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Memorias del Instituto de Investigaciones en Ciencias de la Salud

On-line version ISSN 1812-9528

Mem. Inst. Investig. Cienc. Salud vol.15 no.3 Asunción Dec. 2017

https://doi.org/10.18004/mem.iics/1812-9528/2017.015(03)03-005 

Articles

Education, an ally against cervical cancer

María Angélica Leguizamón 1  

1Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, Paraguay


Cervical cancer (CC) and its implications is a preventable disease that affects many women. This disease is an important public health problem1.Paraguay ranks first in incidence and mortality in CC at the southern cone level, with incidence and mortality figures similar to those of the African continent.Compared with countries such as Australia and New Zealand having estimated incidence rates of 5.5 x 100,000 women and the mortality rate is 2 x 100,000 women2.

Cervical screening programs have been introduced in many countries and, in general, are considered the most appropriate and effective method currently available to prevent CC3, but taking into account the high incidence of CC in our country, the incorporation of Educational interventions to raise awareness of this pathology could reinforce or complement the actions already established by the authorities.

In this age of technology it is important to use all available tools to provide CC education at all levels. An educational intervention4 concerning the CC should have a succession of content related to the subject, from the general characteristics of the cancer, to the form of contagion, related to the human papillomavirus (HPV) and early detection of it. The content5 to be considered should incorporate epidemiological aspects of the disease, risk factors, clinical features, form of detection and treatment, emphasizing that this disease is preventable. The information on the Papanicolau (PAP) test is usually incorporated into the section of early detection within the generalities of the CC. On the other hand, the contents about the HPV constitute a separate chapter when dealing with the CC, which goes from the virological history of the HPV6 to specific data on the vaccine7. In general terms there is agreement that the basic content on HPV should consider the natural history and forms of transmission of the virus, the relationship between HPV and CC, forms of prevention (preventive behaviors) and the HPV vaccine8.

However, what methodology should be used? This point is the central element, because if up to now the incidence is high, it is because maybe the basic information is not arriving in an effective or timely manner.

The methodologies that have been used in educational interventions for CC prevention are varied, with the most common being educational brochures and discussion sessions9. The educational brochures in their different modalities (diptychs and triptychs) are a low-cost material, with information limited to the central theme and written in simple language, which are used as a single material or complementary to other methodologies (reinforcing content), and which can be delivered before, during or at the end of the intervention.

The discussion sessions (also known as question and answer sessions) are interactive meetings with small groups of women in which different issues around the CC are addressed. These sessions usually combine different methodologies stemming from the questioning by a moderator that motivates the discussion.

The incorporation of brochures (delivered at the beginning or the end of the discussion session); the presentation of theoretical contents (using Microsoft office power point); the representation of a real situation (role-play); or a combination of the previous mentioned methodologies that keeps as a central axis the discussion on the subject. Other methodologies that are used in educational interventions for the prevention of CC are role-play (which tends to be complementary to another methodology), focus groups, media campaigns (radio programs, television messages or newspapers) and home visits.

In a study performed in Nigeria on educational intervention on CC, in which an intervention and control group participated, it was found that after the intervention, the group that participated developed a high awareness of cervical cancer and on detection, and knowledge and perception were relatively better10, while those of the control groups remained at a very low level.The same result appeared in a study in Peru11.

In an interview with the newspaper, ABC color, the Paraguayan oncologist, José León Duarte, discussed the commitment that specialists, society, the government and the entire population should have in carrying out prevention campaigns.He stressed that much emphasis should be placed on the education of the people, which basically consists of teaching women to have their regular cervical exams and mammary exams since they are the two cancers with the highest incidence. He also stressed that due to this pathology many young women, especially in the reproductive age between 30 and 50 years of age, and those who can be prevented or reach an early diagnosis, are being lost12.

