Perception and knowledge of human papillomavirus (HPV) vaccine for cervical cancer prevention among fully vaccinated female university students in the era of HPV vaccination: a cross-sectional study

Objective To assess the perception and knowledge of cervical cancer prevention among fully vaccinated female university students in the era of human papillomavirus (HPV) vaccination. Design Cross-sectional using a validated questionnaire. Setting Face-to-face interview at a public university in Malaysia. Participants 384 fully vaccinated female students were included in the study. Results The total knowledge score in the questionnaire was 18 and was ranked according to score level into three groups: poor (score <= 5), moderate (score 6-10) and good (score >= 11). Mean score for knowledge of cervical cancer prevention was 8.24 (SD +/- 3.85), with 170 respondents (44.3%) scoring moderate knowledge level. The mean score for knowledge of HPV infection and its association with cervical cancer was 4.56 +/- 2.47, while the mean score for knowledge of HPV vaccination for cervical cancer prevention was 3.68 (SD +/- 1.98). A total of 186 (48.4%) respondents perceived that regular Pap smear was unnecessary after HPV vaccination. Respondents' perceived seriousness and susceptibility of HPV infection correlated well with knowledge of cervical cancer prevention. Two main reasons for their acceptance of HPV vaccine were self-health awareness and free vaccination. Conclusion The knowledge of HPV vaccination for cervical cancer prevention was average among vaccinated university students. Many of them had poor knowledge about Pap smear and did not consider regular Pap smear as an important cervical cancer screening tool following HPV vaccination. There is still a need for continued health education to improve the perception and knowledge about HPV infection and cervical cancer prevention among young adults in the community.