This document summarizes a study that evaluated the knowledge, attitudes, and practices of female physicians in Saudi Arabia regarding cervical cancer screening and the HPV vaccine. A survey of 200 physicians found that specialists like OBGYNs had better knowledge about HPV's role in cervical cancer and screening methods like the Pap smear test. While nearly half knew about the HPV vaccine, providing information increased the number willing to recommend it to patients. The conclusion is that continued education for physicians in Saudi Arabia could benefit prevention of HPV and cervical cancer.
This study aimed to determine the prevalence of high-risk HPV infections in healthy Saudi women attending gynecology clinics in western Saudi Arabia. The study found that 27 out of 485 women (5.6%) tested positive for high-risk HPV. The highest prevalence was among women aged 60 years and older. This prevalence of HPV in Saudi women is similar to other Arab countries but lower than Western countries. The results provide useful baseline data for establishing HPV testing in a cervical cancer screening program in Saudi Arabia.
Attitudes, knowledge, and practices in relation to cervicalTariq Mohammed
This document summarizes a study that assessed knowledge, attitudes, and practices related to cervical cancer screening among women in Saudi Arabia. 500 women completed questionnaires. The study found:
1) 67.6% of women were aware of Pap smear screening but only 16.8% had ever had the test, with the main reason being lack of awareness.
2) Knowledge of HPV as a cause of cervical cancer was reported by 14.4% of women and awareness of the HPV vaccine was 9.8%.
3) After receiving an educational pamphlet, 58.4% of women expressed willingness to get screened and 76.2% supported introducing the HPV vaccine, indicating awareness needs to be improved.
This research proposal aims to assess awareness of breast cancer in Pakistan by surveying female medical and non-medical students in two cities. A questionnaire will evaluate participants' knowledge of early warning signs, risk factors, and general information about breast cancer. The study hopes to highlight the need for awareness campaigns and education to promote early detection and reduce breast cancer mortality in Pakistan.
This study assessed knowledge, awareness and attitudes towards cervical cancer and screening among women in Makkah, Saudi Arabia. The authors conducted a questionnaire-based study of 210 women across 3 hospitals. They found that only 12.9% of women had good knowledge of cervical cancer, and awareness of screening was very low at 13.8%. While the majority of women had positive attitudes towards screening and vaccination, actual screening rates were low, with just 21.4% having undergone Pap smear testing and only 1.9% receiving the HPV vaccine. The authors recommend implementing widespread public awareness programs utilizing various media to improve knowledge on cervical cancer and screening.
This document provides a case study analysis of an observational study on cervical cancer conducted in South Asia. The study aimed to identify what stages of cervical dysplasia would progress to cancer to help design cervical cancer screening guidelines. Over 1000 women participated over 12 years. However, midway another study found that all dysplasia requires treatment, and the researchers continued without treatment. Many women's cancers progressed or spread by the end without treatment provided. Questions are raised about ethics approval given facility limitations, informed consent without disclosing disease progression risk, and continuing the study after learning about treatment needs from another study.
This document summarizes primary and secondary prevention strategies for cervical cancer in Saudi Arabia. It begins with epidemiological data showing cervical cancer rates are lower in Saudi Arabia than worldwide but there is currently no organized screening program. It then reviews the role of HPV in causing cervical cancer and limitations of traditional Pap smear screening including sensitivity. The document discusses how HPV testing may improve screening through use as a primary test or to triage abnormal Pap results. Large clinical trials show HPV testing is more sensitive for detecting cervical precancers. The document concludes by stating vaccination could provide active primary prevention against HPV types that cause cervical cancer.
Khalid sait saudi belgium seminal march 18 2014Tariq Mohammed
This document summarizes information from a presentation on cervical cancer prevention in Saudi Arabia. It notes that cervical cancer incidence is low in Saudi Arabia but increasing cases are expected as seen elsewhere. The presentation discusses HPV as the primary cause, the availability of HPV vaccines, and the need for a national screening program in Saudi Arabia using HPV testing to help prevent additional cervical cancer cases and deaths. It provides details on an existing cervical cancer screening program in Jeddah as an example for a potential future national program.
This document summarizes a study that evaluated the knowledge, attitudes, and practices of female physicians in Saudi Arabia regarding cervical cancer screening and the HPV vaccine. A survey of 200 physicians found that specialists like OBGYNs had better knowledge about HPV's role in cervical cancer and screening methods like the Pap smear test. While nearly half knew about the HPV vaccine, providing information increased the number willing to recommend it to patients. The conclusion is that continued education for physicians in Saudi Arabia could benefit prevention of HPV and cervical cancer.
This study aimed to determine the prevalence of high-risk HPV infections in healthy Saudi women attending gynecology clinics in western Saudi Arabia. The study found that 27 out of 485 women (5.6%) tested positive for high-risk HPV. The highest prevalence was among women aged 60 years and older. This prevalence of HPV in Saudi women is similar to other Arab countries but lower than Western countries. The results provide useful baseline data for establishing HPV testing in a cervical cancer screening program in Saudi Arabia.
Attitudes, knowledge, and practices in relation to cervicalTariq Mohammed
This document summarizes a study that assessed knowledge, attitudes, and practices related to cervical cancer screening among women in Saudi Arabia. 500 women completed questionnaires. The study found:
1) 67.6% of women were aware of Pap smear screening but only 16.8% had ever had the test, with the main reason being lack of awareness.
2) Knowledge of HPV as a cause of cervical cancer was reported by 14.4% of women and awareness of the HPV vaccine was 9.8%.
3) After receiving an educational pamphlet, 58.4% of women expressed willingness to get screened and 76.2% supported introducing the HPV vaccine, indicating awareness needs to be improved.
This research proposal aims to assess awareness of breast cancer in Pakistan by surveying female medical and non-medical students in two cities. A questionnaire will evaluate participants' knowledge of early warning signs, risk factors, and general information about breast cancer. The study hopes to highlight the need for awareness campaigns and education to promote early detection and reduce breast cancer mortality in Pakistan.
This study assessed knowledge, awareness and attitudes towards cervical cancer and screening among women in Makkah, Saudi Arabia. The authors conducted a questionnaire-based study of 210 women across 3 hospitals. They found that only 12.9% of women had good knowledge of cervical cancer, and awareness of screening was very low at 13.8%. While the majority of women had positive attitudes towards screening and vaccination, actual screening rates were low, with just 21.4% having undergone Pap smear testing and only 1.9% receiving the HPV vaccine. The authors recommend implementing widespread public awareness programs utilizing various media to improve knowledge on cervical cancer and screening.
This document provides a case study analysis of an observational study on cervical cancer conducted in South Asia. The study aimed to identify what stages of cervical dysplasia would progress to cancer to help design cervical cancer screening guidelines. Over 1000 women participated over 12 years. However, midway another study found that all dysplasia requires treatment, and the researchers continued without treatment. Many women's cancers progressed or spread by the end without treatment provided. Questions are raised about ethics approval given facility limitations, informed consent without disclosing disease progression risk, and continuing the study after learning about treatment needs from another study.
This document summarizes primary and secondary prevention strategies for cervical cancer in Saudi Arabia. It begins with epidemiological data showing cervical cancer rates are lower in Saudi Arabia than worldwide but there is currently no organized screening program. It then reviews the role of HPV in causing cervical cancer and limitations of traditional Pap smear screening including sensitivity. The document discusses how HPV testing may improve screening through use as a primary test or to triage abnormal Pap results. Large clinical trials show HPV testing is more sensitive for detecting cervical precancers. The document concludes by stating vaccination could provide active primary prevention against HPV types that cause cervical cancer.
