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Witwaranukool P, Sumdaengrit B, Dandamrongrak C, Kue J. Knowledge and health literacy related to human papillomavirus infection, cervical cancer, and cervical cancer screening among nursing students in rural and urban areas of Thailand. NURSE EDUCATION TODAY 2025; 148:106624. [PMID: 39987675 DOI: 10.1016/j.nedt.2025.106624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2024] [Revised: 02/05/2025] [Accepted: 02/06/2025] [Indexed: 02/25/2025]
Abstract
BACKGROUND Cervical cancer is the second leading cause of death among women in Thailand. Understanding health literacy and knowledge of HPV, cervical cancer, and their screening is vital for nursing students as they prepare for professional practice. OBJECTIVES To identify factors influencing health literacy and knowledge of HPV infection, cervical cancer, and screening among Thai nursing students at rural and urban universities. DESIGN A cross-sectional descriptive comparative study. PARTICIPANTS/SETTINGS Current undergraduate nursing students from rural and urban universities in Thailand. METHODS A self-administered survey assessed health literacy and knowledge related to HPV infection, cervical cancer, and their screening. Descriptive and logistic regression analyses were used to identify factors associated with these variables. RESULTS Among 641 nursing students (255 rural students and 386 urban students), rural students had significantly higher mean scores in cervical cancer screening knowledge (t = -4.86, p < 0.001) and health literacy compared to urban students (t = -2.57, p = 0.01). Rural students using the internet more than three days per week were 1.92 times more likely to have better knowledge of HPV and cervical cancer (95 % CI: 1.10-7.73). Awareness of HPV (ORa = 2.51, 95 % CI: 1.31-4.80) and frequent internet use (ORa = 2.31, 95 % CI: 1.04-5.12) were associated with higher knowledge about cervical cancer screening and health literacy among rural nursing students. CONCLUSIONS Rural students exhibit higher health literacy and knowledge about cervical cancer screening than urban students. These findings highlight the need for diverse teaching strategies to enhance students' understanding and competency.
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Affiliation(s)
- Porawan Witwaranukool
- Ramathobodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand; Mahidol University Ramathibodi School of Nursing: A JBI Affiliated Group, Bangkok, Thailand.
| | - Bualuang Sumdaengrit
- Ramathobodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
| | - Chawisa Dandamrongrak
- Ramathobodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand; College of Nursing, University of South Florida, USA
| | - Jennifer Kue
- College of Nursing, University of South Florida, USA
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Zhou X, Wu M, Zhou Y, Su F, He Y, Ding J, Xie L. Knowledge, attitudes, behaviors, and information needs of women vaccinated with the HPV vaccine regarding cervical cancer prevention: a cross-sectional study. Front Public Health 2025; 13:1493589. [PMID: 40017550 PMCID: PMC11865027 DOI: 10.3389/fpubh.2025.1493589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2024] [Accepted: 01/31/2025] [Indexed: 03/01/2025] Open
Abstract
Background Cervical cancer poses a serious threat to women's health globally, especially in China. HPV vaccination and screening are crucial prevention and control measures. However, the screening coverage among Chinese women remains low, and there is a need to better understand the knowledge, attitudes, behaviors, and information needs of Chinese HPV-vaccinated women regarding cervical cancer prevention to optimize prevention and control strategies. Objectives To explore the knowledge, attitudes, behaviors, and information needs of women vaccinated with the HPV vaccine regarding cervical cancer prevention. Methods This cross-sectional study was conducted using a convenience sampling method from October 1 to December 30, 2023. A questionnaire survey was administered to 439 women vaccinated with the HPV vaccine at the Shu Shan District Community Health Service Center in Hefei, Anhui Province. The survey tool was self-designed. Data were analyzed using descriptive statistics, chi-square tests, and binary logistic regression. Results The average age of the 439 participants was 27.82 ± 6.42 years. The average cervical cancer prevention knowledge score was 35.01 ± 5.76. 434 (98.9%) women held a positive attitude towards cervical cancer screening, and 320 (72.9%) women had undergone cervical cancer screening after receiving the HPV vaccine. Educational levels such as college (OR = 2.995, 95%CI: 1.233-7.279, p = 0.015), bachelor's degree (OR = 3.694, 95%CI: 1.718-7.943, p = 0.001), and postgraduate and above (OR = 4.826, 95%CI: 2.176-10.707, p < 0.001), as well as occupation as medical workers (OR = 4.660, 95%CI: 2.292-9.474, p < 0.001), were associated with higher knowledge of prevention and treatment scores. Individuals aged 26-35 years (OR = 7.431, 95%CI: 2.856-19.331, p < 0.001), 36-45 years (OR = 11.466, 95%CI: 2.279-57.694, p = 0.003), married individuals (OR = 4.307, 95%CI: 1.455-12.750, p = 0.008), and participants who had received health education related to cervical cancer prevention (OR = 2.125, 95%CI: 1.169-3.863, p = 0.013) and possessed good knowledge of prevention (OR = 16.770, 95%CI: 8.667-32.451, p < 0.001) were more inclined to undergo cervical cancer screening. Among the 254 participants who had received health education, 34.2% still had unmet information needs regarding cervical cancer prevention, and 29.5% hoped to receive health education services from professionals. Conclusion Chinese HPV-vaccinated women have a good understanding of cervical cancer prevention and a positive attitude and behavior towards cervical cancer screening. However, their knowledge of cervical cancer screening is not sufficient, and their information needs have not been fully met.
