Cervical cancer, proxies for HPV exposure, screening scare and use of proximal and distal defense behaviors in fear buffering

PhD ceremony: Mr. I.G. Leckie, 13.15 uur, Academiegebouw, Broerstraat 5, Groningen

Thesis: Cervical cancer, proxies for HPV exposure, screening scare and use of proximal and distal defense behaviors in fear buffering

Promotor(s): prof. A. Dijkstra, prof. A.P. Buunk, prof. H.E. Lamur

Faculty: Behavioural and Social Sciences

As study about risk behavior in relation to getting infected with HPV, fear intensity and screening behavior of women and the use of psychological defense mechanisms in coping with fear. The risk of getting cervical cancer in Latin America and Suriname is six times greater than in west Europe. The incidence in Latin America and the Caribbean including Suriname is 30 or more per 100,000 women per year. The average cervical cancer mortality rate in Latin America and the Caribbean is roughly 5 deaths per 100,000 women. The study of behavioral aspects of 4,898 women who participated in the first national Pap smear campaign in Suriname showed that educational level significantly distinguishes women with positive and negative Pap smear results. Women with a higher level of education exhibit the following behaviors: they tend to become sexually active later; they get children later in life; they have fewer children, and they are more likely to use a condom. This reduces their chance of getting HPV, the most important risk factor in developing cervical cancer. A significant difference was found with regard to Pap smear results and ethnicity. Maroon and Creole women show significantly more positive results. Their first intercourse is at a very young age and they have a greater number of children. Both of these variables are significantly correlated with positive Pap smear results. Women with a high risk for cervical cancer are: women who start sexual intercourse early , particularly under the age of 12; women with high parity; women who become pregnant at an early age, particularly under the age of 14 women with low educational level. These are all indicators for (early) exposure to HPV. With regard to experienced fear, no relation with education was found. A high screening fear intensity can lead to avoidance of the screening for cervical cancer. More women who did not participate in the screening for cervical cancer reported a higher fear intensity.