Abstract
BACKGROUND: While studies on cervical cancer screening (CCS) and human papillomavirus (HPV) vaccine uptake exist in China, few have examined both within populations participating in CCS programs. METHODS: This cross-sectional, population-based survey included 37,797 women aged 18-64 years attending gynecological outpatient clinics. Participants completed a questionnaire assessing CCS awareness and participation. Additionally, HPV vaccine knowledge was investigated in a sub-sample of 17,010 women aged <45 years. RESULTS: The mean age of participants was 45.06 years (SD: 8.52). The mean CCS knowledge score was 63.13%, with 52.53% reporting prior CCS uptake. Factors associated with lower CCS knowledge included low monthly household income, lack of rural cooperative medical insurance, low literacy, not having received CCS within the past 3 years, unmarried status, and childbirth history. A strong positive correlation was observed between CCS knowledge and adherence to CCS recommendations (Spearman correlation coefficient: 0.708, p < 0.01). Awareness of the HPV vaccine was reported by 48.33% of participants, with HPV vaccine knowledge positively correlated with CCS awareness (Spearman correlation coefficient: 0.629, p < 0.01). CCS knowledge partially mediated the relationship between HPV vaccine knowledge and willingness to vaccinate, with a mediating effect size of 21.16%. CONCLUSION: Integrated health education efforts targeting CCS and HPV vaccine awareness are essential. Empowering women to understand the significance of HPV vaccination and regular CCS participation can enhance cervical cancer prevention strategies.