Vaccination against human papillomavirus (HPV) can prevent several types of cancer, including cervical, oral/oropharyngeal, penile, and anal cancers. Unfortunately, vaccination rates, as well as public knowledge regarding the link between HPV and these cancers, are lagging, according to research presented during the 2023 American Association for Cancer Research Annual Meeting.
“Over 90% of HPV-associated cancers could be prevented with the HPV vaccination, yet vaccine uptake remains suboptimal,” explained lead investigator Eric Adjei Boakye, PhD, Assistant Scientist, Department of Health Sciences and Department of Otolaryngology – Head and Neck Surgery, Henry Ford Health System, Detroit, MI, in a press conference regarding the findings.
Approximately 45,000 HPV-associated cancers are diagnosed in the United States each year. Cervical cancers are the most common HPV-associated malignancies among women. According to the Centers for Disease Control and Prevention, there are more than 11,000 cases of HPV-associated cervical cancer reported annually.1 In addition, the number of oropharyngeal cancer cases now exceeds 20,000 per year. More than 17,000 of these oropharyngeal cases occur in men, and of these, 12,500 (72%) are associated with HPV.
However, as of 2022, only approximately 60% of adolescents have received the recommended doses of the HPV vaccine, despite the fact that the US government has established a goal of an 80% vaccination rate in this population. Although several educational initiatives have been developed to improve awareness of HPV-associated cancers and the preventive value of the HPV vaccine, these efforts have fallen short.
Dr Boakye and colleagues wanted to explore the level of awareness of the causal link between HPV and HPV-associated cancers between 2014 and 2020 in a representative population of the United States. Their study was based on the Health Information National Trends Survey (HINTS), which includes adults aged ≥18 years in the civilian, noninstitutionalized US population. Five different time points were assessed between 2014 (HINTS 4 cycle 4) and 2020 (HINTS 5 cycle 4). At each time point, between 2000 and 2350 adults responded to the survey. These were different groups of people who were asked: “Do you think HPV can cause anal, cervical, oral, and penile cancers?” Response options were: “Yes,” “No,” and “Not sure.”
The total number of respondents was 10,933 (approximately 2000 per time point). Overall, 58% were women, 68% were non-Hispanic White, 38% had a college degree, 91% used the internet, and 89% resided in urban areas.
The researchers found an absolute decrease of 7.4% over time regarding an awareness of the link between cervical cancer and HPV. In 2014, 77.6% of respondents reported that they were aware that HPV caused cervical cancer; that number decreased to 70.2% in 2020.
Awareness of the association between HPV and anal, oral, and penile cancers remained steady but low. Specifically, awareness of the link between HPV and anal cancer was 27.9% and 27.4% in 2014 and 2020, respectively; awareness of the link between HPV and oral cancer was 31.2% and 29.5% in 2014 and 2020, respectively; and awareness of the link between HPV and penile cancer was 30.3% and 28.4% in 2014 and 2020, respectively.
Over the same time period, the incidence of HPV-positive oral and anal cancers has been on the rise in the United States, the investigators noted.
“Given the connections between HPV-associated cancer awareness and HPV vaccination uptake, it is important we increase the population’s awareness of this link, as it may help increase vaccine uptake,” Dr Boakye said, adding that novel and targeted strategies are needed to counteract HPV vaccine disinformation.
The HPV vaccine was first approved for girls and women aged 9 to 25 years in 2006. Then in 2009, approval was expanded to include boys and men. Currently, the recommended age for receiving the vaccine is 11 or 12 years.
“The talk about HPV was very female-centric when the vaccine was first approved and recommended. As a result, a lot of people know about HPV causing cervical cancer, but not the other cancers,” Dr Boakye explained.
Some strategies that may lead to improved uptake of the vaccine include educational efforts aimed at healthcare providers who treat adolescents and young adults, as well as the public at large. Dr Boakye said that increasing awareness will require combined efforts from healthcare providers and public health experts.
- Centers for Disease Control and Prevention. HPV and cancer. Updated October 3, 2022. www.cdc.gov/cancer/hpv/statistics/cases.htm. Accessed April 24, 2023.