Demographic and attitude determinants regarding the receipt of the human papillomavirus vaccine among individuals with cervical dysplasia (455)

Abstract

Objectives: Human papillomavirus (HPV) vaccination reduces the risk of high-grade dysplasia and cervical cancer. We evaluated patterns in demographics and attitudes regarding HPV vaccination among women with prior colposcopy as a risk factor for cervical cancer. Methods: Women aged 21-45 years who underwent colposcopy at an academic medical center between October 1, 2018-October 31, 2020 were e-mailed a self-administered structured questionnaire including demographic variables and “yes/no” statements to assess the attitudes of those receiving versus those not receiving the HPV vaccine. Categorical demographic variables were analyzed using Chi-square or Fisher’s exact test. Binary logistic regression was performed to determine associations between vaccination and demographic variables. Results: A total of 206 responses were received from the 1331 patients (15.8%); 60% of respondents (n=126) reported receiving the HPV vaccine. On univariate analysis, the White race, private insurance status, and higher education were positively associated with HPV vaccination. African American race and current or former tobacco use were negatively associated with vaccination (Table 1). After adjusting for covariates, patients with a college degree or higher education were 11-fold more likely to be vaccinated (OR: 11.3, 95% CI: 1.2-103.1). Current or former smokers were less likely to be vaccinated (OR: 0.3, 95% CI: 0.1-0.7). Common reasons cited for not receiving the vaccine included that it was not offered by the physician (53.7%) and that the patient believed she was too old (48.8%). Only 7.3% of respondents cited insurance as a reason for not being vaccinated. Among those who received the HPV vaccine, patients cited believing the vaccine could prevent HPV-related cancer (73.2%), believing the vaccine to be safe (66.1%), and provider recommendation (48.8%) as reasons for receiving the vaccine. Conclusions: Education level and smoking status are independent predictors of HPV vaccination in a high-risk group of women. Our results highlight the importance of physician recommendations for vaccination, as well as the importance of patient and physician education regarding indications and age range for HPV vaccination. Patients did not frequently cite insurance as a barrier to vaccination. Objectives: Human papillomavirus (HPV) vaccination reduces the risk of high-grade dysplasia and cervical cancer. We evaluated patterns in demographics and attitudes regarding HPV vaccination among women with prior colposcopy as a risk factor for cervical cancer. Methods: Women aged 21-45 years who underwent colposcopy at an academic medical center between October 1, 2018-October 31, 2020 were e-mailed a self-administered structured questionnaire including demographic variables and “yes/no” statements to assess the attitudes of those receiving versus those not receiving the HPV vaccine. Categorical demographic variables were analyzed using Chi-square or Fisher’s exact test. Binary logistic regression was performed to determine associations between vaccination and demographic variables. Results: A total of 206 responses were received from the 1331 patients (15.8%); 60% of respondents (n=126) reported receiving the HPV vaccine. On univariate analysis, the White race, private insurance status, and higher education were positively associated with HPV vaccination. African American race and current or former tobacco use were negatively associated with vaccination (Table 1). After adjusting for covariates, patients with a college degree or higher education were 11-fold more likely to be vaccinated (OR: 11.3, 95% CI: 1.2-103.1). Current or former smokers were less likely to be vaccinated (OR: 0.3, 95% CI: 0.1-0.7). Common reasons cited for not receiving the vaccine included that it was not offered by the physician (53.7%) and that the patient believed she was too old (48.8%). Only 7.3% of respondents cited insurance as a reason for not being vaccinated. Among those who received the HPV vaccine, patients cited believing the vaccine could prevent HPV-related cancer (73.2%), believing the vaccine to be safe (66.1%), and provider recommendation (48.8%) as reasons for receiving the vaccine. Conclusions: Education level and smoking status are independent predictors of HPV vaccination in a high-risk group of women. Our results highlight the importance of physician recommendations for vaccination, as well as the importance of patient and physician education regarding indications and age range for HPV vaccination. Patients did not frequently cite insurance as a barrier to vaccination.