Human Papillomavirus Cervical Cancer Research Articles

Factors that influence the uptake of human papillomavirus vaccine among preadolescent girls in South Africa: A Scoping Review.

Human papillomavirus (HPV) infection is a sexually transmitted infection which causes cancer, especially cervical cancer. HPV infection and cervical cancer are a public health concern in South Africa. Primary prevention interventions, such as vaccination against cervical cancer, have been rolled out in the country. However, the uptake of the vaccine faces challenges due to various factors. The aim of the review was to identify factors which influence the uptake of the vaccine. A six-step framework developed by Levac, Colquhon and O'Brien was adopted to guide this scoping review. The articles were searched in the following databases: EBSCOhost, PubMed, CINAHL and Google scholar. The search, conducted from May to July 2023 was limited to articles published in English between 2008-2023 and those conducted in Africa. The results showed that most studies were conducted in sub-Saharan Africa, with majority of the studies being from Nigeria. Subthemes were extracted from the articles and categorised under the four themes of the Social Ecological Model. The four themes used from the Social Ecological Model were individual factors; interpersonal factors; community and societal factors, and organisational factors and public policy. The subthemes were socioeconomic and sociodemographic of parents, knowledge, fear and mistrust, family structure and proximity to cancer/STI, misinformation from social media, religion, culture and tradition, free vaccination programme and lack of engagement. The identified gap in literature was a lack of studies of factors which influence HPV vaccination uptake in South Africa and qualitative studies that explore and provide the factors influencing uptake. We conclude that in designing effective interventions for the uptake of HPV vaccines, it is important to consider influential factors that are tailor-made for specific demographics.

Human papilloma virus (HPV)-related information acquisition and seeking behavior among infected women: A single center cross-sectional survey in Shanghai, China.

Lacking of adequate knowledge is an obstacle to effective prevention of cervical cancer, yet factors that affect the information acquisition and seeking behavior as well as the information communication process are not well studied. We assessed information acquisition and seeking behavior, as well as perceived barriers of doctor-patient communication regarding human papilloma virus (HPV)-related information of infected women. Among 437 participants, 405 (93%) expressed demands for HPV-related information, while only a small proportion (100/437, 22.9%) actively sought information and felt obstacles comprehending. Web-based channels were most frequently utilized and medical personnel were the most trusted information source. Patients' satisfaction was significantly correlated with doctor's patience (r = 0.581, p < 0.001) and emotional caring (r = 0.555, p < 0.001). Compared to patients not actively seeking information, those actively seeking information were more likely to be single (p = 0.005), had higher education (p = 0.009) and monthly individual-level income (p = 0.023), and was more likely to undergo regular cervical cancer screening (p = 0.003), and were already or willing to be vaccinated (p = 0.008). The actively seeking information group also achieved higher scores in HPV knowledge test (p = 0.007). Public health interventions targeting HPV-infected women using specifically designed educational materials may influence information seeking behavior, increase HPV literacy and knowledge, which could potentially increase HPV vaccine uptake and cervical cancer screening rate.

Attitudes toward an HPV vaccine for condyloma acuminata and willingness to undergo vaccination among STD clinic attendees in China: Focus on STI prevention with HPV vaccine

BackgroundCondyloma acuminata (CA) is a common, and recurrent sexually transmitted disease (STD) that greatly contributes to direct health care costs and has a substantial psychosocial impact. Human papillomavirus (HPV) vaccination (containing L1 protein for HPV types 6 and 11) effectively controls CA.ObjectivesWe investigated attitudes toward the HPV vaccine for CA and willingness to undergo vaccination among STD clinic attendees in China.MethodsAttendees at STD clinics at two selected hospitals in Guangdong and Jiangsu Provinces from May to September 2017 were requested to complete a self-administered questionnaire for this cross-sectional study.ResultsThe participants’ median age was 28 years (IQR: 24.0–34.0), and the sex ratio was balanced; 63.5% were from Guangdong, 36.5% were from Jiangsu, and 44.5% had a history of CA. The vaccine acceptance rate was high among the participants (85.8%,235/274) to whom the HPV vaccine for CA was available, especially among those who had heard of CA (89.0%, AOR = 3.14, 95% CI: 1.29–7.63, p = 0.0114). 95 (34.7%) of 274 participants had a positive attitude toward the HPV vaccine for CA. STD clinic attendees who had heard of the connection between HPV and CA (AOR = 2.56, 95% CI: 1.31-5.00, p = 0.0060), had heard of the HPV vaccines or cervical cancer vaccines (AOR = 1.90, 95% CI: 1.02–3.54, p = 0.0444) and had ever proactively discussed CA or the vaccine with others (AOR = 1.95, 95% CI:1.00-3.79, p = 0.0488) had better attitudes toward the HPV vaccine for CA. Over half of the participants (52.5%) expected the price of the HPV vaccine for CA to be under $90.ConclusionThe acceptance of the HPV vaccine for CA was high among STD clinic attendees in China, and the participants’ self-perceived knowledge of CA and HPV was associated with better attitudes toward the HPV vaccine for CA. Education to improve knowledge is vital for reducing vaccine hesitancy.

