Sociodemographic factors associated with HPV awareness/knowledge and cervical cancer screening behaviors among caregivers in the U.S

Misconceptions and knowledge gaps about HPV, cervical cancer, and HPV vaccination among central American immigrant parents in the United States

Cervical cancer is one of the most preventable cancers globally, yet it remains a significant health issue, primarily due to persistent high-risk human papillomavirus (HPV) infection. Ethnic minority and immigrant populations experience notable gaps in knowledge about HPV, the HPV vaccine, and its link to cervical cancer. This study assessed awareness and understanding of HPV, the HPV vaccine, and its connection to cervical cancer among Central American immigrant parents in the United States. A qualitative, exploratory study used in-depth, semi-structured interviews. Both inductive and deductive thematic analyses were conducted with MAXQDA software to identify key themes related to participants' awareness of HPV, the vaccine, and its link to cervical cancer. Fifty-six parents (33 mothers, 23 fathers; mean age = 42.7 years), nearly all foreign-born (92.8%) from El Salvador, Guatemala, and Honduras (average 17.3 years of U.S. residency), participated in the study. Only 26.8% (n = 15) demonstrated clear awareness of cervical cancer. Overall knowledge was limited, particularly regarding diagnosis and the role of HPV in cancer development. Furthermore, understanding of the HPV vaccine's role in prevention was minimal, with many unaware of its ability to reduce the risk of HPV-related cancers, including cervical cancer. Findings reveal significant knowledge gaps and misconceptions about HPV, cervical cancer, and the HPV vaccine, highlighting the need for targeted educational interventions to improve understanding and increase vaccination rates in immigrant and ethnic minority communities. Efforts should focus on improving understanding of cervical cancer detection, HPV's role in cancer development, and the vaccine's effectiveness in prevention.

HPV vaccination coverage rate in women undergoing conization for cervical intraepithelial neoplasia in Spain: The COVAR study

OBJECTIVE

Females subjected to cervical excisional therapy (conization) due to high-grade squamous intraepithelial lesions/cervical intraepithelial neoplasia HSIL/CIN have a higher risk of developing cervical lesions compared to the general population. Research suggests that HPV vaccination may reduce post-treatment HSIL/CIN risk. Since 2014, HPV vaccination is recommended and funded in Spain at regional level for women who had undergone treatment for cervical precancerous lesions (HSIL/CIN2-3 or any other potentially tumoral cytohistological alteration). In 2018, the Ministry of Health standardized the recommendations but the vaccination coverage rate (VCR) for this population has not been published. The COVAR Study aimed to estimate the annual HPV VCR among women undergoing conization for SIL/CIN in Spain and assess sociodemographic and COVID-19 pandemic influence. To estimate the annual HPV vaccination coverage rate (VCR) among women undergoing conization for squamous intraepithelial lesions/cervical intraepithelial neoplasia (SIL/CIN) in Spain and assess the influence of sociodemographics and the COVID-19 pandemic.

METHODS

This was a multicentric, cross-sectional retrospective study conducted in six Spanish public hospitals from January 1, 2019, to December 31, 2021.

RESULTS

Annual HPV VCR was 87.3% (1135/1300), increasing to 89.8% (983/1095) in women with a conization for high-grade SIL (HSIL)/CIN. Among vaccinated women, 30.2% (343/1135) were vaccinated after SIL/CIN diagnosis but before conization and 58.3% (662/1135) were vaccinated after conization; the remaining 11.5% (130/1135) received at least one dose before SIL/CIN diagnosis. Of the conizations, 32.4% (517/1594) were performed during the pre-pandemic period, decreasing to 19.6% (312/1594) during the first COVID-19 restriction period; the annual HPV VCR also decreased (30% [259/865] to 20.7% [179/865], P < 0.001), for women vaccinated after conization.

CONCLUSION

The annual HPV VCR in our population was 87.3%, reflecting effective vaccination strategies. The COVID-19 pandemic substantially impacted the annual percentage of conizations and HPV vaccination.

