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Knowledge and attitudes of allied health personnel in university hospital related to Human Papilloma Virus and the vaccine
Abstract
Objective: In this study, it is aimed to determine the knowledge and attitudes of allied health personnel at a university hospital on Human Papilloma Virus (HPV) infection, transmission and prevention ways, its relation with cancer and HPV vaccine. Methods: A cross-sectional study entitled as "Evaluation questionnaire for the knowledge and attitudes about HPV" was performed on 192 allied health personnel at Hitit University Hospital. The questionnaire contained 32 questions prepared by taking the studies previously performed as model. The questionnaire form was composed of 3 main Parts 1-basic data of the health personnel, 2-knowledge on HPV infection and HPV cervical cancer relation, 3-attitude against HPV vaccination. Results: The basic properties of 192 allied health personnel who participated the survey was evaluated. It was detected that 87.5% of participants correctly knew the cancer virus relationship, 56.2% HPV transmission ways, 86.5% reasons of cervical cancer. 90.3% of participants had a knowledge about HPV vaccine (p <0.001). But only 1% of participants was vaccinated. Conclusion: In conclusion, it was shown that knowledge and attitudes of allied health personnel on HPV and its vaccine were not sufficient as desired. The level of knowledge was more satisfactory in nurses and midwifes than others. The vaccination ratio in all groups was too small. Therefore, all allied health personnel must be educated about HPV and the vaccine as a part of national health projects. This process must also be focused on issues that will change the attitudes and inspire confidence about HPV vaccine.
... Human papillomavirus (HPV) is one of the most widespread sexually transmitted infections, whose >100 genotypes have been identified until now, and at least 13 of them are identified to cause cancer. High-risk HPV types are 16,18,31,33,35,39,45,51,52,56 and 58, and HPV 16 and HPV 18 are responsible for 70% of cervical cancers and precancerous lesions. Although most of the HPV infections are asymptomatic, the virus can cause vaginal, penile, anal cancers, different types of benign and malignant tumor on the skin and mucosa such as common warts on the skin, anogenital warts, oral and pharyngeal papilloma, and recurrent respiratory papillomatosis. ...
... Four in the studies around the world and it is 26%-100% in our country. [20,[33][34][35][36] Although there are many studies about the knowledge level of HPV of different groups in the world and in our country, the number of studies analyzing different occupations together as our study is very few. ...
... The knowledge level of cervical cancer is 38.7%-95.4% according to the studies in different countries, whereas the range changes between 33% and 92.6% in those of Turkey. [33,37,40] It was expressed in a study in Malatya by Türkol et.al. that 79.5% of married women between 15 and 49 ages heard about cervical cancer. ...
... Human papillomavirus (HPV) is one of the most widespread sexually transmitted infections, whose >100 genotypes have been identified until now, and at least 13 of them are identified to cause cancer. High-risk HPV types are 16,18,31,33,35,39,45,51,52,56 and 58, and HPV 16 and HPV 18 are responsible for 70% of cervical cancers and precancerous lesions. Although most of the HPV infections are asymptomatic, the virus can cause vaginal, penile, anal cancers, different types of benign and malignant tumor on the skin and mucosa such as common warts on the skin, anogenital warts, oral and pharyngeal papilloma, and recurrent respiratory papillomatosis. ...
... Four in the studies around the world and it is 26%-100% in our country. [20,[33][34][35][36] Although there are many studies about the knowledge level of HPV of different groups in the world and in our country, the number of studies analyzing different occupations together as our study is very few. ...
... The knowledge level of cervical cancer is 38.7%-95.4% according to the studies in different countries, whereas the range changes between 33% and 92.6% in those of Turkey. [33,37,40] It was expressed in a study in Malatya by Türkol et.al. that 79.5% of married women between 15 and 49 ages heard about cervical cancer. ...
Background:
Cervical cancer is one of the most common types of cancer among women. Early diagnosis and effective treatment are possible with Pap smear test. However, women should be informed about human papilloma virus (HPV), cervical cancer, and Pap smear test to protect against cervical cancer.
Aim:
The aim of this study is to identify knowledge level and behavior of women from various occupations, who reside in a city in the south of Turkey, about HPV, cervical cancer, and Pap smear test.
Materials and methods:
The study was conducted with 753 women consisting of 228 nurses, 28 doctors, 135 teachers, 20 academicians, 21 policewomen, and 321 homemakers. The data were collected with face-to-face interview method using survey form and attitude scale related to early diagnosis of cervical cancer.
Results:
Of the women whose age average is 34.7 ± 7.51, 79% are married, 52.9% have middle income, 62.5% live in towns, and 58.6% are primary school graduates. It was determined that 69.2% of these women had gynecological examination, 27.8% had Pap smear test, and 1.3% had HPV vaccination. About 59.5% of these women stated not having heard of HPV, 61.3% of HPV vaccination, and 41.9% that HPV causes cervical cancer. Those women who have a good education and income level and who live in the city are found to have higher knowledge levels of HPV, HPV vaccination, Pap smear test, and cervical cancer (P < 0.05). Among the occupational groups, it was determined that the nurses are the ones who have least gynecological examination had and the doctors are the ones who have the most number of Pap smear tests had. It was found that average point that women got from the attitude scale of early diagnosis of cervical cancer was 101.91 ± 10.77 that the doctors and nurses had the highest points, 105.29 ± 11.65 and 103.15 ± 9.92, respectively, and that police officers had the lowest points by 93.42 ± 16.50.
Conclusion:
It was determined that the knowledge level and attitudes of the participant women about HPV, cervical cancer, and Pap smear test were insufficient.