Carcinogenesis and epidemiology of cervical cancer: The hallmark of human papillomavirus-associated cancer.

Cervical cancer affects women worldwide and is the most common human papillomavirus (HPV)-associated cancer. Carcinogenesis caused by HPV results in specific cancer behavior because of the underlying viral infection. The mechanism and timing of the transformation from viral infection to cancer cells have been elucidated in detail. Treatments for this cancer are based on its characteristics and are being implemented. Moreover, HPV infection is widespread worldwide and is transmitted through sexual activity. Although the HPV vaccination is the most effective strategy of preventing cervical cancer, it is not feasible to vaccinate the entire human population especially in low- and middle-income countries. In order to consider the next step for HPV vaccination, we need to understand the characteristics of HPV carcinogenesis and cervical cancer. Additionally, treatment aimed at preservation of reproductive function in patients with cervical cancer is often required, as the cervix is a reproductive organ and because the disease is more prevalent in the adolescent and young adult generation. Thus, there are still many challenges in the diagnosis, treatment, and prevention of cervical cancer.

Cervical cancer in Thailand: 2023 update.

Cervical cancer continues to pose a challenge to the health of Thai women, as the second most common cancer after breast cancer. Since high-risk human papillomavirus (HPV) types are the main cause for cervical cancer, cervical cancer screening and HPV vaccination are necessary to reduce the incidence of this disease. At present, the World Health Organization hopes to reduce the incidence of cervical cancer to 4 or less cases per 100,000 women-years using 90%- 70%-90% intervention by 2030. The first intervention involves vaccinating 90% of women aged 15 years with the HPV vaccine. The second intervention involves screening 70% of women between the ages of 35 and 45 years using a high-performance screening test. The third intervention involves detecting cervical lesions in 90% of affected women to enable diagnosis and treatment. In this context, this study reviews trends in the incidence and mortality rates of cervical cancer in Thailand, in addition to providing an up-to-date overview of the causes and necessary risk factors for cervical cancer, as well as reporting on cervical screening and HPV vaccination rates and cervical cancer during the coronavirus disease 2019 (COVID-19) pandemic. This study may prove useful for the formulation of policy aimed at eliminating cervical cancer in Thailand, such as the implementation of a free HPV vaccine service and providing athome kits for cervical screening through clinics and pharmacies. In addition, this review also highlights the need for further research on the effects of the COVID-19 pandemic on cervical cancer screening rates in Thailand.

Assessment of HPV Knowledge and Awareness among Students and Staff at IBB University, Niger State, Nigeria: Implications for Health Education and Prevention.

