Effect of an educational intervention on Hungarian adolescents’ awareness, beliefs and attitudes on the prevention of cervical cancer

Marek, Erika; Dergez, Timea; Rébék-Nagy, Gábor; Szilard, István; Kiss, István; Ember, István; Göcze, Péter M.; D’Cruz, Gibson

doi:10.1016/j.vaccine.2012.09.012

Cited by 49 publications

(58 citation statements)

References 27 publications

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“…Lloyd and colleagues (43) observed an increase in knowledge in 13–16-year-old girls with an increase in fear but not in anxiety about infections after the distribution of a leaflet (not specific for HPV test and including other sexually transmitted diseases as well). Similar results were observed by Papa and colleagues (44) in women undergoing an HPV test and by Marek and colleagues (45) after a brief HPV-oriented program for adolescent. A limit of these two studies was the absence of information about SES.…”

Section: Resultssupporting

confidence: 87%

The Possible Effects on Socio-Economic Inequalities of Introducing HPV Testing as Primary Test in Cervical Cancer Screening Programs

2014

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Background: Screening with HPV is more effective than Pap test in preventing cervical cancer. HPV as primary test will imply longer intervals and a triage test for HPV positive women. It will also permit the development of self-sampling devices. These innovations may affect population coverage, participation, and compliance to protocols, and likely in a different way for less educated, poorer, and disadvantaged women.Aim: To describe the impact on inequalities, actual or presumed, of the introduction of HPV-based screening.Methods: The putative HPV-based screening algorithm has been analyzed to identify critical points for inequalities. A systematic review of the literature has been conducted searching PubMed on HPV screening coverage, participation, and compliance. Results were summarized in a narrative synthesis.Results: Knowledge about HPV and cervical cancer was lower in women with low socio-economic status and in disadvantaged groups. A correct communication can reduce differences. Longer intervals will make it easier to achieve high-population coverage, but higher cost of the test in private providers could reduce the use of opportunistic screening by disadvantaged women. There are some evidences that inviting for HPV test instead of Pap increases participation, but there are no data on social differences. Self-sampling devices are effective in increasing participation and coverage. Some studies showed that the acceptability of self-sampling is higher in more educated women, but there is also an effect on hard-to-reach women. Communication of HPV positivity may increase anxiety and impact on sexual behaviors, the effect is stronger in low educated and disadvantaged women. Finally, many studies found indirect evidence that unvaccinated women are or will be more probably under-screened.Conclusion: The introduction of HPV test may increase population coverage, but non-compliance to protocols and interaction with opportunistic screening can increase the existing inequalities.

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Section: Resultssupporting

confidence: 87%

The Possible Effects on Socio-Economic Inequalities of Introducing HPV Testing as Primary Test in Cervical Cancer Screening Programs

2014

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“…Safe practices might include, but are not limited to, regular usage of condoms and limiting the number of sexual partners. Therefore, health education interventions could be introduced to reduce the HPV prevalence by increasing awareness, encouraging safe sex [26], teaching about the routes of HPV transmission, and promoting the use of the HPV vaccine [27]. …”

Section: Discussionmentioning

confidence: 99%

Factors associated with genital human papillomavirus infection among adult females in the United States, NHANES 2007–2010

et al. 2014

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BackgroundPatients with human papillomavirus (HPV) infection are at risk of developing cancer later in their life. Current research estimates the prevalence of genital HPV infection and explores the factors that are associated with the infection.FindingsThe National Health and Nutrition Examination Survey 2007–2010 was used in this research study. The study population included females in the United States aged 18–59 years. The weighted prevalence of HPV infection was 41.9%. An estimated 59.4% of non-Hispanic black females had HPV infection. In a multivariate analysis, number of sexual partners, race, age, education level, marital status, income, smoking, and insurance status were associated with HPV infection. HPV infection was 5.77 times more likely for women with >11 sexual partners compared to women with 0–1 partners. Non-Hispanic black females were 1.87 times more likely to have HPV infection compared to non-Hispanic white females. Participants with only a high school degree had a 58% increased prevalence compared to college-educated women. Uninsured women had a 39% increased prevalence compared to those with insurance.ConclusionThis study found that 41.9% of U.S. females aged 18–59 years tested positive for genital HPV infection. We determined that individuals with more sexual partners, with a lower education level, with non-Hispanic black race, and with no insurance were the populations at greatest risk. It is necessary to continue monitoring the prevalence of this infection in the general population to provide a basis for effective treatment and prevention in the target populations.

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“…27,28 Perceptions Sixteen studies reported outcomes surrounding beliefs of vulnerability to HPV infection. 19,22,25,33,36,38,42,43,48,50,53,63,64,67,68,70 In four of the 16 studies, some respondents appeared unconcerned about infection with HPV or HPV-associated disease, 22,36,50,64 for example, 17.3% of 15-to 16-yearold Swedish schoolchildren did not believe they would ever be infected. 50 However, stronger intentions to accept the HPV vaccine were significantly related to greater worries about STIs other than HPV.…”

Section: Clinical Outcomesmentioning

confidence: 99%

“…24,30,31,37,39,54,62,65,66 Only two studies reported no significant association between knowledge levels and intention to be vaccinated. 22,52 Knowledge relating to the Pap smear (cervical screening) and cervical cancer was captured in 13 studies, 19,20,30,38,[44][45][46]49,50,52,54,57,64 with awareness typically recorded as poor (eight studies). 30,38,45,46,49,50,57,64 Good awareness of the need for regular Pap smears after vaccination was noted in one Italian study (93.3% of girls).…”

Section: Knowledge and Awarenessmentioning

confidence: 99%

The association of human papillomavirus vaccination with sexual behaviours and human papillomavirus knowledge: a systematic review

et al. 2014

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Since the 2008 introduction of the human papillomavirus (HPV) vaccination programme for adolescent girls in the UK, parents and other groups have expressed fears that immunisation condones sexual activity, promotes promiscuity and encourages risky sexual behaviour. This study aimed to explore whether HPV vaccination programmes have increased knowledge surrounding HPV and associated disease and whether uptake has influenced sexual behaviour. MEDLINE, Embase, Cochrane Library and PsycINFO electronic databases were interrogated. Studies of behaviour, attitudes and knowledge associated with HPV vaccination (or vaccination intent) in subjects of any age and gender in programmes reflective of UK practice were included in the review (n = 58). The evidence regarding the association of HPV vaccination with high-risk sexual behaviour was varied, primarily due to the heterogeneous nature of the included studies. Young females typically exhibited better knowledge than males, and vaccinated respondents (or those with vaccination intent) had higher levels of knowledge than the unvaccinated. However, knowledge surrounding HPV and genital warts was generally poor. This review highlights the need to provide effective education regarding the HPV vaccine and HPV-associated disease to adolescents of vaccination age, nurses, teachers, parents and guardians to ultimately allow informed decisions to be made regarding receipt of the HPV vaccine.

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Effect of an educational intervention on Hungarian adolescents’ awareness, beliefs and attitudes on the prevention of cervical cancer

Cited by 49 publications

References 27 publications

The Possible Effects on Socio-Economic Inequalities of Introducing HPV Testing as Primary Test in Cervical Cancer Screening Programs

The Possible Effects on Socio-Economic Inequalities of Introducing HPV Testing as Primary Test in Cervical Cancer Screening Programs

Factors associated with genital human papillomavirus infection among adult females in the United States, NHANES 2007–2010

The association of human papillomavirus vaccination with sexual behaviours and human papillomavirus knowledge: a systematic review

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