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Eva FN, Khan MAS, Islam T, Monisha UK, Meem NES, Hossain MA, Goutam A, Zerin T, Alam N, Nath R, Sifat S, Sultana S, Sultana MS, Saha SK, Sarker NE, Rahman ML, Nabi MH, Hawlader MDH. Awareness of HPV vaccine and its socio-demographic determinants among the parents of eligible daughters in Bangladesh: A nationwide study. Heliyon 2024; 10:e30897. [PMID: 38778954 PMCID: PMC11109798 DOI: 10.1016/j.heliyon.2024.e30897] [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: 11/10/2023] [Revised: 05/07/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
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.
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Affiliation(s)
- Fahima Nasrin Eva
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Md Abdullah Saeed Khan
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
- National Institute of Preventive and Social Medicine (NIPSOM), Dhaka, 1212, Bangladesh
| | - Tariful Islam
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Umme Kulsum Monisha
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
- Mandy Dental College & Hospital, Dhaka, 1209, Bangladesh
| | - Nur-E-Safa Meem
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Mohammad Ali Hossain
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
- Ibn Sina Medical College Hospital, Kallyanpur, Dhaka, 1216, Bangladesh
| | - Arpita Goutam
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Tahmina Zerin
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Nishat Alam
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Rima Nath
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Shamma Sifat
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Sayla Sultana
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Mosammat Sadeka Sultana
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Sumit Kumar Saha
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Naifa Enam Sarker
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Mohammad Lutfor Rahman
- Institute of Statistical Research and Training (ISRT), University of Dhaka, Dhaka, 1000, Bangladesh
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Albayat SS, Mundodan JM, Elmardi K, Hasnain S, Khogali H, Baaboura R, Al-Romaihi HE, AlKubaisi NJ, Bougmiza MI. Knowledge, attitude, and practices regarding human papilloma virus vaccination among physicians in Qatar. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241227360. [PMID: 38282514 PMCID: PMC10826392 DOI: 10.1177/17455057241227360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 12/19/2023] [Accepted: 01/04/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND The human papilloma virus is a global problem that affects sexually active women and men, with cervical cancer being the most serious associated disease. Most cervical cancer cases can be prevented by vaccination against the human papilloma virus early in life. The objective of this study was to assess the knowledge, attitudes, and practices among physicians working in Qatar, regarding the human papilloma virus, infection, and prevention using vaccines. STUDY-DESIGN This was a cross-sectional study using quantitative data collection. METHODOLOGY An online survey targeting physicians working in Qatar was conducted, using a web-based pretested questionnaire. The questionnaire comprised four sections capturing a few demographic details, 33 questions in the Knowledge Section, 12 questions eliciting the attitude, and 14 practice-related questions. Mean knowledge score was calculated and those with a score more than the mean score were considered to have sufficient knowledge. Association between knowledge and attitude/practices/independent variables were looked for using bivariate and multivariate analysis. Logistic regression was used to identify the predictors for recommending human papilloma virus vaccines. RESULTS Of the 557 physicians who participated, 83.7% had sufficient knowledge, but only 69.1% knew that human papilloma virus vaccines were available in Qatar. The majority (89.4%) knew that human papilloma virus infection could be asymptomatic and 96.1% knew at least one symptom; 77% believed the human papilloma virus vaccine would substantially decrease the chances of human papilloma virus infection and related cancers and 46.5% felt physicians were less motivated to promote the human papilloma virus vaccine. The perceived barriers to community acceptance of the human papilloma virus vaccine were lack of awareness regarding the relationship between human papilloma virus and cervical cancer (61.6%), doubts regarding efficacy (32.5%), fear regarding safety (26.9%), concern that the human papilloma virus vaccination may encourage risky sexual behavior (26.8%), and perceived low-risk (23.3%) and cost (24.6%). Only 21.5% commonly discussed sexual health with their clients. More than one-third were not interested in recommending the human papilloma virus vaccine. Bivariate analysis showed nationality, specialization, discussing with patients, and recommending vaccine to be significantly associated with knowledge. Bivariate and regression analysis identified that female gender and physician's religion were significant predictors to recommend the human papilloma virus vaccine. CONCLUSION Most physicians have good knowledge. Less than one-fourth commonly discussed sexual health with their clients. More than one-third were not interested in recommending the human papilloma virus vaccine. This issue might affect the human papilloma virus vaccination program implementation if not well addressed.
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Affiliation(s)
| | | | - Khalid Elmardi
- HP-CDC, Department of Public Health, Ministry of Public Health, Doha, Qatar
| | - Samina Hasnain
- HP-CDC, Department of Public Health, Ministry of Public Health, Doha, Qatar
| | - Hayat Khogali
- HP-CDC, Department of Public Health, Ministry of Public Health, Doha, Qatar
| | | | | | | | - Mohamed Iheb Bougmiza
- Community Medicine Residency Program Director, Primary Health Care Corporation, Doha, Qatar
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3
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Lu Z, Zhao P, Lu H, Xiao M. Analyses of human papillomavirus, Chlamydia trachomatis, Ureaplasma urealyticum, Neisseria gonorrhoeae, and co-infections in a gynecology outpatient clinic in Haikou area, China. BMC Womens Health 2023; 23:117. [PMID: 36944923 PMCID: PMC10029165 DOI: 10.1186/s12905-023-02259-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 03/06/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND The purpose of this study was to study the infection rates of Chlamydia trachomatis (CT), Ureaplasma urealyticum (UU), Neisseria gonorrhoeae (NG), and co-infections with human papillomavirus (HPV) in a hospital gynecology outpatient clinic in the Haikou region in 2021. METHODS From January to December 2021, the Women and Children Medical Center of Hainan Province collected 2389 samples of cervical exfoliated cells and vaginal swab specimens from gynecologic outpatients. The samples were then analyzed descriptively for data, and the detection rate of each pathogen was tallied. All vaginal swabs were obtained for CT, UU, and NG DNA testing, and cervical exfoliated cells for HPV genotyping. Analyses were performed on the detection rate of each group. RESULTS In 2389 samples, the frequencies of pathogen identification among the 2389 samples were as follows: UU (58.43%); HPV (17.29%); CT (7.99%); and NG (0.38%). HPV, CT, UU, and NG were detected in 33.33%, 22.55%, 77.45%, and 2.94% of individuals between 15 and 20 years of age, respectively. The detection rates of CT, UU, and NG were substantially greater in the HPV-positive group than the the HPV-negative group (P < 0.05). CONCLUSION Among gynecologic outpatients at a hospital in the Haikou area, the probability of mixed infections with genital tract pathogens in HPV-positive patients was higher compared to HPV-negative patients. Reproductive tract infections are becoming more prevalent in younger people, hence adolescent sexual health education needs improvement.
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Affiliation(s)
- Zhe Lu
- Clinical Laboratory, Women and Children's Health Care Center of Hainan, 75 Longkun Nan Road, Haikou City, 570100, Hainan Province, China
| | - Peizhen Zhao
- Clinical Laboratory, Women and Children's Health Care Center of Hainan, 75 Longkun Nan Road, Haikou City, 570100, Hainan Province, China
| | - Huijun Lu
- Clinical Laboratory, Women and Children's Health Care Center of Hainan, 75 Longkun Nan Road, Haikou City, 570100, Hainan Province, China
| | - Meifang Xiao
- Clinical Laboratory, Women and Children's Health Care Center of Hainan, 75 Longkun Nan Road, Haikou City, 570100, Hainan Province, China.
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4
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Wang D, Wu J, Du J, Ong H, Tang B, Dozier M, Weller D, Campbell C. Acceptability of and barriers to human papillomavirus vaccination in China: A systematic review of the Chinese and English scientific literature. Eur J Cancer Care (Engl) 2022; 31:e13566. [PMID: 35229931 PMCID: PMC9287030 DOI: 10.1111/ecc.13566] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 02/06/2022] [Accepted: 02/08/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Widespread adoption of the human papillomavirus (HPV) vaccine will require population acceptance and tailoring of immunisation services to community needs and preferences. We examined peer-reviewed publications on the acceptability of and barriers to the HPV vaccine across China. METHODS We searched English (MEDLINE, Embase, and Web of Science) and Chinese (CNKI, VIP, Wanfang data) databases between 1 January 2006 and 31 December 2017. We adopted a narrative approach for data synthesis. RESULTS We identified 73 studies. The overall median acceptability of HPV vaccine was 71.8% (Q1-Q3: 58.6%-81%). Low levels of acceptability (<40%) of HPV vaccine were found in eastern regions of China. The largest differences of acceptability were observed between rural western regions (all >90%) and urban eastern regions (all <35%). Despite these regional variations, common barriers to HPV vaccine acceptance were concerns about vaccine safety, uncertainty over vaccine effectiveness, low perceived risk of cervical cancer and the price of the vaccine. The level of willingness to pay for the HPV vaccine (over 153 US dollars) was very low (<7%). CONCLUSION The acceptability of and attitudes towards HPV vaccine vary by regions and populations across China. HPV vaccination programmes will need to tailor service delivery as well as information materials to take account of regional concerns.
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Affiliation(s)
- Du Wang
- Usher Institute, Teviot Place, University of Edinburgh, Edinburgh, UK.,The George Institute for Global Health, Peking University Health Science Center, Beijing, China
| | - Jing Wu
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | | | - Haley Ong
- Usher Institute, Teviot Place, University of Edinburgh, Edinburgh, UK
| | - Biwei Tang
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Marshall Dozier
- College Lead for Library Academic Support, Medicine & Veterinary Medicine Library & University, University of Edinburgh, Edinburgh, UK
| | - David Weller
- Usher Institute, Teviot Place, University of Edinburgh, Edinburgh, UK
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5
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Lin W, Chen B, Hu H, Yuan S, Wu B, Zhong C, Huang W, Liu Z, Wang Y. Joint effects of HPV-related knowledge and socio-demographic factors on HPV testing behaviour among females in Shenzhen. Eur J Public Health 2021; 31:582-588. [PMID: 33846720 DOI: 10.1093/eurpub/ckab049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Limited population-based studies explore the utilization and associated barriers or facilitators to cervical cancer screening in China. We attempted to investigate the associations of socio-demographic factors, HPV specific knowledge with HPV testing behaviour in Shenzhen, China. METHODS A citywide cross-sectional survey was conducted from January to June 2015 in Shenzhen city by using a multistage stratified cluster sampling method. Socio-demographic information, awareness and specific knowledge of HPV, practice of HPV testing, and HPV vaccination-related attitude were collected. Multivariate logistic regression model was used to analyse possible associations. RESULTS Approximately one third of total 8639 women aged from 30 to 60 years old had ever received HPV testing. Overall, 67.6% of all participants demonstrated low knowledge level of HPV. High HPV knowledge level was significantly associated with HPV testing behaviour (odds ratio: 3.792, 95% confidence interval: 3.400-4.230). The impact of residence and education on testing behaviour only turned to be significant if women had low level of HPV knowledge (P for multiplicative interactions: 0.001 and <0.001, respectively), whereas monthly income exerted promotion effects apparently among those with high knowledge level (P for multiplicative interaction: 0.037). CONCLUSIONS Our study revealed gaps in HPV knowledge and screening participation among Chinese women, and provided novel clues that women with high HPV knowledge level would be more appeal to involve in HPV testing behaviour. The influence of HPV-related knowledge on HPV testing also lies in the joint effects with socio-demographic factors, including residence, education and monthly income.
