Knowledge of Cervical Cancer Prevention Among Women in Amazonian Peru

Abstract

Background and Purpose: Survey-based research was conducted in Yantalo, Peru, a rural Amazonian community, to assess the knowledge base among women surrounding cervical cancer, human papilloma virus (HPV), and preventative health practices as well as to gain a better understanding of barriers to accessing care. Methods: A total of 217 women were interviewed out of the 1612 female inhabitants of Yantalo utilizing a structured interview-style questionnaire with both closed and open-ended questions. Results: Our average respondent was 41.6 years old with the equivalent of some high school education. Approximately 75% of respondents reported that they had heard of HPV and/or cervical cancer, with 44.4% reporting they had received a test to check for cervical cancer within their lifetime. When given a 10-question knowledge assessment regarding safe sex practices and cervical cancer, women obtained an average score of 57.3%. When asked about receiving the HPV vaccine, 29% reported "Yes", 59.4% reported "No", and 11.6% reported "I don't know." Although 62.6% of women indicated that they have "easy access to cervical cancer screening," 37.4% of women reported experiencing at least one barrier to accessing care. The highest reported barriers include fear of the test causing them pain and/or lack of knowledge of the necessity cervical cancer testing. Cervical cancer rates in Peru are approximately three times that in developed countries. Conclusions: Gathering data surrounding knowledge and the barriers among the female population in rural communities is essential to developing targeted initiatives that address pertinent obstacles within these and other vulnerable communities.

Keywords: HPV; Papanicolaou; Peru; cervical cancer; knowledge.

FIG. 1.

Geography of Peru: map of Peru with the San Martin region highlighted (left); provinces of San Martin region with arrowhead indicating Yantalo, Peru (right).

FIG. 2.

Knowledge assessment score stratified by age group: women between 30–39 and 40–49 years received the highest scores on the knowledge assessment. One-way ANOVA was significant F(6, 194) = 4.11, p ≤ 0.001. A post hoc ANOVA test revealed that women 30–39 (M = 62.7, SD = 15.6), F(13, 51) = 2.75, p = 0.001 and 40–49 (M = 64.1, SD = 15.2), F(13, 33) = 2.90, p = 0.013 years of age scored significantly higher compared with women 70–79 years of age (M = 43.7, SD = 25.9). Error bars represent 95% CI. Asterisk indication: *p < 0.05. 80+ age group was excluded due to low validity (n = 3). ANOVA, analysis of variance; CI, confidence interval.

FIG. 3.

Knowledge assessment score stratified by education level: women with vocational school degrees performed the highest, with an average 70%. One-way ANOVA was significant F(6, 164) = 2.51, p ≤ 0.05. A post hoc ANOVA test revealed women who did not complete primary school scored significantly lower (M = 47, SD = 22) than women who completed secondary schooling (M = 61, SD = 16), F(31, 80) = 1.545, p = 0.025 and those who completed vocational school (M = 70, SD = 18), F(7, 31) = 1.49, p = 0.012. Error bars represent 95% CI. Asterisk indication: *p < 0.05, **p < 0.01.