Questionnaire survey on cervical cancer screening and HPV awareness among patients at a local cancer center in Japan

TL;DR

This study surveyed patients in Japan about cervical cancer screening and HPV awareness, finding low screening rates and knowledge gaps that could hinder early detection.

Contribution

The study provides insights into patient behaviors and knowledge gaps in Japan, highlighting barriers to cervical cancer screening and diagnosis.

Findings

Only 43.6% of Japanese women underwent cervical cancer screening in 2022, with older patients less aware of HPV's role in cancer.

Patients with advanced-stage cancer were less likely to have had recent screenings and often sought care due to symptoms.

Endocervical canal tumors and non-squamous cell carcinoma histology pose challenges for accurate screening detection.

Abstract

The incidence of cervical intraepithelial neoplasia is increasing in Japan. Although human papillomavirus (HPV) vaccination and cancer screening are crucial in preventing cancer-related mortality, the cervical cancer screening rate in Japan was only approximately 43.6% in 2022. This study aimed to conduct an epidemiological analysis of cervical cancer by collecting data from individual patients.

A questionnaire survey was administered to patients who visited our hospital between January 2017 and July 2023 owing to abnormal cervical cytological findings or a cancer diagnosis. Patients answered questions regarding their history of cervical cancer screening as well as their knowledge of HPV and cervical cancer.

During the study period, 471 patients participated in the survey, with 35 declining to participate. Patients with Stage 1b1–4b primarily sought medical attention due to self-reported symptoms (P < 0.001); however, they were less likely to have undergone cervical cancer screening (P < 0.001). Additionally, older patients were less likely to be aware of the association of HPV with cervical and other cancers. Notably, 28 of the 129 patients with stage 1b1–4b cancer underwent cervical cancer screening within 2 years. The tumor location within the endocervical canal emerged as a significant factor contributing to the difficulty for an accurate diagnosis of precancerous or cervical cancer during cervical screening. Furthermore, non- squamous cell carcinoma (SCC) histology was another possible factor.

Our findings suggest the need to widely disseminate information regarding the significance of cancer screening to increase cancer screening rates. Moreover, establishing strategies for improving the accuracy of detecting lesions during screening for non-SCC and endocervical canal tumors is crucial.

The online version contains supplementary material available at 10.1186/s12905-024-03256-z.