Singaporean men's knowledge of cervical cancer and human papillomavirus (HPV) and their attitudes towards HPV vaccination

Little is known of men's knowledge of cervical cancer and its links with human papillomavirus (HPV), or of their attitudes and beliefs about HPV vaccination. This is despite men's sexual behaviour contributing to HPV transmission and their potential role in deciding whether their children are vaccinated against HPV. To address this, a comprehensive survey was conducted in Singapore where plans are underway for an HPV vaccination program. A representative sample of 930 Singaporean men was found to have moderate knowledge of cervical cancer but poor knowledge and awareness of HPV. Although these men showed strong support for HPV vaccination, overall findings highlight the importance of including men in education campaigns that aim to decrease the incidence of cervical and other HPV-related cancers and to increase the uptake of HPV vaccination.     

Evidence-informed vaccine decision making: The introduction of Human Papilloma Virus (HPV) vaccination in the Netherlands

Little is known about the role of (economic) information or evidence in the different stages of the decision-making process on vaccine introduction. By conducting a document analysis on the public decision-making process of introducing human Papilloma virus (HPV) vaccine into the national vaccination program (NVP) in the Netherlands, we aim to gain insight into which information plays a role during the introduction of a vaccination programme.A document analysis was performed on the public decision-making process regarding the introduction of HPV vaccine into the NVP in the Netherlands. Information used or asked for by various stakeholders during different stages of the policymaking process was identified. In total, 42 documents were found, analyzed and synthesized, for the period between August 2006 and September 2009. Documents were analyzed using directed content analysis based on eight broad categories of criteria used in decision-making frameworks for introducing a vaccine.Our analysis demonstrates that a wide variety of stakeholders is involved in the process. Financial or economic issues were stipulated in 64.3% of the documents and information on vaccine characteristics were discussed in 59.5%. Economic information from economic evaluations was discussed most (47.6%). Based on our analysis, it can be concluded that economic information, in particular information from economic evaluations, played an important role in the decision-making process regarding the introduction of HPV-vaccination.     

人类乳头瘤病毒与宫颈癌关系的研究

用Southern blot核酸杂交技术检测宫颈组织HPV16DNA相关序列。山东省116例宫颈癌病人的癌组织HPV16DNA相关序列阳性率为50．9％，36例无宫颈疾病妇女的宫颈组织阳性率为5．6％，宫颈癌与HPV16有强的联系。OR＝17．60，X^2=23.47，P＜0．01。HPV16DNA相关序列阳性率与宫颈癌病人的年龄、肿瘤的组织类型、临床类型及临床分期均无统计学上联系（P均大于0．25）。本文首次从山东省宫颈癌病人组织中检测到HPV33DNA4例及HPV31DNA1例。     

Women's knowledge of human papillomavirus (HPV) and their attitudes toward HPV vaccine: preparing for HPV vaccination in China

To explore women's knowledge of human papillomavirus (HPV) and attitudes toward the HPV vaccine in Zhejiang, China, women attending the checkup clinics were invited to participate. A questionnaire-guided interview was conducted with a representative sample of 1490 women, and 1432 effective questionnaires were obtained. The authors found 39.1% of women in urban areas and 27.1 % in rural areas had heard of HPV, whereas 23.7% and 15.1%, respectively, had heard of the HPV vaccine. The mean score of HPV knowledge was 3.75 in urban areas and 3.18 in rural areas, with a significant difference (P = .016). Of the sample who had heard of the HPV vaccine, the supportive mean score was 2.59 and 2.11, with a significant difference (P = .003). Women with more HPV knowledge were more likely to support the HPV vaccination (r = 0.50 and r = 0.61). The authors conclude that inadequate knowledge and misconceptions about HPV are common. Attitudes toward HPV vaccine are unsatisfactory. Education campaigns targeting different populations are needed prior to the introduction of an HPV vaccine.     

