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BACKGROUND: This study aims to understand how criminal-legal involved women from three U.S. cities navigate different health resource environments to obtain cervical cancer screening and follow-up care. METHODS: We conducted a cross-sectional study of women with criminal-legal histories from Kansas City KS/MO; Oakland, CA; and Birmingham, AL. Participants completed a survey that explored influences on cervical cancer prevention. Responses from all women with/without up-to-date cervical cancer screening and women with abnormal Pap testing who did/did not obtain follow-up care were compared. Proportions and associations were tested with chi-square or analysis of variance tests. Multivariable regression was performed to identify variables independently associated with up-to-date cervical cancer screening and reported as odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: There were n = 510 participants, including n = 164 Birmingham, n = 108 Kansas City, and n = 238 Oakland women. Criminal-legal involved women in Birmingham (71.3%) and Kansas City (68.9%) were less likely to have up-to-date cervical cancer screening than women in Oakland (84.5%, p = 0.01). More women in Birmingham (14.6%) and Kansas City (16.7%) needed follow-up for abnormal Pap than women in Oakland (6.7%, p = 0.003), but there were no differences in follow-up rates. Predictors for up-to-date cervical cancer screening included access to a primary care provider (OR: 3.3, 95% CI: 1.4–7.7), health literacy (OR: 0.3, 95% CI: 0.2–0.7), and health behaviors, including avoiding tobacco (OR: 0.4, 95% CI: 0.1–0.9) and HPV vaccination (OR: 3.4, 95% CI: 1.0–10.9). CONCLUSIONS: Cervical cancer screening and follow-up varied by study site. The results suggest that patient level factors coupled with the complexity of accessing care in different health resource environments impact criminal-legal involved women's cervical cancer prevention behaviors.

While the benefits of human papillomavirus (HPV) vaccination relating to cervical cancer prevention have been widely documented, recent published evidence is suggestive of an impact on adverse pregnancy outcomes (APOs) in vaccinated mothers and their infants, including a reduction in rates of preterm births and small for gestational age infants. In this review, we examine this evidence and the possible mechanisms by which HPV vaccination may prevent these APOs. Large-scale studies linking HPV vaccination status with birth registries are needed to confirm these results. Potential confounding factors to consider in future analyses include other risk factors for APOs, and historical changes in both the management of cervical precancerous lesions and prevention of APOs. If confirmed, these additional benefits of HPV vaccination in reducing APO rates will be of global significance, due to the substantial health, social and economic costs associated with APOs, strengthening the case for worldwide HPV immunization.

Despite being highly preventable, cervical cancer is the fourth most common cancer and cause of cancer death in women globally. In low-income countries, cervical cancer is often the leading cause of cancer-related morbidity and mortality. Women living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome are at a particularly high risk of cervical cancer because of an impaired immune response to human papillomavirus, the obligate cause of virtually all cervical cancers. Globally, approximately 1 in 20 cervical cancers is attributable to HIV; in sub-Saharan Africa, approximately 1 in 5 cervical cancers is due to HIV. Here, the authors provide a critical appraisal of the evidence to date on the impact of HIV disease on cervical cancer risk, describe key methodologic issues, and frame the key outstanding research questions, especially as they apply to ongoing global efforts for prevention and control of cervical cancer. Expanded efforts to integrate HIV care with cervical cancer prevention and control, and vice versa, could assist the global effort to eliminate cervical cancer as a public health problem.

Cervical cancer screening practices in the United States have been inefficient, with variable screening rates. Some women are screened too frequently, overmanaged, lost to follow-up, or are at risk and should be screened but are not. Timely screening, identification, and management of abnormal cervical cells is vital in order to prevent progression to cervical cancer. Educating, counseling, screening, and offering the human papillomavirus vaccine continue to be the primary methods of cervical cancer prevention practices. Guidelines and primary screening methods have been updated because of supporting evidence, and clinicians must stay up-to-date in order to provide effective patient care.

Objective Thermal ablation (TA) was implemented in public sector cervical cancer prevention services in Zambia in 2012. Initially introduced as a treatment modality in primary healthcare clinics, it was later included in mobile outreach campaigns and clinical research trials. We report the feasibility, acceptability, safety, and provider uptake of TA in diverse clinical contexts. Methods Screening services based on visual inspection with acetic acid were offered by trained nurses to non-pregnant women aged 25-59 years. Women with a type 1 transformation zone (TZ) were treated with same-visit TA. Those with a type 2 or 3 TZ, or suspicious for cancer, were managed with same-visit electrosurgical excision or punch biopsy, respectively. A provider survey was conducted. Results Between 2012 and 2020, 2123 women were treated with TA: primary healthcare clinics, n = 746; mobile outreach clinics, n = 1127; research clinics, n = 250. Of the 996 women treated in primary healthcare and research clinics, 359 (48%) were HIV positive. Mild cramping during treatment was the most common adverse effect. No treatment interruptions occurred. No major complications were reported in the early (6 weeks) follow-up period. Providers expressed an overwhelming preference for TA over cryotherapy. Conclusion TA was feasible, safe, and acceptable in diverse clinical contexts. It was the preferred ablation method of providers when compared with cryotherapy.

Background: Reproductive health problems faced by women today are increasing infections in the reproductive organs, which in turn lead to cancer, one of that is cervical cancer. Lack of awareness to prevent cervical cancer is one of the problems that often occur in the health of Fertile Age Women. The effort that needs to be done to prevent cervical cancer is by providing health education through online media, to increase the knowledge and behavior of Fertile Age Women in preventing cervical cancer. The purpose of this research is to determine the effect of health education on early detection of cervical cancer through online media on the knowledge and behavior of Fertile Age Women in cervical cancer prevention in Nanga Public Health Center of Sikka Regency. Method of this research used a pre-experimental design with one group pre-test post-test design method, using a consecutive sampling technique, with as many as 199 respondents. The data collection tool used a questionnaire. Data were analyzed through the Wilcoxon Signed Rank Test with SPSS for windows version 20. Results of this research indicated that there was a very significant effect on the provision of health education through online media on early detection of cervical cancer on knowledge and behavior of cervical cancer prevention of Fertile Age Women in Nanga Public Health Center of Sikka Regency with a p-value of 0.000 (p < 0.05). Providing health education on early detection of cervical cancer with online media can increase knowledge and behavior of cervical cancer prevention of Fertile Age Women. It is hoped that the public health center will provide health education with online media, to support the prevention of covid-19 transmission and to increase the knowledge and behavior of Fertile Age Women in cervical cancer prevention.

The study aimed to evaluate the effectiveness of a cervical cancer prevention education program for rural Korean immigrant women. A total of 46 Korean immigrant women who had not been screened in the past three years participated. The experimental group participated in the intervention program once a week for four weeks and completed a post-program survey in week 12. Compared to the control group, significant increases were detected in level of knowledge of cervical cancer prevention ( p = .001), behavioral attitude toward cervical cancer prevention ( p = .029) and behavioral intention regarding cervical cancer prevention ( p = .005) in the experimental group. Pap screening rate of the experimental group was significantly increased ( p = .029), but the rate of change in the selection of primary care providers was not significant. The results suggest the need for a multilevel approach to address cultural and systemic barriers to Korean immigrant women in promotion of cervical cancer prevention behavior.