Khalid sait saudi belgium seminal march 18 2014Tariq Mohammed
This document summarizes information from a presentation on cervical cancer prevention in Saudi Arabia. It notes that cervical cancer incidence is low in Saudi Arabia but increasing cases are expected as seen elsewhere. The presentation discusses HPV as the primary cause, the availability of HPV vaccines, and the need for a national screening program in Saudi Arabia using HPV testing to help prevent additional cervical cancer cases and deaths. It provides details on an existing cervical cancer screening program in Jeddah as an example for a potential future national program.
The utility-visual-inspection-with-acetic-acid-cervical-cancer-screening-ecoa...Amarlasreeja
Cervical cancer is potentially preventable but still remains a leading cause of cancer mortality in in developing countries like Nigeria. Cytology-based screening programmers are difficult to maintain in these countries.
This document summarizes a qualitative study that explored perceptions of breast cancer screening among Iranian women who had never had a mammogram. Through interviews with 16 women, researchers identified 3 main themes: 1) low awareness - women lacked medical knowledge about breast cancer and screening and had misconceptions about risk factors, 2) worries - women expressed fears about mammography outcomes and side effects and embarrassment about breast exams, and 3) lack of motivation - women cited lack of social support and priorities as well as environmental constraints as barriers to screening. The study aimed to understand perceptions in order to improve breast cancer education and screening programs in Iran.
This study analyzed 558 Pap smear reports from women ages 20-70 who presented to a gynecology clinic in Bangladesh from 2015-2016. Most women (70.2%) presented with chronic white discharge and itching. The majority (92.4%) of Pap smears showed inflammatory changes. Premalignant lesions were found in 3.7% of smears, including low-grade squamous intraepithelial lesions (LSIL) in 3% and high-grade squamous intraepithelial lesions (HSIL) in 0.7%. Suggestive of squamous cell carcinoma was seen in 0.7% of smears. The study concludes that Pap smear screening can effectively detect premalign
Knowledge, Attitude and Practice toward Cervical Cancer and Cervical Cancer S...ijtsrd
BACKGROUND Invasive Cervical Cancer ICC has been identified as the second most common cause of morbidity and mortality compared to other cancers among women in Cameroon. Cervical cancer can be treated e ectively if diagnosed early. Less than half the number of participants presented with good practice.The correlation between participants’ knowledge, attitude and practice showed that there was a significant association which therefore provides sufficient evidence to reject the null hypothesis. The result obtained in this study indicates how useful it will be to establish health education programs to increase women’s awareness and knowledge about cervical cancer. Fongang Che Landis | Enow-Orock George | Njajou Omer | Ngowe Ngowe Marcelin "Knowledge, Attitude and Practice toward Cervical Cancer and Cervical Cancer Screening and Its Associated Factors among Women in the City of Bamenda, Cameroon" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-4 , June 2021, URL: https://www.ijtsrd.compapers/ijtsrd43667.pdf Paper URL: https://www.ijtsrd.commedicine/other/43667/knowledge-attitude-and-practice-toward-cervical-cancer-and-cervical-cancer-screening-and-its-associated-factors-among-women-in-the-city-of-bamenda-cameroon/fongang-che-landis
A prospective study of breast lump andclinicopathologicalanalysis in relation...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Aboriginal Patterns of Cancer Care Project Breast Cancer paper BMCCancer 1471...Cancer Council NSW
Aboriginal women in New South Wales, Australia have lower rates of survival from breast cancer than non-Aboriginal women. Aboriginal women were less likely to receive surgical treatment for their breast cancer and were more likely to have other health issues. After accounting for differences in factors like age, disease stage at diagnosis, surgical treatment, and health issues, Aboriginal women still had a 30% higher risk of death from breast cancer. Improving access to surgical treatment and reducing health issues may help increase breast cancer survival rates for Aboriginal women.
This document summarizes a study on the clinico-demographic characteristics of colorectal carcinoma in Bangladeshi patients. The study found that the mean age was 47 years, with most patients between 50-59 years of age. Males were slightly more affected than females. The most common presenting symptoms were per rectal bleeding, abdominal pain, and altered bowel habits. Histological examination found that 88% of cases were adenocarcinoma. The study concludes that middle-aged males in Bangladesh are most at risk for colorectal carcinoma, which commonly presents with bleeding, pain, or changes in bowel habits.
This audit studied 583 breast cancer patient records from a Nigerian hospital between 2008-2012 to analyze management approaches and clinical factors. Most patients were middle-aged females presenting with invasive ductal carcinoma. Nearly three-quarters received combination treatment including neoadjuvant and adjuvant chemotherapy, though completion rates for treatment cycles were low. The study found breast cancer in Nigeria is still primarily managed through combination therapies but more efforts are needed for early detection, education, and improving socioeconomic factors to support treatment.
Cancer Magnitude in Elderly Indian Women, an Experience from Regional Cancer ...Crimsonpublishers-IGRWH
Cancer Magnitude in Elderly Indian Women, an Experience from Regional Cancer Centre, India by Ravi Kiran Pothamsetty in Open access journal of Gynecology
Dr nisreen anfnan cervical cancer in saudi arabia last versionTariq Mohammed
The document discusses cervical cancer in Saudi Arabia. It finds that incidence of cervical cancer is low in Saudi Arabia, ranking 11th among cancers in females, with 152 new cases and 55 deaths per year. HPV is detected in 31.6-5.6% of women in Saudi Arabia. Nearly all cervical cancer cases (92.9-100%) are associated with HPV infection, most commonly HPV 16 and 18. The document calls for a nationwide cervical cancer screening program in Saudi Arabia, as the actual reasons for low incidence are unknown without screening. It proposes a screening program using HPV testing to screen women ages 30-65 every 5 years until age 65.
This study analyzed 558 pap smear tests conducted in Bangladesh and found that 92.4% showed inflammatory changes, 3% showed low-grade squamous intraepithelial lesions, and 0.7% showed high-grade squamous intraepithelial lesions or suggestive of squamous cell carcinoma. Pap smear screening identified pre-cancerous and cancerous cervical lesions and can help reduce cervical cancer mortality when used for routine screening in developing countries. The study concluded that pap smears are an inexpensive and effective method for early detection of cervical cancer even in areas with limited resources.
This study evaluated the effectiveness of a brief continuing medical education (CME) module on breast cancer diagnosis provided to primary care physicians in Egypt and Tunisia. Physicians completed a pre-test, attended a 30-minute presentation of the educational module, and then completed a post-test. The study found that physicians demonstrated significantly improved knowledge on several topics after the CME module, including risk factors for inflammatory breast cancer and breast cancer, the importance of early detection and clinical examination, and referral of inflammatory breast cancer cases. However, Egyptian physicians scored worse on questions about advising mastitis patients who do not respond to antibiotics to get a biopsy. Overall, the CME module was effective at improving breast cancer diagnostic knowledge, especially for physicians
Crimson Publishers_Oral Contraceptives and Breast Cancer Risk: A Study among ...CrimsonPublishers-SBB
Oral Contraceptives and Breast Cancer Risk: A Study among the Bengalee Females of West Bengal, India by Abhishikta Ghosh Roy in Significances of Bioengineering & Biosciences
Periodontitis among adult populations in the arab world idj12002Axex Dental
Periodontitis is an important oral health issue globally and is prevalent in many developing countries, including those in the Arab World. However, there is a lack of recent and representative data on the prevalence of periodontitis among adult populations in the Arab countries. The few existing studies report a wide range of periodontitis prevalence, from 0% to 54.6%, depending on the measurement methods and case definitions used. Standardizing data collection and reporting methods would help develop more accurate understandings of periodontitis burden and inform public health programs for the region.