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Affiliation(s)
- Xuan Zhou
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Miaomiao Wu
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Yuling Zhou
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Fang Su
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Yiqing He
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Jinxia Ding
- Department of Medical Oncology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Lunfang Xie
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
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Huang X, Ruan G, Sun P. Assessment of Knowledge Gaps in Cervical Cancer Screening and HPV Vaccination Among Chinese Women: A Comprehensive Population-Based Study. Cancer Manag Res 2025; 17:267-279. [PMID: 39957903 PMCID: PMC11829636 DOI: 10.2147/cmar.s500946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2024] [Accepted: 01/14/2025] [Indexed: 02/18/2025] Open
Abstract
Background While studies on cervical cancer screening (CCS) and human papillomavirus (HPV) vaccine uptake exist in China, few have examined both within populations participating in CCS programs. Methods This cross-sectional, population-based survey included 37,797 women aged 18-64 years attending gynecological outpatient clinics. Participants completed a questionnaire assessing CCS awareness and participation. Additionally, HPV vaccine knowledge was investigated in a sub-sample of 17,010 women aged <45 years. Results The mean age of participants was 45.06 years (SD: 8.52). The mean CCS knowledge score was 63.13%, with 52.53% reporting prior CCS uptake. Factors associated with lower CCS knowledge included low monthly household income, lack of rural cooperative medical insurance, low literacy, not having received CCS within the past 3 years, unmarried status, and childbirth history. A strong positive correlation was observed between CCS knowledge and adherence to CCS recommendations (Spearman correlation coefficient: 0.708, p < 0.01). Awareness of the HPV vaccine was reported by 48.33% of participants, with HPV vaccine knowledge positively correlated with CCS awareness (Spearman correlation coefficient: 0.629, p < 0.01). CCS knowledge partially mediated the relationship between HPV vaccine knowledge and willingness to vaccinate, with a mediating effect size of 21.16%. Conclusion Integrated health education efforts targeting CCS and HPV vaccine awareness are essential. Empowering women to understand the significance of HPV vaccination and regular CCS participation can enhance cervical cancer prevention strategies.
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Affiliation(s)
- Xinxin Huang
- The Ministry of Health, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, People’s Republic of China
| | - Guanyu Ruan
- Laboratory of Gynecologic Oncology, Fujian Clinical Research Center for Gynecologic Oncology, Fujian Matermity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, People’s Republic of China
| | - Pengming Sun
- Laboratory of Gynecologic Oncology, Fujian Clinical Research Center for Gynecologic Oncology, Fujian Matermity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, People’s Republic of China
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Kang C, Qiu L, Duo Y, Bi F, Liu Z, Wang J, Zheng L, Zhao N. HPV18 E6/E7 activates Ca 2+ influx to promote the malignant progression of cervical cancer by inhibiting Ca 2+ binding protein 1 expression. Biotechnol Appl Biochem 2025; 72:104-115. [PMID: 39113388 DOI: 10.1002/bab.2650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 07/25/2024] [Indexed: 02/06/2025]
Abstract
Mounting studies have shown that the oncoproteins E6 and E7 encoded by the human papillomavirus (HPV) genome are essential in HPV-induced cervical cancer (CC). Ca2+ binding protein 1 (CABP1), a downstream target of HPV18-positive HeLa cells that interferes with E6/E7 expression, was identified through screening the GEO Database (GSE6926). It was confirmed to be down-regulated in CC through TCGA prediction and in vitro detection. Subsequent in vitro experiments revealed that knocking down E6/E7 inhibited cell proliferation, migration, and invasion, whereas knocking down CABP1 promoted these processes. Simultaneously knocking down CABP1 reversed these effects. Additionally, the results were validated in vivo. Previous studies have indicated that CABP1 can regulate Ca2+ channels, influencing Ca2+ influx and tumor progression. In this study, it was observed that knocking down CABP1 enhanced Ca2+ inflow, as demonstrated by flow cytometry and confocal microscopy. Knocking down E6/E7 inhibited these processes, whereas simultaneously knocking down E6/E7 and CABP1 restored the inhibitory effect of knocking down E6/E7 on Ca2+ inflow. To further elucidate that E6/E7 promotes CC progression by inhibiting CABP1 expression and activating Ca2+ influx, BAPTA/AM treatment was administered during CABP1 knockdown. It was discovered that Ca2+ chelation could reverse the effect of CABP1 knockdown on CC cells. In conclusion, our results offer a novel target for the diagnosis and treatment of HPV-induced CC.
