HPV Vaccine Knowledge and Beliefs Among Cambodian American Parents and Community Leaders

Background: The cervical cancer incidence rate among Cambodian American women is 15.0 per 100,000,compared to 7.7 per 100,000 among non-Latina white women. HPV infection has been identified as a universalrisk factor for cervical cancer. The HPV vaccine was recently approved in the United States for females aged 9-26 years. There is little information about HPV vaccination knowledge and beliefs in Southeast Asian communities.Methods: We conducted 13 key informant interviews with Cambodian community leaders, as well as four focusgroups with Cambodian parents (37 participants). Two of the focus groups included fathers and two of the focusgroups included mothers. Interview and focus group questions addressed HPV vaccine barriers and facilitators.Results: Participants had limited knowledge about HPV infection and the HPV vaccine. Barriers to HPVvaccination included a lack of information about the vaccine, as well as concerns about vaccine safety, effectiveness,and financial costs. The most important facilitators were a health care provider recommendation for vaccinationand believing in the importance of disease prevention. Discussion: Future cervical cancer control educationalprograms for Cambodians should promote use of the HPV vaccine for age-eligible individuals. Health careproviders who serve Cambodian communities should be encouraged to recommend HPV vaccination.     

National HPV Immunisation Programme: Knowledge and Acceptance of Mothers Attending an Obstetrics Clinic at a Teaching Hospital,Kuala Lumpur

Background: Introduction of the HPV vaccine is a forefront primary prevention method in reducing theincidence of carcinogenic human papillomavirus (HPV) and cervical cancer. The Malaysia government hasimplemented the National HPV immunisation programme since 2010, supplying HPV vaccine free to targeted13 year olds. This study aimed to explore the level of knowledge among mothers on cervical cancer, HPV,HPV vaccine and National HPV (NHPV) immunisation programme since its’ implementation. It also assessedacceptance of mothers towards HPV vaccine being administered to their daughter, son or themselves. Materialsand Methods: A cross sectional study was conducted on 155 respondents using self-administered questionnaires;conducted in December 2012 at the Obstetrics and Gynaecology Clinic in a teaching hospital in Kuala Lumpur.Respondents were selected using a multistage sampling technique. Results: A response rate of 100% was obtained.Overall, 51.0% of mothers had good knowledge, with 55% having good knowledge of cervical cancer, 54.2%for both HPV and the National HPV immunisation programme and 51.0% for the HPV vaccine. Regressionanalyses showed that ethnicity was associated with knowledge on cervical cancer (p=0.003) while education wasassociated with knowledge on HPV (p=0.049). Three factors are associated with knowledge of the National HPVimmunisation programme; ethnicity (p=0.017), mothers’ education (p=0.0005) and number of children (p=0.020).The acceptance of HPV vaccine to be administered among daughter was the highest at 87.1%, followed by formothers themselves at 73.5%, and the least is for sons 62.6%. Conclusions: This study found that the overalllevel of knowledge was moderate. Adequate information on cervical cancer, HPV, HPV vaccination and theNational HPV immunisation programme should be provided to mothers in order to increase acceptance of theHPV vaccine which can reduce the disease burden in the future.     

Awareness of Turkish Female Adolescents and Young Women about HPV and their Attitudes Towards HPV Vaccination

Background: The aim of the study was to assess the knowledge about HPV and HPV vaccines and attitudestowards vaccination among the females aged 9-24 years in Turkey. Materials and Methods: Self-administeredquestionnaires were filled out individually by the participants covering demographic information, knowledgeabout HPV infection and HPV vaccines, attitudes towards vaccination, and the perceptions of them about theirparental attitudes about vaccination. Results: Of the 408 subjects participating in the study, 41.6% (n=170) hadheard of HPV. Thirty-three percent (n=136) knew the causal relationship between HPV and cervical cancer.Only 27.9% (n=114) of them knew that HPV vaccines can prevent cervical cancer. Eleven percent (n=46) of thefemales participating in the study were willing to be vaccinated, and only 1.4% (n=6) were already vaccinated atthe current time. The main reason listed among the participants who were not willing to be vaccinated was lackof information. Conclusions: Awareness and knowledge of Turkish female adolescents and young women aboutHPV, relation with cervical cancer and prevention of cervical cancer by Pap smear and vaccine are still limited.If the most important barrier to vaccination, which is reported as lack of information, were to be addressed, itwould greatly impact the decision-making and vaccine acceptance.     

