Prevalence and predictors of human papillomavirus (HPV) vaccination among young women surviving childhood cancer

Abstract

Purpose Human papillomavirus (HPV) is a sexually transmitted infection and the cause of cervical and other cancers. Vaccination is available to protect against genital HPV and is recommended for individuals aged 9-26 years. This study aimed to estimate the prevalence of HPV vaccination among childhood cancer survivors and to identify factors associated with vaccine outcomes. Methods Young adult females with (n = 114; M age =21.18 years, SD =2.48) and without (n = 98; M age = 20.65 years, SD = 2.29) a childhood cancer history completed surveys querying HPV vaccination initiation/completion, as well as sociodemographic, medical, and health belief factors. Multivariable logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for vaccine outcomes. Results Among survivors, 38.6% (44/114) and 26.3% (30/114) initiated or completed vaccination compared to 44.9% (44/98) and 28.6% (28/98) among controls, respectively. In the combined survivor/control group, physician recommendation (OR = 11.24, 95% CI, 3.15 – 40.14), and familial HPV communication (OR = 7.28, 95% CI, 1.89 – 28.05) associated with vaccine initiation. Perceptions of vaccine benefit associated with vaccine completion (OR = 10.55, 95% CI, 1.59 – 69.92), whereas perceptions of HPV-related severity associated with non-completion (OR = 0.14, 95% CI, 0.03 – 0.71). Conclusion Despite their increased risk for HPV-related complication, a minority of childhood cancer survivors have initiated or completed HPV vaccination. Modifiable factors associating with vaccine outcomes were identified. Implications HPV vaccination is a useful tool for cancer prevention in survivorship, and interventions to increase vaccine uptake are warranted.

HPV vaccination knowledge, intentions, and practices among caregivers of childhood cancer survivors

“…While our HPV vaccine report of 40% is higher than other studies of childhood cancer survivors, 10,14 it is still well below the HealthyPeople 2020 goal of 80% series completion by age 15 and lower than the most recently reported rates for Utah of 58.8%. 12 Recently, there has been considerable effort to improve HPV vaccination uptake in our region 15 and in the United States through provider and health-care team training, practice level changes for utilization of reminder/recall systems, and parent/caregiver education.…”

Human Papillomavirus Vaccine Is Crucial for Adolescent and Young Adult Cancer Survivors

“…Vaccine uptake has been examined through observational studies in two cohorts of female cancer survivors. [14][15][16] These studies demonstrate low HPV vaccine initiation rates in female cancer survivors, ranging from 36% to 45% in adolescents 15,16 to 39% in young adults. 14 Discussion of the vaccine with a healthcare provider and receiving a physician recommendation for the vaccine were identified as consistent predictors of vaccine initiation among AYA female survivors in these studies.…”

“…14 Discussion of the vaccine with a healthcare provider and receiving a physician recommendation for the vaccine were identified as consistent predictors of vaccine initiation among AYA female survivors in these studies. [14][15][16] To our knowledge, no studies of male survivors or interventions to increase HPV vaccination in cancer survivors have been published to date.…”

“…However, cancer survivors are less likely than healthy peers to report a provider recommendation for the HPV vaccine, suggesting that survivorship-focused care interactions may not include a discussion of the HPV vaccine. 14 AYA survivors participate in risky sexual behavior at a similar rate compared with peers, 18 yet they may receive less education from providers regarding sexual health 19 ; when coupled with their increased risk of HPV-associated cancers, this makes them an especially vulnerable population.…”

A cross‐sectional study of factors associated with influenza vaccination in Korean cancer survivors

“…A study on young women surviving childhood cancer showed that physician recommendation (OR: 11.24, 95% CI: 3.15–40.14) and intra‐familial HPV communication (OR: 7.28, 95% CI: 1.89–28.05) were associated with vaccination (Klosky et al, 2016). Similarly, in our study, lifestyle modification counselling during cancer treatment was positively associated with flu vaccination, especially in survivors under 65.…”