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Affiliation(s)
- Cong Kang
- Department of Gynecology, Harrison International Peace Hospital, Hengshui, Hebei, China
| | - Lei Qiu
- Department of Pathology, Harrison International Peace Hospital, Hengshui, Hebei, China
| | - Yali Duo
- Central Laboratory, Harrison International Peace Hospital, Hengshui, Hebei, China
| | - FengLing Bi
- Department of Gynecology, Harrison International Peace Hospital, Hengshui, Hebei, China
| | - Zhongjie Liu
- Department of Gynecology, Harrison International Peace Hospital, Hengshui, Hebei, China
| | - Jing Wang
- Department of Gynecology, Harrison International Peace Hospital, Hengshui, Hebei, China
| | - Lei Zheng
- Central Laboratory, Harrison International Peace Hospital, Hengshui, Hebei, China
| | - Ning Zhao
- Department of Gynecology, Harrison International Peace Hospital, Hengshui, Hebei, China
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Song SY, Guo Y, Li YH, Wang Z, Gao W. Analysis of factors influencing HPV vaccination intention among Chinese college students: structural equation modeling based on health belief theory. Front Public Health 2025; 12:1510193. [PMID: 39949340 PMCID: PMC11821927 DOI: 10.3389/fpubh.2024.1510193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2024] [Accepted: 12/16/2024] [Indexed: 02/16/2025] Open
Abstract
Background Increasing human papillomavirus (HPV) vaccination rates is vital for achieving society-wide public health goals, yet current research on HPV vaccine-related knowledge, vaccination intentions, and behaviors among college students in ethnic minority regions is inadequate. This investigation sought to explore the present circumstances of college students in China's ethnic minority regions concerning their awareness, attitudes, and practices related to the HPV vaccine. This study also aimed to provide a scientific basis for future health education and HPV vaccine promotion in China's college student population. Methods Based on health belief theory, 1,388 valid questionnaires were collected online to investigate college students' knowledge, beliefs, and behaviors related to HPV vaccination and the factors influencing their willingness to be vaccinated. The data were analyzed via SPSS 26.0 for descriptive analysis and Amos 24.0 for structural equation modeling, factor analysis and path analysis. Results The overall HPV vaccine awareness rate was 77.9%. In terms of health attitudes, the positive intention rate was 50.4%, with females having more positive attitudes than males (OR = 2.242, 95% CI = 1.777-2.829). In terms of health behaviors, the rate of positive behaviors was low (40.0%), and the probability of positive behaviors was significantly lower for students with nonmedical-related majors than for those with medical majors (OR = 0.579, 95% CI = 0.442-0.759). The results of the structural equation modeling analysis revealed that college students' perceptions of the perceived benefits of the HPV vaccine positively and directly affect their willingness to be vaccinated (β = 0.290, p < 0.001), and perceived severity has an indirect effect on their willingness to be vaccinated (β = 0.198, p < 0.05). Conclusion Although college students in ethnic minority areas have a high rate of HPV-related knowledge, their willingness to be actively vaccinated and their positive behaviors need to be improved. In addition, enhancing the levels of perceived severity and perceived efficacy among college students can help increase their willingness to receive the HPV vaccine.
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Affiliation(s)
- Shi-Yuan Song
- Department of Epidemiology, Preventive Medicine, Medical School, Yanbian University, Yanji, China
| | - Ying Guo
- Department of Epidemiology, Preventive Medicine, Medical School, Yanbian University, Yanji, China
| | - Yi-Hua Li
- Department of Epidemiology, Preventive Medicine, Medical School, Yanbian University, Yanji, China
| | - Zheng Wang
- Department of Epidemiology, Preventive Medicine, Medical School, Yanbian University, Yanji, China
| | - Wei Gao
- School Hygiene and Disinfection Products Hygiene Supervision Section, Yanji City Center for Disease Control and Prevention, Yanji, China
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Krishna E, Patil SK, Nirala SK, Naik BN, Kumar V, Singh CM, Kumar V. Understanding cervical cancer, human papillomavirus (HPV), and HPV vaccine acceptance in college-going students: Institutional-based cross-sectional study from Bihar State. J Family Med Prim Care 2025; 14:363-370. [PMID: 39989516 PMCID: PMC11845009 DOI: 10.4103/jfmpc.jfmpc_1277_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 08/29/2024] [Accepted: 09/17/2024] [Indexed: 02/25/2025] Open
Abstract
Background Cervical cancer is the second leading cause of cancer-related deaths in Indian women, constituting a significant public health problem. Improving knowledge regarding cervical cancer, human papillomavirus (HPV), and HPV vaccines will help in increased vaccine acceptance and prevention of cervical cancer. Material and Methods This cross-sectional study was conducted among 801 college-going students of Patna, Bihar, using a predesigned, semistructured, self-administered questionnaire. Data analysis was performed using the SPSS version 20 (Statistical Package for Social Sciences) software. Results A total of 801 students participated in the study, and the mean (SD) age was 20.6 ± 2.2 years. The knowledge of students in the medical group was found to be higher than that in the nonmedical group. In the medical group, 93% of the students were aware of cervical cancer versus 71.3% students in the nonmedical group. Awareness regarding the etiological role of HPV in cervical cancer was 84.3% in the medical group compared to 16% in the nonmedical group. Most (82.5%) medical students knew of the existence of a vaccine against HPV in contrast to just 12.5% of the nonmedical group. Willingness to take the vaccine in the medical group was 84.3% versus 46.5% in the nonmedical group. Willingness to pay for the vaccine was reported by 55.6% and 7.5% in the medical and nonmedical groups, respectively. Conclusion The comparative results of the two groups identified specific areas where awareness campaigns should be intensified for both medical and nonmedical groups. This study further highlighted nonmedical students, which also represents the general population has very less knowledge about HPV and the HPV vaccine. The findings emphasize the importance of awareness campaigns and educational interventions to improve understanding and vaccine uptake among potential beneficiaries.
