Regular Pap Tests Research Articles

HPV Positive Women and Risk Factors in Development Cervical Intraepithelial Lesions

Background: Human papillomavirus is a risk factor in the development of cervical cancer. Other risk factors are frequent vaginal infections, cigarette smoking, use of oral contraceptives, but also lack of lacrobacillus in women with HPV infection. Objective: The objective of our study was to determine the risk factors for the development of cervical intraepithelial lesions in women with normal and pathological Pap test results. Methods: The research is a prospective study conducted in the Gynecology Center "Dr. Mahira Jahić" Tuzla and Dom Zdravlja Tešanj since February. 2023 to March 2024. The research included 200 respondents aged 25 to 50. Tested group: 100 subjects with pathological Pap smear findings (ASCUS, LSIL and HSIL) and a control group of 100 subjects with normal Pap smear findings. Sociodemographic data were obtained from the subjects during interviews and examinations: age, cigarette consumption and frequency of previous vaginal infections and the presence of lactobacilli. The obtained results were processed using the methods of descriptive statistics, student's t test and X2 test. A difference for a value of p<0.5 was considered statistically significant. Results: The mean age of the dpbo examined group was 38.1±1.7, while in the control group it was 39.6±1.9 years. Cigarettes were consumed by 62 (31%), 38 (19%) of the examined group, and 24 (12%) of the control group with a statistically significant difference of p<0.05. Out of a total of 100 in the examined group, 60 subjects had LSIL, 9 subjects had HSIL (CIN 2 two subjects and CIN 3 had 7), and ASCUS 29 and ASC-H 2 subjects. Subjects with pathological findings had significantly more vaginal infections during one year (p<0.05). HPV was positive in 65 (65%) subjects with a pathological Pap smear test, and negative HPV in 35 (35%). HPV 16,18 was present in 19 (19%) test subjects in combined form, and mono-isolate HPV 16 in 14 (14%) and HPV 18 in one case. In the combined form of several HPVs, HPV 16 and HPV 31, 33, 35, 45, 56 were found in 5 (5%), and HPV 18 in 4 (4%) with HPV 36, 59, 68. The most frequently isolated HPV 16 in 38 (38%) as monoisolate and in combined form. Lactobacilli were present in 26 (13%) subjects in the test group and in 60 (30%) subjects in the control group, with a statistically significant difference (p<0.05). The presence of Lactobacillus in subjects with a regular Pap test is significantly more frequent compared to women with cervical intraepithelial lesions (ASCUS, LSIL, ASC-H and HSIL) ) in the finding of the Pap test. Conclusion: Altered microflora of the vagina, lack of lactobacilli, frequent vaginal infections and smoking are risk factors for the development of CIN lesions in women positive for high-risk HPV.

Awareness, risk for cervical cancer and readiness for Papanicolaou (Pap) testing among female housekeeping staff in a tertiary care hospital Karnataka-A quantitative approach

Problem consideredCervical cancer is the second most prevalent cancer in India and the fourth most common cancer globally. The lack of awareness surrounding cervical cancer creates challenges in achieving early detection and timely screening. The study aimed to assess the awareness about cervical cancer, to identify the risk for cervical cancer, and to assess the readiness for Pap testing. MethodsA descriptive survey design was adopted among female housekeeping staff in a tertiary care hospital in Udupi district, Karnataka. A total of 340 female housekeeping staff were selected based on the purposive sampling technique. Data was collected using structured questionnaires developed by the researcher that were self-administered to the participants and analysis was done using both descriptive and inferential statistics. ResultsOut of 340, the majority 210(61.8%) had poor awareness on cervical cancer and 310(91.2%) were ready for Pap test. The top five self-reported risk factors among the participants were: partners not using condoms during sexual intercourse 326(95.9%), partners not circumcised 325(95.6%), given birth 312(91.2%), had not undergone regular Pap test for screening cervical cancer 291(85.6%), and being sexually active 137(40.3%). There was a significant association between awareness and variables like attainment of menopause (χ2 = 8.28, p = 0.016), and heard about cervical cancer (χ2 = 21.8, p=<0.001). ConclusionThe study findings highlight the importance of an awareness program on cervical cancer since most of the participants had high readiness for pap tests regardless of poor awareness. Hence the participants were motivated to undergo screening tests through the awareness program conducted in small groups.

