A multinational cross-sectional study on human papillomavirus and cervical cancer knowledge, vaccination attitudes, and risk factors in the Middle East

Human papillomavirus is the most common viral sexually transmitted infection worldwide and affects individuals of all ages and both sexes. It is also the most preventable cause of cervical cancer. The World Health Organization’s Cervical Cancer Elimination Strategy (2030 targets) aims for 90% of girls to receive the Human papillomavirus vaccine by age 15, 70% of women to be screened by ages 35–45, and 90% of cervical-cancer cases to be appropriately treated. To determine cervical-cancer–related risk factors and knowledge levels, and to assess Human papillomavirus -related knowledge and attitudes toward vaccination. The survey also examined general adult vaccination behaviors—including measles, influenza, coronavirus, respiratory syncytial virus, and shingles vaccines—among adults. A cross-sectional study was conducted among 1,174 randomly selected adults from Egypt, Syria, Jordan, and Yemen between March and May 2025, using a validated Arabic self-administered questionnaire. Most participants were female (635, 54.2%), university-educated or higher (699, 59.6%), and living in urban areas (796, 67.9%). Regarding risk factors, 489 (41.7%) were smokers, 94 (8.0%) reported genital laser hair removal, 84 (7.2%) had oral or other herpes lesions, and 81 (6.9%) had a family history of reproductive-system cancer. Overall, 626 (53.4%) had poor Human papillomavirus knowledge and 779 (66.5%) had poor cervical-cancer knowledge. Only 60 (9.5%) had ever undergone cervical-cancer screening, and 23 (2.0%) had received at least one Human papillomavirus -vaccine dose. Reported adverse events included allergic reactions (13, 6.8%) and dizziness or fainting (13, 56.5%). Approximately 578 (49.3%) were unaware of the Human papillomavirus vaccine, while 976 (83.3%) had not received—and did not intend to receive—the vaccine, citing lack of information, perceived low risk, adherence to preventive measures, or vaccine unavailability. Most participants demonstrated poor overall knowledge of Human papillomavirus and cervical cancer. Several demographic determinants significantly influenced knowledge and attitudes toward vaccination. Comprehensive health-education initiatives are urgently needed to enhance awareness and progress toward the World Health Organization 2030 elimination targets.