Relationship between HPV vaccine hesitancy and attitudes towards early detection of cervical cancer in women of reproductive age.

While HPV vaccination is effective in prevention of many HPV-associated cancers, only 61.4% of US adolescents were up to date on their HPV vaccinations in 2023. In the period following the COVID-19 pandemic, a decrease in vaccine uptake was reported, along with a rise in vaccine hesitancy. This study aimed to understand these changes to HPV vaccination and vaccine hesitancy that occurred following the COVID-19 pandemic from providers’ perspectives. We conducted 1-hour interviews with 12 participants over video calls that were then de-identified and transcribed. Eleven out of 12 providers noticed changes in their patients’ attitudes toward vaccines after the onset of the COVID-19 pandemic. Many providers mentioned COVID vaccine hesitancy impacting the reputation of unrelated vaccinations. Other notable topics included an overwhelming volume of health information, polarization of viewpoints, and lack of trust in authority. Future research would include a larger, more diverse pool of provider participants, as well as incorporate patient interviews. The results of this study emphasize the need to promote health literacy and rebuild trust between patients and the healthcare system to combat vaccine hesitancy.

IntroductionCompared to other-race peers, Black women are disproportionately impacted by human papillomavirus [HPV] infection, related health outcomes, and cervical cancer mortality as a result of suboptimal HPV vaccine uptake during adolescence. Few studies in the United States have examined psychosocial determinants of HPV vaccine acceptability and hesitancy among Black parents. The current study integrated the health belief model and the theory of planned behavior to evaluate the extent to which psychosocial factors are associated with pediatric HPV vaccination intentions among this population.MethodsBlack mothers (N = 402; age range = 25 to 69 years, M = 37.45, SD = 7.88) of daughters ages 9 to 15 years completed an online survey assessing HPV infection and vaccine beliefs and attitudes across four domains: Mother’s HPV Perceptions, Mother’s Vaccine Attitudes, Cues to Action, and Perceived Barriers to HPV Vaccination. Participants indicated their willingness to vaccinate their daughter on a 5-level ordinal scale (“I will definitely not have my daughter get the vaccine” to “I will definitely have my daughter get the vaccine”) which was dichotomously recoded for binomial logistic regressions.ResultsHalf of the sample (48%) intended to vaccinate their daughter. Number of daughters, mother’s HPV vaccine status, perceived HPV vaccine benefits, HPV vaccine safety concerns, pediatric HPV vaccine peer norms, and doctor recommendations emerged as independent factors of Black mothers’ intentions to vaccinate their daughters against HPV when controlling for all other factors.DiscussionIn addition to medical training to increase doctor recommendation of the HPV vaccine for Black girls, population-tailored public health messaging aimed at promoting HPV vaccine acceptance among Black mothers is urgently needed. This messaging should engage community support and emphasize the benefits of vaccination for adolescent Black girls while also addressing parental concerns regarding the safety of pediatric HPV vaccination.

Background:Cervical cancer screening and vaccination practices is reported to have low coverage in most developing countries. It has been reported that most women are aware of cervical cancer screening and vaccination worldwide. Nevertheless, the rate at which women participate in cervical cancer screening and vaccination was found to be low both locally and internationally. Consequently, in sub-Saharan Africa, cervical cancer screening programs have poor coverage. The aim of this study was to explore the practices of cervical cancer screening and vaccination among females at Oyibi community. Methods:The researchers employed a qualitative exploratory design to recruit 35 participants put into five Focus Group Discussions (FGDs). Five FGDs were formed with seven (7) members in each group. The members were purposely recruited. The sample size was based on data saturation. Data was retrieved using a semi-structured interview guide. The researchers served as moderators in the group. Results:Two (2) main themes with Eight (8) subthemes were generated from the data analysis. The themes were; (cervical cancer screening and vaccination practices), and (perceived benefits of cervical cancer screening and vaccination). The subthemes that emerged were as follows: types of cervical screening and vaccination done by participants, experiences during cervical cancer screening, experiences during cervical cancer vaccination, decision to go for cervical cancer screening and vaccination, willingness to recommend cervical cancer screening and vaccination to other women, early detection of cervical cancer through early screening, benefits of cervical cancer vaccination, and willingness to receive cervical cancer vaccine. The study also revealed that most of the women who had done the screening and vaccination were young (19-29 years). Conclusion:The results from the study indicated that the participants’ utilization of cervical cancer screening and vaccination were poor although they were conscious of the benefits of cervical cancer screening and vaccination and were willing to recommend it to their relatives and their loved ones.

