Knowledge and Perceptions about Cervical Cancer and HPV Screening in Women in Rural Areas of Ecuador: A Qualitative Research Study

Bautista-Valarezo, Estefanía; Vega, Bernardo; Maldonado-Rengel, Ruth; Espinosa, María Elena; Neira, Vivian Alejandra; Verhoeven, Véronique

doi:10.3390/ijerph191711053

Cited by 5 publications

(6 citation statements)

References 20 publications

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“…Ecuador should consider the use of HPV DNA tests, as this could reduce the time and effort that both women and health staff have to invest in cervical cancer screening. However, other barriers still have to be addressed to reap the benefits of HPV DNA testing and self-testing [ 58 , 59 ].…”

Section: Discussionmentioning

confidence: 99%

Barriers and facilitators to cervical cancer screening among under-screened women in Cuenca, Ecuador: the perspectives of women and health professionals

et al. 2022

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Background Cervical cancer screening is a cost-effective method responsible for reducing cervical cancer-related mortality by 70% in countries that have achieved high coverage through nationwide screening strategies. However, there are disparities in access to screening. In Ecuador, although cervical cancer is the second most common cancer in women, only 58.4% of women of reproductive age have ever been screened for cervical cancer. Methodology A qualitative study was performed to understand the current barriers to screening and to identify strategies that could increase uptake in Azuay province, Ecuador. Seven focus group discussions (FGDs) were conducted with under-screened women and health professionals (HPs). The FGDs were recorded and transcribed. Content analysis was done using the socio-ecological framework to categorize and analyse the data. Results Overall, 28 women and 27 HPs participated in the study. The two groups perceived different barriers to cervical cancer screening. The HPs considered barriers to be mainly at the policy level (lack of a structured screening plan; lack of health promotion) and the individual level (lack of risk perception; personal beliefs). The women identified barriers mainly at organizational level, such as long waiting times, lack of access to health centres, and inadequate patient–physician communication. Both groups mentioned facilitators at policy level, such as national campaigns promoting cervical cancer screening, and at community and individual level, including health literacy and women’s empowerment. Conclusions The women considered access to health services the main barrier to screening, while the HPs identified a lack of investment in screening programmes and cultural patterns at the community level as major obstacles. To take an integrated approach to cervical cancer prevention, the perspectives of both groups should be taken into account. Additionally, new strategies and technologies, such as self-administered human papillomavirus (HPV) testing and community participation, should be implemented to increase access to cervical cancer screening.

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Section: Discussionmentioning

confidence: 99%

Barriers and facilitators to cervical cancer screening among under-screened women in Cuenca, Ecuador: the perspectives of women and health professionals

et al. 2022

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“…Additional topics covered in the guide have been previously published elsewhere. 16 Questions related to the advantages and barriers of each sampling method were used to motivate participation and ascertain opinions on each technique (eg, clinician sampling "What are the advantages and barriers of this method?"). Box 1, displays the key questions utilized during the FGDs.…”

Section: Data Collectionmentioning

confidence: 99%

“…13,14 Additionally, the lack of risk perception and knowledge about CC could pose obstacles for women residing in rural areas. 15,16 In 2021, the World Health Organization (WHO) launched The Cervical Cancer Elimination Initiative. 4 The strategy of this initiative, named 90-70-90, promotes that 90% of the target population is vaccinated against HPV, 70% of the population is screened with highly sensitive HPV diagnostic tests, at least twice during their lifetime (at 35 and 45 years), and addressing 90% of abnormal results are addressed with appropriate treatment and follow-up.…”

Section: Introductionmentioning

confidence: 99%

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“Barriers and Advantages of Self-Sampling Tests, for HPV Diagnosis: A Qualitative Field Experience Before Implementation in a Rural Community in Ecuador”

