Abstract
Women with inflammatory bowel disease (IBD) may be at increased risk of human papilloma virus (HPV) infection and HPV-related malignancies, as many are immunocompromised secondary to the use of immunosuppressant agents. Several studies have addressed the knowledge about cervical cancer risk factors in different populations, particularly HPV infection and its association with cervical malignancies; most of these studies show poor patient knowledge. The purpose of this study is to describe the knowledge of females with IBD about HPV infection and the HPV vaccine. We performed a cross-sectional study in 147 consecutive patients attending the clinics of the University of Puerto Rico Center for IBD from 2009 to 2010. An interviewer-administered questionnaire was used to collect information on demographics, lifestyles, and HPV-related knowledge of participants. Bivariate analysis using the chi-square statistics and Fisher’s exact test was used to examine factors associated with HPV awareness. The mean age of participants was 36.6 years (SD = 13.91 years). Three fourth (77 %) of women had awareness of the existence of HPV, and 58 % did know about the existence of HPV vaccines. Among those who had heard about HPV, 79.6 % knew that HPV can cause cervical cancer, and 57.5 % knew that the virus is sexually transmitted. Among those who knew of the vaccine, 75.3 % learned about its existence through the media, while only 15.3 %, through their health-care provider. Only three women within recommended ages (2 %) had been vaccinated against HPV, although 50 % of participants indicated that they would definitely/probably vaccinate against HPV in the future. A significant trend was observed, where more educated women were more likely to have heard of HPV (p for trend = 0.0017). Women who were high school graduates/some college (OR = 6.63, 95 % CI = 1.71–25.66) and those with at least an associate degree (OR = 11.69, 95 % CI = 3.05–45.89) were more likely to be aware of the HPV vaccine than women without a high school degree. Our study documents poor knowledge of HPV and HPV vaccine in this population of IBD patients in Puerto Rico. Although vaccination coverage is low in this population, women are receptive to the possibility of vaccination in the future. Given that this population may be at an increased risk of HPV infection and related morbidities, education and vaccination programs should be promoted among them.
Highlights
Human papilloma virus (HPV) is the primary etiologic agent for the development of cervical cancer and cervical dysplasia, along with other premalignant and malignant conditions of the vagina, vulva, and cervix
Those participants who reported awareness about HPV (n=113) answered general questions about HPV knowledge and risk factors. Among those who had ever heard about HPV, 79.6 % knew that HPV can cause cervical cancer and 57.5 % knew that the virus is sexually transmitted
Our study illustrates this medical issue in women with inflammatory bowel disease (IBD) evaluated in the UPR Center for Inflammatory Bowel Diseases
Summary
Human papilloma virus (HPV) is the primary etiologic agent for the development of cervical cancer and cervical dysplasia, along with other premalignant and malignant conditions of the vagina, vulva, and cervix. Several studies have found that patients with inflammatory bowel disease (IBD) have a higher risk of developing cervical dysplasia [2, 3] compared with healthy women. J. Racial and Ethnic Health Disparities (2016) 3:55–62 inflammatory conditions that affect the gastrointestinal tract, being Crohn’s disease and ulcerative colitis the most frequent. Racial and Ethnic Health Disparities (2016) 3:55–62 inflammatory conditions that affect the gastrointestinal tract, being Crohn’s disease and ulcerative colitis the most frequent These patients often require immunosuppressive therapy to control symptoms and disease progression. The risk of cervical dysplasia in IBD patients might be related to the use of immunosuppressive therapy in a high percent of these patients
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