Cervical cancer is a malignant disease that remains a major cause of morbidity and mortality among women in the world. In Indonesia, only 5% of women of reproductive age screen for cervical cancer. 76.6% of cervical cancer patients are detected with the disease when they entered the advanced stage. Early detection of cervical cancer is the key intervention in the reduction of incidence and mortality of cervical cancer. Other studies reported that the awareness of women of reproductive age to do cervical cancer screening is still very low due to a lack of knowledge about cervical cancer. This study aimed to determine the correlation of knowledge and participation in early detection of cervical cancer in women in reproductive age. This study used an analytical survey with a cross-sectional approach. The sampling technique used incidental sampling with a total of 36 women in reproductive age. Data analysis used Chi-Square test. Statistical results showed that there was a significant correlation between knowledge of women in reproductive age about cervical cancer and participation in early detection of cervical cancer, which is p value = 0.020 (< 0.05) and coefficient of contingency (r) = 0.423. The level of closeness of the correlation is medium. Therefore, there is a need for tailored services that could improve knowledge of women in reproductive age about cervical cancer to improve participation with a view to preventing cervical cancer by early detection.

The burden of disease caused by cervical cancer ranked second among female tumors in China. The HPV vaccine has been proven to be a cost-effective measure to prevent cervical cancer, but the vaccination rate remained low to date among university students. This study aimed to understand the status quo of HPV vaccine hesitancy among university students across China during the COVID-19 pandemics and systematically analyze determinants of HPV vaccine hesitancy based on the WHO 3Cs model. Cross-sectional data were collected using an online survey of female university students in four cities across China in June 2022. Multinomial logistic regression was adopted to determine factors influencing vaccine hesitancy based on the 3Cs model with three dimensions, namely complacency, convenience, and confidence. Among 1438 female university students surveyed in this study, 89.7% did not hesitate to vaccinate against HPV, only 8.9% hesitated to some extent, and 1.4% refused to vaccinate. The actual vaccination rate for the HPV vaccine was 34.2%. Based on the 3Cs model, this study found that the trust on the efficacy of vaccines, risk perception of being infected by HPV, price, and distance/time were influencing factors of vaccine hesitancy. Knowledge of the HPV vaccine and sociodemographic characteristics, such as education levels, were also statistically relevant. Therefore, it is recommended that relevant scientific knowledge on cervical cancer and the HPV vaccine should be spread on campus, the vaccination appointment procedure should be simplified, and the affordability of vaccination should be increased through strategic purchasing or providing subsidies, so as to reduce HPV vaccine hesitancy.

