Human Papillomavirus (HPV) and Cervical Cancer: A Call to action for Pakistan

Human Papillomavirus and Vaccination

HPV vaccination in south Asia: new progress, old challenges.

Human Papillomavirus (Cervical Cancer) Vaccine Update

Global strategy to eliminate cervical cancer as a public health problem: are we on track?

Far too few adults getting recommended vaccines

Background: The Latinx population in the United States faces tremendous health disparities, particularly with regards to cervical cancer. Data from the American Cancer Society show that cervical cancer incidence and mortality rates among Latinx women in the US are 40% and 26% higher than in US whites, respectively. These data are surprising considering cervical cancer is highly preventable through use of the Human Papilloma Virus (HPV) vaccination. About 70% of cervical cancer cases are the result of infection with HPV 16 or 18. The 9vHPV vaccine targets HPV 16 and 18 as well as 7 other HPV strains, and it was recently approved for use by the CDC in women through the age of 45. In 2015, only 44% of US Hispanic girls between the ages of 13 and 17 were vaccinated with all three HPV doses. Prior studies have shown that lack of information, cost, and fear are some of the main barriers that prevent Latinx women from receiving the HPV vaccination and vaccinating their children, and that these factors differ across subgroups of Latinx women. Methods: Our goal was to address these health disparities by assessing whether the Latinx population in East Los Angeles also showed low rates of HPV vaccination, and if so, why these women had not received the vaccination. We administered a promotora led survey (in Spanish) to a random sample of 89 Latinx women (aged 25-79) in East Los Angeles to assess rates of HPV vaccination in women and their children, attitudes towards the HPV vaccine, knowledge about the vaccine, and barriers to vaccination. We hypothesized that there would be differences in knowledge about the HPV vaccine, as well as differences in vaccination rates, based on age (>50) and country of origin (Mexico or other) in Latinx women. Results: We found a significant lack of knowledge about the HPV vaccine that persisted across all 89 women. None of the women surveyed had received a single dose of the HPV vaccinations themselves, either because they “did not think it was necessary,” or “did not know why it was important.” About 76% of women surveyed said they did not know what causes most cervical cancer (99% CI [65%-88%]), and of the 23% of women who said they did know what causes cervical cancer, none of the women cited HPV as a cause (99% CI [12%-35%]). Only 55% of women surveyed had heard about the HPV vaccine (99% CI [41%-68%]), and 82% of women did not understand the purpose of the HPV vaccine (99% CI [72%-93%]). However, Chi Square analysis revealed no significant age or country of origin differences in knowledge about the HPV vaccine or vaccination rates. Conclusions: These data show the need for culturally appropriate interventions that are both language specific and literacy level appropriate, in order to increase knowledge about the importance of HPV vaccination among Latinx women of East Los Angeles, particularly how it relates to cervical cancer prevention. Improved access to health education in the community could increase vaccination rates and decrease rates of cervical cancer in this population. Citation Format: Sarita Sooklal, Rosa Barahona, Lourdes Baezconde- Garbanati. Human papillomavirus vaccination rates and knowledge among Latinx women in East Los Angeles [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-274.

HPV vaccines in Brazil and the world

Cost Effectiveness of HPV Vaccine for Boys

Impact of the human papillomavirus vaccine in low-resource settings

Racial Disparity in the Prevalence of Cervical Cancer

Vaccinating Adolescents—New Evidence of Challenges and Opportunities

Increasing HPV vaccine interest via standardized multimodal education in an underserved patient population (363)

Numbers game: Researchers explore whether fewer than 3 doses of HPV vaccine are effective.

