Evidence map›Paper›PMID 42646566›Full record

Observational studyMedical sciences (Basel, Switzerland)2026

The Cervical Cancer Paradox in Eastern Europe: How Knowledge and Institutional Trust Shape HPV Vaccination Attitudes in Romania.

Ionel-Daniel Nati, Carmen Mihaela Mihu, Dan Mihu, Razvan Ciortea, Doru Diculescu, Mihaela Oancea, Carmen Bucuri, Maria Patricia Roman, Cristina Mihaela Ormindean, Viorela Suciu and 2 more

Abstract readObservational Study
In one paragraph

Observational study in Medical sciences (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Ionel-Daniel Nati2nd Department of Obstetric and Ginecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400610 Cluj-Napoca, Romania.ORCID 0000-0003-0187-3682
Carmen Mihaela MihuDepartment of Morphofunctional Sciences, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.ORCID 0000-0002-9419-4824
Dan Mihu2nd Department of Obstetric and Ginecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400610 Cluj-Napoca, Romania.
Razvan Ciortea2nd Department of Obstetric and Ginecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400610 Cluj-Napoca, Romania.
Doru Diculescu2nd Department of Obstetric and Ginecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400610 Cluj-Napoca, Romania.
Mihaela Oancea2nd Department of Obstetric and Ginecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400610 Cluj-Napoca, Romania.
Carmen Bucuri2nd Department of Obstetric and Ginecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400610 Cluj-Napoca, Romania.
Maria Patricia Roman2nd Department of Obstetric and Ginecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400610 Cluj-Napoca, Romania.
Cristina Mihaela Ormindean2nd Department of Obstetric and Ginecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400610 Cluj-Napoca, Romania.
Viorela Suciu2nd Department of Obstetric and Ginecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400610 Cluj-Napoca, Romania.ORCID 0009-0003-1909-7367
Dumitru Rares Ciocoi-PopPhysical Therapy and Theoretical Subjects Department, Babeș-Bolyai University of Cluj Napoca, 400347 Cluj-Napoca, Romania.
Andrei Mihai Malutan2nd Department of Obstetric and Ginecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400610 Cluj-Napoca, Romania.

Funding

Iuliu Hațieganu University of Medicine and Pharmacy 32153/18/16.12.2024
6 · The paper itself

Abstract

backgroundAlthough cervical cancer is a highly preventable malignancy, Romania continues to report critical mortality rates. This paradox is largely attributable to the suboptimal implementation of clinical guidelines and a passive, "opt-in" administrative framework. This cross-sectional study investigates the cognitive and behavioural determinants-specifically, human papillomavirus (HPV) knowledge, institutional trust in healthcare systems, and digital misinformation exposure-that modulate female attitudes toward HPV immunisation.

methodsAn observational cross-sectional study was conducted between December 2025 and March 2026 across four obstetrics and gynaecology clinics. Data were collected via digital questionnaires administered to adult female patients aged 18 to 65 years. The assessment tool evaluated four primary domains: HPV knowledge, perceived vaccine safety, immunisation intention, and the degree of exposure to social media misinformation.

resultsThe cohort demonstrated a substantially low vaccination rate (28.6%). Statistical analysis elucidated significant positive correlations between HPV knowledge, trust in health authorities, and vaccination intention. Furthermore, reliance on official information sources strongly correlated with perceived vaccine safety. Conversely, exposure to negative online content exhibited a weak negative association with knowledge levels, yet it did not directly influence vaccination intention.

conclusionsHealth literacy and institutional trust emerge as fundamental pillars for HPV vaccine acceptance. To overcome patient vaccine hesitancy, the national healthcare system must initiate a strategic paradigm shift, prioritising the neutralization of digital misinformation and transitioning from a passive model to a proactive, "opt-out" infrastructure.

Indexed as

Health Knowledge, Attitudes, PracticePapillomavirus InfectionsPapillomavirus VaccinesUterine Cervical NeoplasmsVaccinationAdolescentAdultAgedCross-Sectional StudiesFemaleHuman Papillomavirus VirusesHumansMiddle AgedRomaniaSurveys and QuestionnairesTrustPapillomavirus Vaccinescervical cancerhealth literacyHPV vaccinationinstitutional trustmisinformationvaccine hesitancy

Identifiers

PMID42646566
PMCPMC13515567

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.