Cervical Cancer Incidence Rates Research Articles

Investigation of awareness of human papilloma virus infection among female health workers at Ondokuz Mayıs University

Less developed areas have the highest incidence rates of cervical cancer, which vary by geographic region. If the right lifestyle changes are made, all cervical cancer risk factors can be avoided. Furthermore, vaccines have been created to guard against a number of the high-risk strains of the human papillomavirus (HPV). Not all women are aware of cervical cancer or how to prevent it, even though it is preventable. Therefore, every woman must assess level of knowledge regarding HPV prevention and cervical cancer. We applied a validated questionnaire between January and June 2021 to the female health workers at Ondokuz Mayıs University Hospital to assess their knowledge of cervical cancer and HPV protection as well as their attitudes toward it. Our findings indicate that women's knowledge on this topic is lacking, especially regarding the most recent advancements in HPV testing and vaccination-based cervical cancer prevention. Only 99% of the women who responded to the survey were actually aware that HPV testing was available. Although the incidence of cervical cancer is low, this figure is subject to change, particularly in light of the economic crisis and rising immigration rates, which could lead to higher rates of HPV infection in the population if no action is taken. Although the HPV vaccine has been available for some time, the Turkish government does not recommend it as a routine vaccine as part of the National Immunization Program. Even among the highly educated workforce in the healthcare industry, there is a lack of understanding about HPV vaccine. Healthcare professionals should be fully informed about the HPV vaccine for their own benefit so that they can discuss it with their patients. This study aimed to remove vaccination barriers and assess healthcare professionals' current knowledge of cervical cancer and HPV vaccination in a tertiary hospital.

The temporal trend of women's cancer in Changle, China and a migrant epidemiological study.

Although the etiology of women's cancer has been extensively studied in the last few decades, there is still little evidence comparing the temporal pattern of these cancers among different populations. Cancer incidence and mortality data from 1988 to 2015 were extracted from the Changle Cancer Register in China, and cancer incidence data for Los Angeles were extracted from Cancer Incidence in Five Continents plus database. A Joinpoint regression model was used to analyze the temporal trends of incidence and mortality for breast, cervical, corpus uteri and ovarian cancers. The standardized incidence ratios were applied to compare the cancer risk across populations. An increasing trend of incidence rate for breast, cervical, corpus uteri and ovarian cancer was observed in Changle, although the rate leveled off for breast and cervical cancer after 2010, although not statistically significant. The mortality rate of breast and ovarian cancer was slightly increased during this period, while we found a decreased mortality of cervical cancer from 2010. The mortality of corpus uteri cancer showed a decreasing and then increasing trend. The incidence of breast, corpus uteri and ovarian cancer in Chinese American immigrants in Los Angeles was significantly higher than indigenous Changle Chinese and lower than Los Angeles whites. However, the incidence of cervical cancer in Chinese American immigrants shifted from significantly exceeding to lower than Changle Chinese. The incidence and mortality of women's cancers in Changle were generally on the rise, and this study concluded that environmental changes were important factors affecting the occurrence of these cancers. Appropriate preventive measures should be taken to control the occurrence of women's cancers by addressing different influencing factors.

Immunogenicity, efficacy,and safety of human papillomavirus vaccine: Data fromChina.

The incidence rate and mortality rate of cervical cancer have steadily increased in young women in China. Therefore, it is critical to improve HPV vaccination rates, particularly for the younger population. There are currently five types of prophylactic vaccines in China: bivalent HPV vaccine (AS04-HPV-16/18), quadrivalent HPV vaccine, 9-valent HPVvaccine, homemade Escherichia coli-produced HPV bivalent vaccine, and Pichia pastoris produced HPV bivalent vaccine. All these five HPV vaccines have completed relevant clinical trials in China, and have been proven to be generally well-tolerated and immunogenic, efficacious against persistent HPV-related infections and genital precancerous lesions (data for 9-valent HPV vaccine is absent), and have demonstrated acceptable safety profiles, as previously shown in global studies. Given that the HPV vaccination rate in China is still very low, additional HPV vaccine coverage is needed to reduce the incidence and mortality rates of cervical cancer.