Factors associated with Human Papilloma Virus (HPV) vaccine recommendation by physicians in Lebanon,a cross-sectional study

Persistent Human Papilloma Virus (HPV) infection is associated with the development of cervical cancer, a leading cause of female death worldwide. In Lebanon, cervical cancer is the 6th most common cancer amongst girls and women aged 14–44 years. Cervical cancer is preventable through HPV vaccination; however, Lebanon does not include HPV vaccination in its national routine vaccination schedule. Hence, physician recommendation is key for patient vaccine uptake. We conducted a cross-sectional study in Beirut, Lebanon to assess factors affecting physician recommendation regarding HPV vaccination. Physicians practicing in Obstetrics and Gynecology (OBGYN), Pediatrics, Family Medicine and Infectious Diseases were included in the study. In total, 228 physicians completed the survey (28.79% response rate). The survey consisted of a set of demographic and HPV knowledge questions along with clinical vignettes. The vignettes presented theoretical patients who differed in gender, age, sexual activity, social background and whether the patient presented with his mother or not. The results show that physicians tend to recommend the vaccine more commonly for vignettes presenting female patients, with an Adjusted Odds Ratio (AOR) of 6.8. Also, physicians were more likely to recommend the vaccine for vignettes with patients coming from a non-conservative background (AOR = 2.1), vignettes where patients claim to be sexually active (AOR = 2.7) and vignettes where patients presented with their mother (AOR = 1.4). Physicians tend to recommend the vaccine less in vignettes with married patients (AOR = 0.5). Physicians with higher knowledge scores recommended the vaccine more often (AOR = 3.4). Overall, OBGYN physicians recommended the vaccine less than pediatricians (AOR = 0.5). These results show that Lebanese physicians’ recommendations rely on factors external to international guidelines. The results also highlight the importance of knowledge in adequate patient consultation. Thus, improved physician awareness towards international guidelines and physician education regarding HPV vaccination is essential in order to improve patient care in Lebanon.     

Knowledge,attitudes and acceptance toward Human papillomavirus (HPV) vaccination: Perspectives of Muslim women and men

ObjectivesHuman papillomavirus (HPV) infection is the leading risk factor for the development of anogenital cancers. Most Arab countries lack both HPV education and national HPV vaccination programs. The objective of this study was to assess knowledge, attitudes, and acceptance toward HPV vaccination in men and women from Oman, a country in the Middle Eastern North Africa region.MethodsThis cross-sectional quantitative study used convenience sampling to recruit male and female participants, aged 18 years and above from all 11 governorates of Oman to complete a validated self-administered questionnaire online in the Arabic language. The questionnaire comprised five sections, with a total of 32 questions. The questionnaire, including Arabic and English versions, was content validated and piloted.ResultsA total of 1403 participants, including 952 parents and 369 healthcare providers, completed the survey. The results showed a lack of knowledge regarding HPV infection and vaccines, including among healthcare providers. Less than a quarter of the participants had heard of HPV infection, with digital sources of information being the most common. Factors such as being a woman or a healthcare provider or completing higher levels of education were independently and significantly positively association with HPV awareness (p < 0.001). The majority of the participants lacked vaccine safety knowledge, had concerns about the vaccine's side effects, and sought reassurance of its protection against HPV infection (62%, 71.5%, and 84.6%, respectively). Nevertheless, nearly two-thirds of the participants agreed to take the HPV vaccine, with support for both boys and girls being vaccinated. There was almost universal agreement among the participants regarding the need for parental and adolescent HPV educational programs.ConclusionOmani women and men showed a high level of acceptance and favorable attitude toward HPV vaccination. The study findings support future efforts to implement school and public-level HPV education and a national HPV vaccination program in Oman.     

Parental attitudes to pre-pubertal HPV vaccination

OBJECTIVES: To determine the acceptability of childhood HPV vaccination and examine demographic, cultural, and psychosocial predictors of vaccine acceptance. DESIGN: School-based survey. PARTICIPANTS: Questionnaires sent to 1205 mothers of 8-14-year-old girls. Responses from 684 were included in the analyses. SETTING: Ten schools (seven primary, three secondary) in four areas of England. RESULTS: Seventy-five percent of mothers would accept the vaccine for their daughter. Vaccine acceptance was higher in mothers who had experience of cancer in the family (OR=1.61, CI: 1.14-2.29), had older daughters (OR=1.15, CI: 1.04-1.27), perceived approval from husband/partner (OR=14.51, CI: 6.15-34.25) and believed vaccine acceptance would be more normative (OR=1.78, CI: 1.59-2.01). Having concerns about too many vaccinations (OR=0.22, CI: 0.15-0.31) or vaccine side effects (OR=0.37, CI: 0.28-0.50) and worry about increasing promiscuity (OR=0.47, CI: 0.36-0.62) emerged as deterrents. The modal preferred age was 12 years. Endorsing vaccination at earlier ages was predicted by feeling able to discuss related topics, including sex, at younger ages (OR=1.37, CI: 1.24-1.51) and concern about increasing promiscuity (OR=0.61, CI: 0.47-0.78). CONCLUSIONS: Overall, there was a favourable response to HPV vaccination. Emphasising the widespread acceptance of the vaccine might promote acceptance further, as would information on immunological and social benefits of earlier vaccination.     

