Knowledge, attitudes and beliefs about cervical cancer and human papilloma virus vaccination with related factors in Turkish university students

The Impact of HPV Vaccination on Cervical Cancer in adolescent females: A narrative review

To effectively prevent cervical cancer, a leading cause of global morbidity and mortality among women, widespread adoption of the HPV vaccine has a well-established link to human papillomavirus (HPV) infection. HPV vaccine must be the vaccine's effectiveness in reducing HPV infections, and subsequent cervical lesions have been extensively demonstrated, marking a pivotal milestone in public health. Important research highlights the vaccine's safety profile, allaying worries and promoting trust in its application. By targeting HPV strains responsible for a majority of cervical cancer cases, vaccination emerges as a strategic intervention to curb the burden of this malignancy. The strategy is used to search PubMed and Google Scholar, with only free full-text and English language study included. However, addressing existing misconceptions and ensuring equitable vaccine access remains imperative. Informed decision making is pivotal, necessitating comprehensive public health initiatives that educate communities about the vaccine's benefits. Encouragingly, successful vaccination programs in various regions have demonstrated tangible reductions in HPV prevalence and cervical cancer incidence. This review concludes by emphasizing the urgent need for global collaboration to integrate HPV vaccination into routine immunization schedules, thereby fortifying the collective effort to mitigate cervical cancer's impact. As a cost-effective, evidence-based strategy, widespread HPV vaccination stands as a linchpin in the ongoing battle against cervical cancer, promising a healthier future for women worldwide.

Assessment of health literacy and HPV knowledge among university students: An observational study

Health literacy (HL) level is related to promotion of health, improved health behaviors, and early diagnosis of diseases, as well as the appropriate use of health services. Human papillomavirus (HPV) vaccination is the primary method of protection against cervical cancer and recommended for women aged 9 to 27. This study aims to assess the university students' knowledge about HPV and the association between HL and HPV vaccination. In this cross-sectional and descriptive study, an electronic survey was used. Demographic characteristics and anthropometric measurements of the participants were questioned. HPV Knowledge Scale (HPV-KS) and Turkish Health Literacy Scale (THLS-32) were used to evaluate HPV knowledge and HL. Statistical analyzes were performed with SPSS version 26. A total of 361 university students (74% women), aged 21.98 ± 4.72 years, were included in the study. About 52% of the participants were health sciences students. The total THLS-32 score was 34.68 ± 9.37 (95% CI = 33.71-35.65), and the total adequate/excellent HL level was 51%. The mean HPV-KS score of the participants was 10.28 ± 8.15 (95% CI = 9.44-11.12) of a possible 35. Health sciences students had higher rates of HPV awareness (78% vs 65%; P = .007). General HPV knowledge level was significantly better among women (P < .001), >20 years (P = .002), and those with a family history of cancer (P < .001) and significantly lower among students at prep or first year of school (P < .001). There was a weak, positive relation between THLS-32 and HPV-KS score (R = 0.136; P = .01). Participants with higher levels of HPV knowledge (P = .034) and total HPV-KS score (P = .025) were statistically significantly higher in students with adequate/excellent HL. Our results reveal that knowledge about HPV vaccination is closely related to HL levels. Educational interventions on HL may be considered to increase HPV vaccination rates.

Using social marketing theory as a framework for understanding barriers and facilitators of human papillomavirus screening in women: A qualitative study

BACKGROUND

Human papillomavirus (HPV) is known as the common sexually transmitted disease and the cause of cervical cancer. The HPV test is being proposed as the primary screening tool for cervical cancer. This study aimed to identify barriers and facilitators of screening based on the social marketing model in designing interventions and planning to increase HPV screening.

MATERIALS AND METHODS

This qualitative directed content analysis was conducted between December 2020 to September 2021 to identify the key concepts of social marketing theory (i.e., the four P's: product, price, place, and promotion) in Mashhad, Iran. Semistructured interviews were fulfilled with 24 individuals (10 women with HPV and 14 key informants) after obtaining participants' consent, who were initially purposively sampled and snowball sampling was then used to facilitate further recruitment. Data analysis was carried out simultaneously with data collection.

RESULTS

Following the code extraction, four main categories (themes) and 10 subcategories extracted. Subcategories included knowledge on screening, screening benefits, and motivational factors for screening (product), individual inhibitors, environmental inhibitors, and facility problems related to price, place of service delivery, and service delivery channels (place) and health promotion and education.