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Affiliation(s)
- Wei Lin
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China.,Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Bin Chen
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China.,Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Haiyan Hu
- Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China.,Department of Gynaecology, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Shixin Yuan
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China.,Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Bo Wu
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China.,Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Chuyan Zhong
- Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China.,Department of Gynaecology, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Weikang Huang
- Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China.,Department of Gynaecology, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Zhihua Liu
- Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China.,Department of Gynaecology, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Yueyun Wang
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China.,Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
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Qiao J, Wang Y, Li X, Jiang F, Zhang Y, Ma J, Song Y, Ma J, Fu W, Pang R, Zhu Z, Zhang J, Qian X, Wang L, Wu J, Chang HM, Leung PCK, Mao M, Ma D, Guo Y, Qiu J, Liu L, Wang H, Norman RJ, Lawn J, Black RE, Ronsmans C, Patton G, Zhu J, Song L, Hesketh T. A Lancet Commission on 70 years of women's reproductive, maternal, newborn, child, and adolescent health in China. Lancet 2021; 397:2497-2536. [PMID: 34043953 DOI: 10.1016/s0140-6736(20)32708-2] [Citation(s) in RCA: 176] [Impact Index Per Article: 58.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Jie Qiao
- National Clinical Research Center for Obstetrical and Gynecological Diseases, Ministry of Education Key Laboratory of Assisted Reproduction, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
| | - Yuanyuan Wang
- National Clinical Research Center for Obstetrical and Gynecological Diseases, Ministry of Education Key Laboratory of Assisted Reproduction, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Xiaohong Li
- National Office for Maternal and Child Health Surveillance of China, National Center for Birth Defect Surveillance of China, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Fan Jiang
- Child Health Advocacy Institute, National Children's Medical Center, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yunting Zhang
- Child Health Advocacy Institute, National Children's Medical Center, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jun Ma
- Institute of Child and Adolescent Health, Key Laboratory of Reproductive Health, School of Public Health, Peking University, Beijing, China
| | - Yi Song
- Institute of Child and Adolescent Health, Key Laboratory of Reproductive Health, School of Public Health, Peking University, Beijing, China
| | - Jing Ma
- China Program for Health Innovation & Transformation, Department of Population Medicine, Harvard University, Boston, MA, USA
| | - Wei Fu
- China National Health and Development Research Centre, Beijing, China
| | - Ruyan Pang
- China Maternal and Child Health Association, Beijing, China
| | - Zhaofang Zhu
- China National Health and Development Research Centre, Beijing, China
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xu Qian
- School of Public Health & Global Health Institute, Fudan University, Shanghai, China
| | - Linhong Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiuling Wu
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hsun-Ming Chang
- National Clinical Research Center for Obstetrical and Gynecological Diseases, Ministry of Education Key Laboratory of Assisted Reproduction, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Peter C K Leung
- National Clinical Research Center for Obstetrical and Gynecological Diseases, Ministry of Education Key Laboratory of Assisted Reproduction, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Meng Mao
- National Office for Maternal and Child Health Surveillance of China, National Center for Birth Defect Surveillance of China, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Duan Ma
- Key Laboratory of Metabolism and Molecular Medicine, Ministry of Education, Department of Biochemistry and Molecular Biology, Fudan University, Shanghai, China
| | - Yan Guo
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Jie Qiu
- Gansu Provincial Maternity and Child-care Hospital, Lanzhou, China
| | - Li Liu
- Department of Population Family and Reproductive Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Haidong Wang
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Robert J Norman
- Robinson Research Institute, Fertility SA, University of Adelaide, Adelaide, SA, Australia
| | - Joy Lawn
- Centre for Maternal, Adolescent, Reproductive and Child Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Robert E Black
- Department of Population Family and Reproductive Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Carine Ronsmans
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - George Patton
- Centre for Adolescent Health, Murdoch Children's Research Institute, University of Melbourne, Melbourne, VIC, Australia
| | - Jun Zhu
- National Office for Maternal and Child Health Surveillance of China, National Center for Birth Defect Surveillance of China, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China.
| | - Li Song
- Department of Women and Children Health, National Health Commission of the People's Republic of China, Bejing, China.
| | - Therese Hesketh
- Center for Global Health, School of Medicine, Zhejiang University, Hangzhou, China; and Institute for Global Health, University College London, London, UK
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7
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Xu X, Wang Y, Liu Y, Yu Y, Yang C, Zhang Y, Hong Y, Wang Y, Zhang X, Bian R, Cao X, Xu L, Hu S, Zhao F. A nationwide post-marketing survey of knowledge, attitudes and recommendations towards human papillomavirus vaccines among healthcare providers in China. Prev Med 2021; 146:106484. [PMID: 33647350 DOI: 10.1016/j.ypmed.2021.106484] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 01/22/2021] [Accepted: 02/22/2021] [Indexed: 02/03/2023]
Abstract
Since licensure of human papillomavirus (HPV) vaccine in mainland China, little research has been conducted about healthcare providers' (HCPs) understanding and recommendation of HPV vaccine. A multi-stage convenience sample of Chinese HCPs (N = 5270) were surveyed, involving obstetrician-gynecologists, HCPs from Division of Expanded Program on Immunization (DEPI), Community Health Center (CHC) and other non-HPV closely related professions. Binary logistic regression was conducted to explore factors associated with knowledge and recommendation behaviors. Overall, HCPs showed basic HPV/HPV vaccine knowledge with median (interquartile range) score at 9.5 (7.5-11.6) out of 16 and relatively high recommendation behavior (74.8%). Identified knowledge gaps among HCPs included risk factors of HPV infection, best time to vaccinate, prophylactic functions of HPV vaccine and especially classification of low-risk and high-risk types. Profession-specific analysis in individual knowledge item showed HCPs from CHC were suboptimal on HPV while obstetrician-gynecologists were less competent on HPV vaccine knowledge. Obstetrician-gynecologists also recommended vaccination less frequently than HCPs from DEPI and CHC. Besides being key predictors of recommendation practice (2.74, 95% CI: 2.34-3.21), knowledge shared independent determinants with recommendation behavior on age and ethnicity and additionally associated with education and title by itself. Findings highlight overall and profession-specific gaps on HPV and HPV vaccine knowledge and recommendation practice. Future education and training efforts should be profession-niche-targeting and focus much on HCPs with lower title or education background and from minorities.
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Affiliation(s)
- Xiaoqian Xu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yueyun Wang
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Yawen Liu
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, China
| | - Yanqin Yu
- School of Public Health, Baotou Medical College, Baotou, Inner Mongolia, China
| | - Chunxia Yang
- Department of Epidemiology and Biostatistics, West China School of Public Health/West China Forth University Hospital, Sichuan University, Chengdu, China
| | - Yanyang Zhang
- Institute for Expanded Program on Immunization, Henan Provincial Center for Disease Control and Prevention, Zhengzhou, China
| | - Ying Hong
- Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Yan Wang
- Department of Cancer Institute, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, China
| | | | - Rui Bian
- MRL Global Medical Affairs, MSD China, Shanghai, China
| | - Xian Cao
- MRL Global Medical Affairs, MSD China, Shanghai, China
| | - Lili Xu
- MRL Global Medical Affairs, MSD China, Shanghai, China
| | - Shangying Hu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fanghui Zhao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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8
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Ma X, Harripersaud K, Smith K, Fairley CK, Zou H, Zou Z, Wang Y, Zhuang G, Zhang L. Modeling the epidemiological impact and cost-effectiveness of a combined schoolgirl HPV vaccination and cervical cancer screening program among Chinese women. Hum Vaccin Immunother 2021; 17:1073-1082. [PMID: 33269990 PMCID: PMC8018426 DOI: 10.1080/21645515.2020.1832835] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 09/26/2020] [Indexed: 01/17/2023] Open
Abstract
Human papillomavirus (HPV) infection is common in women and also the main cause of cervical cancer. Based on a dynamic compartmental model, we aimed to evaluate the population impact and cost-effectiveness of strategies that combined cervical cancer screening and HPV schoolgirl vaccination for Chinese women. The effectiveness of interventions was assessed by comparing modeled scenarios to the status quo, where a 3-y cervical cancer screening program remained at a 20% coverage and without a universal HPV vaccination program. Our study demonstrated that increasing screening coverage from 20% to 50% would reduce the high-risk HPV (HR-HPV) prevalence to 5.4%, whereas a universal schoolgirl vaccination program using the quadrivalent vaccine (qHPV) with a coverage of 50% would reduce the prevalence to 2.9% by 2069. Scaling-up the cervical screening coverage to 50% will prevent 16,012 (95% CI: 8,791 to 25,913) Disability-Adjusted Life-Years (DALYs) per year, with an incremental cost-effectiveness ratio (ICER) of US$ 10,958 (95% CI: $169 to $26,973)/DALY prevented. At the current qHPV price, vaccinating 50% of school girls will prevent 13,854 (95% CI: 8,355 to 20,776) DALYs/year, but the corresponding incremental cost-effectiveness ratio (ICER, US$ 83,043, 95% CI: $52,234 to $138,025) exceeds cost-effectiveness threshold (i.e., 3 times GDP per-capita of China: $30,792). The qHPV vaccine requires at least a 50% price reduction to be cost-effective. Vaccinating schoolgirls will result in a large population health benefit in the long term, but such a universal HPV vaccination program can only be cost-effective with a substantial price reduction.
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Affiliation(s)
- Xiaomeng Ma
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Health Science Centre, Xi’an Jiao Tong University, Xi’an, China
- Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Katherine Harripersaud
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Kumi Smith
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Christopher K. Fairley
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Australia
- Central Clinical School, Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, Australia
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Guangzhou, China
| | - Zhuoru Zou
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Health Science Centre, Xi’an Jiao Tong University, Xi’an, China
| | - Yueyun Wang
- Department of Maternal Care, Shenzhen Maternity and Child Health Hospitals, Shenzhen, Guangdong, China
| | - Guihua Zhuang
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Health Science Centre, Xi’an Jiao Tong University, Xi’an, China
| | - Lei Zhang
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Health Science Centre, Xi’an Jiao Tong University, Xi’an, China
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Australia
- Central Clinical School, Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, Australia
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9
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Hu S, Xu X, Zhu F, Hong Y, Hu Y, Zhang X, Pan Q, Zhang W, Zhang C, Yang X, Yu J, Zhu J, Zhu Y, Chen F, Zhao S, Karkada N, Tang H, Bi D, Struyf F, Zhao F. Efficacy of the AS04-adjuvanted HPV-16/18 vaccine in young Chinese women with oncogenic HPV infection at baseline: post-hoc analysis of a randomized controlled trial. Hum Vaccin Immunother 2021; 17:955-964. [PMID: 33180670 PMCID: PMC8018349 DOI: 10.1080/21645515.2020.1829411] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Human papillomavirus (HPV) vaccines are efficacious against HPV infections and associated lesions in women HPV-naïve at vaccination. However, vaccine efficacy (VE) against oncogenic, high-risk HPV (HR-HPV) types in women infected with any other HR-HPV type at first vaccination (baseline) remains unclear. This post-hoc analysis of a phase II/III study (NCT00779766) evaluated AS04-adjuvanted HPV-16/18 (AS04-HPV-16/18) VE against HR-HPV type infection in 871 Chinese women aged 18–25 years over a 72-month follow-up period. Study participants were DNA-negative at baseline to HR-HPV type(s) considered for VE and DNA-positive to any other HR-HPV type. Initial serostatus was not considered. Baseline DNA prevalence was 14.6% for any HR-HPV type and 10.6% excluding HPV-16/18. In the total vaccinated cohort for efficacy, VE against 6-month and 12-month HPV-16/18 persistent infections (PIs) in women DNA-negative to HPV-16/18 but DNA-positive to any other HR-HPV type at baseline was 100.0% (95% Confidence Interval [CI]: 79.8–100.0) and 100.0% (95%CI: 47.2–100.0), respectively. VE against HPV-16/18 incident infections in women DNA-positive to one vaccine type but DNA-negative to the other one at baseline was 66.8% (95%CI: −18.9–92.5). VE against HPV-31/33/45 incident infections, in women DNA-positive to HPV-16/18 and DNA-negative to the considered HPV type at baseline was 71.0% (95%CI: 27.3–89.8). No HPV-16/18 PIs were observed in vaccinated women with non-vaccine HPV A7/A9 species cervical infection at baseline. These findings indicated that women with existing HR-HPV infection at vaccination might still benefit from the AS04-HPV-16/18 vaccine. However, this potential benefit needs further demonstration in the future.
