HPV Vaccination and Knowledge of Cervical Cancer among Female University Students in a Multiethnic Institution, USA

Crossmark: check for updates

Authors

  • Nasar U. Ahmed Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL 33199, USA
  • Michael E. Delgado Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL 33199, USA
  • Abraham Degarege Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL 33199, USA

DOI:

https://doi.org/10.17140/EPOJ-2-111

Keywords:

College students, HPV, Cervical cancer, Knowledge, HPV vaccine, Vaccination

Abstract

Objective: College-aged women are at high-risk of Human Papillomavirus (HPV) infection. Although, HPV vaccination is most effective, its rates remain quite low among college students. It may be due to inadequate understanding of the relationship between HPV and cervical cancer. Therefore, the objective of this study was to examine the level of knowledge about HPV, cervical cancer and their associations with HPV vaccination among female college students.
Methods: Cross-sectional questionnaire based survey was conducted among female students in a Multiethnic University in Florida. We assessed HPV vaccination status, annual health checkup status, knowledge about HPV and cervical cancer among the students. The response rate for the survey was 91.5%.
Results: Out of 141 students, 39.7% received HPV vaccine, and 38.3% did annual medical checkup within a year. Out of 4, the mean and the median knowledge score of students about cervical cancer was 2.87 and 3.0, respectively. A greater percentage of students who did annual health checkup (44%) received HPV vaccine than those who did not (15%). The odds of receiving HPV vaccine was nearly 5 times as much for the students who achieved knowledge scores about causes of cervical cancer greater than or equal to the median compared with the students with knowledge scores below the median (adjusted odds ratio [aOR]:4.85, 95% confidence  interval [CI]:2.15, 10.92). The odds of receiving HPV vaccine was almost three times as much of students who knew that HPV causes cervical cancer than those who did not know it to be so (aOR:2.9, 95% CI:1.1, 8.2).
Conclusion: Receipt of HPV vaccination was associated with knowing that HPV infection is a cause of cervical cancer and that it’s preventable. HPV vaccination was also associated with annual health checkup status.

References

Centers for Disease Control and Prevention (CDC). Genital HPV Infection. Web site. http://www.cdc.gov/std/hpv/stdfact-hpv.htm. Accessed July 1, 2016.

Dunne EF, Unger ER, Sternberg M, et al. Prevalence of HPV infection among females in the United States. JAMA. 2007; 297(8): 813-819. doi: 10.1001/jama.297.8.813

Satterwhite CL, Torrone E, Meites E, et al. Sexually trans-mitted infections among US women and men: Prevalence and incidence estimates, 2008. Sex Trans Dis. 2013; 40(3): 187-193. doi: 10.1097/OLQ.0b013e318286bb53

Abma JC, Martinez GM, Copen CE. Teenagers in the United States: Sexual activity, contraceptive use, and childbearing, Na-tional Survey of Family Growth 2006-2008. Vital Health Stat. 2010; 23(30): 1-47.

Trotter EC, Alderson KG. University students’ definitions of having sex, sexual partner, and virginity loss: The influence of participant gender, sexual experience, and contextual factors. Can J Hum Sex. 2007; 16: 11-29.

Ljubojevic S, Skerlev M. HPV-associated diseases. Clin Dermatol. 2014; 32(2): 227-234. doi: 10.1016/j.clinderma-tol.2013.08.007

Gadducci A, Barsotti C, Cosio S, Domenici L, Riccardo Genazzani A. Smoking habit, immune suppression, oral contra-ceptive use, and hormone replacement therapy use and cervical carcinogenesis: A review of the literature. Gynecol Endocrinol. 2011; 27(8): 597-604. doi: 10.3109/09513590.2011.558953

Snijders PJ, Steenbergen RD, Heideman DA, Meijer CJ. HPV-Mediated cervical carcinogenesis: Concepts and clinical implications. J Pathol. 2006; 208(2): 152-164. doi: 10.1002/ path.1866

World Health Organization (WHO). World Cancer Report 2014. Washington, DC, USA: World Health Organization Press; 2014.

GLOBOCAN Cancer Fact Sheets: Cervical cancer – IARC: Cervical Cancer: Estimated Incidence, Mortality and Prevalence Worldwide in 2012. Web site. http://globocan.iarc.fr/old/Fact-Sheets/cancers/cervix-new.asp. Accessed August 18, 2016.

U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999-2013 Incidence and Mortality Web-based Re-port. Atlanta (GA): Department of Health and Human Services, Centers for Disease Control and Prevention, and National Can-cer Institute; 2016. Web site. http://www.cdc.gov/uscs. Accessed August 18, 2016.

De Vicenzo R, Conte C, Ricci C, Scambia G, Capelli G. Long-term efficacy and safety of human papillomavirus vac-cination. Int J Wom Health. 2014; 6: 999-1010. doi: 10.2147/ IJWH.S50365

Yoshikawa H, Ebihara K, Tanaka Y, Noda K. Efficacy of quadrivalent human papillomavirus (types 6, 11, 16 and 18) vac-cine (GARDASIL) in Japanese women aged 18-26 years. Can-cer Sci. 2013; 104: 465-472. doi: 10.1111/cas.12106

Chesson HW, Ekwueme DU, Saraiya M, Watson M, Lowy DR, Markowitz LE. Estimates of the annual direct medical costs of the prevention and treatment of disease associated with hu-man papillomavirus in the United States. Vaccine. 2012; 30: 6016-6019. doi: 10.1016/j.vaccine.2012.07.056

Markowitz LE, Hariri S, Lin C, et al. Reduction in human papillomavirus (HPV) prevalence among young women fol-lowing HPV vaccine introduction in the United States, National Health and Nutrition Examination Surveys, 2003–2010. J Infect Dis. 2013; 208(3): 385-393. doi: 10.1093/infdis/jit192

CDC. Surveillance of vaccination coverage among adult populations — United States, 2014. 2016; MMWR. 65(1); 1-36.

