French women’s knowledge of and attitudes towards cervical cancer prevention and the acceptability of HPV vaccination among those with 14 – 18 year old daughters: a quantitative-qualitative study

BMC Public Health

Christine Lasset³  Franck Chauvin¹  Philippe Vanhems⁴  Yann Leocmach²  Véronique Régnier¹  Anne-Carole Jacquard²  Giovanna Barone³  Julie Kalecinski¹  Delphine Lutringer-Magnin³  Julie Haesebaert³ 

[1]Institut de Cancérologie Lucien Neuwirth, CIC-EC 3 Inserm, IFR 143, Saint-Etienne, France

[2]Sanofi-Pasteur MSD, Lyon, France

[3]Université Lyon 1, CNRS UMR 5558 Centre Léon Bérard, 28, rue Laënnec, 69373 cedex 08, Lyon, France

[4]Université Lyon 1, CNRS UMR 5558 and Hospices Civils de Lyon, Lyon, France

关键词: Mothers;    Women;    Acceptability;    Cervical cancer prevention;    HPV vaccine;    Papillomavirus;   

Others  :  1162774
DOI  :  10.1186/1471-2458-12-1034

 received in 2012-07-20, accepted in 2012-11-15,  发布年份 2012

【 摘 要 】

Background

In France, it is recommended that girls and women aged 14–23 are vaccinated against the human papillomavirus (HPV). However, French women’s knowledge of and attitude towards the vaccine has been little studied.

Methods

Thirty-nine general practitioners, representative of those working in the large Rhône-Alpes region, offered a self-administered questionnaire on cervical cancer (CC) prevention to all 18–65 year-old women who came for consultation during June and July 2008. In addition, semi-structured interviews were undertaken with a sample of those who had daughters aged 14–18.

Results

Of the 1,478 women who completed the questionnaire, only 16.9% mentioned HPV as the cause of CC, even though 76.2% knew of the vaccine. 210 women had daughters aged 14–18, and 32 were interviewed. Compared with the wider group, more of these women were aware of the HPV vaccine (91.4%). 44.8% knew the target population and 17.1% the recommended ages for vaccination. 54.3% favoured HPV vaccination; 37.2% were undecided and only 0.9% were opposed. The main barrier to acceptance was the recency of the vaccine’s introduction and concern about possible side effects (54.9%); 14.1% preferred to rely on their GP’s decision. Factors associated with acceptance of the HPV vaccine were having previously vaccinated a child against pneumococcus (OR=3.28 [1.32-8.11]) and knowing the target population for HPV vaccination (OR=2.12 [1.15-3.90]). Knowing the recommended frequency of Papanicolaou smear testing (Pap test) screening was associated with lower acceptance (OR=0.32 [0.13-0.82]).

Conclusions

Few mothers are opposed to HPV vaccination. Factors associated with acceptability were knowledge about the vaccine, acceptance of other vaccines and, unexpectedly, lack of knowledge about the recommended frequency of Pap testing. On multivariate analysis, compliance with recommendations for Pap test screening and socioeconomic factors had no effect on views about HPV vaccination. Given that concern about possible side effects is the major barrier to wider acceptance of the HPV vaccine in France, GPs have a key role in providing information.