Cervical cancer is the second most common cancer in Solomon Islands; no national cervical screening programme currently exists. In 2015 the Solomon Islands Government invited Family Planning Austra...

Cervical cancer imposes a huge global burden. Cervical carcinoma is one of the most common and feared diseases of women, and in India, it accounts for 16 per cent of total cervical cancer cases occurring globally. The situation is more alarming in the rural areas where the majority of women are illiterate and ignorant about the hazards of cervical cancer. To date, various studies have been conducted on the risk factors associated with cervical cancer. Accumulated evidence has demonstrated the reasons by which HPV infection causes carcinogenesis. Two viral oncoproteins E6 and E7could play a key role in the HPV-infected cervical cancers. It has been documented that not all integrations necessarily depend on the E6 and E7 oncogenes expression. Currently, clinical treatment managements for cervical cancer typically include surgery, radiotherapy, and platinum-based chemotherapy. Treatment for early stage disease often is surgical therapy such as cervical conisation, total simple hysterectomy, or radical hysterectomy based on extent of spread of cervical cancer. In the recent years, a series of systemic treatments, for instance, the platinum-based chemotherapy and the recent FDA approved pembrolizumab, have applied for recurrent and advanced cervical cancer. Although screening and advanced therapeutic strategies have improved the survival rate of cervical cancer, some patients still die due to metastasis and drug resistance. Without a doubt, HPV vaccination could pre-vent the development of cervical cancer; however, many patients’ in underdeveloped countries cannot get HPV vaccination due to economic condition. The aim of this study was to investigate the incidence, mortality, and geographical distribution of cervical cancer and its risk factors in the world and study the molecular mechanisms of cervical cancer development and progression, to discover the novel molecular diagnostic methods and systemic management for cervical cancer. The findings of this study demonstrated that several factors including sexually transmitted infections, reproductive factors, hormonal influences, genetics and host factors are responsible for the incidence of cervical cancer. The results of this review study suggested that combination of biological, economic and health factors contributes to the incidence of cervical cancer. A large proportion cervical cancer can be prevented by prevention programs, lifestyle enhancement, smoking cessation, and timely and effective treatment of pre-cancerous lesions.

HPV infection is estimated to be responsible for about 5% of human cancers worldwide. Among all HPV-associated malignancies, cervical cancer is the most important cause of morbidity and mortality worldwide. Cervical cancer is the fourth most common cancer in women worldwide and leading cause of cancer death among females in less developed countries. Persistent HPV infection is a necessary cause of invasive cervical cancer with a prevalence of 99.7% in cervical cancer worldwide.At least 70% of cervical cancers are caused by HPV 16 and HPV 18. HPV vaccination in combination with regular screening offers the most effective way for women to be protected against cervical cancer.The global burden of cervical cancer falls heaviest on the developing countries which haven’t introduced the HPV vaccine as part of their national public health strategy to prevent and control cervical cancer. Different studies showed a drop in the prevalence of HPV associated diseases in vaccinated populations. Sustained efficacy, immunogenicity, and safety of the bHPV vaccine were observed in the final analysis of a follow-up study up to 9.4 years postvaccination. Cervical cancer is a major public health problem in Bangladesh. There has been little success with screening program against cervical cancer in Bangladesh. Therefore, a National HPV Vaccination Program seems to be the window of opportunity to reduce the mortality and morbidity of cervical cancer in Bangladesh. J Bangladesh Coll Phys Surg 2021; 39(2): 123-131

Cervical cancer remains a leading cause of cancer death for women in low- and middle-income countries. The goal of our study was to evaluate screening and triage strategies, including high-resolution microendoscopy (HRME), to detect cervical abnormalities concerning for precancer at the point of care. Women (n = 1824) were enrolled at the Instituto de Cancer de El Salvador. All underwent screening by both human papillomavirus (HPV) testing using careHPV and visual inspection with acetic acid (VIA). Screen-positives, along with 10% of screen-negatives, were invited to return for a follow-up examination that included triage with VIA, colposcopy and HRME imaging. Biopsies were taken of any abnormalities identified. If no abnormalities were identified, then the worst scoring site by HRME was biopsied. The sensitivities of HPV testing and VIA to screen for cervical intraepithelial neoplasia Grade 2 or more severe diagnoses (CIN2+) were 82.1% and 75% (P = .77), while the specificities were 90.4% and 80.9% (P < .001), respectively. The sensitivities of VIA, colposcopy and HRME as triage tests for CIN2+ were 82.1%, 82.1% and 71.4%, respectively (P ≥ .38). HRME had a significantly higher specificity (66.7%) than VIA (51.9%) (P < .001) and colposcopy (53.3%) (P < .001). When evaluating different theoretical screening and triage strategies, screening with HPV testing followed by triage with HRME would result in more women receiving appropriate care (97%) compared to screening with VIA (75%) or HPV alone (90%). Our findings demonstrate that screening with HPV is superior to VIA, and that triage with HRME imaging increases the specificity of detecting CIN2+ at the point of care in a low-resource setting.

OBJECTIVE This study compared cervical cancer knowledge, screening practices, and barriers to screening among undocumented and documented Hispanic women. MATERIALS AND METHODS An anonymous cross-sectional survey was administered to self-identifying Hispanic women older than 21 years at community-based clinics and health care-focused community sites in Rhode Island. The survey included demographics, immigration status, questions related to cervical cancer knowledge, screening practices, and barriers to screening. Participants were stratified based on their immigration status. Categorical variables were compared by χ2 or Fisher exact test. Knowledge scores and the number of barriers were compared by t test and Wilcoxon rank sum test, respectively. p values of less than .05 were considered statistically significant. RESULTS Seventy-three undocumented women and 70 documented women were enrolled. Undocumented women had a significantly lower mean cervical cancer knowledge score (3.53, SD =1.97) compared with documented women (4.43, SD = 2.04; p = .0085) and also experienced more barriers to having cervical cytology or a human papillomavirus test (p = .001). Eighty-eight percent of the undocumented women and 47% of the documented women did not have health insurance (p < .0001). Sixty-two percent of the undocumented women felt that their lack of documentation was a barrier to cervical cancer screening. Fifty percent of the undocumented and 47% of the documented women had never heard of the human papillomavirus vaccine. CONCLUSIONS Undocumented women have significantly lower mean cervical cancer knowledge scores compared with documented women. A lack of legal documentation is a significant barrier to cervical cancer screening among Hispanic women. Challenges inherent to being undocumented may contribute to women's lower knowledge scores and more pronounced barriers.

