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Williams N, Griffin G, Wall M, Bradfield Z. The sexual and reproductive health knowledge of women in Australia: A scoping review. Health Promot J Austr 2024. [PMID: 39097983 DOI: 10.1002/hpja.908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 05/28/2024] [Accepted: 07/18/2024] [Indexed: 08/06/2024] Open
Abstract
ISSUE ADDRESSED Sexual and reproductive health (SRH) knowledge influences health literacy and promotes positive health behaviours. This scoping review explores the SRH knowledge of women in Australia and reports on knowledge assessment, ways of learning, enablers and barriers, and interventions to improve knowledge. METHODS Seven databases were searched for eligible articles published in English between 2012 and 2022. RESULTS Eighty-five sources were included for analysis. Data were mapped by knowledge topic and population group and charted against four review objectives. Assessment of knowledge was the primary focus in 59% of sources. Two sources used a validated knowledge assessment tool. Knowledge was assessed using self-assessment, a measurement of correctness, or both. Women learnt about SRH through a range of sources, including healthcare providers, peers, family, internet, and school. Enablers and barriers spanned information content, delivery, timing, accessibility, interactions with those providing information, cultural and gendered norms, pre-migration experiences, and functional health literacy. Nine sources reported on interventions to facilitate SRH knowledge. CONCLUSIONS This review identified topics, population groups, and gaps in assessment of SRH knowledge of women in Australia. Overall, the measurement of women's SRH knowledge is largely conducted using unvalidated tools focusing on specific topics. SO WHAT?: It is recommended a validated tool be developed to comprehensively assess the SRH knowledge of women in Australia allowing for intersectional population analysis and exploration of knowledge conceptualisation. This would enable assessment of interventions aiming to improve SRH knowledge thereby facilitating improved health literacy and outcomes.
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Affiliation(s)
- Natalie Williams
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Western Australia, Australia
- School of Nursing, Curtin University, Bentley, Western Australia, Australia
| | - Georgia Griffin
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Western Australia, Australia
| | - Megan Wall
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Western Australia, Australia
| | - Zoe Bradfield
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Western Australia, Australia
- School of Nursing, Curtin University, Bentley, Western Australia, Australia
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Kola‐Palmer S, Rogers M, Halliday A, Rickford R. "A lot can happen in five years": Women's attitudes to extending cervical screening intervals. Eur J Cancer Care (Engl) 2022; 31:e13655. [PMID: 35838304 PMCID: PMC9786642 DOI: 10.1111/ecc.13655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 06/16/2022] [Accepted: 06/24/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Evidence suggests that cervical screening intervals can be extended and lifetime cervical screening for human papillomavirus (HPV)-vaccinated women could be reduced. This study examines UK women's attitudes to extending screening intervals and assesses associations between knowledge, risk perception and HPV vaccination status, and acceptability of changes. METHODS Using a convenience sampling strategy, an anonymous mixed-methods online survey was used and data recorded from 647 women (mean age = 28.63, SD = 8.69). RESULTS Across the full sample, 46.1% of women indicated they would wait 5 years for their next cervical screening, while 60.2% of HPV-vaccinated women would be unwilling to have as few as three cervical screens in a lifetime. Multivariate analysis revealed those who are regular screened, those who intend to attend when invited, and those who perceive greater personal risk of cervical cancer are less likely to accept a 5-year screening interval. Qualitative findings relating to benefits of extending intervals included convenience of less tests, less physical discomfort, and psychological distress. Concerns identified included the likelihood of developing illness, increased psychological distress relating to what may be happening in the body, and worries about increased risk of cervical cancer. CONCLUSION Women need clear and specific information about HPV timelines, their relationship with cancer risk, and the rationale for extending screening intervals.
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Affiliation(s)
| | - Melanie Rogers
- Department of Nursing and MidwiferyUniversity of HuddersfieldHuddersfieldUK
| | - Abigail Halliday
- Department of PsychologyUniversity of HuddersfieldHuddersfieldUK
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Yamaguchi M, Sekine M, Kudo R, Adachi S, Ueda Y, Miyagi E, Hara M, Hanley SJB, Enomoto T. Differential misclassification between self-reported status and official HPV vaccination records in Japan: Implications for evaluating vaccine safety and effectiveness. ACTA ACUST UNITED AC 2018; 6:6-10. [PMID: 29807210 PMCID: PMC5991905 DOI: 10.1016/j.pvr.2018.05.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 05/23/2018] [Accepted: 05/24/2018] [Indexed: 01/02/2023]
Abstract
Japan has no national vaccine registry and approximately 1700 municipalities manage the immunization records independently. In June 2013, proactive recommendations for the human papillomavirus (HPV) vaccine were suspended after unconfirmed reports of adverse events following immunization in the media, despite no vaccine safety signal having been raised. Furthermore, studies assessing HPV vaccine safety and effectiveness published post suspension are predominantly based on self-reported information. Our aim was to examine the accuracy of self-reported vaccination status compared with official municipal records. Participants were women aged 20–22 yrs, who were attending for cervical screening in Niigata city. Among the 1230 eligible registrants, vaccine uptake, defined as any dose, was 75.0% and 77.2% according to a self-reported questionnaire and municipal records, respectively. The accuracy rate of self-reported information was as follows: positive predictive value (PPV) was 87.7%; negative predictive value (NPV) was 54.5%; sensitivity was 85.2%; and specificity was 59.8%. The validity of self-reported information was only moderate (Kappa statistic = 0.44, 95% confidence interval 0.37–0.50). This combined with the low NPV may lead to reduced estimation of effectiveness and safety. A more reliable method, such as a national HPV vaccine registry, needs to be established for assessing HPV immunization status in Japan.