A randomized controlled trial of a tailored navigation intervention to promote breast and cervical cancer screening among intergenerational Southeast Asian women

BackgroundCancer is the leading cause of death for Southeast Asian women in the U.S. Southeast Asian women have significantly high rates of breast and cervical cancers, yet are least likely to obtain regular mammography and Pap testing of all racial/ethnic groups in the U.S. ObjectivesThe purpose of this study is to compare a tailored navigation intervention delivered by bilingual and bicultural Community Health Advisors to information and reminder only to increase age-appropriate breast and cervical cancer screening completion among Southeast Asian women. MethodsThe Southeast Asian Women's Health Project study will enroll 232 Cambodian, Filipino, Lao, and Vietnamese women who are not up to date with their breast and cervical cancer screenings. Women randomized to navigation will receive the intervention for 10 weeks. Women in the information group will be mailed information on mammography and Pap testing only. All participants will be contacted post-enrollment to assess screening completion. DiscussionWe will examine intervention efficacy, predictors of each intervention group, and the influence of intergenerational exchange of breast and cervical cancer screening information between mothers and daughters. We will disseminate study results locally to the community, nationally at conferences, and through peer-reviewed journals.

Barriers to Cervical Cancer Screening among transgender men / Barreiras ao exame do Câncer do Colo do Útero entre homens transgêneros

Purpose: to evaluate the barriers to cervical cancer screening among transgender men, and also to understand their experiences and preferences for cervical cancer screening. Methods: 19-item online survey structured based on the Health Belief Model, a conceptual formulation for understanding why individuals do or do not engage in health-related actions. It consists of the following dimensions: perceived susceptibility, perceived severity, perceived benefits, perceived barriers and general health motivation. Familiarity with cervical cancer, with Human Papillomavirus (HPV) and with Pap Test, being up-to-date on Pap Tests and preference for HPV self-sampling were additionally assessed. Results: 27 transgender men aged 18-51 years completed the survey. Most of them have a formal job, income up to 1 minimum wage per month, and are health-insured. The majority is single, heterossexual, and completed high school. Despite the fact that most are familiar with HPV and cervical cancer and are aware of the importance of regular Pap Tests, less than 20% are up-to-date. The barriers to cervical cancer screening may be related to discrimination, fear of invasive procedures and also the gaps in preventive health care associated with Covid-19. Only 25.9% of participants preferred HPV self-sampling over provider-collected Pap Test screening. Conclusion: most participants were not up-to-date on Pap Test screening, and refer unpleasant experiences in the past, discrimination and fear of invasive procedures. Healthcare professionals should be aware of the needs of this specific population, in order to provide better care and to affirm the gender identity.

P164 Assessment of awareness and compliance with the recommendations of primary and secondary prevention of cancer in patients with Inflammatory Bowel Disease

