Investigating Bangladeshi Rural Women's Awareness and Knowledge of Cervical Cancer and Attitude Towards HPV Vaccination: a Community-Based Cross-Sectional Analysis

Awareness of HPV vaccine and its socio-demographic determinants among the parents of eligible daughters in Bangladesh: A nationwide study

Background

Vaccination against Human papillomavirus (HPV) is recommended to avoid HPV infections and its associated diseases, including cervical cancer. However, there is no awareness study among Bangladeshi population. Hence, this nationwide study was conducted to explore HPV vaccine awareness and its determinants among parents of eligible adolescent girls.

Methods

This study was conducted among the parents of daughters aged 9-15 years from 42 out of 64 randomly selected districts of Bangladesh between June 28 to August 2, 2023. A multistage sampling method was used to enroll 2151 study participants from all eight divisions of Bangladesh. A semi-structured questionnaire was used for face-to-face interviews in this study. The statistical software Stata (Version 17) was used for statistical analyses.

Results

The average age of the participants was 38.18 (±5.86) years. Only 22.32 % of the participants were aware of the HPV vaccine. Every additional year of age increased the likelihood of being aware of the HPV vaccine by 3 % (AOR: 1.03; 95%CI: 1.00-1.06). Participants residing in the urban area had 3.56 times higher odds of awareness than rural and semi-urban people. Businessmen and housewives had 60 % (AOR: 0.40; 95 % CI: 0.22-0.69) and 77 % (AOR: 0.23; 95 % CI: 0.16-0.33) lower odds in comparison to job holders. The lower-income group exhibited significantly higher odds of awareness (AOR: 0.25, 95%CI: 0.16-0.39) compared to the middle and the higher-income group. Participants who never went through routine health check-ups had 77 % lower odds of being aware than those who availed of regular routine check-ups (AOR: 0.23; 95%CI: 0.16-0.34).

Conclusion

Awareness of the HPV vaccine among the general population of Bangladesh is very low. Age, residence, occupation, monthly income, and routine medical check-ups were associated with HPV vaccine awareness. A nationwide awareness campaign would increase this awareness level among the Bangladeshi population, especially among the parents of daughters.

Utility of Scoring System for Screening and Early Warning of Cervical Cancer Based on Big Data Analysis

Objective

To explore the utility of the scoring system for screening and early warning of cervical cancer based on big data analysis.

Methods

A total of 420 women undergoing physical examination in Shenyang from January 2021 to January 2022 were screened by convenient sampling as the study subjects. All females accepted the human papilloma virus (HPV) tests and thin-prep cytology test (TCT), a Rating Questionnaire for Screening and Early Warning of Cervical Cancer was developed, and a warning threshold was derived according to the scores of the questionnaire and the goodness of fit for the results of HPV+TCT tests. The patients were graded according to the threshold, and corresponding intervention strategies for patients of different grades were developed.

Results

Among the 420 people undergoing physical examination, 92 (21.90%) obtained scores ≥8 points, and 328 (78.10%) obtained scores < 8 points; in diagnosing cervical cancer, the Rating Questionnaire for Screening and Early Warning of Cervical Cancer had an AUC value of 0.848, specificity of 97.22%, and sensitivity of 86.46%; after scientific intervention, HPV test results showed a significant decrease in both high-risk positive cases and low-risk positive cases (p < 0.05), and TCT results showed that there was a significant difference in the number of patients with CIN I before and after intervention (p < 0.05).

Conclusion

The scoring system for screening and early warning of cervical cancer based on big data analysis presents certain clinical value in the clinical screening of cervical cancer, which can further improve the screening coverage, is of great significance for the diagnosis and treatment of disease, and helps physician implement hierarchical diagnosis and treatment quickly and precisely.

Automated invasive cervical cancer disease detection at early stage through suitable machine learning model

Cervical cancer is a common cancer that affects women all over the world. This is the fourth leading cause of death among women and has no symptoms in its early stages. At the cervix, cervical cancer cells develop slowly. If it can be detected early, this cancer can be successfully treated. Health professionals are now facing a major challenge in detecting such cancer until it spreads rapidly. This study applied various machine learning classification methods to predict cervical cancer using risk factors. The main aim of this research work is to be described of the performance variation of eight most classifications algorithm to detect cervical cancer disease based on the selection of various top features sets from the dataset. Multilayer Perceptron (MLP), Random Forest and k-Nearest Neighbor, Decision Tree, Logistic Regression, SVC, Gradient Boosting, AdaBoost are examples of machine learning classification algorithms that have been used to predict cervical cancer and help in early diagnosis. A variety of approaches are used to avoid missing values in the dataset. To choose the various best features, a combination of feature selection techniques such as Chi-square, SelectBest and Random Forest was used. The performance of those classifications is evaluated using the accuracy, recall, precision and f1-score parameters. On a variety of top feature sets, MLP outperformed other classification models. The majority of classification models, on the other hand, claim to have the highest accuracy on the top 25 features in dataset splitting ratio (70:30). For each model, the percentage of correctly classified instances has been presented and all of the results are then discussed. Medical professionals will be able to use the suggested approach to perform research on cervical cancer.

Human papillomavirus vaccination uptake in low-and middle-income countries: a meta-analysis

BACKGROUND

The proportion of incident cases of HPV-attributable cancers is highest in the low- and middle-income countries (LMICs) but many are yet to initiate HPV vaccination programs. This meta-analysis was performed to assess the uptake of HPV vaccination in LMICs at the beginning of the global strategy to eliminate cervical cancer and describes the gaps and challenges.

METHODS

A systematic search was conducted in PubMed, EMBASE, Scopus, Web of Science, and CENTRAL databases for observational studies that reported the uptake of HPV vaccination until October 2020. The meta-analysis was done using a random-effects model to assess the pooled estimate of HPV uptake. CRD42021218429.

FINDINGS

During 2008-2020, an estimated 3.3 million females received at least one dose of HPV vaccine with 61.69% of the target population vaccinated. In countries with high uptake, the pooled estimate of uptake was higher in females than males (45.48% vs 8.45%) and showed significant decline in 2015-2020 compared to 2006-2014 (89.03% vs 41.48%). In countries with low uptake, the estimate of uptake was low in both males and females (5.31% vs 2.93%) and showed increase in uptake in 2015-2020 compared to 2006-2014 (0.76% vs 5.22%). In countries with high uptake, compared to routine programs, the estimate was higher when delivered through demonstration programs (89.94% vs 59.74%).

INTERPRETATION

The major concern was a significant drop in the uptake in countries that started with high uptake, challenges in the maintenance of vaccine uptake, sustainability of funding and the lack of standard monitoring and reporting.