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Affiliation(s)
- Manako Yamaguchi
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Masayuki Sekine
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Risa Kudo
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Sosuke Adachi
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yutaka Ueda
- Departments of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Megumi Hara
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Sharon J B Hanley
- Department of Women's Health Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Venturelli F, Baldacchini F, Campari C, Perilli C, Pascucci MG, Finarelli AC, Moscara L, Rossi PG. Association between mothers' screening uptake and daughters' HPV vaccination: a quasi-experimental study on the effect of an active invitation campaign. BMJ Open 2017; 7:e016189. [PMID: 28951407 PMCID: PMC5722088 DOI: 10.1136/bmjopen-2017-016189] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES In Emilia-Romagna, the Human Papillomavirus (HPV) vaccination campaign started in 2008 offering free vaccines for 1996 and 1997 cohorts. Systematic active invitation was implemented for the 1997 cohort. Our study aimed at measuring the impact of the active invitation campaign on HPV vaccine coverage and on coverage inequalities in 11-year-old girls. Second, we evaluated the effect of the HPV vaccination campaign on participation in cervical cancer screening by mothers of target girls. METHODS We collected information on vaccination status for girls residing in Reggio Emilia in 2008 and mothers' screening history, before and after the 2008 vaccination campaign. Log-binomial regression models were performed to estimate Relative Risk (RR) and 95% confidence intervals (CIs) of being vaccinated as regarded citizenship, siblings, mothers' education, marital status and screening history, stratified by birth cohort. We also calculated RR of receiving a Pap test after the vaccination campaign as regarded education, daughter's cohort and mothers' decision to have their daughter vaccinated. Interaction between education and cohort in mothers overdue for Pap testing was calculated. RESULTS Vaccination coverage was 46.3% for the uninvited cohort (1046/2260) and 77.9% for the invited cohort (1798/2307). In the uninvited cohort, daughters' vaccination showed association with mothers' education (8 to 11 years of education vs. graduated mothers, RR 1.61 95% CI 1.14-2.28), citizenship (foreigners vs. Italians, RR 0.45 95% CI 0.37-0.56) and screening history (regular vs. non-participant; RR 1.72 95% CI 1.26-2.36). In the invited cohort, only a slight association with screening history persisted (regular vs. non-participant; RR 1.20 95% CI 1.04-1.40). Highly educated under-screened mothers of the invited cohort showed a higher probability of receiving a Pap test after the vaccination campaign period (RR 1.27 95% CI 1.04-1.56) compared with those not invited, CONCLUSION: Active invitation could increase overall HPV immunisation coverage and reduce socio-demographic inequalities and the association with mothers' screening participation.
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Affiliation(s)
- Francesco Venturelli
- Interinstitutional Epidemiology Unit, Local Health Authority of Reggio Emilia, Reggio Emilia, Italy
- Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Flavia Baldacchini
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST)-IRCCS, Meldola, Italy
| | - Cinzia Campari
- Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
- Coordination Screening Centre, Local Health Authority of Reggio Emilia, Reggio Emilia, Italy
| | - Cinzia Perilli
- Public Health Service, Local Health Authority of Reggio Emilia, Reggio Emilia, Italy
| | - Maria Grazia Pascucci
- Directorate General for Health and Social Policy - Emilia-Romagna Region, Bologna, Italy
| | - Alba Carola Finarelli
- Directorate General for Health and Social Policy - Emilia-Romagna Region, Bologna, Italy
| | - Luigi Moscara
- Community paediatrics, Local Health Authority of Reggio Emilia, Reggio Emilia, Italy
| | - Paolo Giorgi Rossi
- Interinstitutional Epidemiology Unit, Local Health Authority of Reggio Emilia, Reggio Emilia, Italy
- Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
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Barroeta JE, Adhikari-Guragain D, Grotkowski CE. Cervical cancer screening in the era of HPV vaccination: A review of shifting paradigms in cytopathology. Diagn Cytopathol 2017; 45:903-914. [PMID: 28589649 DOI: 10.1002/dc.23737] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 03/16/2017] [Accepted: 04/07/2017] [Indexed: 01/14/2023]
Abstract
Significant changes in cervical cancer screening practice, guidelines, and prevention of cervical cancer have taken place in recent years including the raising of initial cervical cancer screening age, changes in frequency of cytology screening, and the adoption of high risk HPV and cytology co-testing for some patients; the introduction of the bivalent, quadrivalent, and 9-valent HPV vaccines; and the recent approval of high risk HPV testing as primary screening with the use of cytology as triage in positive cases. This review discusses the significance of primary HPV screening, the impact of HPV vaccination in the prevalence of cervical cancer and its precursors, the interplay between high risk HPV testing and vaccination, and the implications for clinical and cytological management. Future strategies for cervical screening in the post-vaccination era are also discussed.
