The male factor in cervical carcinogenesis: a questionnaire study of men's awareness in primary care.

Background: The incorporation of testing for human papillomavirus into protocols for cervical cancer screening has far-reaching consequences for counseling patients. The sexual transmission of HPV implies the recognition of sexual behavior of both men and women as a risk factor for cervical cancer. The aim of this study was to investigate which knowledge men have of the relation of HPV and cervical cancer.

Methods: A patient questionnaire was developed in which 20 possible risk factors for cervical cancer development were suggested. In a family practice setting in Flanders, Belgium in 2004, male patients were asked to rate the importance of these factors on a five-point scale.

Results: Participants (n=121) rated genetic factors highest (mean score 4.03) regardless of age or educational level. Not having cervical smears regularly (3.76), smoking (3.75) and infections were also perceived as important risk factors (3.69 for bacterial and 3.34 for viral infections). Sexual behavior of the male partner was scored much lower (2.63).

Conclusions: This study shows that awareness of HPV and its sexually transmitted nature is low among male general practice attendees. Promoting safe sex to reduce HPV transmission for primary prevention of cervical cancer should target at both male and female patients.