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

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 correlatesin Southwest China in order to address any potential gap in their knowledge base. Methods: We conducted across-sectional survey among medical students in six selected universities across Southwest China based on apretested questionnaire regarding HPV infection, cervical cancer, and HPV vaccines. Results: We successfullysurveyed 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 clinicalmedicine. While 76.5% had heard of HPV only 48.8% knew that the prevention of cervical cancer was possiblethrough HPV vaccination. Only 42.9% of the male and 49.2% of the female students correctly answered over 10out of 22 questions on HPV related knowledge. Female students appeared to know more about HPV and HPVvaccination (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 malesand 91.4% of females were willing to have more HPV related education by experts (p<0.001). Only 10.1% of thestudents acknowledged that people had asked for their advice regarding HPV vaccination. Conclusions: Oursurvey 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 schoolcourses to inform these future health care providers and ensure success of programs for cervical cancer controland prevention.     

Knowledge of cervical cancer and HPV vaccine post- vaccination among mothers and daughters in Vietnam

Background: Limited human papillomavirus (HPV) related knowledge might be a barrier to future vaccineacceptance. From 2008-2010, PATH conducted an HPV vaccination demonstration project in partnership withthe government immunization program in Vietnam, which included awareness campaigns prior to vaccination.Objective: To assess and compare knowledge and attitudes about cervical cancer and HPV vaccines betweenmothers and daughters, and whether knowledge was associated with vaccination status. Methods: We analyzedHPV-related knowledge and attitude data from mother-daughter paired responses to a cross-sectional householdsurvey. After parents completed the survey, daughters were asked the same questions. We calculated the frequencyof responses for each question and devised a scaled composite measure for knowledge. Results: Participantsbelieved they had received enough information about cervical cancer and HPV vaccines and it was sufficient tomake a decision about vaccination. Fifty percent of the participants knew HPV causes cervical cancer and 80%knew the HPV vaccine prevented cervical cancer. Mothers had more knowledge about cervical cancer and HPVinfection (p<0.01), compared to daughters, who had more vaccine specific knowledge (p<0.01). However, thetotal mean knowledge score was similar for the groups. Girls not fully vaccinated had a lower mean knowledgescore than fully vaccinated girls (p<0.001). Conclusions: Our results suggest that the purpose of the HPVvaccine was clearly messaged; however, some misconceptions about cervical cancer and HPV still exist. Limitedknowledge about the magnitude of cervical cancer, HPV as a cause of cervical cancer, and HPV vaccines mayhave contributed to incomplete vaccination.     

HPV Vaccination in Hong Kong: Implications for Medical Education

Objective. To explore the experience and attitudes of physicians in clinics, and to facilitate physicians’promotion of HPV vaccination. Data Sources. Primary data collected from conducting semi-structural indepthinterviews from May to June 2010 with 12 physicians in one district in Hong Kong to understand theirexperience of providing HPV vaccines, the difficulties in promoting HPV vaccines, and their attitudes towardsHPV vaccination. Study Design. Physicians identified 4 categories of factors related to their experiences of andattitudes to providing HPV vaccination: (a) background information on HPV vaccination provided by physicians,(b) factors influencing women to receive vaccination, (c) physicians’ recommendations to the public on HPVvaccines, and (d) physicians’ perspectives on HPV vaccine promotion. Conclusions. Our findings show thatpublic knowledge on HPV and cervical cancer is insufficient and the role of government in vaccine promotionis unclear. Promotion strategies such as physicians’ recommendation, financial assistance and health educationprovided by the government will influence HPV vaccination and its promotion.     

Human papillomavirus and vaccination: knowledge, attitudes, and behavioural intention in adolescents and young women in Italy

This study assesses knowledge, attitudes, and behavioural intention towards human papillomavirus (HPV) infection and vaccination in a random sample of 1348 adolescents and young women aged 14-24 years in Italy. A self-administered anonymous questionnaire covered demographics; knowledge about HPV infection, cervical cancer, and HPV vaccine; the perceived risk for contracting HPV infection and/or for developing cervical cancer, the perceived benefits of a vaccination to prevent cervical cancer, and willingness to receive an HPV vaccine. Only 23.3% have heard that HPV is an infection of the genital mucosa and about cervical cancer. Those older, with at least one parent who is a health care professional, with personal, familiar, or friendly history of cervical cancer, and having underwent a health checkup in the last year with information about HPV vaccination were significantly more knowledgeable. Risk perception scores (range: 1-10) of contracting HPV infection and of developing cervical cancer were 5.8 and 6.5. Older age, not having a parent who is a health care professional, having had a personal, familiar, or friendly history of cervical cancer, and need of additional information were predictors of the perceived susceptibility of developing cervical cancer. The vast majority professed intent to receive an HPV vaccine and the significant predictors were having at least one parent who is a health care professional, a high perceived risk of contracting HPV infection and of developing cervical cancer, and a high belief towards the utility of a vaccination for preventing cervical cancer. Knowledge about HPV infection and cervical cancer should be improved with more attention to the benefit of HPV vaccination.     