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Affiliation(s)
- Julieta E Barroeta
- Department of Pathology, Cooper University Hospital, M.D. Anderson Cancer Center at Cooper, Camden, New Jersey
| | - Deepti Adhikari-Guragain
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Carolyn E Grotkowski
- Department of Pathology, Cooper University Hospital, M.D. Anderson Cancer Center at Cooper, Camden, New Jersey
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Urrutia MT, Gajardo M, Padilla O. Development and testing of the questionnaire CEC-61: Knowledge about cervical cancer in Chilean adolescents. Women Health 2017; 58:647-660. [PMID: 28532342 DOI: 10.1080/03630242.2017.1333073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Despite a clear association between human papillomavirus and cervical cancer, knowledge in adolescent populations regarding the disease and methods for its detection and prevention is deficient. The aim of this study was to develop and test a new questionnaire concerning knowledge on cervical cancer. An instrument was developed and validated to measure knowledge in 226 Chilean adolescents between April and June 2011. Content validity, construct validity, and reliability analysis of the instrument were performed. The new, validated instrument, called CEC-61 (Conocimientos en Cancer Cérvicouterino-61 items/Knowledge in Cervical Cancer-61 items), contains nine factors and 61 items. The new questionnaire explained 81% of the variance with a reliability of 0.96. The assessment of knowledge with a valid and reliable instrument is the first step in creating interventions for a population and to encourage appropriate preventive behavior. CEC-61 is highly reliable and has a clear factorial structure to evaluate knowledge in nine domains related to cervical cancer disease, cervical cancer risk, papilloma virus infection, the Papanicolaou test, and the papilloma virus vaccine.
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Affiliation(s)
| | - Macarena Gajardo
- b Undergraduate Program, School of Medicine, Universidad de Chile , Santiago , Chile
| | - Oslando Padilla
- c Department of Public Health , School of Medicine, Pontificia Universidad Católica de Santiago , Santiago , Chile
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Diaz A, Kang J, Moore SP, Baade P, Langbecker D, Condon JR, Valery PC. Association between comorbidity and participation in breast and cervical cancer screening: A systematic review and meta-analysis. Cancer Epidemiol 2017; 47:7-19. [DOI: 10.1016/j.canep.2016.12.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 12/11/2016] [Accepted: 12/22/2016] [Indexed: 01/08/2023]
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Hestbech MS, Gyrd-Hansen D, Kragstrup J, Siersma V, Brodersen J. How does HPV vaccination status relate to risk perceptions and intention to participate in cervical screening? a survey study. BMC Public Health 2016; 15:708. [PMID: 27488178 PMCID: PMC4973036 DOI: 10.1186/s12889-016-3397-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 07/28/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Women in several countries will soon be covered by two preventive programmes targeting cervical cancer: HPV vaccination and cervical screening. The HPV vaccines are expected to prevent approximately 70 % of cervical cancers. It has been speculated, that HPV vaccinated women will not attend screening because they falsely think that the vaccine has eliminated their cervical cancer risk. The aim of this study was to investigate the association between HPV vaccination status and perceptions of cervical cancer risk; perceptions of vaccine effect; and intention to participate in cervical screening. Furthermore, to investigate associations between perceptions of cervical cancer risk and intention to participate in cervical screening. METHODS A random sample of Danish women from the birth cohorts 1993-1995 was invited to complete a web-based questionnaire concerning risk perceptions and intentions to participate in cervical screening. Main outcomes were: perceived lifetime-risk of cervical cancer; perceived HPV vaccine effect; and intention to participate in cervical screening. RESULTS HPV vaccinated women more often than unvaccinated women intended to participate in screening: adjusted odds ratio (OR) for being HPV vaccinated when intending to participate in screening of 3.89 (95 % CI: 2.50-6.06). HPV vaccinated women perceived cervical cancer risk to be higher than unvaccinated women did: adjusted OR of 0.11 (95 % CI: 0.03-0.39) and 0.51 (95 % CI: 0.33-0.78) for being HPV vaccinated while having the lowest perception of risk (in two different pre-specified dichotomisations). HPV vaccinated women perceived the vaccine effect to be larger than unvaccinated women did: adjusted OR of 0.31 (95 % CI: 0.18-0.51) and 0.37 (95 % CI: 0.25-0.53) for being HPV vaccinated while having the lowest perception of vaccine effect (in two different pre-specified dichotomisations). There were no associations between perceived cervical cancer risk and intention to participate in screening. CONCLUSIONS HPV vaccinated women more often than unvaccinated women intended to participate in screening and they perceived cervical cancer risk to be higher and the vaccine effect to be larger than unvaccinated women did. However, in our analyses, risk perceptions could not explain screening intentions neither among vaccinated nor among unvaccinated women.
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Affiliation(s)
- Mie Sara Hestbech
- Section of General Practice and Research Unit for General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, PO Box 2099, 1014, Copenhagen K, Denmark.
| | - Dorte Gyrd-Hansen
- COHERE, Department of Business and Economics & Department of Public Health, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Jakob Kragstrup
- Section of General Practice and Research Unit for General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, PO Box 2099, 1014, Copenhagen K, Denmark
| | - Volkert Siersma
- Section of General Practice and Research Unit for General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, PO Box 2099, 1014, Copenhagen K, Denmark
| | - John Brodersen
- Section of General Practice and Research Unit for General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, PO Box 2099, 1014, Copenhagen K, Denmark.,Primary Health Care Research Unit, Zealand Region, Denmark
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9
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Associations between prior HPV4 vaccine doses and cervical cancer screening participation. Cancer Epidemiol 2016; 42:108-14. [DOI: 10.1016/j.canep.2016.04.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 04/04/2016] [Accepted: 04/05/2016] [Indexed: 11/19/2022]
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Higgins LM, Dirksing KN, Ding L, Morrow CD, Widdice LA, Kahn JA. Adolescents' intention and self-efficacy to follow Pap testing recommendations after receiving the HPV vaccine. Hum Vaccin Immunother 2016; 12:1498-503. [PMID: 26934107 DOI: 10.1080/21645515.2016.1150395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Human papillomavirus (HPV) vaccines are recommended in the US for girls and women 11-26 y of age. Because these vaccines do not prevent all cervical cancers, Papanicolaou (Pap) screening is still recommended after vaccination. Young women who have been vaccinated may perceive themselves at lower risk for HPV infection and cervical cancer, which could lead to lower intention and self-efficacy to follow cervical cancer screening guidelines, and subsequent nonadherence to Pap testing. The aim of this study was to examine whether perceived risk of human papillomavirus (HPV) after vaccination and other factors are associated with adolescents' intention and self-efficacy to get Pap testing after HPV vaccination. Women 13-21 y of age (N = 339) receiving their first HPV vaccine dose completed a survey. Multivariable logistic regression examined associations between perceived risk of HPV and intention/self-efficacy to get a Pap test while adjusting for other factors. Approximately half of participants reported high intention and half reported high self-efficacy to get a Pap test. Factors significantly associated with high intention were Pap testing history and knowledge about HPV/HPV vaccines; factors significantly associated with high self-efficacy included insurance plan, Pap testing history, communication with clinician about needing a Pap test after vaccination, lifetime number of male sexual partners, and recent smoking. In conclusion, educating adolescents about HPV/HPV vaccines and the need for Pap testing may increase self-efficacy/intention to get a Pap test after vaccination.
