title: Prevalence of HPV Infection And Cervical Intraepithelial Neoplasia And Attitudes towards HPV Vaccination among Chinese Women Aged 18-25 in Jiangsu Province.
abstract: OBJECTIVE
  Few data are available on the epidemiology of HPV and cervical cancer among Chinese women younger than 25 years old. This study aimed to estimate the HPV infection rate and the prevalence of cervical intraepithelial neoplasia (CIN) in women aged 18-25, as well as their knowledge of and attitudes towards HPV vaccination.
  
  
  METHODS
  A population-based cervical cancer screening study was conducted on women aged 18-25 in Jiangsu province in 2008. Participants provided socio-demographic, reproductive and behavioral information and completed a survey about their knowledge of and attitudes towards HPV vaccination. Women then underwent a gynecologic exam to provide two cervical exfoliated cell samples for high risk HPV DNA testing and liquid-based cytology (LBC) as well as visual inspection with acetic acid (VIA). Women testing positive for any test were referred to colposcopy and biopsy. The gold standard for diagnosis of cervical lesions was directed or random biopsies.
  
  
  RESULTS
  Within the sample of 316 women, 3.4% of them were diagnosed with CIN grade 2 or worse lesions and 17.1% were found to be positive for HPV DNA. Among these young women, extra-marital sexual behavior of them (OR=2.0, 95%CI: 1.1-3.8) or their husbands (OR=2.6, 95%: 1.4-4.7) were associated with an increased risk of HPV positivity. Although overall HPV awareness was low, after a brief educational intervention, 98.4% reported they would electively receive HPV vaccination and would also recommend that their daughters be vaccinated. However, most urban and rural women reported their ideal maximum out-of-pocket contribution for HPV vaccination to be less than 500 RMB and 50-100 RMB, respectively.
  
  
  CONCLUSIONS
  Our study indicates cervical disease burden is relatively high among sampled Chinese women aged 18-25. Appropriate educational interventions for female adolescents and strategies to subsidize vaccine costs are definitely needed to ensure the effectiveness of vaccination campaigns in China.
authors: Department of Epidemiology & Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences; ; Department of Cancer Epidemiology, Chinese Academy of Medical Sciences; Peking Union Medical College, Beijing 100021, China.
authors: Shang-Ying
authors: SY
authors: Hu
authors: Ying
authors: Y
authors: Hong
authors: Fang-Hui
authors: FH
authors: Zhao
authors: Adam K
authors: AK
authors: Lewkowitz
authors: Feng
authors: F
authors: Chen
authors: Wen-Hua
authors: WH
authors: Zhang
authors: Qin-Jing
authors: QJ
authors: Pan
authors: Xun
authors: X
authors: Zhang
authors: Cindy
authors: C
authors: Fei
authors: Hui
authors: H
authors: Li
authors: You-Lin
authors: YL
authors: Qiao
keywords: Attitude; Cervical cancer; Cervical intraepithelial neoplasia; Human papillomavirus; Knowledge