Knowledge and Attitudes of Medical and Non-Medical Turkish University Students about Cervical Cancer and HPV Vaccination

Background: This study was conducted to determine knowledge, attitudes and practices about cervical cancer and HPV vaccination of students studying in various faculties of Erciyes University. Materials and Methods: The study was performed among the first and fourth grade students of Medicine, Theology, Education and Economics and Administrative Sciences (FEAS) faculties of Erciyes University. It was aimed to reach 1,073 students and 718 were evaluated. A questionnaire consisting of 48 questions related to the socio-demographic characteristics, knowledge, attitude and practices about cervical cancer and HPV vaccination was administered to the students. The chi-square test and logistic regression were used for the statistical analyses. Results: Of the students, 78.3% were aware of cervical cancer, while 36.1% of them were aware of the HPV vaccine. The percentage hearing about cervical cancer and HPV vaccination was significantly higher among the students of the medical faculty than the others and among fourth grade students comparing with the first grade. The marital status and the presence of a health worker in the family had no significant impact on the knowledge level of the students. The acceptability of the HPV vaccination was low among all students. Conclusions: The knowledge levels of the university students about cervical cancer and HPV vaccination are inadequate. This deficiency is more pronounced among the non-medical students and there is no significant increase during the faculty years. Non-medical students must be provided with information about important public health issues by elective courses. HPV vaccination could provide many benefits for men and women by decreasing the morbidity and mortality of cervical, anal, and penile cancers.     

HPV Vaccination Uptake Among Cambodian Mothers

Women of Southeast Asian descent have higher cervical cancer incidence rates than any other group. Widespread use of HPV vaccination could prevent up to 70% of cervical cancers. There is little published information addressing HPV vaccination uptake among Asian Americans. We conducted a survey of Cambodian women with daughters who were age-eligible for HPV vaccination. Survey items addressed HPV vaccination barriers, facilitators, and uptake. Only 26% of the survey participants reported any of their age-eligible daughters had received vaccination, and only 40% reported a previous physician recommendation for vaccination. Higher levels of vaccine uptake were strongly associated with having received a doctor’s recommendation for vaccination (p < 0.001) and having asked a doctor for vaccination (p = 0.002). HPV vaccine uptake was relatively low in our Cambodian study group. Educational initiatives should encourage health care providers who serve Cambodian families to recommend HPV vaccination and empower Cambodian mothers to ask their daughters’ doctors for vaccination.     

Knowledge about Human Papillomavirus and Cervical Cancer: Predictors of HPV Vaccination among Dental Students

Background: The objective of this study is to determine the influence of dental students’ knowledge and attitude regarding human papillomavirus infection of cervical cancer on willingness to pay for vaccination. Basic research design: A convenience sampling method was used. The minimal sample size of 136 was calculated using the Raosoft calculator with a 5 % margin of error and 95% confidence level. Participants: The study population were all final year dental students from the School of Dentistry. Methods: A self-administered questionnaire was used to measure knowledge levels and attitudes regarding human papillomavirus vaccination. Contingent valuation was conducted for willingness to pay for vaccination. Main outcome measures: The Center for Disease Control and Prevention has stated that human papillomavirus are associated with oropharynx cancer and the American Dental Association insist on expanding public awareness of the oncogenic potential of some HPV infections. Thus, as future dental practitioners, dental students should be aware of human papillomavirus and their links with cancer and the benefits of vaccination. Results: Knowledge on HPV and cervical cancer did not impact on attitudes towards vaccines. However, significant correlation existed between knowledge and willingness to pay for vaccination. Conclusions: Dental students’ knowledge on HPV and cervical cancer has no influence on their attitude towards HPV vaccines. However, their willingness to pay for HPV vaccination is influenced by their knowledge of cervical cancer and HPV vaccination.     