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Affiliation(s)
- Ekta Krishna
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Shreyas Kumar Patil
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Santosh Kumar Nirala
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Bijaya Nanda Naik
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Vijay Kumar
- Department of Community Medicine, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Chanda Mani Singh
- Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Vijay Kumar
- Department of Radiology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
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Chen X, Xu T, Wu J, Sun C, Han X, Wang D, Zhang Z, Qiao C, Tao X. Exploring factors influencing awareness and knowledge of human papillomavirus in Chinese college students: A cross-sectional study. Hum Vaccin Immunother 2024; 20:2388347. [PMID: 39140222 PMCID: PMC11326451 DOI: 10.1080/21645515.2024.2388347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 07/09/2024] [Accepted: 08/01/2024] [Indexed: 08/15/2024] Open
Abstract
Cervical cancer remains a significant health burden in China, characterized by high incidence and mortality rates, which are exacerbated by low Human Papillomavirus (HPV) vaccination coverage, leading to substantial loss of productivity, emotional suffering, and family strain. Understanding factors that influence HPV awareness and knowledge is crucial for developing effective educational strategies. This cross-sectional study, conducted from September to October 2022, involved 2,679 college students from various educational institutions in Jiangsu Province, China. Data were collected via an online questionnaire covering demographics, HPV knowledge, and vaccination behaviors. Statistical analyses, including Chi-square tests and multifactorial logistic regression, were used to identify factors influencing HPV knowledge. The study revealed that while over 90% of students correctly identified HPV's transmission and risks, significant knowledge gaps and misconceptions persist, particularly regarding HPV's association with HIV/AIDS and its treatment. Factors significantly associated with better HPV knowledge included age (22-24 years), female gender, being a medical major, being in a relationship, familiarity with HPV, and participation in sexual education programs. Despite a high willingness to receive the HPV vaccine (91.64%), actual vaccination rates remained low. These findings suggest that while Chinese college students were generally aware of HPV, targeted educational interventions are essential to address knowledge gaps and promote HPV vaccination effectively.
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Affiliation(s)
- Xian Chen
- Department of Gynecology, Women's Hospital of Nanjing Medical University (Nanjing Women and Children's Healthcare Hospital), Nanjing, PR China
| | - Ting Xu
- Public Health Department, Jiangsu Health Vocational College, Nanjing, PR China
| | - Jinfeng Wu
- School of Nursing, Nanjing Medical University, Nanjing, PR China
| | - Cuihua Sun
- Secretary Department, Jiangsu Nursing Association, Nanjing, China
| | - Xue Han
- Department of Gynecology, Women's Hospital of Nanjing Medical University (Nanjing Women and Children's Healthcare Hospital), Nanjing, PR China
| | - Dan Wang
- Oncology Department, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, PR China
| | - Zhengxian Zhang
- Public Health with Concentration in Biostatistics, University of California, San Diego, USA
| | - Chengping Qiao
- Department of Gynecology, Women's Hospital of Nanjing Medical University (Nanjing Women and Children's Healthcare Hospital), Nanjing, PR China
| | - Xiaoxiang Tao
- Department of Gynecology, Women's Hospital of Nanjing Medical University (Nanjing Women and Children's Healthcare Hospital), Nanjing, PR China
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Zhao C, Zhao Y, Li J, Li M, Shi Y, Wei L. Opportunities and challenges for human papillomavirus vaccination in China. Hum Vaccin Immunother 2024; 20:2329450. [PMID: 38575524 PMCID: PMC10996835 DOI: 10.1080/21645515.2024.2329450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/08/2024] [Indexed: 04/06/2024] Open
Abstract
Current estimates of the HPV infection rate in China vary by geographic region (9.6-23.6%), with two age peaks in prevalence in women ≤20-25 years of age and 50-60 years of age. HPV-16, 52 and 58 are the most commonly-detected HPV genotypes in the Chinese population. In China, five HPV vaccines are licensed and several others are undergoing clinical trials. Multiple RCTs have shown the efficacy and safety of the bvHPV (Cervarix), Escherichia coli-produced bvHPV (Cecolin), Pichia pastoris-produced bvHPV (Walrinvax), qvHPV (Gardasil) and 9vHPV (Gardasil-9) vaccines in Chinese populations, including two studies showing long-term efficacy (≥8 years) for the bvHPV and qvHPV vaccines. Real-world data from China are scarce. Although modeling studies in China show HPV vaccination is cost-effective, uptake and population coverage are relatively low. Various policies have been implemented to raise awareness and increase vaccine coverage, with the long-term aim of eliminating cervical cancer in China.