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Affiliation(s)
- Shangying Hu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaoqian Xu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fengcai Zhu
- Jiangsu Province Center for Disease Prevention and Control, Nanjing, China
| | - Ying Hong
- Department of Gynaecology and Obstetrics, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Yuemei Hu
- Jiangsu Province Center for Disease Prevention and Control, Nanjing, China
| | - Xun Zhang
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qinjing Pan
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenhua Zhang
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chengfu Zhang
- Lianshui Center for Disease Prevention and Control, Lianshui, China
| | - Xiaoping Yang
- Jintan Center for Disease Prevention and Control, Jintan, China
| | - Jiaxi Yu
- Xuzhou Center for Disease Prevention and Control, Xuzhou, China
| | - Jiahong Zhu
- Lianshui Center for Disease Prevention and Control, Lianshui, China
| | - Yejiang Zhu
- Binhai Center for Disease Prevention and Control, Yancheng, China
| | - Feng Chen
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shuang Zhao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | | | | | - Dan Bi
- GSK, Clinical Research & Development, Wavre, Belgium
| | - Frank Struyf
- GSK, Wavre, Belgium at the Time This Analysis Was Performed. Current Affiliation: Janssen Research & Development, Beerse, Belgium
| | - Fanghui Zhao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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10
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Holt HK, Zhang X, Hu SY, Zhao FH, Smith JS, Qiao YL. Inequalities in Cervical Cancer Screening Uptake Between Chinese Migrant Women and Local Women: A Cross-Sectional Study. Cancer Control 2021; 28:1073274820985792. [PMID: 33517761 PMCID: PMC8482714 DOI: 10.1177/1073274820985792] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/23/2020] [Accepted: 12/10/2020] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Uptake of cervical cancer screening services in Chinese migrant workers is unknown and may be lower than non-migrant workers in China. METHODS We conducted a cross-sectional study among migrant and non-migrant women aged 21-65 at 7 provinces across China and administered a questionnaire investigating knowledge and attitudes regarding cervical cancer, human papillomavirus (HPV), and HPV vaccine. We used multivariable logistic regression to evaluate odds of previous cervical cancer screening in migrant workers. RESULTS 737 women participated in the study. Mean age was 41.9 ± 7.2 years. 50.2% of the participants were migrant workers. 27.6% of the migrant workers reported previous cervical cancer screening compared to 33.2% of local participants. 36.6% migrant workers reported awareness of HPV compared to 40.2% of local participants. In adjusted analysis migrant status was not associated with increased odds of previous cervical cancer screening (aOR = 1.11 95%CI: 0.76-1.60). High school or higher education compared to less than high school education and employer-sponsored insurance compared to uninsured were associated with increased odds of previous cervical cancer screening (aOR = 2.15 95%CI: 1.41-3.27 and aOR = 1.67 95% CI: 1.14-2.45, respectively). Having heard of HPV compared to no awareness of HPV was associated with increased odds of cervical cancer screening (aOR = 2.02 95%CI: 1.41-2.91). Awareness of HPV among migrant workers was associated with increased odds of cervical cancer screening compared to migrant and local participants without awareness (aOR = 2.82 95% CI: 1.70-4.69 and 2.97 95%CI: 1.51-5.83, respectively). CONCLUSIONS Efforts to increase education opportunities, provide insurance, and promote HPV awareness could increase cervical cancer screening uptake in migrant women in China.
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Affiliation(s)
- Hunter K. Holt
- Department of Family and Community Medicine, University of California, San Francisco, CA, USA
| | - Xi Zhang
- Beijing Office for Cancer Prevention and Control, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shang-Ying Hu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fang-Hui Zhao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jennifer S. Smith
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - You-Lin Qiao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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11
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Hu S, Xu X, Zhang Y, Liu Y, Yang C, Wang Y, Wang Y, Yu Y, Hong Y, Zhang X, Bian R, Cao X, Xu L, Zhao F. A nationwide post-marketing survey of knowledge, attitude and practice toward human papillomavirus vaccine in general population: Implications for vaccine roll-out in mainland China. Vaccine 2020; 39:35-44. [PMID: 33243631 DOI: 10.1016/j.vaccine.2020.11.029] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 11/03/2020] [Accepted: 11/09/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) vaccine has been increasingly discussed in mainland China since its first approval in 2016. To date, nearly all studies assessing HPV vaccine perceptions and attitudes were implemented during pre-licensure period. Therefore, the nationwide post-marketing survey was conducted to update knowledge, attitudes and practice on HPV vaccine among general population in mainland China. METHODS Participants aged 18-45 years living in mainland China were recruited in April 2019 by multi-stage non-randomized sampling. Sociodemographic factors, HPV and HPV vaccine related awareness, knowledge, attitudes, vaccine uptake and potential obstacles were assessed in questionnaires. Bivariate analysis and multivariate regression were used to identify disparity among subgroups with different sociodemographic characteristics. RESULTS 4,000 women (32.1 ± 7.81y) and 1,000 men (31.8 ± 7.96y) were included in final analysis. Less than one third of participants had heard of HPV (female: 31%; male: 22%) and HPV vaccine (female: 34%; male: 23%). Knowledge score was also unfavorable on HPV (female: 3 out of 13; male: 1.8 out of 13) and HPV vaccine (female: 3 out of 6; male: 2 out of 5). Only 3% females had been vaccinated three years after HPV licensure in China, although willingness to get vaccinated among those unvaccinated were high (mean willingness score ± SD: female: 3.3 ± 0.97; male: 3.0 ± 0.98). Industry of employment and household income were the major factors related to awareness and knowledge of vaccine, whereas HPV and HPV vaccine awareness were key influential factors for willingness. The main obstacles of vaccination were safety concerns, lack of knowledge, and high price of HPV vaccines. CONCLUSIONS Findings highlight a lack of vaccine awareness, knowledge, and poor uptake in mainland China and underscore the necessity of health education campaigns. The identified priority groups, contents to be delivered and practical obstacles could furthermore provide insight into health education to reduce disparities and accelerate HPV vaccine roll-out in China.
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Affiliation(s)
- Shangying Hu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaoqian Xu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yanyang Zhang
- Institute for Expanded Program on Immunization, Henan Provincial Center for Disease Control and Prevention, Zhengzhou, China
| | - Yawen Liu
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, China
| | - Chunxia Yang
- Department of Epidemiology and Biostatistics, West China School of Public Health/West China Forth University Hospital, Sichuan University, Chengdu, China
| | - Yueyun Wang
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Yan Wang
- Department of Cancer Institute, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, China
| | - Yanqin Yu
- School of Public Health, Baotou Medical College, Baotou, Inner Mongolia, China
| | - Ying Hong
- Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | | | - Rui Bian
- MRL Global Medical Affairs, MSD China, Shanghai, China
| | - Xian Cao
- MRL Global Medical Affairs, MSD China, Shanghai, China
| | - Lili Xu
- MRL Global Medical Affairs, MSD China, Shanghai, China
| | - Fanghui Zhao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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12
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Drokow EK, Zi L, Han Q, Effah CY, Agboyibor C, Sasu E, Akpabla GS, Foli F, Sun K. Awareness of Cervical Cancer and Attitude Toward Human Papillomavirus and Its Vaccine Among Ghanaians. Front Oncol 2020; 10:1651. [PMID: 33014828 PMCID: PMC7506130 DOI: 10.3389/fonc.2020.01651] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 07/28/2020] [Indexed: 12/16/2022] Open
Abstract
Background: Cervical cancer (CC) is the fourth most commonly diagnosed cancer among women. Ghana is a low-middle- income country with annual diagnosed cases of 3,151 and 2,119 deaths. The high prevalence rate of cervical cancer in Ghana is mainly due to ineffective preventive measures and insufficient knowledge about the disease. Therefore, our objective was to evaluate the level of knowledge and awareness of cervical cancer and attitude toward human papillomavirus and its vaccine among Ghanaians. Methods: This descriptive cross-sectional survey on the awareness of cervical cancer and attitude toward human papillomavirus and its vaccine was carried out from March 2019 to February 2020. SPSS v. 23.0 was used in the data analysis. The participants' demographic characteristics, knowledge of cervical carcinoma, human papillomavirus vaccine and HPV, and the likelihood to be vaccinated were represented as percentages and frequencies. The difference between males and females was assessed using the chi-square test. The logistic regression analysis was used to evaluate the relationship of possible related indicators with the willingness to receive the HPV vaccine. A p < 0.05 was considered statistically significant. Results: A total of 1,376 participants were involved in the final analysis. Among the 1,376 participants involved in this survey, 1,240 participants (90.1%) representing 456 males (33.1%) and 784 females (57.0%) were aware of the terminology “cervical cancer” with a significant p = 0.001. When stratified by gender, women had significantly greater knowledge, compared to men in terms of “cervical cancer being common in middle age (35–50) females” (75.5 vs. 67.5%, respectively, p ≤ 0.001). When stratified by gender, women had significantly greater knowledge of human papillomavirus (54.5 vs. 43.6%, respectively, p < 0.001) and the human papillomavirus vaccine (39.3 vs. 33.1%, respectively, p = 0.019) compared to men. Conclusion: Majority of the respondents had poor knowledge regarding cervical cancer risk factors, symptoms, HPV, and its vaccine. Hence, this indicates a wakeup call for government to increase the awareness and knowledge level via the media and health professionals.
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Affiliation(s)
- Emmanuel Kwateng Drokow
- Department of Radiation Oncology, Zhengzhou University People's Hospital and Henan Provincial People's Hospital Henan, Zhengzhou, China
| | - Liu Zi
- Department of Radiation Oncology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Qian Han
- Department of Radiation Oncology, Zhengzhou University People's Hospital and Henan Provincial People's Hospital Henan, Zhengzhou, China
| | | | - Clement Agboyibor
- School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, China
| | - Evans Sasu
- Department of Radiotherapy, National Centre for Radiotherapy and Nuclear Medicine, Korle Bu Teaching Hospital, Accra, Ghana
| | | | - Francis Foli
- Department of Internal Medicine, Seventh-Day Adventist Hospital, Takoradi, Ghana
| | - Kai Sun
- Department of Haematology, Zhengzhou University People's Hospital and Henan Provincial People's Hospital Henan, Zhengzhou, China
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13
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Phuong NTN, Xuan LTT, Huong LT, Toan DTT, Oh JK, Won YJ, Choi KS. Knowledge of Cervical Cancer and Human Papillomavirus Vaccines among Child-Bearing Aged Women in Hanoi, Vietnam. Asian Pac J Cancer Prev 2020; 21:1951-1957. [PMID: 32711420 PMCID: PMC7573401 DOI: 10.31557/apjcp.2020.21.7.1951] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Indexed: 11/25/2022] Open
Abstract
Objectives: The study sought to examine knowledge of cervical cancer and human papillomavirus (HPV) vaccines among child-bearing aged women in Hanoi, Vietnam. Methods: In 2016, 807 women aged 18 to 49 years were recruited from one urban area and one rural area in 2016 and were examined through face-to-face paper-based interviews. Pearson’s chi-square test and an independent t-test were utilized to compare awareness of cervical cancer and HPV vaccination among women according residential status. Results: Overall, 83.8% and 71.3% women had heard about cervical cancer and HPV vaccination, respectively. Mean knowledge scores for cervical cancer and HPV vaccination were 4.60±1.43 out of 7 and 1.53±1.35 out of 5, respectively. Women living in an urban area were more likely to be aware of cervical cancer and to be more knowledgeable of HPV vaccination than women in a rural area. Conclusions: Despite strong awareness, we found knowledge on cervical cancer and HPV vaccination to be alarmingly insufficient among Vietnamese women.
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Affiliation(s)
- Nguyen Thi Ngoc Phuong
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, 10408, Republic of Korea.,Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, 10000, Vietnam
| | - Le Thi Thanh Xuan
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, 10000, Vietnam
| | - Le Thi Huong
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, 10000, Vietnam
| | - Do Thi Thanh Toan
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, 10000, Vietnam
| | - Jin Kyung Oh
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, 10408, Republic of Korea
| | - Young Joo Won
- Cancer Registration and Statistic Branch, National Cancer Center, Goyang, Gyeonggi-do, 10408, Republic of Korea
| | - Kui Son Choi
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, 10408, Republic of Korea
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14
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Le XTT, Nguyen PTN, Do TTT, Nguyen TH, Le HT, Nguyen CT, Ha GH, Hoang CL, Tran BX, Latkin CA, Ho RC, Ho CS. Intention to Pay for HPV Vaccination among Women of Childbearing Age in Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093144. [PMID: 32365964 PMCID: PMC7246945 DOI: 10.3390/ijerph17093144] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/18/2020] [Accepted: 04/20/2020] [Indexed: 11/22/2022]
Abstract
The intention to pay for human papillomavirus (HPV) vaccination among women of childbearing age in Vietnam, where cervical cancer remains a significant public health concern, has been mostly lacking. To examine this issue, we conducted a cross-sectional study of 807 pregnant women in an urban and a rural district (Dong Da and Ba Vi) of Hanoi, Vietnam. The vast percentage of our respondents expressed a firm intention to vaccinate, especially women in rural areas (over 90.0%). However, on being informed of the current price of the HPV vaccine, their intention to vaccinate dropped to about one-fifth of overall respondents, i.e., only 4.4% of women in rural areas. It was also observed that the initial intention to get the HPV vaccination among women in the rural district was about ten times higher than that of women living in the metropolitan district. Those participants who had greater knowledge of cervical cancer and HPV vaccinations also had a significantly higher intention to vaccinate. Our findings underscore the need to develop a well-designed vaccination program in Vietnam and other countries in a similar situation to increase the adoption of HPV vaccination.