Awareness of cervical cancer and HPV vaccination and its affordability among rural folks in Penang Malaysia

Introduction: As the second most common cancer in women worldwide, cervical cancer causes major health and economic burdens. Recent introduction of HPV immunization program locally has been encouraging but vaccine uptake remains poor. In addition, no study has been conducted to explore the people’s awareness and knowledge on cervical cancer, HPV and its vaccine in a rural setting in Malaysia after the inception of the HPV vaccination program. Objective: This study was conducted to determine the awareness of cervical cancer, HPV vaccination and its affordability among people in a rural area in Malaysia. Method: A cross-sectional study was conducted among 116 participants in a village in Penang. All consenting female villagers aged 13 years and above, and males who were married were interviewed using a questionnaire. Results: Most participants (88.8%) had heard of cervical cancer, however only 29.3% and 42.2% of them had heard of HPV and HPV vaccination respectively. Only 5.2% knew the actual market price for the vaccine. They were willing to pay an average of RM 96.7 (USD $27.7) for the full course of vaccination if it is not given to them for free, whereas the market price is RM1200 (USD $342.85). Conclusion: Awareness among the Malaysian population in a rural setting on HPV and HPV vaccination is low. Educating the public on the infection can help control the illness. Cost of the HPV vaccine is a serious barrier to the success of the vaccination program in Malaysia.     

Barriers,Attitudes and Clinical Approach of Lebanese Physicians Towards HPV Vaccination; A Cross- Sectional Study

Objectives: HPV infection is associated with the development of cervical and oropharyngeal cancer. HPV vaccination prevents cervical cancer, but is still not part of Lebanon’s routine vaccination schedule. As such, understanding physicians’ practice towards HPV vaccination is essential. Material and Methods: We conducted a cross-sectional study in Greater Beirut, Lebanon to assess the barriers, attitudes and clinical approach of Lebanese physicians towards HPV vaccination. We also aimed to analyze the factors associated with physicians’ barriers to HPV vaccination. Results: In total, 228 physicians completed the survey. Our results show that physicians and parents consider the cost of HPV vaccination to be a main barrier (58.9% and 80.7% respectively). Also, parents tend to have concerns about vaccine safety (78.1%), efficacy (68.6%), and lack education concerning HPV infection (81.8%). Furthermore, female physicians tend to have fewer barriers when compared to male physicians (aOR = 0.39; p-value = 0.007). Additionally, physicians who completed residency programs in the USA also showed fewer barriers when compared to physicians who completed Lebanese residency programs (aOR = 0.24; p-value = 0.040). Finally, physicians with higher knowledge score have fewer barriers when compared to those with lower knowledge scores (aOR = 0.42; p-value = 0.018). Conclusions: Physician gender, residency program and level of knowledge play a role in HPV vaccine barriers and recommendation in Lebanon. Future improvements in cost and awareness about HPV might improve vaccination rates. Creating uniform practices towards HPV vaccine is warranted to improve patient care.     

Knowledge of cervical cancer and acceptance of HPV vaccination among secondary school students in Sarawak, Malaysia

Cervical cancer is the third most common cancer in women in peninsular Malaysia and very prevalent worldwide. HPV vaccination and routine Pap smear testing are the best preventive measures. The objective of this study was to determine the knowledge level of secondary school students from Sarawak, East Malaysia regarding cervical cancer and its prevention. Multistage random sampling with various methods in each step was employed to select the sample of 76 students. Results showed that 61.8% had poor knowledge level of cervical cancer and its prevention. There were 60.5% of students who were aware of cervical cancer with Chinese and form four students showing significantly the highest awareness (p<0.05). The main source of cervical cancer information was from their parents (25.9%). HPV vaccination acceptance among students was 22.3% and an association was found between knowledge of cervical cancer with race and HPV vaccination acceptance (p<0.05). In conclusion, the students had poor knowledge level of cervical cancer, its prevention and HPV vaccination acceptance. More efforts should be made to improve cervical cancer knowledge and awareness of the public especially secondary school students in Sarawak. This in turn will enhance the practice of prevention against cervical cancer among students.     