Utilization of cervical cancer screening services and its associated factors in Iran: a case–control study

BackgroundConsidering the high incidence rate of cervical cancer (CC) in Iran, screening is an effective way of reducing the impact of the disease due to early detection. Thus, the recognition of the factors affecting the use of cervical cancer screening (CCS) services is essential.The present study aimed to determine the associated factors of CCS in women living in the suburbs of Bandar Abbas in the south of Iran.MethodsThe present case–control study was conducted between January and March 2022 in the suburban areas of Bandar abbas. Two hundred participants were assigned to the case group and 400 participants were assigned to the control group. A self-constructed questionnaire was used to collect the data. This questionnaire contained demographic information, reproductive information, knowledge of CC, knowledge of CCS and access to the screening. Univariate and multivariate regression analyses were run to analyze the data. The data were analyzed in STATA 14.2 at a significance level of p < 0.05.ResultsThe mean and standard deviation of participants’ age in the case group was 30.33 ± 4.892, and in the control group was 31.35 ± 6.149. The mean and standard deviation of knowledge in the case group was 10.21 ± 1.815 and in the control group was 7.24 ± 2.447. The mean and standard deviation of access was 43.72 ± 6.339 in the case and 37.17 ± 4.828 in the control group. The results of multivariate regression analysis showed the following factors increased the odds of CCS: knowledge (OR medium = 18.697, OR high = 13.413), access (OR medium = 4.028, OR high = 8.126), being married (OR = 3.193), being educated (OR diploma = 2.587, OR university degree = 1.432), middle and high SES (OR Middle = 6.078, OR Upper = 6.608), and not smoking (OR = 1.144). Also, women's reproductive status, including history of sexually transmitted diseases (OR = 2.612), use of oral contraceptives (OR = 1.579), sexual hygiene (OR = 8.718).ConclusionsIn the light of the present findings, it can be concluded that besides increasing suburban women’s knowledge, their access to screening facilities should be improved. The present findings showed the need to remove the barriers to CCS in women of low SES to increase the rate of CCS. The present findings contribute to a better understanding of factors involved in CCS.

Detection of HPV Infection and the Current Status of Vaccine Research: A Review

Objectives: Purpose of this narrative review is to comprehensively summarize and compare the methods of human papilloma viruses (HPV) detection to provide a reference for clinical selection. And it also concludes the research progress of preventive HPV vaccines and therapeutic HPV vaccines to provide new ideas for the future development of HPV vaccines. Mechanism: A comprehensive search of published relevant articles was conducted. Multiple database were searched including PubMed, SCOPUS, and Ovid. Searches included the key terms: human papilloma viruses (HPV), HPV infection, epidemiology, HPV vaccine, cervical cancer (CC) screening, detection technology. Findings in Brief: HPV is a sexually transmitted virus and also a common cause of female reproductive tract infections. HPV has been reported to be associated with approximately 5% of human cancers worldwide, among which high-risk HPV (HR-HPV) infection is the most closely related to cervical cancer. The advantages of using HPV testing for cervical cancer screening are the high long-term negative predictive value (NPV), the high sensitivity (90–95%) for cervical intraepithelial neoplasia (CIN) 2 or 3, and the significant reduction in CIN2/3 and cancer in test-negative women over long term follow-up. The current detection of HPV infection is mainly for HPV DNA, RNA and oncoprotein, and vrious methods have their own features. Currently, there is no treatment for an HPV infection, so prevention is the key to cancer reduction. HPV vaccine is an important means to reduce the incidence rate of HPV infection and HPV related cervical cancer. Conclusions: With the development of assay technology, assays with low cost, high versatility and operability will be needed in the future. The HPV vaccine, as a primary prevention measure for cervical cancer, has achieved significant results in preventing HPV infection and reducing the incidence of reproductive tract diseases. In the future, it is expected that the HPV vaccine will make significant breakthroughs in the treatment of current HPV infections and cervical cancer.

