Secondary Prevention Of Cervical Cancer Research Articles

Communication strategies to reduce cancer disparities: Insights from African-American mother–daughter dyads.

Mothers and daughters share a powerful and unique bond, which has potential for the dissemination of information on a variety of women's health issues, including the primary and secondary prevention of breast and cervical cancer. This study presents formative research from a long-term project examining the potential of mother-daughter communication in promoting cancer screening among African American women. Thirty-two mother-daughter pairs (N = 64) completed orally administered surveys regarding their cancer knowledge, beliefs and attitudes, and barriers to care. This study compares the attitudes and beliefs of low-income, urban, African American mothers and their adolescent daughters regarding cervical and breast cancer screening. Both mothers and daughters had fairly high levels of knowledge about breast and cervical cancer. In addition, there was a high concordance rate between mothers' and daughters' responses, suggesting a potential sharing of health knowledge between mother and daughter. These results have implications for selecting communication strategies to reduce health disparities, and support that the mother-daughter dyad could be a viable unit to disseminate targeted screening information. (PsycINFO Database Record

Human Papillomavirus (HPV) Testing for Secondary Prevention of Cervical Cancer

The strong causal association between human papillomavirus (HPV) and cervical cancer led to the development of HPV detection tests as alternatives to cytology. Several cross-sectional studies evaluated the HPV detection tests in a variety of settings. The pooled sensitivity of HPV test for detection of cervical intraepithelial neoplasia (CIN) 2+ and 3+ diseases was 90 and 95 %, respectively, in these studies. Randomized controlled studies demonstrated substantially higher detection rates of CIN 2+ and 3+ lesions than cytology in the baseline round of screening. In subsequent rounds of screening, HPV-negative women had significantly lower risk of developing CIN 3 or invasive cancers compared to the cytology-negative women, thus proving the higher protective effect of HPV screening. The World Health Organization recommends HPV detection tests as the test of first choice for cervical cancer screening, if affordable. HPV tests are also recommended to triage minor cytological abnormalities and follow up women after treatment of high-grade lesions.

Acceptability of Primary and Secondary Prevention of Cervical Cancer among Medical Students in West China.

Acceptability of Primary and Secondary Prevention of Cervical Cancer among Medical Students in West China.

The impact of HPV vaccination on future cervical screening: a simulation study of two birth cohorts in Denmark

ObjectivesTo explore the interplay between primary and secondary prevention of cervical cancer by estimating future screening outcomes in women offered human papillomavirus (HPV) vaccination when they were sexually naïve.DesignEstimation of...

See-and-treat: striking a balance between over- and under-treatment.

Secondary prevention of cervical cancer based on cervical cytology generally employs a multi-visit approach: screening with cytology, diagnosis with colposcopically directed biopsy, and treatment. Updated screening and management guidelines emphasise the precision of diagnosis and use estimates of risk to avoid overtreatment or undertreatment. The need to return for multiple visits presents an obstacle for many women and may prevent them from completing the process from screening to treatment. A recent analysis of a population-based screening registry in New Mexico found that 16.3% of women with cervical smear tests indicating high-grade squamous intraepithelial lesions had no follow up within a 12-month period. Those with low-grade smears had higher rates of loss to follow up. Furthermore, among those with a high-grade smear who had a biopsy confirming cervical intraepithelial neoplasia (CIN) 3 or worse, only 60.0% received excisional treatment within 1 year (Kinney et al. Gynecol Oncol 2014;132:628–35). The see-and-treat approach can reduce loss to follow up between biopsy and treatment. Women with abnormal cytology are examined colposcopically and treated with an outpatient loop electrosurgical excision procedure in a single visit, so bypassing a visit for biopsy. There is tension between the multivisit approach with its inherent risk of undertreatment from loss to follow up and see-and-treat, in which the lack of a colposcopically directed biopsy often leads to overtreatment. Overtreatment may take two forms, treatment of a cervix with less than final histology results of no CIN or CIN1, and treatment of high-grade squamous intraepithelial lesions that, if observed over time would have spontaneously regressed. Ebisch et al. in this issue of BJOG analyse the impact of cytology and colposcopic impression on overtreatment, i.e. ultimate histology of no CIN or CIN1 (BJOG 2015;doi: 10.1111/1471-0528.13530). They extracted data from 13 studies and show a relatively low (11.6%) rate of overtreatment in women with both high-grade cytology and a high-grade colposcopic impression. The overtreatment rate in this group of women was significantly lower than in those with high-grade cytology and a low-grade colposcopic impression (29.3%) or those with low-grade smear regardless of whether the colposcopic impression was high-grade (46.4%) or low-grade (72.9%). The management guidelines of the American Society for Colposcopy and Cervical Pathology (ASCCP) recommend see-and-treat as an acceptable option in cases of a high-grade smear, when possible perinatal risks from excision are not a consideration. (Massad et al. J Low Genit Tract Dis 2013;17:S1–27). Colposcopic impression is not part of the ASCCP metric, but human papillomavirus status, if known and in the rare case that it is negative, may be considered. Ebisch's data suggest that colposcopic impression may indeed have a role to play when a high-grade smear is associated with a low-grade colposcopic impression. In these women, as part of shared decision-making, biopsy may be the better option. Clearly see-and-treat is an important option in selected women; it can reduce incomplete care. Can we further reduce overtreatment? Additional research is needed to evaluate the possible role of biomarkers such as human papillomavirus genotypes or immunostains, or newer imaging modalities. More and larger studies evaluating the role of the colposcopic impression are also needed. Full disclosure of interests available to view online as supporting information. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Human Development Index and secondary prevention of breast and cervical cancer: an ecological study

