Human Papillomavirus Research Articles

HPV and HCMV in Cervical Cancer: A Review of Their Co-Occurrence in Premalignant and Malignant Lesions

Cervical cancer remains a significant global health concern, particularly in low- and middle-income countries. While persistent infection with high-risk human papillomavirus (HR-HPV) is essential for cervical cancer development, it is not sufficient on its own, suggesting the involvement of additional cofactors. The human cytomegalovirus (HCMV) is a widespread β-herpesvirus known for its ability to establish lifelong latency and reactivate under certain conditions, often contributing to chronic inflammation and immune modulation. Emerging evidence suggests that HCMV may play a role in various cancers, including cervical cancer, through its potential to influence oncogenic pathways and disrupt host immune responses. This review explores clinical evidence regarding the co-presence of HR-HPV and HCMV in premalignant lesions and cervical cancer. The literature reviewed indicates that HCMV is frequently detected in cervical lesions, particularly in those co-infected with HPV, suggesting a potential synergistic interaction that could enhance HPV’s oncogenic effects, thereby facilitating the progression from low-grade squamous intraepithelial lesions (LSIL) to high-grade squamous intraepithelial lesions (HSIL) and invasive cancer. Although the precise molecular mechanisms were not thoroughly investigated in this review, the clinical evidence suggests the importance of considering HCMV alongside HPV in the management of cervical lesions. A better understanding of the interaction between HR-HPV and HCMV may lead to improved diagnostic, therapeutic, and preventive strategies for cervical cancer.

Genosensor based on polypyrrole and dendrimer-coated gold nanoparticles for human papillomavirus detection

Human Papillomavirus (HPV) is an often asymptomatic widespread sexually transmitted infection responsible for causing various health issues. Low-risk HPV primarily causes genital warts. High-risk HPV types are associated with several cancers, including cervical, anal, and oropharyngeal cancers, posing significant health risks. In this work, we developed an electrochemical biosensor for the detection and differentiation of HPV genotypes based on electropolymerized polypyrrole (PPy) and PAMAM dendrimer-coated gold nanoparticles (PAMAM-AuNPs) for the immobilization of a DNA probe for detecting different HPV genotypes. Electrochemical impedance spectroscopy (EIS), cyclic voltammetry (CV), and atomic force microscopy (AFM) were used to characterize the biosensor. AFM analysis revealed varied topographic surfaces associated with the increased peaks concerning the biosensor and against patient samples. Electrochemical responses indicated that the genosensor could detect HPV using plasmid (HPV 6, 16, 18, 31, and 33) and cDNA samples (HPV 6, 18, and 31) from infected patients. Different electrochemical profiles were obtained between high-risk and low-risk genotypes. The sensor presented an excellent analytical performance, presenting a lower LOD of 0.04 pg.µL−1 and 0.34 pg.µL−1 for plasmidial and cDNA samples, respectively. Electrochemical analysis pointed out the ability of the developed genosensor platform to differentiate the HPV genotypes. The proposed biosensor is a promising tool for detecting and monitoring HPV and related diseases such as cervical cancer.

Genomic diversity of HPV6 and HPV11 in recurrent respiratory papillomatosis: Association with malignant transformation in the lungs and clinical outcomes

Recurrent respiratory papillomatosis (RRP) is a rare, proliferative disease caused by human papillomavirus 6 (HPV6) and HPV11. RRP can occasionally spread and undergo malignant transformation.We analysed samples across time for five RRP patients with malignant transformation and four with highly recurrent, non-malignant RRP by applying high-throughput sequencing.Patients with malignant transformation were infected by HPV11_A1/A2, while most non-malignant cases were associated with HPV6. Transient multiple infections with HPV6 and HPV11 were found in two patients, and resolved later to single infections. Viral genome loads were homogeneous across groups (median = 78 viral genomes per human genome). Within-patient, we did not observe differences between the viral sequences in the papillomatous lesions and in the malignant tissue. Genetic analysis of the NLRP1 gene revealed no known mutations linked to idiopathic RRP, though some novel variants merit to be explored in larger cohorts.HPV11 infections appear associated with RRP malignant transformation in young patients. Multiple infections can occur in RRP, but within-patient viral diversity is minimal for a given genotype. Our results confirm the importance of viral genotype in disease prognosis and are consistent with growing evidence of HPV11 infections to be differentially associated with RRP malignant transformation in young patients.

