Knowledge, Attitudes and Perceptions about Cervical Cancer Risk, Prevention and Human Papilloma Virus (HPV) in Vulnerable Women in Greece

Abstract

Cervical cancer can be largely preventable through primary and secondary prevention activities. Following the financial crisis in Greece since 2011 and the increased number of refugees/migrants since 2015 the proportion of vulnerable population groups in Greece increased greatly and the ability of the healthcare sector to respond and to cover the health needs of the population is put under tremendous stress. A cross-sectional study was designed to assess the characteristics of vulnerable women in Greece regarding cervical cancer risk factors, prevention through screening activities and Human Papilloma Virus (HPV) knowledge. Two cohorts of women aged 18 to 70 years were studied (142 in 2012 and 122 in 2017) who completed an interviewer-administered questionnaire based on the behavioural model for vulnerable populations. According to this model, the factors that affect the behaviour of women in relation with their knowledge, attitudes and beliefs towards cervical cancer and the HPV vaccine in our study sample are categorised in predisposing factors (age, educational status, nationality menopausal status and housing) and enabling factors (lack of insurance coverage). Results from both univariate and multivariate analyses show that older age, low educational background, refugee/migrant or ethnic minority (Roma) background, menopausal status, housing conditions and lack of insurance coverage are linked with insufficient knowledge on risk factors for cervical cancer and false attitudes and perceptions on cervical cancer preventive activities (Pap smear and HPV vaccine). This is the first study in Greece showing the lack of knowledge and the poor attitudes and perceptions on cervical cancer screening and the HPV vaccine in various groups of vulnerable women. Our results indicate the need of health education and intervention activities according to the characteristics and needs of each group.

Predicting cervical screening and HPV vaccination attendance of Roma women in Hungary: community nurse contribution is key

“…When considering our screening attitude assessment, both income and education was positively linked to screening attendance and vaccination (more income and better education increased turnout probability). These results were in support of Adjei Boakye et al [ 3 ], Jeudin et al [ 11 ], Marlow [ 4 ] and Riza et al [ 7 ].…”

“…Besides ethnic affiliation and personal knowledge, religious orientations were also identified as either constraints or enablers of vaccination [ 5 , 6 ]. Riza et al [ 7 ] confirmed that socio-economic background and education were important facilitators of Pap smear testing and HPV vaccination. They argued that Roma ethnic origin was associated with misguided beliefs concerning cervical screening and the HPV vaccine.…”

The Role of Vaccination and Screening in Limiting the Worldwide Disease Burden of Preventable Female Cancers: A Review

“…Moreover, dedicated prevention protocols should be considered to protect vulnerable populations like female migrants/refugees, considered at higher risk for CC incidence, whereas evidence suggests that women with a migration background of BC tend to acquire the same exposure risk of and are less likely to participate in mammography screenings than autochthonous women [100][101][102]. In the future, preventive measures should be adopted to limit the burden of incidence and mortality of female cancers and be actively offered to the general population in developed and less developed countries.…”

Predicting Cervical Screening and HPV Vaccination Attendance of Roma Women in Hungary: Community Nurse Contribution is Key

“…Besides ethnic a liation and personal knowledge, religious orientations were also identi ed as either constraints or enablers of vaccination (Chaparro et al, 2020, Shelton et al, 2013. Riza et al (2020) con rmed that socio-economic background and education were important facilitators of Pap smear testing and HPV vaccination. They argued that Roma ethnic origin was associated with misguided beliefs concerning cervical screening and the HPV vaccine.…”