This ecological study assessed mammography and Papanicolaou test (Pap smear) screening rates and their association with the Human Development Index (HDI) in Brazilian state capitals and Federal District in 2011, based on VIGITEL telephone survey data. More than 70% of women had a mammogram some time in life in all the state capitals, while the Pap smear rates any time in life and in the previous three years fell short of the 80% target in most state capitals. There was a strong positive correlation between HDI and the test rates (r = 0.52 and 0.66 for mammogram any time in life and in the previous two years and r = 0.66 and 0.71 for Pap smear any time in life and in the previous three years, respectively). Prevalence ratio (PR) for mammogram in the previous two years was 1.06 (95%CI: 1.01-1.10) and PR for Pap smear in the previous three years was 1.07 (IC95%: 1.04-1.10). The promotion of public health policies that encourage Brazil's urban economic and social development should help increase coverage for these tests.

The Impact of Accessible Cervical Cancer Screening in Peru-The Día del Mercado Project.

The purpose of this study was to determine the potential impact of accessible secondary cervical cancer prevention efforts in indigenous Peruvian women living in the rural Andes Mountain region of Peru. Peruvian women presenting for a Pap test or visiting a local marketplace, clinic, or public facility were asked to complete a questionnaire that assessed their response to the rural Pap screening program. We identified the following: 1) barriers to care, 2) patient knowledge of cervical cancer and Pap tests, and 3) perceptions of and reactions to the market clinic model. Chi-square or Fisher exact tests, t tests and 1-way ANOVA were used to examine differences between locations. Of 4,560 women enrolled, those examined in tents indicated it was easier to get a Pap test (98.7%, P = 0.001) compared with women seen in buildings (96.8%) or CerviCusco (98.0%), and they felt it was more important to have a Pap test close to their home more often (99.3%) than those seen at CerviCusco (97.8%) or buildings (98.8%). Women examined in tents felt the market was a good place to have a Pap test more often (67.0%, P < 0.001) than women who went to buildings (46.0%) or CerviCusco (29.2%). Many poor indigenous women living in isolated regions are unable to travel to distant health-care facilities. Using a novel mobile clinic model, the "Dia del Mercado Project" successfully reduced barriers to cervical cancer screening by using local marketplaces.

Influence of risk-taking health behaviours of adolescents on cervical cancer prevention: a Hungarian survey.

