Abstract
BackgroundHuman papillomavirus (HPV) has recently been implicated as a causative agent in a rapidly growing number of oropharyngeal cancers. Emerging literature supports the hypothesis that HPV vaccination may protect against HPV-related head and neck cancer (HNC) in addition to HPV-related cervical and anogenital disease. While the association between HPV infection and cervical cancer is widely understood, its relation to HNC is less well known. The purpose of this study was to better understand HPV counseling practices for infection and vaccination in relation to HNC of primary care physicians (PCPs), Obstetricians/Gynecologists (OBGYNs), and Otolaryngology - Head and Neck Surgeons (OHNSs) in Canada.MethodsA Canada-wide electronic questionnaire regarding counseling practices on HPV infection, transmission, and vaccination was designed and distributed to PCPs, OBGYNs, and OHNSs across Canada through electronic and paper-based methods. Basic Descriptive statistics were used to analyze responses.ResultsIn total, 337 physicians responded (239 family physicians, 51 OHNSs, 30 OBGYNs, and 17 pediatricians). Three out of four PCPs reported routine counseling of their patients regarding HPV infection, transmission, and vaccination. Among this group, 68% reported “never” or “rarely” counseling patients that HPV can cause HNC. The most commonly reported reason that PCPs cited for not counseling was a lack of knowledge. The majority of OHNSs (81%) and OBGYNs (97%) counseled patients regarding HPV infection, transmission, and vaccination. However, very few OHNSs (10%) regularly counseled patients with HPV-related HNC about HPV-related anogenital cancer. Similarly, very few OBGYNs (18%) regularly counseled patients with HPV related cervical/anogenital cancer about HPV related HNC.ConclusionsThe rate of counseling on HPV infection, transmission, and vaccination in relation to HNC among PCPs is low. The most common reason is a lack of knowledge. Specialists rarely counsel patients with confirmed HPV-related cancer about other HPV-related malignancies. More research is needed on the relationship between different HPV-related cancers in order to better inform counseling practices.
Highlights
Human papillomavirus (HPV) has recently been implicated as a causative agent in a rapidly growing number of oropharyngeal cancers
The high-risk HPV serotypes 16 and 18 that have long been associated with cervical and anogenital cancers have been implicated as causative agents in a growing number of oral and oropharyngeal squamous cell carcinomas (OPSCC), a particular subset of head and neck cancer (HNC) [2,3,4,5,6]
The incidence of OPSCC is rapidly increasing in North America, and this is thought to be a direct result of the increasing prevalence of oncogenic HPV strains among the general population [7, 8]
Summary
Human papillomavirus (HPV) has recently been implicated as a causative agent in a rapidly growing number of oropharyngeal cancers. The high-risk HPV serotypes 16 and 18 that have long been associated with cervical and anogenital cancers have been implicated as causative agents in a growing number of oral and oropharyngeal squamous cell carcinomas (OPSCC), a particular subset of head and neck cancer (HNC) [2,3,4,5,6]. The incidence of OPSCC is rapidly increasing in North America, and this is thought to be a direct result of the increasing prevalence of oncogenic HPV strains among the general population [7, 8]. Nova Scotia, and Prince Edward Island include males in their routine HPV vaccination programs [13]. This decision is based on the cost of vaccine. The failure to vaccinate males does not take advantage of the potential importance of HPV vaccination in preventing other HPV-related cancers including anogenital and HNC, both of which can occur in men or women
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