This document provides updated guidelines for healthcare providers on managing menopause in asymptomatic healthy women and women with menopausal symptoms. It presents lifestyle interventions, medications, and complementary therapies for treating menopausal symptoms according to their efficacy. It also reviews counselling strategies for sexuality concerns during peri- and postmenopause. Approaches to identifying and treating osteoporosis risk are presented in a companion guideline. The guidelines are based on a literature review of recent clinical practice guidelines, randomized controlled trials, observational studies, and other sources.
The document discusses the establishment of a national cervical cancer screening program in Saudi Arabia using HPV testing. It outlines plans to use the Digene Hybrid Capture 2 HPV test as the primary screening, with reflex pap testing for HPV-positive women. The program will target women ages 30-65, both Saudi and non-Saudi, and aims to screen over 94,000 eligible women in the Jeddah region. Implementation will involve collaboration between the Early Detection Unit, local laboratories, and healthcare providers to conduct screening at primary health centers and hospitals.
This document discusses cervical cancer prevention in Saudi Arabia. It begins with background information on cervical cancer globally and in Saudi Arabia specifically. The population in Saudi Arabia is young and growing, so cervical cancer cases are expected to increase. Currently, little is known about HPV prevalence and screening in Saudi Arabia. The document then reviews the limited local data on Pap smear abnormalities and HPV genotypes. It identifies challenges to implementing screening, including understanding sexual practices and HPV epidemiology. The document recommends starting screening later (age 25-30) and using HPV testing initially. Further research is needed to inform the screening program, such as determining the age of sexual debut and HPV prevalence. The goal is to establish an effective and culturally appropriate cervical cancer prevention strategy
Knowledge, attitudes, and practices regarding cervical cancer screening among...Tariq Mohammed
This document summarizes a study on knowledge and practices regarding cervical cancer screening among female physicians in western Saudi Arabia. The study found that while most physicians were aware of HPV as a cause of cervical cancer and the Pap test as a screening method, awareness of the HPV vaccine was lower. Physicians specializing in gynecology demonstrated greater knowledge of cervical cancer screening and treatment compared to other specialists. The study concluded that further education for physicians in Saudi Arabia on available screening and HPV prevention could benefit cervical cancer reduction efforts.
Massive ascites as a presentation in a young womanTariq Mohammed
A 26-year-old woman presented with massive ascites and an increased CA-125 level suggestive of ovarian cancer. Laparotomy revealed 5L of hemorrhagic ascites, bilateral ovarian cysts, and areas of reddish color within the pelvis consistent with endometriosis. Histopathology of biopsy specimens confirmed endometriosis. The patient received GnRH analogue treatment for 6 months, experienced a reduction in ascites, and had full remission after 2 years. This case report highlights that endometriosis should be considered as a potential cause of ascites in reproductive-aged women, as it can mimic ovarian cancer.
The utility-visual-inspection-with-acetic-acid-cervical-cancer-screening-ecoa...Amarlasreeja
Cervical cancer is potentially preventable but still remains a leading cause of cancer mortality in in developing countries like Nigeria. Cytology-based screening programmers are difficult to maintain in these countries.
This document summarizes a qualitative study that explored perceptions of breast cancer screening among Iranian women who had never had a mammogram. Through interviews with 16 women, researchers identified 3 main themes: 1) low awareness - women lacked medical knowledge about breast cancer and screening and had misconceptions about risk factors, 2) worries - women expressed fears about mammography outcomes and side effects and embarrassment about breast exams, and 3) lack of motivation - women cited lack of social support and priorities as well as environmental constraints as barriers to screening. The study aimed to understand perceptions in order to improve breast cancer education and screening programs in Iran.
This study analyzed 558 Pap smear reports from women ages 20-70 who presented to a gynecology clinic in Bangladesh from 2015-2016. Most women (70.2%) presented with chronic white discharge and itching. The majority (92.4%) of Pap smears showed inflammatory changes. Premalignant lesions were found in 3.7% of smears, including low-grade squamous intraepithelial lesions (LSIL) in 3% and high-grade squamous intraepithelial lesions (HSIL) in 0.7%. Suggestive of squamous cell carcinoma was seen in 0.7% of smears. The study concludes that Pap smear screening can effectively detect premalign
Knowledge, Attitude and Practice toward Cervical Cancer and Cervical Cancer S...ijtsrd
BACKGROUND Invasive Cervical Cancer ICC has been identified as the second most common cause of morbidity and mortality compared to other cancers among women in Cameroon. Cervical cancer can be treated e ectively if diagnosed early. Less than half the number of participants presented with good practice.The correlation between participants’ knowledge, attitude and practice showed that there was a significant association which therefore provides sufficient evidence to reject the null hypothesis. The result obtained in this study indicates how useful it will be to establish health education programs to increase women’s awareness and knowledge about cervical cancer. Fongang Che Landis | Enow-Orock George | Njajou Omer | Ngowe Ngowe Marcelin "Knowledge, Attitude and Practice toward Cervical Cancer and Cervical Cancer Screening and Its Associated Factors among Women in the City of Bamenda, Cameroon" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-4 , June 2021, URL: https://www.ijtsrd.compapers/ijtsrd43667.pdf Paper URL: https://www.ijtsrd.commedicine/other/43667/knowledge-attitude-and-practice-toward-cervical-cancer-and-cervical-cancer-screening-and-its-associated-factors-among-women-in-the-city-of-bamenda-cameroon/fongang-che-landis
A prospective study of breast lump andclinicopathologicalanalysis in relation...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Aboriginal Patterns of Cancer Care Project Breast Cancer paper BMCCancer 1471...Cancer Council NSW
Aboriginal women in New South Wales, Australia have lower rates of survival from breast cancer than non-Aboriginal women. Aboriginal women were less likely to receive surgical treatment for their breast cancer and were more likely to have other health issues. After accounting for differences in factors like age, disease stage at diagnosis, surgical treatment, and health issues, Aboriginal women still had a 30% higher risk of death from breast cancer. Improving access to surgical treatment and reducing health issues may help increase breast cancer survival rates for Aboriginal women.
This document summarizes a study on the clinico-demographic characteristics of colorectal carcinoma in Bangladeshi patients. The study found that the mean age was 47 years, with most patients between 50-59 years of age. Males were slightly more affected than females. The most common presenting symptoms were per rectal bleeding, abdominal pain, and altered bowel habits. Histological examination found that 88% of cases were adenocarcinoma. The study concludes that middle-aged males in Bangladesh are most at risk for colorectal carcinoma, which commonly presents with bleeding, pain, or changes in bowel habits.
This audit studied 583 breast cancer patient records from a Nigerian hospital between 2008-2012 to analyze management approaches and clinical factors. Most patients were middle-aged females presenting with invasive ductal carcinoma. Nearly three-quarters received combination treatment including neoadjuvant and adjuvant chemotherapy, though completion rates for treatment cycles were low. The study found breast cancer in Nigeria is still primarily managed through combination therapies but more efforts are needed for early detection, education, and improving socioeconomic factors to support treatment.
Cancer Magnitude in Elderly Indian Women, an Experience from Regional Cancer ...Crimsonpublishers-IGRWH
Cancer Magnitude in Elderly Indian Women, an Experience from Regional Cancer Centre, India by Ravi Kiran Pothamsetty in Open access journal of Gynecology
Dr nisreen anfnan cervical cancer in saudi arabia last versionTariq Mohammed
The document discusses cervical cancer in Saudi Arabia. It finds that incidence of cervical cancer is low in Saudi Arabia, ranking 11th among cancers in females, with 152 new cases and 55 deaths per year. HPV is detected in 31.6-5.6% of women in Saudi Arabia. Nearly all cervical cancer cases (92.9-100%) are associated with HPV infection, most commonly HPV 16 and 18. The document calls for a nationwide cervical cancer screening program in Saudi Arabia, as the actual reasons for low incidence are unknown without screening. It proposes a screening program using HPV testing to screen women ages 30-65 every 5 years until age 65.