... Türkiye genelinde yapılan çalışmalarda, HPV aşılama oranları %1,0-4,3 arasında değişmektedir. 12,22,32,33 Elde ettiğimiz diğer bir bulgu da aşı yaptırmayanların sadece küçük bir bölümünün (%15,9) aşı yaptırmaya istekli olmasıdır. Karasu ve ark.nın çalışmasında katılımcıların yarısından azının HPV aşısı yaptırmaya istekli olduğu belirtilmiştir. ...
... In a study conducted in Turkey, intended for the evaluation of the level of knowledge about HPV and HPV vaccination among allied health personnel, 15% of the respondents stated that they were unaware of the HPV vaccine; and 12% and 44% of the respondents could not correctly reply the questions about the HPV-cervical relationship and HPV's mode of transmission, respectively. 11 These findings indicate the importance of increasing the level of knowledge about HPV vaccination among allied health personnel. Likewise, studies conducted in America showed that health care professionals support the vaccine more when they are given information about it. ...
Objective
In this study, we aimed to emphasize the critical role of physician recommendations in increasing the HPV vaccination rates, and to create awareness in this regard, by revealing the approach of oncologists, gynecologists, pediatricians, and family physicians, who are the primary interlocutors in the matter of HPV vaccination.
Procedures
The study was prepared by conducting a questionnaire in a face-to-face manner, with the participation—on the basis of volunteerism—of 425 physicians including oncologists, gynecologists, pediatricians and family physicians. The interviews were conducted at 4 separate national oncology, pediatrics, gynecology and family medicine congresses. With the questions, the participants' attitudes towards HPV vaccination as well as the power, timing, consistency and scope of their recommendations were questioned.
Findings
In the study; 33% of the respondents stated that the vaccination was not important, and the ones who considered it to be unnecessary (31%) pointed out its non-cost effectiveness to justify their opinion. Only 51% of the respondents stated that the vaccine should be administered to both girls and boys. The rate of the respondents who stated that it should be administered to those with a risk factor was only 19%. 21% of the respondents stated that they promoted the vaccination in their routine practice. In addition, it was observed that the respondents, who answered correctly the question intended for questioning the their knowledge about HPV’s share in all types of cancer, considered the vaccine to be more important and recommended it more in their routine practices.
Results
The results of the analyses reveal that the low HPV vaccination rates are caused substantially by the attitudes of physicians regarding the vaccination; that they do not adequately play a role in its promotion; and that it should be the basic strategy to increase the physicians’ level of knowledge about the vaccine, for increasing the rate of vaccination.
Efficacy
This is the first study in the literature, which involves the evaluation of the attitudes of physicians—who are the primary interlocutors in the matter of HPV vaccination—from 4 branches towards HPV vaccination. The study is also one of the first studies involving a sophisticated evaluation of the attitudes of physicians towards HPV vaccination. In terms of its results, the study has a nature that gives information and inspiration to people, institutions, and organizations both in Turkey and other countries, who/which have an aim to increase the rates of HPV vaccination.
Objective The aim of this study is to determine parents' knowledge levels and attitudes about childhood human papillomavirus (HPV) vaccination and reveal the differences between parents who are health care workers and nonhealth care workers. The HPV vaccine can potentially prevent initial HPV infection and HPV-related genital and anal precancerous disorders and cancers.
Methods Questions and attitudes toward childhood HPV vaccination were asked to 564 parents who agreed to participate in the study.
Results In our study, the rate of health care worker parents considering having their children vaccinated against HPV (63.1%) was higher than that of nonhealth care worker parents (11.4%). Only 5% of parents had their children previously vaccinated against HPV; however, there was no difference between parents who were health care workers and those who were not. In addition, this rate was relatively low compared to other paid vaccines (49.8, 35.3, and 18.8%, respectively). Parents who had not previously vaccinated their children against HPV were considering getting their children vaccinated, especially if a pediatrician recommended it.
Conclusion The parents' high level of health literacy may not be effective in deciding to vaccinate their children against HPV. Therefore, adequate information and awareness should be provided to all parents about HPV vaccination as early as possible for all children of appropriate age. Pediatricians should be given important roles in raising the awareness of parents about childhood HPV vaccination by health authorities.
Metilfenidat tedavisi için çocuk kardiyoloji polikliniğine
başvuran hastaların yakın dönem EKG parametrelerinin izlemi
Amaç: Literatürde kronik boyun ağrısını ekranlı araç kullanımı açısından
değerlendiren spesifik bir çalışmaya rastlanmamıştır. Bu çalışmada
amacımız Bournemouth Boyun Ağrı Ölçeği’ni kullanarak iş yaşamında kronik
boyun ağrısı şikayeti ve ağrıya bağlı kısıtlılığı etkileyebilecek
sosyodemografik etkenlerin (yaş, cinsiyet, VKİ, medeni durum, eğitim, gelir düzeyi,
meslek) ve başta bilgisayar, cep telefonu kullanımı, oturarak çalışma şekli olmak üzere
çevresel faktörlerin değerlendirilmesidir.
Gereç ve Yöntemler: Gözlemsel (kesitsel) tipte planlanan çalışmamız 10 Mart- 10
Temmuz 2020 tarihleri arasında Gaziosmanpaşa Eğitim ve Araştırma Hastanesi Aile
Hekimliği ve Fizik Tedavi Polikliniklerine başvuran kronik boyun ağrısı mevcut 306
gönüllünün katılımı ile gerçekleştirildi. Katılımcılara sosyodemografik verileri,
Bournemouth boyun ağrı ölçeği, Birinci Basamakta Fiziksel Aktivite Anketi ve PHQ-9
sağlık değerlendirme sorularını içeren yüz yüze anket formu uygulandı. Verilerin
analizinde SPSS 22 programı kullanıldı.
