title: Impact of medical education on knowledge and attitudes regarding the human papilloma virus and vaccination: comparison before and 6 years after the introduction of the vaccines.
abstract: OBJECTIVE
  The lifetime risk for acquiring a human papilloma virus (HPV) infection is 80% for sexually active people. High-risk HPVs are causally related to almost every case of cervical cancer, and to a subgroup of vaginal, vulvar, anal, penile and oral/oropharyngeal cancer. Low-risk HPVs are related to cutaneous, anogenital, and oral warts. Two prophylactic vaccines were launched in 2007: they were included in the national vaccination program in Belgium (2009) and in the Netherlands (2010). The objectives of the present study were to determine and compare knowledge and attitudes regarding HPV and vaccination among a study population in 2006 and in 2012.
  
  
  METHODS
  Shortly before the introduction, and three years after the inclusion, 715 (2006) and 678 participants (2012) were questioned. Participants were categorised as into non-medics, medics, or paramedics.
  
  
  RESULTS
  In general, knowledge about HPV has increased over time (p<0.01). Well-known facts are the relationship of HPV with cervical cancer (>94% in 2006; >96% in 2012), and that an HPV infection might be asymptomatic (>95% in 2006; >99% in 2012). In 2012, versus in 2006, paramedics and non-medics (both p<0.01), were more likely to vaccinate all female teenagers. Medics were less likely to support this (p=0.001). More respondents agreed to vaccinate their daughters (p<0.01), as well as their sons (p<0.01). In 2012, when compared with 2006, less non-medics and medics (both p<0.01) and more paramedics (p=0.001) would accept a free catch-up vaccination. Arguments against catch-up vaccination reflected the belief not being at risk and doubts about the vaccines' safety.
  
  
  CONCLUSIONS
  The facts that vaccination programs are regarded as being important, and that knowledge on HPV increased, do not automatically result in an increase in participation in HPV vaccination programs. To increase participation, information must be provided with arguments that cannot be misinterpreted.
authors.affiliation: Radboud University Medical Center, Department of Urology, Route 659, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands. Electronic address: k.dhauwers@uro.umcn.nl.
authors.forename: K W M
authors.initials: KW
authors.lastname: D'Hauwers
authors.forename: P F E
authors.initials: PF
authors.lastname: Gadet
authors.forename: A R T
authors.initials: AR
authors.lastname: Donders
authors.forename: W A A
authors.initials: WA
authors.lastname: Tjalma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium; D003430:Cross-Sectional Studies; D004501:Education, Medical; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D030361:Papillomavirus Infections / Q000517:prevention & control; D053918:Papillomavirus Vaccines; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control / Q000821:virology; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: Acceptance; Gender; Human papillomavirus; Medical background; Parenthood; Vaccination