Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Cancer
Published in: BMC Cancer 1/2014

Open Access 01-12-2014 | Research article

Knowledge, awareness and attitudes about cervical cancer among women attending or not an HIV treatment center in Lao PDR

Authors: Chanvilay SICHANH, Fabrice QUET, Phetsavanh CHANTHAVILAY, Joeffroy DIENDERE, Vatthanaphone LATTHAPHASAVANG, Christophe LONGUET, Yves BUISSON

Published in: BMC Cancer | Issue 1/2014

Login to get access

Abstract

Background

Cervical cancer is the first female cancer in Lao PDR, a low-income country with no national screening and prevention programs for this human papillomavirus (HPV) associated pathology. HIV-infected women have a higher risk of persistent oncogenic HPV infection.
The purpose of this study was to determine the knowledge, awareness and attitudes about cervical cancer among Lao women attending or not an HIV treatment center, in order to understand if this attendance had offered an opportunity for information and prevention.

Methods

A cross-sectional case–control survey was conducted in three provinces of Lao PDR, Vientiane, Luang Prabang and Savannakhet. Cases were 320 women aged 25 to 65, living with HIV and followed in an HIV treatment center. Controls were 320 women matched for age and place of residence, not attending an HIV treatment center.

Results

Cases had a greater number of sexual partners and used condoms more often than controls. Only 36.6% of women had consulted a gynecologist (47.5% among cases and 25.6% among controls, p < 0.001) and 3.9% had benefited from at least one Pap smear screening (5.6% cases and 2.2% controls, p = 0.02). The average knowledge score was 3.5 on a 0 to 13 scale, significantly higher in cases than in controls (p < 0.0001). Despite having a lower education level and economic status, the women living with HIV had a better knowledge about cervical cancer and were more aware than the controls of the risk of developing such a cancer (35.9% vs. 8.4%, p = 0.0001). The main source of information was healthcare professionals. The main reasons for not undergoing Pap smear were the absence of symptoms and the default of medical injunction for cases, the lack of information and ignorance of screening usefulness for controls.