Background: The human papillomavirus (HPV) vaccine was first approved for use in females in 2006, and then in 2009, for both males and females. However, the knowledge of HPV and HPV vaccine, and uptake of the vaccine has been suboptimal and worse among males. In addition, the burden of HPV-associated cancers in the United States is very high among males, especially in head and neck, anal, and penile cancers. If the current HPV vaccination trend persists, then the Healthy People 2020 goal of achieving 80% HPV vaccination will not be achieved. Objective: The aim of this study was to quantify gaps in HPV and HPV vaccine knowledge among adult males in the United States. Methods: Data from the Health Information National Trends Survey 4 Cycle 4 (November 2014) were analyzed for 3,677 survey participants aged 18 years and older. Primary outcome of interest was men's knowledge of HPV and HPV vaccine. Secondary outcome of interest were men's knowledge that HPV causes certain cancers. Participants were asked if they have heard about the HPV and HPV vaccine. Respondents who answered “no” were excluded (n = 1,389). Final sample size used for analyses for the secondary outcomes of interest was 2,288. Results: Sixty-four percent of respondents (56% of men and 72% of women) had heard of HPV and the HPV vaccine. In multivariate analyses, after adjusting for known covariates, males were 67% (95% CI: 0.25 – 0.45) less likely to have heard of HPV, and 76% (95% CI: 0.18 – 0.32) less likely to have heard of the HPV vaccine compared to females. Seventy percent (73% of men and 67% of women) knew that HPV is sexually transmitted disease (STD), 78% (76% of men and 79% of women) knew HPV causes cervical cancer, but only 29% of men and women knew it causes penile cancer, 26% (27% of men and 25 % of women) knew it causes anal cancer, and 30% (31% of men and 29% of women) knew it causes oral cancer. Among those that had heard of HPV, there was no statistical difference in knowledge between males and females with regard to the knowledge that HPV causes cervical, penile, anal and oral cancer. However males were less likely than females to know that HPV causes cervical cancer while females were less likely to know that HPV causes oral cancer. Modified by race, non-Hispanic Black women were 54% less likely to have heard of HPV (OR = 0.46, 95% CI: 0.24 – 0.88); and 64% less likely to have heard of HPV vaccine (OR = 0.36, 95% CI: 0.19 – 0.67), compared to non-Hispanic White women. Similarly, compared to non-Hispanic White women, Hispanic women were 51% less likely to have heard of HPV vaccine (OR = 0.49, 95% CI: 0.27 – 0.88). For men, compared to non-Hispanic White men, Hispanic men were 69% less likely to have heard of HPV vaccine (OR = 0.31, 95% CI: 0.16 – 0.62). Conclusion: A two-third of respondents were aware of HPV and HPV vaccine, but a clear gender and racial gap still exist in HPV and HPV vaccine knowledge. This underscores the need for more tailored interventions specifically targeted towards males and minority racial groups in order to increase knowledge and uptake of the HPV vaccine. It also highlights the need for more deliberate efforts on the part of physicians to discuss the HPV vaccine with eligible patients and parents Citation Format: Nosayaba Osazuwa-Peters, Eric Adjei Boakye, Betelihem B. Tobo, Kahee Agid Mohammed. HPV is not just a woman's business! Understanding the gaps in men's knowledge of HPV and HPV vaccine. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr B89.

Purpose: Human Papilloma Virus (HPV) vaccination is a key primary prevention method against cervical cancer which is given to young girls before onset of sexual activity. In Tanzania, cervical cancer is the most frequent occurring cancer among women and is the leading cause of cancer mortality. The HPV Vaccination program was rolled-out in Tanzania in 2018 for adolescent girls aged 9-14 years old to receive two doses at a six months interval, with the annual vaccine uptake of 46.1%. In 2019, the uptake of the HPV vaccine was 64%, where as the national coverage target is 75%. This study is aimed at assessing the determinants of HPV vaccination among adolescent girls in Hai district, Kilimanjaro region, northern Tanzania. Methods: A cross-sectional study was conducted between July and August 2020 among 14 years old girls in selected secondary schools within Hai district. Close ended questionnaire interviews were conducted to the girls on the study. Data was analysed using SPSS version 20 and odds ratio was used to assess the association between several factors and HPV vaccination. Results: A total of 301 adolescent girls aged 14 years consented to the study. HPV vaccination uptake was 65% (196). More than three fifth (60.7%, 119) reported to have received the two required doses. Knowledge of HPV (OR = 5.68 95% CI (0.72- 44.96); p-value = 0.01) and HPV vaccine (OR = 20.11 95% CI (10.88- 37.99); p-value = 0.01) contributed significantly to HPV vaccine uptake among the adolescent girls in the study. More than one-third (34.9%, 105) of the participants were not vaccinated, main reasons adduced for not being vaccinated include lack of proper information about HPV vaccine (60.0%), fear of side effects (14%) and parental refusal (11%). Conclusion: HPV vaccination is globally accepted as a pivotal primary prevention means against cervical cancer. Emphasizing dissemination of clear and comprehensible information to the society, especially to the adolescent girls, about HPV, cervical cancer and HPV vaccine will significantly increase HPV vaccination among the adolescent girls. Utilizing health care workers and policy makers in providing such education will facilitate its successful implementation. Citation Format: Jojet Josephat. Human Papilloma Virus Vaccination and Its Determinants Among Adolescent Girls Aged 14 Years Old in Hai District of Kilimanjaro Region in Northern Tanzania [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 46.