Adolescents' awareness of HPV infections and attitudes towards HPV vaccination 3 years following the introduction of the HPV vaccine in Hungary

Hungary takes the fourth place regarding the incidence and the fifth regarding the mortality of cervical cancer among the member countries of the European Union, with 500 deaths due to this preventable illness and nearly 1200 new cases diagnosed every year. Although the vaccines have been available for 3 years, the estimated rate of the female population vaccinated against HPV is approximately 10% in the 12-26-year-age cohort. The aim of this study was to determine factors and motivations affecting the uptake of HPV vaccination among Hungarian adolescents. Examining the effects of some possible sociodemographic predictors (age and gender) and the exposure to health information on HPV vaccine acceptability were also focused on, as well as assessing the most trusted sources of information about sexually transmitted diseases (STDs).A nationwide anonymous questionnaire survey with a sample of 1769 students attending public primary or secondary schools was organised by the authors in 16 Hungarian cities and towns. Data were analysed using the Statistical Package for the Social Sciences (SPSS).Adolescents’ awareness of HPV was relatively low. Only 35% of the participants reported they had heard about HPV prior to the survey. Almost 70% of the potentially affected study population had not heard about the vaccine previously. Every fourth student did not believe that vaccination against HPV can prevent cervical cancer. If the vaccination was available free of charge, almost 80% of respondents would request it, but in case they had to pay for it, this number would significantly decrease. Significantly better knowledge and also more positive attitudes towards HPV vaccination was found in relation to the number of information sources. The majority of respondents (62-83%) were open for further information about STDs. The main trusted mediators were school-health services (61.3%), education on health at school (49.2%), health professionals (42.2%) and electronic media (24.6%).Since Hungarian adolescent students expect guidance about STDs principally from school health education, an urgent need for well-designed, HPV-focused educational programmes emerges. Launching such programmes would be especially important for the adolescent population to increase their awareness of the risks associated with HPV infection thus reducing the high incidence of cervical cancer in Hungary in the future.     

澳门妇女和医师对HPV疫苗的认知态度调查及其推广应用分析

目的了解澳门特别行政区女性和执业医师在人乳头瘤病毒(human papillomavirus,HPV)疫苗纳入免费防疫接种计划之前对其认知、接受度,及疫苗的使用情况,分析影响接种的主要因素,评估HPV疫苗在澳门发展情况,为宫颈癌预防工作提供适当的模式。方法 2008年8~12月采用问卷抽样调查方式对澳门特别行政区1 716名女性及108名执业医师进行问卷调查,利用SPSS 13.5软件进行统计分析。结果受调查妇女中,47.1%的女性曾听过HPV,76.7%的女性听过宫颈癌疫苗,认为HPV感染与宫颈癌有关联性的仅为35.4%。另外,38.4%的女性及其中43.4%的母亲愿意自己或女儿接种疫苗。据多因素logistic回归分析得出年龄、个人收入、职业、个人防护、担心患宫颈癌、担心疫苗来源、认为自己年龄太大或太小是影响接受疫苗的主要因素。澳门医师对HPV及HPV疫苗都有中高度认知。约60%受调查医师对HPV疫苗有信心,而评价疫苗的不足主要是价格太贵。结论澳门宣传有关HPV及HPV疫苗的知识是有效的,HPV疫苗在澳门使用人数逐渐增加。为增加澳门居民对疫苗的接受程度,达到预防宫颈癌的目的,政府仍需采用多种宣传方式加强宣传力度。     

人乳头瘤病毒与宫颈病

宫颈癌在女性肿瘤中居第2位,占癌症患者总数的15％,现已明确人乳头瘤病毒（HPV）感染是宫颈癌的根本致病因素。研究证实,大多数宫颈上皮内瘤样病变（CIN）伴有HPV感染,90％宫颈癌标本可以检测出HPVDNAE[1]。     

人乳头瘤病毒感染与宫颈癌

<正> 一、宫颈癌问题 宫颈癌一直是影响妇女健康的重要问题,据世界范围调查,全球每年约有466000例宫颈癌的新发病例,其中80％的病例发生在发展中国家。其原因是发展中国家没有建立有效的宫颈癌筛查体系,它已成为发展中国家妇女死亡的主要原因,死亡率仅次于乳腺癌,居第二位。     

