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Cervical cancer awareness among female medical students in Porto. Facts, risk factors, detection, prevention and treatment. 1 st Protocol Draft 2 nd November ‘09. What is cervical cancer?. Background. A slow developing malignant cancer that starts in the tissues of the cervix.

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facts risk factors detection prevention and treatment

Cervical cancer awareness among female medical students in Porto

Facts, risk factors, detection, prevention and treatment

Introdução à Medicina I

Class 16 - 2009/2010

1st Protocol Draft

2nd November ‘09


What is cervical cancer?

  • A slow developing malignant cancer that starts in the tissues of the cervix.
  • Human papillomavirus (HPV) is implicated in more than 99% of these cancers. (Kaplan-Myrth N, 2007, Family Physicians of Canada)

HPV as the necessary main cause

  • Cervical cancer is most often diagnosed in middle-aged women.
      • 50% cases in the ages 35-55
      • 20% cases in ages over 65
      • Rarely diagnosed in women younger than 20 years.

They’re still at risk!

Cervical cancers develop in older women but result from HPV infections that occurred many years earlier


How common is cervical cancer?

  • Cervical cancer is the second most common cancer in women worldwide. (Kaplan-Myrth N, 2007, Family Physicians of Canada)
  • 40 women die daily in Europe because of cervical cancer.(Ferlay J et al, 2004, Globocan 2002)
  • In 2002, 956 new cases were diagnosed and 378 women died with cervical cancer, in Portugal.(Ferlay J et al, 2004, Globocan 2002)

Incidence in Portugal = 13,5


What is HPV?

  • A family of more than 200 DNA viruses.
  • Some types are responsible for common and plantar warts.
  • Other types infect the genital tract – these are transmittable through sexual contact:
      • intercourse;
      • oral and anal sex;
      • genital to genital contact.

High-risk types – 16 & 18

Low-risk types – 6 & 11

70% of cervical cancers

Most genital warts


Risk cofactors

  • Some factors increase the HPV’s ability to cause cervical cancer.
  • Smoking (Anna R. Giuliano, 2002)
  • Other sexually transmitted infections (STI):
    • Chlamydia
    • Herpes virus
    • HIV virus
  • Immunodepressive drugs
  • Others increase the probability of getting infected.
  • Having many sexual partners
  • Having a partner with many sexual partners

How does cervical cancer develop?


HPV infection

must persist for

more than one year








HPV Infection



HPV Clearance


Symptoms and detection

  • Early cervical cancer is generally asymptomatic.

Regular screening in order to detect precancerous lesions

  • Detection/screening techniques:

HPV DNA test


Papanicolaou smear





  • Abstinence is the only completely effective method of HPV infection prevention.
  • Use of condom reduces the chance of getting infected.
  • Reduced number of sexual partners.
  • HPV Vaccination – recommended for women aged 6-26.

Quadrivalent vaccine (Gardasil®)

Types 6, 11, 16 & 18

Bivalent vaccine (Cervarix®)

Types 16 & 18

  • Vaccination does not substitute routine cervical cancer screening. (Kaplan-Myrth N, 2007, Family Physicians of Canada)


  • Treatment depends on the stage and location of the cervical cancer.
  • Cryosurgery – kills pre-invasive cancers by freezing them
  • Laser surgery – burning off abnormal tissues and pre-invasive cancers
  • Cone biopsy – excision of a cone-shaped section of the cervix
  • Hysteroctomy – excision of the uterus and cervix.
  • Chemotherapy
  • Radiation

and motivation

  • Although knowledge is not a direct predictor of health behavior, it is a key first step to:
    • Any health education intervention
    • Appropriate decision-making
  • Awareness among female medical students has double importance:
    • They’re young citizens who belong to the risk group
    • They’re future health professionals,
  • We believe there’s potential for better results on prevention of cervical cancer.
research questions

and aims

Research questions
  • Are female medical students concerned enough about cervical cancer?
  • Are they conscious of:
    • Portugal’s situation on cervical cancer?
    • Availability of vaccine?
    • Campaigns and recommendations?
  • We aim to assess students’ knowledge of cervical cancer on several aspects by means of a questionnaire:
    • HPV connection with cervical cancer
    • Transmission
    • Detection and prevention
  • Also, we want to compare the degree of awareness according to:
    • Sexual activity
    • Age
    • Studies level
    • Other variables
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