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Affiliation(s)
- Chao Zhao
- Gynaecology, Peking University People’s Hospital, Beijing, China
| | - Yun Zhao
- Gynaecology, Peking University People’s Hospital, Beijing, China
| | - Jingran Li
- Gynaecology, Peking University People’s Hospital, Beijing, China
| | - Mingzhu Li
- Gynaecology, Peking University People’s Hospital, Beijing, China
| | - Yujing Shi
- MRL Global Medical Affairs, MSD China, Shanghai, China
| | - Lihui Wei
- Department of Gynecology and Obstetrics, Peking University People’s Hospital
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Hu Q, Rui Y, Jiang J, Yang J, Yao H, Yang X, Liu Z, Li C, Pan H, Xie Y. Awareness regarding human papillomavirus and willingness for vaccination among college students with or without medical background in Guizhou Province. Hum Vaccin Immunother 2024; 20:2295992. [PMID: 39693188 DOI: 10.1080/21645515.2023.2295992] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/12/2023] [Accepted: 12/13/2023] [Indexed: 12/20/2024] Open
Abstract
This cross-sectional epidemiological study aimed to investigate awareness regarding human papillomavirus (HPV) and willingness for vaccination among college students with or without medical background in Guizhou Province, China. A logistic regression model was used for univariate and multivariate analyses of cognition to determine factors influencing willingness for vaccination. In total, 2,540 questionnaires were collected, of which 2,360 were valid. The medical and nonmedical groups included 737 (31.2%) and 1,623 (68.8%) individuals, respectively. The medical group had heard of HPV and its vaccines more frequently than the nonmedical group, with the former also having greater awareness than the latter (P < .001). Females (1,325, 56.1%) had heard of HPV and its vaccines more frequently than males (1,035, 43.9%), with the former also having greater awareness than the latter. The cost, safety, and efficacy of the HPV vaccine and lack of knowledge regarding HPV and its vaccines were the main barriers for vaccination. The overall level of knowledge regarding HPV and its vaccines was lower in the nonmedical group and males than in the medical group and females. To help promote willingness for vaccination among the nonmedical group and males, strategies that deepen their knowledge regarding the HPV vaccine are needed.
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Affiliation(s)
- Qiongdan Hu
- School of Public Health, Zunyi Medical University, Zunyi City, Guizhou Province, China
- The First College of Clinical Sciences, Zunyi Medical University, Zunyi City, Guizhou Province, China
| | - Yuanqin Rui
- School of Public Health, Zunyi Medical University, Zunyi City, Guizhou Province, China
| | - Jing Jiang
- School of Public Health, Zunyi Medical University, Zunyi City, Guizhou Province, China
| | - Jing Yang
- School of Public Health, Zunyi Medical University, Zunyi City, Guizhou Province, China
| | - HanYun Yao
- School of Public Health, Zunyi Medical University, Zunyi City, Guizhou Province, China
| | - XiaoFang Yang
- School of Public Health, Zunyi Medical University, Zunyi City, Guizhou Province, China
| | - Zhe Liu
- The First College of Clinical Sciences, Zunyi Medical University, Zunyi City, Guizhou Province, China
| | - Chencui Li
- The First College of Clinical Sciences, Zunyi Medical University, Zunyi City, Guizhou Province, China
| | - Hong Pan
- School of Public Health, Zunyi Medical University, Zunyi City, Guizhou Province, China
| | - Yan Xie
- School of Public Health, Zunyi Medical University, Zunyi City, Guizhou Province, China
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Fallatah DI, Khalil MA, Abd ElHafeez S, Gouda S, Alshanbari HM, Awadalla M, Ahram M, Alosaimi B. Factors influencing human papillomavirus vaccine uptake among parents and teachers of schoolgirls in Saudi Arabia: a cross-sectional study. Front Public Health 2024; 12:1403634. [PMID: 39494075 PMCID: PMC11528711 DOI: 10.3389/fpubh.2024.1403634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 09/30/2024] [Indexed: 11/05/2024] Open
Abstract
Introduction Cervical cancer is a highly prevalent disease among women worldwide. However, the advent of a vaccine against HPV, the main cause of the disease, has prevented its spread. The acceptability of the HPV vaccine to different sectors of the Saudi community has yet to be clarified. Since parents and teachers are major influencers in the decision-making process of vaccination for HPV, this study aimed to assess the knowledge and attitudes of teachers and parents toward cervical cancer, HPV, and the HPV vaccine, and unraveled the factors that would influence recommending the vaccine. Methods A cross sectional study was done among 927 individuals (373 teachers and 356 parents). A newly developed validated questionnaire was used to collect data on knowledge, attitude, and factors influencing cervical cancer, HPV, HPV vaccine. The relationship between different factors with knowledge and attitude were assessed using univariate and multivariate analysis. Results Of the study participants, 94% were females, with a median (Interquartile range) age of 38(31-44) years, 12.2% were teachers, 38.7% were parents and 49.1% were parents and teachers. The majority (78.5%) were married, and 75.6% had at least one child. Among those with children, 88.6% had at least one girl, and among those with girls, 72.2% had at least one girl aged between 10 and 18 years. The total median (IQR) knowledge score was 9 [(-5)-(-26)] and the total median (IQR) attitude score was 49 (43-56). The knowledge score significantly increased by receiving postgraduate education, working in the health or education sectors, if a person knew someone diagnosed with cervical cancer, having girls in the age group of 10-18 years, reading about medical issues or having previously heard about the HPV vaccine. The attitude score significantly increased by high knowledge score and decreased if the person has previously diagnosed with cervical cancer. Conclusion Physician's recommendation and the amount of information on the HPV vaccine, opinions about vaccines in general, and government decrees are the main factors influencing decision on HPV vaccine Uptake. This study emphasizes the role of healthcare providers, awareness of cervical cancer, HPV and its vaccine, and social status, in favoring vaccine uptake in Saudi Arabia.
