Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/12965
Title: Like mother, like daughter? Mother's history of cervical cancer screening and daughter's Human Papillomavirus vaccine uptake in Flanders (Belgium)
Authors: Lefevere, Eva
HENS, Niel 
Theeten, Heidi
Van den Bosch, Karel
Beutels, Philippe
De Smet, Frank
Van Damme, Pierre
Issue Date: 2011
Publisher: ELSEVIER SCI LTD
Source: VACCINE, 29(46), p. 8390-8396
Abstract: Objective: We investigated whether and to what extent the uptake of the Human Papillomavirus (HPV) vaccine by girls aged 12-18 was related to the cervical cancer screening history of age-appropriate older female household members (assumed to be their mothers) in Flanders (Belgium). Methods: We studied administrative records on 127,854 female members of the National Alliance of Christian Mutualities, which is the largest health insurance fund in Flanders. Reimbursement data for HPV vaccination of girls for the period 2007-2009 were linked with reimbursement data for cervical cancer screening of their mothers in the three preceding years. A multilevel logit model was used to study associations between both preventive behaviors. In the model we controlled for both the girl's and the mother's age, the province of residence and the socio-economic background of the family. Results: A clear association between a mother's history of participation in cervical cancer screening and her daughter's HPV vaccination initiation was found. The conditional odds of HPV vaccination initiation were more than 4 times higher for girls whose mother had one Pap test than for girls whose mother had none (odds ratio [OR] = 4.5; 95% confidence interval [CI] = 3.5-5.9). For girls whose mother had three or more Pap tests, the conditional odds were 16 times higher than for girls whose mother did not have any pap tests ([OR] = 16.0; 95% [CI] = 12.1-21.2). The effect of screening (having received 1 pap smear as compared to none) was larger for girls living in neighborhoods with the lowest median income ([OR] = 6.0, 95% [CI] = 3.6-10.1). Conclusion: In a situation where both cervical cancer screening and HPV vaccination are opportunistic, we found evidence that these preventive behaviors cluster within families. (C) 2011 Elsevier Ltd. All rights reserved.
Notes: [Lefevere, Eva; Van den Bosch, Karel] Univ Antwerp, Herman Deleeck Ctr Social Policy, B-2000 Antwerp, Belgium. [Lefevere, Eva] Res Fdn Flanders FWO, B-1000 Brussels, Belgium. [Hens, Niel] Hasselt Univ, Ctr Stat, B-3590 Diepenbeek, Belgium. [Hens, Niel; Theeten, Heidi; Beutels, Philippe; Van Damme, Pierre] Univ Antwerp, Vaccine & Infect Dis Inst VAXINFECTIO, B-2610 Antwerp, Belgium. [Hens, Niel; Theeten, Heidi; Van Damme, Pierre] Univ Antwerp, Ctr Evaluat Vaccinat, B-2610 Antwerp, Belgium. [Hens, Niel; Beutels, Philippe] Univ Antwerp, CHERMID, B-2610 Antwerp, Belgium. [De Smet, Frank] Natl Alliance Christian Mutual, Med Management Dept, B-1031 Brussels, Belgium. [De Smet, Frank] Univ Louvain, Dept Occupat Environm & Insurance Med, B-3000 Louvain, Belgium. eva.lefevere@ua.ac.be; niel.hens@uhasselt.be; heidi.theeten@ua.ac.be; karel.vandenbosch@ua.ac.be; philippe.beutels@ua.ac.be; frank.desmet@cm.be; pierre.vandamme@ua.ac.be
Keywords: Hpv vaccination; Cervical cancer screening; Family; Multilevel analysis; Cost-effectiveness;Immunology; Medicine, Research & Experimental
Document URI: http://hdl.handle.net/1942/12965
ISSN: 0264-410X
e-ISSN: 1873-2518
DOI: 10.1016/j.vaccine.2011.08.039
ISI #: 000296988500030
Category: A1
Type: Journal Contribution
Validations: ecoom 2012
Appears in Collections:Research publications

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