Bulgular: %66’sı (n=202) kadın ve %34’ü (n=104) erkek olan 306 hastanın yaş ortalaması
40.6±13.1 yıl ve ağrı süreleri ortalama 26.04±29.9 aydı. Katılımcıların %57’si evli, %57.5
‘u üniversite mezunu, %64.7’si asgari ücret üzeri gelire sahipti. Kronik boyun ağrısı,
hastaların %73.5’unda mekanik boyun ağrısı nedenli idi. Bournemouth skoru; obez
olanlarda olmayanlara göre (p=0.003), düşük eğitim düzeyi olanlarda lise ve üniversite
mezunlarına göre (p= 0.039), sigara içenlerde içmeyen veya bırakanlara göre (p=0.001),
olası depresif olanlarda olmayanlara göre (p=0.000), fiziksel aktivite durumu hareketli
olanlarda olmayanlara göre (p=0.002) anlamlı düzeyde daha yüksek bulunurken, ayakta
ya da oturarak çalışma şekli açısından farklılık görülmedi. Bournemouth skoru ile günlük
telefon kullanma süresi (p=0.000 ;r=0.207), günlük bilgisayar başında geçirilen süre
(p=0.002 ;r=0.180), PHQ-9 depresyon düzeyi (p=0.000 ;r=0.558), boyun ağrı süresi (ay)
(p=0.031 ;r=0.123), ve VKİ (p= 0.025;r=0.128) arasında aynı yönlü, günlük uyku süresi
(p= 0.033;r= -0.122) ve yaş (p=0.000 ;r= -0.216) ile ters yönlü ilişki olduğu görüldü.
Günlük cep telefonu kullanım süresi arttıkça sırası ile istirahatte, aktivite sırasında ve
gece olan boyun ağrısı şiddetinde artış gözlenirken ( sırası ile r=0.114 p=0.045; r=0,247
p=0,000; r=0.206 p=0.000) günlük bilgisayar kullanımı arttıkça sadece aktivite sırasında
boyun ağrısı şiddetinde artış anlamlı bulunmuştur (r=0,183 p=0.001). PHQ depresyon
skorunun artışı ile bilgisayar (r=0.128 p=0.025) ve cep telefonu kullanımı (r=0,152
p=0,008) süresi arasında da ilişki saptanmıştır. Bournemouth boyun ağrı ölçeği
sorularının çalışmamızdaki Cronbach’s alpha değeri 0.914 bulunarak iç güvenirliliğinin
yüksek (>0.70) olduğu görülmüştür.
Sonuç: Çalışmamızda kronik boyun ağrısı nedenli şikayet ve özür artışını ölçen
Bournemouth boyun ağrı ölçek skoruna göre oturarak çalışma şekli ve oturma süresi
anlamlı bulunmazken, özellikle cep telefonu ve bilgisayar başında geçen süre anlamlı
bulunmuştur. İşyerlerinde ekranlı araç kullanımı kronik boyun ağrısı gibi meslek
hastalıkları gelişimi ve ergonomi açısından dikkate değer görülmüştür.
Anahtar Kelimeler: Bournemouth, boyun ağrısı, fiziksel aktivite, kronik ağrı
Özet
Amaç:
Lateks, Havea Brasiliensis bitki öz suyunun içerisine birtakım katkı
maddelerinin eklenmesi sonucu elde edilen bir ürün olup sağlık alanında
birçok tıbbi araç ve gereç içerisinde günlük yaşamda yaygın olarak
kullanılmaktadır. Günümüzde lateks alerjisi sıklığı; spina bifida, mesane
ekstrofisi gibi sık cerrahi girişimlere maruz kalan duyarlı popülasyonda,
sağlık çalışanlarında, lateksle ilgili üretim yapan işçilerde ve genel popülasyonda gittikçe
artmaktadır.
Lateks alerjisi sıklığı sağlık çalışanlarında %9.7, duyarlı hasta grubunda %7.2 ve genel
popülasyonda %4.3 olarak bildirilmektedir 1 . Lateks alerjisi iritan veya alerjik kontakt
dermatitten ürtiker, angioödem, rinit, astım, konjonktivit hatta anafilaksiye kadar
gidebilen klinik tablolara yol açabilir 2,3 . Anafilaksiye neden olan ajanlar arasında
nöromuskuler bloke edici ilaçlardan sonra ikinci sırada yer alır 4,5 . Lateks alerjisinin
tanısında deri prick test, K82 lateks spesifik IgE ve bunlarla sonuç alınamadığı
durumlarda nasal provokasyon testleri kullanılır. Ayrıca lateks malzemelerde kullanılan
yardımcı katkı maddeleri ve buna bağlı gelişen dermatit ile ilgili deri patch testleri demevcuttur. Biz burada polikliniğimizde takip ettiğimiz hastaları derledik ve lateks
alerjisinin yaygınlığına ve sağlık çalışanlarında sık görülen bir meslek hastalığı olduğuna
dikkat çekmeyi amaçladık.
Gereç ve Yöntem:
2014-2020 yılları arasında hastanemiz Alerji ve İmmunoloji Polikliniği’ne başvuran ve
polikliniğimiz takibinde olan lateks alerjisi tanılı hastalar rektrospektif olarak tarandı.
Hastalar yaş, cinsiyet, meslek, deri prick testi sonucu, K82 lateks spesifik IgE ve
semptomlar açısından değerlendirildi.
