Faculty, Staff and Student Publications

Language

English

Publication Date

6-1-2026

Journal

JAMA Network Open

DOI

10.1001/jamanetworkopen.2026.20133

PMID

42340719

PMCID

PMC13294774

PubMedCentral® Posted Date

6-24-2026

PubMedCentral® Full Text Version

Post-print

Abstract

Importance: Religiosity, trust in physicians, and trust in government health agencies influence individual decision-making and behavior toward public health programs. However, trust in information about cancer from these sources and their association with public awareness of human papillomavirus (HPV) as a cause of cervical cancer remain understudied.

Objective: To assess the association of trust in cancer information sources with awareness that HPV causes cervical cancer among US adults.

Design, setting, and participants: This cross-sectional study used the nationally representative 2022 Health Information National Trends Survey (HINTS) data on noninstitutionalized US adults aged 18 years or older collected between March 7 and November 8, 2022 and analyzed between July 23, 2025 and April 9, 2026.

Exposure: Trust in government health agencies, physicians, and religious organizations for cancer information.

Main outcomes and measures: The primary outcome was awareness of HPV as a cause of cervical cancer among US adults who have heard of HPV.

Results: Our study included 3914 respondents who had heard of HPV. Of these, 625 (15.0%) were Hispanic, 558 (10.0%) were non-Hispanic Black, 2290 (65.2%) were non-Hispanic White, and 2557 (55.8%) were female. Overall, 2910 (75.1%), 1173 (30.3%), and 157 (3.5%) US adults had a lot of trust in physicians, government health agencies, and religious organizations for cancer information, respectively. The prevalence of awareness that HPV causes cervical cancer was 870 (70.2%), 1922 (64.8%), and 86 (48.9%) among individuals with a lot of trust in government health agencies, physicians, and religious organizations for cancer information, respectively. In the logistic regression model, compared with individuals with a lot of trust, those with some trust (aOR, 0.71; 95% CI, 0.52-0.96) and little or no trust (aOR, 0.68; 95% CI, 0.49-0.95) in government health agencies for cancer information had lower odds of awareness that HPV causes cervical cancer. Similarly, compared with individuals with a lot of trust, those with some trust in physicians (aOR, 0.71; 95% CI, 0.52-0.98) had lower odds of awareness that HPV causes cervical cancer. In contrast, individuals with little or no trust in religious organizations (aOR, 1.88; 95% CI, 1.10-3.24) had higher odds of awareness of HPV as a cause of cervical cancer. Compared with non-Hispanic White respondents, non-Hispanic Asian respondents had lower odds of awareness of HPV as a cause of cervical cancer (aOR, 0.31; 95% CI, 0.18-0.52). Compared with female respondents, male respondents had lower odds (aOR, 0.62; 95% CI, 0.47-0.81) of awareness of HPV as a cause of cervical cancer. Compared with individuals who had college or postgraduate education, individuals with up to high school (aOR, 0.42; 95% CI, 0.30-0.60) and after high school or some college education (aOR, 0.47; 95% CI, 0.35-0.62) had lower odds of awareness of HPV as a cause of cervical cancer.

Conclusions and relevance: In this cross-sectional study of US adults, trust in government health agencies and physicians was positively associated with public awareness of HPV as a cause of cervical cancer. Through public health promotion campaigns, we must address the decreasing trends in trust in physicians and government health agencies to achieve the goal of cervical cancer elimination in the US.

Keywords

Humans, Female, Uterine Cervical Neoplasms, Trust, Adult, Cross-Sectional Studies, United States, Middle Aged, Health Knowledge, Attitudes, Practice, Papillomavirus Infections, Human Papillomavirus Viruses, Young Adult, Aged, Male, Adolescent

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