Conclusion

In Lao PDR, routine consultation in HIV treatment centers is not enough harnessed to inform women of their high risk of developing cervical cancer, and to perform screening testing and treatment of precancerous lesions. Implementing this cost-effective strategy could be the first step toward a national prevention program for cervical cancer.
Appendix
Available only for authorised users
Literature
1.
Mandelblatt JS, Lawrence WF, Gaffikin L, Limpahayom KK, Lumbiganon P, Warakamin S, King J, Yi B, Ringers P, Blumenthal PD: Costs and benefits of different strategies to screen for cervical cancer in less-developed countries. J Natl Cancer Inst. 2002, 94: 1469-1483. 10.1093/jnci/94.19.1469.CrossRefPubMed
2.
zur Hausen H: Papillomaviruses in the causation of human cancers - a brief historical account. Virology. 2009, 384: 260-265. 10.1016/j.virol.2008.11.046.CrossRefPubMed
3.
Smith JS, Melendy A, Rana RK, Pimenta JM: Age-specific prevalence of infection with human papillomavirus in females: a global review. J Adolesc Health. 2008, 43 (4 Suppl): S5-S25.PubMed
4.
Schiffman M, Castle PE, Jeronimo J, Rodriguez AC, Wacholder S: Human papillomavirus and cervical cancer. Lancet. 2007, 370: 890-907. 10.1016/S0140-6736(07)61416-0.CrossRefPubMed
5.
Luque AE, Hitti J, Mwachari C, Lane C, Messing S, Cohn SE, Adler D, Rose R, Coombs R: Prevalence of human papillomavirus genotypes in HIV-1-infected women in Seattle, USA and Nairobi, Kenya: results from the Women’s HIV Interdisciplinary Network (WHIN). Int J Infect Dis. 2010, 14: e810-e814. 10.1016/j.ijid.2010.03.016.CrossRefPubMedPubMedCentral
6.
Sun X-W, Kuhn L, Ellerbrock TV, Chiasson MA, Bush TJ, Wright TC: Human Papillomavirus infection in women infected with the human immunodeficiency virus. N Engl J Med. 1997, 337: 1343-1349. 10.1056/NEJM199711063371903.CrossRefPubMed
7.
Hawes SE, Critchlow CW, Faye Niang MA, Diouf MB, Diop A, Touré P, Aziz Kasse A, Dembele B, Salif Sow P, Coll-Seck AM, Kuypers JM, Kiviat N: Increased risk of high-grade cervical squamous intraepithelial lesions and invasive cervical cancer among African women with human immunodeficiency virus type 1 and 2 infections. J Infect Dis. 2003, 188: 555-563. 10.1086/376996.CrossRefPubMed
8.
Nappi L, Carriero C, Bettocchi S, Herrero J, Vimercati A, Putignano G: Cervical squamous intraepithelial lesions of low-grade in HIV-infected women: recurrence, persistence, and progression, in treated and untreated women. Eur J Obstet Gynecol Reprod Biol. 2005, 121: 226-232. 10.1016/j.ejogrb.2004.12.003.CrossRefPubMed
9.
Veldhuijzen NJ, Braunstein SL, Vyankandondera J, Ingabire C, Ntirushwa J, Kestelyn E, Tuijn C, Wit FW, Umutoni A, Uwineza M, Crucitti T, van de Wijgert JH: The epidemiology of human papillomavirus infection in HIV-positive and HIV-negative high-risk women in Kigali, Rwanda. BMC Infect Dis. 2011, 11: 333-10.1186/1471-2334-11-333.CrossRefPubMedPubMedCentral
10.
Ng’andwe C, Lowe JL, Richards PJ, Hause L, Wood C, Angeletti PC: The distribution of sexually-transmitted Human Papillomaviruses in HIV positive and negative patients in Zambia, Africa. BMC Infect Dis. 2007, 7: 77-10.1186/1471-2334-7-77.CrossRefPubMedPubMedCentral
11.
Moscicki A-B, Ellenberg JH, Vermund SH, Holland CA, Darragh T, Crowley-Nowick PA, Levin L, Wilson CM: Prevalence of and risks for cervical Human Papillomavirus infection and squamous intraepithelial lesions in adolescent girls. Impact of infection with Human Immunodeficiency Virus. Arch Pediatr Adolesc Med. 2000, 154: 127-134. 10.1001/archpedi.154.2.127.CrossRefPubMed
12.
Franceschi S, Jaffe H: Cervical cancer screening of women living with HIV infection: a must in the era of antiretroviral therapy. Clin Infect Dis. 2007, 45: 510-513. 10.1086/520022.CrossRefPubMed
13.
