Girls’ and Parents’ Decision-Making About HPV Vaccination Uptake

Abstract

__Abstract__ In Europe 60,000 women are diagnosed with cervical cancer every year. In the Netherlands, about 700 women are diagnosed with cervical cancer annually and about 200 to 250 women die from the disease [www.rivm.nl]. Cervical cancer can only develop in the presence of infection with a high-risk type of human papillomavirus (HPV). There are two types of HPVs: high-risk (oncogenic) and low-risk. HPV 16 and 18, both high-risk strains, cause approximately 70% of cervical cancers. HPV 16 and 18 can also cause cancer of the vulva, vagina, penis, or anus; and oropharyngeal cancer (cancer in the back of throat). The low-risk strains HPV 6 and 11 cause approximately 90% of genital warts. HPV infections are sexually transmitted, most often during vaginal or anal sex. Condoms may lower the risk of HPV infection, but do not provide complete protection. The estimated lifetime risk of HPV infection is 75% to 80% in Europe and in the US, so it is very common. Most HPV infections are cleared rapidly by the immune system and do not progress into cervical cancer. When the infection persists there is a risk of developing precancerous lesions of the cervix. The precancerous lesions are called cervical intraepithelial neoplasia (CIN) an