In Nigeria, statistics reveal that there is a high rate of cervical cancer among women and a significant lack of awareness surrounding Human Papillomavirus (HPV), which poses a substantial risk of HPV infection. This cross-sectional survey, conducted at Ibrahim Badamasi Babangida (IBB) University, focuses on adapting and exploring the factors that influence a 20-item scale to measure HPV knowledge, evaluating knowledge-associated patterns and HPV-associated risk factors. We examined HPV vaccination rates, infection awareness, vaccine awareness, and the impact of ethnicity on HPV knowledge. Various validated forms were adapted to measure HPV awareness and knowledge. Non-parametric tests addressed non-normality. Data were presented using median and IQR and categorical data were frequency-based. Bivariate tests (Mann-Witney, Kruskal Wallis) explored knowledge-associated factors, while quantile regression (75th percentile) examined HPV knowledge factors. Variables were considered statistically significant at p < 0.05. The adapted 20-item knowledge scale revealed strong reliability (Cronbach's alpha = 0.913), ensuring internal consistency. The median knowledge score was 0, with an interquartile range (IQR) of 0-5. Our findings revealed a significant lack of awareness and knowledge about HPV; only 34.8% of the population were aware of HPV infection and 25.0% were familiar with HPV vaccination. Furthermore, ethnicity was found to be significantly associated with knowledge of HPV. This study emphasizes the necessity for targeted interventions to enhance HPV awareness, especially within specific ethnic groups. Despite a robust knowledge scale, educational initiatives such as seminars/conferences about HPV and cervical cancer remain crucial in addressing this gap, ultimately reducing HPV infection and cervical cancer risks in Nigeria.

Knowledge, Attitudes and Practices among Women of Reproductive Age on Human Papillomavirus Infection, Cervical Cancer and Vaccination in Otukpo, Nigeria.

Knowledge, attitudes and practices (KAP) of human papilloma virus (HPV) is a necessary measure in curtailing delayed diagnosis and poor control practices. The objective of this study was to assess the knowledge, attitudes and practices vis-à-vis HPV infection, cervical cancer and vaccination among women. This cross-sectional study was conducted at 15 selected health-care facilities in Otukpo metropolis and it involved 168 pregnant women. The data were collected using structured questionnaire, and analysed for descriptive and analytical statistics using Epi Data Version 3.1 and SPSS statistical package Version 21. Most of the respondents (75.0%) have heard of human papilloma virus and their information source were mostly the health-care providers. In total, 132(78.6%) agreed to take the vaccine if offered for free but 152(90.5%) stated that it is imperative to seek the opinion of health providers before vaccine uptake. However, only 27(16.1%) have undergone recommended checkup for human papilloma virus/cervical cancer and 23(13.7%) have taken at least a vaccine dose. Some respondents 66(39.3%) had good knowledge while 95(56.6%) demonstrated positive attitude. However, most respondents 161(95.8%) demonstrated poor practices. There is enormous need to improve HPV sensitization especially in women due to cervical cancer associated risks. Healthcare personnel are therefore encouraged to create more awareness on HPV infection and screening of cervical cancer (CC) via counseling sessions and communications tool like the new media. KAP approach is a critical tool towards successful CC screening and HPV control.

Perceived barriers to self-collected HPV testing for cervical cancer screening, and knowledge of HPV: a survey of primary healthcare smear-takers across Aotearoa New Zealand.

Cervical cancer remains a burden within Aotearoa New Zealand, with 2022 screening rates sitting 12.7% below target. The National Cervical Screening Programme has changed to primary human papillomavirus (HPV) testing for all screen-eligible people, with the aim for home self-testing. Little is known about the readiness of primary care for the change to self-testing and its associated challenges. A pilot HPV cervical cancer screening programme is being conducted in 17 practice centres. The aim of this study is to explore smear-taker knowledge at these centres about the use of primary HPV testing for cervical cancer screening. This is an ethically approved questionnaire study, with data from a structured web-based questionnaire sent to all smear-takers at the pilot centres. We achieved a total completion rate of 57.8%. The average score for "Knowledge of HPV" was 56.5% (range=20-100%). The challenges to patient home HPV self-testing were felt to be overall "not at all" to "mildly challenging". Up to 73.3% of participants identified ongoing needs for further education. The findings indicate knowledge deficits regarding HPV testing for cervical cancer screening and a desire for the provision of further education. Overall, respondents felt that no major barriers to implementing HPV self-testing would occur.