Background: Cervical cancer is the fourth most prevalent cancer in women. Pap smear and visual inspection acetic acid (VIA) are essential screening tests to early detect cervical cancer. However, the use of screening tests remained low among women of reproductive age in Nganjuk district, East Java. This study aimed to determine the effectiveness of health education using flip chart and video on knowledge about early detection of cervical cancer among women of reproductive age in Nganjuk district, East Java. Subjects and Method: A randomized control trial conducted in Rejoso, Nganjuk, East Java, from October to November 2019. A sample of 120 women of reproductive age was randomized into two groups: (1) Experiment group that received health education using a flip chart and video, and (2) Control group that received no intervention. The dependent variable was knowledge of early detection of cervical cancer. The independent variable was health education using a flip chart and video. The data were collected using questionnaire. The data were analyzed by independent t-test. Results: After the intervention, knowledge about early detection of cervical cancer in the experimental group (Mean= 80.40; SD= 10.54) was higher than the control group (Mean= 70.53; SD= 9.68), and it was statistically significant (p <0.001). Conclusion: Health education using a flip chart and video is effective in improving knowledge about early detection of cervical cancer among women of reproductive age. Keywords: early detection, cervical cancer, health education, women of reproductive age Correspondence: Ike Nurrochmawati. School of Health Sciences Satria Bhakti, Nganjuk. Jl. Panglima Sudirman VI, Nganjuk, East Java. Email: ike.nurrochma@gmail.com. Mobile: +6282141578108. DOI: https://doi.org/10.26911/the7thicph.02.36

Cervical cancer is a scary disease for women all over the world. This disease can actually be prevented and identified early. Pap smear is one of the tools of early detection to determine the presence of symptoms of cervical cancer. If women’s knowledge is good about pap smear’s early detection of cervical cancer, it can prevent the disease. The objective of this study was to know the effect of health education in women about pap smear which aids in early detection and prevention of cervical cancer. This was a quasi-experimental one group pretest, conducted without a control group at Murni Teguh Memorial Hospital (MTMH), Medan, North Sumatra from June to July 2018. There were 36 samples selected using purposive sampling. Wilcoxon signed-rank test was used for data analysis. The results of this study showed that there was a difference in the mean value of women's knowledge levels (p = 0. 000) before and after the intervention. The conclusion of this study was that there was a significant effect of health education in terms of an increase in the level of women's knowledge about pap smear’s early detection and prevention of cervical cancer. It is expected that health education about pap smear’s early detection and prevention of cervical cancer will prove to be very important in the future.

Background There is the urgent need for innovative, evidence-based approaches to HPV vaccine promotion among underserved migrant communities. Objectives This study aimed to assess the impact of an educational intervention which consisted of 9 group and 27 individual onsite sessions in reducing vaccine hesitancy and increasing vaccine uptake among Ukrainian migrant and refugee (UMR) parents in Poland. Methods A pre/post study was conducted among 178 UMR parents who engaged in an 5-months intervention. We used this method based on the another program which evaluated an HPV vaccine intervention on vaccine completion in a migrant population. Participants were actively recruited by research staff from parents registered to a net of GP surgeries, using phone calls, then screened for eligibility and consented prior to participation. Four Ukrainian GPs were trained to deliver educational sessions. Parents completed pre/post-data on HPV vaccine knowledge and hesitancy via surveys distributed onsite. McNemar, and multilevel regression tests were used for statistical analyzes. Results Overall, 178/180 (98.9%) participants completed the follow-up survey. Parents demonstrated significant improvements in HPV vaccine knowledge and vaccination intent after the intervention. HPV knowledge increase was reported - pre: mean 5.2, SD ± 2.1, post: mean 8.2, SD ± 1.7; p < 0.0001, and reduction in vaccine hesitancy among mothers was observed - pre: 43.4%, post 35.2%; p = 0.04. A 1 year follow-up revealed that 135 Ukrainian children were vaccinated with the 1st dose of HPV vaccine at the vaccination point dedicated to the UMR registered for the project. Conclusions The study results emphasize the potential of culturally appropriate educational interventions for vaccination promotion among migrant populations and the importance of advocating for such interventions to improve HPV vaccination rates and reduce disparities.