An anonymous questionnaire survey was conducted among the Hungarian adolescents to establish their use of tobacco, alcohol and drugs in relation to sexual behaviours, knowledge of human papillomavirus (HPV) and cervical cancer, and beliefs and attitudes towards screening and vaccination. Results indicated that adolescent risk-taking health behaviours correlate with risky sexual behaviours. As risk-taking behaviours do not correlate with a better awareness of the risk associated with HPV infection, it is of crucial importance that HPV/cervical cancer preventing educational programmes shall be sensitive to this 'vulnerable' population and draw the attention of these adolescents to their increased risk of sexually transmitted diseases and undesired pregnancies. Well-designed behavioural change interventions may be effective when in addition to providing adolescents (both men and women) with clear information about the implications of an HPV infection, they also aim to improve safer sex behaviours: consistent condom usage, limiting the number of sex partners, as well as encouraging regular participation in gynaecological screenings and uptake of the HPV vaccine. As this study population demonstrated positive attitudes towards the primary and secondary prevention of cervical cancer, the free HPV vaccination for the 12-13-year-old girls in Autumn 2014 will hopefully increase the currently low uptake of the vaccine in Hungary.

Knowledge, opinions and attitudes of Italian mothers towards HPV vaccination and Pap test.

This study evaluated the knowledge and attitudes of Italian mothers - whose daughters had been vaccinated in 2012 - towards primary (anti-HPV vaccination) and secondary (Pap test screening) cervical cancer prevention, as well as sources of information and mother-daughter communication on health issues. The survey - part of a multicenter study carried out in 4 Italian cities (Ferrara, Rome, Cassino and Palermo) - was conducted through self-administered questionnaires. The first univariate analysis evaluated differences between mothers of under-18s and over-18s relative to knowledge and attitudes on HPV vaccination and Pap test. The second univariate analysis evaluated differences between the 2 groups of mothers and possible geographical variations regarding the sources of information on HPV and Pap test. The sample proved knowledgeable about the correlation between HPV and cervical cancer (&gt;85%) but less aware of other HPV-related diseases. HPV vaccination should be administered before first sexual intercourse according to mothers of over-18s, and to 14- to 17-year-olds according to mothers of under-18s. Up to 88% of mothers of under-18s and 80% of mothers of over-18s declared that the vaccine should be given free of charge. More mothers of under-18s consulted a general practitioner (GP) or gynecologist before deciding to vaccinate their daughters. Mothers of under-18s received information on HPV vaccination mainly from GPs and gynecologists, while mothers of over-18s were informed through TV and books/journals. Over 80% of the sample declared satisfaction with the information received from their gynecologist during the Pap test. The findings provide useful information for the development of effective public health interventions that may help improve acceptance of HPV vaccination among mothers.

Histological-cytological reports correlation and reliability of papanicolau test for the detection of malignant changes in the cervix

The incidence rate of cervical cancer in Serbia is among the highest in Europe and is 23.8 in 100.000. Papanicolaou test, colposcopy and pathohistology report are the basic method of secondary prevention of cervical cancer. The aim of the study was to examine the correlation between histological-cytological findings and reliability of the Papanicolaou test in detection of cervical lesions. We analyzed cervical smears (Papanicolaou test) in 3868 women. Among them 190 women had suspect finding and because of that they were underwent to cervical biopsy. We detected premalignant or malignant changes of the cervix in 77 women. LSIL was found at 43 (22.6%), HSIL at 25 (13.2%) and carcinoma planocellulare at 9 (4.7%) women. There is a statistically significant positive correlation (Spearman=0.829; p<0,001) between histological and cytological findings of the respondents. Most estimates of diagnostic performance of Papanicolaou test in discrimination of LSIL, HSIL and carcinoma planocellulare in accordance with cervicitis are for cytological findings of ASCH (PA IIIa) (Sp=90.6% and Sn=100% for carcinoma planocellulare; Sn = 96% for HSIL and Sn=86% for LSIL). In discrimination HSIL from LSIL the best discrimination is achieved by finding LSIL (PAIIIb) Papanicolaou test (Sn=72.0%, Sp=67.4%), and in discrimination carcinoma planocellulare from LSIL best discrimination is achieved by finding HSIL (PA IIIb/IV) Papanicolaou test (Sn=77.8%, Sp=97.7%). Based on our results we can conclude that there is a positive correlation between histological-cytological findings and that the Papanicolaou test more reliable in detecting severe premalignant lesions. Cytological diagnosis of ASCH (PAIIIa) and LSIL (PAIIIb) can reliably indicate the presence of premalignant cervical lesions in women, and patients with these findings must be more controlled and treated.

Acceptability and correlates of primary and secondary prevention of cervical cancer among medical students in southwest China: implications for cancer education.