DISCUSSION

Lack of knowledge about HPV and screening, negative attitudes toward sexually transmitted diseases, taboo about sexual issues in society, fear of the reaction of spouse and family members, lack of proper policies and information and communication challenges, high costs of screening, access barriers to facilities such as difficult transportation have been challenges of health systems. It is suggested that HPV screening as a standard method for detection of cervical cancer be considered and the barriers to access are removed.

Awareness and Knowledge about Human Papilloma Virus Infection among Students at Secondary Occupational Health School in China

Cervical cancer (CC) is one of the most common causes of cancer-related deaths worldwide. CC is mainly caused by human papilloma virus (HPV), which can be prevented by vaccination. We conducted a cross-sectional study in secondary occupational health school (SOHS) through a questionnaire aimed to assess the awareness and knowledge regarding HPV infection of students. A total of 2248 students participated in the survey, 45.3% of them had heard about CC, while only 21.9% of them had heard about HPV; and 74.2% had no idea of the causal link between HPV infection and CC. Most participants displayed poor awareness and knowledge about HPV infection. The results suggested that age, grade, major, academic performance, etc. were correlated with higher awareness of CC, HPV and HPV infection (p < 0.05). In multivariable logistic analysis, third-grade students had the most increased awareness of CC (OR = 17.13, 95%CI: [8.11, 36.15]), HPV (OR = 6.59, 95%CI: [4.16, 10.43]) and HPV vaccine (OR = 2.78, 95%CI: [1.78, 4.32]) when compared to first-grade. Awareness and knowledge regarding HPV infection were insufficient among students in SOHS. As the future healthcare providers, these results highlight the need to supplement targeted education to improve their awareness and knowledge of HPV and vaccination.

Identification of the Knowledge Level of Students Receiving Health Education About the Human Papilloma Virus, Screening Tests, and Human Papilloma Virus Vaccination

This study aims to identify the knowledge level of students receiving health education about the human papilloma virus, screening tests, and human papilloma virus vaccination. The present study was designed as a descriptive study. It was conducted in the Nursing department and First and Emergency Aid programs in a city in the Eastern part of Turkey between November and December 2019. The sample of the study included 312 students who volunteered to participate in the study. The data collection tools used were the Socio-demographic Form and the Human Papilloma Virus Knowledge Scale. The students' Human Papilloma Virus Knowledge Scale total mean score was 5.86 ± 6.40. The HPV knowledge Scale total score, the General HPV Knowledge sub-scale, and the General HPV Vaccination Knowledge subs-scale mean scores were found to be significantly higher in women, in those who were enrolled in 3rd year, and in those who were knowledgeable about sexually transmitted diseases and cervical cancer. The HPV screening Test Knowledge sub-scale mean score was found to be significantly higher in those who were enrolled in 3rd year and who were knowledgeable about cervical cancer (p < 0.05). The results showed that students' knowledge levels about HPV were not sufficient, and variables such as gender, class level, and knowledge about sexually transmitted diseases and cervical cancer were found to affect the knowledge level about HPV, screening tests, and vaccination. It is recommended that similar studies should be conducted in larger groups, and initiations to increase the knowledge levels of students should be planned.

Knowledge and Behavior of University Students toward Human Papillomavirus and Vaccination

Objectives:

Human papillomavirus (HPV) causes cervical cancer. This study aimed to determine the knowledge and attitude of university students toward HPV infection and vaccine prevention in Turkey.

Methods:

A total of 1563 female and male university students participated in the study. The study design was descriptive and cross-sectional. The study included students enrolled in the departments of faculties and vocational schools.

Results:

In total, 16.8% of students stated that they had heard of HPV. There was a statistically significant relationship between the mean awareness of HPV and different variables, such as age, gender, marital status, family history of cancer, and conversation about sexual matters (P < 0.01). As the age of the students increased, the chance of hearing about HPV also increased. Of all the students, 1.5% took HPV vaccination. Furthermore, 87.7% of the female students stated that they had heard of cervical cancer.

Conclusions:

The depth of knowledge among Turkish university students toward cervical cancer, HPV infection, and vaccination was inadequate. It is important to provide educational and counseling services by nurses to make university students aware of HPV infection and vaccination.