Knowledge and Awareness of Human Papillomavirus Vaccination and Cervical Cancer among Men and Women in Japan: A Questionnaire Survey.

In many advanced countries other than Japan, the incidence and mortality rates of cervical cancer, which is mainly caused by the human papillomavirus (HPV) infection, are decreasing probably due to the high rate of HPV vaccination and cervical cancer screening. In Japan, these rates are on the rise owing to the stagnation of vaccination and low screening rate. To improve these situations, active promotion of HPV vaccination and screening is required. As a preliminary stage, we investigated perceptions regarding cervical cancer and HPV vaccines among Japanese men and women and examined the difference in perceptions by sex. This was a prospective cross-sectional questionnaire survey targeting Sojo University students and working adults. University students were targeted before learning about cervical cancer. Working adults were recruited on the basis of information from the Health Promotion of Health and Welfare Department of Kumamoto Prefectural Government in Japan and from companies via student organizations promoting cancer prevention. We surveyed respondents' knowledge and awareness about HPV vaccination and cervical cancer and performed logistic regression analysis to compare the results between men and women. A total of 557 completed questionnaires (205 men and 352 women) were analyzed. Women had high levels of knowledge and awareness about HPV vaccination and cervical cancer compared with men. However, 70% of women surveyed had never been screened for cervical cancer. A total of 557 completed questionnaires (205 men and 352 women) were analyzed. Women had high levels of knowledge and awareness about HPV vaccination and cervical cancer compared with men. However, among surveyed women, the degree of knowledge and awareness was lower than that among women in other countries with established HPV vaccination programs. Furthermore, 70% of women surveyed had never been screened for cervical cancer.

Disparities among Japanese municipalities in recommendations for routine and catch-up HPV vaccinations.

In November 2021, the government of Japan announced a reversal of its decision in 2013 to suspend the previous proactive recommendation for HPV vaccination. However, the program for young girls to receive routine and catch-up vaccinations has not necessarily developed as expected. We conducted a nationwide questionnaire survey by mail in September 2022. The survey was mailed to 133 municipalities consisting of all cities/wards of the Tokyo and Osaka Prefectures and all other prefectural capital cities. Responses were received from 82 municipalities (62.7%). Notification of routine HPV vaccinations had already been sent to 76 (92.7%) of the municipalities; 70 (85.4%) had been encouraged to promote catch-up vaccinations. The questionnaire forms for registration and pre-vaccination screening for routine immunization had been sent to 74.1% (60/81) of the municipalities and 68.8% (55/80) for catch-up immunizations. For catch-up vaccination, only 54 municipalities (65.9%) had detailed vaccination records for those eligible. In total, 10 municipalities (12.2%) had virtually no vaccination records because these had already been discarded. In addition, 61 municipalities (74.4%) had notified only women and girls eligible for a catch-up vaccination based on their vaccination record, whereas 25.6% (21/82) of the municipalities reported that they had sent, or would send, the notification to all women and girls within the targeted grades, including those who had already been vaccinated with three injections. The survey revealed disparities among the municipalities in their HPV vaccine notification processes. Future research on monitoring HPV vaccination rates and incidence rates of cervical cancer and precancerous lesions in each municipality will be desirable.

Preferences for Breast and Cervical Cancer Screening Among Women and Men in Kenya: Key Considerations for Designing Implementation Strategies to Increase Screening Uptake.

