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Knowledge, Behavioral, and Sociocultural Factors Related to Human Papillomavirus Infection and Cervical Cancer Screening Among Inner-City Women in Panama

Journal of Community Health volume 40, pages 1047–1056 (2015)Cite this article

Abstract

Cervical cancer remains a leading cause of mortality in developing countries regardless of biomedical advances in prevention modalities. Specifically, Panama experiences one of the highest rates of cervical cancer worldwide. The objective of this study was to explore knowledge, behavioral, and sociocultural factors related to cervical cancer prevention among Panamanian women. A theory-guided, population-based quantitative survey following participatory processes was administered to a randomized sample of females (18–44 years) residing in a high-risk Panamanian community. Participants (n = 324) reported low knowledge regarding HPV, cervical cancer, and the purpose of the Pap test. Furthermore, low perceived susceptibility, high-risk sexual behaviors (e.g., low contraception and condom use) and adverse attitudes toward the Pap test (e.g., shame, fear) were identified. Television, newspapers/magazines, and relatives/friends/neighbors were common sources to receive health information. Significant gaps in knowledge and behavioral factors were identified, which may interfere with cervical cancer prevention efforts. Future strategies should reflect the sociocultural context, such as interpersonal relations, when developing and implementing cervical cancer programs, with the ultimate goal of decreasing the persistent burden among Latin American women.

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References

  1. Castellsague, X. (2008). Natural history and epidemiology of HPV infection and cervical cancer. Gynecologic Oncology, 110(3 Suppl. 2), S4–S7. doi:10.1016/j.ygyno.2008.07.045.

    Article  PubMed  Google Scholar 

  2. Villa, L. L. (2012). Cervical cancer in Latin America and the Caribbean: The problem and the way to solutions. Cancer Epidemiology Biomarkers, 21, 1409–1413. doi:10.1158/1055-9965.EPI-12-0147.

    Article  Google Scholar 

  3. Calvo, A., Brown, K. M., McDermott, R. J., Bryant, C. A., Coreil, J., & Loseke, D. (2012). Social construction of cervical cancer screening among Panamanian women. American Journal of Health Education, 43, 153–163. doi:10.1080/19325037.2012.10599232.

    Article  Google Scholar 

  4. Parkin, D. M., Almonte, M., Bruni, L., Clifford, G., Curado, M. P., & Pineros, M. (2008). Burden and trends of type-specific human papillomavirus infections and related diseases in the Latin America and Caribbean region. Vaccine, 26(Suppl. 11), L1–L15. doi:10.1016/j.vaccine.2008.05.043.

    Article  PubMed  Google Scholar 

  5. Eluf-Neto, J., & Nascimento, C. M. (2001). Cervical cancer in Latin America. Seminars in Oncology, 28, 188–197. doi:10.1053/sonc.2001.21966.

    CAS  Article  PubMed  Google Scholar 

  6. Pan-American Health Organization (PAHO). (2004). A situational analysis of cervical cancer in Latin America and the Caribbean. Washington, DC: PAHO.

    Google Scholar 

  7. Luciani, S., & Andrus, J. K. (2008). A Pan-American Health Organization strategy for cervical cancer prevention and control in Latin America and the Caribbean. Reproductive Health Matters, 16, 59–66. doi:10.1016/S0968-8080(08)32405-7.

    Article  PubMed  Google Scholar 

  8. Pierce Campbell, C. M., Curado, M. P., Harlow, S. D., & Soliman, A. S. (2012). Variation of cervical cancer incidence in Latin America and the Caribbean. Pan-American Journal of Public Health, 31, 492–498. doi:10.1590/S1020-49892012000600007.

    Article  PubMed  Google Scholar 

  9. Calvit, L., Tribaldos, M., Moreno, M., et al. (n.d.). Epidemiología del virus del papiloma humano en mujeres mayores de 15 años en Panamá: Resultados preliminares. Panama City, Panama: Gorgas Memorial Institute for Health Studies. http://www.gorgas.gob.pa/images/HPV.pdf. Accessed October 19, 2013.

  10. Reeves, W. C., Caussy, D., Brinton, L. A., et al. (1987). Case–control study of human papillomaviruses and cervical cancer in Latin America. International Journal of Cancer, 40(4), 450–454. doi:10.1002/ijc.2910400403.

    CAS  Article  Google Scholar 

  11. DeBritton, R. C., Hildesheim, A., De Lao, S. L., Brinton, L. A., Sathya, P., & Reeves, W. C. (1993). Human papillomaviruses and other influences on survival from cervical cancer in Panama. Obstetrics and Gynecology, 81, 19–24.

    CAS  PubMed  Google Scholar 

  12. Winkler, J. L., Wittet, S., Bartolini, R. M., et al. (2008). Determinants of human papillomavirus vaccine acceptability in Latin America and the Caribbean. Vaccine, 26(Suppl. 11), L73–L79. doi:10.1016/j.vaccine.2008.05.027.

    Article  PubMed  Google Scholar 

  13. Abraido-Lanza, A. F., Chao, M. T., & Gammon, M. D. (2004). Breast and cervical cancer screening among Latinas and non-Latina whites. American Journal of Public Health, 94, 1393–1398. doi:10.2105/AJPH.94.8.1393.