Abstract Background Patients with Inflammatory Bowel Disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), are at risk of developing malignancies, so prevention and adherence to cancer screening may improve its detection. The aim of this study was to asses the compliance with medical recommendations, especially primary and secondary prevention of cancer. Methods This prospective, one-center study was carried out between June and October 2021r. amongst patients from Department of Internal Medicine and Gastroenterology with IBD Division, Central Clinical Hospital of Ministry of Interior Affairs and Administrations, Warsaw, Poland. Patients were asked to complete anonymous questionnaire which included 42 questions concerning lifestyle, cancer risk factors, cancer history, and checkups in patients with IBD. Results A total of 190 patients with IBD were included in survey. 117 (61.6%) had CD, 67 (35.3%) UC and 6 (3.2%) unclassified disease. 43.7% were women and more than a half of them had &amp;gt;8 years of the length of the disease. In total 84.2% were taking mesalazine, 48.4% immunosupresive medication and 77.9% biological treatment. Statistically significantly (p=0.034) more patients with CD than those with UC practiced regular physical activity (respectively 65.8% and 48.5%). Patients with UC more often were non-smokers (76.7% vs 92.5% for CD and UC respectively; p=0.007). 39.7% of patients with CD and 27.3% with UC declared alcohol consumption (p=0.128). Only 6% of patients responded not to use sun protection measures when sun-bathing but 24.8% with CD and 34.4% with UC didn’t have regular full-body skin examinations. 78.7% of patients had abdominal ultrasound scan performed in the last year. Out of 52.7% who had colonoscopy recommended, 49.3% of patients declared that the examination was carried out (36.8% of CD and 65.5% of UC; p= 0.038) and another endoscopy was scheduled (18.6% of CD and 48.4% of UC; p&amp;lt;0.001). According to respondents cholangio-MRI was recommended to 14.3% patients with CD and 6.2% with UC (p=0.219). Only 1 patient in both groups did not perform this examination. Most of the examinations were recommended by gastroenterologists. Moreover, in the last 12 months 59.6% of female answerer declared to have ultrasound imagining of the breast and 98.7% gynecological examination performed (65.4% had regular Pap-test screening). 82.3% of respondents knew about HPV vaccination but only 25% were vaccinated. Conclusion Our study reveals that many of IBD patients are exposed on risk factors of malignancies. Screening for cancer and regular checkups should be regularly performed. Primary prevention, such as HPV vaccinations, should be reminded to all patients.

Altered Vaginal pH Value and Enterobacteria as a Risk Factor in the Development of Precancerous Lesions of the Cervix

Background: Vaginal microflora plays an important role in cervical carcinogenesis. An increase in vaginal pH is associated with the severity of squamous intraepithelial lesion (SIL) and a decrease in the number of lactobacilli. Microbial dysbiosis contributes to the damage of the epithelial barrier, as well as the reprogramming of immune and metabolic signaling. Dysbiotic bacteria cause damage to the epithelial barrier, immune dysregulation and genotoxicity and create a tumor-permissive microenvironment. Objective: The aim of this study was to determine the presence of risk factors (abnormal colposcopic and microbiological status, elevated pH of the vaginal environment) in regular Pap tests and LSIL. Methods: Retrospective prospective study 2021-2022. 90 women with pap smears were analyzed: 40 with LSIL at the Gynecological Center “Dr. Mahira Jahić” Tuzla and 50 with normal findings at the Tesanj Health Center. General data such as: age of the subjects, reproductive status, contraception, smoking and data on colposcopic examination, microbiological findings and vaginal pH value were analyzed. Statistical data processing was done in the SPSS program. Results: The average age of the test subjects is 39.94, in normal Pap 41.20 years, and in LSIL 38.38 years. The vital characteristics of the subjects did not differ significantly, except for smoking, where in LSIL findings, they consumed cigarettes significantly more often. Abnormal colposcopic examination were found in 85% (N-34) of women with LSIL. In subjects with LSIL, a positive microbiological test for enterobacteria was found in 47.5% (N-19) and a normal pap test in 12% (N-6). Statistically significant difference p=0.00523 p&lt;0.05, E faecalis and E coli had the highest prevalence in LSIL. The mean pH value of the vaginal environment in LSIL is 5.38, and 4.96 in a regular pap test. Subjects with LSIL in 10% (N-4) had a normal pH test, and 48% (N-24) had a normal Pap test. P=0.00129 p &lt; (0.05). A normal pH value was significantly more common in subjects with a normal Pap test. Microbiological flora, especially enterogenic bacteria, are more common in LSIL than in women with a regular pap test. Conclusion: when monitoring women with LSIL, special attention should be paid to the elimination of present enterobacteria (E.faecalis and E.coli) as a possible risk factor in the development of precancerous lesions (SIL) and cervical cancer.

