Disparity of Cervical Cancer Risk in Young Japanese Women: Bipolarized Status of HPV Vaccination and Cancer Screening.
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ABSTRACT:
SUBMITTER: Taniguchi M
PROVIDER: S-EPMC8003385 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:AbstractHuman papillomavirus (HPV) vaccination in young women is low. Women aged 21 to 65 years in the United States (U.S.) have not reached the Healthy People 2020 objective of 93% for cervical cancer screening. The main aim of this study was to investigate the association between HPV vaccination status and cervical cancer screening among privately insured women aged 21 to 26 years in the U.S.This was a retrospective cohort study using the IBM MarketScan database (2006-2016). The study population included 190,982 HPV-vaccinated women and 763,928 matched unvaccinated women. Adjusted incidence rate ratio (IRR) and the 95% confidence intervals (CIs) were obtained using the generalized estimating equations models with a Poisson distribution.Among a total of 954,910 women included in the analysis, age (mean [SD]) was 23.3 [1.6] years. During 967,317 person-years of follow-up, a total of 475,702 incidents of cervical cancer screening were identified. The incidence density rates of cervical cancer screening were 461 per 1000 person-years (PY) for unvaccinated women and 787 per 1000 PY for those who received 3 doses of the HPV vaccine. After adjusting for other covariates, the IRR of cervical cancer screening was 34% higher among HPV-vaccinated women with at least one vaccine dose than unvaccinated women (adjusted IRR = 1.34, 95% CI: 1.33-1.35; P < .0001). The IRR of cervical cancer screening varied by the dose of HPV vaccination. There was evidence of a linear dose-response relationship between the number of HPV vaccine doses and cervical cancer screening (P-trend < .0001). Compared with unvaccinated women, the IRR of cervical cancer screening were 14%, 39%, and 60% higher among those who received 1, 2, and 3 doses of the HPV vaccine, respectively.In this large retrospective cohort study of privately insured women, HPV-vaccinated women were more likely to be screened for cervical cancer compared with unvaccinated women.
| S-EPMC8519251 | biostudies-literature
Project description:IntroductionIn Japan, two groups of women, HPV vaccinated and unvaccinated, are approaching age 20, when they should begin cervical cancer screening. To improve Japan's current poor cervical cancer screening rate, we need to know how these women are thinking about screening.MethodsWe conducted an internet survey of 20-y-old women, exploring their understanding of HPV and cervical cancer screening. We then gave them leaflets with basic information about HPV and cervical cancer, stressing the importance of early detection by screening. We analyzed the leaflet's effects on their attitudes based on their vaccination status.ResultsOur study of 618 women found a significantly higher intention for engagement for cervical cancer screening in women HPV-vaccinated as teenagers (29% versus 17%). They were also more aware that: (1) HPV is transmitted by sexual intercourse (49.1% versus 39.2%); (2) the HPV vaccine prevents cervical cancer (49.0% to 34.0%); and (3) the appropriate cervical cancer screening interval is every 2 y (63.3% versus 56.2%). Women in both groups responded well to the leaflet, with significant improvements in intention to receive screening. However, 65%-67% were not swayed.DiscussionHPV-vaccinated women were more knowledgeable about cervical cancer and had a greater intention to receive screening. Our educational leaflet was moderately effective in both groups for increasing intentions to screen, but the majority in both groups were still resistant to screening.ConclusionJapan needs to develop more effective educational programs and tools to vigorously impart the importance of cervical cancer screening.
| S-EPMC7899660 | biostudies-literature
Project description:BackgroundThis study assessed awareness, attitudes, and uptake of human papillomavirus (HPV) vaccination and cervical cancer screening in detained women.MethodsThe cross-sectional study was conducted from April to June 2022 in four women prisons in Italy.Results41.1% of participants recognized HPV infection as an sexually transmitted diseases (STD), 36.4% identified cervical, and 16.8% oral cancer as an HPV-associated disease. Overall, 70% had never heard of HPV vaccination, and 45.8% believed it is effective to prevent cervical cancer. Among the age-eligible women for HPV vaccination, none reported to have undergone it, nor had talked about it with a physician in the previous year. Only 13.5% declared to have ever undergone cervical cancer screening, and adherence was significantly higher in those who were involved in a working activity in prison, who were aware that HPV infection is an STD and that can cause cervical and oral cancer, and who were older at their first sexual intercourse.ConclusionThese findings documented an extremely low awareness of HPV infection and an unsatisfactory adherence to prevention through HPV vaccination and cervical cancer screening. There is a need for evidence-based interventions for incarcerated women to promote participation in HPV vaccination and cervical cancer screening programs as routine activities.