This study analyzed 558 pap smear tests conducted in Bangladesh and found that 92.4% showed inflammatory changes, 3% showed low-grade squamous intraepithelial lesions, and 0.7% showed high-grade squamous intraepithelial lesions or suggestive of squamous cell carcinoma. Pap smear screening identified pre-cancerous and cancerous cervical lesions and can help reduce cervical cancer mortality when used for routine screening in developing countries. The study concluded that pap smears are an inexpensive and effective method for early detection of cervical cancer even in areas with limited resources.
This study evaluated the effectiveness of a brief continuing medical education (CME) module on breast cancer diagnosis provided to primary care physicians in Egypt and Tunisia. Physicians completed a pre-test, attended a 30-minute presentation of the educational module, and then completed a post-test. The study found that physicians demonstrated significantly improved knowledge on several topics after the CME module, including risk factors for inflammatory breast cancer and breast cancer, the importance of early detection and clinical examination, and referral of inflammatory breast cancer cases. However, Egyptian physicians scored worse on questions about advising mastitis patients who do not respond to antibiotics to get a biopsy. Overall, the CME module was effective at improving breast cancer diagnostic knowledge, especially for physicians
Crimson Publishers_Oral Contraceptives and Breast Cancer Risk: A Study among ...CrimsonPublishers-SBB
Oral Contraceptives and Breast Cancer Risk: A Study among the Bengalee Females of West Bengal, India by Abhishikta Ghosh Roy in Significances of Bioengineering & Biosciences
Periodontitis among adult populations in the arab world idj12002Axex Dental
Periodontitis is an important oral health issue globally and is prevalent in many developing countries, including those in the Arab World. However, there is a lack of recent and representative data on the prevalence of periodontitis among adult populations in the Arab countries. The few existing studies report a wide range of periodontitis prevalence, from 0% to 54.6%, depending on the measurement methods and case definitions used. Standardizing data collection and reporting methods would help develop more accurate understandings of periodontitis burden and inform public health programs for the region.
This document provides updated guidelines for healthcare providers on managing menopause in asymptomatic healthy women and women with menopausal symptoms. It presents lifestyle interventions, medications, and complementary therapies for treating menopausal symptoms according to their efficacy. It also reviews counselling strategies for sexuality concerns during peri- and postmenopause. Approaches to identifying and treating osteoporosis risk are presented in a companion guideline. The guidelines are based on a literature review of recent clinical practice guidelines, randomized controlled trials, observational studies, and other sources.
The document discusses the establishment of a national cervical cancer screening program in Saudi Arabia using HPV testing. It outlines plans to use the Digene Hybrid Capture 2 HPV test as the primary screening, with reflex pap testing for HPV-positive women. The program will target women ages 30-65, both Saudi and non-Saudi, and aims to screen over 94,000 eligible women in the Jeddah region. Implementation will involve collaboration between the Early Detection Unit, local laboratories, and healthcare providers to conduct screening at primary health centers and hospitals.
This document discusses cervical cancer prevention in Saudi Arabia. It begins with background information on cervical cancer globally and in Saudi Arabia specifically. The population in Saudi Arabia is young and growing, so cervical cancer cases are expected to increase. Currently, little is known about HPV prevalence and screening in Saudi Arabia. The document then reviews the limited local data on Pap smear abnormalities and HPV genotypes. It identifies challenges to implementing screening, including understanding sexual practices and HPV epidemiology. The document recommends starting screening later (age 25-30) and using HPV testing initially. Further research is needed to inform the screening program, such as determining the age of sexual debut and HPV prevalence. The goal is to establish an effective and culturally appropriate cervical cancer prevention strategy
Knowledge, attitudes, and practices regarding cervical cancer screening among...Tariq Mohammed
This document summarizes a study on knowledge and practices regarding cervical cancer screening among female physicians in western Saudi Arabia. The study found that while most physicians were aware of HPV as a cause of cervical cancer and the Pap test as a screening method, awareness of the HPV vaccine was lower. Physicians specializing in gynecology demonstrated greater knowledge of cervical cancer screening and treatment compared to other specialists. The study concluded that further education for physicians in Saudi Arabia on available screening and HPV prevention could benefit cervical cancer reduction efforts.
Massive ascites as a presentation in a young womanTariq Mohammed
A 26-year-old woman presented with massive ascites and an increased CA-125 level suggestive of ovarian cancer. Laparotomy revealed 5L of hemorrhagic ascites, bilateral ovarian cysts, and areas of reddish color within the pelvis consistent with endometriosis. Histopathology of biopsy specimens confirmed endometriosis. The patient received GnRH analogue treatment for 6 months, experienced a reduction in ascites, and had full remission after 2 years. This case report highlights that endometriosis should be considered as a potential cause of ascites in reproductive-aged women, as it can mimic ovarian cancer.
This document appears to be a log-in page for a manuscript submission and review system for the Saudi Medical Journal. It lists three manuscripts with their titles, current statuses, submission dates, and acceptance dates. The manuscripts are about knowledge and attitudes regarding cervical cancer screening among physicians, conservative treatment of ovarian cancer and its effects, and attitudes and knowledge of Saudi women regarding cervical cancer and screening.
- The study evaluated 39 patients in Saudi Arabia who underwent conservative surgery for ovarian cancer between 2000-2010 to preserve ovarian function and fertility.
- Most patients (80%) had stage I cancer, with germ cell tumors being the most common (52% of cases).
- After treatment, 98% of patients returned to regular menstruation, and 20% went on to have a normal pregnancy and delivery.
- The study found conservative surgery for ovarian cancer to be safe and allow for ovarian preservation and fertility in most selected cases.
Hysterectomy for benign conditions in a university hospital in2Tariq Mohammed
This study examined 251 women who underwent hysterectomies for benign conditions at a university hospital in Saudi Arabia between 1990 and 2002. The most common indications for hysterectomy were uterine fibroids (41.6%) and dysfunctional uterine bleeding (27.1%). Most abdominal hysterectomies (79%) were performed for fibroids and bleeding, while most vaginal hysterectomies (21%) were for uterine prolapse. Overall complication rates were 33.5% for abdominal hysterectomy and 30.4% for both procedures combined, with the most common complication being postoperative infection (18.7%).
This case report describes a 32-year-old woman who developed multiple large urinary stones 6 years after undergoing a total pelvic exenteration and creation of a continent urostomy due to cervical cancer. She presented with recurrent urinary tract infections. Imaging revealed 10 large stones measuring 2.5-3cm each in the urostomy pouch. She underwent laparotomy and removal of the stones through an incision in the pouch. Analysis found the stones were composed of various minerals, and the patient was found to have a metabolic defect causing low citrate in her urine which contributed to stone formation. She was treated with citrate supplementation and has had no further stones or infections since.
Pseudomyxoma peritonei diagnosis and managementTariq Mohammed
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise boosts blood flow, releases endorphins, and promotes changes in the brain which help enhance one's emotional well-being and mental clarity.
Primitive neuroectodermal tumor of the ovaryTariq Mohammed
This document describes a case report of a 31-year-old woman who presented with abdominal pain and a rapidly enlarging abdomen. Imaging revealed a large ovarian cystic mass. She underwent surgery which found a right ovarian mass and omental mass. Pathology determined the tumor was a primitive neuroectodermal tumor (PNET) originating from the right ovary. She received chemotherapy but the tumor recurred and she did not respond to further treatment, dying 15 months after diagnosis. PNET is a rare and aggressive sarcoma most common in children and young adults that can rarely originate in the ovaries.
