Milestones in HPV research

Effects of a Videotape Intervention on Pap Smear Knowledge, Attitudes and Behaviour

This study assessed the capacity of modelling videotapes to promote Pap smear screening. A total of 245 women watched videotapes modelling the process of Pap smear testing, and completed pre- and post-questionnaires which assessed knowledge and attitudes relating to Pap smears and cervical cancer. 186 also completed follow-up questionnaires five weeks later. Behavioural effects were strong. One third of those women identified as due for a Pap smear reported having had the test by follow-up. Initial levels of knowledge of Pap smears and of risk factors for cervical cancer were low, but increased significantly at post-test and follow-up. Health Belief Model variables, particularly perceived barriers, were associated with reported Pap smear behaviour, but a large proportion of the variance remained unexplained. The results suggest that modelling videotapes of this type, combined with appropriate encouragement and reassurance from medical practitioners, could significantly increase Pap smear rates and thus increase the detection and treatment of cervical cancer in its early stages.

Cervical intra-epithelial neoplasia and koilocytotic lesions of the lower genitalia in an Icelandic population

This study is based on women who participated in cervical cancer screening and on 390 women referred from the screened group for colposcopy. The study analyzed the frequency of atypia, CIN and koilocytosis and evaluated the efficiency of cytologic vs. histologic diagnosis. The clinical expression of the koilocytotic lesions and the rate of infected partners were evaluated. In the screened population the prevalence of smears with atypia and CIN was 3.2% and that of koilocytosis 0.5%. In the colposcopic group the frequency of koilocytosis in the histologic sections was 98% compared to 18% of the smears. The koilocytotic lesions were mostly multicentric, subclinical and asymptomatic and often associated with normal cytology. The rate of infected partners of women with normal smears and non-symptomatic vulvar lesions was low (15%), increased if smears were abnormal (30%), and was highest when the partner had gross condylomata (89%). As to atypia and CIN, the rate of undegraded smears was 18%, false-negative smears 8%, undergraded colposcopic biopsies 33%, false-negative colposcopic biopsies 3%, and the false-negative rate of combined cytology and colposcopy was less that 1%. Colposcopy is recommended for unclassified CIN and CIN 2–3 repeat smear for atypia and CIN 1 and combined cytology and colposcopy for condylomata.