Knowledge and attitudes toward cervical cancer, human papillomavirus (HPV), and HPV vaccination among women in Taizhou area, China

Abstract Background: Human papillomavirus (HPV) vaccine has been licensed in mainland China since 2016; however, the acceptability of HPV vaccination is unclear. This study aimed to evaluates women’s knowledge and attitudes toward cervical cancer, HPV infection and its vaccination in Taizhou area, southeast of China. Methods: A cross-sectional survey was conducted among women who visited the gynaecological clinic of Taizhou Hospital using a questionnaire-based interview. The process was divided into two periods, period I was May to August 2017, and period II was January to March 2019. Results: A total of 819 women were conducted, and 736 were included in the final analysis. Most women (92.4%) had ever heard of cervical cancer. Almost half of women had ever heard of HPV (57.5%) and HPV vaccines (53.1%). Knowledge level of cervical cancer, HPV infection and its vaccines was inadequate; only 12.2% achieved 21-30 scores (at a 30-point scale). Logistic regression analysis showed that marital status, education, occupation, and family annual income were statistically significantly related to the knowledge level ( P <0.05). Additionally, 64.8% of women knew that HPV vaccines are now available in mainland China; however, only 4.3% have been vaccinated. 37.8% of women knew about the preventable effect of HPV vaccines on cervical cancer (period I vs. period II, 31.0% vs. 48.9%, P <0.05). Although women with the low awareness of HPV, the willingness to receive HPV vaccination was high (94.1%) in the present study. Conclusion: Our survey indicated that there is an urgent need for the persistent public health education to ensure successful implementation of HPV vaccination program in Taizhou area, China. Emphasis should be directed to educate the knowledge on HPV infection and its association with cervical cancer, thereby helping to increase HPV vaccination and reduce incidence of cervical cancer.