Determination of knowledge levels, attitude and behaviors of female university students concerning cervical cancer, human papiloma virus and its vaccine

Actions speak louder than words; pediatricians, gynecologists, nurses, and other mothers' perspectives on the human papillomavirus vaccine: an Istanbul multicenter study

Introduction

Gynecologists and pediatricians have an essential duty to prevent cervical cancer. In this study, we compared the compliance of gynecologists (n = 22) and pediatricians (n = 49) with nurse/midwife (n = 66) and non-medical moms (n = 120) with regards to cervical cancer precautions.

Methods

A questionnaire was used to gather data on their demographics, personal vaccination and screening practices, children's immunization status, and awareness of cervical cancer prevention.

Results

The findings demonstrated that gynecologists and pediatricians were better than others at understanding the risk factors and prevention of cervical cancer. It was noted that compared to other groups, physician mothers and their offspring had higher vaccination rates (n = 13, 18.3%; n = 10, 29.4%, respectively). Medical professionals typically provided thorough and accurate answers to informational questions. More frequent Pap smear tests were performed by gynecologists. It was noted that mothers who worked as pediatricians and nurses/midwives neglected their own screening needs.

Discussion

This questionnaire survey sought to ascertain Istanbul's health professionals' present opinions regarding HPV vaccination. Healthcare professionals should be the first to receive information on HPV vaccination and cervical cancer incidence reduction. The public could then readily use them as an example.

Knowledge and Attitudes toward Human Papillomavirus and Vaccination: A Survey among Nursing Students in Saudi Arabia

INTRODUCTION

One of the most prevalent conditions affecting the vaginal organs is the human papilloma virus (HPV). Human papillomavirus (HPV) knowledge and attitudes have been the subject of numerous studies in Saudi Arabia. However, there are only a few studies that have examined university students' attitudes and knowledge of the human papillomavirus and the vaccine that is associated with it.

AIM

To predict the level of knowledge and attitudes regarding HPV and its related vaccine among undergraduate nursing students.

METHODOLOGY

This was descriptive cross-sectional research. After being selected from Princess Nourah bint Abdulrahman University's College of Nursing, 307 nursing students agreed to take part and completed an online survey that was self-administered.

RESULTS

The majority of the participants (73.5%) had a low level of knowledge of HPV with a mean score of 2.77 ± 1.78. In addition, more than half of the participating nursing students (57%) had a moderate attitude toward HPV vaccination with a mean score of 51.18 ± 11.16. The study results also verified that there was a highly significant correlation between the nursing students' demographics and their knowledge and attitudes toward HPV (p < 0.001). According to the SEM, nursing students' knowledge regarding HPV accounted for 48% of the variance in students' attitudes.

CONCLUSION

Nursing students' knowledge regarding HPV vaccination is an important predictor of students' attitudes regarding HPV.

Knowledge and attitude towards human papillomavirus and its vaccination and affecting factors among nursing and medical students: a questionnaire study

The aim of this study was to investigate the knowledge about the Human Papillomavirus (HPV), HPV testing and HPV vaccinations and affecting factors among nursing and medical students and explore their attitudes regarding HPV vaccination. A cross-sectional study was conducted with 635 undergraduate nursing and medical students from March to June 2020 at a state university in Turkey. The data were collected using the Questionnaire Form and HPV Knowledge Scale (HPV-KS). The HPV-KS mean scores of the students were 17.07 ± 6.95. The students were aged 26 and over, females, had good economic status, registered at the faculty of medicine, at higher year of studies, had sexual experience and recommended HPV vaccination got higher knowledge scores regarding HPV, HPV testing and HPV vaccination (p ˂ .05). Despite low vaccination rate (2.0%), almost all the students recommended the HPV vaccine (95.9%). Sex, place of residence, faculty (departments), and year of study are among the significant predictor of knowledge about HPV, HPV testing and HPV vaccinations level up to 39% (p ˂ .05). This study highlights the need for further education and training are required to increase the knowledge about HPV, HPV testing and HPV vaccination, which may help increase awareness and improve the ratio of vaccination.IMPACT STATEMENTWhat is already known on this subject? Human papillomavirus (HPV) is one of the most common sexually transmitted diseases and most likely to cause cervical cancer. Prophylactic vaccine administrations is critical in primary protection from HPV.What the results of this study add? The study revealed the needs for education among nursing and medical students about HPV, HPV testing and HPV vaccines. Knowledge regarding HPV, HPV testing and HPV vaccines is statistically significantly associated with age, sex, economic status, place of residence, faculty, year of study, sexual experience and recommending HPV vaccines. Sex, place of residence, faculty, and year of study are among the statistically significant positive predictors for HPV knowledge.What the implications are of these findings for clinical practice and/or further research? Educators should increase education and/or training opportunities related to HPV among nursing and medical students who are the future healthcare providers and in the risky group for HPV during undergraduate education.