Factors influencing HPV vaccination status in a Latino population; and parental attitudes towards vaccine mandates

We performed a retrospective cohort study in a largely Latino population in Los Angeles, surveying 95 parents of 11–17 year old girls between May and June 2008 to examine factors associated with [1] parental consent for Human Papillomavirus (HPV) immunization one year after vaccine implementation and [2] parental support of an HPV vaccine mandate for adolescents prior to middle school entry. 73% of participants had heard of the HPV vaccine and 37% of daughters had already received the vaccine. Variables associated with vaccination included Latino ethnicity, the belief that vaccines are safe, and that HPV vaccine prevents cervical cancer. The most frequent reasons for refusing vaccination included parental request for more information and missed opportunities in clinic. Variables associated with parents agreeing with a law mandating HPV vaccination included: belief in vaccine safety, recent maternal Pap Smear, HPV vaccination of participant's daughter prior to survey, and Latino ethnicity. Our survey supports the work of previous studies recommending continued educational campaigns emphasizing the safety of HPV vaccine, and its efficacy in reducing cervical cancer.     

Female human papillomavirus (HPV) vaccination: Global uptake and the impact of attitudes

Human papillomavirus (HPV) is the causative agent in cervical cancer and has been implicated in a range of other malignancies. Preventative vaccines are now internationally available and provide high levels of protection from common viral strains. The introduction of a comprehensive vaccination programme (except ‘program’ in computers) could prevent over 60% of current cervical cancer cases, but this is dependent on such programmes achieving a high level of coverage. In this review, we summarise the current trends in female HPV vaccination coverage throughout the world, and place it in the context of available research on attitudes towards vaccination amongst the public and health professionals.     

HPV vaccination,knowledge, and attitudes among young cervical cancer survivors in the Deep South

Introduction

Although FDA approved for over 10?years, uptake of the human papillomavirus (HPV) vaccination has been slow, particularly among states in the Deep South with high cervical cancer incidence and mortality. The purpose of this study was to explore variables associated with cervical cancer among survivors who were age-eligible for the HPV vaccine and to assess HPV vaccination history, barriers, perceptions, and other associated behaviors within this cohort.

Human papillomavirus (HPV) vaccination in the transition between adolescence and adulthood

PurposeYoung adulthood is characterized by changes in health care decision-making, insurance coverage, and sexual risk. Although the human papillomavirus (HPV) vaccine is now approved for adults up to age 45, and catch-up vaccination is currently recommended up through age 26, vaccination rates remain low in young adults. This study explored perspectives on HPV vaccination among young adults receiving care at the student health center of a large public university.MethodsWe conducted semi-structured interviews (n = 27) and four focus groups with female and male undergraduate and graduate students (n = 18) and semi-structured interviews with health care providers (n = 6). Interviews and focus groups explored perceived risk of HPV infection, benefits of the HPV vaccine, and motivations for and barriers to HPV vaccination.ResultsMany young adults cited their parents’ views and recommendations from medical providers as influential on their decision-making process. Students perceived that cervical cancer prevention was a main benefit of the HPV vaccine and sexual activity was a risk factor for HPV infection. Students often lacked knowledge about the vaccine’s benefits for males and expressed some concerns about the safety and side effects of a vaccine perceived as new. Logistical barriers to vaccination included uncertainty over vaccination status and insurance coverage for the vaccine, and concerns about balancing the vaccine schedule with school obligations. Providers’ vaccine recommendations were impacted by health system factors, including clinical infrastructure, processes for recommending and documenting vaccination, and office visit priorities. Suggested vaccination promotion strategies included improving the timing and messaging of outreach efforts on campus and bolstering clinical infrastructure.ConclusionsAlthough college may be an opportune time to reach young adults for HPV vaccination, obstacles including navigating parental influence and independent decision-making, lack of awareness of vaccination status, and numerous logistical and system-level barriers may impede vaccination during this time.     

青少年人乳头瘤病毒感染的研究进展

人乳头瘤病毒分布广泛,且有很强的传染性,感染后引起的尖锐湿疣在性传播疾病中位居第3位.宫颈癌是世界上威胁妇女健康的第2大肿瘤,而99％的宫颈癌患者都存在生殖道人乳头瘤病毒的感染.人乳头瘤病毒感染后无法根治,严重威胁患者的健康甚至是生命,而人乳头瘤病毒疫苗可有效预防尖锐湿疣和宫颈癌的发生.青少年是人乳头瘤病毒的易感人群,重视此类患者人乳头瘤病毒感染的预防有重要意义.