What is the level of knowledge of first year dentistry students about human papillomavirus? a cross-sectional study

Background: Epidemiological studies have shown increasing trends of HPV-associated oral cancers worldwide. HPV-related diseases are a new public health problem that negatively affects the field of dentistry. The aim of this study is to determine the knowledge levels of first-year dentistry students about HPV. Methods: The study population consisted of 130 students enrolled in the first year of the Faculty of Dentistry in the academic year of 2023 and 2024. The Human Papilloma Virus Knowledge Scale (HPV-KS) was used to determine students' HPV knowledge levels. In the analysis of the data, the t test, and Mann-Whitney U test were used. Results: 53.6% of the students were female and 96% were in the 18-21 age group. The HPV-KS score of the students was found to be 10.60±7.27 (0-33). 58.4% of the students stated that they had heard of HPV before, 57.6% had heard of the HPV test before, and 50.4% had heard of the HPV vaccine before. Furthermore, female students scored significantly higher than male students in the HPV vaccine knowledge questions sub-dimensions (p=0.037). Conclusions: Considering the knowledge levels of students in the first grade, it can guide the educational programs to be prepared. In order to protect public health, it is recommended to increase the knowledge of dentistry students about HPV and HPV-related diseases.

Human papillomavirus vaccine for cervical cancer prevention in India: new improvement and way forward

Cervical cancer is the malignant abnormal changes in the tissues of cervix mostly transmitted through the human papilloma virus. Prophylactic vaccination against HPV is effective strategy to prevent cervical cancer. India has access to two types of vaccines that are licensed worldwide, the bivalent cervarix and the quadrivalent Gardasil. The drug controller general of India has authorized “CERVAVAC” a new HPV vaccination that is less expensive and is being offered in India as a single dose for females between the ages of 9 and 19 years. The government said in February 2024 that girls between the ages of 9 and 14 will receive the HPV vaccine as part of universal immunization programme. There are significant obstacles to vaccination implementation in India like lack of epidemiological evidences for illness prioritization, vaccine duration, parental attitude and vaccine acceptance. The WHO's goal of eradicating cervical cancer by 2030 depends on implementing socially and culturally relevant public awareness campaigns after educational initiatives for healthcare professionals.

Genital infections in high-risk human papillomavirus positive Paraguayan women aged 30–64 with and without cervical lesions

Objective To determine the prevalence of genital infections (GIs), including sexual transmitted STIs: Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium, Trichomonas vaginalis, and opportunistic pathogens that generally do not cause STIs, non-classic STI: Ureaplasma urealyticum, Ureaplasma parvum and Mycoplasma hominis, in women with high-risk oncogenic human papillomavirus (hr-HPV) infection and their association with cervical lesions. Methods A cross-sectional study was carried out including 231 hr-HPV positive women. Of these, 46 has histologically confirmed cervical intraepithelial neoplasia 3 (CIN3) or more (including CIN3 and cervical cancer lesions-CIN3+). GIs were detected by multiplex real time PCR. Odds ratios (OR) were estimated to explore possible associations between GIs and the presence or absence of CIN3+ lesions. Additionally, we examined associations between sociodemographic, sexual, and clinical characteristics and the presence of GIs. Results In total, there were 174/231 cases of GIs corresponding to an overall prevalence of 75.3% (95%CI: 69.4–80.4), being non-classic STIs the most common (72.3%) compared to STIs (12.6%). The most prevalent non-classic STI and STI were U. parvum (49.8%) and C. trachomatis (7.4%), respectively. The odds of presenting GIs were 3 times higher in women under 46 years compared to older counterparts (OR: 3.32, 95%CI: 1.74–6.16), and in women with a normal Pap smear with inflammation compared to those without inflammation (OR: 3.31, 95%CI: 1.15–9.77). GIs were equally present in women with and without CIN3+ lesions. Conclusion We observed an association of GIs with inflammation in the Pap smear, but no association with CIN3+, as some of them are very common and likely part of the normal vaginal flora, suggesting that such infections do not appear to be cofactors in cervical carcinogenesis, although larger prospective studies are needed.