"I Saw it Incidentally but Frequently": Exploring the Effects of Online Health Information Scanning on Lung Cancer Screening Behaviors Among Chinese Smokers

In China, lung cancer is the most common cancer with high mortality. While prior research suggests that health information scanning influences cancer screening within the general population, a deeper exploration of the underlying mechanisms is imperative. This study specifically targets smokers, aiming to investigate whether online health information scanning can effectively encourage lung cancer screening and elucidate the mechanisms driving this association. Data were extracted from a Chinese national survey conducted between January and September 2023, exclusively involving current smokers (N = 992). A moderated mediation model was employed to examine a cognitive-affective sequential chain of mediation through risk perceptions and cancer worry. Results showed that 99.1% of Chinese smokers reported online health information scanning, which possessed significant influence. Online health information scanning was positively associated with effective lung cancer screening among smokers directly (OR = 1.927, p < .01) and indirectly (OR = .065, p < .001). The perceived threat of smoking and cancer worry served as the cognitive and affective mediating mechanisms. Furthermore, a moderating effect of eHealth literacy was observed (OR = 6.292, p < .05). Smokers with higher eHealth literacy are more inclined to undergo effective lung cancer screening. Based on these findings, public health sectors should leverage online platforms to disseminate tailored cancer screening education and implement initiatives to enhance public eHealth literacy.

Impact of social determinants and medical mistrust on parent-child HPV vaccination in economically disadvantaged communities: implications for cancer prevention

Introduction

Human papillomavirus (HPV) vaccination and intentions, their correlates, and barriers among age-eligible parents and their children living in very economically disadvantaged communities were assessed.

Methods

Parents (N=198; 45% Black, 42% Latine, 57% educated <=high school [HS], 74% income <$60k annually) with children ages 10-17 from Washington, DC and Hackensack, NJ were intercepted at community events and surveyed.

Results

Among age-eligible parents, 20% were vaccinated against HPV. Comparing vaccinated to unvaccinated parents, those who were non-white (OR=5.5, 95% CI=3.5, 9.4, p<0.001) and with unvaccinated children (OR=8.9, 95% CI=3.7, 23.3, p<0.001) were less likely to be vaccinated themselves. Among children, 37% were vaccinated. Unvaccinated children were more likely to have parents who were non-white (OR=2.7, 95% CI=2.6, 2.8, p<.01), with a <=HS education (OR=3.0, 95% CI=1.52, 6.25, p<.01), and were unvaccinated themselves (OR=10.2, 95% CI=4.01, 28.61, p<.001). Nearly two-thirds (63%) of parents with unvaccinated children expressed an intention to vaccinate within the next year: 48% confirmed receiving advice from a healthcare provider to do so. Common HPV vaccine barriers included lack of information (35%), safety concerns (16%), and perceptions of sexual inactivity (13%). An adjusted model revealed an interaction between parent education and medical mistrust (B=.35, SE=.13, 95% CI=0.09, 0.61, p<.01). For parents with <=HS education, when levels of provider trust were strong, they were more open to vaccinating their children.

Conclusions

HPV vaccine prevalence was low among parents and children living in disadvantaged communities. Comprehensive education and intervention to build trust are warranted to prevent the spread of HPV-linked cancers and reduce cancer disparities.

Factors associated with awareness of and undergoing Pap smear tests among Jordanian women

Several screening methods are used to detect cervical cancer, with Pap smear test is considered as one of the most reliable screening methods to diagnose cervical cancer. The aim of this study was to investigate the factors associated with awareness of undergoing Pap smear tests among Jordanian women. A cross-sectional study was conducted among 525 Jordanian women attending the outpatient maternity hospital consecutively from February to July 2023. Data encompassed demographic characteristics (age, occupation, and education), awareness of Pap smears, beliefs regarding their importance, sources of information, and the history of undergoing Pap smear tests were collected using a structured questionnaire. Of the total 525 Jordanian women, 87.6% were aware of Pap smears. The awareness varied significantly depending on age and education level. Women aged 41-50 (adjusted odds ratio (AOR): 6.0; 95%CI: 2.3-15.3) and with a university education (AOR: 2.6; 95%CI: 1.4-4.8) were associated with increased odds of being aware of Pap smears. Among the women who were aware of Pap smears, the majority (94.1%) expressed belief in the importance of undergoing Pap smear tests and 61.7% reported having undergone the procedure at least once in their lives. In the multivariate analysis, women aged 30-40 years (AOR: 1.7; 95%CI: 1.1-2.8), 41-50 years (AOR: 4.1; 95%CI: 2.3-7.3), and older than 50 years (AOR: 9.8; 95%CI: 4.2-23.0) had a higher likelihood of undergoing Pap smear tests than those of under 30 years old. Being a housewife (AOR: 1.7; 95%CI: 1.1-2.7) and those who believed in the importance of Pap smear testing (AOR: 2.6; 95%CI: 1.1-6.0) were also more likely to have a Pap smear test. Nearly half of the women who had undergone Pap smears reported doing so every 2-3 years, while 25.7% indicated annual screening. Importantly, the overwhelming majority (97.9%) preferred the procedure to be performed by a gynecologist. In conclusion, the majority of women were aware of Pap smears. Two-thirds of women reported having undergone the procedure at least once. Prevention programs targeting cervical cancer and Pap smear tests should be tailored to women with low education, younger than 30 years, and those employed to maximize screening uptake for cervical cancer.