Bulgular:
Hastaların 18 (%69,2)’i kadın, 8 (30,8)’i erkek ve yaş ortalaması 41,6 idi. Hastaların
çoğunluğunu
%77(20/26) (1 cerrah, 1 sağlık memuru, 1 diş teknisyeni, 17 hemşire
olmak üzere) sağlık çalışanları oluşturdu. Dört hasta lateks eldiven kullanan işçi, 1 hasta
memur, 1 hasta da ev hanımı idi. Lateks prick testleri 2+ ila 5+ arasındaydı. K82 lateks
spesifik IgE bakılabilen hastalarda 1+ ila 4+ arasında değişmekte idi, sadece 1 hastada
ise K82 lateks spesifik Ige negatif bulundu. Semtomların sıklığı; %92 (24) dermatit, %38
(10) angioödem, %35 (9) rinit, %19 (5) konjonktivit, %11(3) ürtiker, %3 (1) dispne, %3 (1)
astım, %8 (2) anafilaksi ve bu semptomların kombinasyonları mevcut idi.
Sonuç:
Lateks alerjisi, lateks eldiven kullananlarda, kauçuk ve lastik üretimi yapan işçilerde,
lateks büro malzemeleri kullanan memur ve ofis çalışanlarında ve daha büyük
çoğunlukta da sağlık çalışanlarında görülebilen bir hastalıktır. Lateks eldivenlerin ve
lateksten yapılmış tıbbi malzemelerin yaygın kullanımı da lateks alerjisinin duyarlıkişilerde ortaya çıkmasının altında yatan sebeptir. Sağlık çalışanlarında sık görüldüğü için
de bir meslek hastalığı olarak değerlendirilmesinin uygun olacağını düşünüyoruz.
Anafilaksi gibi ölümcül klinik tablolara yol açabilmesi de bu konunun önemine işaret
etmektedir.
Anahtar Kelimeler: Lateks Alerjisi, Semptom, Tanı, Sağlık Çalışanları
Özet
Giriş ve Amaç: Psödoeksfoliasyon (PEX) sendromu, ekstraselüler matrikste fibriler bir materyalin üretimi, intraoküler ve ekstraoküler dokularda progresif birikimi ile karakterize bir hastalıktır. PEX sendromunda göz açısından başlıca glokom olmak üzere, katarakt, fakodonesis, lens subluksasyonu, yetersiz dilatasyon, kornea endoteli dekompazyonu gibi komplikasyonlar da görülebilir. PEX’in ekstraoküler manifestasyonları ile ilgili yapılmış çalışmalar, koroner arter hastalığı (KAH), koroner arter ektazisi, sistemik endotel disfonksiyonu, geçici iskemik ataklar, plazmada artmış homosistein seviyeleri nedeniyle kardiyovasküler sonlanımlarla ilişkili bir hastalık olabileceğini göstermektedir. Epikardiyal yağ dokusu (EAT), miyokardiyumun çevresinde bulunan yağ dokusu olup metabolik sendrom, koroner ateroskleroz, atriyal fibrilasyon gibi patolojilerin insidansı ile ilişkili olduğu gösterilmiştir. Biz bu çalışmada PEX sendromunun EAT kalınlığı ile ilişkisini değerlendirmeyi amaçladık.
Metod: Çalışmaya Sivas Cumhuriyet Üniversitesi Göz Hastalıkları polikliniği tarafından PEX sendromu tanısı konan 36 hasta ile yaş ve cinsiyet açısından benzer 50 sağlıklı gönüllüden oluşan toplam 86 katılımcı alındı. PEX sendromu olan hastalar ayrıca glokomu olan ve olmayanlar olarak değerlendirildi. Kardiyoloji bölümü tarafından yapılan transtorasik ekokardiyografide iki grubun ekokardiyografik parametreleri ve epikardiyal yağ dokusu kalınlığı kıyaslandı. EAT kalınlığının (mm) ölçümleri yapılırken parasternal uzun eksen görüntü kullanıldı ve sağ ventrikülün serbest duvarı önündeki epikardiyal yağ dokusunun maksimum diastolik kalınlığı en az üç kardiyak döngüde ölçülerek ortalaması alındı. Bulgular: Çalışmaya alınan 36 PEX’li hastanın ortalama yaşları 71,75±8,48 olup 19’u kadındı. Kontrol grubunun ise ortalama yaşları 69,08±8,47 olup 25’ i kadındı (p=0,09). Gruplar arasında diyastolik parametreler açısından anlamlı fark izlenmedi (p>0,05). Sol ventrikül end sistolik çapı PEX grubunda kontrol grubuna göre anlamlı olarak azalmıştı (3,25±0,37, 3,57±0,44, sırasıyla, p=0,001). Sağ ventrikül çapı PEX grubunda kontrol grubuna göre daha düşüktü (2,76±0,5, 3,06±0,42, sırasıyla, p=0,006). EAT değeri ise PEX grubunda kontrol grubuna göre anlamlı olarak daha yüksek izlendi (0,51±0,24, 0,36±0,21, sırasıyla p<0,005). PEX sendromu olan hastaların 16’sında glokom mevcuttu. Ekokardiyografik parametreler açısından değerlendirildiğinde glokomu olan ve olmayan gruplar arasında istatistiksel fark izlenmedi (p>0,05). PEX sendromunun bağımsız prediktörlerini belirlemek için yapılan çok değişkenli lojistik regresyon modelinde EAT'nin bağımsız bir prediktör olduğu gözlendi. (OR=2,43 [1,138-113,434], p=0,038) Sonuç: Epikardiyal yağ dokusu kalınlığı, kardiyovasküler sonlanımlar üzerinde progognostik bilgiler sağlayan ve KAH ciddiyeti ile ilşkilendirilen kolay uygulanabilir ve ucuz bir belirteçtir. PEX sendromu olan hastalarda epikardiyal yağ dokusu kalınlığı artışı, PEX sendromunda izlenen artmış kardiyovasküler sonlanımlar ile ilişkilendirilebilir.