Breast and cervical cancer incidence rates and mortality rates in Kenya are high. Screening is globally accepted as a strategy for early detection and downstaging of these cancers for better outcomes, but despite the efforts established by the Kenyan government to provide these services to eligible populations, uptake has remained disproportionately low. Using data from a larger study aimed at understanding the implementation and scale-up of cervical cancer screening services, we analyzed data to compare the preferences for breast and cervical cancer screening services between men and women (25-49years) in rural and urban communities in Kenya. Participants were recruited in concentric circles starting at the center of six subcounties. One woman and one man per household were enrolled for data collection on a continuous basis. More than 90% of both men and women had a monthly income of less than US $500. The top three preferred sources of information on screening for cancers affecting women were health care providers; community health volunteers; and media such as television, radio, newspapers, and magazines. More women (43.6%) than men (28.0%) trusted community health volunteers to provide health information on cancer screening. Printed materials and mobile phone messages were preferred by approximately 30% of both genders. Over 75% of both men and women preferred an integrated model of service delivery. These findings show that there are many similarities that can be leveraged when designing implementation strategies for population-wide breast and cervical cancer screening hence reducing the challenge of addressing diverse preferences of men and women which may not be easy to reconcile.

Knowledge, Attitude and Practice on Cervical Cancer Screening Among Female Reproductive Health Clients in Zewditu Memorial Hospital, Addis Ababa, Ethiopia

<i>Background: </i>Cervical cancer is the most common gynaecologic malignancy among women. In general, poor level of awareness, lack of effective screening program, overshadowed by other health concerns (such as AIDS, TB, cardiovascular and mental health), and lack of attentiveness to women’s health are a few of the possible factors for the noticed higher incidence rate of cervical cancer in Ethiopia.<i> Objective: </i>To assess the level of knowledge, attitude, and practice on cervical cancer screening among reproductive health clients aged 18-49 of Zewditu Memorial Hospital, Addis Ababa, Ethiopia. <i>Methods:</i> The study design was a cross-sectional descriptive study, conducted on 237 women who were enrolled with a simple random sampling method from March to October 2020. A structured pretested questionnaire was carried out to gather data and the collected data were entered into SPSS version 23 for analysis. Descriptive analysis using frequency, percentages, mean, and SD with bivariate analysis and multiple regressions was done. <i>Result: </i>About three-quarters (75.1%) of the participants heard about cervical cancer and out of the total participants 59% of them were found to have adequate knowledge, 58.2% with a positive attitude, and 51% of the participants were screened for cervical cancer. Lack of information about cervical cancer was the most reported reason for not attending cervical cancer screening. <i>Conclusion and recommendation:</i> The study showed more than half of the respondents had adequate knowledge, attitude, and practice on cervical cancer and screening for a premalignant cervical lesion. But still, there is a need to promote cervical cancer screening among women by informing them on their susceptibility to cervical cancer and encouraging a belief that active and regular screening can detect cervical cancer at the precancerous stage, hence enabling the early treatment and prevention of cancer development.

HPV and Cervical Cancer: A Review of Epidemiology and Screening Uptake in the UK.

Cervical cancer is the fourth most common malignancy in females worldwide, and a leading cause of death in the United Kingdom (UK). The human papillomavirus (HPV) is the strongest risk factor for developing cervical intraepithelial neoplasia and cancer. Across the UK, the national HPV immunisation programme, introduced in 2008, has been successful in protecting against HPV-related infections. Furthermore, the National Health Service (NHS) implemented the cytology-based cervical cancer screening service to all females aged 25 to 64, which has observed a decline in cervical cancer incidence. In the UK, there has been an overall decline in age-appropriate coverage since April 2010. In 2019, the COVID-19 pandemic disrupted NHS cancer screening and immunisation programmes, leading to a 6.8% decreased uptake of cervical cancer screening from the previous year. Engagement with screening has also been associated with social deprivation. In England, incidence rates of cervical cancer were reported to be 65% higher in the most deprived areas compared to the least, with lifestyle factors such as cigarette consumption contributing to 21% of cervical cancer cases. In this article, we provide an update on the epidemiology of cervical cancer, and HPV pathogenesis and transmission, along with the current prevention programmes within the NHS.