Awareness of human papillomavirus and acceptability of the vaccine among women in Palestine: is it time for policy adjustment?

Background

Progress has been made in the reduction of morbidity and mortality of cervical cancer by the implementation of human papillomavirus (HPV) vaccination programs. This study aimed to assess the awareness of Palestinian women about HPV as well as their knowledge and acceptability of the HPV vaccine and to examine the factors associated with good awareness.

Methods

This was a national cross-sectional study. Adult women were recruited from hospitals, primary healthcare centers, and public spaces in 11 Palestinian governorates using convenience sampling. A structured questionnaire was used for data collection. For each correctly answered question, one point was given. The total score was calculated and categorized into poor (0–10) and good awareness (11–21).

Results

The questionnaire was completed by 7223 women out of 8086 who were approached (response rate = 89.3%). A total of 7058 questionnaires were included in the final analysis; 4403 from the West Bank and Jerusalem (WBJ) and 2655 from the Gaza Strip. Women recruited from the Gaza Strip were younger, getting lower monthly incomes, and with fewer chronic diseases than women recruited from the WBJ.

Only 33 women (0.5%) displayed good awareness of HPV and its vaccine with 0.7% of women from WBJ and only 0.2% of women from the Gaza Strip. Completing post-secondary education, being employed or a student, and having a higher monthly income were associated with an increase in the likelihood of having good awareness.

Among women who had heard of HPV (n = 571, 8.1%), only 46 women (8.1%) reported familiarity with its vaccine. Women from the WBJ were more likely than women from the Gaza Strip to have heard about the HPV vaccine (0.9% vs. 0.2%). Most women agreed to receive the HPV vaccine themselves or for their daughters if it was given without cost or with a co-payment. No differences were found in the likelihood of agreeing to receive the HPV vaccine among women in the WBJ versus the Gaza Strip.

Conclusion

The overall awareness of HPV and its vaccine was extremely low. Inclusion of the HPV vaccine in the national immunization program could change this, especially as the HPV vaccine appeared to be acceptable.

Knowledge and Use of Cervical Cancer Prevention Services among Social Work and Nursing University Students

The present study examines: (a) the knowledge of healthcare students on cervical cancer (CC) issues and the use of related preventive services, as well as their association with the field of study and other sociodemographic characteristics; (b) the possible effect of social capital and its parameters. A cross-sectional study was conducted, using a convenience non-probability sampling technique. The final sample consisted of forty-nine social work and fifty-one nursing students. The two groups were similar regarding their sociodemographic characteristics and the knowledge and use of gynecological preventive services. However, the nursing students undertook a PAP smear check-up to a lesser extent (48.6%) compared to social work students (51.4%) (p = 0.026). The social capital scores were high for both groups, but social work students were significantly more ‘Tolerant to diversity’. For the total sample, only the ‘Family and friends connections’ subscale correlated with knowledge about the existing gynecological preventive services. Among the main reasons explaining university students’ avoidance of preventive testing were the feelings of fear and embarrassment associated with the PAP smear test. Given the significance of the future professional roles of healthcare students as information sources and leaders in women’s CC preventive behavior, understanding the individual factors contributing to their own adherence is essential. It is equally important to increase their scientific knowledge through the improvement of academic curricula regarding these issues.