Evaluation of endocervical curettage (ECC) in colposcopy for detecting cervical intraepithelial lesions.

Diagnostic challenges in colposcopy arise especially in women aged 50 or older, with postmenopausal status and transformation zone type 3 (TZ3). Endocervical curettage (ECC) is a valuable tool for diagnosing intracervical lesions. The aim of this retrospective analysis was to evaluate the use of ECC in colposcopy for detecting cervical intraepithelial lesions. A retrospective study was carried out of colposcopies performed in the certified Dysplasia Unit at Erlangen University Hospital between July 2016 and June 2023. Pap and human papillomavirus (HPV) results were correlated with the histologic findings via ECC, obtained during examinations or surgery. The primary outcome was the rate of accuracy between the colposcopic and histologic findings with regard to cytology, age of patients, and type of transformation zone (TZ). A total of 429 colposcopies in 413 women with histologic samples obtained via ECC were included in the final analysis. In all, 355 women had TZ3. Among patients with TZ3, evidence of high-grade lesions and invasive carcinoma was also found in women with normal or low-grade abnormal cytology. For patients with normal colposcopic findings, cervical intraepithelial neoplasia (CIN) 2 and CIN3/adenocarcinoma in situ (AIS) were found in 56 patients (16%), and invasive carcinoma was found in four patients (0.1%). This analysis suggests that ECC is a valuable tool in the diagnosis of cervical intraepithelial neoplasia, especially for patients who present with a normal colposcopy of the cervix and vagina but have either recurrent abnormal cytologic findings or high-grade abnormal cytology indicating CIN2 + .

Assessment of Perceptions of Human Papillomavirus (HPV) Vaccine Among Japanese Healthcare Professional University Students Using Text Mining Analysis

Assessment of Perceptions of Human Papillomavirus (HPV) Vaccine Among Japanese Healthcare Professional University Students Using Text Mining Analysis

Awareness and attitude towards human papillomavirus vaccination for cervical cancer prevention among college students in South Kerala

Background: Carcinoma cervix is the second most common cancer among women, and the most common cause of cancer deaths in developed countries, but the awareness regarding it’s prevention by HPV vaccine is limited. This study targets to identify the awareness of cervical cancer and HPV vaccine among the college students. Methods: An observational cross-sectional study was conducted among 963 college students of Kollam district of South Kerala, using a semi-structured questionnaire. Results: Among the study subjects, only 48.6% had previously heard about HPV vaccine, 85.6% knew HPV causes cervical cancer, 80.2% recommends HPV vaccine to their siblings and peers. Medical students had better awareness, practice of HPV vaccination was less among medical and non-medical students; 11.6% medical students and 4.9% non- medical students had taken HPV vaccination. Conclusions: Even though awareness regarding cervical cancer is present, to increase the practice of HPV vaccination, proper health education regarding HPV vaccination is of prime importance among college students.