【 授权许可】

   
2012 Haesebaert et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Belot A, Grosclaude P, Bossard N, Jougla E, Benhamou E, Delafosse P, Guizard AV, Molinie F, Danzon A, Bara S, et al.: Cancer incidence and mortality in France over the period 1980–2005. Rev Epidemiol Sante Publique 2008, 56:159-175.
• [2]Munoz N, Bosch FX, de Sanjose S, Herrero R, Castellsague X, Shah KV, Snijders PJ, Meijer CJ: Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med 2003, 348:518-527.
• [3]HAS: Etat des lieux et recommandations pour le dépistage du cancer du col de l'utérus en France. 2010. File available online at: http://www.has-sante.fr/portail/upload/docs/application/pdf/2010-11/argumentaire_recommandations_depistage_cancer_du_col_de_luterus.pdf webcite
• [4]Rousseau A, Bohet P, Merliere J, Treppoz H, Heules-Bernin B, Ancelle-Park R: Evaluation du dépistage organisé et du dépistage individuel du cancer du col de l'utérus: utilite des données de l’assurance maladie. Bulletin d'épidémiologie hebdomadaire 2002, 19:81-83.
• [5]HAS: Recommandation du Collège de la HAS sur les vaccins anti-HPV. 2008.
• [6]Dempsey AF, Davis MM: Overcoming barriers to adherence to HPV vaccination recommendations. Am J Manag Care 2006, 12:S484-S491. this file is available online at: http://www.snfge.asso.fr/01-bibliotheque/0d-pratiques-cliniques/has/recommandation_college_has_cervarix_170408.pdf webcite
• [7]Das A, Madhwapathi V, Davies P, Brown G, Dearnley E, Spencer A, Williams H: Knowledge and acceptability of the HPV vaccine by school children and their parents in Birmingham. Vaccine 2010, 28:1440-1446.
• [8]Yeganeh N, Curtis D, Kuo A: Factors influencing HPV vaccination status in a Latino population; and parental attitudes towards vaccine mandates. Vaccine 2010, 28:4186-4191.
• [9]Barnack JL, Reddy DM, Swain C: Predictors of parents' willingness to vaccinate for human papillomavirus and physicians' intentions to recommend the vaccine. Womens Health Issues 2010, 20:28-34.
• [10]Dahlstrom LA, Tran TN, Lundholm C, Young C, Sundstrom K, Sparen P: Attitudes to HPV vaccination among parents of children aged 12–15 years-a population-based survey in Sweden. Int J Cancer 2010, 126:500-507.
• [11]Constantine NA, Jerman P: Acceptance of human papillomavirus vaccination among Californian parents of daughters: a representative statewide analysis. J Adolesc Health 2007, 40:108-115.
• [12]Marlow LA, Waller J, Wardle J: Public awareness that HPV is a risk factor for cervical cancer. Br J Cancer 2007, 97:691-694.
• [13]Fang CY, Coups EJ, Heckman CJ: Behavioral correlates of HPV vaccine acceptability in the 2007 Health Information National Trends Survey (HINTS). Cancer Epidemiol Biomarkers Prev 2010, 19:319-326.
• [14]Marlow LA, Waller J, Wardle J: Trust and experience as predictors of HPV vaccine acceptance. Hum Vaccin 2007, 3:171-175.
• [15]Dempsey AF, Zimet GD, Davis RL, Koutsky L: Factors that are associated with parental acceptance of human papillomavirus vaccines: a randomized intervention study of written information about HPV. Pediatrics 2006, 117:1486-1493.
• [16]Chao C, Slezak JM, Coleman KJ, Jacobsen SJ: Papanicolaou screening behavior in mothers and human papillomavirus vaccine uptake in adolescent girls. Am J Public Health 2009, 99:1137-1142.
• [17]Rosenthal SL, Rupp R, Zimet GD, Meza HM, Loza ML, Short MB, Succop PA: Uptake of HPV vaccine: demographics, sexual history and values, parenting style, and vaccine attitudes. J Adolesc Health 2008, 43:239-245.
• [18]Marlow LA, Waller J, Wardle J: Sociodemographic predictors of HPV testing and vaccination acceptability: results from a population-representative sample of British women. J Med Screen 2008, 15:91-96.