Procena uticaja stavova žena o benefitu skrininga i motivacionih faktora na njihovo učešće u Papanikolau skrining testu

Introduction: In Serbia, cervical cancer (CC) is the second most common cancer, after breast cancer, The Papanicolaou test is used for the early detection of cervical cancer. Motivational factors and attitudes of women about the benefits of the Papanicolaou screening test can affect the rate of participation in it. The aim of the research was to examine whether there is a connection between women's attitudes about the benefits of screening and motivational factors and their participation in the Papanicolaou screening test of CC. Methods: This cross-sectional study included 300 women aged 25 to 64, who came for a gynecological examination to the Gynecology and Obstetrics Clinic "Narodni Front" in Belgrade, in the period from June to December 2015. Data were collected from all respondents on their demographic characteristics, reason for coming to the clinic, how often they underwent screening (Papanicolaou test), as well as data on their attitudes about the benefits of screening and motivation for undergoing the Papanicolaou screening test using a part of the questionnaire called CPC -28 questionnaire (in Spanish Creencias, Papanicolaou, Cancer - 28). Results: Of the 300 women who participated in the study, 37.3% of women regularly participated in the Papanicolaou test, 43.7% irregularly, and 19.0% never. Women who participated regularly in screening were significantly more likely to believe that it was important to have a regular Pap test to know they were healthy (F = 13.59; p ˂ 0.001) and that the Pap test was the best way to determine early-stage CC (F = 12.29; p ˂ 0.001) compared to women who were irregular and who had never participated in screening. Women who participated irregularly or who had never participated in the screening program would be motivated to participate in it significantly more often if someone developed CC in their family or environment (F = 5.11; p = 0.007), while women who regularly participated would be motivated significantly more often by gynecologist's recommendations (F = 5.58; p = 0.004) and care for their own health (F = 6.93; p = 0.001). The high level of motivation was significantly related to the decision of women to regularly participate in screening (ch² = 13.05; p = 0.001) in relation to women who were irregular or who had never participated in screening. Conclusion: Within this research, it was noticed that only every third respondent regularly underwent the Papanicolaou screening test, which is far lower than the set national goals that at least 75% of the target population of women aged 21 to 69 should be covered by organized screening. It is necessary to raise women's awareness about the importance of Papanicolaou screening for early detection of CC, as well as about all other preventive measures, and especially about the importance of the HPV vaccine.

Troubleshooting of RNA isolation methods in Papanicolaou HPV cervical smears

Cervical cancer is one of the leading causes of cancer in women, worldwide. Infection with human papillomavirus (HPV) has been accepted as the primary cause for the development of invasive cervical cancer and its precursor lesions. Despite HPV infection has been proposed as an indispensable factor for cervical cancer development, only a subset of neoplastic lesions with HPV infection persist and progress to invasive cancer. This suggests us that other molecular events are also involved in cancer progression. Aim of this study was to extract mRNA from cytobrush-collected healthy and HPV infected cervical epithelial cells and investigate various RNA extraction and purification protocols for assessment of RNA yield and quality. Taking into consideration that cervical cancer screening is based on the cytology based Papanicolaou test (Pap test), main challenge is to investigate whether the samples obtained by regular Pap testing can be used for gene expression analysis. For this purpose, a total of 68 cervical specimens were previously tested for HPV infection. Following HPV testing, samples were submitted to RNA extraction and compared to the products after additional purification step involving DNase I. Products obtained after different RNA extraction and purification methods were visualized using 2% agarose gel electrophoresis. In conclusion, DNase I based RNA purification represents a necessary step for the assurance of a high-quality extracted RNA used for gene expression analysis studies. Reliance on commercial kits for RNA extraction only, without performing additional purification step can lead to errors in drawing final conclusions and/or to false negative gene expression profiling, affecting the overall diagnostic procedure. According to obtained results, the type of sampling used in this study was not suitable for the subsequent gene expression analysis.

Sociodemographic and risk factors of cervical cancer among female staff of Federal Medical Centre, Owerri, Imo State, Nigeria

This study examines the sociodemographic and risk factors for cervical cancer among female staff of Federal Medical Centre, Owerri, Imo State Nigeria. It is a descriptive cross-sectional survey which was conducted among 400 female staff using predesigned semi-structured questionnaires. The sampling technique adopted was systematic sampling technique. Data analyses were done using statistical package for social sciences version 23 software package. Chi square was used to determine the associations between age at marriage and cervical erosion. A total of 77(19.3%) respondents consume alcohol, 78(19.5%) have had sexually transmitted infection and 58(14.5%) had multiple sexual partners. Thirty-nine (7.5%) have had regular Pap test, while 293(73.2%) have never had Pap test. Cervical erosion was found among 114(38.3%) out of which 101(25.3%) occurred in women that were married on or before the age of 21 years. This study shows the association of cervical cancer among female staff of Federal Medical Centre, Owerri and their sociodemographic and other risk factors. Monogamy, late commencement of sexual activity, personal hygiene, use of barrier contraceptive methods, regular cervical screening and early detection efforts will help towards primary prevention.