Assessment of adults’ misconceptions for Human papilloma virus through development of an instrument

Abstract Background Misconceptions, myths, and conspiracy theories surrounding Human papilloma virus (HPV) are prevalent and diverse. To comprehensively address these misconceptions about HPV, the HPV Misconceptions Scale (HPV-MS) was developed and implemented, which supports public health initiatives aimed at combating HPV-related diseases. Methods This methodological and cross-sectional study collected data from May 2 to June 28, 2022, involving two sequential participant groups, starting with 150 and expanding to 471 individuals. The survey, which collected demographic data, HPV-MS responses, variables thought to be associated with HPV-MS scores, and knowledge levels using the HPV Knowledge Scale (HPV-KS), was distributed via social networks and analyzed using SPSS and JASP. Results The HPV-MS, which includes 26 items and explains 46.8% of the variance, demonstrated substantial reliability with a Cronbach’s alpha of 0.691. The scores ranged from 2 to 20, with a median score of 14. Higher HPV-MS scores, indicating fewer misconceptions, were associated with younger age, higher education levels, absence of a family history of cervical cancer, and greater knowledge about HPV. Analysis revealed that HPV-KS scores were significant predictors of HPV-MS outcomes, even when controlling for other variables. Conclusions HPV-KS scores significantly predicted HPV-MS outcomes, highlighting the importance of knowledge in reducing misconceptions. Additionally, the HPV-MS effectively identifies widespread misconceptions about HPV, which is crucial for designing targeted educational measures. The wider use of this tool could help refine strategies to address HPV-related misconceptions across diverse populations. Key messages • HPV-KS scores were significant predictors of HPV-MS outcomes, even when controlling for other variables, highlighting the importance of knowledge in reducing misconceptions about HPV. • The HPV-MS effectively identifies widespread misconceptions about HPV, which is important for designing targeted educational measures.

HPV vaccination in Croatia (2016-2023): Increased vaccine uptake and declining sex disparities

Abstract Background The Human papillomavirus (HPV) is a known cause of cervical cancer, and is associated with the development of vaginal, vulvar, anal, penile, and head and neck cancer. The availability of the HPV vaccine has enabled generations of young people to be protected from HPV-related cancers. In 2016, a national immunization program targeting 14-year-old girls and boys has been initiated in Croatia. To date, systematic data on HPV vaccination coverage (VC) in Croatia is lacking. This study aims to determine HPV VC, examine trends in HPV vaccination in Croatia from 2016 to 2023 in the context of the national vaccination program, and assess differences between sexes. Methods The study is designed as a retrospective analysis covering the data from 2016 to 2023, collected from primary healthcare providers. HPV VC within 2000-2008 birth cohorts (BC) are analyzed for all vaccinated with at least one dose and assessed by sex. The trend in HPV vaccination is shown using joinpoint regression. The chi-square for trend is used to compare the vaccination coverage of females (FVC) and males (MVC). The rate ratio between FVC and MVC is calculated. Results HPV VR increased significantly among observed BCs from 6,44 % in 2000 BC to 44,22 % in 2008 BC (FVC rose from 10,67 % to 52,78 %, and males MVC from 2,47 % to 36,05 %). Joinpoint analysis revealed a statistically significant increase in all birth cohorts, while the steeper increase is seen in 2000-2006 BCs (APC = 35,47, P < 0,05) than in 2006-2008 BCs (APC = 13,93, P < 0,05). FVC is significantly higher than MVC in all birth cohorts (Extended Mantel-Haenszel chi-square for linear trend = 809.23, P < 0,001). The highest FVC/MVC rate ratio was observed in the initial 2000 BC (4,31), and the lowest in the last 2008 BC (1,46). Conclusions In Croatia, HPV VC continuously increases among observed BCs. The positive trend is present in both sexes, and the rate ratio between female and male cohorts is decreasing. Key messages • The study presents a systematical overview of HPV vaccination coverage in Croatia from the beginning of the national immunization program, which is crucial for monitoring progress. • In the following years, if the revealed trends persist or advance, Croatia could be closer to reaching Europe’s Beating Cancer Plan concerning eliminating HPV-related diseases.