Parental perspective on human papillomavirus (HPV) vaccination in Serbia: Knowledge, attitudes and practice

STUDY OBJECTIVE

Assessing knowledge and attitudes of parents towards human papillomavirus (HPV) vaccination of their children and estimating factors associated with parental positive attitude towards HPV immunization.

STUDY DESIGN

Cross-sectional.

SETTING

Two Community Health Centers. A total of 282 adult parents of boys and/or girls who presented at the pediatrician's office with their child aged ≤18 years from December 2015 to May 2016.

MAIN OUTCOME MEASURES

HPV vaccination coverage with one dose, knowledge and attitudes towards HPV vaccination. Parental knowledge was tested through a set of 10 items such as the infectious nature of HPV, mode of transmission, symptoms and its association with cervical cancer and circumstances surrounding HPV vaccine in Serbia. Answers were graded on a 5-point Likert scale from "strongly disagree" to "strongly agree".

RESULTS

Coverage with one dose of HPV vaccine was 2.0%. Majority of parents knew that the vaccine existed (71.0%). One quarter of parents confirmed that their child should be vaccinated against HPV. Parents expressed highest level of agreement with the statement that HPV vaccination in Serbia is not sufficiently promoted (4.17 ± 1.21 points). Having female child and more knowledge on HPV were independently associated with positive attitude towards vaccination among parents of children aged <9 years. Having received recommendation for HPV vaccination from a pediatrician was independently associated with positive attitude towards HPV vaccination among parents of children aged ≥9 years.

CONCLUSION

Coverage with one dose of HPV vaccine is low. Health-care authorities are urged to consider inclusion of HPV vaccination in immunization schedule.

Preliminary evaluation of the in vitro efficacy of 1, 2-di (quinazolin-4-yl) diselane against SiHa cervical cancer cells

Cervical cancer is one the most common malignancies among females. In recent years, its incidence rate has shown a rising trend in some countries so that development of anticancer drugs for cervical cancer is an urgent priority. In our recent anticancer drug discovery screen, 1, 2-di (quinazolin-4-yl)diselane (LG003) was found to possess wide spectrum anticancer efficacy. In the present work, the in vitro anticancer activity of LG003 was evaluated in the SiHa cervical cancer cell line. Compared with commercial anticancer drugs 10-hydroxycamptothecin, epirubicin hydrochloride, taxol and oxaliplatin, LG003 showed better anticancer activity. Furthermore, inhibition effects were time- and dose-dependent. Morphological observation exhibited LG003 treatment results in apoptosis like shrinking and blebbing, and cell membrane damage. Lactate dehydrogenase release assay revealed that LG003 exerts such effects in SiHa cells through a physiology pathway rather than cytotoxicity, which suggests that title compound LG003 can be a potential candidate agent for cervical cancer.

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

BACKGROUND

The purpose of the study is to investigate knowledge, attitudes and behaviours concerning cervical cancer, HPV and HPV vaccine of female students studying at a university in a health related department and explore variables affecting taking the vaccine.

METHODS

The research group consists of female students attending a health related department in Balıkesir University. The data of this cross-sectional research was collected via surveys.

RESULTS

The average total knowledge score of the students concerning risks, symptoms and screening methods of cervical cancer and HPV vaccines was 14.15 ± 6.7. The HPV knowledge score of the students attending the faculty of medicine was higher compared to the students attending other departments and their HPV vaccine knowledge score was higher compared to the students attending nursing and paramedics students. The HPV vaccine knowledge score of the students attending the department of midwifery was significantly higher compared to other students. Only 0.9 % of the students took the vaccine. One third of the students who did not take the vaccine did not know that the vaccine was available in our country. In terms of the department that they attended, the students with a higher total knowledge score compared to the average (OR:1.5) and students with history of cancer in their families (OR:1.6) were more likely to consider taking the vaccine.

CONCLUSIONS

Research group's knowledge on risk factors of cervical cancer, Pap smear test, symptoms and prevention ways of cancer, HPV and HPV vaccine was low.

