Women's knowledge about risk factors, prevention and diagnostics of cervical precancerous changes at colposcopy clinic in Latvia

Authors

  • Anita Ungure Department of Obstetrics and Gynaecology, Faculty of Medicine, Riga Stradiņš University, Riga, Latvia
  • Jana Žodžika Department of Obstetrics and Gynaecology, Riga Stradiņš University, Riga, Latvia Gynaecology Clinic, Riga East Clinical University Hospital, Riga, Latvia
  • Nellija Lietuviete Department of Obstetrics and Gynaecology, Riga Stradiņš University, Riga, Latvia Gynaecology Clinic, Riga East Clinical University Hospital, Riga, Latvia
  • Dace Rezeberga Department of Obstetrics and Gynaecology, Riga Stradiņš University, Riga, Latvia Gynaecology Clinic, Riga East Clinical University Hospital, Riga, Latvia
  • Ilva Šenfelde Gynaecology Clinic, Riga East Clinical University Hospital, Riga, Latvia

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20183296

Keywords:

Cervical cancer, Colposcopy, Screening

Abstract

Background: The incidence of cervical cancer in Latvia is one of the highest among European countries. An organized cervical cancer screening program in Latvia was introduced in 2009. Women’s knowledge and attitude regarding cervical cancer is the key component for successful prevention of this disease. The aim of this study was to evaluate women’s knowledge about the risk factors, prevention and diagnostic methods of precancerous and invasive disease of the uterine cervix in the main colposcopy clinic in Latvia and to compare women's knowledge before and after their first colposcopy visit.

Methods: This was a cross sectional study where 100 women were included while attending their first colposcopy visit at Colposcopy Clinic of Riga East Clinical University Hospital. Study was performed in the period September 2017 to November 2017. Exclusion criteria were colposcopy follow-up examination and pregnancy. The most common reason for a planned colposcopy was suspected precancerous changes during cytology testing.

Results: The most common information resources regarding reproductive health were gynaecologist (79%) and mass media (51%). Women knowledge about the risk factors of cervical precancerous changes were as follows: 30% marked smoking and 26% - early onset of the first sexual intercourse. 31% of women knew that vaccination against HPV is an effective prevention. 53% of women considered cervical cytology and 52% - colposcopy as a diagnostic method for precancerous changes. Higher number of women evaluated their general knowledge as sufficient after the visit (10% vs. 30%, p<0.05), but only smoking as a risk factor was recognized significantly more often (30% vs. 42%, p<0.05).

Conclusions: Although current study presented specific population of women attending Colposcopy clinic because of suspected precancerous disease, less than a half of women knew risk factors, prevention and diagnostics of these changes. Overall women were satisfied with information they received during their first colposcopy visit, but afterward only knowledge about smoking as a possible risk factor improved significantly. It is important to improve women's knowledge about the meaning of prevention methods in order to increase the awareness of cervical cancer in Latvia.

References

Centre of Disease Prevention and Control. Statistical Yearbook of Healthcare in Latvia 2016. Available at https://www.spkc.gov.lv/en/statistics. Accessed 31 January 2018.

Altobelli E, Lattanzi A. Cervical carcinoma in the European Union: An update on disease burden, screening program state of activation, and coverage as of March 2014. Int J Gynecol Cancer. 2015;25(3):474-83.

Shiraz A, Majmudar T. Colposcopy and cervical intraepithelial neoplasia. Obstet Gynaecol Reprod Med. 2017;27(6):177-83

Kola S, Walsh JC. Patients' psychological reactions to colposcopy and LLETZ treatment for cervical intraepithelial neoplasia. Eur J Obstet Gynecol Reprod Biol. 2009;146(1):96-9.

De Bie RP, Massuger LFAG, Lenselink CH, Derksen YHM, Prin JB, Bekkers RLM. The role of individually targeted information to reduce anxiety before colposcopy: A randomised controlled trial. BJOG An Int J Obstet Gynaecol. 2011;118(8):945-50.

Petkeviciene J, Ivanauskiene R, Klumbiene J. Sociodemographic and lifestyle determinants of non-attendance for cervical cancer screening in Lithuania, 2006 - 2014. Public Health. 2018;156:79-86.

National Health Service of Latvia. Health services: National Cancer Early Detection Programme. Cervical Cancer Coverage Rates (2009-2017). Available at http://www.vmnvd.gov.lv/lv/veselibas-aprupes-pakalpojumi/veza-savlaicigas-atklasanas-programma/programmas-rezultati. Accessed 30 November 2017.

