Introduction: Cervical cancer screening has demonstrated high efficacy in reducing cervical cancer mortality worldwide. However, clinician sampling is often perceived as an uncomfortable procedure that could reduce screening uptake. Self-sampling methods for HPV diagnosis have shown high sensitivity, which could increase acceptance and screening rates among women. Purpose: This study aims to identify the perceived barriers and advantages of self-sampling methods versus clinician sampling for cervical cancer screening in a rural setting in Ecuador. Patients and Methods: A qualitative study was conducted. Seven focus group discussions took place in the rural Parish of El Valle in Azuay Province, Cuenca, Ecuador. Women native to this rural area were included in the study. FGDs were recorded and transcribed, and content analysis was performed to categorize and analyze the data. Results: A total of 45 women participated in the study. Clinician sampling was perceived as a painful and intrusive method. However, participants believed that it is more reliable compared to self-sampling methods, attributing this to the direct visualization of the cervix, which facilitates the detection of cervical pathologies. The perceived advantages of self-sampling included increased comfort, pain reduction, time savings, the ability to perform the test at home, and the potential for widespread availability through pharmacies or local traditional healers. Nevertheless, doubts about the test’s reliability as well as the user’s proficiency in self-testing posed barriers to the adoption of this technique. Conclusion: Self-sampling methods offer several advantages over clinician sampling, such as enhanced privacy, comfort, and accessibility to cancer screening. Barriers primarily revolved around users’ proficiency in performing the test and the reliability of the results. Providing training for using self-sampling tests could address these barriers.

Cervical cancer (CC) is the second leading cause of death from malignancy in women in Ecuador. Human papillomavirus (HPV) is the main causative agent of CC. Although several studies have been conducted on HPV detection in Ecuador, there are limited data on indigenous women. This cross-sectional study aimed to analyze the prevalence of HPV and associated factors in women from the indigenous communities of Quilloac, Saraguro and Sevilla Don Bosco. The study included 396 sexually active women belonging to the aforementioned ethnicities. A validated questionnaire was used to collect socio-demographic data, and real-time Polymerase Chain Reaction (PCR) tests were used to detect HPV and other sexually transmitted infections (STIs). These communities are located in the southern region of Ecuador and face geographical and cultural barriers to accessing health services. The results showed that 28.35% of women tested positive for both types of HPV, 23.48% for high-risk (HR) HPV, and 10.35% for low-risk (LR) HPV. Statistically significant associations were found between HR HPV and having more than three sexual partners (OR 1.99, CI 1.03–3.85) and Chlamydia trachomatis infection (OR 2.54, CI 1.08–5.99). This study suggests that HPV infection and other sexually transmitted pathogens are common among indigenous women, highlighting the need for control measures and timely diagnosis in this population.

The elderly population in Ecuador is increasing rapidly, with an increasing incidence of diet-related diseases. The elderly living in the community seek alternative and complementary methods to improve their diet and quality of life. This study aimed to investigate the impact of an educational intervention on knowledge related to healthy eating among older adults. This intervention is rooted in the principles of meaningful learning and incorporates culturally adapted materials. A quasi-experimental study design was employed using a pre-test–post-test control group. Study participants were a total of 109 elderly (intervention: n = 51, control: n = 58) people in Cuenca, Ecuador. The educational intervention based on Ausubel’s theory of significant learning and Vygotsky’s sociocultural theory was programmed to be carried out for one session per week, over 24 weeks, with a duration of 120 min per session. The measures were the general characteristics of the study participants and knowledge about necessary amounts, food sources and the consequences of deficits or excesses in the consumption of macro- and micronutrients. Data were collected from August 2018 to February 2019. Statistically significant differences were observed between the intervention group (IG) and the control group (CG) in terms of knowledge about healthy eating for older adults following the educational intervention. The outcomes of this study strongly suggest the efficacy of the program in improving knowledge related to healthy eating among older adults. Healthcare providers should prioritize food education based on meaningful learning, utilizing culturally adapted materials for the elderly individuals residing within the community.

Introduction: Cervical Cancer (CC) is a preventable and treatable disease if detected early, yet it remains a global health challenge. In Ecuador, CC is the second most common cancer; however, screening uptake remains suboptimal due to poor knowledge, low willingness, and limited access to healthcare. Traditionally, CC screening requires a healthcare professional, creating social and access barriers. Innovative techniques such as “self-sampling” (SS) for human papillomavirus (HPV) detection offer a promising alternative. Objective: This study evaluates the acceptability, attitudes, and user experience of a community-based SS program among a hard-to-reach population following a local educational session. Methods: A quasi-experimental study was conducted in a rural community in Cuenca, Ecuador. Educational sessions were organized, after which women were offered the option to perform SS for HPV detection. Three questionnaires were administered to assess population characteristics, risk factors, and experiences toward the process. Results: Of the 130 participants, 90% accepted SS, and 10% rejected SS. A significant number of women reported that SS was faster and less painful compared to traditional Papanicolaou tests ( P < .05). Conclusions: SS shows strong potential for increasing CC screening, especially in hard-to-reach areas, emphasizing the need to adapt screening programs to meet diverse community needs.

