title: Sociodemographic factors predicting mother's cervical screening and daughter's HPV vaccination uptake.
abstract: BACKGROUND
  Achieving high human papillomavirus (HPV) vaccine coverage may reduce inequalities in cervical cancer prevention by mitigating the inequalities seen in the cervical screening programme. This paper assesses whether the same sociodemographic factors are associated with both cervical screening and HPV vaccination.
  
  
  METHODS
  Girls' HPV vaccination records were linked by address to cervical screening records for their mothers in the North West of England. Index of Multiple Deprivation scores (2010) and census ethnicity data (2001) were used to investigate the association between deprivation and ethnic composition of area of residence with HPV vaccination and cervical screening uptake, along with potential differences between Primary Care Trusts (PCTs), which were responsible for vaccine delivery.
  
  
  RESULTS
  Deprivation was not associated with routine (12-13-year-olds) vaccination initiation, but girls living in the most deprived quintile were significantly less likely to complete the three vaccine doses (OR 0.75; 95% CI 0.63 to 0.88). Mother-daughter pairs failing to engage in either screening or vaccination were also more likely to live in deprived areas (routine vaccination OR for most deprived quintile: 2.35; 95% CI 2.00 to 2.77). There were differences between PCTs after controlling for demographic effects (OR 1.35; 95% CI 1.23 to 1.52).
  
  
  CONCLUSIONS
  Ensuring completion of the vaccine schedule is critical for organisations responsible for vaccine delivery in order to reduce cancer risk among girls living in deprived areas. There remains a small minority of mothers and daughters from disadvantaged backgrounds who do not participate in either cervical screening or HPV vaccination.
authors.affiliation: Manchester Urban Collaboration on Health, Institute of Population Health, Manchester Academic Health Sciences Centre, University of Manchester, , Manchester, UK.
authors.forename: Angela M
authors.initials: AM
authors.lastname: Spencer
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Roberts
authors.forename: Loretta
authors.initials: L
authors.lastname: Brabin
authors.forename: Julietta
authors.initials: J
authors.lastname: Patnick
authors.forename: Arpana
authors.initials: A
authors.lastname: Verma
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D016208:Databases, Factual; D055088:Early Detection of Cancer / Q000191:economics* / Q000706:statistics & numerical data; D004739:England; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009035:Mothers / Q000706:statistics & numerical data; D009313:National Health Programs / Q000706:statistics & numerical data; D009679:Nuclear Family; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage / Q000191:economics*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011204:Poverty Areas; D012572:School Health Services / Q000706:statistics & numerical data; D012923:Social Class; D002583:Uterine Cervical Neoplasms / Q000209:etiology / Q000517:prevention & control* / Q000821:virology
chemical_list: D053918:Papillomavirus Vaccines
keywords: CANCER: CERVIX; SCREENING; VACCINATION