Non-adherence to cervical cancer screening recommendations among women in Eswatini: a cross-sectional study

BackgroundIn 2018, Eswatini had the world's highest age-standardised cervical cancer incidence rate. Cervical cancer screening reduces women’s risk of invasive cervical cancer. Data on adherence to cervical cancer screening recommendations in Eswatini are scarce. The purpose of the current study was to determine Eswatini women’s self-reported adherence to cervical cancer screening recommendations, attitudes toward screening, and factors associated with non-adherence.MethodsA cross-sectional survey of women (n = 377) aged 25 to 59 accessing primary healthcare clinics (n = 4) in Eswatini assessed screening participation, attitudes and knowledge regarding cervical cancer screening, and socio-demographic variables. Adjusted logistic regression was used to assess factors associated with non-adherence to Eswatini cervical cancer screening recommendations.ResultsOne hundred and sixty-six (44%) women were classified as adherent to cervical cancer screening recommendations. Attitudinal barriers endorsed by over one-third of participants included a perceived low risk of cervical cancer (n = 161, 43%) and a view that screening is likely to be painful (n = 146, 38%). Participants had higher odds of being classified as non-adherent if they: were single compared with married (OR = 1.78, 95% CI: 1.05, 3.01, p = 0.03), perceived screening as likely painful (OR = 4.43, 95% CI: 2.62, 7.46, p < 0.001); and had not been advised by a doctor/ nurse to screen (OR = 2.82, 95% CI: 1.71, 4.64, p < 0.001). Also, a 1-year increase in age was associated with an increase in the odds of being classified as non-adherent (OR = 1.42, 95% CI: 1.39, 1.45, p = 0.01).ConclusionsSelf-reported adherence was moderate among this group of women. Tailored interventions are needed to increase participation in cervical cancer screening, especially for those women with characteristics associated with being classified as non-adherent. Primary healthcare clinic nurses (and other health providers) may contribute toward improving participation in cervical cancer screening by advising eligible women to screen and providing health education addressing negative attitudes toward screening.

A questionnaire study on disparity of cervical cancer prevention programs in Asia-Oceania.

Despite the introduction of cervical cancer screening and human papillomavirus (HPV) vaccines, the utilization pattern was not standardized. The aim of this study was to elicit the current prevention care in Asia-Oceania. An online questionnaire was circulated to different countries/cities in Asia-Oceania. The primary objective was to evaluate the coverage of HPV vaccination and cervical screening programs. The secondary objectives were to study the structures of these programs. Five case scenarios were set to understand how the respondents manage the abnormal screening results. Fourteen respondents from 10 countries/cities had participated. Cervical cancer ranked the first in Myanmar and Nepal. About 10%-15% did not have national vaccination or screening program. The estimated coverage rate for vaccination and screening varied from less than 1% to 70%, which the coverage ran in parallel with the incidence and mortality rates of cervical cancer. All regions approved HPV vaccines, although only four provided free or subsidized programs for nonavalent vaccine. Cervical cytology remained the most common screening tool, and 20%-30% relied heavily on visual inspection using acetic acid. The screening age groups varied in different regions. From the case scenarios, it was noted that some respondents tended to offer more frequent screening tests or colposcopy than recommended by international guidelines. This study revealed discrepancy in the practice of cervical cancer prevention in Asia-Oceania especially access to HPV vaccines. There is an urgent need for a global collaboration to eliminate cervical cancer by public education, reforming services, and medical training.

Population-Based Trends in Cervical Cancer Incidence and Mortality in Brazil: Focusing on Black and Indigenous Population Disparities.

This study aimed to explore trends in cervical cancer (CC) incidence and mortality rates according to race/skin color in Brazil focusing on the seriousness of the racial disparity. Data from Brazilian Population-Based Cancer Registries (PBCRs) were analyzed for trends in incidence between 2010 and 2015. For mortality, data from the National Mortality Information System were retrieved between 2000 and 2020. A self-declaration on race/skin color was collected following the classification proposed by the Brazilian Institute of Geography and Statistics - white, black, brown/mixed race, yellow, or indigenous. For the analysis, black and brown/mixed race were grouped as black. Between 2010 and 2015, 10,844 new cases of CC were registered in the participating PBCRs, distributed among white women (49.6%), black (48.0%), and other race/skin color (2.3%). Compared with white counterparts, black women had a 44% higher risk of incident CC. As for mortality, between 2000 and 2020, 108,590 deaths from CC occurred nationwide. The mean age-adjusted mortality rates according to race/skin color were 3.7/100,000 for white, 4.2/100,000 for black, 2.8 for yellow, and 6.7 for indigenous women. Taking the mortality rates in white women as a reference, there was a 27% increase in death risk in black women (RR = 1.27) and 82% in indigenous women (RR = 1.82). These findings suggest that the higher rates of incidence and mortality from CC in vulnerable populations of black and more impactfully indigenous women in Brazil remain alarming. More efficient HPV vaccination strategies synchronized with well-conducted Pap smear-based screening should be prioritized in these more vulnerable populations.

