Laboratorio Virología, Facultad de Medicina, Universidad Mayor de San Simón, Cochabamba, Bolivia.
Unité de Microbiologie Pharmaceutique et Hygiène, Faculté de Pharmacie, Université Libre de Bruxelles (U.L.B.), CP205/2, Campus Plaine, Boulevard du Triomphe, 1050, Brussels, Belgium.
BMC Public Health. 2019 Jan 17;19(1):80. doi: 10.1186/s12889-019-6401-5.
Incidence and mortality rates of cervical cancer in Bolivia are the highest in Latin America. Vaginal cell self-sampling can improve screening coverage. Information on common reasons for low screening coverage and preferences for future screening are essential to reduce cervical cancer incidence. We aimed to evaluate the knowledge about human papillomavirus (HPV) and cervical cancer of Bolivian women from urban, peri-urban and rural areas of Cochabamba and to determine their degree of acceptability and confidence towards vaginal HPV self-sampling. In addition, we assessed the impact of self-sampling on cervical cancer screening coverage in a selected peri-urban area.
We gathered information from women living in urban, peri-urban and rural areas of Cochabamba province in Bolivia using two different structured questionnaires. In Survey1, we collected information from 222 women about their knowledge on HPV and cervical cancer. In Survey 2, the acceptance and confidence towards vaginal HPV self-sampling compared to the physician-sampling was assessed in 221 women. A non-probabilistic stratified sampling by areas was carried out for the two questionnaires. In the third phase of the study, we determined the impact of HPV self-sampling collection on screening coverage in a peri-urban area of Cochabamba.
Bolivian women knew little or nothing about cervical cancer and HPV infection in all areas. They all found self-sampling collection easier to perform (86.9 to 93.2%) and more comfortable (79.4 to 83.3%) compared to physician sampling. Sampling accuracy to detect cervical cancer was probably higher in their point of view when it was taken by physician (35.1 to 63.5%). However in rural areas women preferred self-sampling. Accordingly, the campaign of vaginal HPV self-sampling in this peri-urban area increased screening coverage, reaching in three months the annual rate average.
The knowledge about cervical cancer and HPV infection is poor in Bolivia. Despite greater acceptance of the vaginal HPV self-sampling in all areas, women kept greater confidence in the screening performed by the gynecologist although HPV self-sampling improved coverage rate.
玻利维亚的宫颈癌发病率和死亡率在拉丁美洲是最高的。阴道细胞自我采样可以提高筛查覆盖率。了解导致筛查覆盖率低的常见原因和对未来筛查的偏好对于降低宫颈癌发病率至关重要。我们旨在评估科恰班巴市城乡地区玻利维亚妇女对人乳头瘤病毒（HPV）和宫颈癌的认识，并确定她们对阴道 HPV 自我采样的接受程度和信心。此外，我们评估了在选定的城市郊区地区自我采样对宫颈癌筛查覆盖率的影响。
我们使用两个不同的结构化问卷从玻利维亚科恰班巴省城乡地区的妇女那里收集信息。在调查 1 中，我们从 222 名妇女那里收集了有关 HPV 和宫颈癌知识的信息。在调查 2 中，在 221 名妇女中评估了对阴道 HPV 自我采样与医生采样的接受程度和信心。两个问卷都采用了按地区分层的非概率抽样方法。在研究的第三阶段，我们确定了科恰班巴市城市郊区 HPV 自我采样对筛查覆盖率的影响。
玻利维亚妇女在所有地区对宫颈癌和 HPV 感染知之甚少或一无所知。与医生采样相比，她们都认为自我采样采集更容易（86.9% 到 93.2%）且更舒适（79.4% 到 83.3%）。从她们的角度来看，当由医生进行采样时，检测宫颈癌的采样准确性可能更高（35.1% 到 63.5%）。然而，在农村地区，妇女更喜欢自我采样。因此，在这个城市郊区开展阴道 HPV 自我采样活动提高了筛查覆盖率，在三个月内达到了年度平均水平。
玻利维亚对宫颈癌和 HPV 感染的认识很差。尽管在所有地区对阴道 HPV 自我采样的接受程度更高，但女性对妇科医生进行的筛查仍更有信心，尽管 HPV 自我采样提高了覆盖率。
