highgrade CIN
Summary
Cervical cancer is the fourth most common cause of cancer death [1]. An estimated 265,700 women died in 2012 alone due to cervical cancer. Within the European Union (EU), the highest cervical cancer mortality is seen in those countries in which participation in screening programs is the lowest [3]. High participation in screening programs through the Papanicolaou test (cytology-based) and subsequent treatment of cervical dysplasia has effectively reduced the cervical cancer mortality [4,5,6]. Population-based cytology-based cervical cancer screening program has been in place in Sweden since 1967, with a participation rate of 73% (as of 2010), and cervical cancer mortality rate the 9th lowest in the EU [3, 7]. Cervical cancer is considered a major public health issue in Sweden, with a heavy economic burden, estimated as €58 million in 2006 alone [10]
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