Advancing data-driven decision-making for human papillomavirus (HPV)

Abstract Background HPV is among the most important infections associated with cancers in men and women, including cervical cancer which is the second most common cancer affecting women aged 15-44 years in the EU. Yet, data on vaccine uptake, HPV infection rates and incidence of related cancers is lacking across Europe, obstructing policymakers’ ability to build adequate prevention strategies towards the EU’s goal of eliminating HPV-related cancers. Methods Vaccines Europe analysed the landscape of data collection practices for HPV, highlighting discrepancies across Europe as well as successful initiatives. Results Our analysis reveals stark gaps in data collection across Europe. Some countries do not report disease levels and vaccination coverage for HPV. When reporting does occur, methods and timelines often differ between countries. Limited data availability exists for vaccination uptake in boys and young adults. This lack of standardisation hinders the comparability and reliability of collected data. It also impedes the integration and analysis of data within and across countries, hindering the development of effective elimination strategies. Concrete actions are needed at EU and national level to further develop and strengthen data collection, sharing and use in decision-making. Our research calls on strengthening ECDC’s role, promoting best practice sharing between countries, ensuring sustained resource allocation for data systems/surveillance, establishing electronic vaccination registries, an EU implementation roadmap to support countries in achieving the objectives of Europe’s Beating Cancer Plan, and translating data into policy recommendations. The Council Recommendation on vaccine-preventable cancers provides a framework for EU Member States to establish electronic vaccination registries and the ECDC to develop an HPV dashboard by the end of 2024. Key messages • Current data collection practices leave Europeans more vulnerable in the fight against cancer. • Robust data can guide policy and support elimination strategies for vaccine-preventable cancers.

The Influence of Health Education on Vaccination Coverage and Knowledge of the School Population Related to Vaccination and Infection Caused by the Human Papillomavirus

Background/Objectives: Human papillomavirus (HPV) is a causative agent of infections and cancers of the reproductive and digestive tract, and vaccination is the most effective prevention method. This research aimed to assess the impact of health education on vaccination coverage and knowledge of the school population related to HPV infection and vaccination. Methods: This non-randomized clinical trial included 170 participants out of the 221 students in the generation of 2022/2023, who were divided into a group of Subjects and Controls and who self-assessed their knowledge and tested knowledge at four and two time points, respectively. Results: The study examined whether there is a difference in the share of vaccinated students of the entire generation compared to the previous generation (62% vs. 47%). The self-assessment and assessment of one’s knowledge in the group of subjects was significantly lower before education than during other time points during the research. At “moment zero”, there was no significant difference in the knowledge assessment between the groups. However, after 8 weeks, the knowledge assessment was significantly higher in the Subject group. Conclusions: The results suggest a positive impact of health education, which may contribute to raising awareness about the importance of prevention and vaccination against HPV.

EHealth Communication Intervention to Promote Human Papillomavirus Vaccination Among Middle-School Girls: Development and Usability Study.

As the age of initiating sexual intercourse has gradually decreased among South Korean adolescents, earlier vaccination of adolescents for human papillomavirus (HPV) is necessary before their exposure to HPV. Health communication includes "cues to action" that lead to preventive health behaviors, and recently, social networking services, which operate with fewer time and space constraints, have been used in various studies as a form of eHealth communication. This study aims to investigate the feasibility and usability of an eHealth communication intervention for HPV vaccination in middle-school girls aimed at the girls and their mothers. The eHealth communication intervention for HPV vaccination was developed using a 6-step intervention mapping process: needs assessments, setting program outcomes, selection of a theory-based method and practical strategies, development of the intervention, implementation plan, and testing the validity of the intervention. A review of 10 studies identified effective health communication messages, delivery methods, and theories for HPV vaccination among adolescents. Barriers including low knowledge, perceived threat, and the inconvenience of taking 2 doses of the vaccine were identified through focus groups, suggesting a need for youth-friendly and easy-to-understand information for adolescents delivered via mobile phones. The expected outcomes and the performance objectives are specifically tailored to reflect the vaccination intention. Behavior change techniques were applied using trusted sources and a health belief model. Health messages delivered through a KakaoTalk chatbot improved awareness and self-efficacy. Quality control was ensured with the use of a log system. The experts' chatbot usability average score was 80.13 (SD 8.15) and the average score of girls was 84.06 (SD 7.61). Future studies need to verify the effectiveness of health communication strategies in promoting HPV vaccination and the effectiveness of scientific intervention using a chatbot as a delivery method for the intervention.

