Women’s knowledge and utilization of gynecological cancer prevention services in the Northwest of Greece

Purpose of investigation: In Greece an organized cervical or breast cancer screening program does not exist and the population coverage is unknown. Methods: Women of all ages completed a questionnaire, which assessed women's awareness of and participation in breast and cervical screening and human papillomavirus (HPV) vaccination. The women were randomly approached in public areas. Results: 1,012 women completed the questionnaire. 52% of the women over 39 years old had undergone mammography in the last year and 76% of the women over 20 years old had a cervical smear test within the last three years in an opportunistic basis. In addition, the likelihood of having regular mammograms was positively associated with the likelihood of having regular cervical smears. Fifty percent of the responders did not identify HPV as the cause of cervical cancer and 38% were not aware of the HPV vaccine. From the women aged 16 to 28 years old, 11% had been vaccinated against HPV and an additional 23% intended to have the vaccine in the next six months. Conclusion: Knowledge and utilization of mammography and cervical screening was quite satisfactory, although HPV vaccination coverage was low. Preventive services could be improved through the development of a plan for the information of the public and the distribution of the HPV vaccine.

Cancer; Breast; Cervix; HPV vaccine; Cytodiagnoses; Mammography

[1] Quinn M., Babb P., Jones J., Allen E.: “Effect of screening on incidence of and mortality from cancer of cervix in England: evaluation based on routinely collected statistics”. BMJ, 1999, 318, 904.

[2] Roder D., Houssami N., Farshid G., Gill G., Luke C., Downey P. et al.: “Population screening and intensity of screening are associated with reduced breast cancer mortality: evidence of efficacy of mammography screening in Australia”. Breast Cancer Res. Treat., 2008, 108, 409.

[3] Arbyn M., Primic-Zakelj M., Raifu A.O., Grce M., Paraskevaidis E., Diakomanolis E. et al.: “The burden of cervical cancer in south-east Europe at the beginning of the 21st century”. Coll. Antropol., 2007, 31, 7.

[4] Villa L.L., Costa R.L., Petta C.A., Andrade R.P., Paavonen J., Iversen O.E. et al.: “High sustained efficacy of a prophylactic quadrivalent human papillomavirus types 6/11/16/18 L1 virus-like particle vaccine through 5 years of follow-up”. Br. J. Cancer, 2006, 95, 1459.

[5] Paavonen J., Jenkins D., Bosch F.X., Naud P., Salmeron J., Wheeler C.M. et al.: “Efficacy of a prophylactic adjuvanted bivalent L1 virus-like-particle vaccine against infection with human papillomavirus types 16 and 18 in young women: an interim analysis of a phase III double-blind, randomised controlled trial”. Lancet, 2007, 369, 2161.

[6] Sener Costanza S., Evans W.P. III, Foster R.S. Jr., Hendrick E., Eyre H.J., Smith R.A. et al.: “American Cancer Society Guidelines for Breast Cancer Screening: Update 2003”. CA Cancer J. Clin., 2003, 53, 141.

[7] International Agency for Research on Cancer. Handbooks of Cancer Prevention, Vol 9. Cervix Cancer Screening. Lyon, IARCPress, 2004.

[8] Nieminen P., Kallio M., Anttila A., Hakama M.: “Organised vs spontaneous Pap-smear screening for cervical cancer: A casecontrol study”. Int. J. Cancer, 1999, 83, 55.

[9] Dimitrakaki C., Boulamatsis D., Mariolis A., Kontodimopoulos N., Niakas D., Tountas Y.: “Use of cancer screening services inGreece and associated social factors: results from the nation-wide Hellas Health I survey”. Eur. J. Cancer Prev., 2009, 18, 248.

[10] Durex Network [Internet]. Network founded by the condom brand Durex; 2005-2010. Research Face of Global Sex; Available from: http://www.durexnetwork.org/SiteCollectionDocuments/Research%20-%20Face%20of%20Global%20Sex%202007.pdf.