Knowledge regarding human papillomavirus and cervical cancer prevention among medical students from Chulalongkorn University in Thailand

BackgroundCervical cancer is one of the leading causes of death among women in Thailand. General practitioners, within their primary healthcare role, play a vital role in the cervical cancer screening program, as they are the healthcare professionals most easily accessible to the general population. This study aims to determine the level of knowledge of cervical cancer and human papillomavirus (HPV) infection, HPV vaccination, and cervical cancer screening among last-year medical students.MethodsA cross-sectional study was conducted among sixth-year medical students using an electronic self-administered questionnaire. The two-part questionnaire comprised demographic data and 12 true/false questions that assessed knowledge regarding HPV infection, HPV vaccination, and cervical cancer screening recommendations. Pilot testing revealed a high Cronbach’s alpha and test–retest reliability coefficient.ResultsA 67% response rate was achieved. Among the 198 respondents, only one (0.5%) student correctly answered over 80% of the questions while most respondents (172, 71.7%) correctly answered less than 60% of the questions. Less than half of the respondents correctly identified crucial aspects such as the primary cause of cervical cancer, recommended vaccination age, cytology sensitivity compared to HPV testing, and the recommended screening frequency for average-risk women.ConclusionsThis study highlights a significant lack of comprehension among Thai medical students concerning HPV infection, vaccination, and cervical cancer screening guidelines. Encouraging educational enhancement, effective communication, and heightened awareness of these crucial topics within the medical school curriculum are imperative.

Parental Knowledge of HPV Infection, Cervical Cancer and the Acceptance of HPV Vaccination for their Children in Jos, Nigeria.

Despite the high prevalence of human papillomavirus (HPV) infections and cervical cancer in Nigeria, the utilization of the HPV vaccine as a highly effective preventive measure remains low. The aim of this study was to find out if parental knowledge of HPV infection and cervical cancer influenced the acceptance of HPV vaccines for their 9-14-year-old children. This was a cross-sectional survey of 509 parents comprising 262 fathers and 247 mothers in 8 randomly selected communities in Jos, Plateau State Nigeria. A pretested semi-structured investigator-administered questionnaire, without identifiers, was used to collect information on parental knowledge of HPV, cervical cancer, HPV vaccine and its acceptance for their 9-14-year-old children. The data were analysed using SPSS version 23.0. Bivariate analysis was done using chi-square statistical test. Point estimates with corresponding 95% confidence interval (CI) were estimated with a value of P ≤ 0.05 was considered as statistically significant. Five hundred and nine parents were interviewed. The mean age of the respondents was 43.7 ± 9.43 years. Most of the participants (86.1%) had formal education from primary to tertiary level. Only 1.60%, 11.60% and 1.62% of respondents had knowledge of HPV, cervical cancer and HPV vaccines respectively, whereas 67.8% of parents were willing to pay for the cancer-preventing HPV vaccines out-of-pocket. There was no statistically significant associations between parental level of education (P = 0.056), parental knowledge of cancer of cervix (P = 0.483), religion of parents (P = 0.324) and the acceptance of HPV vaccination for their children. There was a statistically significant association between parental willingness to pay for HPV vaccines if not offered free (P = 0.001) with acceptance of vaccination. Vaccine acceptability was associated with positive attitude towards the vaccine (odds ratio [OR] = 4.178; 95% CI, 1.714-10.180; P = 0.002), whereas parental knowledge of HPV, cervical cancer and HPV vaccine did not show significant association with acceptability of HPV vaccination for their children. Despite poor parental knowledge of HPV infection and cervical cancer, there was high acceptability of HPV vaccination for their children. HPV vaccination was acceptable to parents regardless of educational level or religion. Parents in Jos communities seems to have much faith in preventive vaccines as advertised by the health authorities. Accordingly, efforts should be geared towards ensuring availability, affordability and the provision of basic information regarding HPV vaccination in Northern Nigeria.

Human papillomavirus and cervical cancer in the microbial world: exploring the vaginal microecology.

The vaginal microbiota plays a crucial role in female reproductive health and is considered a biomarker for predicting disease outcomes and personalized testing. However, its relationship with human papillomavirus (HPV) infection and cervical cancer is not yet clear. Therefore, this article provides a review of the association between the vaginal microbiota, HPV infection, and cervical cancer. We discuss the composition of the vaginal microbiota, its dysbiosis, and its relationship with HPV infection, as well as potential mechanisms in the development of cervical cancer. In addition, we assess the feasibility of treatment strategies such as probiotics and vaginal microbiota transplantation to modulate the vaginal microbiota for the prevention and treatment of diseases related to HPV infection and cervical cancer. In the future, extensive replication studies are still needed to gain a deeper understanding of the complex relationship between the vaginal microbiota, HPV infection, and cervical cancer, and to clarify the role of the vaginal microbiota as a potential biomarker for predicting disease outcomes, thus providing a theoretical basis for personalized testing.