Stakeholders’ perspectives on informed decision-making for migrant women in CC prevention programs

Abstract Background This study gathered the perspectives of stakeholders regarding participation in cervical cancer (CC) screening and human papilloma virus (HPV) vaccination among migrant women in the Netherlands. Considering their perspectives by developing interventions that are tailored to migrant women’s information needs regarding CC screening and HPV vaccination will support informed decision-making. Methods In total five focus group discussions were held with community leaders, healthcare professionals and communication experts separately. The focus group discussions were transcribed verbatim in Dutch, and analyzed thematically according to the Grounded Theory. Results The analysis resulted in six themes. The first theme describes the existing views and misconceptions regarding CC (screening) and HPV vaccination in the target population according to the stakeholders. The second theme is about the current approach of informing about these health programs, and its belonging barriers. Theme three dives into the differences within the target population, such as generations and level of language. Theme four describes the conditions to which interventions should adhere. In theme five and six suggestions for interventions were introduced, focused on the target population and their (social) network respectively. Conclusions The results of this study showed that stakeholders are willing to play a role to support informed decision-making regarding CC (screening) and HPV vaccination among migrant women, but they need more training to support. Community leaders express a need for training to gather more medical knowledge of CC and its prevention programs. Healthcare professionals expressed a need for more insight into the practical, cultural, religious and emotional aspects that play a role within this target population. Communication experts emphasize the need for customized information materials and a more district-oriented approach. Key messages • Stakeholders operating at different levels are willing to play a role in increasing informed decision-making regarding CC screening and HPV vaccination. • Migrant women’s (social) network need more training and support to be able to provide tailored information regarding CC screening and HPV vaccination.

8.D. Scientific session: Equitable Immunization: Leveraging Prisons for Vaccination Equity in Europe

Abstract Addressing low vaccine coverage is a pressing public health concern in Europe, where pockets of unvaccinated individuals persist despite ongoing efforts. The European region sees an estimated 1.4 million individuals detained on any given day, with a significantly higher number passing through prisons annually due to high turnover rates. Those experiencing incarceration often come from socially marginalized and disadvantaged groups, facing a multitude of health challenges including non-communicable diseases, infectious diseases, mental illness, cognitive disabilities, and substance dependence. Despite their elevated health needs, individuals in prison frequently encounter barriers to accessing healthcare services, including preventive measures such as vaccination. Available but limited data suggest that individuals entering the prison system are often under-immunized, particularly against Hepatitis B Virus (HBV), influenza, measles, mumps, rubella (MMR), and pneumococci. Unfortunately, vaccination services within prisons are often insufficient, typically being provided according to national schedules or in response to outbreaks of vaccine-preventable diseases (VPDs). It’s crucial to distinguish between the availability of vaccination services and actual coverage, as the modalities of vaccination offerings vary across the region. While individuals in prison are recognized as a target group for HBV vaccination, the methods of offering vaccines may differ based on factors such as age or risk group. Nevertheless, systematic implementation of HBV vaccination in prisons has shown clear benefits for both incarcerated individuals and the wider community. Given the significance of vaccinations in preventing diseases like HBV and human papillomavirus (HPV), which are linked to cancer, initiatives like the Europe Beating Cancer Plan and the European Council Recommendation on vaccine-preventable cancer emphasize their importance. Prisons can serve as a strategic point for delivering comprehensive healthcare and vaccination services to incarcerated individuals, yet routine data on vaccination coverage at entry and uptake during incarceration are often lacking, hindering effective health planning. To address this public health challenge, the ‘Reaching the hard-to-reach: Increasing access and vaccine uptake among prison population in Europe’ (RISE-Vac) project consortium has been formed. This collaborative effort brings together diverse expertise and established networks in the field of prison health, reflecting the varied epidemiological and structural landscapes across Europe. The objective of this workshop is to showcase recent research findings, evidence-based practices, and policy recommendations aimed at enhancing vaccination equity in the European region. By sharing insights and best practices, we aim to bolster efforts to improve vaccine access and uptake among incarcerated populations, ultimately contributing to broader public health goals. Key messages • Prison health is public health: vaccination services in prison are essential to achieve immunization targets in Europe. • Maximizing inter-sectoral collaboration is crucial for bridging the gap in vaccination access and uptake among people living in prison in Europe.