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Affiliation(s)
- Xuan Thi Thanh Le
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; (X.T.T.L.); (P.T.N.N.); (T.T.T.D.); (T.H.N.); (H.T.L.); (B.X.T.)
| | - Phuong Thi Ngoc Nguyen
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; (X.T.T.L.); (P.T.N.N.); (T.T.T.D.); (T.H.N.); (H.T.L.); (B.X.T.)
| | - Toan Thi Thanh Do
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; (X.T.T.L.); (P.T.N.N.); (T.T.T.D.); (T.H.N.); (H.T.L.); (B.X.T.)
| | - Thang Huu Nguyen
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; (X.T.T.L.); (P.T.N.N.); (T.T.T.D.); (T.H.N.); (H.T.L.); (B.X.T.)
| | - Huong Thi Le
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; (X.T.T.L.); (P.T.N.N.); (T.T.T.D.); (T.H.N.); (H.T.L.); (B.X.T.)
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam;
- Faculty of Medicine, Duy Tan University, Da Nang 550000, Vietnam
| | - Giang Hai Ha
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam;
- Faculty of Pharmacy, Duy Tan University, Da Nang 550000, Vietnam
- Correspondence: ; Tel.: +84-86-9548-561
| | - Chi Linh Hoang
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam; (C.L.H.); (R.C.M.H.)
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; (X.T.T.L.); (P.T.N.N.); (T.T.T.D.); (T.H.N.); (H.T.L.); (B.X.T.)
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Carl A. Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Roger C.M. Ho
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam; (C.L.H.); (R.C.M.H.)
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119077, Singapore
| | - Cyrus S.H. Ho
- Department of Psychological Medicine, National University Hospital, Singapore 119074, Singapore;
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15
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Lin W, Zhou L, Hu H, Chen B, Yuan S, Wu B, Liu Z, Wang Y. The number and gender of children synergistically impact on a mother’s practice of human papillomavirus testing and attitudes towards vaccination in Shenzhen, China. Cancer Epidemiol 2020; 65:101682. [DOI: 10.1016/j.canep.2020.101682] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 01/11/2020] [Accepted: 01/28/2020] [Indexed: 01/24/2023]
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16
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Drokow EK, Zi L, Han Q, Effah CY, Agboyibor C, Sasu E, Akpabla GS, Foli F, Sun K. Awareness of Cervical Cancer and Attitude Toward Human Papillomavirus and Its Vaccine Among Ghanaians. Front Oncol 2020; 10:1651. [PMID: 33014828 DOI: 10.3389/fonc.2020.01651/bibtex] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 07/28/2020] [Indexed: 05/21/2023] Open
Abstract
Background: Cervical cancer (CC) is the fourth most commonly diagnosed cancer among women. Ghana is a low-middle- income country with annual diagnosed cases of 3,151 and 2,119 deaths. The high prevalence rate of cervical cancer in Ghana is mainly due to ineffective preventive measures and insufficient knowledge about the disease. Therefore, our objective was to evaluate the level of knowledge and awareness of cervical cancer and attitude toward human papillomavirus and its vaccine among Ghanaians. Methods: This descriptive cross-sectional survey on the awareness of cervical cancer and attitude toward human papillomavirus and its vaccine was carried out from March 2019 to February 2020. SPSS v. 23.0 was used in the data analysis. The participants' demographic characteristics, knowledge of cervical carcinoma, human papillomavirus vaccine and HPV, and the likelihood to be vaccinated were represented as percentages and frequencies. The difference between males and females was assessed using the chi-square test. The logistic regression analysis was used to evaluate the relationship of possible related indicators with the willingness to receive the HPV vaccine. A p < 0.05 was considered statistically significant. Results: A total of 1,376 participants were involved in the final analysis. Among the 1,376 participants involved in this survey, 1,240 participants (90.1%) representing 456 males (33.1%) and 784 females (57.0%) were aware of the terminology "cervical cancer" with a significant p = 0.001. When stratified by gender, women had significantly greater knowledge, compared to men in terms of "cervical cancer being common in middle age (35-50) females" (75.5 vs. 67.5%, respectively, p ≤ 0.001). When stratified by gender, women had significantly greater knowledge of human papillomavirus (54.5 vs. 43.6%, respectively, p < 0.001) and the human papillomavirus vaccine (39.3 vs. 33.1%, respectively, p = 0.019) compared to men. Conclusion: Majority of the respondents had poor knowledge regarding cervical cancer risk factors, symptoms, HPV, and its vaccine. Hence, this indicates a wakeup call for government to increase the awareness and knowledge level via the media and health professionals.
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Affiliation(s)
- Emmanuel Kwateng Drokow
- Department of Radiation Oncology, Zhengzhou University People's Hospital and Henan Provincial People's Hospital Henan, Zhengzhou, China
| | - Liu Zi
- Department of Radiation Oncology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Qian Han
- Department of Radiation Oncology, Zhengzhou University People's Hospital and Henan Provincial People's Hospital Henan, Zhengzhou, China
| | | | - Clement Agboyibor
- School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, China
| | - Evans Sasu
- Department of Radiotherapy, National Centre for Radiotherapy and Nuclear Medicine, Korle Bu Teaching Hospital, Accra, Ghana
| | | | - Francis Foli
- Department of Internal Medicine, Seventh-Day Adventist Hospital, Takoradi, Ghana
| | - Kai Sun
- Department of Haematology, Zhengzhou University People's Hospital and Henan Provincial People's Hospital Henan, Zhengzhou, China
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Lin W, Wang Y, Liu Z, Chen B, Yuan S, Wu B, Gong L. Awareness and attitude towards human papillomavirus and its vaccine among females with and without daughter(s) who participated in cervical cancer screening in Shenzhen, China. Trop Med Int Health 2019; 24:1054-1063. [PMID: 31264319 DOI: 10.1111/tmi.13283] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVES To evaluate the awareness of HPV and HPV vaccine, and willingness to be vaccinated against HPV, among women with and without daughter(s) in Shenzhen, China. METHODS Cross-sectional survey in January and June 2015 by means of a self-administered questionnaire to collect information. Multivariate logistic regression was used to explore the factors associated with awareness of HPV and its vaccine and the willingness to be vaccinated. RESULTS A total of 9855 women (mean age 37.09 years, SD 7.48) were included in the analysis. Although only 42.3% had heard of HPV and 21.0% of HPV vaccine, 63.3% were willing to be vaccinated. 73.9% of the 5799 women with daughter(s) were willing have their daughter(s) vaccinated. Women with daughter(s) did not have a higher awareness of HPV (43.2% vs. 41.5%, P = 0.109) and HPV vaccine (21.1% vs. 20.9%, P = 0.854) than women without daughter(s), but did tend to be more willing to be vaccinated themselves (66.3% vs. 59.9%, P < 0.001). Women's awareness of HPV and specific knowledge of HPV vaccine were predictors of the willingness to have both themselves and their daughters vaccinated. These associations may be modified by residency status, education and monthly income. CONCLUSIONS Although awareness of HPV and HPV vaccine among women in Shenzhen was low, willingness to have themselves and their daughter(s) vaccinated was relatively high, especially among mothers. High awareness of HPV and its vaccine will help improve the acceptability of HPV vaccination according to residency status, education and monthly income.
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Affiliation(s)
- Wei Lin
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Yueyun Wang
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Zhihua Liu
- Department of Gynecology, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Bin Chen
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Shixin Yuan
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Bo Wu
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Lin Gong
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
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Lin W, Wang Y, Liu Z, Chen B, Yuan S, Wu B, Gong L. Inequalities in Awareness and Attitude towards HPV and Its Vaccine between Local and Migrant Residents Who Participated in Cervical Cancer Screening in Shenzhen, China. Cancer Res Treat 2019; 52:207-217. [PMID: 31291712 PMCID: PMC6962482 DOI: 10.4143/crt.2019.053] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 06/28/2019] [Indexed: 12/24/2022] Open
Abstract
PURPOSE A cross-sectional survey was conducted to evaluate the differences on awareness and attitude towards human papillomavirus (HPV) and its vaccine between local and migrant residents who participated in cervical cancer screening in Shenzhen, China. Materials and Methods A total of 9,855 females sampled from healthcare institutions in 20 street blocks through the Cervical Cancer Prevention Network were surveyed in this study by a self-administered questionnaire. Multivariate logistic regression was conducted to explore the role of the hukou and resident status in the willingness to receive HPV vaccination. RESULTS Local residents had a relatively higher awareness of HPV (62.0% vs. 35.6% vs. 29.9%, p < 0.001) and its vaccine (35.3% vs. 15.4% vs. 14.8%, p < 0.001), as well as a higher willingness to receive HPV vaccination (68.5% vs. 62.5% vs. 56.2%, p < 0.001) than non-permanent residents and floating population. Except for age, education level, marital status, monthly income, having daughter(s), and heard of HPV and its vaccine, the hukou and resident status significantly associated with the willingness to receive HPV vaccination (local residents vs. floating population: odds ratio, 1.216; 95% confidence interval, 1.057 to 1.398). None significant difference on the associated factors was found between local residents and internal migrants (p for interactions > 0.05). CONCLUSION Inequalities in awareness and attitude towards HPV and its vaccine existed between local and migrant residents in Shenzhen. The hukou and resident status did impact on the willingness to receive HPV vaccination, therefore, it is critical to implement effective health education campaigns on HPV and its vaccine among internal migrants.
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Affiliation(s)
- Wei Lin
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Yueyun Wang
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Zhihua Liu
- Department of Gynaecology, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Bin Chen
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Shixin Yuan
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Bo Wu
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Lin Gong
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
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Knowledge of Human Papillomavirus (HPV) and the HPV Vaccine Among Medical and Nursing Students of Duhok, Iraq. WOMEN’S HEALTH BULLETIN 2019. [DOI: 10.5812/whb.87203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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McSherry LA, O’Leary E, Dombrowski SU, Francis JJ, Martin CM, O’Leary JJ, Sharp L. Which primary care practitioners have poor human papillomavirus (HPV) knowledge? A step towards informing the development of professional education initiatives. PLoS One 2018; 13:e0208482. [PMID: 30543647 PMCID: PMC6292662 DOI: 10.1371/journal.pone.0208482] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 11/19/2018] [Indexed: 01/09/2023] Open
Abstract
Background Primary care practitioners (PCP) play key roles in cervical cancer prevention. Human papillomavirus (HPV) knowledge is an important influence on PCPs’ cervical cancer prevention-related behaviours. We investigated HPV knowledge, and associated factors, among general practitioners (GPs) and practice nurses. Methods A survey, including factual questions about HPV infection and vaccination, was mailed to GPs and practice nurses in Ireland. Multivariable logistic regression was used to determine which PCPs had low knowledge (questions correctly answered: infection ≤5/11; vaccination: ≤4/10). Questions least often answered correctly were identified. Results 697 PCPs participated. For HPV infection, GPs and practice nurses answered a median of nine and seven questions correctly, respectively (p<0.001). Significantly associated with low HPV infection knowledge were: being a practice nurse/male GP; working fewer hours/week; not having public patients; and having never taken a cervical smear. For HPV vaccination, both GPs and practice nurses answered a median of six questions correctly (p = 0.248). Significantly associated with low HPV vaccination knowledge were: being a practice nurse/male GP; working more years in general practice, fewer hours/week, in a smaller practice or in a practice not specialising in women’s health; and having never taken a smear. Six HPV infection questions, and seven HPV vaccination questions, were not answered correctly by >⅓ of PCPs. Conclusions There are important limitations in HPV infection and vaccination knowledge among PCPs. By identifying factors associated with poor knowledge, and areas of particular uncertainty, these results can inform development of professional education initiatives thereby ensuring women have access to uniformly high-quality HPV-related information and advice.