Barriers and facilitators of prevention of infections related to cancer: A systematic literature review

Chronic infections such as Helicobacter pylori (Hp), Hepatitis B virus (HBV), Hepatitis C virus (HCV), and Human papillomavirus (HPV) are a major cause of gastric, liver, and HPV-related cancers that contribute significantly to the global burden of human cancers. Infections related to cancers can be prevented by preventing infection through vaccination, timely detection through screening, and eradication of the underlying infections. These strategies have proven effective in different countries, but the participation rates of vaccination, screening, and eradication programs for Hp, HCV, and HPV are less than optimal. Research has shown that participation rates are influenced by various social, cultural, economic, and personal barriers and facilitators. To uncover the current evidence and enhance the understanding of the factors of prevention of infections related to cancer, we conducted a systematic literature review of such barriers and facilitators. We searched Web of Science, PubMed, and Scopus databases to identify relevant original articles published between 2013 and 2023. After screening 685 articles, a total of 23 studies were included for full-text analysis. Most of the studies analyzed factors related to the prevention of HBV, HPV, and HCV infections, while there was a relative lack of studies for Hp infections. Vaccination as a prevention measure of infections related to cancer was analyzed in most of the studies, followed by screening and treatment. We found several personal, social, economic, and cultural factors that act as barriers to the prevention of infections related to cancer and classified and connected these barriers and facilitators through the prism of health capital. Knowledge about the barriers that influence individuals' engagement with prevention measures of infections related to cancer has the potential to inform and guide health policymakers by targeting vulnerable populations through effective educational programs and improvements to the quality of healthcare services.

Cervical cancer: Challenges and prevention strategies: A narrative review

Background and Aims

Human papillomavirus (HPV) infections that continue to exist are the main cause of cervical cancer (CC), two-thirds of CC occurrences worldwide are caused by HPV 16 and HPV 18, and 99.7% of CC tumors are linked to oncogenic HPV infection. To identify challenges of CC and its prevention and treatment modalities.

Methods

This review examined the epidemiology, predisposing factors, genetic factors, clinical assessment methods, current treatment options, and prevention approaches for CC. We had perform a narrative data synthesis rather than a pooled analysis. A thorough literature search in pertinent databases related to CC was done with the inclusion of data that were published in the English language.

Results

Early detection of CC is of utmost importance to detect precancerous lesions at an early stage. Therefore, all responsible agencies concerned with health should make all women aware of the benefits of CC screening and educate the general public. HPV vaccination coverage is very low in resource-limited settings.

Conclusion

To achieve the goal of eliminating CC as a public health problem in 2030, the World Health Organization will pay special attention to increasing HPV vaccination coverage throughout the world. To further improve HPV vaccine acceptability among parents and their children, safety-related aspects of the HPV vaccine should be further investigated through post-marketing surveillance and multicentre randomized clinical trials.