Objectives: We are reporting the evaluation of an opportunistic point of care cervical cancer screening initiative in Pune, India using a mobile screening unit (MSU). Methods: We conducted 290 cervical cancer screening outreach clinics in the MSU. Screening was performed by trained nurses/ health care providers using visual inspection with 5% acetic acid (VIA). Screen positive women when eligible were treated by thermal ablation during the same sitting. Women with large lesions not eligible for treatment with thermal ablation were referred for colposcopy and treatment. Results: A total of 10, 925 women were screened between Nov 2016 and June 2019 in 290 outreach clinics in the MSU. The overall screen positivity was 6.6% (95% CI 6.1, 7.0) with a declining trend over time. A total of 304/717 (42.4%, 95% CI 38.7, 46.1) women received treatment with thermal ablation. About 3.6% (11/304) reported minor side effects and 1.6% (5/304) reported lower abdominal pain and all of them subsided after treatment. Among the 413 women who were advised colposcopy, only 84 (20.33%) women underwent the procedure. Of these 84 women, 64 (76.19%) had normal colposcopy/ histopathology, 7 (8.33%) had CIN1, 2 (2.38%) had CIN 2, 9 (10.71%) had CIN 3 disease and 2 (2.38%) women were diagnosed with invasive cancer. Conclusion: MSUs are useful for providing cervical cancer screening services, using the ‘screen and treat’ strategy. Thermal ablation is safe in the field clinics. Additional efforts are needed to improve the compliance for referral of those with large lesions requiring additional visits.

Objective: Intern nurses will play an important role in the use of vaccination to prevent cervical cancer. This study assesses the knowledge about human papillomavirus (HPV) infection and cervical cancer prevention among intern nurses. Methods: We developed a questionnaire to investigate intern nurses' knowledge about HPV infection and cervical cancer prevention. Participants included 323 intern nurses from eight schools. Results: The effective response rate was 79.8%. Some (7.0%) knew that early-stage cervical cancer is commonly asymptomatic. Only 9.7% knew that infection is generally asymptomatic and 20.5% knew that vaccination has no major side effects. There were differences in gender, age, school type, and place of residence for several questions. Conclusions: This study indicates a low level of knowledge about HPV infection and cervical cancer prevention among intern nurses. Our findings highlight the need for more education in this topic to increase the knowledge of intern nurses.

Objective: Cervical cancer is common disease worldwide and ranks fourth among all malignancies for women. It has been reported to have been responsible for almost quarter of a million deaths annually, of which about 85% occurred in developing nations. Hence, the present study was conducted to assess the knowledge and attitude on cervical cancer prevention and its associated factors among female students in Batu Preparatory School, Ziway town, Oromia Regional State, Ethiopia in 2018. Methods: Institution based quantitative cross sectional study was conducted using anonymous self- administered questionnaire among female students in Batu Preparatory School in 2018. Results: Our results showed, the overall (62.1%) female preparatory students had heard of cervical cancer for most the source of information was mass media (50.7%). Though most has information on CC, only 33.3% were knowledgeable. Of the participants, 7.8% of had information about risk factor and 16% were aware of at least one of the symptom of CC. Results indicated that 72.5% of the participants believes that CC is preventable disease but only 21% had good knowledge on prevention. The overall positive attitude of the participants was 58.8%. Conclusion: Most participant believe that CC is preventable disease, and their knowledge on prevention is either poor or not satisfactory. In addition, most of the participants showed positive attitude towards CC prevention.

O objetivo deste estudo foi analisar o perfil das mulheres que realizaram o exame de Papanicolaou. Trata-se de um estudo transversal, retrospectivo e quantitativo. A população estudada foram mulheres atendidas em uma Unidade Básica de Saúde entre os anos de 2014 a 2016, totalizando 215 mulheres. A coleta de dados ocorreu por meio de fichas arquivadas na Unidade Básica de Saúde. A análise descritiva foi realizada com frequências absolutas e relativas. Evidenciou que a maior parte das mulheres apresentou idade entre 25-64 anos (80,9%), com companheiro (61,6%), com trabalho remunerado (48%), não fumantes (71,2%), com índice de massa corpórea elevada (50,4%), sem queixas ginecológicas (66,8%), ativas sexualmente (69,6%), sedentárias (51,2%) e que não utilizavam métodos contraceptivos (35,2%). Ressalta-se que o estudo possibilitou conhecer o perfil da população estudada, auxiliando no direcionamento das atividades em consonância com as recomendações da Política de Prevenção do câncer de colo de útero.

Background: Carcinoma of cervix is common yet preventable. Sri Lankan young population is at risk. This study was conducted among the students attached to three non-conventional higher education institutions with ref­erence to assessing the awareness, screening methods, Human Papilloma Virus (HPV) as causative factor and attitude towards HPV vaccination.Methods: A validated questionnaire was used. Data were analyzed using SPSS 25 software.Results: 120 females participated, age ranging 19 to 25 years. Seventy (57.5%) participants were aware of the cervical cancer. Seventy percent of them were also aware HPV as causative factor. About half of the participants (50.8%) were not aware of availability of cervical screening. Among those aware of the screening, about half re­ported the availability of both Pap smear and HPV testing. Totally about 87% were aware of the Pap smear. Sixty nine students [57.5%] were ‘not sure’ of the availability of HPV vaccine and 58 of them stated ‘unsure of vaccine received’. About 16% did not want to receive the vaccine. One third mentioned that the HPV Vaccine is available in Sri Lanka.Conclusions: The awareness noted under 60% of the participants indicates the need for structured awareness programs to young population. Majority of participants were confused about the availability and whether they had received of HPV vaccine.

Laura M Torrado-García, Ruth A Martínez-Vega, Bladimiro Rincon-Orozco Microbiology School, Universidad Industrial De Santander, Bucaramanga, Santander, ColombiaCorrespondence: Bladimiro Rincon-Orozco Email blrincon@uis.edu.coIntroduction: Human papillomavirus molecular detection prevents cervical cancer (CC). To widen its use, cervical-vaginal self-collection devices are proposed. Our aim was to determine the acceptability of self-sampled cervical-vaginal protocol and the reproducibility of results using HPV detection brushes in a low-income Colombian population between 35 and 65 years old.Methods: Cross-sectional study including women classified as medium to high-risk for developing CC by using a short-standardized survey. After receiving instructions, women self-collected a cervical-vaginal sample. Subsequently, a perception survey was conducted.Results: Four hundred and twenty-three women performed self-collected sampling. The median age was 46.5 years (IQR 40– 52), 56.5% were housewives, and 55.1% had finished elementary school. About 99% of the population (n=419) considered that they understood the instructions, 19.4% (n=82) reported having concerns about the self-collected sample, 9.2% (n=39) distrusted the results because of the self-collection, 7.3% (n=31) felt uncomfortable with the procedure, and 9.7% (n=41) reported some pain. The majority would recommend the procedure to others (99%), 88.5% of the sampled population preferred the self-collected method, 4% preferred conventional cytology, and 7.3% were not sure. The reasons behind favoring the self-collected procedure included privacy (n= 149, 40.1%), comfort (n=110, 29.7%), easiness (n=52, 14%), reliability (n=46, 12.4%), and less painful (n=110, 29.7%). The percentage of HPV detection agreement between the self-collected and the healthcare professional-collected procedures was 98.99% (Cohen’s Kappa=0.9774).Conclusion: Women living in low-income households in Bucaramanga, Colombia preferred the self-sampling procedure because it was easy to use, convenient, and private, resulting in 98% acceptability, and positioning it as an excellent tool for CC prevention.Keywords: cervical smear, uterine cervical neoplasms, female, self-collected HPV

From normal epithelial cells to invasive cervical cancer take a long time. It needs a step-by-step process. Normal cervical cells may be infected with the high-risk human papillomavirus (HPV). The infection may persist or be cleared. The HPV persistence may change normal cells to invasive cancer. Recent findings showed that the intrauterine device (IUD) might have a protective effect on cervical cancer. Inflammation in the cervix induces the immune response that may alter normal cells' progression to cervical cancer. This article will explain the change from normal cells to invasive cervical cancer, the role of the IUD in cervical cancer prevention.