| S-EPMC9416201 | biostudies-literature
Project description:In Japan, public funding for HPV vaccination began in 2010 for girls aged 13-16 years (birth cohort years 1994-1997) and women born in 1994 who turned 25 in 2019. We aimed to verify the long-term effectiveness of the bivalent HPV vaccine in women aged 25 years. Subjects were women aged 25-26 years who underwent cervical cancer screening and HPV testing in Niigata from 2019 to 2020 (birth cohort years 1993-1994). Information on vaccination status and sexual behavior was obtained from a questionnaire and municipal records. We compared the HPV infection rates of the vaccinated and unvaccinated groups. Of the 429 registrants, 150 (35.0%) and 279 (65.0%) were vaccinated and unvaccinated, respectively. The average period from HPV vaccination to HPV testing was 102.7 months (8.6 years), with a median of 103 months (range 92-109 months). The HPV high-risk infection rate was 21.3% (32/150) in the vaccinated group and 23.7% (66/279) in the unvaccinated group (P = 0.63). The HPV16/18 infection rate was 0% (0/150) in the vaccinated group and 5.4% (15/279) in the unvaccinated group, showing a significant difference (P = 0.0018), and the vaccine effectiveness was 100%. The cross-protective type HPV31/45/52 infection rate in the vaccinated group was significantly lower than that in the unvaccinated group (3.3% vs. 10.0%, P = 0.013). There was no significant difference in the mean age at sexual debut and the number of previous sexual partners between the two groups. We have demonstrated the long-term 9-year effectiveness of the bivalent vaccine against HPV infection for the first time in Japan.
| S-EPMC8990292 | biostudies-literature
Project description:Eradication of cervical cancer involves the expansion of human papillomavirus (HPV) vaccine coverage and the development of efficient screening guidelines that take vaccination into account. In Korea, the HPV National Immunization Program was launched in 2016 and is expected to shift the prevalence of HPV genotypes in the country, among other effects. The experiences of another countries that implement national immunization programs should be applied to Korea. If HPV vaccines spread nationwide with broader coverage, after a few decades, cervical intraepithelial lesions or invasive cancer should become a rare disease, leading to a predictable decrease in the positive predictive value of cervical screening cytology. HPV testing is the primary screening tool for cervical cancer and has replaced traditional cytology-based guidelines. The current screening strategy in Korea does not differentiate women who have received complete vaccination from those who are unvaccinated. However, in the post-vaccination era, newly revised policies will be needed. We also discuss on how to increase the vaccination rate in adolescence.
| S-EPMC5956112 | biostudies-literature
Project description:The prevalence of cervical cancer among women aged 20-30 years has been increasing. A better understanding of the factors correlated with cervical cancer screening is vital to better identify suitable candidates and develop effective interventions. However, few studies have examined factors correlated with cervical cancer screening using a quantitative research design. Thus, this study aimed to assess the prevalence of and factors correlated with cervical cancer screening among unmarried and sexually active Japanese women aged 20-29 years.Seven hundred Japanese women who responded to an internet-based cross-sectional survey conducted by a marketing research company in 2015 were enrolled. Associations between lifetime cervical cancer screening and demographic profile, sexual behavior, and psychosocial factors were assessed via univariate analysis. Variables indicating significance (P?<?0.05) were used in the univariate analysis to determine adjusted odds ratios (AOR).Overall, 383 (54.7%) respondents underwent cervical cancer screening during their lifetime. Multiple regression analysis indicated that age, employment status, income, lifetime number of sex partners, human papillomavirus (HPV) vaccination, receipt of a free coupon for cervical cancer screening from the local government, perceived susceptibility and logistical barriers (cost/time), and confidence of receiving Pap testing from a male physician were significantly correlated with lifetime cervical cancer screening. Individuals aged 28-29 years (AOR?=?1.86) and those with full-time employment (AOR?=?3.30), income ? ¥ 4,000,000($35,000) (AOR?=?1.60), >?5 lifetime sex partners (AOR?=?1.97), HPV vaccination (AOR?=?4.88), coupon from the local government (AOR?=?3.14), higher perceived level of cervical cancer susceptibility (middle, AOR?=?1.77; high, AOR?=?3.23), lower perceived logistical barriers (middle, AOR?=?0.55; high, AOR?=?0.31), and higher confidence of receiving pap testing from a male physician (AOR?=?2.66) were more likely to undergo cervical cancer screening.Women who were younger and unemployed and those with lower perceived cervical cancer susceptibility, higher perceived logistical barriers, and lower confidence of receiving Pap testing from a male physician were less likely to undergo lifetime cervical cancer screening. Thus, to increase the cervical cancer screening rate among young women, it may be effective to target younger unemployed women, provide interventions to increase perceived susceptibility, and recommend tests while considering psychosocial barriers.