Acceptance, Knowledge, and Attitude of Parents Toward the Human Papillomavirus Vaccine in the Eastern Region of Saudi Arabia: A Cross-Sectional Study

Background Human papillomavirus (HPV) is a common sexually transmitted virus associated with conditions such as skin warts and cervical cancer. Although many individuals clear the infection, some face persistent risks. Cervical cancer, which is linked to certain types of HPV, is a major health concern both globally and in Saudi Arabia, with preventive measures including HPV vaccination. However, parental knowledge and attitudes toward vaccinating their children vary. Therefore, this research aims to assess parental acceptance and understanding of the HPV vaccine in the Eastern Region of Saudi Arabia. Methodology This cross-sectional study was conducted in the Eastern Region of Saudi Arabia using an online questionnaire during 2022-2023. The data were cleaned in Excel and analyzed using SPSS version 29 (IBM Corp., Armonk, NY, USA). The study assessed parents' knowledge and acceptance of HPV vaccination. Results A total of 380 participants were included in this study, the majority of whom were female, married, well-educated, and residents of Al-Ahsa, Saudi Arabia. Awareness about the HPV vaccine was modest, with only 46.6% of participants having heard of it. Most parents reported that their doctors did not mention the vaccine (62.9%), and 67.1% stated that their children had not received it. Factors influencing acceptance included support from the Ministry of Health and belief in the vaccine's effectiveness. Concerns about side effects and vaccine effectiveness were the main barriers to vaccination. Sociodemographic factors, including gender, age, education, employment, and number of children, significantly influenced both knowledge and acceptance. Notably, awareness of HPV was strongly associated with acceptance. Conclusions Our study revealed limited knowledge and vaccine acceptance among parents in the Eastern Region of Saudi Arabia. Sociodemographic factors, including gender, age, education, employment, and number of children, significantly influenced both knowledge and acceptance. Thus, sociodemographic factors played a significant role in shaping these attitudes, emphasizing the need for targeted awareness campaigns and improved communication between healthcare providers and parents to enhance vaccine uptake.

A Moderating Role of Gender in Online Health Information Seeking Behaviors for Colorectal Cancer Knowledge among Korean Americans Aged 50 to 75 Years

Korean Americans have consistently reported the underutilization of colorectal cancer (CRC) screening, despite their high rates of CRC incidence and mortality. Research has indicated suboptimal CRC knowledge in Korean Americans as one of the main barriers to their recommended CRC screening. Also, research has shown the potential of online health information seeking (OHIS) to improving cancer knowledge and the gender-based differences in the link between OHIS and cancer knowledge. Thus, this study aimed to examine the association between OHIS and CRC knowledge and the moderating effect of gender in this association among Korean Americans. A cross-sectional survey with purposive sampling was conducted of 421 Korean Americans aged 50 to 75 years in the Southeastern U.S. Three-step hierarchical multiple regression analyses were performed to investigate if three blocks of variables-Block 1: control variables (sociodemographics and health-related information), Block 2: independent variables (OHIS and gender), and Block 3: an (OHIS × gender) interaction term-significantly reduce unexplained variance in CRC knowledge. The analyses showed that the final model fits best accounting for 29.3% of the variance in CRC knowledge. Also, the analyses showed that OHIS was positively associated with CRC knowledge and gender moderated the association between OHIS and CRC knowledge. The findings close the knowledge gap existing in the body of literature on the connection of OHIS to CRC knowledge in Korean Americans. Findings also extend the understanding of gender-specific approaches leveraging OHIS for CRC prevention education among Korean Americans.

Human Papilloma Virus Knowledge Among University Students, Staff, and Faculty in the State of Indiana During 2016, 2019, and 2022

Studies of Human Papillomavirus (HPV) knowledge among university students have previously been conducted, typically to the exclusion of faculty and staff. The study aim was to assess HPV knowledge among university students, staff, and faculty in the state of Indiana during 2016, 2019, and 2022. The three samples comprised a total of 1275, 1056, and 403 students, staff, and faculty respectively during 2016, 2019, and 2022. Ages ranged from 18 to 70 + each year of the study. A 27-item survey was administered including sociodemographic questions and quantitative HPV knowledge questions were modified from a previously validated instrument. Descriptive statistics characterized the study participants and differences in scores were reported. Among the overall sample who answered receiving the vaccine question (n = 1917), 39% had received the HPV vaccine. HPV knowledge significantly increased among students from 2016 to 2019 but decreased in 2022. Among staff, there was a significant knowledge difference between 2016 and 2022, but no significant knowledge difference among the faculty. About 86% of the total sample did not know that HPV usually does not need any treatment. Further, participants correct knowledge scores were less than average on the following items: HPV can cause throat cancer (49%); HPV can be transmitted by skin-to-skin contact (42%). More education and campus-wide efforts need to be implemented to increase awareness and accurate HPV-knowledge. Targeted and individual messaging for students, staff, and faculty may be a way to increase awareness of HPV and improve HPV knowledge.