Background: Human papillomavirus (HPV)-DNA testing combined with self-sampling could increase cervical cancer screening effectiveness, utilizing a sensitive screening modality and an easy sampling method with minimal pain or discomfort. Self-sampling acceptability, though, is pivotal. Materials and Methods: This study is a nested cross-sectional survey within GRECOSELF, a cross-sectional study on HPV-based screening with self-sampling, aiming at investigating self-sampling acceptability among Greek women residing in rural areas, and the factors affecting it. Women between 25 and 60 years old were recruited by midwives participating in a nationwide midwifery network. Participants, after self-sampling, filled out a questionnaire with three sections, one regarding demographic characteristics, a second with questions pertaining to the participants' cervical cancer screening history, and a third with questions regarding the self-sampling process per se. Results: The sample included 13,111 women. Most participants (67.9%), including those screened or not in the past, would prefer self-sampling if assured that the results are not inferior to standard testing. Discomfort or pain during self-sampling was absent or minimal in 97.1% and 96.5% of the cases, respectively, and 74.4% of the women felt adequately confident that they followed the instructions correctly. Women mostly preferred self-sampling at home compared with health care facilities. Pain and discomfort during the procedure, although rare, were significant factors against acceptance. Most of the women reporting a negative impression had a negative experience with conventional sampling in the past. Conclusion: Self-sampling is highly acceptable. Acceptance can be further improved with proper communication of the process and its noninferiority compared with conventional screening.

Introduction Cervical cancer is the fourth most common cancer among women. It is related to persistent HPV infection. In order to improve diagnostic methods, a lot of research has been focused on detecting HPV DNA. A test known as a high-risk HPV test or HPV primary screening provides very encouraging results. Objective The aim of this review is to present the actual knowledge about the possibilities of cervical cancer screening methods. Particular attention is paid to the question concerning the effectiveness of detecting viral DNA as a screening programme, compared to pap smear. State of knowledge The HPV primary screening has higher sensitivity than the cervical smear test and it is able to detect lower-stage lesions, which are considered clinically irrelevant. Nonetheless, many HPV infections recede naturally. Therefore, relying only on the results of this test may expose women to unnecessary colposcopies and stress. Due to this fact, women under 30 years should not be screened with the hrHPV test. In view of its limitations, the HPV primary screening strategy is still tested worldwide as a pilot project. In Poland in 2019, a pilot project with the hrHPV test started at the National Institute of Oncology. Conclusions Detecting viral DNA has its advantages and disadvantages. Further research is still required, but the hrHPV test has a great opportunity to become one of the main screening programmes worldwide, or at least, a valuable addition to cervical smear test.

Cervical cancer is a malignant tumor that grows in the cervix or serviks. This cancer occurs because cells in the cervix has multiplied and the abnormalities. Cervical cancer usually occurs in women of child-bearing age who are 30-45 years old because the average woman at that age has been active in sexual intercourse and has been productive, but it can also occur in women aged 18 years due to women's inability to maintain cleanliness and the health of the reproductive organs. This study aims to describe the awareness and behavior of cervical cancer in Women of Child-bearing Age. This study used a quantitative methods type of descriptive survey research with a sample of 150 respondents and Accidental sampling technique. The analysis used is univariate (age, occupation, last education, awareness, and behavior). The average univariate results of respondents were 31 years old (6,0%), the average of the last high school education was 83 people (55.3%), the majority of women who came to the health center 141 people (94.0%), most of them had a good awareness of 91 people (60.7%), and positive behavior 104 people (69.3%) for early prevention of cervical cancer. Researcher hope that respondents who had never done early cervical cancer screaning should checkup immediately and respondents who had already done screaning must to improve and maintain the efforts to prevent cervical cancer. Bibliograph: 59 (2003-2018) Key words: Cervical Cancer, Awareness, Behavior

Background and Purpose: Survey-based research was conducted in Yantalo, Peru, a rural Amazonian community, to assess the knowledge base among women surrounding cervical cancer, human papilloma virus (HPV), and preventative health practices as well as to gain a better understanding of barriers to accessing care. Methods: A total of 217 women were interviewed out of the 1612 female inhabitants of Yantalo utilizing a structured interview-style questionnaire with both closed and open-ended questions. Results: Our average respondent was 41.6 years old with the equivalent of some high school education. Approximately 75% of respondents reported that they had heard of HPV and/or cervical cancer, with 44.4% reporting they had received a test to check for cervical cancer within their lifetime. When given a 10-question knowledge assessment regarding safe sex practices and cervical cancer, women obtained an average score of 57.3%. When asked about receiving the HPV vaccine, 29% reported “Yes”, 59.4% reported “No”, and 11.6% reported “I don't know.” Although 62.6% of women indicated that they have “easy access to cervical cancer screening,” 37.4% of women reported experiencing at least one barrier to accessing care. The highest reported barriers include fear of the test causing them pain and/or lack of knowledge of the necessity cervical cancer testing. Cervical cancer rates in Peru are approximately three times that in developed countries. Conclusions: Gathering data surrounding knowledge and the barriers among the female population in rural communities is essential to developing targeted initiatives that address pertinent obstacles within these and other vulnerable communities.

Background: Cancer, next to cardiovascular disease, obesity, diabetes, accidents, and mental illness, is one of the most common diseases of the 21st century. In the female population, cervical cancer is most often diagnosed at late stages. Aim of the study: The goal of the study is to determine the opinions of women who reside in Bialski poviat about midwife participation in cervical cancer screening and prevention. Material and methods: The study group was recruited from randomly selected patients from two physiotherapy offices in the Bialski poviat, as well as students and employees of the State University Pope John Paul II in Biala Podlaska. The research tool consisted of the author’s questionnaire concerning the role of midwives in cervical cancer prevention and consisted of 25 questions. Results: Almost half of the respondents or 44.2% (76) believe that the role of a midwife in cervical cancer prevention is based on health education given to women about cervical cancer screening and prevention. 27.3% (47) believe that the role of a midwife in prevention is based on the availability of cytological pap smears. Most or 56% (14) respondents from the age group over 55 and 29.2% (7) surveyed in the 18-25 age group knew about the important role of midwives performing cytological pap smear as part of a prevention strategy against cervical cancer. Conclusions: 1. The knowledge base of the women examined, regarding the role of a midwife in the prevention of cervical cancer, is lacking or insufficient. 2. The role of the midwife in the prevention of cervical cancer is unknown to young women in the 18-25 age group.