    PubMed Central  Article  PubMed  Google Scholar 

  14. Puschel, K., Thompson, B., Coronado, G. D., Lopez, L. C., & Kimball, A. M. (2001). Factors related to cancer screening in Hispanics: A comparison of the perceptions of Hispanic community members, health care providers, and representatives of organizations that serve Hispanics. Health Education and Behavior, 28, 573–590. doi:10.1177/109019810102800505.

    CAS  Article  PubMed  Google Scholar 

  15. Bandura, A. (2001). Social cognitive theory: An agentic perspective. Annual Review of Psychology, 52, 1–26. doi:10.1146/annurev.psych.52.1.1.

    CAS  Article  PubMed  Google Scholar 

  16. Baranowski, T., Perry, C., & Parcel, G. (2002). How individuals, environments, and health behavior interact: Social cognitive theory. In K. Glanz, B. K. Rimmer, & K. Viswanath (Eds.), Health behavior and health education: Theory, reserach and practice (4th ed., pp. 165–184). San Francisco: Jossey-Bass.

    Google Scholar 

  17. National Institute for Statistics and Censuses. (2010). XI National censuses of population and VII census of households: Final results. National Comptroller of the Republic. http://www.contraloria.gob.pa/inec/Publicaciones/Publicaciones.aspx?ID_SUBCATEGORIA=59&ID_PUBLICACION=363&ID_IDIOMA=1&ID_CATEGORIA=13

  18. Lazcano-Ponce, E., Rivera, L., Arillo-Santillan, E., Salmeron, J., Hernandez-Avila, M., & Munoz, N. (2001). Acceptability of a human papillomavirus (HPV) trial vaccine among mothers of adolescents in Cuernavaca, Mexico. Archives of Medical Research, 32, 243–247. doi:10.1016/S0188-4409(01)00277-6.

    CAS  Article  PubMed  Google Scholar 

  19. Agurto, I., Bishop, A., Sanchez, G., Betancourt, Z., & Robles, S. (2004). Perceived barriers and benefits to cervical cancer screening in Latin America. Preventive Medicine, 39, 91–98. doi:10.1016/j.ypmed.2004.03.040.

    CAS  Article  PubMed  Google Scholar 

  20. Daley, E., Perrin, K., Vamos, C., et al. (2013). Confusion about Pap smears: Lack of knowledge among high-risk women. Journal of Women’s Health, 22, 67–74. doi:10.1089/jwh.2012.3667.

    Article  PubMed  Google Scholar 

  21. Moreira, E. D, Jr, Oliveira, B. G., Ferraz, F. M., Costa, S., Costa Filho, J. O., & Karic, G. (2006). Knowledge and attitudes about human papillomavirus, Pap smears, and cervical cancer among young women in Brazil: Implications for health education and prevention. International Journal of Gynecological Cancer, 16, 599–603. doi:10.1111/j.1525-1438.2006.00377.x.

    Article  PubMed  Google Scholar 

  22. Luque, J., Mason, M., Reyes-Garcia, C., Hinojosa, A., & Meade, C. (2011). Salud es vida: Development of a cervical cancer education curriculum for promotora outreach with Latina farmworkers in rural Southern Georgia. American Journal of Public Health, 101, 2233–2235. doi:10.2105/AJPH.2011.300324.

    PubMed Central  Article  PubMed  Google Scholar 

  23. O’Brien, M., Halber, C., Bixby, R., Pimentel, S., & Shea, J. (2010). Community health worker intervention to decrease cervical cancer disparities in Hispanic women. Journal of General Internal Medicine, 25, 1186–1192. doi:10.1007/s11606-010-1434-6.

    PubMed Central  Article  PubMed  Google Scholar 

  24. Munoz, N., Franco, E. L., Herrero, R., et al. (2008). Recommendations for cervical cancer prevention in Latin America and the Carribean. Vaccine, 26S, L96–L107. doi:10.1016/j.vaccine.2008.05.062.

    Article  Google Scholar 

  25. PAHO. (n.d.). Regional strategy and plan of action for cervical cancer prevention and control in Latin American and the Caribbean. http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&gid=15744&Itemid. Accessed December 10, 2013.

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Acknowledgments

Eternal gratitude to the substantial guidance provided by Jill De Zapien from University of Arizona. Researchers would like to thank the numerous community men and women from San Miguelito in Panama that made this study possible and opened us the doors of their homes. The study was funded through a National Institutes of Health, Fogarty Center Grant (NIH# 1 R03 TW007662-01).

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Affiliations

  1. Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd., MDC56, Tampa, FL, 33612, USA

    Cheryl A. Vamos, Arlene E. Calvo, Ellen M. Daley & Humberto López Castillo

  2. Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

    Anna R. Giuliano

Authors
  1. Cheryl A. Vamos
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  2. Arlene E. Calvo
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  3. Ellen M. Daley
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  4. Anna R. Giuliano
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  5. Humberto López Castillo
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Correspondence to Cheryl A. Vamos.

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Vamos, C.A., Calvo, A.E., Daley, E.M. et al. Knowledge, Behavioral, and Sociocultural Factors Related to Human Papillomavirus Infection and Cervical Cancer Screening Among Inner-City Women in Panama. J Community Health 40, 1047–1056 (2015). https://doi.org/10.1007/s10900-015-0030-4

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  • DOI: https://doi.org/10.1007/s10900-015-0030-4

Keywords

  • Cervical cancer
  • HPV
  • Knowledge
  • Behaviors
  • Sociocultural
  • Panama