title: HPV vaccination among French girls and women aged 14-23 years and the relationship with their mothers' uptake of Pap smear screening: a study in general practice.
abstract: BACKGROUND
  HPV vaccination is recommended in France for girls aged 14 and for those aged 15-23 before sexual debut or who have become sexually active within the previous year. The first aim was to describe vaccination practice among 14-23-year-old girls visiting a general practitioner. A second objective was to investigate factors associated with starting vaccination among girls aged 14-18, in particular the regular practice of Pap-smear screening (PSS) by their mothers.
  
  
  METHODS
  A cross-sectional study was conducted from June to August 2009. A total of 87 general practitioners from the large Rhône-Alpes region contributed data on 502 girls/women who came for consultation.
  
  
  RESULTS
  231 (46.0%) of these girls/women had begun the process of HPV vaccination (68.2%, 56.9% and 18.7% of the 14-16, 17-20 and 21-23-year-olds respectively) of whom 139 (60.2%) had received all three doses. 92 girls/women (39.8%) had received only one or two doses at the time of study. However, in 71 (77.2%) cases, the gap between the last dose received and the time of study was within the between-dose interval recommended in the vaccination schedule. GPs reported that 16 (11.5%) had mentioned side effects following injections. Having a mother who practised regular PSS (Odds Ratio 6.2 [1.5-25.8]), having never lived with a partner (4.6 [1.6-13.5]) and vaccination against hepatitis B (3.2 [1.6-6.1]) were found to be independently correlated with the initiation of HPV vaccination among girls/women aged 14-18 years.
  
  
  CONCLUSIONS
  Two years after the start of the programme, only half of girls/women aged 14-23 years had begun the process of HPV vaccination. HPV vaccination status was correlated with PSS in the mother, family status and hepatitis B vaccination. Such information may help to better target girls who are less likely to be vaccinated.
authors.affiliation: Centre Léon Bérard, Lyon, France; Université Lyon 1, CNRS UMR 5558, France. Electronic address: delphine.lutringer@lyon.unicancer.fr.
authors.forename: D
authors.initials: D
authors.lastname: Lutringer-Magnin
authors.forename: C
authors.initials: C
authors.lastname: Cropet
authors.forename: G
authors.initials: G
authors.lastname: Barone
authors.forename: G
authors.initials: G
authors.lastname: Canat
authors.forename: J
authors.initials: J
authors.lastname: Kalecinski
authors.forename: Y
authors.initials: Y
authors.lastname: Leocmach
authors.forename: P
authors.initials: P
authors.lastname: Vanhems
authors.forename: F
authors.initials: F
authors.lastname: Chauvin
authors.forename: C
authors.initials: C
authors.lastname: Lasset
mesh_terms: D000293:Adolescent; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D058006:General Practice; D006801:Humans; D009035:Mothers; D065006:Papanicolaou Test / Q000706:statistics & numerical data*; D030361:Papillomavirus Infections / Q000517:prevention & control*; D010287:Parent-Child Relations; D055815:Young Adult
keywords: Cervical cancer screening; France; Human papillomavirus vaccination; Pap smear; Side effects