HPV-Related Knowledge and Impact of Patient–Provider Communication on HPV-Associated Cervical Cancer Awareness and Pap Smear Completion in US Women Aged 21–65 Years
Simple Summary
Abstract
1. Introduction
2. Methods
2.1. Survey Administration and Sample Selection
2.2. Analytic Sample
2.3. Study Measures
2.4. Patient–Provider Communication Variables
2.5. Statistical Analyses
3. Results
3.1. Demographic Characteristics of Participants
3.2. Knowledge of HPV and Cervical Cancer Prevention
3.3. Patient–Provider Communication Quality
3.4. Bivariate Analysis to Examine Associations Between Pap Smear History and Knowledge of HPV
3.5. Logistic Regression Analysis of Associations Between Patient–Provider Communication and HPV-Related Variables
3.5.1. Associations with Having Had a Pap Smear
3.5.2. Associations with HPV Knowledge, HPV-Associated Cervical Cancer Risk, and Vaccine Awareness
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Demographic Characteristics | N (%) Unweighted n (Weighted %) |
Age (n = 2286) | |
21–65 | 2286 (100%), Mean = 47.12 (Standard deviation= 12.5) |
Occupational Status (n = 2264) | |
Employed | 1408 (62.19%) |
Homemaker/student/retired/disabled | 342 (15.10%) |
Unemployed | 282 (12.46%) |
Multiple occupation statuses | 180 (7.95%) |
Other occupation | 52 (2.30%) |
Marital Status (n = 2252) | |
Married/living as married or living with a romantic partner | 1183 (52.53%) |
Divorced/widowed/separated | 544 (24.16%) |
Single | 525 (23.31%) |
Education (n = 2194) | |
Less than high school | 128 (5.84%) |
Completed high school/post-high school training | 517 (23.56%) |
Some college | 456 (20.78%) |
College graduate/postgraduate | 1093 (49.82%) |
Hispanic Origin (n = 2198) | |
Not Hispanic | 1717 (78.12%) |
Hispanic | 481 (21.88%) |
Race (n = 2082) | |
White | 1405 (67.48%) |
Black | 421 (20.22%) |
Asian | 108 (5.19%) |
Multiple races selected | 93 (4.47%) |
Other Pacific Islander | 33 (1.59%) |
American Indian or Alaska Native | 22 (1.05%) |
Income Level (n = 2126) | |
$0 to $49,999 | 880 (41.39%) |
$50,000 to $99,999 | 638 (30.01%) |
$100,000 to $199,999 | 428 (20.13%) |
$200,000 or more | 180 (8.47%) |
Have you heard of HPV? (N = 2019) | |
Yes | 1651 (81.77%) |
No | 368 (18.23%) |
Do you think HPV can cause cervical cancer? (N = 1636) | |
Yes | 1179 (72.07%) |
No | 457 (27.93%) |
Before today, have you heard of cervical cancer vaccine or HPV shot? (N = 1634) | |
Yes | 1439 (88.07%) |
No | 195 (11.93%) |
When was your last Pap screen? (N = 1615) | |
≤1 year | 699 (43.28%) |
1–5 years ago | 654 (40.50%) |
More than 5 years ago | 204 (12.63%) |
I have never had a Pap test | 58 (3.59%) |
Give you the chance to ask all healthcare-related questions | |||
Always | Usually | Sometimes | Never |
823 (56%) | 487 (33%) | 143 (10%) | 15 (1%) |
Give the attention you needed to your feelings and emotions | |||
Always | Usually | Sometimes | Never |
615 (42%) | 545 (37%) | 249 (17%) | 59 (4%) |
Involve you in decisions about your health care as much as you wanted | |||
Always | Usually | Sometimes | Never |
772 (53%) | 484 (33%) | 187 (13%) | 25 (2%) |
Make sure you understood the things you needed to do to take care of your health | |||
Always | Usually | Sometimes | Never |
803 (55%) | 486 (33%) | 159 (11%) | 20 (1%) |
Explain things in a way you could understand | |||