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Affiliation(s)
- Lisa M Higgins
- a Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine , Cincinnati , OH , USA
| | - Kelsie N Dirksing
- a Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine , Cincinnati , OH , USA
| | - Lili Ding
- a Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine , Cincinnati , OH , USA
| | - Charlene D Morrow
- a Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine , Cincinnati , OH , USA
| | - Lea A Widdice
- a Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine , Cincinnati , OH , USA
| | - Jessica A Kahn
- a Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine , Cincinnati , OH , USA
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Palmer TJ, McFadden M, Pollock KGJ, Kavanagh K, Cuschieri K, Cruickshank M, Nicoll S, Robertson C. HPV immunisation and increased uptake of cervical screening in Scottish women; observational study of routinely collected national data. Br J Cancer 2016; 114:576-81. [PMID: 26794278 PMCID: PMC4782202 DOI: 10.1038/bjc.2015.473] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 12/03/2015] [Accepted: 12/04/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND To measure the uptake of first invitation to cervical screening by vaccine status in a population-based cohort offered HPV immunisation in a national catch-up campaign. METHODS A retrospective observational study of routinely collected data from the Scottish Cervical Screening Programme. Data were extracted and linked from the Scottish Cervical Call Recall System, the Scottish Population Register and the Scottish Index of Multiple Deprivation. Records from 201 023 women born between 1 January 1988 and 30 September 1993 were assessed. Women born in or after 1990 were eligible for the national catch-up programme of HPV immunisation. Attendance for screening was within 12 months of the first invitation at age 20 years. RESULTS There was a significant decline in overall attendance from the 1988 cohort to the 1993 cohort with the adjusted attendance ratio of the 1988 cohort being 1.49 times (95% CI 1.46-1.52) that of the 1993 cohort. Immunisation compensated for this decrease in uptake with unvaccinated individuals having a reduced ratio of attendance compared with those fully vaccinated (RR=0.65, 95% CI 0.64-0.65). Not taking up the opportunity for HPV immunisation was associated with an attendance for screening below the trend line for all women before the availability of HPV immunisation. CONCLUSIONS HPV immunisation is not associated with the reduced attendance for screening that had been feared. Immunised women in the catch-up cohorts appear to be more motivated to attend than unimmunised women, but this may be a result of a greater awareness of health issues. These results, while reassuring, may not be reproduced in routinely immunised women. Continued monitoring of attendance for the first smear and subsequent routine smears is needed.
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Affiliation(s)
- T J Palmer
- Department of Pathology, University of Edinburgh, EH16 4SA, University of Edinburgh, Edinburgh, Scotland
| | - M McFadden
- Information Services Division, NHS National Services Scotland, Gyle Square, Edinburgh EH12 9EB, UK
| | - K G J Pollock
- Health Protection Scotland, Glasgow G2 6QE, Scotland
| | - K Kavanagh
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow G1 1XH, Scotland
| | - K Cuschieri
- Scottish Human Papillomavirus Reference Laboratory, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, Scotland
| | - M Cruickshank
- Department of Gynaecology, Aberdeen Royal Infirmary, Aberdeen AB25 2ZD, Scotland
| | - S Nicoll
- Department of Cytology, Ninewells Hospital, Dundee DD1 9SY, Scotland
| | - C Robertson
- Health Protection Scotland, Glasgow G2 6QE, Scotland
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow G1 1XH, Scotland
- International Prevention Research Institute, Lyon, France
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12
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Gallagher KE, Kadokura E, Eckert LO, Miyake S, Mounier-Jack S, Aldea M, Ross DA, Watson-Jones D. Factors influencing completion of multi-dose vaccine schedules in adolescents: a systematic review. BMC Public Health 2016; 16:172. [PMID: 26895838 PMCID: PMC4759915 DOI: 10.1186/s12889-016-2845-z] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 02/08/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Completion of multiple dose vaccine schedules is crucial to ensure a protective immune response, and maximise vaccine cost-effectiveness. While barriers and facilitators to vaccine uptake have recently been reviewed, there is no comprehensive review of factors influencing subsequent adherence or completion, which is key to achieving vaccine effectiveness. This study identifies and summarises the literature on factors affecting completion of multi-dose vaccine schedules by adolescents. METHODS Ten online databases and four websites were searched (February 2014). Studies with analysis of factors predicting completion of multi-dose vaccines were included. Study participants within 9-19 years of age were included in the review. The defined outcome was completion of the vaccine series within 1 year among those who received the first dose. RESULTS Overall, 6159 abstracts were screened, and 502 full texts were reviewed. Sixty one studies were eligible for this review. All except two were set in high-income countries. Included studies evaluated human papillomavirus vaccine, hepatitis A, hepatitis B, and varicella vaccines. Reported vaccine completion rates, among those who initiated vaccination, ranged from 27% to over 90%. Minority racial or ethnic groups and inadequate health insurance coverage were risk factors for low completion, irrespective of initiation rates. Parental healthcare seeking behaviour was positively associated with completion. Vaccine delivery in schools was associated with higher completion than delivery in the community or health facilities. Gender, prior healthcare use and socio-economic status rarely remained significant risks or protective factors in multivariate analysis. CONCLUSIONS Almost all studies investigating factors affecting completion have been carried out in developed countries and investigate a limited range of variables. Increased understanding of barriers to completion in adolescents will be invaluable to future new vaccine introductions and the further development of an adolescent health platform. PROSPERO reg# CRD42014006765.