High-risk human papillomavirus strains are widely known to be the causative agents responsible for cervical cancer development. Aggregated damage caused by papillomaviruses solely is estimated in at least 5% of all malignancies of the human body and 16% in cancers that affect the female genital area. Enhanced understanding of the complex issue on how the high extent of carcinogenicity is eventually formed due to the infection by the Papoviridae family would contribute to enhancing current prevention strategies not only towards cervical cancer, but also other HPV associated cancers. This review article is aimed at presenting the key points in two directions: the current cervical cancer prevention and related aspects of HPV behavior. Virtually all applied technologies related to HPV diagnostics and screening programs, such as HPV tests, colposcopy-based tests (VIA/VILI), conventional and liquid-based cytology, currently available are presented. Issues of availability, advantages, and drawbacks of the screening programs, as well as vaccination strategies, are also reviewed in the article based on the analyzed sources. The current point of view regarding HPV is discussed with emphasis on the most problematic aspect of the HPV family concerning the observed increasing number of highly carcinogenic types. Present trends in HPV infection diagnostics throughout the human fluids and tissues are also reported, including the latest novelties in this field, such as HPV assay/self-sample device combinations. Besides, a brief outline of the related prevention issues in Kazakhstan, the leading country of Central Asia, is presented. Kazakhstan, as one of the post-soviet middle-income countries, may serve as an example of the current situation in those terrains, concerning the implementation of globally accepted cervical cancer prevention strategies. Along with positive achievements, such as the development of a nationwide screening program, a range of drawbacks is also analyzed and discussed.

Background Cytology-based screening has been a cornerstone of cervical cancer prevention for decades. Following extensive evidence demonstrating higher sensitivity and accuracy, lower variability and better reproducibility of human papillomavirus (HPV)-based screening compared with conventional or liquid-based cytology, recent European guidelines strongly recommend primary HPV-based screening over standard cytology-based screening. In addition, HPV-based screening offers the possibility of self-sampling and makes possible longer screening intervals in women with negative screening results. Objectives We summarize the current status of implementation of HPV-based screening in Europe, describe the real-life experience and challenges from countries already performing HPV-based screening, and briefly review immediate and long-term plans for screening implementation in selected European countries. Sources Data were obtained from peer-reviewed literature, personal communication with experts and authorities involved in formulating national recommendations and practical guidelines, and relevant national websites. Content As of July 2019, the Netherlands and Turkey are the only European countries with fully implemented national HPV-based cervical cancer screening. Italy, Sweden and Finland have already implemented HPV-based screening in several regions, and several other countries are at various stages of implementation. Some countries are considering transitioning from cytology-based to HPV-based screening, but are struggling with the suboptimal performance of current population-based programmes. Implementation of HPV-based screening has resulted in higher colposcopy referral rates, but also higher detection rates of CIN3+ lesions and cervical cancers requiring immediate treatment. Cytology is mostly used as a triage test, although other strategies are under consideration in some countries. Implications HPV-based screening is best suited in organized population-based screening settings. In 2019, cervical cancer screening policies across Europe vary greatly. Experience in countries with national and regional HPV-based screening already implemented is generally very positive. Urgent action is needed in many European countries, especially those with suboptimal opportunistic cytology-based cervical cancer screening.

El Cancer Cervicouterino es la cuarta causa mas comun de cancer en las mujeres a nivel mundial y es la segunda neoplasia mas comun en mujeres en Mexico. Se sabe que el estado nutricio comprometido esta asociado con resultados adversos en pacientes con cancer. La evidencia cientifica sugiere que el cancer se puede atender desde la prevencion primaria, favoreciendo la ingesta dietetica. Sin embargo, es importante continuar investigado los antioxidantes y vitaminas en la prevencion del CaCu. Objetivos. Correlacionar la prevencion de cancer cervical mediante la ingesta dietetica vitamina C, zinc. Metodologia . Estudio transversal, observacional, correlacional. La muestra se conformo por 202 mujeres participantes a las cuales se les realizo una entrevista nutricional mediante una encuesta de frecuencia de consumo de alimentos y ademas se les realizo una evaluacion antropometrica. En el analisis estadistico se utilizo la prueba T de student. Resultados . Se encontro que la ingesta de zinc y vitamina C es mayor en personas sanas que en mujeres con NIC. Conclusion . Las mujeres deben consumir alimentos que contienen antioxidantes ya que son requeridos en la dieta humana para favorecer la prevencion del cancer. Antioxidant intake and its association with Cervical Cancer in women of a University System Cervical cancer is the fourth most common women’s cancers cause worldwide and the second most common neoplasm in Mexico. It is well known that poor nutritional status is associated with adverse outcomes at oncological patients. Scientific evidence suggests that cancer can be attended, favoring dietary intake, from primary attention. By the way, It’s important to continue researching the antioxidants and vitamins role at cervical cancer prevention. Objectives : To correlate Cervical cancer prevention through dietary intake of vitamin c and zinc. Methodology : Observational, correlational and transversal study. The sample was made up by 202 women who had a nutritional interview with a food consumption survey, also and anthropometric evaluation was carried out. In the statistical analysis the Student´s T test was used. Results : The intake of zinc and vitamin C is higher in healthy people tan in women with NIC. Conclusion . Women should consume foods that contain antioxidants as they are required in the human diet to promote cancer prevention.

The article describes the current issues of the epidemiology of human papillomavirus infection of high carcinogenic risk and genital herpes, affecting reproductive health. The attention is focused on modern principles of diagnosis and treatment, including approaches to immunotherapy and combination therapy.

Cervical cancer is a scary disease for women all over the world. This disease can actually be prevented and identified early. Pap smear is one of the tools of early detection to determine the presence of symptoms of cervical cancer. If women’s knowledge is good about pap smear’s early detection of cervical cancer, it can prevent the disease. The objective of this study was to know the effect of health education in women about pap smear which aids in early detection and prevention of cervical cancer. This was a quasi-experimental one group pretest, conducted without a control group at Murni Teguh Memorial Hospital (MTMH), Medan, North Sumatra from June to July 2018. There were 36 samples selected using purposive sampling. Wilcoxon signed-rank test was used for data analysis. The results of this study showed that there was a difference in the mean value of women's knowledge levels (p = 0. 000) before and after the intervention. The conclusion of this study was that there was a significant effect of health education in terms of an increase in the level of women's knowledge about pap smear’s early detection and prevention of cervical cancer. It is expected that health education about pap smear’s early detection and prevention of cervical cancer will prove to be very important in the future.