Knowledge, Attitude, and Practice on Cervical Cancer and HPV Vaccination among Medical Students in Jakarta, Indonesia: A Cross-Sectional Study

BACKGROUND: Cervical cancer is the second-most common cancer in Indonesian women. While the cervical cancer screening has been integrated in Indonesian primary health-care facilities, the HPV vaccination has not yet become a national program. AIM: The objective of this research was to measure the knowledge, attitude, and behavior of medical students in Jakarta toward cervical cancer and its prevention. The result of this study could be implemented to develop a more comprehensive national educational program and public health policy. METHODS: We conducted a cross-sectional study on medical students at 10 different universities in Jakarta, Indonesia. Student’s knowledge, attitude, and behavior were collected through a self-administered online questionnaire consist of a total of 27 questions concerning cervical cancer epidemiology, pathogenesis, screening, diagnosis, and prevention. RESULTS: A total of 2159 medical students participated in this study. More than half (55%) of the students obtained satisfactory knowledge score. The students’ knowledge regarding HPV vaccination was low. However, 87.2% of them agreed to get the HPV vaccination. Only 7.0% had participated in cervical cancer screening program and only 16.8% had received HPV vaccination. Female gender, second or third year of study, and three universities had better odds to have good practice score. CONCLUSION: The knowledge and attitude score did not reflect on student’s practice on cervical cancer and its prevention. Effort to increase the awareness toward cervical cancer should be endorsed through university curriculum and public health policy.

The correlation between high-risk HPV infection and precancerous lesions and cervical cancer

OBJECTIVE

To analyze the correlation between high-risk human papillomavirus (HPV) infection and precancerous lesions and cervical cancer.

METHODS

Patients with cervicitis (N=100), cervical intraepithelial neoplasia grade I (CIN I) (N=100), cervical intraepithelial neoplasia grades II-III (CIN II-III) (N=100) and cervical cancer (N=100) were enrolled. The exfoliated cervical cells were collected with the same method, and the detection of the HPV types was carried out by PCR-reverse dot blot (RDB) assay.

RESULTS

The top 5 HPV types in stage I-II cervical cancer were 16, 18, 52, 58, and 53, with a HPV positivity rate of 83.61%, while top 5 HPV types in stage III-IV cervical cancer were 16, 18, 58, 52, and 33, with a HPV positivity rate of 82.05%. The rate of high-risk HPV positivity for cervicitis was 5%, with HPV types of 16, 18, 52, and 33, 12% for CIN I, with HPV types of 16, 58, 52, 33, 56, 66, and 68, and 42% for CIN II-III, with HPV types of 16, 18, 58, 52, 33, 66, and 68. The prevalence of single, dual, and multiple HPV infection was 8.00%, 1.00%, and 0.00% for CIN I, 24.00%, 7.00%, and 1.00% for CIN II-III, and 57.00%, 25.00%, and 3.00% for cervical cancer, respectively. The age of patients with CIN I was mainly ≤24 and 25-34 years while CIN II-III in 25-34 and 35-44 years, and cervical cancer in 35-44 and 45-54 years.

CONCLUSION

The distribution of HPV subtypes in cervical cancer is closely related to the pathological types, lesion grades, and stages of cervical cancer. The incidence of cervical lesions varies with age, suggesting that high-risk groups should be well monitored and receive regular screening and timely HPV vaccination to effectively prevent cervical cancer.

Knowledge of the Human Papillomavirus by Social Stratification Factors

BACKGROUND

Social determinants of health explain most health inequities. Intermediate determinants dictate differences in the exposure and vulnerability of people based on social stratification. Vulnerable women (lower education level, older age, uninsured, etc.) have lower adherence to recommended Pap smear screening guidelines. However, a gap remains concerning the effect of social determinants on human papillomavirus (HPV) infection.

OBJECTIVES

The aim of this study was to analyze the association between the level of knowledge about HPV infection and HPV vaccines with education level and residential setting among a sample of Spanish women.

METHODS

A cross-sectional study at six primary care centers (Cantabria, Spain) was performed. All women >21 years consecutively attended by midwives for routine follow-up were invited to participate during the study period (2015-2016) until a convenience sample was recruited. Participants completed an anonymous questionnaire addressing sociodemographic variables (age, education level, and residential setting) and the level of knowledge regarding HPV infection, including general knowledge about infection and knowledge about the HPV vaccine. Associations between education level (primary, secondary, and university) and residential setting (urban, semiurban, and rural) with the level of knowledge of HPV infection and HPV vaccine were calculated using adjusted logistic regressions. Dose-response associations were estimated based on p-trend.

RESULTS

Compared to university women, a lower education level was associated with limited or no knowledge of either HPV infection or the HPV vaccine. Women living in rural areas poorly identified "promiscuity" as a risk factor of HPV infection and "the use of condoms" as a protective factor. Moreover, living in rural areas was associated with limited or no knowledge of HPV infection and HPV vaccine. There were significant dose-response trends; those who were more educated and living in more urban areas had more knowledge about either HPV infection or the vaccine.