Acceptability of an integrated school-based HPV vaccination program within two districts of Tanzania: A qualitative descriptive study.

Tanzania has one of the highest cervical cancer incidence and mortality rates in sub-Saharan Africa. The Tanzanian Ministry of Health developed an integrated adolescent health program, HPV-Plus, that combines HPV vaccination with additional health services: nutritional assessments, vision screening, and vaccination for adolescent girls, and education for all genders. This qualitative descriptive study evaluated the acceptability of the HPV-Plus program in two districts in Tanzania. Key informants comprising of adolescent girls, parents, program planners, and program implementers in Njombe and Dar es Salaam Tanzania were interviewed to assess the program acceptability. Transcripts were analyzed using a team-based iterative thematic analysis approach, consisting of both inductive and deductive coding. The Theoretical Framework of Acceptability was used to guide analysis, with themes categorized according to theoretical constructs of intervention coherence, affective attitudes and perceptions, and perceived effectiveness. Overall acceptability of the HPV-Plus program was high among stakeholders. The most salient finding regarding factors that influenced HPV vaccine acceptability was largely related to education and knowledge levels surrounding the HPV, cervical cancer, and HPV vaccines. The educational component of the HPV-Plus program was key in increasing acceptability. Parents reported the lowest acceptability towards the program. This was found to be primarily due to perceptions of not being sufficiently engaged throughout program implementation. Increasing acceptability of HPV vaccination programs among key stakeholders is critical to facilitating vaccine uptake and meeting vaccination coverage targets. Our results demonstrate that the inclusion of a comprehensive education component within the HPV-Plus program was key in facilitating HPV vaccine acceptability amongst stakeholders.

Abstract C118: Differences in cervical cancer incidence and screening rates in Guam

Abstract Background: Guam population is 85.9% Asian-Pacific Islander. The cervical cancer incidence and mortality rates are higher on Guam than in the US (9.8 vs 7.4 and 7.6 vs 2.3 respectively; per 100,000 women, aged adjusted, based on 2013-2017 cases and deaths). The purpose of this study was to explore the differences in cervical cancer incidence and screening among ethnic groups on Guam. Methods: This study included 171 in situ and 146 malignant cases reported to Guam Cancer Registry from 1998-2017 (N = 317) with known age and ethnicity. The negative binomial regressions were used to compare rates adjusted for age among CHamoru (N = 189), Filipino (N = 69), and Micronesian women (N = 63) by behavior. The 2012-2018 Behavioral Risk Factor Surveillance System (BRFSS) data was utilized to compare the Pap testing screening behaviors among three major ethnic groups on Guam; including 1077 Filipino, 1598 CHamoru, and 257 Micronesians women. The primary outcome was self-reported Pap testing within 3 years (yes/no). The multivariable logistic regression model was used to assess the differences in Pap testing by ethnicity after adjusting for covariates. Results: The incidence rate ratio (IRR) of invasive cases was significantly higher for CHamoru and Micronesian women when compared to Filipino women (IRR=2.04, 95% CI: 1.19-3.49, and IRR=4.89, 95% CI: 2.69-8.86 respectively). For in-situ cases, only CHamoru women had significantly higher rates than Filipino women (IRR=2.17, 95% CI=1.23-3.86). Pap testing prevalence differed significantly between ethnic groups even after adjusting for age, income level, education level and marital status (p&amp;lt;0.001). Compared to Filipino women, CHamoru women were more likely to receive Pap test (OR=1.56, 95% CI: 1.30-1.87), and Micronesian women were less likely to be screened (OR=0.70, 95% CI: 0.52-0.94). Conclusions: There were significant differences in cervical cancer incidence and screening rates. Micronesian women had the highest invasive incidence rate but the lowest screening rates. There is a need for more outreach effort on Guam. Citation Format: Louis Dulana, Rodney Teria, Renata Bordallo, Lynne Wilkens, Grazyna Badowski. Differences in cervical cancer incidence and screening rates in Guam [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C118.