Objective: To understand the state of education for the prevention of cervical cancer and trends in research. The subject of cervical cancer prevention will be examined. Method: Articles from the ICHUSHI Web version 5, CiNii, and PubMed databases for the period from 2009-2019 were used. Search terms used were cervical cancer, HPV/human papillomavirus, prevention, public awareness, and education. Results: 17 articles (9 Japanese and 8 English) were analyzed. The majority of students had heard of cervical cancer but did not know of the link between it and HPV. Vaccinated individuals were significantly more likely to have deeper knowledge regarding cervical cancer and HPV. Various factors affect the vaccination rate. These include knowledge of HPV and cervical cancer, age, ethnicity, the organization or location which administers the vaccine, how to breach the subject, finances, and the opinions of friends and family. In particular, consultations with parents lead to mothers recognizing the importance of the vaccine. By way of educational intervention, opinions have grown more positive about advancing awareness, being vaccinated, and having cervical cancer screenings for the future. Conclusion: The prevention of cervical cancer requires support and fostering the judgement based on sufficient awareness and adequate education. What we need is educational intervention rooted firmly in the current societal climate aimed not only at students, but at their parents as well.

Cervical cancer is considered as a common female genital cancer. It is also recognized as the second most frequent cause of cancer-related death among women. It is estimated that in Iran cervical cancer ranks the 4th most frequent cancer in women. Therefore, with regard to the importance of Pap smear in preventing cervical cancer, together with the impact of women's knowledge and attitude towards Pap smear performance, we aimed to assess women's knowledge, performance and attitude towards Pap smear test in Sabzevar, Iran. This descriptive cross-sectional study was conducted on 385 women referred to health care centers and gynecological offices in Sabzevar, Iran. A questionnaire designed and validated by Abedian and Dormohamadi (2013) was used for data collection. Descriptive and analytic statistics were used for analysis. The mean scores of knowledge, attitude and performance were reported to be 2.1 ± 0.10, 66 ± 0.43, and 0.70 ± 0.06, respectively. Participants' age, education and their spouses' education were found as effective variables in their Pap smear knowledge, attitude and performance. The findings indicated that despite the fact that participants' knowledge and performance regarding cervical cancer were not desirable, their attitude was rather acceptable. Therefore, education and training of women in health centers by physicians together with engaging the health staff in improving women's knowledge, performance and attitude towards cervical cancer prevention and treatment are highly recommended.

Cervical cancer disproportionally affects women in low- and middle-income countries, in part due to the difficulty of implementing existing cervical cancer screening and diagnostic technologies in low-resource settings. Single-board computers offer a low-cost alternative to provide computational support for automated point-of-care technologies. Here we demonstrate two new devices for cervical cancer prevention that use a single-board computer: 1) a low-cost imaging system for real-time detection of cervical precancer and 2) a low-cost reader for real-time interpretation of lateral flow-based molecular tests to detect cervical cancer biomarkers. Using a Raspberry Pi computer to provide real-time image collection and processing, we developed: 1) a low-cost, portable high-resolution microendoscope system (PiHRME); and 2) a low-cost automatic lateral flow test reader (PiReader). The PiHRME acquired high-resolution (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} }{}$4.4~\mu \text{m}$ \end{document}) images of the cervix at half the cost of existing high-resolution microendoscope systems; image analysis algorithms based on convolutional neural networks were implemented to provide real-time image interpretation. The PiReader acquired and analyzed images of a point-of-care human papillomavirus (HPV) serology test with the same contrast and accuracy as a standard flatbed high-resolution scanner coupled to a laptop computer, for less than one-fifth of the cost. Raspberry Pi single-board computers provide a low-cost means to implement point-of-care tools with automatic image analysis. This work demonstrates the promise of single-board computers to develop and translate low-cost, point-of-care technologies for use in low-resource settings., Cervical cancer disproportionally affects women in low- and middle-income countries, in part due to the difficulty of implementing existing cervical cancer screening and diagnostic technologies in low-resource settings. Here we demonstrate two new devices for cervical cancer prevention that use a single-board computer: 1) a low-cost imaging system for real-time detection of cervical precancer and 2) a low-cost reader for real-time interpretation of lateral flow-based molecular tests to detect cervical cancer biomarkers.

INTRODUCTION: Creating effective programs for cervical cancer prevention is essential to avoid premature deaths from cervical cancer. The Dominican Republic has persistently high rates of cervical cancer, despite the availability of Pap smear screening. This study explored Dominican provider attitudes towards human papillomavirus (HPV) testing and current challenges to effective cervical cancer prevention. METHODS: In this Consolidated Framework for Implementation Research (CFIR)-driven mixed methods study, we conducted in-depth interviews (N=21) and surveys (N=202) with Dominican providers in Santo Domingo and Monte Plata provinces regarding their perspectives on barriers to cervical cancer prevention and their knowledge and attitudes towards HPV testing as an alternative to Pap smear. RESULTS: Providers believed the main barrier to cervical cancer prevention was lack of cervical cancer awareness and resulting inadequate population screening coverage. Providers felt Pap smear was widely available to women in the Dominican Republic and were unsure how a change to HPV testing for screening would address gaps in current cervical cancer screening programs. A subset of providers felt HPV testing offered important advantages for early detection of cervical cancer and were in favor of more widespread use. Cost of the HPV test and target age for screening with HPV testing were the main barriers to acceptability. DISCUSSION: Providers had limited knowledge of HPV testing as a screening test. The group was divided in terms of the potential impact of a change in screening test in addressing barriers to cervical cancer prevention in the Dominican Republic. Findings may inform interventions to disseminate global evidence-based recommendations for cervical cancer screening.

Childbirth educators play an important role in educating pregnant women regarding their health. They bridge the gap between pregnant women and healthcare providers. A paucity of information exists on the benefits that pregnant women derive from interactions with childbirth educators regarding early cervical cancer detection. The purpose of our cross-sectional study was to investigate the association among education during early pregnancy offered by the childbirth educators, access to childbirth educators, availability of childbirth educators in the United States and survival from cervical cancer. Secondary data from the Surveillance, Epidemiology, and End Results (SEER) on 520,153 women were analyzed using logistic regression. Childbirth education delivered by childbirth educators during early pregnancy was associated with significantly fewer cervical cancer deaths (odds ratio = .917, CI = .896–.939, P = .000). Women with late-stage diagnosis had an increased likelihood of dying when diagnosed with cervical cancer (odds ratio = 1.043, CI = 1.042– 1.044, P = .000). Childbirth educators are effective at increasing awareness of cervical cancer among women in the early stages of pregnancy; this can improve survival and lead to positive social change.

Background Cervical cancer is considered as the third most leading cause of death among female worldwide with most of the deaths were found to occur in the developing countries. Several etiological agents were studied however Human papilloma virus (HPV) is identified as the most common etiological agent that involved in the induction of cervical cancer. The aim of our current study was to assess the Knowledge, attitudes, and practices toward cervical cancer prevention among women in Khartoum state, Sudan. Methods this is a descriptive cross-sectional community-based study. An electronic questionnaire was used for data collection. Descriptive statistics like frequency, mean and percentage were computed using SPSS version 20.0 software program. Results About 716 females in age between 18 and 74 years old with a mean age 27.58 years (STD 8.74 years) have enrolled in this study. 93.7 of them are educated at university level or higher. Although that 580 (81.0%) of our study participants have heard about cervical cancer only 29 (4.1%) were vaccinated against HPV as a preventive measure against the disease. Conclusion We highly recommended conducting health education sessions for both the Obstetrician and females in reproductive age regarding the benefit of the Pap test in the early detection of the cervical intraepithelial lesions and malignancy as well as HPV vaccination should be introduced in the local healthcare facilities

Low- and middle-income countries carry a high burden of preventable cervical cancer cases and deaths. Because human papillomavirus DNA-based testing is increasingly becoming the preferred method of screening for cervical cancer prevention, this commentary discusses next steps and key considerations for its expansion.