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Affiliation(s)
- K E Gallagher
- Clinical Research Department, Faculty of Infectious Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
- Mwanza Intervention Trials Unit, The National Institute for Medical Research Mwanza Campus, PO Box 11936, Mwanza, Tanzania.
| | - E Kadokura
- Department of Epidemiology, University of Washington, 1959 NE Pacific Street, Health Sciences Building F-250, Box 357236, Seattle, WA, 98195-7236, USA.
| | - L O Eckert
- Departments of Obstetrics and Gynaecology and Global Health, University of Washington, 1959 NE Pacific Street, Health Sciences Building F-250, Box 357236, Seattle, WA, 98195-7236, USA.
| | - S Miyake
- Clinical Research Department, Faculty of Infectious Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - S Mounier-Jack
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
| | - M Aldea
- Infections and Cancer Unit, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Av. Gran Via de l'Hospitalet 199-203, Hospitalet de Llobregat, 08908, Barcelona, Spain.
- Bellvitge Institute of Biomedical Research (IDIBELL), Barcelona, Spain.
| | - D A Ross
- MRC Tropical Epidemiology Group, Faculty of Epidemiology and Population Health, London school of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - D Watson-Jones
- Clinical Research Department, Faculty of Infectious Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
- Mwanza Intervention Trials Unit, The National Institute for Medical Research Mwanza Campus, PO Box 11936, Mwanza, Tanzania.
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13
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Brotherton JML, Piers LS, Vaughan L. Estimating human papillomavirus vaccination coverage among young women in Victoria and reasons for non-vaccination. Sex Health 2016; 13:190-2. [DOI: 10.1071/sh15131] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 10/13/2015] [Indexed: 11/23/2022]
Abstract
Background
Adult Australian women aged 18 to 26 years were offered human papillomavirus (HPV) vaccine in a mass catch up campaign between 2007 and 2009. Not all doses administered were notified to Australia’s HPV vaccine register and not all young women commenced or completed the vaccine course. Methods: We surveyed vaccine age-eligible women as part of the Victorian Population Health Survey 2011–2012, a population based telephone survey, to ascertain self-reported vaccine uptake and reasons for non-vaccination or non-completion of vaccination among young women resident in the state of Victoria, Australia. Results: Among 956 women surveyed, 62.3 per cent (57.8–66.6%) had been vaccinated against HPV and coverage with three doses was estimated at 53.7 per cent (49.1–58.2%). These estimates are higher than register-based estimates for the same cohort, which were 57.8 per cent and 37.2 per cent respectively. A lack of awareness about needing three doses and simply forgetting, rather than fear or experience of side effects, were the most common reasons for failure to complete all three doses. Among women who were not vaccinated, the most frequent reasons were not knowing the vaccine was available, perceiving they were too old to benefit, or not being resident in Australia at the time. Conclusions: It is likely that at least half of Victoria’s young women were vaccinated during the catch-up program. This high level of coverage is likely to explain the marked reductions in HPV infection, genital warts and cervical disease already observed in young women in Victoria.
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Brotherton JM, Malloy M, Budd AC, Saville M, Drennan KT, Gertig DM. Effectiveness of less than three doses of quadrivalent human papillomavirus vaccine against cervical intraepithelial neoplasia when administered using a standard dose spacing schedule: Observational cohort of young women in Australia. PAPILLOMAVIRUS RESEARCH 2015. [PMCID: PMC5891730 DOI: 10.1016/j.pvr.2015.05.005] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background Optimised two-dose human papillomavirus (HPV) vaccine schedules are now endorsed for young adolescents by the World Health Organization. Limited data are available about effectiveness of <3 doses using a standard dose schedule. Methods Deterministic data linkage was undertaken between the Victorian Cervical Cytology Registry and National HPV Vaccination Program Register to determine quadrivalent HPV vaccination status and incidence of cervical pathology among vaccine eligible women (aged 26 years or younger in 2007) screened in Victoria, Australia between April 2007 and December 2011. Proportional hazards regression was used to estimate hazard ratios (HR) adjusted for age, socioeconomic status and area of residence. Women were stratified into those vaccinated before or after first screen. Results Any number of doses (1, 2 or 3) were associated with lower rates of high grade and low grade cytology diagnoses as long as doses were given before screening commencement (one dose HR high grade 0.44 (95% CI 0.32–0.59), one dose low grade 0.48 (95% CI 0.40–0.58); two doses HR high grade 0.63 (95% CI 0.50–0.80), HR low grade 0.52 (95% CI 0.44–0.61); three doses HR high grade 0.53 (95% CI 0.47–0.60), HR low grade 0.73 (95% CI 0.68–0.78)). Three doses of vaccine, but not fewer, were associated with reduced risk of high grade histologically confirmed abnormality in this cohort, regardless of whether vaccination occurred before or after screening (HR before 0.71 (95% CI 0.64–0.80), HR after 0.87 (95% CI 0.82–0.93)). Secondary analyses censoring end points occurring within 1, 6, 12, or 24 months of final vaccine dose suggested an increasing effect of partial vaccination courses over time. Conclusion Our data suggest that less than three doses of quadrivalent HPV vaccine provides some protection against cervical intraepithelial neoplasia, even when measured within 5 years in a population including those who were sexually active at the time of vaccination.