| S-EPMC6069882 | biostudies-other
Project description:BACKGROUND:In Nicaragua, cervical cancer is the leading cause of cancer-related death for women ages 15-44, yet access to the HPV vaccine is limited to those with financial resources to pay for it. Cervical cytology is provided free of charge in public clinics; however, only 10% of women receive Pap smears at the nationally recommended frequency. Previous studies have not investigated how beliefs regarding cervical cancer screening may differ for urban and rural populations in Nicaragua. Furthermore, no investigation has assessed Nicaraguan women's beliefs about a potential HPV immunization campaign. Given beliefs' influence on health behavior, we investigated the structural, sociocultural, and knowledge-based factors influencing women's beliefs regarding cervical cancer screening among urban and rural women in León, Nicaragua, and assessed acceptance of a potential HPV immunization program. METHODS:Our sequential explanatory mixed-methods study consisted of two phases: (1) a close-ended questionnaire, followed by (2) a qualitative, in-depth interview. Our quantitative sample contained 117 urban and 112 rural participants aged 18-49. We assessed beliefs regarding cervical cancer screening using a 22-item scale, with higher scores indicating screening-promoting beliefs in simple linear and multiple linear regressions. Twenty qualitative interviews, exploring the sociocultural dimensions of knowledge and attitudes indicated by our quantitative findings, were conducted with a sample of 13 urban and 7 rural women aged 19-46. RESULTS:The multiple linear regression indicates that greater knowledge of Pap smears, HPV, and cervical cancer is significantly associated with screening-promoting beliefs after adjusting for other relevant factors. There was no significant difference in screening knowledge and beliefs for urban and rural women. Four recurrent themes representing determinants of knowledge, beliefs, and attitudes regarding cervical cancer screening arose from interviews and built on quantitative findings: (1) women's embarrassment due to the intimate nature of the Pap smear and male gender of exam provider discourages screening; (2) women believe Pap smears and cervical cancer are associated with sexual promiscuity, and this association stigmatizes women with the disease; (3) knowledge of cervical cancer prevention is limited to those who regularly attend health centers; and (4) women find screening inconvenient, believing understaffed clinics increase patient wait time, limit time patients spend with clinicians, and delay Pap results. A fifth theme indicates (5) participants' acceptance of a potential HPV immunization program. DISCUSSION:Future interventions should focus on increasing access to information about cervical cancer prevention for women who do not regularly attend health centers. Furthermore, our results suggest that if funding were allocated to make the HPV vaccine accessible in Nicaragua, it would be well received.