ObjectivesTo understand knowledge about, and acceptability of, cervical cancer screening and HPV vaccines among medical students; and to explore potential factors that influence their acceptability in China.MethodsWe conducted a survey among medical students at six universities across southwest China using a 58-item questionnaire regarding knowledge and perceptions of HPV, cervical cancer, and HPV vaccines.ResultsWe surveyed 1878 medical students with a mean age of 20.8 years (standard deviation: 1.3 years). Of these, 48.8% and 80.1% believed cervical cancer can be prevented by HPV vaccines and screening respectively, while 60.2% and 71.2% would like to receive or recommend HPV vaccines and screening. 35.4% thought HPV vaccines ought to be given to adolescents aged 13–18 years. 32% stated that women should start to undergo screening from the age of 25. 49.2% felt that women should receive screening every year. Concern about side effects (38.3% and 39.8%), and inadequate information (42.4% and 35.0%) were the most cited barriers to receiving or recommending HPV vaccination and cervical cancer screening. Females were more likely to accept HPV vaccines (OR, 1.86; 95% CI: 1.47–2.35) or cervical cancer screening (OR, 3.69; 95% CI: 2.88–4.74). Students with a higher level of related knowledge were much more willing to receive or recommend vaccines (P<0.001) or screening (P<0.001). Students who showed negative or uncertain attitudes towards premarital sex were less likely to accept either HPV vaccines (OR, 0.67; 95% CI: 0.47–0.96), or screening (OR, 0.68; 0.47–0.10). Non-clinical students showed lower acceptability of cervical screening compared to students in clinical medicine (OR, 0.74; 95% CI: 0.56–0.96).ConclusionsThe acceptability of HPV vaccines and cervical cancer screening is relatively low among medical students in southwest China. Measures should be taken to improve knowledge about cervical cancer and awareness of HPV vaccines and screening among medical students at university.

Epidemiology of HPV infection and current status of cervical cancer prevention in Greece: final results of the LYSISTRATA cross-sectional study.

The objective of this study was to assess the overall prevalence of the human papilloma virus (HPV) infection and distribution of high-risk HPV (hrHPV) types in Greece and evaluate the participation of women in primary and secondary cervical cancer prevention. This was a prospective, cross-sectional study carried out between October 2005 and January 2011 in Greece; 5379 women filled out the study questionnaire anonymously. 5107 women underwent cervical HPV-DNA testing, either by Hybrid Capture 2, followed by restriction fragment length polymorphism-PCR, or by the Abbott Real-Time High-Risk HPV test. Overall, 5.8% (295/5107) of women were positive for hrHPV infection. The most common hrHPV type was HPV-16 (24.8% among infected women; 1.4% overall), followed by HPV types 31, 35, 53, 18, 51, 56, 58, 52, 39, 66, 45, 33, 59, and 68. In respect to primary prevention of cervical cancer, acceptance of anti-HPV vaccination appeared to decrease over time (from 85-89.9% annually during 2005-2008 to 64.4-60.5% during 2009-2010, P<0.001). In respect to secondary prevention, only 30.3% of women had regular (annually for more than 5 years) Pap smears; regular gynecologic examinations, Papanicolaou testing, and knowledge of HPV were all associated with various demographic parameters (age, education, place of residence, occupation, and income). The prevalence of hrHPV infection in Greece is similar to that in other European countries; the most common type is HPV-16. The initially relatively high acceptance of HPV vaccination decreased after licensing of the vaccine. Demographic parameters appear to influence participation in cervical cancer screening.

THE ROLE OF CYTOLOGICAL AND VIROLOGICAL STUDIES IN SECONDARY PREVENTION OF CERVICAL CANCER

Abstract. This article is devoted to the role of cytological and virological screening in the secondary prevention of cervical cancer. Five hundred and fifty two cases of carcinoma in situ (of cervical cancer) and 1248 cases of invasive cervical cancer over a period of 15 years were analyzed. This period has separated into three stages: I — 1998–2002, II — 2003–2007, III — 2008–2012 years. Cervical cancer morbidity in Karelia is reported to increase tripled from 10.5 to 30.5 causes per 100 thousand women population. The excess incidence has identified among young women in reproductive age including an age group 30 year. It has been noticed that the detection rate of carcinoma in situ was statistically significant increased from 24.34±9.2% in 1998–2002 to 62.8±20.9% in 2008–2012 years. There are three different level regional groups of early cervical cancer detection (0–I–II stage) in the Republic of Karelia. Despite of the fact, that the cervical cancer is increas-ing significantly, there are a good results of its early diagnostics, thanking to the cytological and virological screening in Karelia.

