Awareness of HPV and Cervical Cancer Prevention Among University Health Sciences Students in Cyprus

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 of cervical cancer screening and associated factors among women attending maternal health services at Aira Hospital, West Wollega, Ethiopia

BACKGROUND

Cervical cancer is one of the major noncommunicable public health problems among women globally. About 500,000 women develop cervical cancer each year, with an estimated 85% or more occurring in developing countries, including Ethiopia.

OBJECTIVE

The main objective of the study was to assess the knowledge of cervical cancer screening and its associated factors among women attending maternal health services at Aira hospital, West Wollega, Ethiopia.

METHODS

An institutional-based cross-sectional study design was conducted among 421 reproductive-age women. A systematic sampling method was used for the study. Data were collected using a pretested and structured questionnaire. Data analysis included descriptive statistics and the statistical association between the outcome variable and the explanatory variables tested by the binary logistic regression. Multivariable logistic regression was used to control confounding factors, the magnitude of the association between the different independent and dependent variable was measured using 95% confidence interval, and p values below 0.05 were considered as statistically significant.

RESULTS

A total of 421 women were responded with 100% response rate and with the mean age of 26.0 ± 5.15 (M ± SD) years. About 95.0% of the respondents ever heard of cervical cancer and 46.8% of the respondents had good knowledge about cervical cancer screening. Age, occupation, educational level, and monthly income were predictors associated with knowledge about cervical cancer screening.

CONCLUSION

The study revealed 46.8% of study participants had knowledge about cervical cancer screening. The age of the participant, occupation, level of education, and monthly income were determinants of knowledge about cervical cancer screening. Prevention programs should focus on cervical cancer screening according to identified factors in the study.

Fra-1 Inhibits Cell Growth and the Warburg Effect in Cervical Cancer Cells via STAT1 Regulation of the p53 Signaling Pathway

The oncogenesis of cervical cancer is a multi-factor and multi-step process, and major risk factors include oncogene activation with tumor suppressor gene inactivation, viral factors, and immune factors. For example, the human papillomavirus (HPV) has been linked to the occurrence of cervical cancer. At present, the pathogenesis of cervical cancer remains unclear. Fra-1 (Fos-related antigen 1, also known as FOSL1) is a member of the Fos family and an important nuclear transcription factor that regulates normal cell growth, differentiation, and apoptosis. In the present study, we found that Fra-1 inhibited the proliferation of cervical cancer cells while also promoting apoptosis and affecting cell cycle distribution. Moreover, Fra-1 up-regulated STAT1 expression and modulated p53 signal pathway activity in cervical cancer cells. Overexpression of Fra-1 inhibited cell senescence by altering sirtuin 1 (SIRT1) expression in HeLa cells, and Fra-1 overexpression restored mitochondrial disorder and suppressed metabolic reprogramming in HeLa cells. Silencing of STAT1 impaired the inhibitory effect of Fra-1 on cervical cancer cell growth, while knock-down of STAT1 reversed the effect on cell senescence and mitochondrial dysfunction caused by Fra-1 in HeLa cells. Silencing of STAT1 also recovered metabolic reprogramming in cervical cancer cells. In summary, our results show that Fra-1 inhibited cervical cancer cell growth and the Warburg effect via STAT1-mediated regulation of the p53 signaling pathway.