Objectives: The aims of this study to assess the practice of preventing cervical cancer of 15 - 49 years old and having gynecological examination women at Lam Dong General Hospital. Research method: A cross-sectional description. Interviewed practice about cervical cancer prevention of 400 women. Results: Over the course of the study, 400 women showed the number of women who had not been vaccinated is still high at 85.5%, the rate who had not been screened for cervical cancer is 62.3%. Based on the results of the study, we recommend that reproductive age women should be communicated more frequently about HPV vaccination and periodic cervical cancer screening to prevent cervical cancer.

Highlights • Provider recommendations significantly improve HPV vaccination rates. • The emphasis a provider gives with a recommendation is important. • Stressing the importance of same-day vaccination increases uptake., The goal was to evaluate how provider recommendations regarding Human Papillomavirus (HPV) vaccination impact uptake in a rural setting. The study used a cross-sectional, population-based design with cluster sampling to survey parents/guardians of children ages 9 to 18 in 2019 in Alabama. In addition to demographics/knowledge questions, participants were asked about type of healthcare provider recommendation and impressions they had from this interaction. The primary outcome variable was the result of the healthcare provider recommendation with options including: child got vaccinated day of recommendation, HPV vaccination was scheduled, or HPV vaccination was not scheduled. Bivariate analysis and multinomial logistic regression were performed. Of the 358 respondents, approximately 40% indicated receiving a recommendation from a provider to vaccinate their child. Age of the parent, race/ethnicity, educational attainment, and health insurance coverage were similar across groups. Female parents were more likely to report receiving HPV vaccination recommendation than males (44.1% vs. 23.3%; p = 0.009). The type of provider recommendation was not significantly associated with HPV vaccination uptake. The impression from the recommendation of HPV vaccination being “important” was significantly associated with the child being vaccinated that day (OR = 7.31, 95% CI = 2.20–24.3) as well as scheduling HPV vaccination (OR = 3.17, 95% CI 1.01–9.92). Parents who got the impression that “there was no hurry” were less likely to vaccinate their child that day (OR = 0.23, 95% CI = 0.09–0.59). Provider recommedation is well-established as a significant predictor of HPV vaccination, these findings indicate that how the recommendation is perceived may play a more important role in HPV vaccination uptake.

Background and Objectives: In Poland, the rates of morbidity and mortality due to cervical cancer are amongst the highest in Europe. A significant percentage of newly diagnosed cases of cervical cancer are at an advanced stage. Unfortunately, only about 20% of Polish women take part in cervical cancer screening. The aim of the study was to assess students’ knowledge of cervical cancer risk factors and prevention. Materials and Methods: The study was provided to Polish students from various universities and faculties between May 2020 and November 2020. The questionnaire was designed specifically for this study and was validated. The chi-square test was used to compare the responses between subgroups. Results: The study was carried out on a group of 995 students (80.6% women, 19% men, 0.4% no data), (average age 21.9 years). Most students knew that the main risk factor for cervical cancer is human papillomavirus (HPV) infection (82% of all responders, 86% of medical students, 73% of non-medical students, p &lt, 0.001). Only 40% of students knew that in Poland the Population Prevention and Early Diagnosis Program is carried out on women aged 25–59 years every three years. Most students correctly indicated that cervical cancer screening in Poland is performed using cervical cytology and were familiar with the basis of cytology. Only 57% of students knew that there are no specific early symptoms of cervical cancer. A total of 78% of all respondents knew that HPV vaccination reduces the risk of cervical cancer. Medical students and students who are sexually active demonstrated a better knowledge of cervical cancer. Conclusions: The Polish students had some knowledge of cervical cancer risk factors and primary and secondary prevention. Significantly better knowledge was demonstrated by medical students. Some efforts should be made to ensure that young people, who are not associated with medicine are better educated about cervical cancer in order to reduce the overall incidence and improve early detection rates.

Cervical cancer is caused by HPV (human papilloma virus). It is the second most common cancer in women living low developed countries. The components of cervical cancer prevention and control comprises primary prevention, secondary prevention and tertiary prevention. Primary prevention of cervical cancer encompasses prevention of infection with HPV. Giving HPV vaccine for girls aged 9–14 years before they initiate sexual activity is one of the interventions of primary prevention of cervical cancer. Screening and treatment is needed in secondary prevention of cervical cancer. Screening of cervical cancer encompasses testing a target group (women) who are at risk for a cervical pre-cancer. Tertiary prevention of cervical cancer comprises treatment of cervical cancer and palliative care. The components of tertiary care comprise surgery, radiotherapy, chemotherapy and palliative care. Community mobilization, health education and counseling on cervical cancer prevention and control is vital to make ownership on cervical prevention. Monitoring and evaluation of cervical cancer prevention and control on key program indicators should be done regularly.

China only recently introduced HPV vaccines, and HPV vaccination is yet to be included in the National Immunization Plan. This article offers an overview of current experience in HPV vaccination in China, including the general background of cervical cancer prevention and control in China, recent advances in HPV vaccination, and major challenges and solutions to HPV vaccination in China. This article found that while current HPV vaccination rate upon full completion was around 3% in China and lower among adolescents, a few advances were under way, such as the exploration of models in which community health service centers serve as the main venue to vaccination, while multiple other channels can be utilized to provide services, as well as the emergence of free vaccination pilots in 2020. Major challenges in HPV vaccination in China included high price and insufficient supply of domestic vaccines, lack of awareness and willingness among the primary target group, and lack of institutional staff capacity and quality and convenient services. This article then made several recommendations to promote HPV vaccination in China, including promoting policy development guided by the WHO elimination strategy, ensuring adequate supply and affordable price of vaccines, improving the quality and coverage of vaccination, strengthening public communication and mobilization, and improving efficiency of vaccine supply through innovative methods.

As Indonesia grapples with COVID-19, it remains vital that other crucial health interventions continue to be prioritised to minimise the overall health footprint of the epidemic. Cervical cancer is a preventable disease, yet it is the most lethal female cancer in Indonesia, responsible for more than 18,000 deaths each year. Thanks to the efforts of several key groups driving health reforms to step up cervical cancer control in recent years, Indonesia has a national screening program and, up until late 2019, a HPV vaccination pilot program was being rolled out across five provinces. An interdisciplinary four-year study exploring the experiences of and health system responses to cervical cancer in Indonesia was underway when the COVID-19 pandemic emerged. Alarmingly, the widespread restrictions on citizens’ mobility and the redistribution of resources to the COVID-19 response has resulted in key services for cervical cancer prevention and screening being paused indefinitely, without a clear path forward. Treat ent seeking, and the availability of support services for women with a cervical cancer diagnosis have also been interrupted. If unaddressed, these pauses will lead to an increase in women presenting with late stage cervical cancer, for which treatment is more invasive and costly, with a lower chance of survival. We are also concerned for the future generation of women in Indonesia, who, without access to affordable HPV vaccination, will face a heightened risk of developing cervical cancer compared with their peers from countries that have prioritised investing in this life saving vaccine.