Human papillomavirus vaccine knowledge and conspiracy beliefs among secondary school students in Lebanon

BACKGROUND

Human Papillomavirus (HPV) is widely prevalent across the globe. In Lebanon, the society is transitioning from traditional conservatism to a more open attitude. Although previous studies have examined the knowledge of adults in Lebanon with regard to HPV and its vaccine, there is a lack of research on secondary school students. Moreover, HPV is considered a worldwide public health matter that needs to be addressed. Therefore, the objective of our study is to assess factors associated with knowledge and conspiracy beliefs towards HPV vaccine among a sample of Lebanese adolescents.

METHODS

Between December 2022 and February 2023, we conducted a cross-sectional study on Lebanese adolescents aged 15 to 18 years old. Parental approval was needed in order to participate. We used a questionnaire to collect data, which included the HPV-knowledge questionnaire (HPV-KQ) and the Vaccine Conspiracy Belief Scale (VCBS).

RESULTS

Of the 406 participants who filled the survey, 64.8% were female, with a mean age of 16.62 ± 1.01. Results showed that 31.0% of students had high knowledge about HPV, while 27.6% had high conspiracy beliefs, and 48% of participants relied on the internet to access information on HPV. Students who had previously heard of HPV, received sexual education at school or outside, and had received at least one dose of the HPV vaccine demonstrated significantly higher knowledge of HPV. Additionally, students with high knowledge had a lower mean House Crowding Index, and those whose fathers had a university education had lower conspiracy beliefs. Females had a higher vaccination rate than males, while no significant difference was found between those who had engaged in sexual activity and those who had not. The multivariate analysis indicated that previous awareness of HPV and receiving sexual education outside school were significantly associated with higher knowledge.

CONCLUSION

Our study brings to light the urgent need for action to increase HPV awareness and vaccination among Lebanese secondary school students. The prevalence of vaccine misconceptions and conspiracy beliefs and the limited knowledge of HPV underscore the importance of more comprehensive sexual education in schools and the dissemination of accurate information about HPV and its vaccine. Furthermore, given the low vaccination rate among males, efforts should be made to promote HPV vaccination among this population. Addressing these issues can improve public health and help prevent the spread of HPV and its related diseases.

Socio-Demographic Factors and Other Predictors of Pap Test Uptake Among Women: A Retrospective Study in Ghana

Introduction

The World Health Organization has reported a rise in cervical cancer in Ghana. Ghanaian women predominantly undergo opportunistic Pap smear screening for cervical cancer. Numerous studies have documented differences in the sociodemographic traits of participants undergoing Pap smear testing or screening, which correlates with their screening habits. This study aims to assess sociodemographic variables, including others that determine Pap test utilization at a single center in Ghana.

Methods

A single-center survey was conducted by extracting data from the records of women who walked in for Pap smear testing. A telephone survey was also conducted among these women to document their barriers to utilizing the center. For data analysis, descriptive statistics and chi-square were utilized.

Results

A total of 197 participants' records were retrieved for the study. Most participants were market women (69.4%) and uneducated (71.4%). Their Pap smear screening records indicate that the majority (86%) had no history of cervical cancer screening, and only 3% tested positive for Pap smear test. Educational level, occupation and family history of cancer significantly correlated with participants' Pap smear history (p<0.05). However, most sociodemographic factors were not significant with the Pap test results of the participants (p>0.05). The perceived barrier identified by most participants was the need for more information (67.40%) on the test.

Conclusion

This study revealed that sociodemographic and gynaecological factors do not correlate with Pap test results. However, education level, occupation, and family history of cancer were significantly associated with the history of Pap smear uptake. The most significant barrier hindering Pap smear services was the need for more information.