Developing HPV Vaccination Communication Strategies: Assessing Knowledge, Attitudes, and Barriers Among Healthcare Professionals in Kazakhstan

Background: Cervical cancer, predominantly caused by human papillomavirus, remains a major public health issue globally and in Kazakhstan, where it ranks among the most common cancers in women. A pilot HPV vaccination programme in Kazakhstan was suspended in 2017 due to mass parental refusals, and it is planned to be restarted in the coming years. This study aims to assess the knowledge, attitudes, barriers, and sources of information about HPV and the HPV vaccine among healthcare professionals in Kazakhstan. Methods: A cross-sectional study (December 2022–May 2023) involving 1189 healthcare professionals in Kazakhstan used a self-administered questionnaire. Statistical analysis included descriptive statistics, mean knowledge score, between-group comparisons, and binary logistic regression to identify factors linked to higher knowledge and vaccine recommendation. Results: The study found that the average knowledge score for HPV and the HPV vaccine among participants was 11 out of a possible 18. Correct answers to the questionnaire were observed more frequently among physicians than among nurses (p < 0.001). In our study, 72.6% of healthcare professionals expressed a positive intention to recommend the HPV vaccine. The likelihood of recommending the HPV vaccine was significantly higher among those with higher knowledge of HPV and its vaccine (OR 1.8; 95% CI 1.3–2.5; p < 0.001), those familiar with cervical cancer patients (OR 2.0; 95% CI 1.5–2.8; p < 0.001), and those with positive attitudes towards the COVID-19 vaccine and childhood vaccination (OR 2.3 and 1.5, respectively). Healthcare professionals identified key barriers to HPV vaccination, including public mistrust (49.4%), fear of side effects (45.9%), and insufficient knowledge among healthcare professionals themselves (30.3%). Information from the internet, including articles and journals, was the most commonly used source of information, followed by social media and colleagues. Conclusions: The disparities identified call for a tailored, multifaceted communication strategy that addresses the diverse needs of health professionals to address the differences in awareness between different groups, in order to ensure successful implementation and coverage of HPV vaccination across Kazakhstan.

Attitudes and Related Factors of Women in Turkey Towards Cancer Screening: Analytical Cross-Sectional Study

Objective: This study aimed to examine women's attitudes and related factors towards cancer screening in Turkey. Methods: This analytical-cross-sectional study was conducted between June and September 2022. The universe of the study consisted of all women between the ages of 30-70 in Turkey, and the sample included 335 women. The data of the study were collected online with the “Personal Information Form’’ and “Attitude Scale for Cancer Screening”. Results: The average Attitude Scale for Cancer Screening total score of the women participating in the study was 84.36±14.55. Of the women who participated in the study, 33.1% did not perform breast self-examination, 63.1% did not perform clinical breast examination, 49.5% did not perform Pap smear and HPV-DNA testing, 60.9% did not perform mammography, 76.1% did not perform fecal occult blood testing and 93.8% did not perform colonoscopy. It was determined that education status, breast self-examination, clinical breast examination, Pap Smear and HPV-DNA test frequencies, and knowing the places where cancer screening was performed affected the Attitude Scale for Cancer Screening score averages (F = 8.729, p = 0.000). Conclusion: It was determined that the attitudes of the women participating in the study towards cancer screening were moderate. Several factors are done affect attitudes towards cancer screening.

