Risk factors for cervical cancer development: what do women think?
M. F. D. Baay A C , V. Verhoeven B , D. Avonts B and J. B. Vermorken AA Department of Medical Oncology, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium.
B Centre for General Practice, UA, Antwerp, Belgium.
C Author for correspondence; email: Marc.Baay@ua.ac.be
Sexual Health 1(3) 145-149 https://doi.org/10.1071/SH04004
Submitted: 18 February 2004 Accepted: 26 July 2004 Published: 23 September 2004
Abstract
Background: The current cervical cancer prevention strategy is exclusively directed towards screening, without taking into account any relationship with sexual risk factors. The introduction of human papillomavirus (HPV) detection into the screening procedure implicates that we should give attention to this relationship. The aim of this study was to investigate what knowledge women have of the relation between HPV and cervical cancer. Methods: Rather than asking about HPV specifically, we suggested 20 risk factors for the development of cervical cancer, including viral infection, and asked 73 women visiting their general practitioner, 67 women visiting a lecture on risk factors for cervical cancer and 28 female students in biomedical sciences to rate the importance of these risk factors on a scale of 1–5. Results: Genetic factors were rated highest with a mean score of 4.5. Bacterial infection ranked second highest with a mean score of 3.8. Smoking ranked fourth at a mean score of 3.6, whereas viral infection shared the sixth place with number of sexual partners with a mean score of 3.4. The presence of high voltage power lines and physical activity appropriately scored the last two places at 2.4 and 2.2, respectively. Twenty-one women suggested a role for sexually transmitted agents, but only five women (3.1%) could actually pinpoint HPV. Conclusion: This enquiry indicates that the risk factor ‘genetic factors’ was over-rated, while knowledge of the most important risk factors, i.e. smoking and sexual habits and (sexually transmitted) infections, would appear to be present to a moderate level in our population. However, knowledge of the role of HPV in cervical cancer development is lacking.
Additional keywords: human papillomavirus (HPV), questionnaire.
Acknowledgements
This study was financed in part by a Research Grant of the Fund for Scientific Research, Flanders (Belgium) to JBV. We are grateful to all women who participated in this study. We also thank Dr Filip Lardon for the opportunity to hand out the questionnaire to his students.
[1] Sasieni P, Cuzick J, Farmery E. Accelerated decline in cervical cancer mortality in England and Wales. Lancet 1995; 346(8989): 1566–7.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[2] Spitzer M. Cervical screening adjuncts: recent advances. Am J Obstet Gynecol 1998; 179(2): 544–56.
| PubMed |
[3] Walboomers JMM, Jacobs MV, Manos MM, Bosch FX, Kummer JA, Shah KV, et al. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol 1999; 189(1): 12–9.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[4] Nobbenhuis MAE, Walboomers JMM, Helmerhorst TJM, Rozendaal L, Remmink AJ, Risse EKJ, et al. Relation of human papillomavirus status to cervical lesions and consequences for cervical-cancer screening: a prospective study. Lancet 1999; 354(9172): 20–5.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[5] Koutsky L. Epidemiology of genital human papillomavirus infection. Am J Med 1997; 102(3): 3–8.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[6] Lambert EC. College students’ knowledge of human papillomavirus and effectiveness of a brief educational intervention. J Am Board Fam Pract 2001; 14(3): 178–83.
| PubMed |
[7] Dell DL, Chen H, Ahmad F, Stewart DE. Knowledge about human papillomavirus among adolescents. Obstet Gynecol 2000; 96(5 Pt 1): 653–6.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[8] Braun V, Gavey N. With the best of reasons: cervical cancer prevention policy and the suppression of sexual risk factor information. Soc Sci Med 1999; 48(10): 1463–74.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[9] Maissi E, Marteau TM, Hankins M, Moss S, Legood R, Gray A. Psychological impact of human papillomavirus testing in women with borderline or mildly dyskaryotic cervical smear test results: cross sectional questionnaire study. Br J Med 2004; 328(7451): 1293–96B.
| Crossref | GoogleScholarGoogle Scholar |
[10] Yacobi E, Tennant C, Ferrante J, Pal N, Roetzheim R. University students’ knowledge and awareness of HPV. Prevent Med 1999; 28(6): 535–41.
| Crossref | GoogleScholarGoogle Scholar |
[11] Gerhardt CA, Pong K, Kollar LM, Hillard PJ, Rosenthal SL. Adolescents’ knowledge of human papillomavirus and cervical dysplasia. J Pediatr Adolesc Gynecol 2000; 13(1): 15–20.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[12] Philips Z, Johnson S, Avis M, Whynes DK. Human papillomavirus and the value of screening: young women's knowledge of cervical cancer. Health Edu Res 2003; 18(3): 318–28.
| Crossref | GoogleScholarGoogle Scholar |
[13] Pitts M, Clarke T. Human papillomavirus infections and risks of cervical cancer: what do women know? Health Edu Res 2002; 17(6): 706–14.
| Crossref | GoogleScholarGoogle Scholar |
[14] Holcomb B, Bailey JM, Crawford K, Ruffin MT. Adults’ knowledge and behaviors related to human papillomavirus infection. J Am Board Fam Pract 2004; 17(1): 26–31.
| PubMed |
[15] Ramirez JE, Ramos DM, Clayton L, Kanowitz S, Moscicki AB. Genital human papillomavirus infections: knowledge, perception of risk, and actual risk in a nonclinic population of young women. J Womens Health 1997; 6(1): 113–21.
| PubMed |
[16] Cuzick J, Terry G, Ho L, Monaghan J, Lopes A, Clarkson P, et al. Association between high-risk HPV types, HLA DRB1* and DQB1* alleles and cervical cancer in British women. Br J Cancer 2000; 82(7): 1348–52.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[17] Storey A, Thomas M, Kalita A, Harwood C, Gardiol D, Mantovani F, et al. Role of a p53 polymorphism in the development of human papillomavirus-associated cancer. Nature 1998; 393(6682): 229–34.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[18] Kjaer SK, van den Brule AJ, Bock JE, Poll PA, Engholm G, Sherman ME, et al. Human papillomavirus — the most significant risk determinant of cervical intraepithelial neoplasia. Int J Cancer 1996; 65(5): 601–6.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[19] Baer H, Allen S, Braun L. Knowledge of human papillomavirus infection among young adult men and women: implications for health education and research. J Community Health 2000; 25(1): 67–78.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[20] Ho GYF, Kadish AS, Burk RD, Basu J, Palan PR, Mikhail M, et al. HPV 16 and cigarette smoking as risk factors for high-grade cervical intra-epithelial neoplasia. Int J Cancer 1998; 78(3): 281–5.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[21] Anhang R, Stryker JE, Wright TC, Goldie SJ. News media coverage of human papillomavirus. Cancer 2004; 100(2): 308–14.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