Heard I: Prevention of cervical cancer in women with HIV. Curr Opin HIV AIDS. 2009, 4: 68-73. 10.1097/COH.0b013e328319bcbe.CrossRefPubMed
14.
15.
Sahasrabuddhe VV, Bhosale RA, Joshi SN, Kavatkar AN, Nagwanshi CA, Kelkar RS, Jenkins CA, Shepherd BE, Sahay S, Risbud AR, Vermund SH, Mehendale SM: Prevalence and predictors of colposcopic-histopathologically confirmed cervical intraepithelial neoplasia in HIV-infected women in India. PLoS One. 2010, 5: e8634-10.1371/journal.pone.0008634.CrossRefPubMedPubMedCentral
16.
Memiah P, Mbuthia W, Kiiru G, Agbor S, Odhiambo F, Ojoo S, Biadgilign S: Prevalence and risk factors associated with precancerous cervical cancer lesions among HIV-Infected women in resource-limited settings. AIDS Res Treat. 2012, 2012: 953743-PubMedPubMedCentral
17.
Massad LS, Seaberg EC, Heather Watts D, Minkoff H, Levine AM, Henry D, Colie C, Darragh TM, Hessol NA: Long-term incidence of cervical cancer in women with Human Immunodeficiency Virus. Cancer. 2009, 115: 524-530. 10.1002/cncr.24067.CrossRefPubMedPubMedCentral
18.
19.
20.
Kietpeerakool C, Phianmongkhol Y, Jitvatcharanun K, Siriratwatakul U, Srisomboon J: Knowledge, awareness, and attitudes of female sex workers toward HPV infection, cervical cancer, and cervical smears in Thailand. Int J Gynecol Obstet. 2009, 107: 216-219. 10.1016/j.ijgo.2009.07.023.CrossRef
21.
Lyimo FS, Bera TN: Demographic, knowledge, attitudinal, and accessibility factors associated with uptake of cervical cancer screening among women in a rural district of Tanzania: three public policy implications. BMC Public Health. 2012, 12: 22-10.1186/1471-2458-12-22.CrossRefPubMedPubMedCentral
22.
Tebeu PM, Major AL, Rapiti E, Petignat P, Bouchardy C, Sando Z, de Bernis L, Ali L, Mhawech-Fauceglia P: The attitude and knowledge of cervical cancer by Cameroonian women; a clinical survey conducted in Maroua, the capital of far North Province of Cameroon. Int J Gynecol Cancer. 2008, 18: 761-765. 10.1111/j.1525-1438.2007.01066.x.CrossRefPubMed
23.
Mbamara SU, Ikpeze OC, Okonkwo JE, Onyiaorah IV, Ukah CO: Knowledge, attitude and practice of cervical cancer screening among women attending gynecology clinics in a tertiary level medical care center in southeastern Nigeria. J Reprod Med. 2011, 56: 491-496.PubMed
24.
Getahun F, Mazengia F, Abuhay M, Birhanu Z: Comprehensive knowledge about cervical cancer is low among women in Northwest Ethiopia. BMC Cancer. 2013, 13: 2-10.1186/1471-2407-13-2.CrossRefPubMedPubMedCentral
25.
Donati S, Giambi C, Declich S, Salmaso S, Filia A, Ciofi degli Atti ML, Alibrandi MP, Brezzi S, Carozzi F, Collina N, Franchi D, Lattanzi A, Meda M, Minna MC, Nannini R, Gallicchio G, Bella A, PreGio Working group: Knowledge, attitude and practice in primary and secondary cervical cancer prevention among young adult Italian women. Vaccine. 2012, 30: 2075-2082. 10.1016/j.vaccine.2012.01.057.CrossRefPubMed
26.
Massad LS, Evans CT, Wilson TE, Goderre JL, Hessol NA, Henry D, Colie C, Strickler HD, Levine AM, Watts DH, Weber KM: Knowledge of cervical cancer prevention and human papillomavirus among women with HIV. Gynecol Oncol. 2010, 117: 70-76. 10.1016/j.ygyno.2009.12.030.CrossRefPubMedPubMedCentral
27.
Rabiu KA, Akinbami AA, Adewunmi AA, Akinola OI, Wright KO: The need to incorporate routine cervical cancer counselling and screening in the management of HIV positive women in Nigeria. Asian Pac J Cancer Prev. 2011, 12: 1211-1214.PubMed
28.
Baranoski AS, Horsburgh CR, Cupples LA, Aschengrau A, Stier EA: Risk factors for nonadherence with Pap testing in HIV-infected women. J Womens Health. 2011, 20: 1635-1643. 10.1089/jwh.2010.2465.CrossRef
29.
Vu LTH, Bui D, Le HTT: Prevalence of cervical infection with HPV type 16 and 18 in Vietnam: implications for vaccine campaign. BMC Cancer. 2013, 13: 53-10.1186/1471-2407-13-53.CrossRefPubMedPubMedCentral
30.