What if we could eradicate cervical cancer?

Abstract Introduction WHO wants to achieve the elimination of Cervical Cancer: all countries must achieve and maintain an incidence rate of less than 4 per 100,000 women. Three key pillars: 90% of girls fully vaccinated against HPV by 15 years of age; 70% of women aged 35-45 years screened; 90% of women with pre-tumour lesion and invasive tumour treated. Our study assessed the position of the Tuscany South East Local Health Authority(LHA TSE) with respect to these three pillars and how to improve it. Methods A retrospective observational study was conducted. The following were used: ISTAT data of incidence of cervical cancer standardised by age from 2013 to 2017;data from ISPRO on screening(PAP and HPV test)from 2013 to 2022;data of vaccination coverage taken from the Health Information System of Collective Prevention(SISPC) from 2012 to 2023 for children<12 years, Results The incidence rate of cervical cancer in LHA TSE is 9.4 per 100 thousand. About HPV vaccine coverage by age 12, for girls it has been rising from 80.5% in 2012 to a peak of 84.8% in 2019 and then progressively decreasing to 76.3% in 2023.Coverage for boys has also been progressively increasing from 0.8% in 2012 to a peak in 2019 of 74.9% and then decreasing to 69.8% in 2023. A total of 52 thousand children are vaccinated. As for the adjusted adherence to screening, we started from an average adherence of 51.8% in 2013 (75 thousand women invited with 102% coverage) to 53.2% in 2022 (54 thousand women invited with 107% coverage). In 2013, ASC-US+ lesions were found in 6.4 % of women by PAP Test and in 2022 in 6.3 % of women. In the examined period, more than 90% of women with pre-tumour lesion and more than 90% with invasive tumour were treated. Conclusions LHA TSE will have to implement actions to increase vaccination coverage and screening adherence rates through awareness campaigns and open days, also considering whether a change in the age range for starting screening is necessary as vaccination coverage increases. Key messages • Cervical cancer is one of the most preventable cancers, but too few young women are vaccinated against HPV infection, the main causative factor. • Prevention through adherence to screening enables early identification of lesions caused by HPV virus.

Exploring factors of HPV self-sampling acceptance:a qualitative study with hard-to-reach women

Abstract Background Cervical cancer disproportionately affects socially disadvantaged women, who tend to be underscreened and are generally called “hard-to-reach”. HPV DNA testing based on self-sampling test is an alternative strategy to address women’s low screening uptake and reduce inequalities. Psychosocial factors like self-efficacy, ethicality, and testing conditions should be considered when assessing the acceptability of HPV self-sampling. However, research on the acceptability of HPV self-sampling is scarce among hard-to-reach women. Our study aims to explore self-efficacy beliefs, perceptions of how well HPV self-sampling fits participants’ values and their preferred testing conditions and understand how these factors influence the acceptability of HPV self-sampling test among hard-to-reach women. Methods This qualitative study used a semi-structured guide based on three constructs of the Theoretical Framework of Acceptability. Focus group discussions (FGD) were conducted with n = 63 hard-to-reach women in Portugal (2 FGD), Ecuador (4 FGD), and Belgium (3 FGD). Data were analysed using deductive content analysis. Results While some women viewed HPV self-sampling as acceptable, others questioned its compatibility with their ethical views and moral principles, stressing that the test cannot replace the clinical examination. Participants held conflicting views, with some expressing confidence in their sampling abilities while others feared making errors when taking the sample. Cultural disparities in preferred testing conditions emerged: Ecuadorian women preferred solo testing, while those in Europe preferred assistance. Conclusions This study indicated ambivalent attitudes towards self-sampling. Further research on HPV self-sampling acceptability is needed to explore socio-cultural nuances. Our study emphasises the importance of culturally attuned interventions to address these populations’ needs and reduce inequalities. Key messages • Hard-to-reach women harbour conflicting views about self-sampling. • Screening policies may include opportunities for self- and clinician sampling.