Background: Human Papilloma Virus (HPV) is the causative agent of cervical cancer. Vaccination against HPV is an effective strategy against cervical cancer. This study aimed to assess the acceptance of HPV vaccination for cervical cancer prevention and its relationship with knowledge and attitude about HPV vaccination among students. Methods: This cross-sectional study was carried out on 360 female students at Bushehr University of Medical Sciences in 2018. Students were recruited using proportional stratified random sampling method. Data was gathered using a questionnaire about knowledge, attitude and effective factors of HPV vaccine acceptance. Descriptive analysis, chi-square, independent sample t-test, and logistic regression were used to analyze the data in SPSS-16.0 (SPSS Inc., Chicago, IL, USA). The significance level was set at P < 0.05. Results: 56.4% of students had poor knowledge while 54.1% were willing to accept HPV vaccination as well as 43% who had positive attitude towards HPV vaccination. Paramedical students were 96% more likely to accept the HPV vaccination compared to health sciences faculty students (OR= 1.96; 95% CI= 1.04-3.68; p=0.036). Also, for each unit increase in the HPV knowledge score, students were 15% more likely to accept the vaccine (OR= 1.15; 95% CI= 1.07-1.24; p

Summary Efforts are being made to scale up human papillomavirus (HPV) vaccination for adolescent girls in India. Bivalent and quadrivalent HPV vaccines were licensed in the country in 2008, and a nonavalent vaccine was licensed in 2018. Demonstration projects initiated in Andhra Pradesh and Gujarat in 2009 introduced HPV vaccination in public health services in India. Following a few deaths in these projects, although subsequently deemed unrelated to vaccination, HPV vaccination in research projects was suspended. This suspension by default resulted in some participants in a trial evaluating two versus three doses receiving only one dose. Since 2016, the successful introduction of HPV vaccination in immunisation programmes in Punjab and Sikkim (with high coverage and safety), government-sponsored opportunistic vaccination in Delhi, prospects of a single dose providing protection, and future availability of an affordable Indian vaccine shows promise for future widespread implementation and evaluation of HPV vaccination in India.

Objective Cervical cancer rates in the United States have declined since the 1940's, however, cervical cancer incidence remains elevated in medically-underserved areas, especially in the Rio Grande Valley (RGV) along the Texas-Mexico border. High-resolution microendoscopy (HRME) is a low-cost, in vivo imaging technique that can identify high-grade precancerous cervical lesions (CIN2+) at the point-of-care. The goal of this study was to evaluate the performance of HRME in medically-underserved areas in Texas, comparing results to a tertiary academic medical center. Methods HRME was evaluated in five different outpatient clinical settings, two in Houston and three in the RGV, with medical providers of varying skill and training. Colposcopy, followed by HRME imaging, was performed on eligible women. The sensitivity and specificity of traditional colposcopy and colposcopy followed by HRME to detect CIN2+ were compared and HRME image quality was evaluated. Results 174 women (227 cervical sites) were included in the final analysis, with 12% (11% of cervical sites) diagnosed with CIN2+ on histopathology. On a per-site basis, a colposcopic impression of low-grade precancer or greater had a sensitivity of 84% and a specificity of 45% to detect CIN2+. While there was no significant difference in sensitivity (76%, p = 0.62), the specificity when using HRME was significantly higher than that of traditional colposcopy (56%, p = 0.01). There was no significant difference in HRME image quality between clinical sites (p = 0.77) or medical providers (p = 0.33). Conclusions HRME imaging increased the specificity for detecting CIN2+ when compared to traditional colposcopy. HRME image quality remained consistent across different clinical settings.

Objectives: Cervical cancer is the fourth most common type of cancer among women worldwide and one of the most common malignancies diagnosed in gravidas. Therefore, routine antenatal Pap smear is such an important examination. The aim of the study was to assess the prevalence of Pap smear performance during prenatal care and to determine possible factors affecting it. Material and methods: A self-composed questionnaire was distributed among 638 women managed in a tertiary obstetric referral center. 33 questions regarded cervical cancer prevention and risk factors. Results: 96.9% of respondents had undergone Pap smear and 80.6% had it performed during pregnancy. For 11.5% women Pap smear in pregnancy was the first one in their life. The most common reasons for lack of Pap smear performance were: no subjective need to perform it (40.9%), no doctor’s recommendation (28.6%) and lack of gynecological care (16.3%). Among professionally active women the percentage of those who had not undergone Pap smear during pregnancy was statistically higher (28.5%) than among those who were on sick leave (13.5%) (p = 0.0003). Also, younger women were at risk of less frequent participation in cervical cancer screening Conclusions: Although performance of Pap smear among surveyed patients was relatively high, there was a significant group of women who had undergone their first test during pregnancy, which makes secondary cervical cancer prevention in prenatal care a useful prophylactic strategy. Special attention should be given to younger and professionally active women.

Objective: Through the identification of the barriers to the uptake of prevention services for cervical cancer and ways to promote prevention of cervical cancer in the community, this research stud...

Purpose A cross-sectional survey was conducted to evaluate the differences on awareness and attitude towards human papillomavirus (HPV) and its vaccine between local and migrant residents who participated in cervical cancer screening in Shenzhen, China. Materials and Methods A total of 9,855 females sampled from healthcare institutions in 20 street blocks through the Cervical Cancer Prevention Network were surveyed in this study by a self-administered questionnaire. Multivariate logistic regression was conducted to explore the role of the hukou and resident status in the willingness to receive HPV vaccination. Results Local residents had a relatively higher awareness of HPV (62.0% vs. 35.6% vs. 29.9%, p < 0.001) and its vaccine (35.3% vs. 15.4% vs. 14.8%, p < 0.001), as well as a higher willingness to receive HPV vaccination (68.5% vs. 62.5% vs. 56.2%, p < 0.001) than non-permanent residents and floating population. Except for age, education level, marital status, monthly income, having daughter(s), and heard of HPV and its vaccine, the hukou and resident status significantly associated with the willingness to receive HPV vaccination (local residents vs. floating population: odds ratio, 1.216; 95% confidence interval, 1.057 to 1.398). None significant difference on the associated factors was found between local residents and internal migrants (p for interactions > 0.05). Conclusion Inequalities in awareness and attitude towards HPV and its vaccine existed between local and migrant residents in Shenzhen. The hukou and resident status did impact on the willingness to receive HPV vaccination, therefore, it is critical to implement effective health education campaigns on HPV and its vaccine among internal migrants.