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Affiliation(s)
| | | | | | - Jill J. Francis
- School of Health Sciences, City University London, London, England
| | - Cara M. Martin
- Coombe Women and Infants University Hospital, Dublin, Ireland
| | - John J. O’Leary
- Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Linda Sharp
- Institute of Health & Society, Newcastle University, Newcastle-upon-Tyne, England
- * E-mail:
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Chen L, Song Y, Ruan G, Zhang Q, Lin F, Zhang J, Wu T, An J, Dong B, Sun P. Knowledge and Attitudes Regarding HPV and Vaccination Among Chinese Women Aged 20 to 35 Years in Fujian Province: A Cross-Sectional Study. Cancer Control 2018; 25:1073274818775356. [PMID: 29761723 PMCID: PMC6028175 DOI: 10.1177/1073274818775356] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The use of the human papillomavirus (HPV) vaccine was recently approved in Mainland China. This study determined the knowledge and attitudes of young women aged 20 to 35 years in Fujian Province, China, with regard to HPV and vaccination and explored the potential factors influencing their attitudes toward HPV vaccination. This was a cross-sectional study that collected data regarding the knowledge on and attitudes toward HPV and vaccination using questionnaires. Furthermore, the prevalence of HPV was determined from the sampled participants. A total of 1001 young women were included in the survey. This study demonstrated that the HPV prevalence rate was 15.7% (157/1001). Among all patients, 44.9% (n = 449) had heard of HPV; however, detailed knowledge about HPV was lacking. The majority (83.7%) expressed a willingness to be vaccinated. Specifically, knowledge of the dangers of HPV infection was significantly associated with the willingness to be vaccinated. In this study, women cited some concerns and expressed high expectations for the HPV vaccine, but the costs of vaccination reduced their willingness to be vaccinated. This study found that most patients did not have a detailed knowledge of HPV. Thus, there is a need for continued HPV promotion and education efforts, especially on the dangers of HPV infection, among young women aged 20 to 35 years in Fujian Province, China. Furthermore, it is important to subsidize the costs of vaccination for promoting vaccination campaigns in China.
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Affiliation(s)
- Lihua Chen
- 1 Laboratory of Gynecologic Oncology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Yiyi Song
- 2 Department of Gynecology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Guanyu Ruan
- 1 Laboratory of Gynecologic Oncology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Qiaoyu Zhang
- 1 Laboratory of Gynecologic Oncology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Fen Lin
- 1 Laboratory of Gynecologic Oncology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Jun Zhang
- 3 Research Center for Medical Molecular Virology of Fujian Province, School of Public Health, Xiamen University, Xiamen, Fujian, People's Republic of China
| | - Ting Wu
- 3 Research Center for Medical Molecular Virology of Fujian Province, School of Public Health, Xiamen University, Xiamen, Fujian, People's Republic of China
| | - Jian An
- 1 Laboratory of Gynecologic Oncology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Binhua Dong
- 1 Laboratory of Gynecologic Oncology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Pengming Sun
- 1 Laboratory of Gynecologic Oncology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China.,2 Department of Gynecology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
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He J, He L. Knowledge of HPV and acceptability of HPV vaccine among women in western China: a cross-sectional survey. BMC WOMENS HEALTH 2018; 18:130. [PMID: 30053844 PMCID: PMC6063014 DOI: 10.1186/s12905-018-0619-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 07/12/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Since most cervical cancer cases are caused by persistent high-risk human papillomavirus (HR-HPV) infection, knowledge of HPV among women is essential for the prevent of cervical cancer. This study was aimed to assess knowledge among women in western China about HPV and its association with cervical cancer, and to assess their acceptance of HPV vaccination. METHODS A sample of healthy women undergoing routine physical examinations in the Health Management Center of West China Hospital, Sichuan University between January and December 2014 completed a questionnaire. RESULTS A total of 1300 questionnaires were distributed, and 1109 were completed and analyzed. Only 28.85% of respondents (n = 320) had heard of HPV; among this subgroup, only half (53.44%) knew that it causes cervical cancer, only 26 (8.13%) correctly answered all questions about HPV. Multivariate analysis showed that respondents who had heard of HPV were more likely than other respondents to have a family history of any cancer, to undergo regular Pap tests and to have completed at least secondary education. Half of all respondents (51.22%) reported that they would be willing to be vaccinated against HPV. CONCLUSION Although most women in western China lack basic knowledge about HPV, at least half are willing to take the HPV vaccine. Public health efforts to educate the public about HPV and its connection to cervical cancer should be strengthened and expanded.
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Affiliation(s)
- Junyong He
- Health Management Center of West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, People's Republic of China
| | - Lixia He
- Health Management Center of West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, People's Republic of China.
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Baloch Z, Yasmeen N, Li Y, Zhang W, Lu H, Wu X, Xia X, Yang S. Knowledge and Awareness of Cervical Cancer, Human Papillomavirus (HPV), and HPV Vaccine Among HPV-Infected Chinese Women. Med Sci Monit 2017; 23:4269-4277. [PMID: 28867818 PMCID: PMC5595099 DOI: 10.12659/msm.903370] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background It is important to understand the knowledge that various groups of a population have about cervical cancer and human papillomavirus (HPV) and their attitudes toward HPV vaccination, as it will ultimately influence their decision-making for or against the acceptability of vaccines and other preventive methods. This study was designed to determine the level of knowledge and awareness about cervical cancer, HPV, and the HPV vaccine among Chinese women in Yunnan province. Material/Methods A survey was conducted in Yunnan province by the Laboratory of Molecular Virology in collaboration with the Yunnan First People’s Hospital in Feb 2015. A total of 388 women were recruited and asked to participate in a questionnaire-based interview that collected information related to their awareness and knowledge about: (1) cervical cancer, (2) HPV and HPV vaccine and willingness to have their children receive vaccination, and (3) demographic characteristics. Results A total of 388 HPV-positive women were included; 300/388 (73.3%) were Han, and 88/388 (22.7%) were other ethnicities. Overall, 204/388 (52.6%) of the women were aware of cervical cancer, with a significant difference between Han women and women of other ethnic groups (168/388, 56.0% and 36/88, 40.9%; P=0.015). Overall, 26.5% of the women were aware of the role of HPV in cervical cancer; 29.0% of the Han women and 18.2% of women of other ethnic groups were aware of this role of HPV (P=0.05). The knowledge that HPV infection leads to cervical cancer was higher among Han women (29.0%) compared to women of other ethnicities (18.2%). Knowledge about the HPV vaccine was very low in all ethnic groups, but the Han women were more willing to allow their children to be vaccinated before they become sexually active. A similar difference has also been found in women from various regions. Conclusions Although level of awareness and knowledge about cervical cancer was moderate, knowledge and awareness of HPV and the HPV vaccine was very low. Targeted communication is very important among populations in which knowledge gaps exist in order to promote dialogue about the vaccine among patients and their healthcare providers.
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Affiliation(s)
- Zulqarnain Baloch
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong, China (mainland).,Key Laboratory of Comprehensive Prevention and Control for Severe Clinical Animal Diseases of Guangdong Province, South China Agricultural University, Guangzhou, Guangdong, China (mainland)
| | - Nafeesa Yasmeen
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong, China (mainland)
| | - Yuanyue Li
- Key Laboratory of Comprehensive Prevention and Control for Severe Clinical Animal Diseases of Guangdong Province, South China Agricultural University, Guangzhou, Guangdong, China (mainland)
| | - Wenhui Zhang
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong, China (mainland).,Key Laboratory of Comprehensive Prevention and Control for Severe Clinical Animal Diseases of Guangdong Province, South China Agricultural University, Guangzhou, Guangdong, China (mainland)
| | - Hongyu Lu
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong, China (mainland).,Key Laboratory of Comprehensive Prevention and Control for Severe Clinical Animal Diseases of Guangdong Province, South China Agricultural University, Guangzhou, Guangdong, China (mainland)
| | - Xiaomei Wu
- The 1st People's Hospital of Yunnan Province, Kunming, Yunnan, China (mainland)
| | - Xueshan Xia
- The Research Center for Molecular Medicine, Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, Yunnan, China (mainland)
| | - Shihua Yang
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong, China (mainland).,Key Laboratory of Comprehensive Prevention and Control for Severe Clinical Animal Diseases of Guangdong Province, South China Agricultural University, Guangzhou, Guangdong, China (mainland)
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Salem MR, Amin TT, Alhulaybi AA, Althafar AS, Abdelhai RA. Perceived Risk of Cervical Cancer and Barriers to Screening among Secondary School Female Teachers in Al Hassa, Saudi Arabia. Asian Pac J Cancer Prev 2017; 18:969-979. [PMID: 28545195 PMCID: PMC5494247 DOI: 10.22034/apjcp.2017.18.4.969] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background: No previous studies had addressed the perceived risk of cervical cancer (CC) and its influence on screening practices and perceived barriers in Saudi Arabia. Methods: This cross-sectional study was conducted on 506 randomly selected Saudi female secondary school teachers in Al Hassa, Saudi Arabia to assess their level of knowledge about risk factors and signs of CC in relation to perceived risk and to characterize CC screening compliance using a self-administered questionnaire. Results: Of the included female Saudi teachers, 65.4% and 63.4% were considered less-knowledgeable about CC risk factors and early signs and symptoms respectively. Only 17.2% reported being previously examined for CC. The majority of participants perceived themselves to be at an average or below average risk of CC. Residing in urban areas was the strongest predictor of CC screening (Odds ratio ‘OR’= 3.39; 95% confidence intervals ‘CI= 1.76-6.46; P=0.001). Awareness of risk factors was significantly associated with higher awareness of signs of CC (OR 2.5; 95% CI=, P=0.001). Exploratory factor analysis showed that personal fears (of screening being embarrassing) was the major factor that hindered CC screening with a high loading eigenvalue of 4.392, explaining 30.8% of the barriers toward utilization, followed by health care related factors. Conclusion: Secondary school teachers in Al Hassa, Saudi Arabia showed low perceived risk, poor awareness about risk factors, signs and symptoms of CC and limited uptake of screening practices. This underlines the need for education programs on CC targeting this group.
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Affiliation(s)
- Marwa Rashad Salem
- Public Health and Community Medicine, Faculty of Medicine, Cairo University, Egypt.
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Fu CJ, Pan XF, Zhao ZM, Saheb-Kashaf M, Chen F, Wen Y, Yang CX, Zhong XN. Knowledge, perceptions and acceptability of HPV vaccination among medical students in Chongqing, China. Asian Pac J Cancer Prev 2017; 15:6187-93. [PMID: 25124596 DOI: 10.7314/apjcp.2014.15.15.6187] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES To evaluate medical students' knowledge of HPV and HPV related diseases and assess their attitudes towards HPV vaccination. METHODS A total of 605 medical undergraduates from Chongqing Medical University in China were surveyed using a structured and pretested questionnaire on HPV related knowledge. RESULTS Some 68.9% of the medical students were females, and mean age was 21.6 (±1.00) years. Only 10.6% correctly answered more than 11 out of 14 questions on HPV related knowledge, 71.8% being willing to receive/ advise on HPV vaccination. Female students (OR: 2.69; 95% CI: 1.53-4.72) and students desiring more HPV education (OR: 4.24; 95% CI: 1.67-10.8) were more willing to accept HPV vaccination. HPV vaccination acceptability was observed to show a positive association with HPV related knowledge. CONCLUSIONS Our survey found low levels of HPV related knowledge and HPV vaccination acceptability among participating medical students. HPV education should be systematically incorporated into medical education to increase awareness of HPV vaccination.
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Affiliation(s)
- Chun-Jing Fu
- Department of Health Statistics and Information Management, School of Public Health and Management, Chongqing Medical University, Chongqing, China E-mail : . com,
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Pan XF, Li R, Pan A, Larson H. Human papillomavirus vaccine approval in China: a major step forward but challenges ahead. THE LANCET. INFECTIOUS DISEASES 2016; 16:1322-1323. [DOI: 10.1016/s1473-3099(16)30450-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Accepted: 10/17/2016] [Indexed: 10/20/2022]
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Zhang Q, Liu YJ, Hu SY, Zhao FH. Estimating long-term clinical effectiveness and cost-effectiveness of HPV 16/18 vaccine in China. BMC Cancer 2016; 16:848. [PMID: 27814703 PMCID: PMC5097411 DOI: 10.1186/s12885-016-2893-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 10/26/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) 16 and 18 are the two most common HPV oncogenic types that can be prevented by vaccination. This study aimed at assessing the cost-effectiveness of 3 doses of the bivalent HPV vaccine in rural and urban settings in China. METHODS A Markov model was adapted to reflect the lifetime of a modelled 100,000 12-year-old girls cohort in rural and urban settings in China. Input parameters were obtained from published literature, official reports and a two-round expert review panel. Clinical and economic outcomes of vaccination at age 12 with screening was compared to screening only. In the base case analysis, a 3 % discount rate, the vaccine cost of 247 CNY (US$ 39, PAHO vaccine cost in 2013), two rounds of screening in a life time and 70 % coverage for both screening and vaccination were used. One-way, two-way and probabilistic sensitivity analyses were performed. We used different thresholds of cost-effectiveness to reflect the diversity of economic development in China. RESULTS Vaccination in addition to screening could prevent 60 % more cervical cancer cases and deaths than screening only. The incremental cost effectiveness ratio varied largely when changing cost of vaccination and discount in one way analysis. Vaccination was very cost-effective when the vaccine cost ranged 87-630 CNY (US$ 13.8-100) in rural and 87-750 CNY (US$ 13.8-119) in urban; and remained cost-effective when the vaccine cost ranged 630-1,700 CNY (US$ 100-270) in rural and 750-1,900 CNY (US$ 119-302) in urban in two way analysis. Probabilistic sensitivity analyses showed that model results were robust. CONCLUSIONS In both rural and urban, the vaccination cost and discounting are important factors determining the cost-effectiveness of HPV vaccination; policy makers in China should take these into account when making a decision on the introduction of HPV vaccine. In areas with a high burden of cervical cancer and limited screening activities, HPV vaccination should be prioritized. However, the vaccine cost needs to be reduced in order to make it very cost-effective and affordable as well, in particular in poverty areas with high disease burden.