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Coles VAH, Patel AS, Allen FL, Keeping ST, Carroll SM. The association of human papillomavirus vaccination with sexual behaviours and human papillomavirus knowledge: a systematic review. Int J STD AIDS 2014; 26:777-88. [PMID: 25300588 DOI: 10.1177/0956462414554629] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 09/15/2014] [Indexed: 11/15/2022]
Abstract
Since the 2008 introduction of the human papillomavirus (HPV) vaccination programme for adolescent girls in the UK, parents and other groups have expressed fears that immunisation condones sexual activity, promotes promiscuity and encourages risky sexual behaviour. This study aimed to explore whether HPV vaccination programmes have increased knowledge surrounding HPV and associated disease and whether uptake has influenced sexual behaviour. MEDLINE, Embase, Cochrane Library and PsycINFO electronic databases were interrogated. Studies of behaviour, attitudes and knowledge associated with HPV vaccination (or vaccination intent) in subjects of any age and gender in programmes reflective of UK practice were included in the review (n = 58). The evidence regarding the association of HPV vaccination with high-risk sexual behaviour was varied, primarily due to the heterogeneous nature of the included studies. Young females typically exhibited better knowledge than males, and vaccinated respondents (or those with vaccination intent) had higher levels of knowledge than the unvaccinated. However, knowledge surrounding HPV and genital warts was generally poor. This review highlights the need to provide effective education regarding the HPV vaccine and HPV-associated disease to adolescents of vaccination age, nurses, teachers, parents and guardians to ultimately allow informed decisions to be made regarding receipt of the HPV vaccine.
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Budd AC, Brotherton JM, Gertig DM, Chau T, Drennan KT, Saville M. Cervical screening rates for women vaccinated against human papillomavirus. Med J Aust 2014; 201:279-82. [DOI: 10.5694/mja14.00021] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 04/15/2014] [Indexed: 11/17/2022]
Affiliation(s)
- Alison C Budd
- Cancer and Screening Unit, Australian Institute of Health and Welfare, Canberra, ACT
| | - Julia M L Brotherton
- Victorian Cytology Service, Melbourne, VIC
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC
| | - Dorota M Gertig
- Victorian Cytology Service, Melbourne, VIC
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC
| | - Theresa Chau
- Cancer and Screening Unit, Australian Institute of Health and Welfare, Canberra, ACT
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17
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Giorgi Rossi P, Baldacchini F, Ronco G. The Possible Effects on Socio-Economic Inequalities of Introducing HPV Testing as Primary Test in Cervical Cancer Screening Programs. Front Oncol 2014; 4:20. [PMID: 24575388 PMCID: PMC3919018 DOI: 10.3389/fonc.2014.00020] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Accepted: 01/24/2014] [Indexed: 11/13/2022] Open
Abstract
Background: Screening with HPV is more effective than Pap test in preventing cervical cancer. HPV as primary test will imply longer intervals and a triage test for HPV positive women. It will also permit the development of self-sampling devices. These innovations may affect population coverage, participation, and compliance to protocols, and likely in a different way for less educated, poorer, and disadvantaged women. Aim: To describe the impact on inequalities, actual or presumed, of the introduction of HPV-based screening. Methods: The putative HPV-based screening algorithm has been analyzed to identify critical points for inequalities. A systematic review of the literature has been conducted searching PubMed on HPV screening coverage, participation, and compliance. Results were summarized in a narrative synthesis. Results: Knowledge about HPV and cervical cancer was lower in women with low socio-economic status and in disadvantaged groups. A correct communication can reduce differences. Longer intervals will make it easier to achieve high-population coverage, but higher cost of the test in private providers could reduce the use of opportunistic screening by disadvantaged women. There are some evidences that inviting for HPV test instead of Pap increases participation, but there are no data on social differences. Self-sampling devices are effective in increasing participation and coverage. Some studies showed that the acceptability of self-sampling is higher in more educated women, but there is also an effect on hard-to-reach women. Communication of HPV positivity may increase anxiety and impact on sexual behaviors, the effect is stronger in low educated and disadvantaged women. Finally, many studies found indirect evidence that unvaccinated women are or will be more probably under-screened. Conclusion: The introduction of HPV test may increase population coverage, but non-compliance to protocols and interaction with opportunistic screening can increase the existing inequalities.
