A New Strategy for Cervical Cancer Prevention Among Chinese Women: How Much Do They Know and How Do They React Toward the HPV Immunization?

Abstract

In 2017, HPV vaccines were first marketed in China. We carried out an investigation among parents of high school students to assess parents' knowledge of cervical cancer and human papillomavirus (HPV)/HPV vaccines, along with their acceptance of HPV vaccination and the factors that influence it, all of which are essential for targeted education regarding HPV vaccination. A cross-sectional study was conducted among parents of high school students in East China using a pretested questionnaire. Data regarding knowledge of cervical cancer, HPV, HPV vaccines, and acceptance of the vaccines were collected and analyzed. In total, 1,200 questionnaires were distributed, with 1,125 valid responses. Overall, 87.5% of respondents knew that cervical cancer is one of the most common genital system cancers; 78.67% knew that HPV causes cervical cancer; 69.2% knew that HPV is primarily transmitted through sex; 54.3% knew that HPV vaccines exist; and 35.6% knew the optimal age for HPV vaccination. Only 4.4% had vaccinated their daughters for HPV, and 35.4% were willing to do so. Reasons for refusal primarily concerned the vaccines' safety (77.4%) and efficacy (61.5%). Multivariate analyses showed that parents who had obtained pneumococcal conjugate vaccines for their daughters showed higher acceptance of HPV vaccines, as well as higher knowledge of cervical cancer, the association of HPV and cervical cancer, and the main transmission route of HPV. Although parents' knowledge level regarding cervical cancer was moderate, it was very low regarding HPV and HPV vaccines. Teenagers' HPV vaccine uptake and parents' willingness to vaccinate their children was also quite low. Educational interventions and awareness campaigns are needed to ensure the success of HPV immunization programs in East China.