Ali SF, Ayub S, Manzoor NF, Azim S, Afif M, Akhtar N, Jafery WA, Tahir I, Farid-ul-Hasnian S, Uddin N: Knowledge and awareness about cervical cancer and its prevention amongst interns and nursing staff in Tertiary Care Hospitals in Karachi, Pakistan. PLoS One. 2010, 5: e11059-10.1371/journal.pone.0011059.CrossRefPubMedPubMedCentral
31.
Giordano L, Webster P, Anthony C, Szarewski A, Davies P, Arbyn M, Segnan N, Austoker J: Improving the quality of communication in organised cervical cancer screening programmes. Patient Educ Couns. 2008, 72: 130-136. 10.1016/j.pec.2008.02.010.CrossRefPubMed
32.
Kritpetcharat O, Wutichouy W, Sirijaichingkul S, Kritpetcharat P: Comparison of Pap Smear screening results between Akha hill tribe and urban women in Chiang Rai province, Thailand. Asian Pac J Cancer Prev. 2012, 13: 5501-5504. 10.7314/APJCP.2012.13.11.5501.CrossRefPubMed
33.
Boonmongkon P, Pylypa J, Nichter M: Emerging fears of cervical cancer in Northeast Thailand. Anthropol Med. 1999, 6: 359-380. 10.1080/13648470.1999.9964593.CrossRef
34.
Zhang HY, Tiggelaar SM, Sahasrabuddhe VV, Smith JS, Jiang CQ, Mei RB, Wang XG, Li ZA, Qiao YL: HPV prevalence and cervical intraepithelial neoplasia among HIV-infected women in Yunnan Province, China: a pilot study. Asian Pac J Cancer Prev. 2012, 13: 91-96. 10.7314/APJCP.2012.13.1.091.CrossRefPubMedPubMedCentral
35.
Atashili J, Adimora AA, Ndumbe PM, Ikomey GM, Rinas AC, Myers E, Eron J, Smith JS, Miller WC: High prevalence of cervical squamous intraepithelial lesions in women on antiretroviral therapy in Cameroon: is targeted screening feasible?. Cancer Epidemiol. 2012, 36: 263-269. 10.1016/j.canep.2011.10.003.CrossRefPubMed
36.
Mwanahamuntu MH, Sahasrabuddhe VV, Stringer JSA, Parham GP: Integrating cervical cancer prevention in HIV/AIDS treatment and care programmes. Bull World Health Organ. 2008, 86 (8): D–E
37.
Firnhaber C, Mayisela N, Mao L, Williams S, Swarts A, Faesen M, Levin S, Michelow P, Omar T, Hudgens MG, Williamson AL, Allan B, Lewis DA, Smith JS: Validation of cervical cancer screening methods in HIV positive women from Johannesburg South Africa. PLoS One. 2013, 8: e53494-10.1371/journal.pone.0053494.CrossRefPubMedPubMedCentral
Metadata
Title
Knowledge, awareness and attitudes about cervical cancer among women attending or not an HIV treatment center in Lao PDR
Authors
Chanvilay SICHANH
Fabrice QUET
Phetsavanh CHANTHAVILAY
Joeffroy DIENDERE
Vatthanaphone LATTHAPHASAVANG
Christophe LONGUET
Yves BUISSON
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2014
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/1471-2407-14-161

Other articles of this Issue 1/2014

BMC Cancer 1/2014 Go to the issue

Research article

ESR1gene promoter region methylation in free circulating DNA and its correlation with estrogen receptor protein expression in tumor tissue in breast cancer patients

Research article

Unraveling the chromosome 17 patterns of FISH in interphase nuclei: an in-depth analysis of the HER2amplicon and chromosome 17 centromere by karyotyping, FISH and M-FISH in breast cancer cells

Research article

Clinicopathological features and EGFR gene mutation status in elderly patients with resected non–small-cell lung cancer

Research article

Superparamagnetic iron oxide nanoparticles mediated 131I-hVEGF siRNA inhibits hepatocellular carcinoma tumor growth in nude mice

Research article

Real world costs and cost-effectiveness of Rituximab for diffuse large B-cell lymphoma patients: a population-based analysis

Study protocol

Rationale and design of LUX-Head & Neck 1: a randomised, Phase III trial of afatinib versus methotrexate in patients with recurrent and/or metastatic head and neck squamous cell carcinoma who progressed after platinum-based therapy
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits