Hestbech Mie Sara, Gyrd-Hansen Dorte, Kragstrup Jakob, Siersma Volkert, Brodersen John
Section of General Practice and Research Unit for General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, PO Box 2099, 1014, Copenhagen K, Denmark.
COHERE, Department of Business and Economics & Department of Public Health, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
BMC Public Health. 2016 Aug 3;15:708. doi: 10.1186/s12889-016-3397-y.
Women in several countries will soon be covered by two preventive programmes targeting cervical cancer: HPV vaccination and cervical screening. The HPV vaccines are expected to prevent approximately 70 % of cervical cancers. It has been speculated, that HPV vaccinated women will not attend screening because they falsely think that the vaccine has eliminated their cervical cancer risk. The aim of this study was to investigate the association between HPV vaccination status and perceptions of cervical cancer risk; perceptions of vaccine effect; and intention to participate in cervical screening. Furthermore, to investigate associations between perceptions of cervical cancer risk and intention to participate in cervical screening.
A random sample of Danish women from the birth cohorts 1993-1995 was invited to complete a web-based questionnaire concerning risk perceptions and intentions to participate in cervical screening. Main outcomes were: perceived lifetime-risk of cervical cancer; perceived HPV vaccine effect; and intention to participate in cervical screening.
HPV vaccinated women more often than unvaccinated women intended to participate in screening: adjusted odds ratio (OR) for being HPV vaccinated when intending to participate in screening of 3.89 (95 % CI: 2.50-6.06). HPV vaccinated women perceived cervical cancer risk to be higher than unvaccinated women did: adjusted OR of 0.11 (95 % CI: 0.03-0.39) and 0.51 (95 % CI: 0.33-0.78) for being HPV vaccinated while having the lowest perception of risk (in two different pre-specified dichotomisations). HPV vaccinated women perceived the vaccine effect to be larger than unvaccinated women did: adjusted OR of 0.31 (95 % CI: 0.18-0.51) and 0.37 (95 % CI: 0.25-0.53) for being HPV vaccinated while having the lowest perception of vaccine effect (in two different pre-specified dichotomisations). There were no associations between perceived cervical cancer risk and intention to participate in screening.
HPV vaccinated women more often than unvaccinated women intended to participate in screening and they perceived cervical cancer risk to be higher and the vaccine effect to be larger than unvaccinated women did. However, in our analyses, risk perceptions could not explain screening intentions neither among vaccinated nor among unvaccinated women.
几个国家的女性很快将纳入两项针对宫颈癌的预防计划：人乳头瘤病毒（HPV）疫苗接种和宫颈癌筛查。HPV疫苗预计可预防约70%的宫颈癌。据推测，接种HPV疫苗的女性不会参加筛查，因为她们错误地认为疫苗已消除了患宫颈癌的风险。本研究的目的是调查HPV疫苗接种状况与宫颈癌风险认知、疫苗效果认知以及参与宫颈癌筛查意愿之间的关联。此外，调查宫颈癌风险认知与参与宫颈癌筛查意愿之间的关联。
从1993 - 1995年出生队列的丹麦女性中随机抽取样本，邀请她们完成一份关于风险认知和参与宫颈癌筛查意愿的网络问卷。主要结果包括：感知的宫颈癌终身风险、感知的HPV疫苗效果以及参与宫颈癌筛查的意愿。
接种HPV疫苗的女性比未接种疫苗的女性更常打算参加筛查：打算参加筛查时接种HPV疫苗的调整优势比（OR）为3.89（95%置信区间：2.50 - 6.06）。接种HPV疫苗的女性认为患宫颈癌的风险高于未接种疫苗的女性：在对风险感知最低的情况下（在两种不同的预先设定的二分法中），接种HPV疫苗的调整OR分别为0.11（95%置信区间：0.03 - 0.39）和0.51（95%置信区间：0.33 - 0.78）。接种HPV疫苗的女性认为疫苗效果比未接种疫苗的女性更大：在对疫苗效果感知最低的情况下（在两种不同的预先设定的二分法中），接种HPV疫苗的调整OR分别为0.31（95%置信区间：0.18 - 0.51）和0.37（95%置信区间：0.25 - 0.53）。宫颈癌风险感知与参与筛查的意愿之间没有关联。
接种HPV疫苗的女性比未接种疫苗的女性更常打算参加筛查，并且她们认为患宫颈癌的风险更高，疫苗效果比未接种疫苗的女性更大。然而，在我们的分析中，风险感知既不能解释接种疫苗女性的筛查意愿，也不能解释未接种疫苗女性的筛查意愿。