Awareness Towards Breast and Cervical Cancer Risk factors and its prevention among students and patients in Bangladesh

Abstract Background The literature on breast and cervical cancer treatment in Bangladesh is nonexistent. There are significant challenges to the development of infrastructure for cancer care in Bangladesh. Methodology: This cross-sectional study was conducted at Jahurul Islam Medical College and Hospital, Bangladesh. Among 685 participants of the survey, 379 respondents were medical students at the age of 18 to 26 years and rest of the participants (306 patients of the hospital) were randomly included in the study using a multistage cluster sampling technique. The IBM SPSS statistics (V21.0) software was used to analyze survey data. Results: The results of the survey indicates that the majority of medical students are familiar with the early detection methods of breast cancer. However, the students were not aware of the risk factors of cervical cancer including HIV infection (27.2%) and the long-term use of contraceptive pill (22.7%). The students also are not going through the regular smear or Pap test (28.0%) or not aware of infection from HPV (16.6%). Only a few students are aware of the risk of breast cancer including Hormone replacement therapy (3.2%) and Benign breast disease (5.5%). On the other hand, the randomly selected patients of the hospital (100%) have no idea about the risk factors of breast and cervical cancer. As a result, they have no knowledge about the early detection methods of breast cancer. Conclusion The summary of this study indicates that the medical students and patients of the hospital are not sufficiently aware of the sign symptoms, risk factors, and preventive measures for breast and cervical cancer. Therefore, necessary steps are very crucial to grow awareness among the general people of Bangladesh from the respective authority to be careful about breast cancer and cervical cancer.

Maternal Factors and Sexual Orientation-Related Disparities in Cervical Cancer Prevention.

Our objective was to explore how mothers' attitudes and relationships with their daughters may impact the cervical cancer prevention behaviors of daughters with diverse sexual orientations. We examined 8,143 mother-daughter dyads from the Nurses' Health Study 2 and Growing Up Today Study. During the daughter's adolescence, each mother reported her beliefs about the importance of regular Pap testing for her daughter, the frequency of communication with her daughter about Pap testing, her beliefs about Pap testing and human papillomavirus (HPV) vaccines, and her acceptance of sexual minorities (e.g., bisexuals, lesbians). Mothers and daughters separately reported relationship satisfaction. Log-binomial models were used to examine the longitudinal association between maternal factors and daughter's receipt of a Pap test and HPV vaccination. Nearly all maternal factors predicted the daughter's likelihood to have a Pap test and HPV vaccination. Higher levels of acceptance for sexual minorities and better relationship quality were also positively associated with these cervical cancer prevention behaviors. Yet, after adjusting for the maternal factors, there was little attenuation of the existing sexual orientation-related disparities in Pap tests or HPV vaccination. Mothers can play an important role in their daughters' cervical cancer prevention behaviors through novel processes like being more accepting of sexual minorities and having a good relationship quality. However, in this study, maternal factors did not explain much of the sexual orientation-related disparities in cervical cancer prevention. Efforts to ensure a mother is accepting of sexual minorities and has a good relationship quality with her daughter may improve that daughter's reproductive health.

Knowledge of HPV and acceptability of HPV vaccine among women in western China: a cross-sectional survey