DISCUSSION

In our sample, the level of knowledge of HPV infection and HPV vaccine was high. However, vulnerable women, defined by a lower education level and living in rural areas, presented a greater lack of knowledge regarding HPV infection and the HPV vaccine.

Knowledge gaps and acquisition about HPV and its vaccine among Brazilian medical students

Objective

To analyze factors associated with knowledge gaps and acquisition about HPV and its vaccine among medical students.

Method

Cross-sectional and analytical study conducted at the University of São Paulo Medicine School, in 2016. A convenience sample of students completed a data collection instrument containing questions on knowledge about HPV and its vaccine, and vaccine acceptability. The level of knowledge and acceptability established as a "good level" was 80% of correct answers on the questionnaire. Internal validity was calculated with Cronbach's alpha value (α) = 0.74. Bivariate and multiple analyzes were performed using the Stata® program (Stata Corp, College Station, USA) 14.0.

Results

To evaluate the internal consistency of the instrument applied, the Cronbach's alpha equation was used, obtaining the alpha value (α) = 0.74 for this population. This value attests that the consistency of the answers obtained with this questionnaire is considered substantial and acceptable. Among the 518 medical students who completed the survey, the majority were men 312 (60.4%) with a mean age of 23 (± 2.8) years old; 199 (38.3%) of the students were in the final years of graduation (5th and 6th years). Students in the first, second and third year of study had a 51% higher risk of a knowledge gap when compared to students in the final years of graduation [PR 1.51 (1.3:1.8); p <0.001]. Men were at 22% higher risk of unsatisfactory knowledge than women are [PR 1.22 (1.07: 1.39). There was no knowledge acquisition during medical school in the following questions (p <0.05), indication of vaccine for individuals with HIV and contraindication in pregnant patients.

Conclusion

Male medical students, in the first year of medical school, and those who were not vaccinated had significant knowledge gaps about HPV. The novelty of the study includes the finding of non- acquisition of knowledge during the medical school graduation on safety and vaccination schedule and vaccine administration in specific populations.

Knowledge, Attitudes, and Intentions towards Human Papillomavirus Vaccination among Nursing Students in Spain

Human papillomavirus (HPV), which is linked to specific types of cancer, can be prevented by vaccination. This study aimed to determine the knowledge and attitudes of nursing students about HPV and its vaccine as well as their intentions towards personal vaccination. A total of 536 Spanish nursing students were invited to complete the Spanish version of the questionnaire “Knowledge, attitudes and intentions towards HPV”. Overall, 367 surveys were completed (68.4% response rate). Data analysis included the calculation of three scores: the knowledge score, categorized into low (<33%), moderate (33%–66%), and good knowledge (>66%); the attitude score, sorted into positive (<2.5), neutral (2.5–3.5), and negative attitude (>3.5); and the intention score, categorized into not favorable (<4), neutral (4–7), and favorable intention (>7). Knowledge about HPV and its vaccine was moderate (54.34 ± 0.9%), and the attitude towards vaccination was positive (2.34 ± 0.03). The intention towards personal vaccination increased significantly after completing the questionnaire (before: 4.14 ± 0.27, after: 6.02 ± 0.28; p < 0.001). The present study highlights the need of training future nurses about HPV and its vaccine, considering the important role it plays in the prevention of sexually transmitted diseases.

Knowledge of human papillomavirus and Pap test among Brazilian university students

SUMMARY OBJECTIVE: Human papillomavirus (HPV) is the most prevalent sexually transmitted virus in the world and is associated with an increased risk of cervical cancer. The most effective approach to cervical cancer control continues to be screening through the preventive Papanicolaou test (Pap test). This study analyzes the knowledge of university students of health science programs as well as undergraduate courses in other areas of knowledge on important questions regarding HPV. METHOD: Four hundred and seventy-three university students completed a questionnaire assessing their overall knowledge regarding HPV infection, cervical cancer, and the Pap test. A descriptive analysis is presented, and multivariate analysis using logistic regression identified factors associated with HPV/cervical cancer information. RESULTS: Knowledge was higher for simple HPV-related and Pap test questions but was lower for HPV interrelations with genital warts and cervical cancer. Being from the health science fields and having high income were factors associated with greater knowledge. Only the minority of the participants recognized all the situations that increased the risk of virus infection presented in the questionnaire. CONCLUSIONS: These findings highlight the need for educational campaigns regarding HPV infection, its potential as a cervical cancer agent and the forms of prevention available.