Secondary prevention of cervical cancer through the development and implementation of a system to optimize diagnostic and therapeutic and rehabilitation measures in the background and precancerous cervical diseases

Secondary prevention of cervical cancer through the development and implementation of a system to optimize diagnostic and therapeutic and rehabilitation measures in the background and precancerous cervical diseases

Achim Schneider: Primary, secondary and tertiary prevention of cervical cancer

papillomavirus and histopathology are analyzed and evaluated. One topic the author extensively covers is colposcopy, which is illustrated by representative images and presented with systematic evidence-based practice guidelines. In the rear part of the monograph, the author has included a “pocket flashcard” that provides a helpful memory aid for learning colposcopy practice guidelines. The author emphasizes the need that any treatment plan derived from the armamentarium of strategies offered to patients with precancerous cervical lesions should be based on a differentiated, individualized and tissue-sparing approach. Diagnosis and therapy offered to women with invasive cervical cancer are described mainly addressing the laparoscopic surgical techniques embedded in the context of a diseasebased, risk-adjusted treatment strategy. The layout of the monograph is innovative: as in a lecture, charts and photographs are commented on with explanatory notes. Another feature is the DVD with numerous video clips (inserted in the rear cover of the book) commented on by the author: there are 24 video-clips that demonstrate colposcopic examinations with interesting findings and colposcopy-guided surgery of the cervix. In addition, the DVD features the five most important laparoscopic and/ or laparoscopic vaginal surgical procedures performed for women with cervical cancer—pelvic lymphadenectomy, para-aortic lymphadenectomy, radical vaginal trachelectomy, vaginal-assisted laparoscopic radical hysterectomy and laparoscopically assisted radical vaginal hysterectomy. These are provided as learning modules in a digital surgical atlas, which contains a video clip for each surgical step alongside the figures and drawings. It is easy to see that the author has been dealing with all aspects of the prevention and treatment of women with cervical cancer and its precursors on an internationally competitive scientific level for more than 30 years—a fact not The monograph by Achim schneider “Primary, secondary and tertiary prevention of cervical cancer” is unique, in particular, because to date there is no compendium available in the Germanor english-speaking world, that has been written by one author, presenting in a compact form the entire thematic range from vaccination to pelvic exenteration. The book begins by describing prophylactic vaccination against HPV, the molecular principles of pathogenesis and related epidemiological findings of cervical cancer and precancer. The merits of the various modalities of cervical cancer prevention such as cytology, detection of human

The Role of Hospitals in Cervical Cancer Prevention

Objective: To evaluate the role of hospitals in DKI Jakarta on primary and secondary cervical cancer prevention. Method: This was a survey conducted to 25 hospitals, chosen with simple random sampling from 109 hospitals in DKI Jakarta. Questionnaire used for interview contained statements regarding knowledge, attitude and behavior of 117 health care professionals along with identification of facility preparedness for cervical cancer prevention within those 25 hospitals.&#x0D; Result: The assessment of knowledge shows that all health care professionals (100%) knew that HPV vaccination is used as a primary prevention for cervical cancer. About 98.3% respondent knew HPV vaccine injected intramuscularly. As much as 91.5% of the respondent knew HPV vaccine is given three times either at month 0, 1, 6 or at month 0, 2, 6. About 71.8% respondent knew deltoid as site for vaccine injection. Most of health care professionals (99.1%) knew VIA (visual inspection with acetic acid) can be used for early detection of cervical cancer. About 76.9% respondent knew how to interpret positive VIA results and 60.7% respondent knew how to do VIA test. As much as 93.2% health care professional knew the purpose of Pap test and about 82.1% knew how to do it. From attitude aspect, most of health care professionals (96.6%) agreed in giving HPV vaccination. About 94% of them agreed to do VIA test and about 98.3% agreed in conducting Pap test. From behavioral aspect, most of the respondent (76.9%) offered HPV vaccination to their clients/patients and 62.4% respondent did HPV vaccination. VIA test was offered and conducted by 52.1% and 30.8% of them, respectively. About 86.3% respondent offered Pap test and 71.8% did the Pap test. As many as 75% of female health care professionals who meet the qualification already had a Pap test for themselves, but only 32.5% ever been vaccinated for HPV. From facility aspect, twenty hospitals (80%) in DKI Jakarta offered HPV vaccination with Pap test can be done in all of them. VIA test and colposcopy were only available in eleven (44%) and ten (40%) hospitals respectively.&#x0D; Conclusion: Most hospitals in DKI Jakarta have health care professionals with good knowledge and attitude in cervical cancer prevention. However, not many have shown expected behavior in the primary prevention. Most hospitals in DKI Jakarta provide facilities for HPV vaccination and Pap test, but only few have VIA facilities and colposcopy.&#x0D; Keywords: cervical cancer prevention, health care professional, hospital