Modeling the Health Impact and Cost-Effectiveness of a Combined Schoolgirl HPV Vaccination and Cervical Cancer Screening Program in Guangdong Province, China.

Low human papillomavirus (HPV) vaccine uptake is a key barrier to cervical cancer elimination. We aimed to evaluate the health impact and cost-effectiveness of introducing different HPV vaccines into immunization programs and scaling up the screening program in Guangdong. We used a dynamic compartmental model to estimate the impact of intervention strategies during 2023-2100. We implemented the incremental cost-effectiveness ratio (ICER) in costs per averted disability-adjusted life year (DALY) as an indicator to assess the effectiveness of the intervention. We used an age-standardized incidence of 4 cases per 100,000 women as the threshold for the elimination of cervical cancer. Compared with the status quo, scaling up cervical cancer screening coverage alone would prevent 215,000 (95% CI: 205,000 to 227,000) cervical cancer cases and 49,000 (95% CI: 48,000 to 52,000) deaths during 2023-2100. If the coverage of vaccination reached 90%, domestic two-dose 2vHPV vaccination would be more cost-effective than single-dose and two-dose 9vHPV vaccination. If Guangdong introduced domestic two-dose 2vHPV vaccination at 90% coverage for schoolgirls from 2023 and increased the screening coverage, cervical cancer would be eliminated by 2049 (95% CI 2047 to 2051). Introducing two doses of domestic 2vHPV vaccination for schoolgirls and expanding cervical cancer screening is estimated to be highly cost-effective to accelerate the elimination of cervical cancer in Guangdong.

Correlation Between Knowledge and Awareness of Human Papillomavirus Vaccine Among Adolescent Girls in Junior High School

&lt;p&gt;Cervical cancer is significantly increased by the Human Papillomavirus (HPV). The HPV vaccine can be administered as a primary preventive to stop cervical cancer. Cervical cancer can be prevented most effectively with vaccination. The decision to acquire the HPV vaccine is influenced by factors related to knowledge and awareness of the disease. This study aims to ascertain how adolescent girls’ knowledge and awareness of the HPV vaccine relate to one another. In this study, a cross-sectional approach was utilized. One hundred twenty-eight respondents were selected using a cluster random sampling. This study employed the Knowledge regarding HPV, Cervical Cancer, and HPV Vaccine Questionnaire and Awareness about Cervical Cancer, HPV, and HPV Vaccines Questionnaire, all declared valid and reliable. The Spearman Rank test was performed to analyze the data. According to the results, there was a relationship between knowledge and awareness of the HPV vaccine in adolescent girls (r= 0.554; p-value=0.000). Therefore, teenage girls’ knowledge and awareness of the HPV vaccine were related. It is suggested that health professionals, particularly those working with young girls, should provide easy-to-understand information about the HPV vaccine and cervical cancer.&lt;/p&gt;

Prevalence and Genotype Distribution of Human Papillomavirus Infection Among Women in Wuhan, China: A Retrospective Study.

Human papillomavirus (HPV) infection is a prevalent sexually transmitted infection worldwide, with its persistence being a significant factor in the development of cervical cancer and precancerous lesions. Understanding the prevalence and genotypes distribution of HPV can aid in the implementation of more focused strategies for cervical cancer prevention and treatment. This study aimed to investigate the prevalence and genotype distribution of HPV infection among outpatient-based populations in Wuhan, China. Our study retrospectively analyzed the results of cervical HPV screening in 14,492 outpatient women. The cervicovaginal infection of 18 high-risk genotypes and 10 low-risk genotypes were analyzed by PCR and reverse dot hybridization techniques. The overall prevalence of HPV infection in the outpatient female population was 15.33%, with a predominance of single infection and a predominance of dual infection among multiple infections. The top five genotypes in terms of prevalence of HR-HPV and LR-HPV were HPV-52 (3.77%), 53 (1.46%), 16 (1.31%), 58 (1.19%), 39 (1.18%) for HR-HPV, and HPV-54 (1.23%), 61 (1.08%), 81 (1.04%), 42 (0.87%), 44 (0.70%) for LR-HPV. Two peaks of HPV infection prevalence were observed among women under 25 years (22.88%) and over 56 years (24.26%). The prevalence and genotype distribution of HPV infection varied among different outpatient populations, with higher rates of HPV single infection, multiple infections, and infection across all ages observed in the gynecology outpatient population compared to the health check-up population. This study revealed the HPV prevalence and genotype distribution among different outpatient populations in Wuhan city, which may provide guidance for HPV vaccination and cervical cancer prevention strategies in the region.

