KAP Study on Cervical Cancer Screening and Coverage in Brazil

Evidence before this study: Pap smear coverage is about 75% in Brazil, yet most samples are never evaluated by cytologists due to poor quality. Lack of organized, population-based screening programs results in both over- and under-screened groups. The present study sought a more comprehensive evaluation of knowledge, attitudes and practices (KAP) related to cervical cancer screening and diagnosis than previous studies, which included questions about cervical cancer, the speculum, HPV/vaccine, the Pap test and colposcopy. By using social media and other online platforms for participant recruitment, this study was able to achieve a sample size that is much larger than any other KAP study on cervical cancer in a Brazilian population (n=4206). Approximately 15% of participants were not screened for five or more years. Over 60% of participants said that they prefer a speculum-free exam, 80% responded that they would be willing to try a DNA-HPV self-sampling, and 63% were willing to try cervix self-visualization. Interest in self-screening was associated with thinking cervical cancer screening and diagnosis are important and having limited adherence to screening. Implications of evidence from study: Adequate levels of knowledge about the disease, understanding the importance of screening, and willingness to try self-visualization and sampling are fundamental to successful implementation of a self-screening program. Both DNA-HPV self-sampling and cervix self-visualization were of interest to study participants, suggesting that tools that can deliver these opportunities could be used to address barriers in cervical cancer screening. In doing so, this will increase access to women who traditionally do not seek these exams, and also promote shared-decision making via informing and enabling preferences to decrease rates of excessive medical screening and intervention.

[Read more on PubMed here]