Human papillomavirus is a common sexually transmitted infection among Mexican males, and urine sample specimens cannot adequately detect the presence of this infection in males.
Morelos es evaluar el uso de la prueba del virus de papiloma humano (VPH), en relación con la prueba de Papanicolaou, para el tamizaje de cáncer cervical. Material y métodos. El Estudio de VPH en Morelos actualmente se está llevando a cabo en México, para examinar la posibilidad de usar la prueba de VPH para la detección de cáncer cervical. Se evaluó el uso de la prueba de VPH en muestras auto-tomadas vaginales y en muestras cervicales tomadas por un clínico. Se comparó la aceptabilidad del uso de la prueba de VPH en muestras autotomadas al uso del Papanicolaou. También se realizó un análisis de costo-efectividad y de costo-beneficio. Resultados. Los resultados del Estudio de VPH en Morelos indican que la prueba de VPH tiene una mayor sensibilidad para detectar los casos de neoplasia intraepitelial cervical 2/3 y cáncer cervical que la prueba de Papanicolaou. Los resultados también indican una Material and Methods. The Morelos HPV Study is currently being conducted in Mexico, to examine the possibility of using HPV testing for CC screening. The HPV testing of self-collected vaginal and clinician-collected cervical specimens was evaluated as part of this study. The acceptability of the HPV testing of self-collected specimens was compared to that of the Pap test. A cost-effectiveness analysis (CEA) and cost-benefit analysis (CBA) was also performed. Results. The Morelos HPV Study results indicate that HPV testing has a greater sensitivity to detect cervical intraepithelial neoplasia (CIN) 2/3 and CC than the Pap test. Our results also indicate an over-all lower acceptability of the Pap test as compared to the self-collected
Currently, information about the psychometric properties of the Beck Anxiety Inventory (BAI) in family caregivers of children with cancer is not available; thus, there is no empirical evidence of its validity and reliability to support its use in this population in Mexico or in other countries. This study examined the psychometric properties of the BAI in family caregivers of children with cancer and pursued four objectives: to determine the factor structure of the BAI, estimate its internal consistency reliability, describe the distribution of BAI scores and the level of anxiety in the sample and test its concurrent validity in relation to depression and resilience. This cross-sectional study was carried out with convenience sampling. A sociodemographic questionnaire, the BAI, the Beck Depression Inventory and the Measurement Scale of Resilience were administered to an incidental sample of 445 family caregivers of children with cancer hospitalized at the National Institute of Health in Mexico City. Confirmatory factor analysis using the maximum likelihood method was performed to determine the factor structure and exploratory factor analysis using axis factorization with oblique rotation was conducted. The two-, three- and four-factor models originally proposed for the BAI did not hold. The exploratory factor analysis showed a model of two correlated factors (physiological and emotional symptoms). Confirmatory factor analysis revealed a lack of discriminant validity between these two factors and supported a single-factor model. The internal consistency of the scale reduced to 11 items (BAI-11) was good (alpha = 0.89). The distribution of BAI-11 scores was skewed to the left. High levels of symptoms of anxiety were present in 49.4% of caregivers. The scale was positively correlated with depression and negatively correlated with resilience. These findings suggest that a reduced single-factor version of the BAI is valid for Mexican family caregivers of children with cancer.
OBJETIVO: Identificar y evaluar los factores que predisponen a la utilización de la prueba de Papanicolaou en la población que usa el servicio del Programa Nacional de Detección Oportuna de Cáncer en México. MÉTODOS: Se realizó un estudio del tipo transversal de enero de 1997 a diciembre de 1998, en la Ciudad de México; se incluyeron a 2.107 mujeres en edad reproductiva que acudieron a un servicio de planificación familiar, las cuáles respondieron a un cuestionario con preguntas sobre características: sociodemográficas, factores de riesgo reproductivo asociados a cáncer cervical, historia de vida sexual, uso de métodos anticonceptivos, conocimiento de la utilidad y utilización del Papanicolaou. Para el análisis de los datos se construyeron modelos multivariados de regresión logística no condicional. RESULTADOS: Los predisponentes de utilización del programa de detección oportuna de cáncer en esta población fueron: el conocimiento de la utilidad del Papanicolaou incrementó en seis veces más la posibilidad de utilización (IC 95% 4,70-7,67); el antecedente de utilización de dos o más métodos de planificación familiar (OR=2,38; IC 95% 1,75-3,24); el antecedente de historia de infección vaginal (OR=2,18; IC 95% 1,73-2,75), y la aceptación del esposo para la realización de exploraciones ginecológicas (OR=1,56; IC 95% 1,07-2,29). CONCLUSIONES: La implementación de programas educativos en la prevención de cáncer, deberán incluir la utilidad de las pruebas de detección. En México, en mujeres en edad reproductiva utilización de la prueba de Papanicolaou se ofrece predominantemente en forma oportunista, por lo que el antecedente de utilización de los Servicios de Salud es un determinante para la utilización del Programa de Detección Oportuna de Cáncer Cervical. Estos resultados muestran la necesidad de ampliar la promoción a la salud de este programa a las mujeres de alto riesgo, incluyendo a sus parejas sexuales.
Both HPV assays detected more cases of CIN2/3 or CC than Pap cytology alone. However, the HPV assays increased the number of colposcopy referrals. Our study suggests that HPV testing could be an effective way to improve the performance of CC screening.
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