Anahtar Kelimeler Epikardiyal Yağ Dokusu, Psödoeksfoliasyon Sendromu, Glokom
Aim:
The aim of this study was to determine the validity and reliability of the 'Cervical Cancer and Human Papilloma Virus Awareness Questionnaire' among fertility age women by adapting the scale into Turkish.
Background:
Cervical cancer is the fourth most commonly form seen among women. Death from cervical cancer ranks third among causes and is one of the most preventable forms of cancer.
Methods:
This cross-sectional study included 360 women from three family health centres between January 5 and June 25, 2014.
Results:
Internal consistency showed that the Kuder-Richardson 21 reliability coefficient in the first part was 0.60, Cronbach's alpha reliability coefficient was 0.61 in the second part. The Kaiser-Meyer-Olkin value of the items on the scale was 0.712. The Barlett test was significant. The confirmatory factor analysis indicated that the model matched the data adequately.
Conclusion:
This study shows that the Turkish version of the instrument is a valid and reliable tool to evaluate knowledge, perceptions and preventive behaviours of women regarding human papilloma virus and cervical cancer.
Implications for nursing and policy makers:
Nurses who work in the clinical and primary care settings need to screen, detect and refer women who may be at risk from cervical cancer.
Introduction:
The aim of the study was to determine the breast, cervical, and colorectal cancer screening rates and the influencing factors in a group of Turkish females.
Methods:
This descriptive study was conducted in a School of Nursing. The study sample consisted of 603 females who were the mothers/neighbors or relatives of the nursing students. Data collection forms were developed by the investigators after the relevant literature was screened and were used to collect the data.
Results:
Of the women aged 30 and over, 32.8% had undergone a pap smear test at least once in their life. Of those aged 50 and over, 48.2% had undergone mammography at least once and FOBT had been performed in 12% of these women in their life. Having heard of the screening tests before, knowing why they are done, and having information on the national cancer screening program were important factors influencing the rates of women having these tests done.
Discussion:
The results of this study show that the rates of women participating in national cervical, breast, and colorectal cancer screening programs are not at the desired levels. Having heard of the screening tests before, knowing why they are done, and having information on the national cancer screening program were important factors influencing the rates of women having these tests done. It is suggested that written and visual campaigns to promote the service should be used to educate a larger population, thus increasing the participation rates for cancer screening programs.
Human papillomavirus (HPV), the most common sexually transmitted infection in the United States, can be contracted by young girls shortly after sexual debut. Human papillomavirus can lead to cervical and anogenital cancers and genital warts. A vaccine has been developed to protect against precancerous lesions. We examined obstetrician-gynecologists' practices, opinions, and knowledge regarding this vaccine.
A 37-item questionnaire was sent out by the American College of Obstetricians and Gynecologists (ACOG) to its fellows and junior fellows between May and November of 2007.
Surveys went to 3896 fellows and junior fellows of ACOG. Of these surveys, 771 were Collaborative Ambulatory Research Network (CARN) members who have volunteered to receive several surveys per year. The remaining 3125 questionnaires were sent to all fellows and junior fellows in ACOG's District V (Ohio, Kentucky, Indiana, Michigan and Ontario, Canada). Response rates were 51.0% and 30.7% for CARN and District V, respectively.
Of those who administer vaccines, most offer the HPV vaccine. Most know this vaccine protects against 4 HPV types. Fewer knew the percentages of cervical cancers and genital warts prevented. Over 20% knew all 3 answers. Only a minority answered all incorrectly. Approximately 15% view HPV vaccine as safe in pregnancy. Many agree cost is a reason for patient refusal and a deterrent from mandating the vaccine.
Obstetrician-gynecologists are knowledgeable of the HPV vaccine and are incorporating it into practice. Financial concerns may limit widespread immunization.
Objective: Our primary aim was to detect how much importance is given to pap smear test by the health staff.Material and Methods: In this study inquiries including questions about age, marital status, occupation, attitude for applying to gynecology polyclinics as well as questions regarding their knowledge about and attitude to pap smear test and HPV vaccination were delivered to health staff as well as to a control group which was formed from patients applying to our polyclinics.Results: Neither of the groups applied for gynecologic control without having complaints.There was no significant difference between the groups when the rates of having smear test at least once were taken into consideration. In this study we detected that the smear test was not offered routinely to nearly half of the patients.Those patients who were offered the smear test had the test by significantly higher rates. 91,17% of the women in the study group had heard about HPV vaccination.Discussion: The awareness of health staff as well as the non-health staff population about pap smear test is far from adequate in Turkey. Furthermore, gynecologists do not offer smear tests to their patients efficiently.This situation may prevent the reduction of cervical malignancies in the near future.
Abstract
Background
The United States (US) Food & Drug Administration (FDA) recently approved a human papillomavirus (HPV) vaccine with the purpose of reducing the risk of cervical cancers caused by HPV 16 and HPV 18. It is important that the general population be educated about HPV and the HPV vaccine in order to make the appropriate decision whether or not to vaccinate against this virus. Participants from the adult US general population of Pittsburgh, Pennsylvania, USA and Hampton, Virginia, USA (18+ years old) were surveyed to determine their knowledge about HPV and the HPV vaccine, and to evaluate their perception of the vaccine efficacy and safety.