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Affiliation(s)
- Paolo Giorgi Rossi
- Servizio Interaziendale di Epidemiologia, Azienda Unità Sanitaria Locale di Reggio Emilia , Reggio Emilia , Italy
| | - Flavia Baldacchini
- Servizio Interaziendale di Epidemiologia, Azienda Unità Sanitaria Locale di Reggio Emilia , Reggio Emilia , Italy
| | - Guglielmo Ronco
- Unit of Cancer Epidemiology II, Center for Cancer Epidemiology and Prevention (CPO) , Turin , Italy
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18
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Miyagi E, Sukegawa A, Motoki Y, Kaneko T, Maruyama Y, Asai-Sato M, Numazaki R, Mizushima S, Hirahara F. Attitudes toward cervical cancer screening among women receiving human papillomavirus vaccination in a university-hospital-based community: interim 2-year follow-up results. J Obstet Gynaecol Res 2014; 40:1105-13. [PMID: 24428631 DOI: 10.1111/jog.12288] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Accepted: 09/03/2013] [Indexed: 11/28/2022]
Abstract
AIM This study investigated the status of cervical cancer screening among women in a university hospital-based community who received catch-up human papillomavirus (HPV) vaccinations as a basic element of our community-based cervical cancer prevention advocacy. METHODS Self-administered questionnaires were distributed to 173 women working or studying in the community at their first HPV vaccination in 2010, at the third vaccination, and 2 years later. Their demographics and attitudes toward the Pap test were analyzed. RESULTS The median age of the participants was 27.5 years and 88.2% were sexually active. Before the first vaccination, 38.5% (57/148) of the screening targets had never had a Pap test. Among the women who completed the third vaccination, Pap test experiences within the recent 2 years increased from 45.3% (63/139) at the first vaccination to 71.2% (99/137) at the third vaccination, and 67.5% (54/80) 2 years later. In 45.3% of the screening targets who had never had a Pap test at the time of their first HPV vaccination, their first Pap test was followed by their vaccination. CONCLUSIONS Having biennial Pap tests in accordance with the Japanese national cancer screening guideline was shown to be difficult even for the women in the medical community; however, education about the Pap test and the efficacy of HPV vaccination in providing opportunistic screening encouraged them to have their first or suspended Pap test. Our interim data suggest the need for urgently changing the cervical cancer prevention strategy for young adult women who are excluded from the national HPV vaccine program.
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Affiliation(s)
- Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama, Japan
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19
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Human papillomavirus (HPV) vaccination coverage in young Australian women is higher than previously estimated: Independent estimates from a nationally representative mobile phone survey. Vaccine 2014; 32:592-7. [DOI: 10.1016/j.vaccine.2013.11.075] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 11/11/2013] [Accepted: 11/21/2013] [Indexed: 11/20/2022]
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20
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Kliewer EV, Mahmud SM, Demers AA, Lambert P. Human papillomavirus vaccination and Pap testing profile in Manitoba, Canada. Vaccine 2013; 32:33-8. [PMID: 24211170 DOI: 10.1016/j.vaccine.2013.10.082] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 10/22/2013] [Accepted: 10/24/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND Females who receive the human papillomavirus (HPV) vaccine may believe they are protected from developing cervical cancer and no longer require screening. Concern has also been expressed that vaccinated females are those that would be screened regularly. This study assesses the Pap testing behavior of vaccinated and non-vaccinated females. METHODS For this population-based retrospective cohort study, vaccination and screening registries were linked for 3540 vaccinated females aged 15 years and over and 9592 matched non-vaccinated females. Conditional logistic regression, the Kaplan-Meier method and Cox regression were used to examine the association between vaccination and Pap testing. RESULTS Vaccinated females were more likely to have had a Pap test within the year prior to the index date than non-vaccinated females (15-19 years old: OR=1.38, 95% CI 1.20-1.59; 20+ years old: OR=2.34, 95% CI 1.98-2.76). In the three-year period after the index date, vaccinated females had a significantly higher cumulative probability of having a Pap test (83.3%) than non-vaccinated females (66.1%). Females who had a Pap test within three years prior to the index date were more likely to have a Pap test after the index date (vaccinated: HR=5.03, 95% CI 4.65-5.45; non-vaccinated HR=3.97, 95% CI 3.70-4.24). Being vaccinated had a significant effect on Pap testing (15-19 years old: HR=1.54, 95% CI 1.39-1.69; 20+ years old: HR=1.87, 95% CI 1.52-2.31). 80.1% of vaccinated females who had a Pap test prior to the index date also had one subsequent to it, compared to 70.1% for non-vaccinated females. 41.1% of females had not been vaccinated nor had a Pap test. CONCLUSION The majority of vaccinated females continue to participate in screening, and do so at a higher rate than non-vaccinated females. Renewed efforts need to be made to include the large proportion of non-vaccinated, non-screened females in vaccination and/or screening.
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Affiliation(s)
- Erich V Kliewer
- Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, Canada; Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada; Cancer Control Research, British Columbia Cancer Agency, Vancouver, BC, Canada.
| | - Salaheddin M Mahmud
- Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, Canada; Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
| | - Alain A Demers
- Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, Canada; Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
| | - Pascal Lambert
- Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, Canada.