Knowledge on the HPV vaccine among university students

The objective is to evaluate knowledge on HPV vaccine and its use among university students. This is a cross-sectional study with 301 participants, of which 202 medical students from UERJ and UNIFESO (101 freshmen = M1 and 101 from the 6th year = M2) and 99 UERJ literature students (50 freshmen = L1 and 49 of the last year = L2). Information was obtained by questionnaires. Input and statistical analysis were carried out with the EPI-INFO 3.5.2 Program. Results showed that, among medical students, 21% of M1 and 16% of M2 used the HPV vaccine (p=0.35), mostly adopted by women (M1=29.7% and M2=21.3%) than men (M1=5.4% and M2=7.5%). Similarly, female students showed more interest in using the vaccine (M1=85.1% and M2=80%) than male (M1=56.2% and M2=20.5%). Among literature students, only women received the vaccine (L1=6.5% and L2=22.2%) and no men were vaccinated (p=0.04). More women expressed interest in receiving the vaccine than men (♀ L1=76%, L2=65% and ♂, L1=47%, L2=40%). Comparison among genders regardless of the course showed that the vaccination rate is higher among women (p<0.001), as is the interest in being vaccinated (p=0.004). We concluded that the majority of male university students know less about the HPV vaccine than the female ones, use less and are less interested in being vaccinated, in all the groups interviewed. Vaccination coverage is low among the university population and is higher among medical students.

Assessment of community health volunteers' knowledge on cervical cancer in Kadibo Division, Kisumu County: a cross sectional survey

Background

Globally, cervical cancer is the fourth most frequent cancer in women, with an estimated 530,000 new cases in 2012, representing 7.5% of all female cancer deaths. Of the estimated more than 270,000 deaths from cervical cancer every year, more than 85% occur in less developed regions. In sub-Saharan Africa, 34.8 new cases of cervical cancer are diagnosed per 100,000 women annually, and 22.5/100,000 women die from the disease. Despite the magnitude of this problem, Kenya still has a screening rate of 3.2%; therefore, cervical cancer prevalence has not been established. Community Health Volunteers (CHV) are required to create demand for screening in the community and capture this in the Ministry of Health (MOH) reporting tool MOH 514. The objective of this study was to determine the knowledge of risk factors, signs and symptoms of cervical cancer and screening services’ availability amongst CHVs to enable them sensitize the community about cervical cancer in Kadibo Division, Kisumu County.

Method

In a cross-sectional study, a saturated sample of 188 CHVs was interviewed. The knowledge of cervical cancer was presented by use of frequencies and proportions; the relationship between demographic characteristics and knowledge was determined using chi-square.

Results

A majority, 161 (85.6%), were women, 47 (25.0%) were aged 40–44, 91 (48.4%) had primary education and 132 (70.2%) were small-scale farmers. A total of 128 (68.1%) had low, 60 (31.9%) had average and none had high amount of knowledge of risk factors. On average, 95 (50.5%) had low, 15 (8.0%) had average and 78 (41.5%) had high amount of knowledge of signs and symptoms. Finally, 77 (41.0%) had high, 40 (21.2%) had average and 71 (37.8%) had low knowledge of the availability of screening services. Education (p = 0.012, χ² = 3.839), occupation (p < 0.0001, χ² = 12.722), and health centre of attachment (p < 0.0001, χ² = 71.013) were significant factors in determining the knowledge of risk factors. The knowledge of the signs and symptoms of cervical cancer was determined by the occupation of the CHVs (p = 0.030, χ² = 15.110) and the years of work as a CHV (p = 0.014, χ² = 8.451). Finally, the education level (p = 0.011, χ² = 8.605), occupation (p = 0.002, χ² = 18.335) and health centre of attachment (p < 0.0001, χ² = 101.705) were significant in determining the knowledge of availability of screening services at the various health facilities.

Conclusion

The following were found to significantly influence the knowledge of CHVs about cervical cancer: level of education, occupation, health facility of attachment and years of service as a CHV. There is need, therefore, for training on cervical cancer.