BackgroundSince most cervical cancer cases are caused by persistent high-risk human papillomavirus (HR-HPV) infection, knowledge of HPV among women is essential for the prevent of cervical cancer. This study was aimed to assess knowledge among women in western China about HPV and its association with cervical cancer, and to assess their acceptance of HPV vaccination.MethodsA sample of healthy women undergoing routine physical examinations in the Health Management Center of West China Hospital, Sichuan University between January and December 2014 completed a questionnaire.ResultsA total of 1300 questionnaires were distributed, and 1109 were completed and analyzed. Only 28.85% of respondents (n = 320) had heard of HPV; among this subgroup, only half (53.44%) knew that it causes cervical cancer, only 26 (8.13%) correctly answered all questions about HPV. Multivariate analysis showed that respondents who had heard of HPV were more likely than other respondents to have a family history of any cancer, to undergo regular Pap tests and to have completed at least secondary education. Half of all respondents (51.22%) reported that they would be willing to be vaccinated against HPV.ConclusionAlthough most women in western China lack basic knowledge about HPV, at least half are willing to take the HPV vaccine. Public health efforts to educate the public about HPV and its connection to cervical cancer should be strengthened and expanded.

Segmenting women eligible for cervical cancer screening using demographic, behavioural and attitudinal characteristics

The best ways to communicate effectively to under-screened women about cervical cancer screening are unknown. Segmentation techniques create homogeneous segments of women in the population that are different from one another, and help to determine on whom communication efforts should be focused and how messaging should be tailored. We used segmentation techniques to better understand the demographics, attitudes and behaviours of women eligible for cervical screening. We developed a brief online questionnaire that consisted of demographic characteristics, attitudes toward health, and cervical screening behaviour. Simple descriptive statistics were used to describe the study population and principal components analysis was used to define the segments. The study sample consisted of 615 women living in Ontario, 508 from the general population and 107 from South Asia; 63.1% reported regular screening. We defined four segments that represented the sample: i) Proactive, ii) Family First, iii) Social and Stylish, and iv) Faith-Driven. South Asians were represented in all segments. Women who were in the Family First and Faith-Driven segments were least likely to have regular Pap tests and were least likely to know about human papilloma virus (HPV)'s role in cervical cancer. The Internet was very popular among women in all segments as a source of health information, particularly among Faith-Driven women. Only 69.2% of Family First women listed their family physician as a source of health information vs. 91.1% of Proactive women. Future research should focus on how to most effectively reach women who meet the Family First and Faith-Driven profiles, and through which communication media.

Cognitive predictors of cervical cancer screening's stages of change among sample of Iranian women health volunteers: A path analysis.

IntroductionThe uptake of Pap smear among Iranian women is low, resulting in a high rate of casualties from cervical cancer in Iran. The present study used the Health Belief Model (HBM) and the Stages of Change theory as theoretical frameworks for understanding the predictors of the behaviour of Iranian Women Health Volunteers (WHVs) with respect to cervical cancer screening.MethodsData from the 1,253 WHVs were analyzed using path analysis to assess the effects of cognitive factors (including knowledge, perceived susceptibility to cervical cancer, perceived severity of cervical cancer, Pap smear benefits, Pap smear barriers, and Pap smear self-efficacy) on the stages of change for Pap-smear behaviour.ResultsThe majority of the respondents (71.5%) reported that they had not taken previous Pap smear tests; only 3% had received a regular Pap test. The perceived benefits to cervical cancer screening, the perceived barriers to cervical cancer screening, and the perceived self-efficacy to perform cervical cancer screening emerged as the predictors of cervical cancer screening’s stages of change; perceived threat to cervical cancer, however, did not.DiscussionUptake of regular cervical screening for Iranian WHVs was very low. Different interventions, such as media campaigns and educational interventions could provide an opportunity to improve women's knowledge on cervical cancer and Pap test benefits, address any misconceptions or fears about the procedure of the Pap test, and finally increase the cervical screening uptake by Iranian women.

Knowledge of HPV/cervical cancer and acceptability of HPV self-sampling among women living with HIV: A scoping review.