Always | Usually | Sometimes | Never |
860 (59%) | 488 (33%) | 108 (7%) | 12 (1%) |
Spend enough time with you | |||
Always | Usually | Sometimes | Never |
577 (39%) | 517 (35%) | 308 (21%) | 66 (5%) |
Help you deal with feelings of uncertainty about your health or healthcare | |||
Always | Usually | Sometimes | Never |
550 (38%) | 512 (35%) | 314 (21%) | 92 (6%) |
Have you ever heard of HPV? | |||
Pap Smear History | Yes | No | p-value |
Had Pap Test | 1731 (77.73%) | 396 (17.78%) | <0.001 * |
Never Had Pap Test | 62 (2.78%) | 38 (1.71%) | |
Before today, have you ever heard of the cervical cancer vaccine or HPV shot? | |||
Pap Smear History | Yes | No | p-value |
Had Pap Test | 1218 (68.66%) | 494 (27.85%) | <0.001 * |
Never Had Pap Test | 28 (1.58%) | 34 (1.91%) | |
Do you think HPV can cause cervical cancer? | |||
Pap Smear History | Yes | No | p-value |
Had Pap Test | 1506 (84.89%) | 206 (11.61%) | 0.004 * |
Never Had Pap Test | 47 (2.65%) | 15 (0.85%) |
Patient–Provider Communication Criteria | Have Not Had a Pap Smear * | Lack of Knowledge Regarding HPV * | Lack of Awareness of the Causality Between HPV and Cervical Cancer * | Lack of knowledge about the HPV Vaccine and Cervical Cancer Prevention Measures * | ||||||||
RR | 95% CI | Sig. ** | RR | 95% CI | Sig. | RR | 95% CI | Sig. | RR | 95% CI | Sig. | |
Chance to ask all health-related questions | ||||||||||||
Always | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref |
Usually | 2.536 | 1.419–4.533 | <0.001 ** | 0.858 | 0.643–1.146 | 0.300 | 1.186 | 0.911–1.545 | 0.205 | 0.903 | 0.611–1.335 | 0.609 |
Sometimes | 3.164 | 1.559–6.419 | <0.001 ** | 1.030 | 0.680–1.560 | 0.888 | 1.048 | 0.691–1.591305 | 0.824 | 1.415 | 0.839–2.387 | 0.193 |
Never | 5.180 | 0.623–6.873 | 0.984 | 1.766 | 0.702–4.447 | 0.227 | 0.253 | 0.0508457–1.256438 | 0.093 | 1.369 | 0.341–5.499 | 0.658 |
Provide attention needed to patient’s feelings and emotions | ||||||||||||
Always | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref |
Usually | 1.395 | 0.739–2.635 | 0.305 | 0.762 | 0.565–1.028 | 0.075 | 1.021 | 0.778–1.340 | 0.881 | 0.964 | 0.647–1.437 | 0.858 |
Sometimes | 2.821 | 1.494–5.328 | <0.001 ** | 1.170 | 0.836–1.638 | 0.359 | 0.854 | 0.601–1.214 | 0.380 | 1.17 | 0.729–1.878 | 0.515 |
Never | 0.350 | 0.044–2.758 | 0.319 | 0.778 | 0.388–1.560 | 0.480 | 0.724 | 0.369–1.419 | 0.346 | 1.509 | 0.687–3.314 | 0.305 |
Allow involvement in healthcare decisions to patient’s satisfaction | ||||||||||||
Always | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref |
Usually | 1.996 | 1.093–3.646 | 0.024 ** | 1.006 | 0.754–1.343 | 0.965 | 0.963 | 0.733–1.267 | 0.790 | 1.056 | 0.706–1.578 | 0.792 |
Sometimes | 2.827 | 1.428–5.594 | 0.003 ** | 1.108 | 0.763–1.608 | 0.591 | 1.284 | 0.894–1.845 | 0.176 | 1.889 | 1.187–3.005 | 0.007 ** |
Never | 1.543 | 0.324–7.342 | 0.585 | 1.115 | 0.458–2.719 | 0.810 | 0.755 | 0.284–2.007 | 0.573 | 1.267 | 0.403–3.982 | 0.686 |
Ensure patient understanding about actions to be taken to improve health | ||||||||||||
Always | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref |
Usually | 1.361 | 0.762–2.433 | 0.298 | 0.896 | 0.674–1.191 | 0.450 | 1.095 | 0.838–1.431 | 0.507 | 0.757 | 0.503–1.140 | 0.183 |
Sometimes | 1.847 | 0.913–3.735 | 0.088 | 0.777 | 0.503–1.200 | 0.255 | 1.188 | 0.802–1.761 | 0.390 | 1.561 | 0.954–2.555 | 0.076 |