Cervical cancer is a type of cancer that occurs in the cervix or the neck of the uterus. Cervical cancer remains a major cause of morbidity and mortality among women globally and is a gynecological disease with a relatively high malignancy rate. The low level of knowledge among women of reproductive age (WRA) regarding the importance of early detection of cervical cancer in Indonesia is due to a lack of awareness and information about methods for prevention and early detection of cervical cancer. Visual Inspection with Acetic Acid (VIA) is one method for the early detection of cervical cancer. The purpose of this study was to determine the relationship between the knowledge and attitude of women of reproductive age (WRA) and the early detection of cervical cancer using the VIA method at Bakunase Community Health Center in 2016. This study used an analytical survey research design with a cross-sectional approach. The population in this study was WRA, totaling 622 people. The sampling technique used was accidental sampling, which involved 86 people. The data collection instrument was a questionnaire. Data analysis included univariate analysis in the form of frequency distribution and percentage, and bivariate analysis using the chi-square (x2) test. Out of the 86 respondents, 47 respondents (54.7%) had good knowledge and 39 respondents (45.3%) had poor knowledge. Regarding attitude, there were 65 respondents (75.6%) with a positive attitude and 21 respondents (24.4%) with a negative attitude. There is a relationship between the knowledge and attitude of WRA and the early detection of cervical cancer using the VIA method with a p-value of 0.043.

Despite strenuous efforts to increase vaccination rates against human papillomavirus (HPV), the rate of vaccination remains low in the U.S. The COVID-19 pandemic poses an additional challenge to HPV vaccination. This study aimed to explore the factors that contribute to HPV vaccination among Asian immigrant college students, based on the Theory of Planned Behavior (TPB), with HPV vaccine literacy and HPV vaccine hesitancy as additional constructs. This cross-sectional survey used convenience sampling, with133 Asian immigrant college students from New York City as study participants. Data were collected online using self-reported measures of the following study variables: HPV vaccine literacy, attitudes, subjective norms, self-efficacy, vaccine hesitancy, vaccination intention, and HPV vaccination. The data were analyzed using path analysis. Vaccine literacy and vaccination intention directly affected HPV vaccination. Vaccine subjective norms and literacy directly affected vaccination intention. Moreover, vaccine attitudes and self-efficacy directly and negatively affected vaccine hesitancy. These results indicate the importance of developing a multifaceted intervention that considers vaccine literacy and subjective norms to promote HPV vaccination of Asian immigrant college students. Interventions to decrease vaccine hesitancy during the COVID-19 pandemic should focus on improving positive attitudes and self-efficacy toward HPV vaccination.

Background: A major reason for suboptimal HPV vaccination coverage in the US is parental vaccine hesitancy. The COVID-19 pandemic and the vaccine had an impact on public trust in public health authorities, science, and medicine. The novelty of the disease and concerns over safety and efficacy of COVID-19 vaccine led to several people refusing the vaccine and increasing hesitancy towards other vaccines, including the HPV vaccine. We examined if HPV vaccine hesitancy among parents with unvaccinated children have changed due to the COVID-19 pandemic in the US. Methods: This study used data from the 2018, 2019, 2022, 2023 National Immunization Survey - Teen. Hesitancy was defined by responses to the question, “How likely is it that [your teen] will receive HPV shots in the next 12 months?” as “not too likely, ” “not likely at all, ” or “not sure/don't know.” The Fisher exact test with FDR control was applied to identify significant predictors among adolescent’s age, gender, race, healthcare engagement, poverty level, doctor recommendation, geographic region; and mother’s age, marital status, education, number of children under 18, COVID-19 phases (2018-2019 as pre-COVID, and 2022-2023 as post-COVID), and their interactions. Next, logistic regression with forward selection was employed to quantify the effects of these predictors. Results: Analysis included 103, 977 unvaccinated adolescents (i.e., had not received any HPV vaccine doses at the time of the survey) whose parents were classified as vaccine hesitant. All demographic predictors and the COVID-19 timeline significantly influenced HPV vaccine hesitancy based on the two-stage estimation. In adjusted difference-in-difference analyses, overall, parental hesitancy during post-COVID years decreased compared to the pre-COVID years (aOR=0.84; 95% CI 0.79, 0.88). The impact of children's age and race and mother’s age showed consistent and significant changes from pre-COVID to post-COVID years. HPV vaccine hesitancy increased from pre-COVID to post-COVID years among parents of adolescents who were 15 (aOR=1.38; 95% CI 1.28, 1.46), 16 (aOR=1.40; 95% CI 1.31, 1.51) and 17 (aOR=1.52; 95% CI 1.40, 1.63), and among mothers who were over 45 years or older (aOR=1.06; 95% CI 1.01, 1.13). Conversely, HPV vaccine hesitancy of parents of non-Hispanic black adolescents (aOR=0.90; 95% CI 0.83, 0.98) decreased from pre-COVID to post-COVID years. Incorporating COVID-related features significantly enhances the ability to predict hesitancy. Conclusions: HPV vaccine hesitancy among parents of unvaccinated adolescents decreased overall from pre-COVID to post-COVID years. However, hesitancy increased within specific groups, notably among parents of adolescents aged 15 to 17 and mothers aged 45 years and older age. These trends highlight the need for future research to explore the underlying factors driving these differences, enabling more targeted and effective public health interventions. Citation Format: Eric Adjei Boakye, Jun Jin, Mrudula Nair, Dakshu Jindal, Joel Fokom Domgue, Olivia Aspiras, Samantha H. Tam, Nosayaba Osazuwa-Peters. Impact of the COVID-19 pandemic on HPV vaccine hesitancy. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 988.

