Massad L Stewart, Evans Charlesnika T, Weber Kathleen M, D'Souza Gypsyamber, Hessol Nancy A, Wright Rodney L, Colie Christine, Strickler Howard D, Wilson Tracey E
Department of Obstetrics & Gynecology, Washington University School of Medicine, St. Louis, MO.
Department of Preventive Medicine and Center for Healthcare Studies, Northwestern University, Chicago, IL and Department of Veterans Affairs Hines Jr. VA Hospital, Hines, IL.
Gynecol Oncol Rep. 2015 Apr 1;12:37-40. doi: 10.1016/j.gore.2015.02.007.
To describe changes in knowledge of cervical cancer prevention, human papillomavirus (HPV), and HPV vaccination among women at high risk for cervical cancer in the first five years after introduction of HPV vaccination.
In 2007, 2008-9, and 2011, women in a multicenter U.S. cohort study completed 44-item self-report questionnaires assessing knowledge of cervical cancer prevention, HPV, and HPV vaccination. Results across time were assessed for individuals, and three study enrollment cohorts were compared. Knowledge scores were correlated with demographic variables, measures of education and attention, and medical factors. Associations were assessed in multivariable models.
In all, 974 women completed three serial questionnaires; most were minority, low income, and current or former smokers. The group included 652 (67%) HIV infected and 322 (33%) uninfected. Summary knowledge scores (possible range 0-24) increased from 2007 (12.8, S.D. 5.8) to 2008-9 (13.9, S.D. 5.3, P < 0.001) and to 2011 (14.3, S.D 5.2, P < 0.0001 vs 2007 and <0.04 vs 2008-9). Higher knowledge scores at first and follow-up administration of questionnaires, higher income, and higher education level were associated with improved knowledge score at third administration. Women not previously surveyed had scores similar to those of the longitudinal group at baseline.
Substantial gaps in understanding of HPV and cervical cancer prevention exist despite years of health education. While more effective educational interventions may help, optimal cancer prevention may require opt-out vaccination programs that do not require nuanced understanding.
描述在引入人乳头瘤病毒（HPV）疫苗接种后的头五年里，宫颈癌高危女性对宫颈癌预防、HPV及HPV疫苗接种的知识变化情况。
在2007年、2008 - 2009年以及2011年，美国一项多中心队列研究中的女性完成了一份包含44个项目的自填式问卷，以评估她们对宫颈癌预防、HPV及HPV疫苗接种的知识。对个体的不同时间结果进行评估，并比较三个研究入组队列。知识得分与人口统计学变量、教育和关注度指标以及医学因素相关。在多变量模型中评估关联。
共有974名女性完成了三份连续问卷；大多数为少数族裔、低收入者，且为当前或既往吸烟者。该组包括652名（67%）感染HIV者和322名（33%）未感染者。总体知识得分（可能范围0 - 24）从2007年的（12.8，标准差5.8）增至2008 - 2009年的（13.9，标准差5.3，P < 0.001），并增至2011年的（14.3，标准差5.2，与2007年相比P < 0.0001，与2008 - 2009年相比P < 0.04）。首次及后续问卷管理时较高的知识得分、较高收入以及较高教育水平与第三次问卷管理时知识得分的提高相关。此前未接受调查的女性得分与纵向组在基线时的得分相似。
尽管多年来开展了健康教育，但在对HPV及宫颈癌预防的理解方面仍存在巨大差距。虽然更有效的教育干预可能会有所帮助，但最佳的癌症预防可能需要无需细致理解的默认接种疫苗计划。
