Cervical cancer and HPV knowledge and awareness: An educational intervention among college students in Guam

The incidence of cervical cancer (CCA) in Guam, a U.S. territory in the Western Pacific, is six times higher among Micronesians and over three times higher for CHamorus (Guam9s indigenous people) and Caucasians living in Guam than the U.S. population. Educational interventions among college students who can still get the HPV vaccine, particularly among women below and about the age for initial CCA screening, is crucial. Our team designed and delivered a 20-30 minute presentation to college students in a classroom setting. Pre- and post-tests measured changes in knowledge and attitudes about CCA. Summary variables were computed for CCA and HPV Knowledge and Awareness. McNemar9s test was used to compare knowledge and attitudes before and after the presentation. A total of 108 students completed the survey. Most participants were female (63.0%), juniors (44.4%), and identified as either CHamoru (36.1%) or Filipino (26.9%). A majority had a regular source of healthcare (77.8%), a primary physician (56.5%), and private health insurance (52.8%). Results show male and female students had similar pre- and posttest scores. Among ethnic groups, Caucasians had the highest pretest scores and non-CHamoru Pacific Islanders had the lowest. All ethnic groups had statistically significant increases in CCA Knowledge and Awareness scores after the presentation. Three individual one-way ANOVAs with gender, ethnicity and class level as the factors were performed using the different total scores of the CCA and HPV Knowledge and Awareness as the dependent variables. There was no significant difference interaction between gender (F=0.498, p=0.482), class level (F=0.371, p=0.774), or ethnicity (F=0.398, p=0.810). However, the results showed a significant main effect of Time on CCA Knowledge and Awareness (p<0.001). There was a significant increase for all independent variables in CCA and HPV Knowledge and Awareness from pre- to post-test. The McNemar test shows that there are significant positive differences in the proportion of correct responses to most of the questions between the pre- and posttest. The percentage of correct answers to questions related to symptoms and causes of CCA, the increased risk caused by HPV, and the prevention of CCA through routine screening was already high at pretest so the difference was not significant. Overall, study participants perceived the presentation an effective tool to educate individuals about CCA. Before the presentation, 63.9% rated their general knowledge about CC as neutral or unknowledgeable. After the presentation, this decreased to 11.1%. This type of educational intervention for CCA is critical for this age group, since most can still get the HPV vaccine and women are at the age of initial CCA screening. This study shows that the college setting is an appropriate venue to increase CCA and HPV awareness and potentially impact HPV vaccination for females. Future studies should test presentation paired with opportunities for HPV vaccination via college or public health services. Citation Format: Lilnabeth P. Somera, Tressa P. Diaz, Angelina Mummert, Jaeyung Choi, Kristian Ayson, Grazyna Badowski. Cervical cancer and HPV knowledge and awareness: An educational intervention among college students in Guam [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-068.