Vega-Crespo,

Neira,

Maldonado - Rengel

et al. 2024

IJWH

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Introduction:Cervical cancer screening has demonstrated high efficacy in reducing cervical cancer mortality worldwide. However, clinician sampling is often perceived as an uncomfortable procedure that could reduce screening uptake. Self-sampling methods for HPV diagnosis have shown high sensitivity, which could increase acceptance and screening rates among women. Purpose: This study aims to identify the perceived barriers and advantages of self-sampling methods versus clinician sampling for cervical cancer screening in a rural setting in Ecuador. Patients and Methods: A qualitative study was conducted. Seven focus group discussions took place in the rural Parish of El Valle in Azuay Province, Cuenca, Ecuador. Women native to this rural area were included in the study. FGDs were recorded and transcribed, and content analysis was performed to categorize and analyze the data. Results: A total of 45 women participated in the study. Clinician sampling was perceived as a painful and intrusive method. However, participants believed that it is more reliable compared to self-sampling methods, attributing this to the direct visualization of the cervix, which facilitates the detection of cervical pathologies. The perceived advantages of self-sampling included increased comfort, pain reduction, time savings, the ability to perform the test at home, and the potential for widespread availability through pharmacies or local traditional healers. Nevertheless, doubts about the test's reliability as well as the user's proficiency in self-testing posed barriers to the adoption of this technique. Conclusion: Self-sampling methods offer several advantages over clinician sampling, such as enhanced privacy, comfort, and accessibility to cancer screening. Barriers primarily revolved around users' proficiency in performing the test and the reliability of the results. Providing training for using self-sampling tests could address these barriers.

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“…It is well understood that lack of information contributes to vaccine reluctance, with many studies suggesting that increasing awareness of HPV, its vaccine and its association with cancer can contribute to better vaccine uptake and infection prevention [ 18 , 21 , 23 , 24 , 25 , 26 , 27 ]. A study involving American Indian adolescents found that HPV vaccine initiation was higher among those whose parents were aware of the vaccine and had received a recommendation from their medical practitioner for their child to receive it [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

Knowledge and Awareness of HPV, the HPV Vaccine and Cancer-Related HPV Types among Indigenous Australians

Lockwood,

Ju,

Sethi

et al. 2024

IJERPH

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Human Papilloma Virus (HPV) infection is a common, preventable, sexually transmitted disease with oncogenic potential and increasing incidence. This study aimed to gain an understanding of the knowledge and awareness of HPV, the HPV vaccine, and HPV-related cancers, and to evaluate the relationship between participant factors and HPV knowledge, vaccination uptake, and high-risk HPV (16/18) infection, among Indigenous Australians. Data from the 12-month follow-up of a longitudinal cohort study were utilized, involving 763 Indigenous Australian adults in South Australia. The data analysis found that the mean 7-item HPV knowledge tool (HPV-KT) score was 2.3 (95% CI: 2.1–2.4), HPV vaccination prevalence was 27.0% (95% CI: 23.6–30.5) and oral HPV 16/18 infection was 4.7% (95% CI: 3.2–6.2). Multivariable log-Poisson regression models showed ratios of approximately 1.5 times higher HPV-KT scores in females, previous recreational drug users, those who had self-rated as having excellent, very good or good general health and who had heard of HPV; and participants who were not HPV vaccinated had 0.8 times (MR = 0.8, 95% CI: 0.7–0.9) lower HPV-KT scores than their counterparts. The findings suggest that culturally safe education strategies are a necessary investment to improve vaccination coverage among Indigenous Australians and to reduce the impact of HPV and related cancers.

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Knowledge and Perceptions about Cervical Cancer and HPV Screening in Women in Rural Areas of Ecuador: A Qualitative Research Study

Cited by 5 publications

References 20 publications

Barriers and facilitators to cervical cancer screening among under-screened women in Cuenca, Ecuador: the perspectives of women and health professionals

Barriers and facilitators to cervical cancer screening among under-screened women in Cuenca, Ecuador: the perspectives of women and health professionals

“Barriers and Advantages of Self-Sampling Tests, for HPV Diagnosis: A Qualitative Field Experience Before Implementation in a Rural Community in Ecuador”

Knowledge and Awareness of HPV, the HPV Vaccine and Cancer-Related HPV Types among Indigenous Australians

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