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Affiliation(s)
- Qian Zhang
- Department of Cancer Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Yi-Jun Liu
- Department of Cancer Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
- Department of Preventive Medicine, School of Public Health, Zunyi Medical College, Zunyi, 563099, China
| | - Shang-Ying Hu
- Department of Cancer Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Fang-Hui Zhao
- Department of Cancer Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
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Ghojazadeh M, Azar ZF, Saleh P, Naghavi-Behzad M, Azar NG. Knowledge and attitude of Iranian University students toward human papilloma virus. Asian Pac J Cancer Prev 2016; 13:6115-9. [PMID: 23464415 DOI: 10.7314/apjcp.2012.13.12.6115] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Increasing prevalence of human papilloma virus (HPV) infection and its association with cervical cancer as a leading cause of death make it necessary to evaluate and improve the public knowledge, especially of university students, about this cause of disease. METHODS A cross-sectional study of knowledge and attitude of a total 669 students from Tabriz University of Medical Sciences was therefore performed with a modified validated questionnaire, arranged into 5 parts and containing 55 questions, in July 2011. Questions were directed to study socio-demographic characteristics of the participant, knowledge about HPV disease, transmission route, relationship with cervical cancer, predisposing factors, and participants attitude toward people with HPV infection. RESULTS All of the participants were Moslem with a mean age 25.6±5.33 years of age. All of the participants had heard of HPV, and acquired their knowledge through university courses (90.6%); the majority of them knew that HPV is a sexually transmitted disease and a potential cause for genital warts but general knowledge about details was not high. Mean knowledge score of residents and post graduate midwifery and nursing students was high as compared to other groups (P<0.001). Statements that indicated the presence of fear to communicate with people suffering HPV and people's avoidance to rely on babysitting of these patients were observed. Educational level (β=0.21, P<0.001), age (β=0.18, P=0.002,) and smoking (β=-0.11, P=0.006) were predicted to effect knowledge. CONCLUSIONS Moderate level of knowledge about HPV among medical university students makes it necessary to set effective national public health efforts on HPV education and prevention considering he excess of young population in Iran vulnerable to cervical cancer.
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Affiliation(s)
- Morteza Ghojazadeh
- Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tarbiz, Iran
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Ghojazadeh M, Naghavi-Behzad M, Azar ZF, Saleh P, Ghorashi S, Pouri AA. Parental knowledge and attitudes about human papilloma virus in Iran. Asian Pac J Cancer Prev 2016; 13:6169-73. [PMID: 23464425 DOI: 10.7314/apjcp.2012.13.12.6169] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Infection by human papillomavirus (HPV) is one of common sexually transmitted diseases leading to cervical cancer. Evaluation of parental knowledge and attitudes toward HPV were aims of present study to provide an appropriate method to decrease burden of this infection on society. During this study, 358 parents were assessed for knowledge about HPV and its related disorders. Some 76% of parents had no information about HPV infection and among the informed parents 36% had obtained their information via internet and others from studying medical resources. The average score of mothers information about HPV infection was higher than that of fathers, and also educational level and age had significant impact on knowledge of parents about HPV. Parent knowledge about the hazards of HPV was higher than their knowledge about modes of transmission. Lack of awareness about HPV infection was high in this study, underlining the urgency of education among all adult people in our society.
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Affiliation(s)
- Morteza Ghojazadeh
- Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Zhang Y, Wang Y, Liu L, Fan Y, Liu Z, Wang Y, Nie S. Awareness and knowledge about human papillomavirus vaccination and its acceptance in China: a meta-analysis of 58 observational studies. BMC Public Health 2016; 16:216. [PMID: 26936076 PMCID: PMC4776385 DOI: 10.1186/s12889-016-2873-8] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 02/16/2016] [Indexed: 11/25/2022] Open
Abstract
Background The human papillomavirus (HPV) vaccines have been widely introduced in immunization programs worldwide, however, it is not accepted in mainland China. We aimed to investigate the awareness and knowledge about HPV vaccines and explore the acceptability of vaccination among the Chinese population. Methods A meta-analysis was conducted across two English (PubMed, EMBASE) and three Chinese (China National Knowledge Infrastructure, Wan Fang Database and VIP Database for Chinese Technical Periodicals) electronic databases in order to identify HPV vaccination studies conducted in mainland China. We conducted and reported the analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results Fifty-eight unique studies representing 19 provinces and municipalities in mainland China were assessed. The pooled awareness and knowledge rates about HPV vaccination were 15.95 % (95 % CI: 12.87–19.29, I2 = 98.9 %) and 17.55 % (95 % CI: 12.38–24.88, I2 = 99.8 %), respectively. The female population (17.39 %; 95 % CI: 13.06–22.20, I2 = 98.8 %) and mixed population (18.55 %; 95 % CI: 14.14–23.42, I2 = 98.8 %) exhibited higher HPV vaccine awareness than the male population (1.82 %; 95 % CI: 0.50–11.20, I2 = 98.5 %). Populations of mixed ethnicity had lower HPV vaccine awareness (9.61 %; 95 % CI: 5.95–14.03, I2 = 99.0 %) than the Han population (20.17 %; 95 % CI: 16.42–24.20, I2 = 98.3 %). Among different regions, the HPV vaccine awareness was higher in EDA (17.57 %; 95 % CI: 13.36–22.21, I2 = 98.0 %) and CLDA (17.78 %; 95 % CI: 12.18–24.19, I2 = 97.6 %) than in WUDA (1.80 %; 95 % CI: 0.02–6.33, I2 = 98.9 %). Furthermore, 67.25 % (95 % CI: 58.75–75.21, I2 = 99.8 %) of participants were willing to be vaccinated, while this number was lower for their daughters (60.32 %; 95 % CI: 51.25–69.04, I2 = 99.2 %). The general adult population (64.72 %; 95 % CI: 55.57–73.36, I2 = 99.2 %) was more willing to vaccinate their daughters than the parent population (33.78 %; 95 % CI: 26.26–41.74, I2 = 88.3 %). Safety (50.46 %; 95 % CI: 40.00–60.89, I2 = 96.6 %) was the main concern about vaccination among the adult population whereas the safety and efficacy (68.19 %; 95 % CI: 53.13–81.52, I2 = 98.6 %) were the main concerns for unwillingness to vaccinate their daughters. Conclusions Low HPV vaccine awareness and knowledge was observed among the Chinese population. HPV vaccine awareness differed across sexes, ethnicities, and regions. Given the limited quality and number of studies included, further research with improved study designis necessary. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-2873-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yanru Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Ying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. .,Mental Health Center, Renmin Hospital of Wuhan University, Hubei Provincial Mental Health Center Wuchang District, Wuhan, Hubei, P. R. China.
| | - Li Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Yunzhou Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Zhihua Liu
- Shenzhen Maternity and Child Health Hospitals, Shenzhen, Guangdong, P. R. China.
| | - Yueyun Wang
- Shenzhen Maternity and Child Health Hospitals, Shenzhen, Guangdong, P. R. China.
| | - Shaofa Nie
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Daniyal M, Akhtar N, Ahmad S, Fatima U, Akram M, Asif HM. Update knowledge on cervical cancer incidence and prevalence in Asia. Asian Pac J Cancer Prev 2016; 16:3617-20. [PMID: 25987011 DOI: 10.7314/apjcp.2015.16.9.3617] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Cervical cancer is the second most common cause of cancer-related death among women worldwide, with over 500,000 new cases diagnosed annually and 50% mortality rate in Asia. In the United States, approximately 10,370 new cases of cervical cancer are diagnosed annually, and estimated 3,710 deaths occur from the disease, making it the sixth most common cause of malignancy among American women. This study aims to provide awareness about cervical cancer as well as an updated knowledge about the prevalence and incidence of cervical cancer in Asia.
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Affiliation(s)
- Muhammad Daniyal
- Faculty of Eastern Medicine and Surgery, Hamdard University, Karachi, Pakistan E-mail :
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Zou H, Meng X, Jia T, Zhu C, Chen X, Li X, Xu J, Ma W, Zhang X. Awareness and acceptance of human papillomavirus (HPV) vaccination among males attending a major sexual health clinic in Wuxi, China: A cross-sectional study. Hum Vaccin Immunother 2015; 12:1551-9. [PMID: 26467510 DOI: 10.1080/21645515.2015.1099771] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE To study the awareness and acceptance of human papillomavirus (HPV) vaccination among sexually active men having sex with men (MSM) and men not having sex with men (MNSM) attending the largest sexual health clinic in Wuxi, China. METHODS A questionnaire about participants' socio-demographic characteristics and view on HPV vaccination was collected. RESULTS A total of 186 MSM and 182 MNSM were recruited. Among MSM, 12.4% were under 20 years old, 64.5% never married and 56.5% from Jiangsu Province (where Wuxi City is located); 64.0% had resided in Wuxi for over 2 years, 64.5% had high school education or more, and 83.9% had an income of 5000 RMB or less per month compared to figures of 5.5%, 50.6%, 73.6%, 54.9%, 86.8% and 64.8% among MNSM, respectively (All P values < 0.05). Among these 2 groups of men, 18.4% and 23.1% had heard of HPV; 10.2% and 15.4% had heard of HPV vaccine; and 26.2% and 20.2% would take HPV vaccine before sexual debut, respectively. MNSM were significantly more willing to take HPV vaccine than MSM (70.9 vs 34.9%, p < 0.001). Factors associated with HPV vaccine acceptance among MSM included engaging mostly in receptive anal sex (Odds ratio (OR)=3.9, 95% Confidence interval (CI): 1.8-13.5), never using a condom in anal sex in the past 6 months (3.5, 1.5-20.2), ever diagnosed with a sexually transmitted infection (STI) (3.4, 1.3-8.4) and ever receiving HIV related services (1.6, 1.1-4.4). Among MNSM these Factors included commercial sex with women (1.7, 1.2-8.6), never using a condom in commercial sex (1.6, 1.4-7.6) and STI diagnosis (2.0, 1.6-7.3). CONCLUSIONS Sexually active MSM and MNSM in Wuxi lacked knowledge of HPV and HPV vaccination. The majority of these at-risk men would not benefit from HPV vaccination as their age at first sex proceeded perceived age of vaccine uptake. Aggressive education aimed at increasing knowledge of HPV and HPV vaccination among these men is warranted.
