Human Papillomavirus and Cervical Screening: Misconceptions Undermine Adherence

Abstract

Purpose. Prophylactic vaccination programs in conjunction with cervical screening can significantly reduce the incidence of cervical cancer worldwide. This study tested the hypothesis that human papillomavirus (HPV) vaccination can adversely affect adherence to cervical screening if the public develops the misconception that the HPV vaccination has removed the need for screening. Design. A postal survey using a stratified random sample was employed. Participants. Overall, 500 medical students and 500 nonmedical students of the Aristotle University of Thessaloniki were invited to participate. The response rate was 82%. Measures. A questionnaire was developed assessing demographic characteristics, adherence to cervical screening, and awareness and attitudes toward HPV. Analysis. Logistic regression was used to assess the impact of HPV awareness and attitudes towards HPV vaccination on adherence to Papanicolaou screening, controlling for place of origin and mother's screening behavior. Results. Students who believed that vaccination against HPV obviated the need for a Papanicolaou test were two times less likely to adhere to cervical screening (adjusted odds ratio, 1.89; 95% confidence interval, 1.37–2.57; p = .0004). The effect was stronger in the nonmedical subgroup (adjusted odds ratio, 3.05; 95% confidence interval, 1.85–5.160; p = .0003). Conclusion. Findings highlight that misconceptions can adversely affect preventive behaviors and reduce the probability of an early diagnosis of cervical cancer.