This study analyzed 103 cases of aggressive histologic variants of endometrial carcinoma, including uterine papillary serous carcinoma, uterine clear cell carcinoma, and mixed tumors, treated at a single cancer center between 1984 and 1994. The median age was 67 years. Various treatment approaches were used including surgery alone, surgery with radiation therapy, and surgery with chemotherapy. The study found that lymphvascular space invasion and stage were independent prognostic factors. Radiation therapy significantly reduced pelvic recurrence for Stages I-III. Chemotherapy improved overall survival but not distant relapse rates. Stage Ia cases treated with surgery alone had a low risk of relapse.
Ov cancer and mayer hauser hauser syndromeTariq Mohammed
A 48-year-old woman with Mayer–Rokitansky–Kuster–Hauser (MRKH) syndrome, right kidney aplasia, and an abdominal-pelvic mass underwent surgery. Pathological examination revealed a poorly differentiated ovarian carcinoma of mixed cell types. Despite her conditions of MRKH syndrome and kidney aplasia, she was diagnosed with stage III ovarian cancer. She received chemotherapy and was asymptomatic 24 months post-operatively, demonstrating that ovarian cancer can rarely be associated with MRKH syndrome.
Early experience with the da vinci® surgicalTariq Mohammed
This document summarizes the author's early experience using the da Vinci surgical robot for gynecological surgeries at King Abdulaziz University Hospital between 2008-2010. The author performed 35 surgeries on patients using the robot, with an average docking time of 7 minutes and hospital stay of 3 days. While there was a 6.5% conversion rate to open surgery for early cases, complications occurred in 14% of patients but were not directly related to the robotic system. The author concludes that with proper training, technical difficulties can be limited when using the robot for gynecological procedures.
This document summarizes stem cell research projects conducted by Dr. Mohammad Abbas at King Abdulaziz University. It outlines 5 research groups: 1) Isolation and characterization of bone marrow mesenchymal stem cells from osteoarthritis patients, 2) Effect of heat shock on bone marrow MSCs from OA patients, 3) Evaluation of ex-vivo cartilage regeneration using MSCs from OA patients, 4) Impact of MSCs impregnated with cartilage paste on repairing cartilage defects in rabbits, and 5) Impact of a hyaluronic acid scaffold impregnated with MSCs and cartilage paste on surgically induced arthritis in rabbits. Additional research includes studies on the effects of catecholamines and NSAIDs
This document outlines the establishment of a stem cell research chair at King Abdulaziz University from 2009-2015. It begins with the author attending a knee surgery course in 2009 where he learned about cartilage regeneration techniques. He then proposed creating a research chair to RACI in 2010, which involved a lengthy approval process. He built up a research team of professors and clinicians from various specialties. Research projects focused on isolating and characterizing mesenchymal stem cells, cartilage regeneration, and animal studies on rabbits. The chair fulfilled regulatory requirements like submitting annual reports and had an organizational structure to oversee the research groups.
Bone marrow mesenchymal stem cells (BM-MSCs) and cartilage fragments were evaluated for their ability to enhance cartilage formation in an ex-vivo osteochondral defect model. BM-MSCs alone, cartilage fragments alone, or a combination of BM-MSCs and cartilage fragments were seeded into osteochondral defects. The combination of BM-MSCs and cartilage fragments showed improved cartilage formation and defect filling compared to BM-MSCs or cartilage fragments alone, as seen on histological and biochemical analysis. The results suggest that a combination of BM-MSCs and cartilage fragments may provide a more effective approach for cartilage repair.
The document describes a study that used whole-exome sequencing to identify novel genetic variations associated with osteoarthritis (OA) patients. Several variations were found in genes involved in cartilage development, extracellular matrix organization, and inflammatory/immune responses. Two novel mutations were validated by Sanger sequencing, including a mutation in the SELP gene and another in the COL6A6 gene. The approach identified variations in genes impacting pathways relevant to OA pathogenesis.
This study investigated the effects of heat from an arthroscope on human bone marrow-derived mesenchymal stem cells (hBMMSCs). hBMMSCs were isolated from osteoarthritis patients and exposed to heat from an illuminated arthroscope for various time periods as single cell suspensions or cell pellets. Cell suspensions exposed to heat showed decreased viability over time, while cell pellets maintained or increased viability. Gene expression analysis found increased expression of heat shock and inflammatory genes in cell suspensions compared to pellets after heat exposure. The results suggest that transplanting hBMMSCs as cell pellets may better protect them from heat effects during arthroscopic procedures and thus support cartilage regeneration.
The international federation for cervical pathology and colposcopy courseTariq Mohammed
This document provides an agenda and speaker information for a 3-day international colposcopy workshop taking place in Jeddah, Saudi Arabia from January 12-14, 2014. The workshop will focus on cervical cancer prevention, advances in understanding HPV, and management of lower genital tract diseases. It will include lectures, hands-on training, and case reviews led by experts from Europe, Canada, and Saudi Arabia. The goal is to train participants and raise awareness of cervical cancer screening and prevention methods.
The international federation for cervical pathology and colposcopy courseTariq Mohammed
This document summarizes the stages of human development from dust, to sperm and egg, to embryo, to fetus, and finally to a child that reaches maturity. It notes that some people die early while others live to a very old age, having gone through the full cycle of knowledge and then forgetting. It also describes how the earth appears barren but grows diverse plants when watered, relating this to human development from simple beginnings. The summary conveys the key points about human origins and development and the cycle of life in a concise three sentences.
The international federation for cervical pathology and colposcopy courseTariq Mohammed
The document discusses how God created humans from dust, then a sperm-drop, then a clinging clot, and then a lump of flesh to show how He develops humans. It notes that God determines the term people will stay in the womb, then brings them out as children to reach maturity. It also mentions that some people die early while others live to a very old age. The document ends by describing how the earth appears barren but grows beautiful plants when watered.
This document discusses treatment approaches for early stage cervical cancer. It notes that for invasive cervical cancers measuring less than 2 cm, removal of the parametrium may be omitted. For some very small tumors, pelvic lymphadenectomy can also be omitted as the risk of lymph node metastasis is limited. It also discusses outcomes from vaginal trachelectomy and laparoscopic pelvic lymphadenectomy for early stage cancers. The document considers conservative treatment approaches for stage IA2-IB1 cancers less than 3 cm in size, including a proposed study design stratifying patients based on tumor diameter.
Adenocarcinoma in situ (AIS) is the only known precursor to cervical adenocarcinoma. Appropriate management of AIS can prevent invasive adenocarcinoma in many cases. Cytology has lower sensitivity for detecting AIS compared to HPV testing. The usual interval between detectable AIS and invasive adenocarcinoma is at least 5 years, allowing time for screening and intervention. Glandular neoplasms account for about 25% of annual cervical cancer diagnoses. Management of AIS typically involves conization, though hysterectomy is the standard treatment due to the high risk of residual disease with conization alone. HPV testing can help monitor women with AIS who wish to preserve fertility after
This document discusses vulvar and vaginal diseases. It begins with anatomical considerations of the vulva and describes various benign and infectious vulvar lesions. It then discusses non-neoplastic epithelial disorders of the vulva and classifications of vulvar dermatological disorders. The document provides details on various vulvar diseases including lichen sclerosus and pigmented lesions. It concludes with a brief section on vaginal intraepithelial neoplasia.
This document summarizes key findings about HPV natural history and HPV testing for cervical cancer screening. It was found that HPV infection is very common but rarely leads to cancer. While persistent HPV infection can cause cervical cancer after 10-15 years, many cofactors are also involved in cancer development. Studies showed that HPV becomes undetectable within 2 years for most women. HPV testing was found to detect more pre-cancer than pap smears but also detected more lesions that may regress. HPV testing allows longer screening intervals for HPV-negative women and better protection against cancer compared to pap smears alone. While HPV testing is more effective, implementing new screening strategies poses challenges where pap smear systems are already in place.