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Affiliation(s)
- Huachun Zou
- a Kirby Institute, University of New South Wales , Sydney , Australia
| | - Xiaojun Meng
- b Wuxi Municipal Centre for Disease Control and Prevention , Wuxi , Jiangsu Province , China
| | - Tianjian Jia
- b Wuxi Municipal Centre for Disease Control and Prevention , Wuxi , Jiangsu Province , China
| | - Chen Zhu
- c Nanchang District Centre for Disease Control and Prevention , Wuxi , Jiangsu Province , China
| | - Xin Chen
- c Nanchang District Centre for Disease Control and Prevention , Wuxi , Jiangsu Province , China
| | - Xiaolin Li
- d Shanghai Entry-Exit Inspection and Quarantine Bureau , Shanghai , China
| | - Junjie Xu
- e The First Affiliated Hospital, China Medical University , Shenyang , China
| | - Wei Ma
- f Department of Epidemiology and Health Statistics , School of Public Health, Shandong University , Jinan , Shandong Province , China
| | - Xuan Zhang
- b Wuxi Municipal Centre for Disease Control and Prevention , Wuxi , Jiangsu Province , China
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Li J, Kang LN, Li B, Pang Y, Huang R, Qiao YL. Effect of a group educational intervention on rural Chinese women's knowledge and attitudes about human papillomavirus (HPV) and HPV vaccines. BMC Cancer 2015; 15:691. [PMID: 26467534 PMCID: PMC4606881 DOI: 10.1186/s12885-015-1682-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 10/02/2015] [Indexed: 11/23/2022] Open
Abstract
Background Statistics regarding HPV prevalence and cervical cancer rates in rural China are high, however, low levels of HPV awareness and HPV-related knowledge pose a great challenge for cervical cancer control. Methods The authors conducted an educational intervention study, which was embedded in a cervical cancer screening project in Yangcheng county, Shanxi Province, China from October to December, 2011 and was designed to assess the short-term effectiveness of a hospital-based, brief, HPV-focused session on rural Chinese women’s knowledge and attitudes. Student’s t-test was used when comparing quantitative variables. Chi-squared test or Fisher’s exact tests was used when comparing qualitative variables. Results We found that following the intervention, significant increases were detected in awareness regarding HPV (5.9 % vs. 59 %, p < 0.001) and cervical cancer (63.0 % vs. 89.2 %, p < 0.001). Changes were also observed regarding women’s intention to vaccinate themselves (82.0 % vs. 89.0 %, p = 0.001) and their daughters (82.9 % vs. 88.0 %, p = 0.011), although the impact was more modest compared with the impact on change of awareness. Among women who were aware of HPV, 60.3 % knew that cervical cancer is related to HPV, while only 5.0 % knew the relationship between HPV and genital warts after the educational intervention. Conclusions Educational campaigns, particularly those targeting women with limited education and poor access to public media or other educational channels are needed to improve knowledge regarding HPV in the general population.
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Affiliation(s)
- Jing Li
- Department of Occupational and Environmental Health, West China School of Public Health, Sichuan University, Chengdu, 610041, China.
| | - Le-Ni Kang
- National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Chengdu, 610041, China.
| | - Bayi Li
- Department of Medical Services, Yangcheng Maternal and Child Health Hospital, Yangcheng, 048100, China.
| | - Yi Pang
- The prevention and control section for STD & AIDS, Center for disease control and prevention of Jinjiang, Chengdu, 610021, China.
| | - Rong Huang
- Department of Human Resource, The People's Hospital of Gansu Province, Lanzhou, 730060, China.
| | - You-Lin Qiao
- Department of Cancer Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100021, China.
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Wang LDL, Lam WWT, Fielding R. Cervical cancer prevention practices through screening and vaccination: A cross-sectional study among Hong Kong Chinese women. Gynecol Oncol 2015; 138:311-6. [DOI: 10.1016/j.ygyno.2015.05.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 05/20/2015] [Accepted: 05/21/2015] [Indexed: 11/30/2022]
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Wen Y, Pan XF, Zhao ZM, Chen F, Fu CJ, Li SQ, Zhao Y, Chang H, Xue QP, Yang CX. Knowledge of human papillomavirus (HPV) infection, cervical cancer, and HPV vaccine and its correlates among medical students in Southwest China: a multi-center cross-sectional survey. Asian Pac J Cancer Prev 2015; 15:5773-9. [PMID: 25081700 DOI: 10.7314/apjcp.2014.15.14.5773] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Since cervical cancer can be prevented and controlled through human papillomavirus (HPV) vaccination, it is important to train health care providers and provide them with appropriate knowledge. This study aimed to understand the level of HPV related knowledge among medical students and correlates in Southwest China in order to address any potential gap in their knowledge base. METHODS We conducted a cross-sectional survey among medical students in six selected universities across Southwest China based on a pretested questionnaire regarding HPV infection, cervical cancer, and HPV vaccines. RESULTS We successfully surveyed 1, 878 medical students, of whom 32.1% were males and 67.9% were females. Their mean age was 20.8 (standard deviation: 1.3) years. 91.8% of them were ethnic Han Chinese, and 43.8% were students in clinical medicine. While 76.5% had heard of HPV only 48.8% knew that the prevention of cervical cancer was possible through HPV vaccination. Only 42.9% of the male and 49.2% of the female students correctly answered over 10 out of 22 questions on HPV related knowledge. Female students appeared to know more about HPV and HPV vaccination (OR: 1.39; 95% CI: 1.11-1.75). In addition, the student knowledge improved with the grade (p<0.001). University courses were the most selected source of knowledge about HPV vaccination (66.4%). 83.6% of males and 91.4% of females were willing to have more HPV related education by experts (p<0.001). Only 10.1% of the students acknowledged that people had asked for their advice regarding HPV vaccination. CONCLUSIONS Our survey indicates that medical students from Southwest China have poor knowledge of HPV and HPV vaccination, but are willing to receive more relevant information. Targeted education should be incorporated into school courses to inform these future health care providers and ensure success of programs for cervical cancer control and prevention.
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Affiliation(s)
- Ying Wen
- Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, China E-mail :
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Johnson DC, Bhatta MP, Gurung S, Aryal S, Lhaki P, Shrestha S. Knowledge and awareness of human papillomavirus (HPV), cervical cancer and HPV vaccine among women in two distinct Nepali communities. Asian Pac J Cancer Prev 2015; 15:8287-93. [PMID: 25339019 DOI: 10.7314/apjcp.2014.15.19.8287] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study assessed human papillomavirus (HPV), cervical cancer, and HPV vaccine knowledge and awareness among women in two sub-populations in Nepal - Khokana, a traditional Newari village in the Lalitpur District about eight kilometers south of Kathmandu, and Sanphebagar, a village development committee within Achham District in rural Far-Western Nepal. METHODS Study participants were recruited during health camps conducted by Nepal Fertility Care Center, a Nepali non-governmental organization. Experienced staff administered a Nepali language survey instrument that included questions on socio-demographics, reproductive health and knowledge on HPV, cervical cancer, and the HPV vaccine. RESULTS Of the 749 participants, 387 (51.7%) were from Khokana and 362 (48.3%) were from Sanphebagar. Overall, 53.3% (n=372) of women were aware of cervical cancer with a significant difference between Khokana and Sanphebagar (63.3% vs 43.0%; p=0.001). Overall, 15.4% (n=107) of women had heard of HPV and 32% (n=34) of these women reported having heard of the HPV vaccine. If freely available, 77.5% of the women reported willingness to have their children vaccinated against HPV. Factors associated with cervical cancer awareness included knowledge of HPV (Khokana: Odds Ratio (OR)=24.5; (95% Confidence Interval (CI): 3.1-190.2, Sanphebagar: OR=14.8; 95% CI: 3.7-58.4)) and sexually transmitted infections (Khokana: OR=6.18; 95% CI: 3.1-12.4; Sanphebagar: OR=17.0; 95% CI: 7.3- 39.7) among other risk factors. CONCLUSIONS Knowledge and awareness of HPV, cervical cancer, and the HPV vaccine remains low among women in Khokana and Sanphebagar. Acceptance of a freely available HPV vaccine for children was high, indicating potentially high uptake rates in these communities.
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Wang W, Ma Y, Wang X, Zou H, Zhao F, Wang S, Zhang S, Zhao Y, Marley G, Ma W. Acceptability of human papillomavirus vaccine among parents of junior middle school students in Jinan, China. Vaccine 2015; 33:2570-6. [PMID: 25887088 DOI: 10.1016/j.vaccine.2015.04.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 03/19/2015] [Accepted: 04/02/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine the level of awareness on human papillomavirus (HPV) vaccine and acceptance of HPV vaccination among parents of junior middle school students. METHODS A cross sectional survey employing cluster sampling was conducted in Jinan, Shandong Province of China in January of 2013. RESULTS A total of 400 parents of junior middle school students participated in the questionnaire survey, among whom 360 (90%) completed valid questionnaires. About 88 (22.63%) parents had ever heard of HPV. Only one in ten (10.2%) knew about HPV vaccine. Parents willing to accept HPV vaccination for children accounted for 40.8%. Factors associated willing to accept HPV vaccination for children among parents were: female parent (AOR: 0.38, 95%CI: 0.21-0.67), having ever heard of HPV vaccine (AOR: 2.38, 95%CI: 1.01-5.61), thinking HPV vaccination should commence before sexual debut(AOR: 2.16, 95%CI: 1.21-3.85), thinking HPV vaccination should commence before 12 years old (AOR: 2.76, 95%CI: 1.02-7.46) or 13-15 years old (AOR: 4.75, 95%CI: 1.79-12.61), concern about suffering from cervical cancer and/or genital warts (AOR: 2.43, 95%CI: 1.31-4.50). About 60% of parents were in favor of future HPV vaccination promoting in China believing that HPV vaccine could efficiently prevent cervical cancer, anal cancer or genital warts, 37.4% of parents with expectation of governmental subsidy and price regulation. CONCLUSION Parental awareness level of HPV vaccine and willingness to accept HPV vaccination for children was low. However, the general attitude of many participants toward future promoting of HPV vaccination in China was encouraging, particularly if certain expectations were met.
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Affiliation(s)
- Wei Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, China
| | - Yuanyuan Ma
- School of Finance & Economics, Shandong Jiaotong University, Jinan, China
| | - Xia Wang
- Zaozhuang Vocational College of Science and Technology, Zaozhuang, China
| | - Huachun Zou
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Fanghui Zhao
- Department of Epidemiology, Cancer Institute of Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Shaoming Wang
- Department of Epidemiology, Cancer Institute of Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Shaokai Zhang
- Department of Epidemiology, Cancer Institute of Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yong Zhao
- The Middle School Attached to Shandong University, Jinan, China
| | - Gifty Marley
- Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, China
| | - Wei Ma
- Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, China.
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Wang JL, Yang YZ, Dong WW, Sun J, Tao HT, Li RX, Hu Y. Application of human papillomavirus in screening for cervical cancer and precancerous lesions. Asian Pac J Cancer Prev 2015; 14:2979-82. [PMID: 23803065 DOI: 10.7314/apjcp.2013.14.5.2979] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Cervical cancer is a commonly-encountered malignant tumor in women. Cervical screening is particularly important due to early symptoms being deficient in specificity. The main purpose of the study is to assess the application value of cervical thinprep cytologic test (TCT) and human papillomavirus (HPV) detection in screening for cervical cancer and precancerous lesions. In the study, cervical TCT and HPV detection were simultaneously performed on 12,500 patients selected in a gynecological clinic. Three hundred patients with positive results demonstrated by cervical TCT and/or HPV detection underwent cervical tissue biopsy under colposcopy, and pathological results were considered as the gold standard. The results revealed that 200 out of 12,500 patients were abnormal by TCT, in which 30 cases pertained to equivocal atypical squamous cells (ASCUS), 80 cases to low squamous intraepithelial lesion (LSIL), 70 cases to high squamous intraepithelial lesion (HSIL) and 20 cases to squamous cell carcinoma (SCC). With increasing pathological grade of cervical biopsy, however, TCT positive rates did not rise. Two hundred and eighty out of 12,500 patients were detected as positive for HPV infection, in which 50 cases were chronic cervicitis and squamous metaplasia, 70 cases cervical intraepithelial neoplasia (CIN) I, 60 cases CIN II, 70 cases CIN III and 30 cases invasive cervical carcinoma. Two hundred and thirty patients with high-risk HPV infection were detected. With increase in pathological grade, the positive rate of high-risk HPV also rose. The detection rates of HPV detection to CIN III and invasive cervical carcinoma as well as the total detection rate of lesions were significantly higher than that of TCT. Hence, HPV detection is a better method for screening of cervical cancer at present.
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Affiliation(s)
- Jin-Liang Wang
- Department of General Oncology, Chinese PLA General Hospital, Beijing, China
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Al-Darwish AA, Al-Naim AF, Al-Mulhim KS, Al-Otaibi NK, Morsi MS, Aleem AM. Knowledge about cervical cancer early warning signs and symptoms, risk factors and vaccination among students at a medical school in Al-Ahsa, Kingdom of Saudi Arabia. Asian Pac J Cancer Prev 2015; 15:2529-32. [PMID: 24761859 DOI: 10.7314/apjcp.2014.15.6.2529] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cervical cancer is the second most common cancer among females and also the most preventable. In the literature there is abundant evidence that awareness regarding cervical cancer and its prevention is low in the developing countries. Medical students are the future health professionals and can play an important role in increasing awareness among the general population. To assess the knowledge regarding symptoms, risk factors and prevention of cervical carcinoma among medical students in th Kingdom of Saudi Arabia, the present study was planned. MATERIALS AND METHODS This cross-sectional study was conducted using a self-administered questionnaire with students at the College of Medicine, King Faisal University, Al-Ahsa, KSA, from December 2012 to May 2013. RESULTS The responses of 188 students (males 111, females 77) in their second, third, fourth, and fifth years were recorded and used in the data analysis. The majority of the students were not aware of the early warning signs, symptoms and risk factors. On average, only 43.7% males and 56% of females were aware about the early signs and symptoms whereas 51.4% males and 57.8% females had knowledge about the risk factors of cervical cancers. Some 55% males and 46.8% females were unable to select the correct answer regarding human papilloma virus (HPV) infection as the cause of cervical cancer. Majority of the students (67%) were not aware about the availability of vaccine against HPV. CONCLUSIONS Lack of knowledge regarding early signs and symptoms, risk factors and prevention of cervical cancer was observed in the present study.