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Affiliation(s)
- Deema I. Fallatah
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Mohammad Adnan Khalil
- Department of Basic Medical Sciences, Faculty of Medicine, Aqaba Medical Sciences University, Aqaba, Jordan
| | - Samar Abd ElHafeez
- Epidemiology Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Salma Gouda
- AlHelal Specialized Hospital, Egyptian Ministry of Health, Cairo, Egypt
| | - Huda M. Alshanbari
- Department of Mathematical Sciences, College of Science, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Maaweya Awadalla
- Research Center, King Fahad Medical City, Riyadh Second Health Cluster, Riyadh, Saudi Arabia
| | - Mamoun Ahram
- Department of Physiology and Biochemistry, School of Medicine, The University of Jordan, Amman, Jordan
| | - Bandar Alosaimi
- Research Center, King Fahad Medical City, Riyadh Second Health Cluster, Riyadh, Saudi Arabia
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11
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Muhammad ZB, Ezenkwa US, Imoudu IA, Katagum DA, Usman I, George SHL, Schlumbrecht M, Audu BM. Cervical cancer awareness, perception, and attitude among tertiary health institution students in northeastern Nigeria. Front Oncol 2024; 14:1415627. [PMID: 38919519 PMCID: PMC11196799 DOI: 10.3389/fonc.2024.1415627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 05/20/2024] [Indexed: 06/27/2024] Open
Abstract
Background The devastating scourge of cervical cancer in Africa is largely due to the absence of preventive interventions, driven by low awareness and poor perception of the disease in the continent. This work is a preliminary effort toward understanding key social drivers promoting this disease in our immediate environment with a view to mitigating it. Method Female students of two tertiary health institutions in Azare, northeastern Nigeria, were approached to participate in this cross-sectional descriptive study. A structured self-administered questionnaire was administered to consenting participants and covered questions on their socio-demographics, awareness, perception, and attitude about/toward cervical cancer and its prevention. The responses were scrutinized for coherency and categorized into themes using summary statistics, while a chi-square test was used to determine the association between awareness of cervical cancer and participant age, marital status, religion, screening uptake, and willingness to undergo screen. Results Awareness of cervical cancer was recorded among 174/230 (75.7%) respondents who enrolled in this study; 117 (67.2%) knew that it was preventable, but only three (1.3%) respondents had undergone screening. Among the aware participants, 91 (52.3%) and 131 (75.3%) knew that sexual intercourse and multiple sexual partners are risk factors for the disease, respectively. In contrast, knowledge of the etiology was poor; 82 (47.1%) respondents who knew it was preventable had heard about human papillomavirus (HPV), while 72 (41.4%) knew that HPV causes cervical cancer. Most (78%) of the participants expressed willingness to take a human papillomavirus vaccine or undergo screening (84.6%) if made available to them. Awareness was significantly associated with participants' age (p = 0.022) and willingness to undergo screening (p = 0.016). Conclusion This study revealed discordance between awareness and knowledge about cervical cancer. Educational initiatives reflective of population perception/knowledge of cervical cancer are needed to mitigate the rising incidence of this disease, especially among female healthcare providers.
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Affiliation(s)
- Zakia B. Muhammad
- Department of Molecular Biology and Research Laboratory, Federal Medical Centre, Azare, Bauchi State, Nigeria
| | - Uchenna S. Ezenkwa
- Department of Anatomic Pathology, Federal University of Health Sciences, Azare, Bauchi State, Nigeria
| | - Iragbogie A. Imoudu
- Department of Paediatrics, Federal Medical Centre, Azare, Bauchi State, Nigeria
- Department of Paediatrics, Federal University of Health Sciences, Azare, Bauchi State, Nigeria
| | - Dauda A. Katagum
- Department of Obstetrics and Gynaecology, Federal University of Health Sciences/Federal Medical Centre, Azare, Bauchi State, Nigeria
| | - Iliyasu Usman
- National Health Insurance Agency, Federal Medical Centre, Azare, Bauchi State, Nigeria
| | - Sophia H. L. George
- Department of Obstetrics, Gynaecology and Reproductive Sciences, Division of Gynaecologic Oncology, Sylvester Comprehensive Cancer Centre, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Matthew Schlumbrecht
- Department of Obstetrics, Gynaecology and Reproductive Sciences, Division of Gynaecologic Oncology, Sylvester Comprehensive Cancer Centre, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Bala M. Audu
- Department of Obstetrics and Gynaecology, Federal University of Health Sciences/Federal Medical Centre, Azare, Bauchi State, Nigeria
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12
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Zhang N, Ma Q, Zhang X, Huang Q. Implicit theories of health predict HPV vaccination intention among young adult Chinese women: The mediating effect of consideration of future consequences and future self-continuity. J Health Psychol 2024:13591053241253065. [PMID: 38767276 DOI: 10.1177/13591053241253065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024] Open
Abstract
This study investigated the predicting effect of implicit theories of health on HPV vaccination intention among young adult Chinese women and its underlying mechanisms. Four-hundred and eighty-three young Chinese women adults (18-26 years old) participated this study by completing measures on implicit theories of health, consideration of future consequences, future self-continuity, and reported their HPV vaccination intention. The results demonstrated that age, whether they knew someone being diagnosed with cancer, implicit (incremental) theories of health, consideration of future consequences (CFC-Future), and future self-continuity significantly predicted young adult Chinese women's HPV vaccination intention. The predicting effect of implicit theories of health was mediated by consideration of future consequences and future self-continuity. Implications of the current research for promoting HPV vaccination among young adult women and directions for future research are discussed.