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Brotherton JML, Murray SL, Hall MA, Andrewartha LK, Banks CA, Meijer D, Pitcher HC, Scully MM, Molchanoff L. Human papillomavirus vaccine coverage among female Australian adolescents: success of the school‐based approach. Med J Aust 2013; 199:614-7. [DOI: 10.5694/mja13.10272] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 08/08/2013] [Indexed: 11/17/2022]
Affiliation(s)
- Julia M L Brotherton
- National HPV Vaccination Program Register, Victorian Cytology Service, Melbourne, VIC
- Discipline of Paediatrics and Child Health, University of Sydney, Sydney, NSW
| | | | | | - Lynne K Andrewartha
- Communicable Diseases Control Unit, Department of Health and Human Services, Hobart, TAS
| | | | - Dennis Meijer
- Communicable Diseases Branch, Health Protection NSW, NSW Health, Sydney, NSW
| | | | - Megan M Scully
- Communicable Disease Control Directorate, WA Health, Perth, WA
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22
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Mullins R, Coomber K, Broun K, Wakefield M. Promoting cervical screening after introduction of the human papillomavirus vaccine: the effect of repeated mass media campaigns. J Med Screen 2013; 20:27-32. [DOI: 10.1177/0969141313478588] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives In 2007, Australia implemented an ongoing, school-based human papillomavirus (HPV) vaccination programme for school-aged girls, and a catch-up programme for 18–26-year-old women that ran until the end of 2009. The availability of what is widely known as the ‘cervical cancer vaccine’ means there is the potential for women to believe, incorrectly, that they no longer require regular cervical screening, and this risk needs to be addressed. The current study aimed to assess the effect of three mass media campaigns to promote cervical screening on the rate of cervical screening tests in the Australian state of Victoria, after HPV vaccine became available. Methods Seasonal time series assessed the effect of media campaigns broadcast in 2007, 2009 and 2010 on the rate of weekly cervical screening tests in Victorian women from 2006 to 2010, stratified by time since last screening test. Results The 2007 and 2009 media campaigns significantly increased the number of cervical screening tests per week. The 2007 campaign had a significant impact on lapsed screeners (>36 months since last test), overdue screeners (28–36 months since last test), and women never previously screened. The 2009 campaign significantly increased screening tests for overdue screeners, and the 2010 media campaign was associated with a significant increase in screening tests for lapsed screeners. Conclusions A well-researched and carefully pretested television advertising campaign with accurate, actionable messages can elicit appropriate screening behaviour among some of the appropriate groups even in a changed environment of complex, and potentially competing, messages.
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Affiliation(s)
- R Mullins
- Centre for Behavioral Research in Cancer, Cancer Council Victoria, Carlton, Victoria, Australia
| | - K Coomber
- Centre for Behavioral Research in Cancer, Cancer Council Victoria, Carlton, Victoria, Australia
| | - K Broun
- Cancer Prevention Centre, Cancer Council Victoria, Carlton, Victoria, Australia
| | - M Wakefield
- Centre for Behavioral Research in Cancer, Cancer Council Victoria, Carlton, Victoria, Australia
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Sopracordevole F, Cigolot F, Mancioli F, Agarossi A, Boselli F, Ciavattini A. Knowledge of HPV infection and vaccination among vaccinated and unvaccinated teenaged girls. Int J Gynaecol Obstet 2013; 122:48-51. [PMID: 23523333 DOI: 10.1016/j.ijgo.2013.02.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2012] [Revised: 01/31/2013] [Accepted: 03/06/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To assess the knowledge of teenaged girls on human papillomavirus (HPV) infection and vaccination 12 months after the start of a vaccine administration and information campaign. METHODS Between May 15 and June 15, 2009, an anonymous questionnaire was given to 629 girls attending a secondary school in a northeastern Italian city (286 were vaccinated against HPV, 343 were unvaccinated) to investigate their knowledge on HPV infection, transmission, prevention, vaccination, and post-vaccination behaviors. The responses were evaluated with respect to the vaccination status of the participants. RESULTS Vaccinated teenaged girls had no more knowledge than unvaccinated ones about the route of HPV transmission, and the relationship between HPV and AIDS. Vaccinated girls had less knowledge than unvaccinated girls about preventing transmission by condom (P=0.003) and about the correlation between HPV and penile cancer (P=0.034) and warts (P=0.001). Furthermore, compared with unvaccinated girls, more vaccinated girls believed that contraceptive pills might prevent HPV-related disease (P=0.001). Vaccinated girls better understood the importance of performing regular Pap smears after vaccination (P=0.021). CONCLUSION Knowledge on HPV infection and vaccination remains suboptimal, especially among vaccinated teenaged girls, despite a broad information campaign. Misconceptions about the utility of secondary prevention may increase risky sexual behaviors.
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Marlow LAV, Zimet GD, McCaffery KJ, Ostini R, Waller J. Knowledge of human papillomavirus (HPV) and HPV vaccination: an international comparison. Vaccine 2012; 31:763-9. [PMID: 23246310 DOI: 10.1016/j.vaccine.2012.11.083] [Citation(s) in RCA: 126] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Revised: 11/27/2012] [Accepted: 11/28/2012] [Indexed: 11/30/2022]
Abstract
Since vaccination against human papillomavirus (HPV) became available, awareness of HPV has dramatically increased. Implementation of a vaccine program varies internationally yet no studies have explored the influence this has on the public's knowledge of HPV. The present study aimed to explore differences in awareness of HPV and HPV knowledge across three countries: The US, UK and Australia. Participants (n=2409) completed a validated measure of HPV knowledge as part of an online survey. There were higher levels of HPV awareness among men and women in the US than the UK and Australia. Being male and having a lower educational level was associated with lower HPV awareness in all three countries. Awareness of HPV vaccine was higher in women from the US than the UK and Australia. Women in the US scored significantly higher on general HPV knowledge (on a 15-item scale) than women in the UK and Australia, but there were no between country differences in HPV vaccine knowledge (on a 6-item scale). When asked about country-specific vaccine availability, participants in the US were less able to identify the correct answers than participants in the UK and Australia. More than half of participants did not know: HPV can cause genital warts; most sexually active people will get HPV at some point in their life; or HPV doesn't usually need treatment. Pharmaceutical advertising campaigns could explain why awareness of HPV and HPV vaccine is higher in the US and this has helped to get some important messages across. Significant gaps in HPV knowledge remain across all three countries.
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Affiliation(s)
- Laura A V Marlow
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology & Public Health, UCL, London WC1E 6BT, United Kingdom
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