Human papillomavirus (HPV) is a prevalent sexually transmitted infection linked to genital warts and various cancers. While effective screening methods exist for women, detecting HPV in men remains challenging due to asymptomatic infections and the lack of standardized, non-invasive diagnostic tools. This study aimed to assess the correlation between HPV DNA detection in urine and semen samples from men attending a fertility clinic in Ecuador. This cross-sectional study included 106 sexually active male patients referred for semen analysis at the Fertility Unit of Hospital del Río, Cuenca, Ecuador, between June 2024 and March 2025. Each participant provided paired semen and urine samples, which were analyzed for HPV genotyping. Sociodemographic and behavioral data were also collected. HPV DNA was detected in 15% of semen samples and 9.4% of urine samples. Both low- and high-risk genotypes were identified in semen and urine. In semen samples, high-risk HPV was detected in 9.4% and low-risk HPV in 5.7%. In urine, high-risk HPV was detected in 8.5% and low-risk HPV in 0.9% of samples. Among high-risk genotypes, HPV 58 was the most frequent in urine (20%), while HPV 81 was the most frequent in semen (19%). Genotypes such as HPV 16, 18, 39, 52, and 66 were detected exclusively in semen. Compared with semen sampling, urine sampling showed a sensitivity of 37.5% and a specificity of 95%. Agreement between the two sample types was fair (kappa = 0.39). Although urine sampling offers a non-invasive option, its limited sensitivity restricts its utility as an HPV detection method in asymptomatic men. Semen analysis provides higher detection rates and may be more reliable for HPV screening in male fertility populations. IMPORTANCE: This study addresses a critical knowledge gap regarding human papillomavirus (HPV) detection in men, a topic insufficiently covered in current control and prevention strategies. While screening and vaccination efforts in women have advanced considerably, the absence of standardized, well-accepted, and non-invasive methods for HPV detection in men limits the recognition of their roles as reservoirs and transmitters in the HPV transmission pathway. Evaluating alternative solutions for HPV testing, such as urine and semen sampling, not only contributes valuable scientific knowledge to improve detection in this population but also establishes the foundation for public health policies on male HPV testing. Ultimately, this work supports the goal of reducing global HPV prevalence and its associated diseases.

Cervical cancer is the second leading cause of death due to oncological pathology in Ecuadorian women. Vaccination and early detection have high efficacy in preventing this disease. The costs of treating cervical cancer are high. Objective: To compare the costs per person for cervical cancer prevention versus the treatment of cervical lesions. Methodology: An analysis of therapeutic recommendation and the cost related with to the treatment and prevention based on the cost schedule for the national health system of Ecuador. Results: The investment in prevention varies according to the scheme used. When using the optimal vaccination and screening with cytology, the investment is $395.62 USD. When using the optimal vaccination and human papillomavirus detection scheme, the cost is $761.42 USD. The cost of follow-up for low-grade lesions is $490.7 USD; for high-grade lesions and in situ cancer with outpatient management, it is $685.43 USD. In the case of in situ cancer/Stage IAI/or non-conizable cervixes, the cost reaches $3465.68 USD. For invasive stages I to 2; IB; IIA, it is $23,762.20 USD, and for stages IIB-III-IV, the minimum cost is $28,560.22 USD. Conclusions: The cost of managing advanced and invasive cervical lesions is 10 to 101 times more expensive than prevention per person. The cost for a person with a basic salary of $460 USD would create inequities in access to treatment and survival. The cost per person that the state must cover for the treatment of advanced cervical cancer is much higher than the investment in prevention. El cáncer de cuello uterino constituye la segunda causa de mortalidad por enfermedad oncológica en las mujeres ecuatorianas. La vacunación y la detección son eficaces en la prevención de esta enfermedad. Los costos de tratamiento del cáncer cervical son elevados. Objetivo: Comparar los costos por persona para la prevención del cáncer cervical versus el tratamiento de las lesiones cervicales. Metodología: Se realizó un análisis de las recomendaciones terapéuticas y los costos asociados al tratamiento y prevención en base al tarifario de prestaciones para el sistema nacional de salud del Ecuador. Resultados. El costo de prevención varía de acuerdo al esquema utilizado. Cuando se utiliza el esquema óptimo de vacunación y tamizaje con citología, la inversión es de 395,62 USD. Si se utiliza el esquema óptimo de vacunación y la detección del virus del papiloma humano el costo asciende a 761,42 USD. Los costos de seguimiento para lesiones de bajo grado son de 490,7 USD; para las lesiones de alto grado y cáncer in situ con manejo ambulatorio es de 685,43 USD. En el caso del cáncer in situ/Estadio IAI/ o cuellos no conizables el costo es de 3.465.68 USD. En las etapas invasoras I a 2; IB; IIA, es costo es de 23.762,20 USD y para las etapas Etapa IIB- III- IV el costo mínimo es 28.560,22 USD. Conclusiones: El manejo de las lesiones avanzadas e invasoras del cuello uterino tiene un costo entre 10 y 101 veces más elevado que la prevención por persona. Esto genera inequidades en el acceso al tratamiento y la supervivencia, especialmente para aquellas personas con un básico de 460 USD. El costo por persona que el estado debe cubrir por el tratamiento de un cáncer cervical avanzado es mucho mayor que la inversión en prevención