Awareness of and attitude towards human papillomavirus infection and vaccination for cervical cancer prevention among adult males and females in Korea: A nationwide interview survey
Introduction
Following its rapid development, the prophylactic vaccine for human papillomavirus (HPV) is promising as a key component of future cervical cancer control programs; accordingly, an international effort to disseminate the vaccine has been implemented [1]. The HPV vaccine has been used in some communities or nations with or without national guidelines for vaccination, although cost-effectiveness analyses and efficacy trials in men are still ongoing.
However, the successful introduction and acceptance of the vaccine will depend on a range of factors including awareness of HPV infection as an important problem related to cervical cancer, the affordability and acceptability of the vaccine among the groups who will influence uptake, and political interest. Furthermore, in the absence of legally mandated and enforced HPV immunization, at-risk persons must voluntarily agree to receive the vaccine, a decision that is affected by individual knowledge, beliefs about susceptibility, perception of vaccine effectiveness, family and physician perspectives, sexual and cultural practices, and cost for vaccination.
For this reason, studies on awareness regarding HPV infections and attitudes towards HPV vaccinations have been conducted in many countries from the perspective of physicians [2], [3], [4], [5], [6], [7], parents [8], [9], [10], adolescents [11], [12], [13], [14], and Asians [15], [16], [17]. These study results differed in the characteristics of the study population, country, and socio-cultural background.
In Korea, HPV is suggested to be one of the most common sexually transmitted infection, with a 10% prevalence in sexually active women aged 20–74 years olds [18], [19]. The prevalence in young adults is also high, as reported in a recent epidemiologic study (15.2% and 8.7% in female and male university students, respectively) [20]. Corresponding to the high prevalence of HPV, uterine cervical cancer is still a major cancer affecting Korean women despite the fact that a national cervical cancer screening program using the Pap test has contributed to a decrease in cervical cancer incidence and mortality [21], [22], [23].
Recently two HPV vaccines were approved by the Korean Food and Drug Administration (KFDA), immunization of adolescent girls against HPV before having their first sexual contact was highly recommended by the Committee on Infectious Diseases of the Korean Pediatric Society [24] and the Korean Society of Gynecologic Oncology and Colposcopy [25]. However, national guidelines for HPV vaccination have not yet been established due to a lack of epidemiologic data, economic evaluations and many practical issues regarding its application.
Currently, although adolescents and young adults have been investigated for future HPV vaccine acceptance in a few studies [20], [26], little is known about adult males and females. However, this information is important in the debate regarding the necessity of mandated vaccination against HPV and for decisions on how the HPV vaccination should be applied to an overall cervical cancer control program.
Therefore, in this study, overall awareness of HPV infection as a necessary cause of cervical cancer and attitudes toward HPV vaccination were investigated among the general adult population, including males.
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Methods
Between November 1 and 19, 2007, in 15 provinces of 16 provinces in Korea (except 1 province, Jeju Island, a very remote area), a population-based cross-sectional survey was conducted by Gallup Korea, which is the leading and experienced research company has been affiliated with Gallup International. With the probability random sampling proportional to size of population and regarding age and gender distribution in each district and province, the fourfold target houses were selected from each
Results
The number of subjects was evenly distributed with regard to sex and age group, although subjects aged over 50 years were more prevalent (Table 1). Those with a high school education accounted for 46%, and 56% of the study population were middle-income (between 2000 and 4000 US dollars). Residents living in a metropolitan area or city accounted for 90% of the population, and the remaining 10% lived in small towns.
A total of 26.1% of subjects (male: 20.6%, female: 31.5%) had known that STIs can
Discussion
The HPV vaccine has been introduced rapidly as a result of its reliability in cervical cancer prevention although there are low-level awareness and various misconceptions regarding HPV infection and vaccination. The present study supports the need of addressing community concern prior to introducing a new vaccine through comprehensive communication strategies.
Particular in Korea, for control of cervical cancer development, control of HPV infection has recently been reinforced in situation of
Acknowledgement
This study was financially supported by the National Cancer Center (grant no. NCC-0710830).
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