# Knowledge, Attitudes, and Practices of Hungarian General Practitioners Regarding Human Papillomavirus (HPV) Infection and Vaccination: A Nationwide Cross-Sectional Study

## TL;DR

This study surveyed Hungarian doctors about their knowledge and attitudes toward HPV and vaccination, finding gaps in understanding vaccine schedules and barriers like parental hesitancy.

## Contribution

The study provides a nationwide assessment of Hungarian GPs' knowledge and practices regarding HPV vaccination and identifies factors influencing proactive vaccine recommendations.

## Key findings

- Most GPs knew HPV causes cervical cancer, but only 56.2% understood the full adolescent vaccination schedule.
- Female physicians, urban practitioners, and those with preventive medicine training had higher knowledge scores.
- Parental hesitancy due to misinformation and perceived lack of need for boys was a common barrier to vaccination.

## Abstract

This nationwide survey assessed Hungarian general practitioners’ (GPs) knowledge, attitudes, and practices regarding HPV infection, and HPV vaccination. Between 30 April and 1 June 2024, an online questionnaire collected demographic data, knowledge of HPV transmission, awareness of vaccination guidelines, and counseling behaviors. A total of 413 GPs responded, most of whom were female with over two decades of experience. While general awareness of HPV’s causal role in cervical cancer was high, many respondents lacked full knowledge of the recommended vaccination schedule for adolescents starting after age 15. Knowledge levels were higher among female physicians, urban practitioners, and those with preventive medicine training. Although attitudes toward HPV vaccination were strongly positive, parental hesitancy—driven by misinformation and low perceived need for vaccinating boys—remained a frequent barrier. Familiarity with WHO and national guidelines strongly predicted proactive vaccine recommendation. Strengthened professional education and communication skills could enhance GPs’ role in improving vaccination uptake.

Objective: To evaluate the level of knowledge, attitudes, and practices of Hungarian general practitioners (GPs) concerning human papillomavirus (HPV) infection, cervical cancer prevention, and HPV vaccination, and to identify physician-level factors associated with proactive recommendation practices. Methods: A cross-sectional nationwide survey was conducted between 30 April and 1 June 2024. The online questionnaire was distributed to practicing Hungarian GPs listed in the National Health Insurance Fund database. Anonymous responses were collected on demographic data, knowledge of HPV transmission and oncogenic potential, awareness of vaccination guidelines, and clinical counseling habits. Descriptive and inferential statistical analyses were performed. A total of 413 responses were received. Results: Most respondents were female (72.6%) with an average of 22.4 ± 9.6 years of professional experience. Although 89.8% correctly identified the causal link between HPV and cervical cancer, only 56.2% were aware of the complete vaccination schedule recommended for adolescents initiating after age 15. Knowledge scores were significantly higher among female physicians, urban practitioners, and those with postgraduate preventive medicine training. While the overall attitude toward HPV vaccination was positive (mean 4.6/5), 38.4% of respondents reported parental hesitancy as a common barrier, often citing misinformation regarding vaccine safety (64.9%) and lack of perceived need for boys (58.7%). Regression analysis revealed that familiarity with WHO and national vaccination guidelines independently predicted proactive vaccine recommendation (β = 0.43, p < 0.001). Conclusions: Hungarian general practitioners demonstrate good baseline awareness of HPV and its oncogenic role; however, knowledge gaps persist regarding vaccination schedules and counseling practices. Enhancing continuous medical education and communication training could strengthen GPs’ role as key advocates in HPV vaccine promotion.