{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T03:28:04Z","timestamp":1791689284514,"version":"4.3.4"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2014,3,25]],"date-time":"2014-03-25T00:00:00Z","timestamp":1395705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Cooperative Agreement","award":["U48\/DP001903"],"award-info":[{"award-number":["U48\/DP001903"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction.<\/jats:title>\n                  <jats:p>Brazil's national strategy for cervical cancer screening includes using the Papanicolaou (Pap) test every 3 years among women aged 25\u201364 years. Comprehensive primary care services are provided through a network of primary health units, but little is known about cervical cancer-related knowledge, attitudes, and practices among health professionals and coordinators working in these facilities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods.<\/jats:title>\n                  <jats:p>In 2011, we conducted a cross-sectional nationally representative phone survey of 1,600 primary health care units to interview one unit coordinator and one health care professional per unit (either nurse, physician, or community health worker). Responses were obtained from 1,251 coordinators, 182 physicians, 347 nurses, and 273 community health workers. Questionnaires were administered to assess health units\u2019 characteristics and capacity for cervical cancer-related services as well as health professionals\u2019 perceived effectiveness of the Pap test, preparedness to talk to women about cervical cancer, adherence with screening guidelines, and willingness to recommend human papillomavirus (HPV) vaccination to females.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results.<\/jats:title>\n                  <jats:p>Most units conducted screening (91.9%), used home visits to conduct recruitment and outreach (83.4%), and provided follow-up to women who did not return to discuss Pap test results (88.1%). Approximately 93% of health professionals stated that Pap testing was effective in decreasing death rates from cervical cancer and 65% stated that national guidelines for cervical cancer screening are very influential; 93% of nurses and physicians reported screening women annually and 75% reported beginning to screen women younger than 25 years old. Regarding HPV vaccination, almost 90% of nurses and physicians would recommend the HPV vaccine to their females patients if it were available. A larger proportion of physicians and nurses recommended the HPV vaccine to older girls (13\u201318 years) and women (19\u201326 years and even older than 26 years) than to younger girls (12 years or younger).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion.<\/jats:title>\n                  <jats:p>Although Brazil's network of primary care units has significantly increased access to cervical cancer screening, effective strategies are needed to ensure that women get screened at the appropriate ages and intervals. Additionally, this study's baseline data on HPV vaccination may be useful as Brazil embarks on a national HPV vaccination program in 2014.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1634\/theoncologist.2013-0318","type":"journal-article","created":{"date-parts":[[2014,3,26]],"date-time":"2014-03-26T02:51:25Z","timestamp":1395802285000},"page":"375-382","source":"Crossref","is-referenced-by-count":24,"title":["Cervical Cancer-Related Knowledge, Attitudes, and Practices of Health Professionals Working in Brazil's Network of Primary Care Units"],"prefix":"10.1093","volume":"19","author":[{"given":"Anal\u00eda Romina","family":"Stormo","sequence":"first","affiliation":[{"name":"Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lenildo","family":"Moura","sequence":"additional","affiliation":[{"name":"Organiza\u00e7\u00e3o Pan-Americana da Sa\u00fade\/Organiza\u00e7\u00e3o Mundial da Sa\u00fade (OPAS\/OMS), Brasilia, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona","family":"Saraiya","sequence":"additional","affiliation":[{"name":"Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2014,3,25]]},"reference":[{"issue":"Suppl","key":"2021122308431902200_B1","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1002\/hec.1607","article-title":"Evaluating the impact of community-based health interventions: Evidence from Brazil's Family Health Program","volume":"19","author":"Rocha","year":"2010","journal-title":"Health Econ"},{"key":"2021122308431902200_B2","doi-asserted-by":"crossref","first-page":"1949","DOI":"10.1016\/S0140-6736(11)60135-9","article-title":"Chronic non-communicable diseases in Brazil: Burden and current challenges","volume":"377","author":"Schmidt","year":"2011","journal-title":"Lancet"},{"key":"2021122308431902200_B3","volume-title":"Instituto Nacional de C\u00e2ncer (INCA). 2010. Monitoramento das acoes de controle do cancer do colo do utero e mama. Brazil, Rio de Janeiro: INCA","year":"2012"},{"key":"2021122308431902200_B4","volume-title":"Union for International Cancer Control. 