{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T20:42:53Z","timestamp":1790628173534,"version":"4.1.0"},"reference-count":22,"publisher":"CSIRO Publishing","issue":"3","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":2298,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,6,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cervical cancer is the second commonest cancer amongst Sri Lankan women. With introduction of the human papillomavirus (HPV) vaccine to the national immunisation schedule, awareness and prevention of disease underpins vaccine uptake. Knowledge of HPV, HPV-related diseases and attitudes towards prevention and screening among urban women was assessed. Methods: Primigravids attending Colombo North Teaching Hospital antenatal clinics were recruited over 8 months as surrogates for women who have recently become sexually active. Data through a self-administered questionnaire on three domains were collected (cervical cancer, Pap testing, HPV and vaccine). Results: Of 667 participants (mean age 23.9 (s.d. = 4.4) years, 68.0% (n = 454) had &amp;gt;11 years of schooling), only 1.5% (n = 10) were aware of all three domains: 55.0% (370\/667) had heard of cervical cancer, 19.0% of whom (70\/370) knew it was sexually acquired, 9.0% (60\/667) were aware of Pap screening, while 5.4% (36\/665) had heard about HPV and &amp;lt;1.0% (5\/667) knew it caused cancer. The total knowledge score ranged from zero (379\/665) to nine (2\/665), with a mean of 0.9 (s.d. \u2013 1.4), with awareness increasing with level of education (\u03c72 = 18.6; P &amp;lt;0.001). Of those aware of Pap testing, 8.0% (5\/60) were reluctant to undergo testing, while 46.6% (28\/60) had no apprehension. Conclusions: Knowledge of cervical cancer, Pap testing, HPV and vaccine was low, especially in terms of HPV. Among those aware of Pap screening, generally there were favourable attitudes to having a test. These data have implications for acceptance of the vaccine and any future expansion of cervical screening with newer, more cost-effective technologies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/sh18080","type":"journal-article","created":{"date-parts":[[2019,5,15]],"date-time":"2019-05-15T01:03:31Z","timestamp":1557882211000},"page":"212-217","source":"Crossref","is-referenced-by-count":1,"title":["Awareness of human papillomavirus, cervical cancer and its prevention among primigravid antenatal clinic attendees in a tertiary care hospital in Sri Lanka: a cross-sectional study"],"prefix":"10.1071","volume":"16","author":[{"given":"Aruni H. W.","family":"de Silva","sequence":"first","affiliation":[{"name":"ADepartment of Family Medicine, Faculty of Medicine, University of Kelaniya, P.O. Box 6, Thalagolla Road, Ragama, Sri Lanka."},{"name":"ICorresponding author. Email: aruni.weerakoon@yahoo.com"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nirma","family":"Samarawickrema","sequence":"additional","affiliation":[{"name":"BDepartment of Biochemistry and Molecular Biology, Monash University, Vic. 3800, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anuradhani","family":"Kasturiratne","sequence":"additional","affiliation":[{"name":"CDepartment of Public Health, Faculty of Medicine, University of Kelaniya, Sri Lanka."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Rachel","family":"Skinner","sequence":"additional","affiliation":[{"name":"DDiscipline of Child and Adolescent Health, Sydney University and Children\u2019s Hospital Westmead, NSW 2145, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ananda Rajitha","family":"Wickremasinghe","sequence":"additional","affiliation":[{"name":"CDepartment of Public Health, Faculty of Medicine, University of Kelaniya, Sri Lanka."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne M.","family":"Garland","sequence":"additional","affiliation":[{"name":"EDepartment of Microbiology and Infectious Diseases, The Royal Women\u2019s Hospital, Parkville, Vic. 3052, Australia."},{"name":"FMurdoch Children\u2019s Research Institute, Parkville, Vic. 3052, Australia."},{"name":"GDepartment of Obstetrics and Gynaecology, University of Melbourne, Vic. 3010, Australia."