Prevalence and correlates of modifiable risk factors for cervical cancer and HPV infection among senior high school students in Ghana: a latent class analysis.
Adolescents
Ghana
HPV infection
Latent class analysis
Risk factors
Schools
Uterine cervical neoplasms
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
15 02 2023
15 02 2023
Historique:
received:
08
07
2022
accepted:
20
12
2022
entrez:
16
2
2023
pubmed:
17
2
2023
medline:
18
2
2023
Statut:
epublish
Résumé
While health risk behaviours are likely to co-occur, there is dearth of studies exploring the clustering of cervical cancer and HPV infection risk factors among adolescents. This study aimed to determine: 1) the prevalence of modifiable risk factors for cervical cancer and HPV infection, 2) the clustering of modifiable risk factors for cervical cancer and HPV infection, and 3) factors associated with the identified clusters. Female students (aged 16-24 years, N = 2400) recruited from 17 randomly selected senior high schools in the Ashanti Region, Ghana completed a questionnaire assessing modifiable risk factors for cervical cancer and HPV infection including sexual experience, early sexual intercourse (< 18 years), unprotected sex, smoking, sexually transmitted infections (STIs); multiple sexual partners (MSP) and smoking. Latent class analysis explored separate classes of students according to their risk factor profiles for cervical cancer and HPV infection. Latent class regression analysis explored factors associated with latent class memberships. Approximately one in three students (34%, 95%CI: 32%-36%) reported exposure to at least one risk factor. Two separate classes emerged: high-risk and low-risk (cervical cancer: 24% and 76% of students, respectively; HPV infection: 26% and 74% of students, respectively). Compared to participants in the low-risk classes i) the cervical cancer high-risk class were more likely to report exposure to oral contraceptives; early sexual intercourse (< 18 years); STIs; MSP and smoking; and ii) the HPV infection high risk class were more likely to report exposure to sexual intercourse; unprotected sex and MSP. Participants with higher risk factor knowledge had significantly higher odds of belonging to cervical cancer and HPV infection high-risk classes. Participants with greater perceived susceptibility to cervical cancer and HPV infection were more likely to belong to the high-risk HPV infection class. Sociodemographic characteristics and greater perceived seriousness about cervical cancer and HPV infection had significantly lower odds of belonging to both high-risk classes. The co-occurrence of cervical cancer and HPV infection risk factors suggests that a single school-based multi-component risk reduction intervention could concurrently target multiple risk behaviours. However, students in the high risk class may benefit from more complex risk reduction interventions.
Sections du résumé
BACKGROUND
While health risk behaviours are likely to co-occur, there is dearth of studies exploring the clustering of cervical cancer and HPV infection risk factors among adolescents. This study aimed to determine: 1) the prevalence of modifiable risk factors for cervical cancer and HPV infection, 2) the clustering of modifiable risk factors for cervical cancer and HPV infection, and 3) factors associated with the identified clusters.
METHODS
Female students (aged 16-24 years, N = 2400) recruited from 17 randomly selected senior high schools in the Ashanti Region, Ghana completed a questionnaire assessing modifiable risk factors for cervical cancer and HPV infection including sexual experience, early sexual intercourse (< 18 years), unprotected sex, smoking, sexually transmitted infections (STIs); multiple sexual partners (MSP) and smoking. Latent class analysis explored separate classes of students according to their risk factor profiles for cervical cancer and HPV infection. Latent class regression analysis explored factors associated with latent class memberships.
RESULTS
Approximately one in three students (34%, 95%CI: 32%-36%) reported exposure to at least one risk factor. Two separate classes emerged: high-risk and low-risk (cervical cancer: 24% and 76% of students, respectively; HPV infection: 26% and 74% of students, respectively). Compared to participants in the low-risk classes i) the cervical cancer high-risk class were more likely to report exposure to oral contraceptives; early sexual intercourse (< 18 years); STIs; MSP and smoking; and ii) the HPV infection high risk class were more likely to report exposure to sexual intercourse; unprotected sex and MSP. Participants with higher risk factor knowledge had significantly higher odds of belonging to cervical cancer and HPV infection high-risk classes. Participants with greater perceived susceptibility to cervical cancer and HPV infection were more likely to belong to the high-risk HPV infection class. Sociodemographic characteristics and greater perceived seriousness about cervical cancer and HPV infection had significantly lower odds of belonging to both high-risk classes.
CONCLUSIONS
The co-occurrence of cervical cancer and HPV infection risk factors suggests that a single school-based multi-component risk reduction intervention could concurrently target multiple risk behaviours. However, students in the high risk class may benefit from more complex risk reduction interventions.
Identifiants
pubmed: 36793003
doi: 10.1186/s12889-022-14908-w
pii: 10.1186/s12889-022-14908-w
pmc: PMC9930033
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
340Subventions
Organisme : National Health & Medical Research Council Early Career Fellowship
ID : APP1073317
Organisme : Australian National Breast Cancer Foundation Post-Doctoral Fellowship Grant
ID : PF-16-011
Informations de copyright
© 2023. The Author(s).
Références
Soc Sci Med. 2018 Jan;197:203-212
pubmed: 29253722
Afr Health Sci. 2013 Dec;13(4):1054-61
pubmed: 24940332
J Adolesc. 2009 Aug;32(4):1023-39
pubmed: 18851878
BMC Public Health. 2012 Jul 29;12(1):571
pubmed: 22839700
Ann Behav Med. 2014 Oct;48(2):205-14
pubmed: 24500081
Infect Agent Cancer. 2016 Jan 26;11:4
pubmed: 26816527
BMC Pediatr. 2015 Feb 15;15:11
pubmed: 25884174
PLoS Med. 2015 Dec 08;12(12):e1001917
pubmed: 26645683
JCO Glob Oncol. 2020 Jun;6:892-903
pubmed: 32589467
J Health Econ. 2004 Jul;23(4):815-38
pubmed: 15587699
Afr J AIDS Res. 2019 Mar;18(1):38-50
pubmed: 30880582
J Public Health (Oxf). 2021 Oct 16;:
pubmed: 34657958
J Adolesc Health. 2002 Oct;31(4):336-42
pubmed: 12359379
J Am Acad Nurse Pract. 2006 Feb;18(2):62-9
pubmed: 16460412
Afr Health Sci. 2021 Sep;21(3):1375-1384
pubmed: 35222603
Prev Sci. 2009 Dec;10(4):376-86
pubmed: 19499339
Ghana Med J. 2019 Mar;53(1):29-36
pubmed: 31138941
J Cancer Educ. 2014 Sep;29(3):555-62
pubmed: 24488557
Cancer Epidemiol Biomarkers Prev. 2006 Feb;15(2):326-33
pubmed: 16492924
S Afr Med J. 2020 Aug 31;110(9):887-893
pubmed: 32880274
PLoS One. 2019 Jun 27;14(6):e0218762
pubmed: 31246997
J Adolesc. 2019 Dec;77:188-197
pubmed: 31770671
Arch Public Health. 2020 Mar 04;78:8
pubmed: 32158545
PLoS One. 2016 Jul 19;11(7):e0159037
pubmed: 27434023
Health Educ Q. 1988 Summer;15(2):175-83
pubmed: 3378902
BMC Public Health. 2018 Jul 31;18(1):941
pubmed: 30064492
Prev Med. 2014 Jul;64:121-5
pubmed: 24704131
J Stud Alcohol Drugs. 2016 Jan;77(1):121-32
pubmed: 26751362
Women Health. 2018 Apr;58(4):434-450
pubmed: 28296626