Knowledge of Human Papillomavirus Infection, Cervical Cancer and Willingness to pay for Cervical Cancer Vaccination among Ethnically Diverse Medical Students in Malaysia

The primary objective of this study was to assess the knowledge of medical students and determine variation between different cultural groups. A secondary aim was to find out the willingness to pay for cervical cancer vaccination and the relationships between knowledge and attitudes towards Human Papillomavirus vaccination. A cross-sectional survey was conducted in a private medical university between June 2014 and November 2014 using a convenient sampling method. A total of 305 respondents were recruited and interviewed with standard questionnaires for assessment of knowledge, attitudes and practice towards human papilloma virus and their willingness to pay for HPV vaccination. Knowledge regarding human papilloma virus, human papilloma virus vaccination, cervical cancer screening and cervical cancer risk factors was good. Across the sample, a majority (90%) of the pupils demonstrated a high degree of knowledge about cervical cancer and its vaccination. There were no significant differences between ethnicity and the participants' overall knowledge of HPV infection, Pap smear and cervical cancer vaccination. Some 88% of participants answered that HPV vaccine can prevent cervical cancer, while 81.5% of medical students said they would recommend HPV vaccination to the public although fewer expressed an intention to receive vaccination for themselves.

Knowledge, attitudes and behaviors of women over 20 years old on cervix cancer in Istanbul, Turkey

PURPOSE

The aim of the study was to evaluate knowledge, attitudes and behaviors of Turkish women over 20 years old on cervix cancer.

MATERIALS AND METHODS

This descriptive study was performed at a primary care center covering 246 women using a questionnaire composed of 3 sections and 38 questions. The data were analyzed using descriptive statistics, chi-square test in univariate analysis and multivariate hierarchical logistic regression analysis.

RESULTS

Of the 93.7% women who knew about cervical cancer, 68.0% of them had heard pap smear test and 46.1% had actually undergone a Pap smear once or more throughout their lives. According to the results of the hierarchical logistic regression analysis about factors affecting the Pap smear test; in Model 1, increase in age and education levels, in Model 2 and Model 3 increase in age and cervical cancer information points were determined. The most important information source for cervical cancer was TV-radio/media (59.9%) and health care workers (62.8%) for pap smear test.

CONCLUSIONS

Although most women have heard of cervical cancer, knowledge about cervical cancer and also Pap smear screening rate are significantly lower. Having Pap smear test for women was affected by age and knowledge level about cervical cancer. Informing women about cervical cancer would be an important intervention.

Cost-effectiveness analysis of HPV vaccination: comparing the general population with socially vulnerable individuals

BACKGROUND

After the WHO recommended HPV vaccination of the general population in 2009, government support of HPV vaccination programs was increased in many countries. However, this policy was not implemented in Korea due to perceived low cost-effectiveness. Thus, the aim of this study was to analyze the cost-utility of HPV vaccination programs targeted to high risk populations as compared to vaccination programs for the general population.

MATERIALS AND METHODS

Each study population was set to 100,000 people in a simulation study to determine the incremental cost-utility ratio (ICUR), then standard prevalence rates, cost, vaccination rates, vaccine efficacy, and the Quality-Adjusted Life-Years (QALYs) were applied to the analysis. In addition, sensitivity analysis was performed by assuming discounted vaccination cost.

RESULTS

In the socially vulnerable population, QALYs gained through HPV vaccination were higher than that of the general population (General population: 1,019, Socially vulnerable population: 5,582). The results of ICUR showed that the cost of HPV vaccination was higher for the general population than the socially vulnerable population. (General population: 52,279,255 KRW, Socially vulnerable population: 9,547,347 KRW). Compared with 24 million KRW/QALYs as the social threshold, vaccination of the general population was not cost-effective. In contrast, vaccination of the socially vulnerable population was strongly cost-effective.

CONCLUSIONS

The results suggest the importance and necessity of government support of HPV vaccination programs targeted to socially vulnerable populations because a targeted approach is much more cost-effective. The implementation of government support for such vaccination programs is a critical strategy for decreasing the burden of HPV infection in Korea.

Mothers' knowledge and attitudes about HPV vaccination to prevent cervical cancers

BACKGROUND

Cervical cancer which is one of the most preventable cancers is an important public health problem worldwide, and especially in developing countries. The aim of this study was to determine knowledge and attitudes about the HPV vaccination of mothers with 0- to 18-year old children.

MATERIALS AND METHODS

Written approval was taken from the local authorities. The study subjects consisted of 799 mothers who agreed to participate. The data were collected via a "Personal Information Form" which included 30 questions that were prepared by the researchers themselves in line with the literature. The data were collected by face to face interviews with the mothers. Analyses were performed using commercial software.

