Personal vs professional HPV vaccination and screening among female healthcare workers in China

Background Female healthcare workers (FHCWs) play a key role in promoting HPV vaccination and cervical cancer screening, yet their own preventive behaviors may not align with their professional recommendations. This study aimed to assess the dissociation between personal uptake and professional promotion of HPV vaccination and cervical cancer screening among FHCWs in China. Methods A cross-sectional survey was conducted among 7149 FHCWs in gynecology and obstetrics across 31 provinces in China in 2024. A unified Bayesian network simultaneously modeled four outcomes: own HPV vaccination, own cervical cancer screening within 3 years, and recommendation of vaccination and screening to patients. Bootstrap resampling (1000 replicates) and conditional independence tests assessed the stability and significance of each predictor. Results Among 7149 FHCWs, 45.3% were vaccinated, 80.8% had been screened within 3 years, 75.2% recommended vaccination to patients, and 83.1% recommended screening to patients. For personal behavior, age was the sole direct parent (100% bootstrap; p < 10 −148 ). For recommendation behavior, profession was directly associated with vaccination recommendation (100% bootstrap; p < 10 −84 ) and screening recommendation (86.0% bootstrap; p < 10 −71 ); physicians recommended vaccination to 87.2% of patients versus 67.6% for nurses ( p < 10 −78 ), despite similar personal vaccination rates (43.8% vs 46.2%; p = 0.052). HPV knowledge was associated with vaccination recommendation (86.9% bootstrap; p < 10 −16 ) but not personal vaccination (36.1% bootstrap). Cervical cancer risk factor knowledge was associated with screening recommendation (83.4% bootstrap; p < 10 −34 ). Conclusion Knowledge and profession were associated with what FHCWs recommend to patients but were not associated with their own vaccination or screening. Increasing FHCW vaccination requires structural interventions. Increasing patient uptake requires improving knowledge and recommendation practices among FHCWs, particularly nurses.