Results
We report herein preliminary data for 202 participants. Fifty-five percent (55%) of the study population was White, 45% Black, and 1% was from other ethnic groups or did not disclose their ethnicity. A large proportion of participants had heard of the human papillomavirus (overall population: 93.6%; Pittsburgh: 95%; Hampton: 90%). Participants of African descent were slightly less aware of HPV than Whites (Black 89% vs. Whites 97%, p > 0.1). Although the majority of participants knew that HPV caused cervical cancer (84%), Whites were more informed than Black participants (91% vs. 73%, p = 0.044). Eighty-seven percent (87%) of participants had heard of the HPV vaccine (Pittsburgh: 92% and Hampton: 74%, p = 0.029); a higher proportion of Whites were aware of the vaccine when compared with Blacks (93% vs. 76%, p = 0.031). However, only 18% of the population knew that the current FDA-approved vaccine protected against genital warts and most cervical cancer (20% of Blacks and 16% of Whites, p > 0.1).
Conclusion
These data suggest that although the general population might be aware of HPV and the HPV vaccine, knowledge of the benefits of the HPV vaccination may not be apparent. Knowledge of HPV and the HPV vaccine could result in a likely choice of HPV vaccination and would subsequently reduce the incidence of cervical cancer.
The United States (US) Food & Drug Administration (FDA) recently approved a human papillomavirus (HPV) vaccine with the purpose of reducing the risk of cervical cancers caused by HPV 16 and HPV 18. It is important that the general population be educated about HPV and the HPV vaccine in order to make the appropriate decision whether or not to vaccinate against this virus. Participants from the adult US general population of Pittsburgh, Pennsylvania, USA and Hampton, Virginia, USA (18+ years old) were surveyed to determine their knowledge about HPV and the HPV vaccine, and to evaluate their perception of the vaccine efficacy and safety.
We report herein preliminary data for 202 participants. Fifty-five percent (55%) of the study population was White, 45% Black, and 1% was from other ethnic groups or did not disclose their ethnicity. A large proportion of participants had heard of the human papillomavirus (overall population: 93.6%; Pittsburgh: 95%; Hampton: 90%). Participants of African descent were slightly less aware of HPV than Whites (Black 89% vs. Whites 97%, p > 0.1). Although the majority of participants knew that HPV caused cervical cancer (84%), Whites were more informed than Black participants (91% vs. 73%, p = 0.044). Eighty-seven percent (87%) of participants had heard of the HPV vaccine (Pittsburgh: 92% and Hampton: 74%, p = 0.029); a higher proportion of Whites were aware of the vaccine when compared with Blacks (93% vs. 76%, p = 0.031). However, only 18% of the population knew that the current FDA-approved vaccine protected against genital warts and most cervical cancer (20% of Blacks and 16% of Whites, p > 0.1).
These data suggest that although the general population might be aware of HPV and the HPV vaccine, knowledge of the benefits of the HPV vaccination may not be apparent. Knowledge of HPV and the HPV vaccine could result in a likely choice of HPV vaccination and would subsequently reduce the incidence of cervical cancer.
Human papillomavirus (HPV) is the most common newly diagnosed sexually transmitted infection in the United States. Although the majority of sexually active adults will be infected with HPV at least once in their lives, it is sexually active women less than 25 years of age who consistently have the highest rates of infection. Besides youth and gender, common risk factors for HPV infection and clinical sequelae of infection include high number of sexual partners and coinfection with Chlamydia trachomatis or herpes simplex virus. Most HPV infections are cleared by the immune system and do not result in clinical complications. Clinical sequelae in cases of low-risk HPV infection consist of genital warts, and clinical manifestations of high-risk HPV infection include abnormal Pap test results, low-grade squamous intraepithelial lesions (LSIL), high-grade squamous intraepithelial lesions (HSIL), and cervical cancer. LSIL, HSIL, and cervical cancer carry significant morbidity and/or mortality; genital warts and abnormal Pap test results are often significant sources of psychosocial distress. Currently, there are neither effective means of preventing HPV transmission nor cures for clinical manifestations: infection can only be prevented via complete sexual abstinence, while treatment for clinical sequelae such as genital warts and cytologic abnormalities consists of removing the problematic cells and watching for recurrence; this method consumes significant health care resources and is costly. New prophylactic HPV vaccines promise to dramatically reduce the incidence of HPV infection, genital warts, and cytologic abnormalities.
These recommendations represent the first statement by the Advisory Committee on Immunization Practices (ACIP) on the use of a quadrivalent human papillomavirus (HPV) vaccine licensed by the U.S. Food and Drug Administration on June 8, 2006. This report summarizes the epidemiology of HPV and associated diseases, describes the licensed HPV vaccine, and provides recommendations for its use for vaccination among females aged 9-26 years in the United States. Genital HPV is the most common sexually transmitted infection in the United States; an estimated 6.2 million persons are newly infected every year. Although the majority of infections cause no clinical symptoms and are self-limited, persistent infection with oncogenic types can cause cervical cancer in women. HPV infection also is the cause of genital warts and is associated with other anogenital cancers. Cervical cancer rates have decreased in the United States because of widespread use of Papanicolaou testing, which can detect precancerous lesions of the cervix before they develop into cancer; nevertheless, during 2007, an estimated 11,100 new cases will be diagnosed and approximately 3,700 women will die from cervical cancer. In certain countries where cervical cancer screening is not routine, cervical cancer is a common cancer in women. The licensed HPV vaccine is composed of the HPV L1 protein, the major capsid protein of HPV. Expression of the L1 protein in yeast using recombinant DNA technology produces noninfectious virus-like particles (VLP) that resemble HPV virions. The quadrivalent HPV vaccine is a mixture of four HPV type-specific VLPs prepared from the L1 proteins of HPV 6, 11, 16, and 18 combined with an aluminum adjuvant. Clinical trials indicate that the vaccine has high efficacy in preventing persistent HPV infection, cervical cancer precursor lesions, vaginal and vulvar cancer precursor lesions, and genital warts caused by HPV types 6, 11, 16, or 18 among females who have not already been infected with the respective HPV type. No evidence exists of protection against disease caused by HPV types with which females are infected at the time of vaccination. However, females infected with one or more vaccine HPV types before vaccination would be protected against disease caused by the other vaccine HPV types. The vaccine is administered by intramuscular injection, and the recommended schedule is a 3-dose series with the second and third doses administered 2 and 6 months after the first dose. The recommended age for vaccination of females is 11-12 years. Vaccine can be administered as young as age 9 years. Catch-up vaccination is recommended for females aged 13--26 years who have not been previously vaccinated. Vaccination is not a substitute for routine cervical cancer screening, and vaccinated females should have cervical cancer screening as recommended.
