What do U.S. women know about human papillomavirus (HPV) and cervical cancer? Free

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Background. Cervical cancer screening with the Pap test is well integrated into the U.S. health care system and widely accepted by women. However, recent advances in cervical cancer etiology, specifically the identification of human papillomavirus (HPV) as a necessary cause, are changing clinical perspectives on what tests (HPV DNA vs. cervical cytology) should be used for screening. Also, results support using a vaccine to prevent transmission of certain carcinogenic HPV types. The changing landscape of technologies used to prevent and detect cervical cancer offers new options to women and health care providers. It is therefore critical that women have accurate knowledge about the HPV-cervical cancer link in order to make appropriate, evidence-based health care choices. Data available from special populations (university students and women attending colposcopy clinics) suggest that women know little about HPV. Less is known about HPV awareness among older women and women with average risk for developing cervical cancer. Assessment of the public's knowledge of HPV in nationally representative samples was identified as a high-priority research aim in 1999 by the Centers for Disease Control and Prevention, but has yet to be achieved. Objectives. To assess factors associated with U.S. women's awareness of human papillomavirus (HPV) and knowledge about its link to cervical cancer. Methods. Analyzed cross-sectional data from women ages 18 to 75 years of age responding to the 2005 Health Information National Trends Survey (n = 3,076). Results. Among the 40% of women (n = 1,248) who had ever heard about HPV, <50% knew it caused cervical cancer. Knowledge that HPV was sexually transmitted and caused abnormal Pap smears was higher (64% and 79%). Factors associated with having heard about HPV included: younger age, higher educational attainment, exposure to multiple health information sources, trusting health information, regular Pap tests, awareness of changes in cervical cancer screening guidelines, and HPV positivity. Accurate knowledge of the HPV-cervical cancer link was associated with recent abnormal Pap and HPV positivity. Conclusions. Awareness about HPV among U.S. women is relatively low. Having heard about HPV did not ensure accurate knowledge. Clear, consistent information about HPV transmission, prevention, detection, and link to cervical cancer needs to be provided during well care visits and not only with abnormal Pap or positive HPV test results.