},{"name":"HDepartment of Microbiology, Royal Children\u2019s Hospital, Parkville, Vic. 3052, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"67","published-online":{"date-parts":[[2019,5,15]]},"reference":[{"key":"2025102617153465600_R1","unstructured":"GLOBOCAN. Cancer fact sheets \u2013 cervical cancer. Lyon: International Agency for Research on Cancer; 2012. Available online at: http:\/\/globocan.iarc.fr\/old\/FactSheets\/cancers\/cervix-new.asp [verified 29 November 2016]."},{"key":"2025102617153465600_R2","unstructured":"Bruni L, Barrionuevo-Rosas L, Albero G, Serrano B, Mena M, G\u00f3mez D, Mu\u00f1oz J, Bosch FX, de Sanjos\u00e9 S. Human papillomavirus and related diseases report in Sri Lanka \u2013 summary report 27 July 2017. Barcelona: ICO Information Centre on HPV and Cancer (HPV Information Centre); 2017."},{"issue":"5","key":"2025102617153465600_R3","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1093\/jnci\/djq562","article-title":"Human papillomavirus testing in the prevention of cervical cancer.","volume":"103","author":"Schiffman","year":"2011","journal-title":"J Natl Cancer Inst"},{"key":"2025102617153465600_R4","unstructured":"Gamage D. National Immunization Summit 2015. Colombo: Epidemiology Unit, Sri Lanka; 2015. Available online at: http:\/\/www.epid.gov.lk\/web\/images\/pdf\/HPV\/national_immunization_summit_hpv_report.pdf [verified 28 September 2018]."},{"key":"2025102617153465600_R5"},{"issue":"10","key":"2025102617153465600_R6","doi-asserted-by":"publisher","first-page":"1154","DOI":"10.1016\/S1473-3099(16)30120-7","article-title":"Efficacy, safety, and immunogenicity of the human papillomavirus 16\/18 AS04-adjuvanted vaccine in women older than 25 years: 7-year follow-up of the phase 3, double-blind, randomised controlled VIVIANE study.","volume":"16","author":"Wheeler","year":"2016","journal-title":"Lancet Infect Dis"},{"issue":"4","key":"2025102617153465600_R7","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1093\/cid\/ciw354","article-title":"Impact and effectiveness of the quadrivalent human papillomavirus vaccine: a systematic review of 10 years of real-world experience.","volume":"63","author":"Garland","year":"2016","journal-title":"Clin Infect Dis"},{"issue":"7","key":"2025102617153465600_R8","doi-asserted-by":"publisher","first-page":"1166","DOI":"10.1111\/IGC.0b013e3181a3d100","article-title":"Efficacy of human papillomavirus vaccines: a systematic quantitative review.","volume":"19","author":"Medeiros","year":"2009","journal-title":"Int J Gynecol Cancer"},{"key":"2025102617153465600_R9","unstructured":"Fernando C. Cervical cancer vaccination launched in Sri Lanka. Daily News Online. 3 June 2010. Available online at: http:\/\/archives.dailynews.lk\/2010\/06\/03\/news23.asp [verified 20 June 2016]."},{"key":"2025102617153465600_R10","unstructured":"Ministry of Health, Nutrition and Indigenous Medicine, Sri Lanka. Guidelines on the introduction of the Human Papillomavirus vaccine into the National Immunization Programme. Colombo: Ministry of Health, Nutrition and Indigenous Medicine; 2017. Available online at: http:\/\/epid.gov.lk\/web\/images\/pdf\/Circulars\/HPV\/guidelines_hpv.pdf [verified 10 November 2017]."},{"issue":"1","key":"2025102617153465600_R11","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1186\/1472-6874-14-44","article-title":"Cervical cancer knowledge and screening behaviors among female university graduates of year 2012 attending national graduate orientation program, Bhutan.","volume":"14","author":"Dhendup","year":"2014","journal-title":"BMC Women\u2019s Health"},{"issue":"4","key":"2025102617153465600_R12","doi-asserted-by":"publisher","first-page":"1193","DOI":"10.7314\/APJCP.2012.13.4.1193","article-title":"Knowledge and practices on breast and cervical cancer screening methods among female health care workers: a Sri Lankan experience.","volume":"13","author":"Nilaweera","year":"2012","journal-title":"Asian Pac J Cancer Prev"},{"issue":"2","key":"2025102617153465600_R13","doi-asserted-by":"publisher","first-page":"105","DOI":"10.4103\/0971-5851.158840","article-title":"Knowledge, attitudes and practice toward cervical cancer screening among Sikkimese nursing staff in