Knowledge, attitude and practice of malaysian medical and pharmacy students towards human papillomavirus vaccination

Human Papillomavirus (HPV) infection is one of the most common sexually transmitted infections and oncogenic HPV is the main cause of cervical cancer. However, HPV vaccination is already available as the primary preventive method against cervical cancer. The objective of this study was to determine the level of knowledge, attitude and practice of HPV vaccination among Universiti Kebangsaan Malaysia (UKM) and Universiti Malaya (UM) students. This study was conducted from March until August 2009. Pre-tested and validated questionnaires were filled by the third year UKM (n=156) and UM (n=149) students from medical, dentistry and pharmacy faculties. The results showed that the overall level of knowledge on HPV infection, cervical cancer and its prevention among respondents was high and the majority of them had positive attitude towards HPV vaccination. Medical students had the highest level of knowledge (p<0.05). Very few students (3.6%) had already taken the vaccine with no significant difference between the two Universities (p=0.399). In conclusion, the knowledge and attitude of the respondents were high and positive, respectively. Only few students took HPV vaccination. Thus, more awareness campaigns and HPV vaccination services should be provided at universities' campuses with the price of the HPV vaccine reduced for the students.     

Knowledge of Human Papillomavirus (HPV) and Oropharyngeal Cancer and Acceptability of the HPV Vaccine among Dental Students

Objectives: To assess knowledge about human papillomavirus (HPV), vaccination, and HPV-related oropharyngeal cancer (OPC) and to evaluate HPV vaccine acceptability among a sample of undergraduate dental students. Methods: All third- and fourth-year dental students enrolled in any of the dental schools in Jeddah, Saudi Arabia, were invited to participate in this cross-sectional study. In total, 500 students completed a self-administered questionnaire on HPV, HPV vaccines, and HPV-related OPC knowledge. HPV, HPV vaccine and HPV-related OPC knowledge scores were calculated. Associations of participants characteristics with the knowledge scores and with willingness to take the HPV vaccine were assessed. Results: Of the participants, 62% had heard of HPV infections, and 57% of HPV vaccines. Average knowledge scores were low: HPV knowledge score 3.8±4.5 out of 16, HPV vaccination knowledge score 0.9±1.6 out of 7, OPC knowledge score 0.9±1.2 out of 5. Clinical-year students had better knowledge and were more willing to take the HPV vaccine than were preclinical-year students, as were those vaccinated for hepatitis B versus those not vaccinated for hepatitis B. Students with higher HPV knowledge scores were more willing to take the HPV vaccine (66%) than were those with lower scores (43%) (p=0.018). Only 4% of males and 12% of females reported taking the HPV vaccine. Of those who refused it, 51% cited lack of knowledge as the primary reason. Conclusions: Knowledge about HPV, its vaccine, and HPV-related OPC is low among this sample of Saudi undergraduate dental students. Improving knowledge among them may increase their awareness, which could affect the care provided to patients.     

Knowledge,Attitude and Practices Regarding HPV Vaccination Among Medical and Para Medical in Students,India a Cross Sectional Study

Background: High risk human papilloma virus (HPV) types 16 and 18 have been proven as central causes of cervical cancer and safety and immunogenicity of HPV vaccines are sufficiently established. Knowledge and practices of HPV vaccination among medical and paramedical students is vital as these may strongly determine intention to recommend vaccination to others in the future. The present study was therefore undertaken to assess the knowledge, attitude and practices regarding cervical cancer screening and HPV vaccination among medical and paramedical students and to analyze factors influencing them. Materials and Methods: The present cross sectional study, conducted in a tertiary care teaching hospital in south India, included undergraduate students aged 18 years and above, belonging to medical, dental and nursing streams, after informed written consent. Results: Out of 957 participants, only 430 (44.9%) displayed good knowledge and only 65 (6.8%) had received HPV vaccination. Among the unvaccinated, 433 (48.54%), were not willing to take the vaccine. Concerns regarding the efficacy (30.5%), safety (26.1%) and cost of the vaccine (21.7%) were responsible for this. Age, gender, family history of malignancy and mother’s education had no influence on knowledge. Compared to medical students, nursing students had better knowledge (OR-1.49, 95% CI 0.96 to 2.3, p = 0.072) and students of dentistry had poor knowledge (OR-0.50 95% CI 0.36 to 0.70, p <0.001). Conclusions: The knowledge and uptake of HPV vaccination among medical and paramedical students in India is poor. Targeted health education interventions may have huge positive impact not only on the acceptance of vaccination among them, but also on their intention to recommend the vaccine in future.     