• [19]Trim K, Nagji N, Elit L, Roy K: Parental knowledge, attitudes, and behaviours towards human papillomavirus vaccination for their children: a systematic review from 2001 to 2011. Obstet Gynecol Int 2012, 2012:921236.
• [20]Marlow LA, Forster AS, Wardle J, Waller J: Mothers’ and adolescents’ beliefs about risk compensation following HPV vaccination. J Adolesc Health 2009, 44:446-451.
• [21]Zimet GD, Perkins SM, Sturm LA, Bair RM, Juliar BE, Mays RM: Predictors of STI vaccine acceptability among parents and their adolescent children. J Adolesc Health 2005, 37:179-186.
• [22]Lutringer-Magnin D, Kalecinski J, Barone G, Leocmach Y, Regnier V, Jacquard AC, Soubeyrand B, Vanhems P, Chauvin F, Lasset C: Human Papilloma Virus (HPV) vaccination: perception and practice among French general practitioners in the year since licensing. Vaccine 2011, 29(32):5322-5328. Submitted
• [23]Miles MB, Huberman MA: Analyse des données qualitatives. Volume 2e ed. Edited by Boeck . Bruxelles: De Boeck; 2003.
• [24]INCA: Les Français face au dépistage des cancers. 2009. http://www.e-cancer.fr/depistage/cancer-colorectal/dossier-pour-les-professionnels/les-modalites-du-depistage#Les%20Fran%C3%A7ais%20face%20au%20d%C3%A9pistage webcite
• [25]Lazcano-Ponce E, Rivera L, Arillo-Santillan E, Salmeron J, Hernandez-Avila M, Munoz N: Acceptability of a human papillomavirus (HPV) trial vaccine among mothers of adolescents in Cuernavaca, Mexico. Arch Med Res 2001, 32:243-247.
• [26]Waller J, McCaffery K, Wardle J: Beliefs about the risk factors for cervical cancer in a British population sample. Prev Med 2004, 38:745-753.
• [27]Ogilvie G, Anderson M, Marra F, McNeil S, Pielak K, Dawar M, McIvor M, Ehlen T, Dobson S, Money D, et al.: A population-based evaluation of a publicly funded, school-based HPV vaccine program in British Columbia, Canada: parental factors associated with HPV vaccine receipt. PLoS Med 2010, 7:e1000270.
• [28]Balinska MA: Hepatitis B vaccination and French Society ten years after the suspension of the vaccination campaign: how should we raise infant immunization coverage rates? J Clin Virol 2009, 46:202-205.
• [29]Gamble HL, Klosky JL, Parra GR, Randolph ME: Factors influencing familial decision-making regarding human papillomavirus vaccination. J Pediatr Psychol 2010, 35:704-715.
• [30]Freed GL, Clark SJ, Butchart AT, Singer DC, Davis MM: Sources and perceived credibility of vaccine-safety information for parents. Pediatrics 2011, 127(Suppl 1):S107-S112.
• [31]Litton AG, Desmond RA, Gilliland J, Huh WK, Franklin FA: Factors associated with intention to vaccinate a daughter against HPV: a statewide survey in Alabama. J Pediatr Adolesc Gynecol 2011, 24:166-171.
• [32]Kennedy A, Sapsis KF, Stokley S, Curtis CR, Gust D: Parental attitudes toward human papillomavirus vaccination: evaluation of an educational intervention, 2008. J Health Commun 2011, 16:300-313.
• [33]Marlow LA, Waller J, Wardle J: Parental attitudes to pre-pubertal HPV vaccination. Vaccine 2007, 25:1945-1952.
• [34]Davis K, Dickman ED, Ferris D, Dias JK: Human papillomavirus vaccine acceptability among parents of 10- to 15-year-old adolescents. J Low Genit Tract Dis 2004, 8:188-194.
• [35]Brewer NT, Fazekas KI: Predictors of HPV vaccine acceptability: a theory-informed, systematic review. Prev Med 2007, 45:107-114.
• [36]Levy-Bruhl D, Bousquet V, King LA, O'Flanagan D, Bacci S, Lopalco PL, Salmaso S: The current state of introduction of HPV vaccination into national immunisation schedules in Europe: results of the VENICE 2008 survey. Eur J Cancer 2009, 45:2709-2713.
• [37]Institut national de prévention et d'éducation pour la santé: Baromètre cancer 2005. 2005. http://www.inpes.sante.fr/CFESBases/catalogue/pdf/991.pdf webcite