Never | 0.694 | 0.087–5.563 | 0.731 | 1.472 | 0.617–3.514 | 0.384 | 0.747 | 0.255–2.189 | 0.594 | 2.023 | 0.680–6.015 | 1.27 |
Explain things to ensure patient understanding | ||||||||||||
Always | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref |
Usually | 1.103 | 0.614–1.980 | 0.743 | 0.945 | 0.711–1.255 | 0.694 | 1.061 | 0.814–1.383 | 0.663 | 0.843 | 0.564–1.261 | 0.405 |
Sometimes | 2.0138 | 0.976–4.153 | 0.058 | 1.257 | 0.815–1.937 | 0.301 | 1.414 | 0.908–2.201 | 0.126 | 1.952 | 1.150–3.312 | 0.013 * |
Never | 1.467 | 0.180–12.009 | 0.719 | 1.521 | 0.502–4.604 | 0.458 | 1.127 | 0.312–4.070 | 0.855 | 7.997 | 2.357–27.140 | <0.001 ** |
Spend enough time with patient | ||||||||||||
Always | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref |
Usually | 1.537 | 0.770–3.070 | 0.223 | 0.931 | 0.691–1.255 | 0.640 | 0.950 | 0.715–1.262 | 0.723 | 0.789 | 0.514–1.212 | 0.279 |
Sometimes | 3.419 | 1.755–6.661 | <0.001 ** | 0.988 | 0.704–1.387 | 0.945 | 1.198 | 0.867–1.654 | 0.274 | 1.320 | 0.846–2.059 | 0.221 |
Never | 1.554 | 0.485–4.986 | 0.458 | 0.887 | 0.481–1.636 | 0.700 | 0.798 | 0.432–1.476 | 0.473 | 1.997 | 1.018–3.916 | 0.044 ** |
Help patient deal with feelings of uncertainty about their health | ||||||||||||
Always | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref |
Usually | 1.048 | 0.541–2.031 | 0.890 | 0.987 | 0.735–1.326 | 0.933 | 0.979 | 0.735–1.304 | 0.885 | 0.915 | 0.599–1.399 | 0.683 |
Sometimes | 2.108 | 1.106–4.016 | 0.023 ** | 0.798 | 0.556–1.139 | 0.214 | 1.08 | 0.781–1.496 | 0.640 | 1.243 | 0.792–1.951 | 0.345 |
Never | 0.990 | 0.322–3.043 | 0.986 | 0.749 | 0.422–1.327 | 0.321 | 0.768 | 0.447–1.320 | 0.339 | 1.444 | 0.746–2.794 | 0.276 |
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Dean, A.; Eldawy, N.; Mendonca, J.; Lobaina, D.; Zerrouki, Y.; Okwaraji, G.; Jhumkhawala, V.; Burgoa, S.; Ejezie, C.L.; Kitsantas, P.; et al. HPV-Related Knowledge and Impact of Patient–Provider Communication on HPV-Associated Cervical Cancer Awareness and Pap Smear Completion in US Women Aged 21–65 Years. Cancers 2025, 17, 1188. https://doi.org/10.3390/cancers17071188
Dean A, Eldawy N, Mendonca J, Lobaina D, Zerrouki Y, Okwaraji G, Jhumkhawala V, Burgoa S, Ejezie CL, Kitsantas P, et al. HPV-Related Knowledge and Impact of Patient–Provider Communication on HPV-Associated Cervical Cancer Awareness and Pap Smear Completion in US Women Aged 21–65 Years. Cancers. 2025; 17(7):1188. https://doi.org/10.3390/cancers17071188
Chicago/Turabian StyleDean, Adrienne, Nada Eldawy, Jennifer Mendonca, Diana Lobaina, Yasmine Zerrouki, Goodness Okwaraji, Vama Jhumkhawala, Sara Burgoa, Chinenye Lynette Ejezie, Panagiota Kitsantas, and et al. 2025. "HPV-Related Knowledge and Impact of Patient–Provider Communication on HPV-Associated Cervical Cancer Awareness and Pap Smear Completion in US Women Aged 21–65 Years" Cancers 17, no. 7: 1188. https://doi.org/10.3390/cancers17071188
APA StyleDean, A., Eldawy, N., Mendonca, J., Lobaina, D., Zerrouki, Y., Okwaraji, G., Jhumkhawala, V., Burgoa, S., Ejezie, C. L., Kitsantas, P., Mejia, M., & Sacca, L. (2025). HPV-Related Knowledge and Impact of Patient–Provider Communication on HPV-Associated Cervical Cancer Awareness and Pap Smear Completion in US Women Aged 21–65 Years. Cancers, 17(7), 1188. https://doi.org/10.3390/cancers17071188