Background: Cervical cancer ranked the fourth most cancer incidence in women. WHO announced that 311,000 women died from the disease in 2018. Cervical cancer screening uptake remains low, especially in low- and middle-income countries. This scoping review aimed to investigate the motivation for early detection of cervical cancer in women of reproductive age. Subjects and Method: A scoping review method was conducted in eight stages including (1) Identification of study problems; (2) Determining priority problem and study question; (3) Determining framework; (4) Literature searching; (5) Article selection; (6) Critical appraisal; (7) Data extraction; and (8) Mapping. The research question was identified using population, exposure, and outcome(s) (PEOS) framework. The search included PubMed, ResearchGate, and grey literature through the Google Scholar search engine databases. The inclusion criteria were English-language and full-text articles published between 2010 and 2020. A total of 275 articles were obtained by the searched database. After the review process, twelve articles were eligible for this review. The quality of searched articles was appraised by Joanna Briggs Institute Critical Appraisal tools. The data were reported by the PRISMA flow chart. Results: Seven articles from developing countries (Jamaica, Nepal, Africa, Nigeria, Libya, and Uganda) and five articles from developed countries (England, Canada, Sweden, and Japan) met the inclusion criteria with cross-sectional studies. The selected existing studies discussed 3 main themes related to motivation to early detection of cervical cancer, namely sexual and reproductive health problems, diseases, and influence factors. Conclusion: Motivation for cervical cancer screening uptake is strongly related to the early detection of cervical cancer among reproductive-aged women. Client-centered counseling and comprehensive sexual and reproductive health education play an important role in delivering information about the importance of cervical cancer screening. Keywords: motivation, cervical cancer, screening, early detection, reproductive-aged Correspondence: Siti Nurul Khotimah. Health Sciences Department of Master Program, Universitas Aisyiyah Yogyakarta. Jl. Siliwangi (Ringroad Barat) No. 63, Nogotirto, Gamping, Sleman, Yogyakarta, 55292. Email: Sitinurulkhotimah1988@gmail.com. Mobile: +6281227888442. DOI: https://doi.org/10.26911/the7thicph.03.65