1) The document discusses the HPV vaccine and summarizes data from clinical trials of the Cervarix and Gardasil vaccines. It finds that Cervarix demonstrated 93.2% efficacy against CIN3+ lesions irrespective of HPV type, while Gardasil demonstrated 43.0% efficacy against the same endpoint.
2) Long-term follow up data of the Cervarix vaccine showed sustained high antibody levels and protection against CIN3+ lesions up to 9 years post-vaccination. Challenge studies found Cervarix elicited an anamnestic response.
3) Both vaccines were well tolerated and showed cross-protection against non-vaccine HPV types. However, Cervarix demonstrated higher long
4 prof james bently management guidelines 2014Tariq Mohammed
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Genital HPV is very common, with a lifetime risk of 70% for HPV infection and 10% for genital warts. Spontaneously, genital warts resolve in 20-30% of cases within 3 months. Biopsy is usually not required for healthy women under 35 years old with typical genital warts. Treatment choices depend on factors like patient preference, provider experience, and pregnancy status. Combination therapies may be used. Even after treatment, the latent virus remains, with a 30% recurrence rate of warts and potential for transmission to partners.
Knowledge, attitudes, and practices regarding cervical cancer screening among physicians in the makkah region0
1. 1
Knowledge, Attitudes, and Practices Regarding Cervical Cancer Screening among
Physicians in the Makkah Region
Dr. Khalid H. Sait MBChB, FRCSC
Department of Obstetrics & Gynecology, Faculty of Medicine
King AbdulAziz University Hospital, Jeddah, Saudi Arabia
Disclosure of Benefit: The authors have no conflicting interests, and not
supported/funded by any Drug Company
Running Title: Cancer cervix awareness in Saudi Arabia
Correspondence
Dr. Khalid Sait
Department of Obstetrics & Gynecology, Faculty of Medicine
King AbdulAziz University, PO Box 80215, Jeddah 21589, Saudi Arabia
Fax: +96626408316
Tel: +966 55693160
E-mail: khalidsait@yahoo.com
2. 2
Abstract
Objectives:
This study evaluated the knowledge on the Pap test; the role of HPV in the etiology of
cervical cancer, the practice of the Pap test and attitude regarding the HPV vaccine presented by
female physicians of the western region in the Saudi Arabian.
Methods:
Across – sectional descriptive study using an interview
through
a
structured
questionnaire
to
get
information
about
cervical
cancer,
practice
in
screening
for
cervical
cancer
and
attitudes
of
the
female
physicians
regarding
the
HPV
vaccine
in
different
health
facilities
in
Saudi
Arabia,
between
May
and
December
2009
Results: Of the 200 respondents, 70 (35%) physicians comprised gynecological doctors (GDs)
group I, and 130 (65%) physicians comprised the non-gynecological doctors (NGDs) group II.
The mean age was 36 years. A total of 63 (90%) in group I and 87 (60.5%) in-group II knew that
HPV is a cause for cervical cancer. Forty-five (64.3%) in group I and 44 (33.8%) in-group II
believed that cervical cancer was curable (P < 0.05). A total of 182 (91%) physicians in the GDs
and NGDs group knew that the Pap smear test was used as a screening method for cervical
cancer. A total of 97 (48.5%) physicians knew about the HPV vaccine. When the physicians
were provided with information regarding the HPV vaccine, 100 (50%) physicians had stated
they would recommend the vaccine to their patients.
Conclusion: Physicians in Saudi Arabia would benefit from further education regarding the
available screening, prevention for HPV and cervical cancer.
Keywords: Cancer cervix, knowledge and attitude, physician
4. 4
Introduction
Cervical cancer is the second most common cancer in women, with an estimated 500,000 new
cases and 231,000 deaths annually worldwide. 1,2
Cervical cancer in Saudi Arabia is the 13th
most frequent cancer in Saudi women and the 5th
most frequent cancer in women between 30 and
44 years of age. The incidence rate in Saudi Arabia is one of the lowest in the world at 1.9 per
100,000 women. 3
Systemic screening can reduce the death rate from cervical cancer by at least
70%.4
The current screening method is the Pap smear test, which is also highly cost-effective. 5
Since the mid-1990s, clinical evidence has established that the human papillomavirus (HPV)
causes cervical cancer. 6
The identification of the potentially cancer-provoking virus has raised
hopes for the development of a vaccine to protect against cervical cancer. Clinical trials have
demonstrated that the vaccine is effective against HPV infection. HPV vaccines are also
expected to protect against cervical cancer, precancerous cervical lesions, persistent infections,
and HPV-related conditions such as genital warts. 7
There are two different types of vaccines
available in Saudi Arabia. Cervarix (GlaxoSmithKline Biologicals, Rixensart, Belgium) is a
bivalent vaccine against HPV-16/18 types, and Gardasil is the quadrivalent vaccine against
HPV-16/18/11/6 that was developed by Merck and Co., Inc. (West Point, PA).
The knowledge of HPV and cervical cancer association has spurred research on HPV-based
strategies for cervical cancer prevention, including the primary prevention of HPV, HPV
vaccines, and the use of HPV testing for the follow-up of women with abnormal Pap results or
after the treatment for severe lesions or microinvasive cancer. To maximize the benefit of these
clinical advances, the medical providers and the public require the appropriate education.
5. 5
Physicians must remain current with the research on HPV and the diagnostic and treatment
technologies for cervical cancer. The appropriate information must be relayed to women in a
way that encourages healthy sexual practices and healthcare-seeking behavior.
Designing effective educational messages is not straightforward. Most HPV infections regress
without treatment and are undetectable within 6-24 months. 8
Over 100 HPV strains exist;
however, only certain types are oncogenic. In the rare case that these strains progress to cancer,
the process can take between 5 and 30 years. 9
Furthermore, given that HPV is transmitted
through skin-to-skin contact, the traditional barrier methods are unreliable in preventing
transmission. 10
Despite the role that physicians have in cervical cancer prevention and
education, the research on these topics is limited with regard to the current Saudi Arabian
healthcare providers. The present survey sought to explore the knowledge, attitudes, and
practices of medical providers regarding cervical cancer in Saudi Arabia (Makkah region) and to
identify their opinions about patient education about the HPV vaccination. Given their different
professional profiles and training backgrounds, we compared specialists [obstetricians and
gynecologists (Ob-Gyns)] with non-specialists to determine how the two groups differed using
the variables described herein.
6. 6
Methods
We performed a cross-sectional descriptive study between May and December 2009 in the
western region of Saudi Arabia. The study included different types of health facilities, including
a hospital, a primary health care center and a private clinic. We included married female
physicians or previously married . Single female physicians were excluded. All participants
were randomly selected and they were voluntarily agreed to participate in the study and were
divided into gynecology doctors (GDs; group I) and non-gynecology doctors (NGDs; group II).
Sample size were calculated to involve minimal of ten participants per question.
The questionnaire were in English. They were short with clear open-ended questions. Its content
validity was confirmed through an extensive literature review and experts specialized in
gynecology, community medicine and medical education. The first seven questions on the
questionnaire gathered background information on the participant. The next nine questions were
divided into those assessing the participant’s knowledge, practice, and attitude regarding cervical
cancer and screening, including their understanding of its underlying etiology and preventive
measures (Table 1). The questionnaires were administered by two interviewers who worked in a
gynecology residency-training program and were managed by a supervisor. The interviewer was
available to answer any query that may have been raised by the participants based on their ability
to find the necessary information.
