Attitudes toward cervical cancer screening among women receiving human papillomavirus vaccination in a university-hospital-based community: interim 2-year follow-up results

Abstract

Aim: This study investigated the status of cervical cancer screening among women in a university hospital-based community who received catch-up human papillomavirus (HPV) vaccinations as a basic element of our community-based cervical cancer prevention advocacy.

Methods: Self-administered questionnaires were distributed to 173 women working or studying in the community at their first HPV vaccination in 2010, at the third vaccination, and 2 years later. Their demographics and attitudes toward the Pap test were analyzed.

Results: The median age of the participants was 27.5 years and 88.2% were sexually active. Before the first vaccination, 38.5% (57/148) of the screening targets had never had a Pap test. Among the women who completed the third vaccination, Pap test experiences within the recent 2 years increased from 45.3% (63/139) at the first vaccination to 71.2% (99/137) at the third vaccination, and 67.5% (54/80) 2 years later. In 45.3% of the screening targets who had never had a Pap test at the time of their first HPV vaccination, their first Pap test was followed by their vaccination.

Conclusions: Having biennial Pap tests in accordance with the Japanese national cancer screening guideline was shown to be difficult even for the women in the medical community; however, education about the Pap test and the efficacy of HPV vaccination in providing opportunistic screening encouraged them to have their first or suspended Pap test. Our interim data suggest the need for urgently changing the cervical cancer prevention strategy for young adult women who are excluded from the national HPV vaccine program.

Keywords: HPV vaccines; Papanicolaou smear; cervical cancer; prevention and control; public advocacy.