Addressing the burden of cervical cancer for Indigenous women in Latin America and the Caribbean: a call for action.

Cervical cancer, primarily caused by human papillomavirus (HPV) infection, poses a significant global health challenge. Due to higher levels of poverty and health inequities, Indigenous women worldwide are more vulnerable to cervical cancer than their non-Indigenous counterparts. However, despite constituting nearly 10% of the population in Latin America and the Caribbean (LAC), the true extent of the burden of cervical cancer among Indigenous people in this region remains largely unknown. This article reviews the available information on cervical cancer incidence and mortality, as well as HPV infection prevalence, among Indigenous women in LAC. The limited existing data suggest that Indigenous women in this region face a heightened risk of cervical cancer incidence and mortality compared to non-Indigenous women. Nevertheless, a substantial knowledge gap persists that must be addressed to comprehensively assess the burden of cervical cancer among Indigenous populations, especially through enhancing cancer surveillance across LAC countries. Numerous structural, social and cultural barriers hindering Indigenous women's access to HPV vaccination and cervical cancer screening worldwide have been identified and are reviewed in this article. The discussion highlights the critical role of culturally sensitive education, community engagement, and empowerment strategies in overcoming those barriers. Drawing insights from the success of targeted strategies in certain high-income countries, the present article advocates for research, policies and healthcare interventions tailored to the unique context of LAC countries.

Knowledge of primary health care visitors in Qassim region regarding HPV vaccine: a cross-sectional study

Objective: This study aimed to assess the Human papillomavirus (HPV) vaccination knowledge and attitudes among the Qasim region&amp;apos;s population in Saudi Arabia to improve vaccine uptake and reduce HPV-related disease burden. Methods: A cross-sectional study was conducted among primary healthcare visitors in the Qassim region. Data were collected using a structured questionnaire that assessed participants&amp;apos; demographic information, and knowledge about HPV disease, cervical cancer, and HPV vaccine. Results: The mean age of participants was 32 years whereas 75% were females and 25% were males. The majority of participants had bachelor&amp;apos;s degrees (58%) and high school diplomas (36%). Most of the participants were married (59%) while 31% were divorced. Knowledge about HPV and cervical cancer was low, with only 32.7% being aware of HPV and 37.2% knowing its link to genital warts. Furthermore, 38.4% were aware of the HPV vaccine, with females more informed than males (41.9% vs. 28.1%). Social media was the primary information source. Only 2.3% reported of participants getting vaccinated. The reasons for low vaccination included a lack of interest and concerns about side effects. Conclusion: Efforts to improve awareness and vaccine uptake should target specific groups like males and younger individuals through tailored educational interventions. Integrating the vaccine into the national schedule and school-based programs can enhance acceptance. Collaboration between stakeholders is vital in promoting vaccine safety and dispelling misconceptions.

Cost-effectiveness analysis of single-dose or 2-dose of bivalent, quadrivalent, or nonavalent HPV vaccine in a low/middle-income country setting.