7. 7
CONSENT PROCEDURES
Individual approach was made where the participants received the necessary information about
the objective and potential benefits of the study. All participants were given the opportunity to
ask further questions, after verbal consent was obtained. The written consent was not
requirement of the local ethical committee to conduct such study. All participants were fully
informed by the interviewers that the information obtained by them were kept confidential and
their participation is voluntary; that they have full right to withdraw from the study at any time,
and the research had received an ethical approval from the unit of biomedical ethics at the
Faculty of Medicine in King Abdulaziz University.
For the analysis of the data on knowledge, practices and attitudes of physicians regarding the role
of HPV in the etiology of cervical cancer; the importance of the Pap test for of the disease
screening, and on the HPV vaccine, as a prophylactic resource in preventing of the infection
HPV and their injuries, we use the following criteria:
• Adequate knowledge: when the participants said that there a direct association between
HPV and cervical cancer; that the Pap test is a useful tool in the prevention of disease;
and correctly answered the interval witht that this exam should be performed.
• Adequate practice: when the participants answered that referred their patients to do the
Pap test and that they themselves get examined.
• Adequate attitude: when the participants answered that they heard about the HPV
vaccine, that have been vaccinated and who had recommended the vaccine for their
patients and their daughters.
8. 8
Data were entered and analyzed using SPSS version 17.0. We used χ2
tests to compare the
outcome variables between the two groups.
Results
A total of 250 doctors were contacted, 200 of which agreed to participate, with a response rate of
80%.
Of
the
respondents,
70
(35%)
were
physicians
classified
in
group
I
(GDs),
and
130
(65%)
In
the
group
II
(NGDs).
The
analysis
of
general
characteristics
of
the
participants
showed
that
mean
age
was
36
years
(range,
22-‐59
years),
mostly
were
of
Saudi
Arabian
descent,
being
in
group
I,
42/70
(6.0%)
and
in
group
II,
80/130
(61.5%),
respectively.
A
total
of
177
(88.5%)
participants
were
married,
16
(8%)
were
divorced
and
7
(3.5%)
were
widowed
at
the
time
of
the
study,
and
156
(78%)
of
the
participants
had
about
of
1-‐4
children
before
the
study
began
(Table
2).
Of the physicians in groups I and II, 63 (90%) and 87 (60.5%) knew that HPV was the
etiological agent for cervical cancer. A total of 45 (64.3%) participants in group I and 44 (33.8%)
participants in-group II believed that cervical cancer was curable. A total of 182 (91%)
participants knew that the Pap smear test was used to screen for cervical cancer between the two
groups, and 78 (39%) participants knew the eligibility interval for screenings. We observed a
significantly higher proportion of adequate knowledge about the role of HPV in the etiology of
cervical cancer, the possibility of curing the disease, as well as on the value of the Pap test as a
screening method aimed at the prevention of cervical cancer, about the need of realization the
examination and how often it should be done, among gynecologists physicians, when compared
with those of other specialties, with p value ranging of 0.041 to 0.001 (Table 3)
9. 9
Of the participants, 70 (35%) had screened or referred a patient for the Pap smear test, and 57
(28.5%) of them had screened themselves. Significant
differences
were
observed
between
the
two
studied
groups,
about
the
realization
of
the
Pap
test,
as
well
as
with
regard
to
referral
of
patients
to
the
program
for
cervical
cancer
screening,
where
the
group
of
gynecologists
physicians
presented
a
higher
proportion
of
subjects
with
adequate
practice,
when
compared
to
group
composed
by
other
medical
specialties
(Table
4).
Regarding
to
knowledge
and
use
of
the
HPV
vaccine
by
the
research
participants,
a total of 97
(48.5%) participants knew about the HPV vaccine with
significant
differences
were
observed
between
the
two
studied
groups
with
p
value
of
0.001
. When they were provided with information
regarding the vaccine, 100 (50%) participants said they would recommend the vaccine to their
patients, 94 (47%) would administer it to their daughters, and 85 (42.5%) of the participants
would take it themselves with no significant difference of subjects with adequate attitude in
between both groups (Table
5).
10. 10
Discussion
Cervical cancer is a preventable disease and one of the most important tool of prevention
is increasing awareness among public and ensure adequate correct information to the health care
provider on different method of prevention and screening. The participating physicians in our
survey had generally accurate knowledge about the association between HPV and cervical
cancer. Nearly 44.5% of all of the respondents believed that patients with cervical cancer had a
good chance of being cured. The findings from a study conducted in 1998 on 520 healthcare
professionals in the state of Morelos demonstrated a poor knowledge of cervical cancer etiology,
diagnosis, and treatment. In the cited study, 40% of Obstetricians and Gynecologists were not
aware of the association between HPV and cervical cancer. 11
In a survey of Mexican physicians
was observed that 80% of the respondents identified the virus as the principle cause of cervical
cancer, although many lacked detailed knowledge about this association. 12
In our study
Approximately 76 % of the physicians knew about the association of HPV and cervical cancer.
It is possible that in the departments outside gynecology, the reasons why physicians who did not
do screening or refer patients for screening may be attributed to their busy practice and/or lack of
knowledge. This explanation, however, does not justify the reluctance of the physicians in this
study to screen themselves despite the unrestricted availability of a free service. In our survey the
majority of gynecologist (97.1%) knew that the Pap smear test is used as a screening method for
cervical cancer. Around two-thirds of them, however, knew about the recent guideline
recommendations of the test eligibility, and only one-third of all doctors had undergone the test
themselves. Our study is consistent with the findings of Mutyaba et al, which showed that the
knowledge regarding the Pap smear test was 83% and the eligibility for the screening interval
11. 11
was less than 40% among healthcare providers in Uganda. 13
Among the respondents, who
included female nurses and medical students, 19% had been screened. Moreover, less than 40%
of the female respondents knew the risk factors for cervical cancer. This percentage was almost
half of the values found in our study. In addition, Mutyaba et al, which showed that the lack of
screening was perpetuated by a lack of knowledge or resources and the absence of clear
screening programs, policies and guidelines. 13
In our study, the alleged reasons by the
participants to do not perform in themselves the pap test and recommend to their patients were
lack of time in 160 (60%) of the respondents, the belief that living in a conservative community
correlated with a decreased risk of cervical cancer in 120 (80%), the lack of knowledge in 60
(30%), the lack of resources in 10 (5%) and having no clear guidelines applicable to the
community 50 (25%) of the respondents.
HPV education will inevitably become more common. Since the inception of the current study,
there have been an increasing number of advertisements in public health on HPV in Saudi
Arabia, showing that HPV education will inevitably become more common. However, new
research and counseling of patients are needed, especially in light of new technologies related to
HPV such as testing and vaccination. The results of these investigations will have important
implications in this country. Currently, no study has addressed the acceptability of the HPV
vaccination in the Arabic community. We found that less than 50% of physicians know of the
existence of the HPV vaccine, and approximately 50% of physicians believe that the vaccine is
not applicable to our community. In Turkey, the vaccine was introduced as a cervical cancer
vaccine rather than one for HPV. A survey by Ilter et al. showed that the high rate of awareness
of the cervical cancer vaccine (76.4%) in the public was a result of the increased education and
training of healthcare professionals. They reported that, among the reasons to be vaccinated, the
12. 12
recommendation from health workers (67%) was the most significant influence .14
A recent
study in Great Britain showed that HPV information tended to cause confusion among women
who did not previously know about its link to cervical cancer. 15
The current study was based on
a probabilistic sample obtained in health unit in the western region of Saudi Arabia. Although
these units were randomly selected, the subjects surveyed within each facility were chosen based
on availability to accept the interview for the questionnaires. A potential problem with this
sampling strategy is that the medical providers participating of the research may not have been
representative of all doctors who worked in these places, because we focused on interview
female doctors. The concern would be if the subjects selected had characteristics that
distinguished them from other providers of medical services in relation to their level of
knowledge or attitudes about HPV and cervical cancer. The other limitation of this survey is the
use of the interviewer rather than have the question self-administered, which has high potential
for interviewer bias. Future survey should focus to avoid such bias and involve other doctors
from different regions of Saudi Arabia.