Cervical cancer rates are disproportionately high among women living with the human immunodeficiency virus (wlhiv). Cervical cancer is preventable through hpv screening, regular Pap tests, and early cancer detection. Evidence indicates that hpv and cervical cancer screening are suboptimal among wlhiv, who face a myriad of access barriers. Considering that screening is an effective first-line defense to cervical cancer, we conducted a scoping review with the aim of gaining a better understanding about: (1) the knowledge and perceptions of hpv and cervical cancer screening among wlhiv; and (2) the acceptability of self-sampling for hpv among wlhiv. We searched five electronic databases for peer-reviewed articles that were published in English within the last ten years, reported on studies with hiv-positive women who were aged 16 or older, and satisfied the topics of the review. A total of 621 articles were found. After accounting for duplicates and unmet criteria, 17 articles and 1 abstract, reporting on studies in the United States and Africa, were included in this review. The review highlighted that most wlhiv had inadequate knowledge of hpv transmission and cervical cancer prevention, which influenced their perceptions of risk and susceptibility. Screening barriers included misconceptions about Pap tests, fear of diagnosis of serious illness, perceived pain, embarrassment, bodily modesty, and limited access to female health care providers. This review also affirms that self-sampling is an acceptable and promising screening option for wlhiv. Implications for policy, research, and practice are discussed.

Knowledge and Attitude towards HPV, PAP Testing and HPV Vaccination among Women with HIV

Background: Although cancer prevention strategies have resulted in a dramatic reduction in the overall cervical cancer burden in developed countries, among women with HIV the problem remains unabated. Several studies have identified limited knowledge as a major contributory factor for cervical cancer especially in vulnerable populations like women with HIV. Objective: To determine the knowledge and attitudes of HPV, Pap smear testing and HPV vaccination among women with HIV utilizing the health belief model as a guiding framework for the study. Methods: 50 HIV positive women in the 21-64 age groups were purposively sampled from the HIV clinic in San Fernando General Hospital, South Trinidad. Data were collected using an administered questionnaire with a 100% response rate after receiving ethical approval. Results: Respondents were generally knowledgeable about Pap Smear testing but had limited knowledge about HPV and HPV vaccination. Most respondents were unaware that HPV infection was a risk factor for cervical cancer. Many respondents knew that the purpose of pap testing and the recommended Pap testing guidelines for women with HIV. Although most respondents 43 (86%) considered Pap Smear testing to be important it was not a regular practice. The main reasons for not having regular Pap test include the procedure is embarrassing and painful, fear of a cervical cancer diagnosis, reluctance to be examined by male doctor and not being asked to do Pap test by healthcare professionals. Respondents also had a negative attitude when asked if they would recommend the vaccine to friends and relatives. Conclusion: While women with HIV may be knowledgeable of the risk associated with cervical cancer, this does not necessarily translate into effective screening behaviours. The findings of this study demonstrate the need for an organized and integrated cervical cancer screening program for women with HIV as an integral component of management.

Predictors of cervical cancer screening for Chinese American women.

Research on Chinese American women's cervical cancer screening behaviours is limited and there are few studies that examine factors associated with obtaining regular Pap tests. The purpose of this study was to use the transtheoretical model (TTM) as a framework to examine correlates of Pap testing and stages of change. Chinese American women (N=121) were recruited to complete a cross-sectional, self-report survey. Survey items assessed stages of change, self-efficacy, perceived benefits and barriers, and demographic variables including screening and family history for cervical cancer. Eighty-one per cent of women reported that they had ever had a Pap test. Most participants were in the maintenance stage (55%), with 10% in each action and pre-contemplation, 8% in contemplation, 1% in preparation and 16% in the relapse stage. Women in the action/maintenance stage were more likely to be older, married and have a higher education level. Women in the action/maintenance stage had significantly lower perceived barrier scores compared to women in both the contemplation/preparation and pre-contemplation/relapse stages. Findings partially support the use of TTM for cervical cancer screening among this population and indicate the importance of perceived barriers. Results may inform interventions to increase screening rates among Chinese American women.

Perceptions of cervical cancer risk and screening among transmasculine individuals: patient and provider perspectives

Transmasculine people (individuals assigned a female sex at birth who identify as male or masculine) are at risk of cervical cancer. Despite low rates of Pap test use in this population, research examining the determinants of cervical cancer screening among transmasculine individuals is scarce. We conducted in-depth interviews and focus groups with 49 participants (32 transmasculine patients and 17 healthcare providers) in order to examine transmasculine individuals’ and healthcare providers’ perceptions of cervical cancer risk and screening among individuals on the transmasculine continuum. Overall, patients believed that transmasculine individuals should receive regular Pap tests, especially in the event of gynaecological concerns. While healthcare providers’ views varied, many perceived transmasculine individuals to be at low risk of cervical cancer. Contrary to existing screening guidelines, several providers believed that transmasculine individuals who did not engage in penile-vaginal intercourse with cisgender men, expressed discomfort about Pap testing or intended to obtain a hysterectomy might not need to be screened regularly or at all. Our findings underscore the importance of educating patients and providers about cervical cancer risk among transmasculine individuals and establishing evidence-based guidelines for cervical cancer screening in this underserved population.