To compare the health impact and economic benefits among individuals who did not receive the human papillomavirus (HPV) vaccine to those who received a single dose, or 2 doses. The comparison was stratified by 4 types of vaccine in conjunction with primary HPV screening in a low/middle-income country setting. A Markov model was employed to simulate HPV infection and cervical cancer in a cohort of 100,000 12-year-old girls free of HPV. The study scrutinized 9 strategies: 1 dose and 2 doses of 2vHPV (Cervarix®), 2vHPV (Cecolin®), 4vHPV (Gardasil®), 9vHPV vaccine (Gardasil9®), and no vaccination. The primary outcome measure was the quality-adjusted life year (QALY) of each strategy. Incremental cost-effectiveness ratios were estimated over a lifetime horizon, accompanied by sensitivity analyses conducted. All vaccination programs yielded 41,298-71,057 QALYs gained accompanied by cost savings of 14,914,186-19,821,655 USD compared to no vaccination. Administering 2 doses of 9vHPV vaccine emerged as the most cost-effective strategy, boasting 406 USD/QALY, within a lower willingness to pay threshold. Sensitivity analysis demonstrated an 80% probability of the cost-effectiveness of the 2 doses of 9vHPV vaccine regimen. Furthermore, uncertainty around the costs of vaccination and vaccine efficacy exerted the most substantial influence on the cost-effectiveness findings. Oping for 2 doses of 9vHPV vaccine in conjunction with a primary HPV screening represents the most cost-effective option for implementing a school-based HPV vaccination program targeting 12-year-old girls in Thailand. Such findings provide valuable insights for policymakers in the realm of cervical cancer prevention.

Abstract B127: The impact of sociodemographic and lifestyle factors on the vaginal microbiome and cervical cancer disparities in Native American women

Abstract Cervical cancer morbidity and mortality are continually experienced by Native American women compared to white women. Human papillomavirus (HPV) is the most common sexually transmitted infection and can cause cervical cancer in women when HPV is not cleared by an individual. Depletion of Lactobacillus species in the vaginal microbiome (VMB) is linked to HPV acquisition and persistence of HPV infection and development/progression of cervical neoplasm. Most Lactobacillus spp. protect the host against invading pathogens of the genital mucosa, including the cervix. Changes in the VMB composition to dysbiotic anaerobes decrease an individual’s ability to clear HPV, increasing susceptibility to malignancy. Depletion of Lactobacilli is associated with race and ethnicity, despite research showing genetics to be statistically similar across ethnicities. However, there may be other factors that drive changes in the microbiome, including demographic, socio-economic, lifestyle and sexual &amp; reproductive health factors. Here, we aim to determine which demographic, socioeconomic, lifestyle and sexual &amp; reproductive health factors impact the microbial community within the VMB, regardless of race and ethnicity. These factors have not been studied in the context and inclusion of NA women. In this study, 31 women at the Native American for Community Action Clinic in Flagstaff, Arizona, U.S. were enrolled, and participants completed self-reported surveys. The survey assessed the individual’s socioeconomic, demographics, lifestyle, reproductive health, as well as their knowledge on HPV and VMB. Vaginal swabs were also collected for microbiome analysis via 16S rRNA sequencing. Surveys were collected and stored in REDCap. Surveys were statistically analyzed using t-test, Fisher’s exact, or Chi-square tests. Most women identified as NA (n=16), white (n=13), and Hispanic (n=5). We identified bacterial profiles of 28 of the 31 participants to be Lactobacillus-dominant (n=16) and non-Lactobacillus-dominant (n=12) and stratified them into two groups. Significant differences were observed, suggesting association of multiple people in a household (p=0.0228), lower level of education (p=0.0093), and high parity (p=0.0283) to undesirable non-Lactobacillus-dominant VMB. It is noteworthy that there were no differences between groups regarding race/ethnicity, age, body mass index, marital status, employment status, household income, hrHPV positivity, vaccination status, use of contraceptives, sexual activity, number of partners and knowledge of HPV and VMB. Yet, the non-Lactobacillus group tended to have more women with high-risk HPV infection. Ongoing analysis includes global health and perceived stress data in relation to the VMB and HPV status. Upon full analysis, we will report on trends between the VMB composition and sociodemographic, lifestyle factors and quality of life. The findings will improve ways for people to find solutions to decrease HPV infections and cervical cancer in Native American populations. Citation Format: Tawnjerae Joe, Paweł Łaniewski, Tristen Eddie, Skyler Bordeaux, Verity Quiroz, Haiyan Cui, Denise Roe, Donna Peace, J. Gregory Caporaso, Naomi Lee, Melissa M. Herbst-Kralovetz. The impact of sociodemographic and lifestyle factors on the vaginal microbiome and cervical cancer disparities in Native American women [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B127.