Postawy studentek kierunków medycznych i niemedycznych wobec profilaktyki raka szyjki macicy – badanie porównawcze

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Olejniczak D, Bień M. The attitude of the female students of medical and non-medical fields of studies towards the cervical cancer prophylaxis. Medical Studies/Studia Medyczne. 2014;30(3):162-172. doi:10.5114/ms.2014.45421. APA Olejniczak, D., & Bień, M. (2014). The attitude of the female students of medical and non-medical fields of studies towards the cervical cancer prophylaxis. Medical Studies/Studia Medyczne, 30(3), 162-172. https://doi.org/10.5114/ms.2014.45421 Chicago Olejniczak, Dominik, and Magdalena Bień. 2014. "The attitude of the female students of medical and non-medical fields of studies towards the cervical cancer prophylaxis". Medical Studies/Studia Medyczne 30 (3): 162-172. doi:10.5114/ms.2014.45421. Harvard Olejniczak, D., and Bień, M. (2014). The attitude of the female students of medical and non-medical fields of studies towards the cervical cancer prophylaxis. Medical Studies/Studia Medyczne, 30(3), pp.162-172. https://doi.org/10.5114/ms.2014.45421 MLA Olejniczak, Dominik et al. "The attitude of the female students of medical and non-medical fields of studies towards the cervical cancer prophylaxis." Medical Studies/Studia Medyczne, vol. 30, no. 3, 2014, pp. 162-172. doi:10.5114/ms.2014.45421. Vancouver Olejniczak D, Bień M. The attitude of the female students of medical and non-medical fields of studies towards the cervical cancer prophylaxis. Medical Studies/Studia Medyczne. 2014;30(3):162-172. doi:10.5114/ms.2014.45421.

Correction: primary, secondary, and tertiary prevention of cervical cancer

J Gynecol Oncol 2014;25:157-8 http://dx.doi.org/10.3802/jgo.2014.25.2.157 In this book review, Professor Michael Hockel was incorrectly spelled as Micahel Hockel.

Book Review: Primary, secondary, and tertiary prevention of cervical cancer

Book Review: Primary, secondary, and tertiary prevention of cervical cancer

Situación de las Unidades de Patología Cervical en España. Resultados de una encuesta nacional

ObjectivesTo determine the extent to which Cervical Pathology Units (CPU) are implemented in Spanish hospitals and to describe their organization and workload and requirements for training, standardization, and quality assurance, as a basis for a joint project of the Spanish Society of Obstetrics and Gynecology (SEGO) and the Spanish Association of Cervical Pathology and Colposcopy (AEPCC) for CPU accreditation. Material and methodsWe performed a descriptive analysis of the results of a survey of Gynecology Services at Spanish hospitals between November 2012 and January 2013. A total of 220 surveys were sent and replies were received from 128 services (58%) representing all the Spanish regions. ResultsA total of 70% of the hospitals in the survey had a CPU. There was an average of 3 full-time gynecologists and 20 part-time gynecologists at each CPU. The mean annual reported activity was 178 new cases, 79 cervical intraepithelial lesions 2 positive, and 87 conizations. Sixty percent of the hospitals had a register of complications and cytological, colposcopic and histological correlations. Ninety percent followed the recommendations of the AEPCC and the SEGO for primary and secondary prevention of cervical cancer. More than 90% of the gynecologists believed it would be appropriate for the AEPCC and the SEGO to promote CPU accreditation. ConclusionsThe overall situation of CPU in Spain is good but could be improved. Most hospitals in the survey believe that implementing the accreditation process would not be difficult.