Cervical cancer is the second most common cancer among Indian women. Prevention and early detection can help reduce the incidence of cervical cancer. Taking care of health needs of the people and preventing diseases is a major concern for health, professionals. Planned teaching programme is one of the most effective teaching strategies, which can be used for improving the knowledge of people. Aim: The aim of this study was to find out the effectiveness of a planned teaching programme in improving the knowledge of women in prevention and early detection of cervical cancer. Material and Methods: Pre experimental design was used to assess the Effectiveness of Planned Teaching Programme (PTP) on knowledge regarding early detection and prevention of cervical cancer. Purposive sampling techniques were used to select 60 women in selected village in Gurugram. Informed written consent was taken from selected women. A structured questionnaire was administered to assess the knowledge on early detection and prevention of cervical cancer. The collected data was analyzed by using descriptive statistics and inferential statistics. Frequency and percentage distribution was used for demographic variables and assessing the knowledge on early detection and prevention of cervical cancer. Chi- square test was used to find out association between knowledge on early detection and prevention of cervical cancer among women and selected demographic variables. Result: The finding of the study revealed that pre test knowledge 35% had poor, 60% had average,5% had good knowledge regarding early detection and prevention of cervical cancer. Post test knowledge 0% had poor, 25% had average, 75% had good knowledge regarding early detection and prevention of cervical cancer. Knowledge was significantly associated with religion0.02 at significance of p<0.05 level. No association was found between knowledge and other demographic variables like age, education, occupation, marital status, number of children, health information. Conclusion: Planned teaching programme will be effective in improving knowledge regarding early detection and prevention of cervical cancer among women in selected villages in Gurugram.

Cervical cancer is the fourth most common cancer among women globally and a significant public health challenge in China, which accounts for nearly 18% of global cervical cancer cases. The HPV vaccine is a proven intervention for preventing high-risk HPV infections and associated cancers. This serial cross-sectional study conducted in Shanghai, China, in 2019 and 2024 analyzed changes in HPV vaccination rates and vaccine hesitancy. Multivariable logistic regression was used to assess the associations between HPV vaccination, general vaccine hesitancy, and HPV-specific vaccine hesitancy, adjusting for sociodemographic factors. The Population Attributable Fraction (PAF) quantified the proportion of non-vaccination attributable to these factors. In 2019 and 2024, two waves of data were collected from 1,037 and 1,450 parents, respectively. Results showed an increase in HPV vaccination from 6% to 30% during the study period, primarily among women aged 18 and older, while coverage among the WHO target group (girls aged 9–14) remained low at 8%. Parents with HPV-specific vaccine hesitancy were 75% less likely to vaccinate their daughters (OR = 0.25, 95% CI: 0.11–0.56), while general vaccine hesitancy reduced vaccination likelihood by 94% (OR = 0.06, 95% CI: 0.00–0.89). PAF analysis indicated that HPV-specific vaccine hesitancy contributed to 24% of non-vaccination cases, higher than general vaccine hesitancy (10%). These findings highlight the critical need for targeted interventions addressing HPV-specific barriers, improving education about vaccination timing and options, and reducing logistical obstacles to align with global cervical cancer elimination goals.

Cancer is a public health problem in the world. Cancer can threaten health both physically and psychologically and can even cause death. One of the cancers that most often causes death in women is cervical cancer. Efforts to prevent cervical cancer with the cervical cancer screening program in 2018 found estimated data on the number of cervical cancer cases in East Java Province of 27,837 which has the largest number of cervical cancer sufferers compared to other provinces. Meanwhile, 2020 experienced obstacles due to the co-19 pandemic. The COVID-19 pandemic has had a major impact on cervical cancer screening. Based on the data results from the 2022 Dasuk Health Center Performance Assessment Report, the total target of WUS (Women of Reproductive Age) in the Dasuk Health Center Work Area is 6. 672 targets. While the number of WUS (Women of Reproductive Age) who carried out early detection of cervical cancer through the IVA method was 438 targets (0.06%). This shows that the awareness of women of childbearing age in conducting early screening for cervical cancer is still low. Identification of factors that influence the low coverage of early detection of cervical cancer in the Working Area of ​​the Dasuk Health Center with fishbone diagram analysis and identification of priority problems with ultrasound analysis shows that the problems that need to be prioritized for resolution are campaign discontinuity, people are afraid to check IVA tests, lack of public understanding of the importance IVA test examination.