This report summarizes the epidemiology of human papillomavirus (HPV) and associated diseases, describes the licensed HPV vaccines, provides updated data from clinical trials and postlicensure safety studies, and compiles recommendations from CDC's Advisory Committee on Immunization Practices (ACIP) for use of HPV vaccines. Persistent infection with oncogenic HPV types can cause cervical cancer in women as well as other anogenital and oropharyngeal cancers in women and men. HPV also causes genital warts. Two HPV vaccines are licensed in the United States. Both are composed of type-specific HPV L1 protein, the major capsid protein of HPV. Expression of the L1 protein using recombinant DNA technology produces noninfectious virus-like particles (VLPs). Quadrivalent HPV vaccine (HPV4) contains four HPV type-specific VLPs prepared from the L1 proteins of HPV 6, 11, 16, and 18. Bivalent HPV vaccine (HPV2) contains two HPV type-specific VLPs prepared from the L1 proteins of HPV 16 and 18. Both vaccines are administered in a 3-dose series. ACIP recommends routine vaccination with HPV4 or HPV2 for females aged 11 or 12 years and with HPV4 for males aged 11 or 12 years. Vaccination also is recommended for females aged 13 through 26 years and for males aged 13 through 21 years who were not vaccinated previously. Males aged 22 through 26 years may be vaccinated. ACIP recommends vaccination of men who have sex with men and immunocompromised persons (including those with HIV infection) through age 26 years if not previously vaccinated. As a compendium of all current recommendations for use of HPV vaccines, information in this report is intended for use by clinicians, vaccination providers, public health officials, and immunization program personnel as a resource. ACIP recommendations are reviewed periodically and are revised as indicated when new information and data become available.
Breast and cervical cancer are the most common causes of cancer mortality among women worldwide, but they are largely preventable. There are limited data on knowledge and practices on screening methods of breast and cervical cancers among female health care workers in Sri Lanka, in spite of having an organized screening programme islandwide. A cross-sectional survey was conducted among 219 female health care workers including public health midwives (68.9%) selected from 6 districts in Sri Lanka using convenient sampling methods. A self-administered questionnaire was used as a pre-test in a capacity building training programme to collect the data. The mean (SD) duration of work experience of the respondents was 12 years and 52.5% were aged over 35 years. Most (76.7%) were married, and a family history of cancer was reported by 24.2%. Over 98% knew about self breast examination. Even though 84.1% practiced it, only 47.9% practiced it on a monthly basis. Clinical breast examination and mammography were known by 94.1% and 64.3% respectively. Only 19.2% had undergone a clinical breast examination within one year and 3.6% had ever undergone a mamography. Only 76.3% knew that a Pap smear detects precancerous stage of cervical cancer. Among 169 married workers, 73.4% had never had a Pap smear and only 17.2% had got it done within the preceding 5 years. Among the reasons for not doing a pap smear within 5 years, 47.0% believed it as not necessary, 17.3% due to fear/dislike, 23.2% as not having symptoms, 3% had not known about it and 3% not known about availability of services. The study findings suggest that the knowledge and practices on breast and cervical cancer screening methods among female health care workers need to be improved. Considering the role that health care workers play in communicating health behaviors to the general public, strengthening health education interventions for this group of females is essential.
Sexual behavior is of public health interest because of the association with reproductive health and sexually transmitted infections such as human papillomavirus, which is the causal factor of cervical cancer. The aim of the study was to describe patterns in women's sexual behavior in four Nordic countries.
Population-based cross-sectional study.
Denmark, Iceland, Norway, and Sweden (November 2004-June 2005).
A random sample of 18-45-year-old women from the female population in the four participating Nordic countries. The participation rate ranged from 81.3% in Denmark to 54.5% in Iceland. In total, 65 623 women were included.
Each participant completed a structured questionnaire containing questions about sociodemographic factors, lifestyle factors and sexual behavior.
Age-specific and country-specific descriptive measures of sexual behavior, notably age at first intercourse and lifetime number of partners. In addition, risk factors for having had multiple (>10) sexual partners were examined.
Overall, median age at first intercourse was 16, and 30.2% (95% CI: 29.9-30.6) of the participating women reported having had ≥10 partners. There was great variation with birth cohort but limited variation between countries. The main correlates of multiple sexual partners were increasing age at enrollment, a higher alcohol intake and young age at first intercourse.
These measurements of sexual behavior before the introduction of national human papillomavirus vaccination programs will form the basis for a comparison with a similar survey performed after vaccination has been introduced.