Harris RJ. A Primer of Multivariate Statistics. 2nd ed. New York, USA: Academic Press; 1985.

Green SB. How many subjects does it take to do a regression Analysis. Multivariate Behav Res. 1991; 26(3): 499-510. doi: 10.1207/s15327906mbr2603_7

Gerend MA, Magloire ZF. Awareness, knowledge, and be-liefs about human papillomavirus in a racially diverse sample of young adults. J Adolesc Health. 2008; 42(3): 237-242. doi: 10.1016/j.jadohealth.2007.08.022

Klug SJ, Hukelmann M, Blettner M. Knowledge about in-fection with human papillomavirus: A systematic review. Prev Med. 2008; 46(2): 87-98. doi: 10.1016/j.ypmed.2007.09.003

Yacobia E, Tennantb C, Ferranteb J, Palc N, Roetzheimb R. University students’ knowledge and awareness of HPV. Prev Med. 1999; 28(6): 535-541. doi: 10.1006/pmed.1999.0486

BM Corp. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY, USA: IBM Corp.; 2012.

Jones M, Cook R. Intent to receive an HPV vaccine among university men and women and implications for vaccine admin-istration. J Am Coll Health. 2008; 57(1): 23-32. doi: 10.3200/ JACH.57.1.23-32

Wong LP, Sam I. Ethnically diverse female university stu-dents’ knowledge and attitudestoward human papillomavirus (HPV), HPV vaccination and cervical cancer. Eur J Obstet Gynecol Reprod Biol. 2010; 148(1): 90-95. doi: 10.1016/j. ejogrb.2009.10.002

Iliyasu Z, Abubakar IS, Aliyu MH, et al. Cervical cancer risk perception and predictors of human papilloma virus vac-cine acceptance among female university students in north-ern Nigeria. J Obstet Gynaecol. 2010; 30(8): 857-862. doi: 10.3109/01443615.2010.511724

Friedman AL, Shepeard H. Exploring the knowledge, at-titudes, beliefs, and communication preferences of the general public regarding HPV: Findings from CDC focus group research and implications for practice. Health Educ Behav. 2007; 34(3): 471-485. doi: 10.1177/1090198106292022

Riecka T, Feigc M, Deleréa Y, Wichmannaa O. Utilization of administrative data to assess the association of an adolescent health check-up with human papillomavirus vaccine uptake in Germany. Vaccine. 2014; 32(43): 5564-5569. doi: 10.1016/j. vaccine.2014.07.105

Reiter PL, McRee AL. Correlates of receiving recommended adolescent vaccines among youth with special healthcare needs: Findings from a statewide survey. Vaccine. 2016; 34: 3125- 3131. doi: 10.1016/j.vaccine.2016.04.062

Kessels SJ, Marshall HS, Watson M, Braunack-Mayer AJ, Reuzel R, Tooher RL. Factors associated with HPV vaccine uptake in teenage girls: A systematic review. Vaccine. 2016; 30(24): 3546-3556. doi: 10.1016/j.vaccine.2012.03.063

Holman DM, Benard V, Roland KB, Watson M, Liddon N, Stokley S. Barriers to human papillomavirus vaccination among US adolescents: A systematic review of the literature. JAMA Pediatr. 2014; 168(1): 76-82. doi: 10.1001/jamapediat-rics.2013.2752

Markowitz LE, Dunne EF, Saraiya M, Lawson HW, Ches-son H, Unger ER. Quadrivalent human papillomavirus vaccine: recommendations of the Advisory Committee on Immunization Practices. MMWR. 2007; 56(RR02): 1-24.

Gilkey MB, Calo WA, Moss JL, Shah PD, Marciniak MW, Brewer NT. Provider communication and HPV vaccination: The impact of recommendation quality. Vaccine. 2016; 34: 1187- 1192. doi: 10.1016/j.vaccine.2016.01.023

Zimet GD, Weiss TW, Rosenthal SL, Good MB, Vichnin MD. Reasons for non-vaccination against HPV and future vacci-nation intentions among 19-26 year-old women. BMC Women’s Health. 2010; 10: 27. doi: 10.1186/1472-6874-10-27

Rand CM, Schaffer SJ, Humiston SG, et al. Patient-pro-vider communication and human papillomavirus vaccine ac-ceptance. Clin Pediatr. 2011; 50: 106-113. doi: 10.1177/00099 22810379907

American College Health Association. American College Health Association-National College Health Assessment II: Ref-erence group undergraduates’ executive summary fall 2015.

Gerend MA, Magloire ZF. Awareness, knowledge, and be-liefs about human papillomavirus in a racially diverse sample of young adults. J Adolesc Health. 2008; 42: 237-242.

Published

2017-09-06

How to Cite

Nasar U. Ahmed, Michael E. Delgado, & Abraham Degarege. (2017). HPV Vaccination and Knowledge of Cervical Cancer among Female University Students in a Multiethnic Institution, USA. Epidemiology, 2(1), 24–31. https://doi.org/10.17140/EPOJ-2-111