India.","volume":"36","author":"Rahman","year":"2015","journal-title":"Indian J Med Paediatr Oncol"},{"issue":"10","key":"2025102617153465600_R14","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1177\/0956462414552813","article-title":"Prevalence of Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae and human papillomavirus in a sexual health clinic setting in urban Sri Lanka.","volume":"26","author":"Samarawickrema","year":"2015","journal-title":"Int J STD AIDS"},{"issue":"2","key":"2025102617153465600_R15","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1093\/inthealth\/ihu021","article-title":"Low uptake of Pap smear testing among medical clinic attendees in a tertiary care hospital in Sri Lanka.","volume":"6","author":"Shivanthan","year":"2014","journal-title":"Int Health"},{"key":"2025102617153465600_R16","doi-asserted-by":"publisher","first-page":"1179","DOI":"10.1186\/s12889-015-2531-6","article-title":"Awareness of female malignancies among women and their partners in Southern Sri Lanka and implications for screening: a cross sectional study.","volume":"15","author":"Witharana","year":"2015","journal-title":"BMC Public Health"},{"issue":"7","key":"2025102617153465600_R17","first-page":"1707","article-title":"Awareness of cervix cancer risk factors in educated youth: a cross-sectional, questionnaire based survey in India, Nepal, and Sri Lanka.","volume":"12","author":"Joy","year":"2011","journal-title":"Asia Pac J Cancer Prev"},{"issue":"2","key":"2025102617153465600_R18","first-page":"305","article-title":"Awareness and practice regarding cervical cancer prevention among female college students of Mangalore city, India.","volume":"8","author":"Kulkarni","year":"2015","journal-title":"Asian J Pharm Clin Res"},{"issue":"6","key":"2025102617153465600_R19","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0011059","article-title":"Knowledge and awareness about cervical cancer and its prevention amongst interns and nursing staff in tertiary care hospitals in Karachi, Pakistan.","volume":"5","author":"Ali","year":"2010","journal-title":"PLoS One"},{"key":"2025102617153465600_R20","unstructured":"Bruni L, Barrionuevo-Rosas L, Albero G, Aldea M, Serrano B, Valencia S, Brotons M, Mena M, Cosano R, Mu\u00f1oz J, Bosch FX, de Sanjos\u00e9 SCX. Human papillomavirus and related diseases in Sri Lanka \u2013 summary report 2016\u201302\u201326. Barcelona: ICO Information Centre on HPV and Cancer (HPV Information Centre); 2016."},{"key":"2025102617153465600_R21","unstructured":"Department of Census and Statistics, Ministry of Policy Planning Economic Affairs, Child Youth and Cultural Affairs Sri Lanka. Household income and expenditure survey 2012\/13 \u2013 final report. Colombo: Ministry of Policy Planning Economic Affairs, Child Youth and Cultural Affairs Sri Lanka; 2012. Available online at: http:\/\/www.statistics.gov.lk\/HIES\/HIES2012_13FinalReport.pdf [verified 17 October 2016]."},{"key":"2025102617153465600_R22","unstructured":"Department of Census and Statistics Ministry of Finance and Planning. Census of population and housing. Colombo: Population Census and Demography Division, Department of Census and Statistics; 2012. Available online at: http:\/\/www.statistics.gov.lk\/PopHouSat\/CPH2011\/Pages\/Activities\/Reports\/FinalReport\/FinalReport.pdf [verified 20 June 2016]."}],"container-title":["Sexual Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/connectsci.au\/sh\/article-pdf\/16\/3\/212\/1255640\/sh18080.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/connectsci.au\/sh\/article-pdf\/16\/3\/212\/1255640\/sh18080.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:15:38Z","timestamp":1761513338000},"score":1,"resource":{"primary":{"URL":"https:\/\/connectsci.au\/sh\/article\/16\/3\/212\/185043\/Awareness-of-human-papillomavirus-cervical-cancer"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,15]]},"references-count":22,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2019,6,12]]}},"URL":"https:\/\/doi.org\/10.1071\/sh18080","relation":{},"ISSN":["1448-5028","1449-8987"],"issn-type":[{"value":"1448-5028","type":"print"},{"value":"1449-8987","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,15]]}}}