Značaj organizovanih programa skrininga raka grlića materice

According to the most recent published data from 2020, cervical cancer is among the first five most frequently diagnosed cancers in the female population. It is the second leading cause of cancer mortality in young, working women during their reproductive period. Prevention of cervical cancer through screening programs has been applied since the 1960s, and the scientific community agrees that it is a highly preventable disease with a strong possibility for cure if detected in a premalignant and early malignant phase and effective treatment administrated without delay. Countries that effectively implement organized screening programs record a significant decrease in the incidence and mortality rates of cervical cancer. Their experience can be useful as a model for countries that still do not have established organized programs or have an unsatisfactory level of implementation or quality. These are mainly underdeveloped and developing countries, where exposure to risk factors is still very high, preventive activities are limited and consequently, the burden of cervical cancer is still at a very high level. The challenge remains how to adapt screening program strategies to the conditions of those countries, to achieve high coverage of the target population with a test of appropriate performance, to establish control over the increasing trend and in the coming decades, to reach the targeted decline in incidence and mortality rates. So far, it is the only malignant disease for which there is scientific evidence that it can be eliminated to a frequency that will no longer represent a public health problem. Reducing the incidence rates should be an effect that would be seen at the global level and to achieve it, it is necessary to strongly support countries in establishing adequate programs of prevention and early detection of cancer supported by effective treatment and care.

Motives and attitudes of parents toward HPV vaccination: Results from the initial period of HPV vaccine rollout in Serbia.

Human papillomavirus (HPV) infection is one of the most common viral infections in sexually active population worldwide, and is the main cause of cervical cancer, which is the fourth most common cancer among women. Serbia ranks third in incidence and mortality rate of cervical cancer in Europe. We conducted a cross-sectional study considering parents' motivation for the HPV vaccination of their children. Statistical analysis included descriptive statistics and a logistic regression model. We found that the strongest motive was "Recommendation from paediatrician" (20.2%), followed by the attitude that HPV vaccine protects against cancers in different localization (15.4%), the motive "It is better to vaccinate a child than expose them to potential risk of HPV infection" (13.3%) and "Feeling anxiety due to a possible infection and cancer in the child" (13.1%). For those parents that vaccinated their child for some other strongest motive, reasons like "Vaccine is free of charge", "Recommendation from friends and family" and motive "My child received all obligatory vaccines, so I want to receive this one as well", were significantly more frequently selected. In the group where paediatricians' recommendation was not a motive for accepting the HPV vaccine, the largest percentage of parents (89.6%) selected motive "HPV vaccine protects against cancers in different localization" and the motive "It is better to vaccinate a child than expose them to potential risk of HPV infection" (78.1%). Paediatrician's recommendation is very important for parents' decision to vaccinate, however, other motives also influenced and had significance in making the parents' decision to vaccinate their children against HPV. Encouraging trust in public health authorities in Serbia, highlighting the advantages of the HPV vaccine and further encouraging healthcare workers to give stronger recommendations can increase the HPV vaccine uptake. Finally, we provided the basis to create more targeted messages that will empower parents to vaccinate their children.