Cancer of cervix uteri is the second most common cancer among women, and it has been shown to be caused by human papillomavirus (HPV) infection in more than 99% of cases. We surveyed Muslim Turkish women, who mostly accept talking about sex as a taboo, to examine their knowledge about Papanicolaou (Pap) smear test, HPV, HPV vaccine, and their attitude toward vaccination to themselves and their daughters.
We surveyed 525 women aged between 19 and 53 years to examine their knowledge about cervical cancer screening Pap smear test, HPV, HPV vaccine, and their attitude toward vaccination to themselves and their daughters with a questionnaire that is consisted of 5 parts with a total of 31 items.
The knowledge of cervical screening was high (70%), and 51% of the subjects were at least once had a Pap smear test, but most respondents (56%) had never heard of HPV. For most women, recommendations from health workers (67%) were the major influences in deciding to get vaccinated.
The importance of successful introduction on the vaccine by the drug providers and health care professionals in Turkey was shown in this present study with a high rate of awareness of cervical cancer vaccine. "Early-age vaccination knowledge" before any sexual contact is probably due to the correct education of mothers by health care professionals. The professionals should be educated and trained about HPV, vaccination, and its relation with cervical cancer to increase the knowledge about it.
Recently, prophylactic human papillomavirus (HPV) vaccines were approved in the USA and Europe to protect against HPV-related disease. However, there is ongoing debate about the acceptance of the HPV vaccine as a part of routine vaccine scheme. The aim of this study is to determine the baseline knowledge Turkish women have about HPV and prophylactic HPV vaccines.
The study included 1434 women from four different cities of Turkey who completed a 22-item questionnaire that assessed their knowledge of HPV and cervical cancer, and their acceptance of HPV vaccine for themselves and their children.
The median age was 35.8 +/- 10.8 years (range: 17-80 years). In all, 12% of the participants had a past history of an abnormal Pap test. Among the participants, 77% believed that sex education should be provided at school, 45% had heard of HPV and 55% had no knowledge about HPV. It was known by 43% of the women that HPV might cause genital lesions. Of the parents, 40% knew HPV is related to cervical cancer, while 34% had no opinion about the subject. Of the parents interviewed, 70% reported they would accept HPV vaccination for themselves, 64% for their daughters and 59% for their sons.
Although less than half of the women had knowledge about HPV, the majority of the women sampled reported that they would accept vaccination for themselves and their children. Health-care providers must focus not only on the diagnosis and treatment of cervical cancer, but must also provide information and education about HPV to women.
In most countries registered nurses play a key role in vaccination. The number of recommended childhood vaccines has increased and several other new vaccines are in the implementation phase or are being considered for public programs. Little is known about nurses' perceived usefulness of recommended vaccines and no recent study has assessed nurses' opinions regarding new candidate vaccines for the public programs.
The main purpose of this survey was to assess nurses' opinions regarding already recommended and new candidate vaccines for public programs; based on nurses responses, to assess the perceived priority of implementation of new vaccination programs, and to determine factors associated with the intention to recommend a new vaccine.
Cross-sectional survey.
The survey was conducted in June-July 2008 with registered nurses (N=299) randomly sampled from the Quebec Order of Nurses registry.
The great majority (97.8%) of nurses somewhat or strongly agreed that the vaccines recommended by public health authorities are very useful. The proportion of nurses that perceived different recommended vaccines as useful varied from 80% to 99%. A high heterogeneity was observed among nurses' opinions regarding the safety and efficacy profile of different new vaccines. From 35% to 69% of nurses self-estimated the information they received on new vaccines as sufficient for their needs. The priority rating of new vaccines was as follows: (1) combined hepatitis A and B vaccine; (2) measles mumps rubella and varicella vaccine; (3) hexavalent diphtheria-tetanus-pertussis based vaccine; (4) pneumococcal 10-valent vaccine; (5) meningococcal ACYW-135 vaccine; (6) human papillomavirus vaccine and (7) Rotaviral vaccine. The willingness to recommend a new vaccine was consistently associated with the perceived vaccine safety, usefulness of a potential immunization program and the perceived professional support of a new vaccine.
The general attitudes of nurses toward vaccines recommended by public health authorities are positive and were not negatively affected by the recent implementation of the pneumococcal, varicella and influenza vaccines in the childhood vaccination program. Important differences are observed when comparing the perceived usefulness, safety, efficacy, acceptability, and intention to recommend new vaccines. Nurses clearly give their priority to combined vaccines and to vaccines they had received more information about. The delivery of clear evidence-based information about the new immunization program targets and vaccine safety, as well as professional support fostering would increase nurses' willingness to recommend new vaccines.
Efforts to reduce global cancer disparities begin with an understanding of geographic patterns in cancer incidence, mortality, and prevalence. Using the GLOBOCAN (2002) and Cancer Incidence in Five Continents databases, we describe overall cancer incidence, mortality, and prevalence, age-adjusted temporal trends, and age-specific incidence patterns in selected geographic regions of the world. For the eight most common malignancies—cancers of lung, breast, colon and rectum, stomach, prostate, liver, cervix, and esophagus—the most important risk factors, cancer prevention and control measures are briefly reviewed.
In 2002, an estimated 11 million new cancer cases and 7 million cancer deaths were reported worldwide; nearly 25 million persons were living with cancer. Among the eight most common cancers, global disparities in cancer incidence, mortality, and prevalence are evident, likely due to complex interactions of nonmodifiable (ie, genetic susceptibility and aging) and modifiable risk factors (ie, tobacco, infectious agents, diet, and physical activity). Indeed, when risk factors among populations are intertwined with differences in individual behaviors, cultural beliefs and practices, socioeconomic conditions, and health care systems, global cancer disparities are inevitable. For the eight most common cancers, priorities for reducing cancer disparities are discussed.
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