RESULTS

The mean age of the mothers who participated in the study was 32.0 ± 6.52, and 88.1% reported no information about HPV, and 83.5% no information about HPV vaccination. Only 0.7% of the mothers had daughters who had HPV vaccination, and 44.3% of the mothers who had sons were found out to be indecisive about having HPV vaccination. There was a significant corelation between the educational status of the mothers and their knowledge about HPV vaccination (p<0.05). However, there was no significant correlation in terms of economic conditions (p>0.05).

CONCLUSIONS

This study suggested that mothers had very little information on HPV and HPV vaccination. Knowledge of the disease and its vaccination is an essential factor for the success of the vaccination program. It is of great importance that mothers are trained in this subject by health professionals.

Innovations in HPV vaccination and roles of nurses in cervical cancer prevention

The human papilloma virus (HPV) is the main aetiological agent for cervical cancer, one of the most frequent cancers observed in women throughout the world. There are effective programs for reducing the incidence of cervical cancer with HPV vaccination. The objective of this study was to discuss the applicability of the HPV vaccination and the role of nurses in prevention of cervical cancer. Use of bivalent and quadrivalent vaccines has been initiated against the types of HPV which are the primary cause of cancer. The quadrivalent HPV vaccination has entered into the routine vaccination schedule in many European countries for use in children and adolescents between 9-15 years of age and for women between 16-26 years of age, whereas it has been proposed that the bivalent vaccination should be given to girls between 9-18 years of age. While cervical cancer is among the cancers that can be prevented, it is essential to continue screening tests while introducing vaccination in a systematic manner for protection. On this subject, among the most important roles of nurses is to implement the screening programs by fulfilling the caregiving, training and consultancy roles for the society and especially, for high risk groups and to increase the awareness of the people.

Challenges of providing cervical cancer prevention programs in Iran: a qualitative study

BACKGROUND

Cervical cancer has become a major public health problem worldwide. Iran, like other developing countries, is facing a number of challenges in managing the disease. This qualitative study documents challenges encountered in cervical cancer preventing programs in Iran.

MATERIALS AND METHODS

In-depth interviews were conducted with 28 participants including eleven patients with cervical cancer, three gynecologic oncologists, five specialists in Obstetrics and Gynecology, five midwives, three health care managers and one epidemiologist in Mashhad Iran, between May and December of 2012. The sample was selected purposively until data saturation was achieved. Data credibility verified via allocated sufficient time for data collection, using member checking and peer debriefing. Data analysis was carried out using conventional content analysis approach with ATLAS. ti software.

RESULTS

Findings from data analysis demonstrated 2 major themes and 6 categories about challenges of providing cervical cancer prevention programs including: individual and social challenges (cognitive/behavioral challenges and socio/cultural challenges) and health system challenges (stewardship, financing, competency of health care providers and access to services). Each category included some subcategories.

CONCLUSIONS

Managing the cervical cancer prevention programs need to include the consideration of individuals, health care providers and health system challenges. Addressing the low level of knowledge, negative attitudes, socio cultural challenges, Poor intersectional collaboration and coordination and intra-sectional management, financing and competency of health care providers are essential steps toward significantly reducing the burdens of cervical cancer.

Knowledge, perception and attitude towards human papillomavirus among pre-university students in Malaysia

BACKGROUND

To evaluate the knowledge, perception and attitudes towards human papilloma virus (HPV) among pre-university students in Malaysia.

STUDY DESIGN

In this cross sectional study, between November 2013 to March 2014, in a public university, a convenient sampling method was used. A total of 716 respondents were recruited and interviewed with a set of standard questionnaires for assessment of knowledge, perception and attitudes towards HPV and predictor variables associated with level of knowledge.

RESULTS

Almost half (48.9%) of the respondents scored less than 5 and were categorised as having poor knowledge. Three hundred and twelve (43.6%) respondents had moderate knowledge and only 54 (7.5%) respondents exhibited good knowledge with the score of 11 and above. Only 142 (20%) students perceived themselves to be vulnerable to HPV infection though 560 (78.2%) students thought that HPV infection is a serious disease. Perceived benefits and desire to be vaccinated were significantly associated with gender (p=0.000) and knowledge of HPV vaccine and cervical cancer (p=0.000).

CONCLUSIONS

The level of knowledge regarding HPV among the pre-university students was low. However, student intention for vaccination increased with increasing level of knowledge. Thus, efforts to improve knowledge and awareness should be prioritised to increase uptake of the HPV vaccination programme and hence reduce morbidity and mortality from consequences of HPV infection, including cervical carcinoma.