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Zhang SK, Pan XF, Wang SM, Yang CX, Gao XH, Wang ZZ, Li M, Ren ZF, Zheng QQ, Ma W, Zhao FH, Qiao YL. Knowledge of human papillomavirus vaccination and related factors among parents of young adolescents: a nationwide survey in China. Ann Epidemiol 2015; 25:231-5. [PMID: 25656922 DOI: 10.1016/j.annepidem.2014.12.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 12/04/2014] [Accepted: 12/27/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE To investigate the human papillomavirus (HPV) vaccine-related knowledge and factors associated with the knowledge among parents of young adolescents in China. METHODS The study was based on data of a survey carried out in seven geographic regions of China. Parents of students in junior middle school were surveyed during parents' meetings. RESULTS A total of 2895 parents were included in the analyses. Of parents, 38.3% responded with "yes" to more than three of the six knowledge questions, among whom only 4.5% of them correctly answered all six questions. Social benefit programs (41.3%), doctors and/or nurses (39.7%), and newspapers and/or magazines (36.5%) were selected as the top three sources of HPV-related knowledge. Mothers, parents who work in the health care sector, and parents with a higher annual income or with vaccination experience outside the expanded program on immunization showed a better knowledge base. Parents who consented to sex education for children or showed fear of cervical cancer were likely to have more HPV-related knowledge. In particular, the knowledge level of parents with prior consultation regarding HPV vaccines was higher. CONCLUSIONS Parents of young adolescents in China possessed a low level of HPV vaccine-related knowledge. Findings highlight the need for tailored health education through different channels to improve HPV-related knowledge among parents.
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Affiliation(s)
- Shao-Kai Zhang
- Department of Cancer Epidemiology, Cancer Institute of Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Cancer Epidemiology, Hennan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Henan Office for Cancer Control and Research, Zhengzhou, China
| | - Xiong-Fei Pan
- Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, China
| | - Shao-Ming Wang
- Department of Cancer Epidemiology, Cancer Institute of Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chun-Xia Yang
- Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, China
| | - Xiao-Hong Gao
- Department of Epidemiology, School of Public Health, Dalian Medical University, Dalian, China
| | - Zeng-Zhen Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Man Li
- Department of Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Ze-Fang Ren
- Department of Epidemiology and Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Quan-Qing Zheng
- Department of Public Health, Medical School of Xi'an Jiaotong University, Xi'an, China
| | - Wei Ma
- Institute of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, China
| | - Fang-Hui Zhao
- Department of Cancer Epidemiology, Cancer Institute of Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - You-Lin Qiao
- Department of Cancer Epidemiology, Cancer Institute of Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Pan XF, Zhao ZM, Sun J, Chen F, Wen QL, Liu K, Song GQ, Zhang JJ, Wen Y, Fu CJ, Yang CX. Acceptability and correlates of primary and secondary prevention of cervical cancer among medical students in southwest China: implications for cancer education. PLoS One 2014; 9:e110353. [PMID: 25360743 PMCID: PMC4215919 DOI: 10.1371/journal.pone.0110353] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 09/14/2014] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To understand knowledge about, and acceptability of, cervical cancer screening and HPV vaccines among medical students; and to explore potential factors that influence their acceptability in China. METHODS We conducted a survey among medical students at six universities across southwest China using a 58-item questionnaire regarding knowledge and perceptions of HPV, cervical cancer, and HPV vaccines. RESULTS We surveyed 1878 medical students with a mean age of 20.8 years (standard deviation: 1.3 years). Of these, 48.8% and 80.1% believed cervical cancer can be prevented by HPV vaccines and screening respectively, while 60.2% and 71.2% would like to receive or recommend HPV vaccines and screening. 35.4% thought HPV vaccines ought to be given to adolescents aged 13-18 years. 32% stated that women should start to undergo screening from the age of 25. 49.2% felt that women should receive screening every year. Concern about side effects (38.3% and 39.8%), and inadequate information (42.4% and 35.0%) were the most cited barriers to receiving or recommending HPV vaccination and cervical cancer screening. Females were more likely to accept HPV vaccines (OR, 1.86; 95% CI: 1.47-2.35) or cervical cancer screening (OR, 3.69; 95% CI: 2.88-4.74). Students with a higher level of related knowledge were much more willing to receive or recommend vaccines (P<0.001) or screening (P<0.001). Students who showed negative or uncertain attitudes towards premarital sex were less likely to accept either HPV vaccines (OR, 0.67; 95% CI: 0.47-0.96), or screening (OR, 0.68; 0.47-0.10). Non-clinical students showed lower acceptability of cervical screening compared to students in clinical medicine (OR, 0.74; 95% CI: 0.56-0.96). CONCLUSIONS The acceptability of HPV vaccines and cervical cancer screening is relatively low among medical students in southwest China. Measures should be taken to improve knowledge about cervical cancer and awareness of HPV vaccines and screening among medical students at university.
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Affiliation(s)
- Xiong-Fei Pan
- Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, China
| | - Zhi-Mei Zhao
- Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, China
| | - Jing Sun
- Department of Pathology, Development and Regeneration Key Laboratory of Sichuan Province, Chengdu Medical College, Chengdu, China
| | - Feng Chen
- Department of Preventive Healthcare and Hospital Infection Control, Deyang People's Hospital, Deyang, China
| | - Qing-Lian Wen
- Department of Oncology, the Affiliated Hospital of Luzhou Medical College, Luzhou, China
| | - Kang Liu
- Institute of Tissue Engineering and Stem Cells, The Second Clinical Hospital of North Sichuan Medical College, Nanchong, China
| | - Gui-Qin Song
- Department of Biology, North Sichuan Medical University, Nanchong, China
| | - Jing-Jing Zhang
- School of Public Health, Kunming Medical University, Kunming, China
| | - Ying Wen
- Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, China
| | - Chun-Jing Fu
- Department of Health Statistics and Information Management, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Chun-Xia Yang
- Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, China
- * E-mail:
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Wang LDL, Lam WWT, Wu J, Fielding R. Hong Kong Chinese Women's Lay Beliefs about Cervical Cancer Causation and Prevention. Asian Pac J Cancer Prev 2014; 15:7679-86. [DOI: 10.7314/apjcp.2014.15.18.7679] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Khan GJ, Naeem HS, Khan S, Jamshaid T, Sajid MI, Bashir I, Jamshaid M. Understanding and Responsiveness Level about Cervical Cancer and its Avoidance among Young Women of Pakistan. Asian Pac J Cancer Prev 2014; 15:4877-83. [DOI: 10.7314/apjcp.2014.15.12.4877] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Wang SM, Zhang SK, Pan XF, Ren ZF, Yang CX, Wang ZZ, Gao XH, Li M, Zheng QQ, Ma W, Zhao FH, Qiao YL, Sivasubramaniam P. Human Papillomavirus Vaccine Awareness, Acceptability, and Decision-Making Factors among Chinese College Students. Asian Pac J Cancer Prev 2014; 15:3239-45. [DOI: 10.7314/apjcp.2014.15.7.3239] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Mellstedt H, Gaudernack G, Gerritsen WR, Huber C, Melero I, Parmiani G, Scholl S, Thatcher N, Wagstaff J, Zielinski C. Awareness and understanding of cancer immunotherapy in Europe. Hum Vaccin Immunother 2014; 10:1828-35. [PMID: 25424789 PMCID: PMC4186017 DOI: 10.4161/hv.28943] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 04/07/2014] [Accepted: 04/17/2014] [Indexed: 11/19/2022] Open
Abstract
The use of immunotherapy in the management of cancer is growing, and a range of new immunotherapeutic strategies is becoming available. It is important that people involved in the care of cancer understand how cancer immunotherapies differ from conventional chemotherapy and apply this knowledge to their clinical practice. Therefore, from August-September 2011 we undertook a survey of awareness, attitudes, and perceptions of cancer immunotherapy among 426 healthcare professionals (HCPs) in Europe with the aim of identifying and prioritizing educational needs. Nearly all (98%) HCPs were aware of cancer immunotherapy. While 68% of HCPs indicated a high level of interest in cancer immunotherapies, only 24% of the HCPs had direct experience with them. Overall perceptions of cancer immunotherapy among HCPs were largely positive (60%) and rarely negative (3%). The key advantages of cancer immunotherapy were perceived to be good safety and tolerability (75%), a targeted mechanism of action (61%) and good efficacy (48%). The leading barriers to use of immunotherapies were costs of treatment (58%), past clinical trial failures (45%), and access/formulary restrictions (44%). The results indicate that, among the respondents, awareness of cancer immunotherapy was high but that knowledge levels varied and direct experience with their use was limited. There appears to be a need for educational activities on cancer immunotherapy, as well as generation and communication of clinical data on long-term efficacy and safety.
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Chang IJ, Huang R, He W, Zhang SK, Wang SM, Zhao FH, Smith JS, Qiao YL. Effect of an educational intervention on HPV knowledge and vaccine attitudes among urban employed women and female undergraduate students in China: a cross-sectional study. BMC Public Health 2013; 13:916. [PMID: 24088392 PMCID: PMC3852612 DOI: 10.1186/1471-2458-13-916] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 09/05/2013] [Indexed: 11/27/2022] Open
Abstract
Background Due to the potential of human papillomavirus (HPV) vaccination for decreasing cervical cancer rates in Mainland China, where some of the highest incidences in the world have been reported, our study aimed to assess HPV and HPV vaccine knowledge, and to evaluate the effect of a brief educational intervention on HPV knowledge and vaccine acceptability in Chinese undergraduate students and employed women. Methods This multi-center, cross-sectional study was conducted across five representative cities of the five main geographical regions of Mainland China. Participants were selected from one comprehensive university and three to four companies in each city for a total of six comprehensive universities and 16 companies. A 62-item questionnaire on HPV knowledge and HPV vaccine acceptability was administered to participants before and after an educational intervention. The intervention consisted of an informative group lecture. Results A total of 1146 employed women and 557 female undergraduate students were surveyed between August and November 2011. Baseline HPV knowledge was low among both groups— 320/1146 (28%) of employed women and 66/557 (12%) of students had heard of HPV, while only 237/1146 (21%) of employed women and 40/557 (7.2%) of students knew that HPV is related to cervical cancer. After educational instruction, 947/1061 (89%) of employed women and 193/325 (59%) of students knew the relationship between HPV and cervical cancer (χ2 = 1041.8, p < 0.001 and χ2 = 278.5, p < 0.001, respectively). Post-intervention, vaccine acceptability increased from 881/1146 (77%) to 953/1061 (90%), (p = <0.001) in employed women and 405/557 (73%) in students to 266/325 (82%), (p < 0.001). Women in both groups cited concerns about the HPV vaccine’s safety, efficacy, and limited use to date as reasons for being unwilling to receive vaccination. 502/1146 (44%) of women were willing to vaccinate their children at baseline, which increased to 857/1061 (81%) post-intervention, p < 0.001. Conclusions Incorporation of our lecture-based education initiative into a government-sponsored or school-based program may improve HPV-related knowledge and HPV vaccine acceptability. Further studies are needed to evaluate and standardize HPV education programs in China.
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Affiliation(s)
- Irene J Chang
- Department of Epidemiology, Cancer Institute of Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, P,R, China.
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Li J, Huang R, Schmidt JE, Qiao YL. Epidemiological Features of Human Papillomavirus (HPV) Infection among Women Living in Mainland China. Asian Pac J Cancer Prev 2013; 14:4015-23. [DOI: 10.7314/apjcp.2013.14.7.4015] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Zhang SK, Pan XF, Wang SM, Yang CX, Gao XH, Wang ZZ, Li M, Ren ZF, Zhao FH, Qiao YL. Perceptions and acceptability of HPV vaccination among parents of young adolescents: A multicenter national survey in China. Vaccine 2013; 31:3244-9. [DOI: 10.1016/j.vaccine.2013.05.046] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2013] [Revised: 05/02/2013] [Accepted: 05/10/2013] [Indexed: 11/28/2022]
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