Practice of HPV Vaccine and Associated Factors among School Girls in Melaka,Malaysia

Objective: The objective of this study is to determine the practice and associated factors of HPV vaccineamong school girls in Melaka, Malaysia. Methodology: A total number of 612 secondary school girls participatedin this study. The questionnaire consists of 38 questions which included 3 sections. The first section is about sociodemography.The Second section is about knowledge and awareness of HPV vaccines. The third section is aboutpractices with associated barriers of HPV vaccination. Verbal consent was obtained from all participants, anddata were analyzed using SPSS 13. Results: A total number of 612 secondary school girl students participated inthis study. The mean age was 13.93±SD (1.09); minimum age was 13 years old and maximum was 17 years old.The majority of them was Malay, from rural areas and had a family monthly income of RM 3000 or less (91.8%,53.1%, 69.6%; respectively). The majority of the parents of the school girls were with secondary educationlevel (56.4%). The majority of the participants did not have a family history of cervical cancer (99.0%). Theprevalence of HPV vaccination was 77.9% among school girls in Melaka. The majority of the participants werevaccinated in their schools (77.0%). About 69% knew about cervical cancer and 77.6% had ever heard aboutHPV vaccine. Regarding the factors that influence the practice of uptake HPV vaccine, they were age, race,income, parents’ education, knowledge about cervical cancer, heard about HPV vaccine and place of getting thevaccine (p<0.001). Conclusion: The prevalence of HPV vaccine among school girls is high. Age, race, income,parents’ education, knowledge about cervical cancer, heard about HPV vaccine and place of getting the vaccinewere the significant factors that influence the practice of uptake HPV vaccine among school girls.     

Knowledge Level of Working and Student Nurses on Cervical Cancer and Human Papilloma Virus Vaccines

Purpose: To determine knowledge levels of working and student nurses about cervical cancer and prophylacticcancer vaccines. Materials and Methods: This study was performed on 259 nursing students in the Departmentof Nursing and 137 nurses working in Health Research and Practice Center, approved to participate in the studybetween April-June 2012. The study was performed universally without selecting a sample. A questionnairethat was prepared for evaluating participants’ knowledge and attitudes about human papilloma virus (HPV)vaccine was distributed to the nurses and data obtained from the forms were transferred to SPSS 15.00 programand statistically analyzed. Results: It was found that 54.8% of the student nurses were between 21-24 years oldand 13.1% of working students were between 25-28 years old. When student nurses and working nurses werecompared in terms of their knowledge about the causes of cervical cancer, their ideas about prevention fromcervical cancer with HPV vaccine, their ideas about possible risks of HPV vaccine and conservation ratios of HPVvaccine, it was observed that there were no statistically significant differences (p>0.05). When student nursesand working nurses were compared in terms of the information-source about HPV, ways of HPV contamination,awareness about people who are susceptible to HPV contamination and age of HPV vaccination, it was determinedthat there was a statistically significant difference (p<0.05). Conclusions: It was found that all nurses had someknowledge about cervical cancer and HPV vaccine, but this was not sufficient. Therefore; it is recommended touse verbal, written and visual communication tools intensively in order to have topics on cervical cancer, earlydiagnosis and prevention in bachelor and master programs for nurses, to inform society about cervical cancerand HPV vaccine for public health and to teach precautions for its prevention.     

Eurogin 2016 Roadmap: how HPV knowledge is changing screening practice

Human papillomaviruses (HPVs) are the necessary cause of most cervical cancers, a large proportion of other anogenital cancers, and a subset of oropharyngeal cancers. The knowledge about HPV has led to development of novel HPV‐based prevention strategies with important impact on clinical and public health practice. Two complementary reviews have been prepared following the 2015 Eurogin Conference to evaluate how knowledge about HPV is changing practice in HPV infection and disease control through vaccination and screening. This review focuses on screening for cervical and anal cancers in increasingly vaccinated populations. The introduction of HPV vaccines a decade ago has led to reductions in HPV infections and early cancer precursors in countries with wide vaccination coverage. Despite the high efficacy of HPV vaccines, cervical cancer screening will remain important for many decades. Many healthcare systems are considering switching to primary HPV screening, which has higher sensitivity for cervical precancers and allows extending screening intervals. We describe different approaches to implementing HPV‐based screening efforts in different healthcare systems with a focus in high‐income countries. While the population prevalence for other anogenital cancers is too low for population‐based screening, anal cancer incidence is very high in HIV‐infected men who have sex with men, warranting consideration of early detection approaches. We summarize the current evidence on HPV‐based prevention of anal cancers and highlight important evidence gaps.