Although the Ministry of Public Health and Social Welfare has launched the campaign #AustineJustified against cervical cancer2 in 2015 which aims to raise awareness among women about the importance of submitting to this study annually and to reduce the risk of mortality, education and prevention campaigns should be intensified to reach people at all levels, especially in the countryside.

Otherwise, too many women suffer from the disease and are not even aware of potential signs that send them to a doctor.

Considering the benefits of educational interventions in the prevention of CC, it is essential to expand its use in other intervention scenarios, as well as piloting new methodologies in the use of advanced technology in education and apply it to health issues. We must not forget that its use implies the prevention of the disease, avoiding the deaths of young women and the increase of the burden of health due to illness of a country.

REFERENCIAS BIBLIOGRÁFICAS

1. FerlayJ, ShinH-R, BrayF, FormanD, MathersC, ParkinDM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 15 de diciembre de 2010;127(12):2893-917. [ Links ]

2. #Ausencia Justificada contra el cáncer de cuello uterino .Ministerio de Salud Pública y Bienestar Social [Internet].[citado27 de diciembre de 2017]. Disponible en: Disponible en: http://www.mspbs.gov.py/ausenciajustificada-contra-el-cancer-de-cuello-uterino/Links ]

3. VivilakiV, RomanidouA, TheodorakisP, LionisC. Are health education meetings effective in recruiting women in cervical screening programmes? An innovative and inexpensive intervention from the island of Crete.Rural Remote Health. 2005;5(2):376. [ Links ]

4. RiquelmeHG, ConchaPX, Urrutia SMT. Intervenciones educativas para la prevención del cáncer cervicouterino. Rev Chil Obstet Ginecol. 2012;77(2):111-5. [ Links ]

5. WrigthK, KuyiniYA, FaduyilleFA. Community education on cervical cancer amongst market women in an urban area of Lagos, Nigeria. Asian Pac J Cancer Prev. 2010;11(1):137-40. [ Links ]

6. WetzelC, TissotA, KollarL, HillardP, StoneR, KahnJ. Development of an HPV educational protocol for adolescents. J Pediatr Adolesc Gynecol. 2007;20(5):281-7. [ Links ]

7. Wong-PingL. HPV information needs, educational messages and channel of delivery preferences: views from developing country with multiethnic populations. Vaccine. 2009;27(9):1414-5. [ Links ]

8. CoxD, CoxA, SturnLynne, ZimetG. Behavioral Interventions to increase HPV vaccination acceptability among mothers of young girls. Health Psychology. 2010;29(1):29-39. [ Links ]

9. MockJ, McPheeSJ, NguyenT, WongC, DoanH, LaiKQ, et al. Effective Lay Health Worker Outreach and Media-Based Education for Promoting Cervical Cancer Screening Among Vietnamese American Women. Am J Public Health. septiembre de 2007;97(9):1693-700. [ Links ]

10. AbiodunOA, Olu-AbiodunOO, SotunsaJO, OluwoleFA. Impact of health education intervention on knowledge and perception of cervical cancer and cervical screening uptake among adult women in rural communities in Nigeria. BMC Public Health[Internet]. 7 de agosto de 2014 [citado 17 de octubre de 2017];14. Disponible en: Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4133628/Links ]

11. ParedesCruzDP. Intervención educativa para elevar el nivel de conocimientos sobre cáncer de cuello uterino y el virus del papiloma humano en estudiantes de la UNASAN, filial Barranca, 2010. [Lima,Perú]: Universidad Nacional Mayor de San Marcos, Facultad de Medicina Humana; 2012. [ Links ]

12. Color ABC. Cáncer de cuello uterino mata a 400 mujeres al año en Paraguay - Edicion Impresa - ABC Color [Internet].[citado21 de noviembre de 2017]. Disponible en: http://www.abc.com.py/edicion-impresa/locales/cancer-de-cuello-uterino-mata-a-400-mujeres-al-ano-en-paraguay-785288.htmlLinks ]

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