Abstract IA12: Addressing cervical cancer disparities in Appalachia: From biology to policy

Abstract IA12: Addressing cervical cancer disparities in Appalachia: From biology to policy

Abstract A53: Causes and barriers associated with the Pap test among Latina farmworkers in Georgia

Abstract Background: Latinas are disproportionately burdened with cervical cancer, with mortality rates 50% higher for Latinas than non-Latina whites, largely due to differences in screening rates. Particular Latino subgroups, such as those from migrant farmworker backgrounds, have less access to health services and lower education than other subgroups. In this study, we report survey findings examining knowledge, beliefs and perceptions about causes of cervical cancer and barriers related to use of the Pap test among Mexican farmworker women in South Georgia. Methods: We employed cultural consensus analysis methods to calculate the level of shared knowledge among a convenience sample of 40 Mexican immigrant women (20 women who have been living in the U.S. &amp;gt;10 years; 20 women who have been living in the U.S. ≤10 years) who had not received a Pap test in over 2 years. In a previous study using free lists, we identified 15 causes of cervical cancer and 15 barriers to screening among Latino immigrant populations. We used several types of questions to assess consensus regarding understanding of 15 causes of cervical cancer and 15 barriers to completing the Pap test. For the causes, we asked participants to rank the severity of the items, sort them into no more than four piles, and label each pile. For the barriers, we asked participants to sort them into piles only and label each pile. This methodology allows for the direct measurement of inter-participant agreement regarding the structure and organization of the knowledge domain and the calculation of both individual estimates of cultural competency and the average level of competency for the group on the knowledge domain. We used UCINET to analyze the rank data and Visual Anthropac to analyze the pile sort data to assess the level of cultural model sharing and to visualize categories using multidimensional scaling and cluster analysis. Results: There was consensus among respondents for the rank order of causes of cervical cancer (Eigenratio = 4.9). Out of the 15 culturally identified causes of cervical cancer, the top five were multiple sex partners, HPV, HIV, lack of a regular Pap test, and sexual relations before 16 years of age. When respondents completed the 15 item pile sort for causes, there was also consensus (Eigenratio = 7.4). Using cluster analysis, the items formed 5 clusters: (1) family history, destiny; (2) chemicals in food, poor diet, smoking; (3) birth control pills, abortion, multiple pregnancies; (4) not using condoms, poor hygiene; and (5) multiple sex partners, sexual relations before age 16, HPV, HIV, not getting a regular Pap test. When respondents completed the 15 item pile sort for reasons not to get the Pap test, there was very high consensus (Eigenratio = 14.2). Using cluster analysis, the 5 clusters were: (1) knowledge (do not know the purpose, do not know the cost, do not know where to get it, lack of knowledge about the test), (2) fear (fear of positive results, fear of the exam, wait for symptoms to appear), (3) social and environmental constraints (too expensive, no insurance, no transportation, do not know English); (4) do not have a regular doctor in U.S. and prefer to use services in Mexico; and (5) not convenient and my husband won't let me go. Conclusions: There was cultural consensus for all three methods among the respondents irrespective of length of time residing in the U.S. There remains possible confusion between HIV and HPV, since these items were sorted into the same piles and ranked high for cervical cancer risk factors. The aggregate findings suggest that cultural models for causes and barriers persist throughout the immigrant's acculturation process in the U.S. According to this study, barriers to screening encountered constituted a shared cultural domain despite varying time residing in the U.S. Citation Format: John S. Luque, Jonathan Maupin, Yelena Tarasenko, Moya Alfonso, Lisa Watson, Claudia Reyes-Garcia. Causes and barriers associated with the Pap test among Latina farmworkers in Georgia. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A53. doi:10.1158/1538-7755.DISP13-A53