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Web-based Recruiting for a Survey on Knowledge and Awareness of Cervical Cancer Prevention Among Young Women Living in Kanagawa Prefecture, Japan

Miyagi, Etsuko MD, PhD*; Motoki, Yoko MD*; Asai-Sato, Mikiko MD, PhD*; Taguri, Masataka PhD; Morita, Satoshi PhD; Hirahara, Fumiki MD*; Wark, John D. MD, PhD‡§; Garland, Suzanne M. MD∥¶#**

International Journal of Gynecological Cancer:
doi: 10.1097/IGC.0000000000000220
Cervical Cancer

Objectives: Cervical cancer (CC) incidence and mortality among young women have been increasing in Japan. To develop effective measures to combat this, we assessed the feasibility of using a social networking site (SNS) to recruit a representative sample of young women to conduct a knowledge and attitude study about CC prevention via an internet-based questionnaire.

Methods: From July 2012 to March 2013, advertising banners targeting women aged 16 to 35 years in Kanagawa Prefecture were placed on Facebook in a similar manner as an Australian (AUS) study conducted in 16- to 25-year-olds in 2010 and on a homepage to advertise our CC advocacy activities. Eligible participants were emailed instructions for accessing our secure Web site where they completed an online survey including demographics, awareness, and knowledge of human papillomavirus (HPV) and CC. Data for the study population were compared with the general Japanese population and the AUS study.

Results: Among 394 women who expressed interest, 243 (62%) completed the survey, with 52% completing it via Facebook. Women aged 26 to 35 years, living in Yokohama City, with an education beyond high school, were overrepresented. Participants had high awareness and knowledge of HPV and CC, comparable with the AUS study participants. However, the self-reported HPV vaccination rate (22% among participants aged 16–25 years) and the recognition rate of the link between smoking and CC (31%) were significantly lower than in the AUS study (58% and 43%, respectively) (P < 0.05). Significant predictors of high knowledge scores about HPV included awareness of HPV vaccine (P < 0.001) and self-reported HPV vaccination (P < 0.05).

Conclusions: The SNS and homepage are efficient methods to recruit young women into health surveys, which can effectively be performed online. A nationwide survey using SNSs would be an appropriate next step to better understand the current lack of uptake of the national HPV vaccine program by young women in Japan.

Author Information

Departments of *Obstetrics and Gynecology and †Biostatics and Epidemiology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan; ‡Department of Medicine and §Bone and Mineral Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia; ∥Department of Microbiology and Infectious Diseases, Royal Women’s Hospital, Parkville, Victoria, Australia; ¶Department of Microbiology, The Royal Children’s Hospital, Parkville, Victoria, Australia; #Infection and Immunity, Murdoch Children’s Research Institute, Parkville, Victoria, Australia; and **Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia.

Address correspondence and reprint requests to Etsuko Miyagi, MD, PhD, Department of Obstetrics and Gynecology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan. E-mail:

Supported by 2012 and 2013 Grants-in-Aid from the Ministry of Health, Labour, and Welfare of Japan.

The authors declare no conflicts of interest.

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Received May 7, 2014

Received in revised form June 18, 2014

Accepted June 19, 2014

© 2014 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.