Obročníková A, Majerníková Ľ. Knowledge, attitudes and practices of cervical cancer prevention. Pielegniarstwo XXI wieku / Nurs 21st Century. 2017;16(2):18-22.

Kivistik A, Lang K, Baili P, Anttila A, Veerus P. Women's knowledge about cervical cancer risk factors, screening, and reasons of non-participation in cervical cancer screening programme in Estonia. BMC Women’s Health. 2011;11(1):43.

Marlow LAV, Ferrer RA, Chorley AJ, Haddrell JB, Waller J. Variation in health beliefs across different types of cervical screening non-participants. Prev Med (Baltim). 2018;111:204-9.

Saulle R, Miccoli S, Unim B, Semyonov L, Giraldi G, De Vito E, et al. Validation of a questionnaire for young women to assess knowledge, attitudes and behaviors towards cervical screening and vaccination against HPV in Italy. Epidemiol Biostat Public Heal. 2014;11(2):1-12.

von Karsa L, Arbyn M, De Vuyst H, Dillner J, Dillner L, Franceschi S, et al. European guidelines for quality assurance in cervical cancer screening. Summary of the supplements on HPV screening and vaccination. Papillomavirus Research. 2015;1:22-31.

Ault KA. Epidemiology and natural history of human papillomavirus infections in the female genital tract. Infect Dis Obstet Gynecol. 2006;2006:1-5.

Moscicki AB, Schiffman M, Burchell A, Albero G, Giuliano AR, Goodman MT, et al. Updating the natural history of human papillomavirus and anogenital cancers. Vaccine. 2012;30-33.

Grandahl M, Rosenblad A, Stenhammar C, Tydén T, Westerling R, Larsson M, et al. School-based intervention for the prevention of HPV among adolescents: a cluster randomized controlled study. Br Med J Open. 2016;6(1):1-11.

Kwan TTC, Tam KF, Lee PW, Chan KK, Ngan HY. The effect of school-based cervical cancer education on perceptions towards human papillomavirus vaccination among Hong Kong Chinese adolescent girls. Patient Educ Couns. 2011;84(1):118-22.

Marek E, Dergez T, Rebek-Nagy G, Szilard I, Kiss I, Ember I, et al. Effect of an educational intervention on Hungarian adolescents’ awareness, beliefs and attitudes on the prevention of cervical cancer. Vaccine. 2012;30(48):6824-32.

Araujo M, Franck JE, Cadot E, Gautier A, Chauvin P, Rigal L, et al. Contextual determinants of participation in cervical cancer screening in France, 2010. Cancer Epidemiol. 2017;48:117-23.

Colposcopy patient survey. East Cheshire. NHS Trust. Available at http://www.eastcheshire.nhs.uk/Downloads/Surveys/Colposcopy%20report%20Apr%2017.pdf. Accessed 2 April 2018.

Galaal K, Bryant A, Deane KH, AL-Khaduri M, Lopes AD. Interventions for reducing anxiety in women undergoing colposcopy. Cochrane database Syst Rev. 2011;(12):CD006013.

O'Connor M, Waller J, Gallagher P, Martin CM, O'Leary JJ, D'Arcy T, et al. Understanding Women's Differing Experiences of Distress after Colposcopy: A Qualitative Interview Study. Women's Health Iss. 2015;25(5):528-34.

The Centre for Disease Prevention and Control. Information about Human Papillomavirus and Cervical Cancer. Available at https://www.spkc.gov.lv/lv/tavai-veselibai/cilveka-papilomas-viruss-un-dz/informacija-iedzivotajiem?glo_template=text. Accessed 15 May 2018.

The Centre for Disease Prevention and Control. Informative leaflet about cervical cancer screening program. Available at https://spkc.gov.lv/upload/Infografikas/dzemdes_kakla_veza_skrinings.pdf. Accessed 15 May 2018.

Latvian Colposcopy Society Official Website. Information for Patients. Colposcopy. Available at http://www.kolposkopija.lv/pacientiem/kolposkopija/. Accessed 15 May 2018.

National Research Programme: Innovation and sustainable development: Latvia's post-crisis experience in a global context (SUSTINNO): Publications, 2016. Available at http://www.sustinno.lv/userfiles/8_LU_74_konf_Silkane_11_03_2016_.pdf. Accessed 30 November 2017.

Sabatino SA, Lawrence B, Elder R, Mercer SL, Wilson KM, DeVinney B, et al. Effectiveness of interventions to increase screening for breast, cervical, and colorectal cancers. Nine updated systematic reviews for the guide to community preventive services. Am J Prev Med. 2012;43(1):97-118.

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Published

2018-07-26

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Original Research Articles