| S-EPMC5660604 | biostudies-literature
Project description:BackgroundThe rise in cervical cancer trends in the past two decades has coincided with the human immunodeficiency virus (HIV) epidemic especially in the sub-Saharan African region. Young people (15 to 24?years old) are associated with many risk factors such as multiple sexual partners, early sexual debut, and high HIV incidences, which increase the chances of developing cervical cancer. The National Cancer Prevention and Control Strategy for Zimbabwe (2014-2018) highlights that no cancer communication strategy focusing on risk factors as primary cancer prevention. Therefore, the study aims to determine the knowledge, attitude and practices of young people in Zimbabwe on cervical cancer, screening, human papillomavirus (HPV) and vaccination.MethodsA cross-sectional survey assessing young people's knowledge, attitude and practices concerning cervical cancer was conducted in five provinces in Zimbabwe. A total of 751 young people were recruited through a three-stage cluster design from high schools and universities. Knowledge, attitudes and practices were assessed using questions based and adapted from the concepts of the Health Belief Model (HBM) and the Cervical Cancer Measuring tool kit-United Kingdom (UK).ResultsMost young people, 87.47% (656/750) claimed to know what the disease called cervical cancer is, with a mean score of 89.98% [95% CI 73.71.11-96.64] between high school and 86.72% [95% CI 83.48-89.40] among university students. There was no significant difference in mean scores between high school and university students (p?=?0.676). A risk factor knowledge proficiency score of ?13 out of 26 was achieved in only 13% of the high school respondents and 14% of the university respondents with a broad range of misconceptions about cervical cancer risk factors in both females and males. There was not much difference on comprehensive knowledge of cervical cancer and its risk factors between female and male students, with the difference in knowledge scores among high school (p?=?0.900) and university (p?=?0.324) students not statistically significant. In contrast, 43% of respondents heard of cervical cancer screening and prevention, and 47% knew about HPV transmission and prevention. Parents' educational level, province and smoking, were some of the factors associated with knowledge of and attitude towards cervical among high school and university students.ConclusionThis study revealed that young people in Zimbabwe have an idea about cervical cancer and the seriousness thereof, but they lack adequate knowledge of risk factors. Cervical cancer education and awareness emphasising causes, risk factors and care-seeking behaviours should be commissioned and strengthen at the community, provincial and national level. Developing a standard cervical cancer primary prevention tool that can be integrated into schools can be a step towards addressing health inequity.
| S-EPMC6712720 | biostudies-literature
Project description:We conducted a critical appraisal of published Phase 2 and 3 efficacy trials in relation to the prevention of cervical cancer in women. Our analysis shows the trials themselves generated significant uncertainties undermining claims of efficacy in these data. There were 12 randomised control trials (RCTs) of Cervarix and Gardasil. The trial populations did not reflect vaccination target groups due to differences in age and restrictive trial inclusion criteria. The use of composite and distant surrogate outcomes makes it impossible to determine effects on clinically significant outcomes. It is still uncertain whether human papillomavirus (HPV) vaccination prevents cervical cancer as trials were not designed to detect this outcome, which takes decades to develop. Although there is evidence that vaccination prevents cervical intraepithelial neoplasia grade 1 (CIN1) this is not a clinically important outcome (no treatment is given). Trials used composite surrogate outcomes which included CIN1. High efficacy against CIN1+ (CIN1, 2, 3 and adenocarcinoma in situ (AIS)) does not necessarily mean high efficacy against CIN3+ (CIN3 and AIS), which occurs much less frequently. There are too few data to clearly conclude that HPV vaccine prevents CIN3+. CIN in general is likely to have been overdiagnosed in the trials because cervical cytology was conducted at intervals of 6-12 months rather than at the normal screening interval of 36 months. This means that the trials may have overestimated the efficacy of the vaccine as some of the lesions would have regressed spontaneously. Many trials diagnosed persistent infection on the basis of frequent testing at short intervals, i.e. less than six months. There is uncertainty as to whether detected infections would clear or persist and lead to cervical changes.
| S-EPMC7068772 | biostudies-literature
Project description:A research project is currently being undertaken looking at Human Papilloma Virus (HPV) vaccination in special risk groups. It aims to see if young women with a chronic illness respond well to the HPV vaccine or whether they may require additional doses to ensure protective immunity. The four valent HPV vaccine protects against HPV types 16 & 18, cervical cancer and HPV types 6 & 11, anogenital warts.
The six special risk groups include:
Paediatric Rheumatological Disease Inflammatory Bowel Disease Acute Lymphoblastic Leukaemia Solid Organ Transplant Recipients (kidney and liver) Chronic Renal Disease Bone Marrow Transplants This immunity is measured by antibody levels of the HPV types, which requires a single blood test one month after the final dose of HPV vaccine.
This is compared to healthy controls using antibody response to HPV vaccine. This will assess directly whether these special risk groups respond as well to the HPV vaccine.
| 2077042 | ecrin-mdr-crc