Empowering Women's Health: Insights Into HPV Vaccination and the Prevention of Invasive Cervical Cancer.

This review article provides a comprehensive analysis of the role of human papillomavirus (HPV) vaccination in empowering women's health by preventing invasive cervical cancer. Cervical cancer remains a significant global health concern, with HPV infection identified as a primary causative factor. The review synthesizes current research findings, epidemiological data, and clinical outcomes to offer a nuanced understanding of the impact of HPV vaccination on cervical cancer prevention. The article explores the biology of HPV, emphasizing its association with cervical carcinogenesis and the development of precancerous lesions. It delves into the epidemiology of HPV infection, highlighting the global prevalence and the burden of cervical cancer, particularly in low-resource settings. The socio-economic factors influencing HPV transmission and cervical cancer incidence are also discussed. The focus of the review is on the efficacy and safety of HPV vaccines, including an examination of vaccine types, dosages, and long-term effectiveness. Insights into the immunological responses triggered by vaccination, as well as the duration of protection against HPV infection and associated cancers, are presented. Special attention is given to addressing myths and misconceptions surrounding HPV vaccination, aiming to enhance public awareness and acceptance. Additionally, the review discusses the impact of vaccination programs on population-wide HPV prevalence and the subsequent reduction in cervical cancer rates. It explores challenges related to vaccine accessibility, affordability, and coverage, especially in underserved populations. Strategies for improving vaccine uptake and ensuring equitable distribution are considered, with a focus on empowering women through education and healthcare access. Furthermore, the article touches upon emerging trends in HPV research, such as the development of next-generation vaccines, therapeutic interventions for existing infections, and the potential for global HPV elimination. The integration of HPV vaccination into comprehensive women's health programs is advocated, emphasizing the importance of a holistic approach to cervical cancer prevention. In conclusion, this review provides a multifaceted exploration of HPV vaccination as a pivotal tool in empowering women's health by preventing invasive cervical cancer. The synthesis of current knowledge underscores the need for continued research, education, and global collaboration to ensure the widespread success of HPV vaccination initiatives, ultimately contributing to the advancement of women's health worldwide.

Cervical Cancer Screening and Treatment Algorithms Using Human Papillomavirus Testing-Lessons Learnt from a South African Pilot Randomized Controlled Trial.

To report quantitative and qualitative results on cervical cancer human papillomavirus (HPV)-based screening and treatment algorithms, with/out triage with visual inspection after acetic acid (VIA), followed by ablative treatment (AT). Women 30 to 54 years old from Durban, South Africa were recruited, regardless of human immunodeficiency virus (HIV) status, randomized into one of two study arms and screened for HPV. VIA triage arm: HPV-positive women were triaged using VIA, biopsied and received AT if VIA positive and eligible; no triage arm: eligible HPV-positive women received AT. Women ineligible for AT were referred to colposcopy. Women were asked about side effects immediately and 1 week after AT. Retention to screening and treatment algorithms was compared between arms. A total of 350 women [275 HIV-uninfected and 75 women living with HIV, (WLWH)] were allocated to receive HPV testing with VIA triage (n = 175) or no triage (n = 175). HPV prevalence was 28% [95% confidence interval (CI) = 23-33]; WLWH: 52% (95% CI = 40-64) versus HIV-uninfected: 21% (95% CI = 17-27; P < 0.05). Among women who underwent VIA triage with histologic diagnosis, 3/17 were VIA negative with cervical intraepithelial neoplasia (CIN)2+; 14/18 were VIA positive with <CIN2. Retention to screening and treatment algorithms was high (92%). This pilot demonstrated the feasibility of implementing screening and treatment algorithms, including performing triage and treatment in one visit; however, VIA triage did not reduce overtreatment and missed some precancerous lesions. This study reports on implementation feasibility of two World Health Organization screening and treatment algorithms (with/out VIA triage). Although the retention to screening and treatment algorithms was high in both arms, the question of how best triaging HPV-positive women deserves further consideration, particularly for WLWH. See related In the Spotlight, p. 763.