Considering the fact that Saudi Arabia consists primarily of Muslim communities where the
relationship with multiple sexual partners is uncommon in such communities, discussing HPV,
as a sexually transmitted disease is taboo. These issues highlight the need for clarity and
consistency in the educational messages regarding HPV.
The belief of many doctors of that information about HPV may cause problems in marriages is
important, because this belief implies in need for more knowledge about the virus, by the health
professionals for do appropriate advice from population. If the Pap test or the HPV vaccination is
to be introduced in Saudi Arabia, the medical providers need to be prepared with accurate
13. 13
information to share with women and their partners. The medical providers must also have
awareness and sensitivity to the implications of this information. For example, when giving a
positive HPV diagnosis to a patient, medical providers might explain that such a diagnosis
should not be taken as an indication of the sexual behavior woman’s or of their husbands, as it is
impossible to identify when or from whom the virus was acquired. Education of the health care
provider is important factor, reflecting directly on public awareness as demonstrated by the results
of recent study, which was conducted in Saudi general population as 45% of the women who had
undergone a previous Pap smear stated that their physician had not recommended it. Of those
women who had not had a previous Pap smear, 18.3% stated that their physician had not
recommended it. 16
In conclusion, this report is the first study to assess knowledge, attitudes and practice of medical
providers in relation to Pap test, cervical cancer and HPV, at the national level in Saudi Arabia. It
is believed that the country is at risk of an unexpected increase in the incidence of cervical
cancer, due to lack of a structured screening program. Our results clearly show that gynecologist
physicians had a better knowledge on the subject in question, when compared with those of other
specialties, but even so, there a significant number of them who did not have knowledge,
attitudes or adequate practice. These results suggest the need for improvement on the medical
teaching, because medical students should receive this information before the graduation.
Furthermore, actions focused for continuing formation of the doctors in Saudi Arabia are needed,
with special attention for improving access to current informations in medical journals and
Internet. With the implementation of a continuing education program, the doctors of Saudi
14. 14
Arabia would benefit, by is upgrading and acquiring new knowledge of protocols available for
prevention, screening and intervention in situations involving HPV and cervical cancer.
15. 15
Acknowledgments
The author would like to thank Dr. Nisrin Anfinan , Dr Ahmad Al marstani and Dr. Salma
Omer for their help in collecting the data and express appreciation for Dr. Basem El-deek
for assisting in the data analysis. We also like to thanks all the doctors who agreed to precipitate
in this survey
16. 16
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17. 17
10. Manhart LE, Koutsky LA Do condoms prevent genital HPV infection, external genital
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18. 18
Table 1
Questionnaires evaluating Saudi physicians awareness on cervical cancer and screening.
Age
Nationality
Smoking history
Have you had any major medical illness that required hospitalization?
Specialty
Marital status
Parity
Knowledge
1- Do you know that HPV is etiological agent for cancer cervix
2- Do you know that cancer cervix is curable
3- Have you heard about cancer cervix screening ( pap smear ), if yes what is the eligibility and interval
Practice
1- Do you screen or refer patient for pap smear ( reason why not?)
2- Have you ever had pap smear your self ( reason why not?)
Attitude
1- Have you heard about HPV vaccine if yes:
2- Would you consider taken it
3- Would you recommended to your patients
4- Would you recommended to your daughter
19. 19
Table
2.Demographic
characteristics
of
participants
Medical
specialties
of
participants
Variable
Group
I
N
=
70
(%)
Group
II
N
=
130
(%)
Total
N
=
200
(%)
Age
(mean
years)
36.31
35.45
35.75
Nationality
Saudi
Expatriate
42
(60.0)
28
(40.0)
80
(61.5)
50
(38.5)
122
(61.0)
78
(39.0)
Smoker
Yes
No
3
(4.3)
67
(95.7)
7
(5.4)
123
(94.6)
10
(5.0)
190
(95.5)
Previous
medical
illness
Yes
No
3
(4.3)
67
(95.7)
13
(10.0)
117
(90.0)
16
(8.0)
184
(92.0)
Marital
status
Married
Divorced
Widow
62
(88.6)
4
(5.7)
4
(5.7)
115
(88.5)
12
(9.2)
3
(2.3)
177
(88.5)
16
(8.0)
7
(3.5)
20. 20
Table
3.
Knowledge
of
physicians
about
cancer
cervix
and
its
screening
Medical
specialties
of
participants
Variable
Group
I:
N=70
Adequate
(%)
Group
II:
N=130
Adequate
(%)
Total
N=200
Adequate
(%)
p-‐value
95%(CI)
HPV
is
associated
with
cancer
cervix
63
(90.0)
89
(68.5)
152
(76.0)
0.003*
(
10.9-‐32.1)
cancer
cervix
is
curable
disease
45
(64.3)
44
(33.8)
89
(44.5)
0.001*
(
16.6-‐44.4)
Pap
smear
test
prevents
cancer
cervix
68
(97.1)
144
(87.7)
182
(91.0)
0.044*
(
2.52-‐16.3)
Pap
smear
test
eligibility
interval
48
(68.6)
30
(23.1)
78
(39.0)
0.001*
(32.4-‐58.6)
*
statistically
significant
CI=
Confidant
interval
21. 21
Table
4.
Practice
of
physicians
regarding
cervical
cancer
screening
(Pap
smear
test)
Medical
specialties
of
participants
Variable
Group
I:
N
=
70
N
(Adequate
%)
Group
II:N
=
130
N
(Adequate
%)
Total
N
=
200
N
(Adequate
%)
p-‐value
95%(CI)
Sent
some
patient
to
Pap
smear
test
43
(61.4)
27
(20.8)
70
(35.0)
0.001*
(27.2
–
53.9
)
Self-‐screening
using
a
Pap
smear
test
26
(37.1)
31
(23.8)
57
(28.5)
0.041*
(
-‐18
–
26.8
)
*
statistically
significant
CI=
Confidant
interval
22. 22
Table
5.
Attitude
of
physicians
regarding
the
HPV
vaccine
Medical
specialties
of
participants
Variable
Group
I:
N
=
70
Adequate
(%)
Group
II:
N
=
130
Adequate
(%)
Total:
N
=
200
Adequate
(%)
p-‐value
95%(CI)
Heard
about
the
HPV
vaccine
46
(65.7)
51
(39.2)
97
(48.5)
0.006*
(12.6-‐
40.4)
Gave
the
HPV
vaccine
to
themselves
33
(47.1)
52
(40.0)
85
(42.5)
0.41
(-‐7.3-‐21.5)
Recommend
the
HPV
vaccine
to
their
patients
42
(60.0
58
(44.6)
100
(50.0)
0.05
(1.09-‐29.7)
Recommend
the
HPV
vaccine
to
their
daughters
39
(55.7)
55
(42.3)
94
(47.0)
0.096
(-‐1.01-‐27.8)
*
statistically
significant
CI=
Confidant
interval
23. 23
Table 6. Brief summary of the studies of health care provider knowledge on cancer cervix
Author
(year)
Number
of
participants
(Respond
Rate)
Knowledge
on
association
of
HPV
and
Cancer
cervix
Knowledge
on
cancer
cervix
screening
Knowledge
on
Cancer
cervix
curability
Mutyaba
et
al
(2006)
288(59%)
29%
83%
81%
Aldrich
et
al
(2005)
1206(76%)
80%
-‐
-‐
Sait
(present
study)
200(80%)
76%
91%
44.5%