2011. Prevention and treatment of breast and cervical cancer in Brazil","year":"2012"},{"key":"2021122308431902200_B5","volume-title":"Brazilian Ministry of Health. 2013. Minist\u00e9rio da Sa\u00fade incorpora vacina contra HPV ao SUS [in Portuguese]","year":"2013"},{"key":"2021122308431902200_B6","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1016\/j.socscimed.2011.12.025","article-title":"Community health workers in Brazil's Unified Health System: A framework of their praxis and contributions to patient health behaviors","volume":"74","author":"Pinto","year":"2012","journal-title":"Soc Sci Med"},{"key":"2021122308431902200_B7","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1186\/1471-2458-13-794","article-title":"Physical activity counseling in primary health care in Brazil: A national study on prevalence and associated factors","volume":"13","author":"Florindo","year":"2013","journal-title":"BMC Public Health"},{"key":"2021122308431902200_B8","first-page":"479","article-title":"Excessive Pap smears due to opportunistic cervical cancer screening","volume":"29","author":"Freitas","year":"2008","journal-title":"Eur J Gynaecol Oncol"},{"key":"2021122308431902200_B9","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1590\/S1020-49892004001000001","article-title":"Coverage and focus of a cervical cancer prevention program in southern Brazil","volume":"16","author":"De Quadros","year":"2004","journal-title":"Rev Panam Salud Publica"},{"key":"2021122308431902200_B10","volume-title":"Cervical cancer and screening. In Handbook of Cancer Prevention. Vol. 10. Lyon, France: IARC, 2005","author":"International Agency for Research on Cancer (IARC)","year":"2011"},{"key":"2021122308431902200_B11","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.amepre.2012.04.009","article-title":"Effectiveness of interventions to increase screening for breast, cervical, and colorectal cancers: Nine updated systematic reviews for the guide to community preventive services","volume":"43","author":"Sabatino","year":"2012","journal-title":"Am J Prev Med"},{"key":"2021122308431902200_B12","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1158\/1055-9965.EPI-12-0147","article-title":"Cervical cancer in Latin America and the Caribbean: The problem and the way to solutions","volume":"21","author":"Villa","year":"2012","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"2021122308431902200_B13","first-page":"1241","article-title":"Adherence to cervical and breast cancer programs is crucial to improving screening performance","volume":"9","author":"Mauad","year":"2009","journal-title":"Rural Remote Health"},{"issue":"Suppl 2","key":"2021122308431902200_B14","doi-asserted-by":"crossref","first-page":"S38","DOI":"10.1016\/j.ijgo.2005.01.015","article-title":"Involving the community in cervical cancer prevention programs","volume":"89","author":"Agurto","year":"2005","journal-title":"Int J Gynaecol Obstet"},{"key":"2021122308431902200_B15","volume-title":"Pan American Health Organization. 2013. Cancer in the Americas: Country profiles 2013"},{"key":"2021122308431902200_B16","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1542\/peds.2009-3500","article-title":"Human papillomavirus vaccination practices: A survey of U.S. physicians 18 months after licensure","volume":"126","author":"Daley","year":"2010","journal-title":"Pediatrics"},{"key":"2021122308431902200_B17","volume-title":"Vaccine introduction guidelines: Adding a vaccine to a national immunization program","author":"World Health Organization","year":"2005"},{"key":"2021122308431902200_B18","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1177\/0163278707307899","article-title":"Methodologies for improving response rates in surveys of physicians: A systematic review","volume":"30","author":"VanGeest","year":"2007","journal-title":"Eval Health Prof"}],"container-title":["The Oncologist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/pericles-gcp.literatumonline.com\/doi\/pdf\/10.1634\/theoncologist.2013-0318","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/pericles-gcp.literatumonline.com\/doi\/full-xml\/10.1634\/theoncologist.2013-0318","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/oncolo\/article-pdf\/19\/4\/375\/41861695\/oncolo_19_4_375.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/oncolo\/article-pdf\/19\/4\/375\/41861695\/oncolo_19_4_375.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,24]],"date-time":"2021-12-24T01:08:02Z","timestamp":1640308082000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/oncolo\/article\/19\/4\/375\/6399553"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,3,25]]},"references-count":18,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2014,3,25]]},"published-print":{"date-parts":[[2014,4,1]]}},"URL":"https:\/\/doi.org\/10.1634\/theoncologist.2013-0318","relation":{},"ISSN":["1083-7159","1549-490X"],"issn-type":[{"value":"1083-7159","type":"print"},{"value":"1549-490X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2014,4,1]]},"published":{"date-parts":[[2014,3,25]]}}}