Abstract A118: Uptake of cervical cancer screening services in urban Zimbabwe: Healthcare provider perspectives

Abstract Background: In sub-Saharan Africa, Zimbabwe is among the top 6 countries with the highest cervical cancer incidence and mortality rates. Despite the disproportionate and growing burden, uptake of cervical cancer screening remains low. Little is known about the perceptions of healthcare providers who play a vital role in the provision and implementation of cervical cancer screening. This study explores healthcare provider perceptions of the factors that influence the uptake of cervical cancer screening in Zimbabwe. Methods: One-on-one in-depth interviews were conducted with healthcare providers currently or previously involved in cervical cancer prevention programs at select hospitals and clinics in Harare and Chinhoyi – two urban cities in Zimbabwe. A deductive thematic approach was used to analyze qualitative data to understand factors influencing the provision and uptake of cervical cancer screening. Results: We conducted 21 interviews with healthcare providers working in cervical cancer prevention for an average of 4 years. Three main themes related to the provision of cervical cancer screening were funding availability through donor support, demand of screening services, and availability of technical and human resources. Experiencing symptoms and no-cost screening services were perceived as facilitators for uptake of cervical cancer screening, while lack of adequate health education about cervical cancer and misconceptions about the screening procedure and outcomes were perceived as barriers to uptake of screening. Majority of the providers recommended increased sensitization and health education through various platforms; outreach initiatives; and training of more healthcare providers to conduct cervical cancer screening. Conclusion: This study contributes to a holistic understanding and identification of intervention points to effectively increase uptake of cervical cancer screening. Multi-level strategies promoting awareness of cervical cancer screening and strengthening healthcare systems may contribute significantly to increasing cervical cancer screening rates which in turn will lead to reducing the burden of cervical cancer in Zimbabwe. Citation Format: Thembekile Shato, Ucheoma Nwaozuru, Eric Adjei Boakye, Qiang John Fu, Juliet Iwelunmor, Anne Sebert Kuhlmann. Uptake of cervical cancer screening services in urban Zimbabwe: Healthcare provider perspectives [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A118.

Trends and future projections of cervical cancer-related outcomes in Japan: What happens if the HPV vaccine program is not implemented?

Contrary to other developed countries, in Japan, recent years have seen increases in cervical cancer incidence and mortality among young people. However, the human papillomavirus (HPV) vaccine program, a key measure for avoiding cervical cancer, has been virtually suspended. Temporal changes in cervical cancer profiles in this unique situation have not been fully investigated epidemiologically. Our study aimed to determine the current status and future trends of the incidence and mortality of cervical cancer and precancerous lesions in Japan. Mortality rates of cervical cancer during 1975 to 2016 and incidence rates of cervical cancer and cervical intraepithelial neoplasia (CIN) 3 during 1975 to 2013 were examined using vital statistics and population-based cancer registry data in Japan. Bayesian age-period-cohort analyses were performed to analyze temporal changes of the three cervical cancer-related outcomes. We also calculated projections to 2028 for the three outcomes, assuming that HPV vaccination coverage and screening rates in Japan would be maintained at the current level after the resumption of the national vaccination program. The risk of occurrence of the three outcomes showed similar changes by birth cohort, peaking in the mid-1890s to 1900s birth cohorts, declining sharply in the 1940s birth cohort, and persistently increasing in the 1950s and later birth cohorts. Projections to 2028 show increases in cervical cancer incidence and mortality in the 30 to 69 age group, with a particular increase in CIN3 incidence in the 25 to 49 age group, if HPV vaccine programs and screening are not effectively implemented. These findings revealed an increasing cervical disease burden among reproductive age females in Japan.

Cervical Cancer in Young Females: A Short Communication

The lower portion of the uterus that links to the vagina, or the cervix, is where the cells of the cervical cancer develop [1]. The fourth most frequent type of cancer and the fourth most common reason for cancer-related death in women globally is cervical cancer [2]. While cervical cancer can affect women of any age, it is typically detected in younger females between the ages of 30 and 49 [3]. Due to anti-Human Papillomavirus (HPV) vaccines and population-based cervical cancer screening programmes, the incidence and mortality rates of cervical cancer have decreased during the past few decades. Epidemiological research, however, indicates a rise in the prevalence of cervical cancer among young women [2].