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Affiliation(s)
- Ning Zhang
- School of Public Health and the Second Affiliated Hospital of Zhejiang University School of Medicine, China
| | - Qinghua Ma
- The Third Hospital of Xiangcheng District, China
| | - Xiaoying Zhang
- School of Public Health and the Second Affiliated Hospital of Zhejiang University School of Medicine, China
| | - Qing Huang
- College of Media and International Culture, Zhejiang University, China
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13
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Ahmad M, Asrar R, Ahmed I, Bule MH. HPV vaccination: A key strategy for preventing cervical cancer. J Infect Public Health 2024; 17:474-475. [PMID: 38271749 DOI: 10.1016/j.jiph.2023.12.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 12/29/2023] [Accepted: 12/31/2023] [Indexed: 01/27/2024] Open
Affiliation(s)
- Muhammad Ahmad
- Institute of Physiology and Pharmacology, Faculty of Veterinary Science, University of Agriculture, Faisalabad 42000, Punjab, Pakistan
| | - Rida Asrar
- Institute of Physiology and Pharmacology, Faculty of Veterinary Science, University of Agriculture, Faisalabad 42000, Punjab, Pakistan
| | - Ishtiaq Ahmed
- Department of Regional Science Operations, La Trobe Rural Health School, Albury Wodonga 3690, VIC, Australia
| | - Mohammed Hussen Bule
- Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia.
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14
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Abdel-Aziz HR, Mohamed NA, Elsehrawy MG. Knowledge, Attitude, and Practice on Cervical Cancer Prevention among Female University Students in Al -Kharj, Saudi Arabia. SAGE Open Nurs 2024; 10:23779608241279152. [PMID: 39220806 PMCID: PMC11366098 DOI: 10.1177/23779608241279152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 07/25/2024] [Accepted: 08/12/2024] [Indexed: 09/04/2024] Open
Abstract
Background Cervical Cancer (CC) is the fourth most frequent malignancy worldwide among females with significant death rates. It ranks as the 8th most frequent cancer in Saudi female. CC is preventable, with likelihood of full treatment by early detection, because of its long pre-invasive period. Lack of awareness and practice on CC prevention and screening increase the risk of disease. Objective to examine knowledge, attitude, and practice on CC prevention among Saudi female university students. Methods A facility-based cross-sectional study with a convenience sample included 594 female university students studying at health and non-health colleges of Prince Sattam bin Abdulaziz University in Al-Kharj City, Saudi Arabia. All female students were asked to complete an online questionnaire on knowledge, attitude, and practice on CC prevention. Results A total of 594 respondents to the questionnaire, 88.7% of them had unsatisfactory knowledge about CC. Out of a total of 27 points, students' knowledge mean score was 9.3 ± 6.4. Conversely the majority of students (94.4%) had positive attitude toward CC; the mean attitude score was 34.52 ± 5.04 out of 45. Regarding students practice, less than 7% of students were vaccinated against HPV and only 3.7% were screened for cancer cervix. Married females, health colleges students, and high attitude score were significant predictors for the students' knowledge about cancer cervix (P < 0.05). Conclusion Majority of the respondents displayed lack of knowledge; however, they had a positive attitude toward CC. Very alarmingly, almost all of students had inadequate practice regarding CC prevention. So, the study recommends developing and implementing educational programs and strategies for female university students to improve their knowledge and practice related to cervix cancer. Results of this study provide evidence that can help in formulating effective awareness strategies and educational programs for women that would help in CC prevention.
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Affiliation(s)
- Hassanat Ramadan Abdel-Aziz
- College of Nursing, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Gerontological Nursing Department, Faculty of Nursing, Zagazig University, Zagazig, Egypt
| | - Nermen Abdelftah Mohamed
- College of Nursing, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Medical Surgical Nursing Department, Faculty of Nursing, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Mohamed Gamal Elsehrawy
- College of Nursing, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Nursing Administration Department, Faculty of Nursing, Port Said University, Port Said, Egypt
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15
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Chen Y, Huang B, Zheng J, He F. Prediction study of prognostic nutrition index on the quality of life of patients with cervical cancer undergoing radiotherapy and chemotherapy. PeerJ 2023; 11:e15442. [PMID: 37223117 PMCID: PMC10202106 DOI: 10.7717/peerj.15442] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 04/30/2023] [Indexed: 05/25/2023] Open
Abstract
Objective To assess the prognostic nutritional index (PNI) and quality of life (QOL) of patients with cervical cancer (CC) who underwent radiotherapy and chemotherapy and to reveal the effect of PNI on QOL and its prognostic value. Methods A total of 138 CC patients who underwent radiotherapy and chemotherapy in the Second Affiliated Hospital of Fujian Medical University from January 2020 to October 2022 were selected as the study subjects via convenient sampling. According to the PNI cut-off value of 48.8, they were divided into a high-PNI group and a low-PNI group, and the quality of life of the two groups was compared. The Kaplan-Meier method was used to draw the survival curve, and the Log-Rank test was employed to compare the survival rates of the two groups. Results The scores of physical functioning and overall QOL in the high-PNI group were significantly higher than those in the low-PNI group (P < 0.05). The scores of fatigue, nausea and vomiting, pain and diarrhea were higher than those in the low-PNI group, and the difference was statistically significant (P < 0.05). The objective response rates were 96.77% and 81.25% in the high-PNI group and the low-PNI group, respectively, and the difference was statistically significant (P = 0.045). The 1-year survival rates of patients with high PNI and low PNI were 92.55% and 72.56% in the high-PNI group and the low-PNI group, respectively; the difference in survival rates was statistically significant (P = 0.006). Conclusion The overall quality of life of CC patients with low PNI receiving radiotherapy and chemotherapy is lower than that of patients with high PNI. Low PNI reduces the tolerance to radiotherapy and chemotherapy and the objective response rate, which can be used as a prognostic indicator for cervical cancer patients.
