Urban–Rural Disparities in HPV Knowledge Among Women in China: A Cross-Sectional Study Based on CDC Survey Data

Abstract

Human papillomavirus (HPV) infection is one of the most important causes of cervical cancer. Although HPV vaccination and cervical cancer screening have been proven effective in reducing cervical cancer risk, the success of these preventive strategies depends greatly on women's awareness and understanding of HPV-related health information. Differences in health knowledge between urban and rural populations may influence women's ability to access preventive services and make informed health decisions. This study examined the difference in HPV knowledge between urban and rural women in China based on data from a China CDC cross-sectional survey conducted in 2018. The study included 7,238 women aged 20-45 years from six provinces in China, including 3,619 urban residents and 3,619 rural residents. HPV knowledge levels were classified into high and low categories. Statistical analyses included percentage comparisons, Pearson's chi-square test, and odds ratio (OR) analysis with 95% confidence intervals (CIs). The results showed that 52.69% of urban women had high HPV knowledge, compared with 36.75% of rural women. A significant difference was observed between the two groups (χ² = 185.42, df = 1, P < 0.001). Urban women had higher odds of having high HPV knowledge than rural women (OR = 1.92, 95% CI: 1.75-2.11). The findings indicate that an obvious urban–rural gap exists in HPV knowledge among Chinese women. More targeted health education and information support may be needed in rural communities to improve awareness of HPV infection, vaccination, and cervical cancer prevention.