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Affiliation(s)
- Ying Chen
- Department of Radiation Oncology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| | - Bifen Huang
- Department of Obstetrics and Gynecology, Quanzhou Medical College People’s Hospital Affiliated, Quanzhou, Fujian, China
| | - Jianqing Zheng
- Department of Radiation Oncology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| | - Fangjie He
- Department of Obstetrics and Gynecology, The First People’s Hospital of Foshan, Foshan, Guangdong, China
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
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Gelassa FR, Nagari SL, Jebena DE, Belgafo D, Teso D, Teshome D. Knowledge and practice of cervical cancer screening and its associated factors among women attending maternal health services at public health institutions in Assosa Zone, Benishangul-Gumuz, Northwest Ethiopia, 2022: a cross-sectional study. BMJ Open 2023; 13:e068860. [PMID: 37188474 DOI: 10.1136/bmjopen-2022-068860] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Cervical cancer ranks as the second most frequent cancer among all women in Ethiopia and the second most frequent cancer among women between 15 and 44 years of age, resulting in over 4884 moralities annually. Although there is a focus on health promotion through teaching and screening in Ethiopia's intended transition toward universal healthcare, there is little information available on baseline levels of knowledge and screening uptake related to cervical cancer. OBJECTIVES This study explored the levels of knowledge and screening rates of cervical cancer along with its associated factors among women of reproductive age in Assosa Zone, Benishangul-Gumuz, Ethiopia in 2022. METHODOLOGY A facility-based cross-sectional study was conducted. A systematic sampling technique was used to select 213 reproductive-age women from selected health institutions, from 20 April 2022 to 20 July 2022. A validated and pretested questionnaire was used for data collection. Multi-logistic regression analyses were done to identify factors independently associated with cervical cancer screening. Adjusted OR with 95% CI was estimated to measure the strength of association. The level of statistical significance was declared at a p value of <0.05. The results were presented in tables and figures. RESULT Knowledge of cervical cancer screening in this study was 53.5%, and 36% of respondents had practised cervical cancer screening. Family history of cervical cancer (AOR)=2.5, 95% CI (1.04 to 6.44)), place of residence (AOR=3.68, 95% CI (2.23, 6.54)) and availability of health services at nearby (AOR=2.03, 95% CI (1.134, 3.643)) were significantly associated with knowledge of cervical cancer screening, while educational status (AOR=2.811, 95% CI (1.038 to 7.610)), knowing someone diagnosed with cervical cancer (AOR=8.3, 95% CI (2.4, 28.69)), Knowledge of cervical cancer(AOR=2.17, 95%CI(1.077, 4.384) and feeling feeling at risk (AOR=3.26 95% CI (1.52, 5.04)) were associated with the practice of cervical cancer screening. CONCLUSION AND RECOMMENDATION Knowledge and practice of cervical cancer screening in this study were low. Therefore, the reproductive women must be encouraged to have early cervical cancer screening at precancerous stage by informing their susceptibility to cervical cancer.
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Affiliation(s)
| | | | | | - Dabeli Belgafo
- Nursing, Assosa University, Assosa, Benishangul-Gumuz, Ethiopia
| | - Daniel Teso
- Nursing, Assosa University, Assosa, Benishangul-Gumuz, Ethiopia
| | - Debela Teshome
- Nursing, Assosa University, Assosa, Benishangul-Gumuz, Ethiopia
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Gao D, Zhao G, Di J, Zhang X, Wang L. Knowledge of Cervical Cancer and HPV, and Willingness to Receive HPV Vaccination Among 20–45-Year-Old Women — Six Provinces, China, 2018. China CDC Wkly 2023; 5:201-205. [PMID: 37007864 PMCID: PMC10061828 DOI: 10.46234/ccdcw2023.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
What is already known about this topic? Cervical cancer is a significant public health problem with approximately 570,000 cases and 311,000 deaths occurring in 2018 globally. It is imperative to raise awareness of cervical cancer and human papillomavirus (HPV). What is added by this report? Compared to previous studies, this is one of the largest cross-sectional studies of cervical cancer and HPV in Chinese adult females in recent years. We found that knowledge level of cervical cancer and HPV vaccine was still inadequate among women aged 20-45 years old, and the willingness to receive HPV vaccination was highly associated with knowledge level. What are the implications for public health practice? Intervention programs should aim to improve awareness and knowledge about cervical cancer and HPV vaccines, primarily focusing on women of lower socio-economic status.
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Affiliation(s)
- Di Gao
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Gengli Zhao
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Jiangli Di
- National Centre for Women and Children’s Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaosong Zhang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
- Xiaosong Zhang,
| | - Linhong Wang
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Linhong Wang,
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