HPV Vaccination Rates Low Among Childhood Cancer Survivors

Research cites lack of discussion on the part of healthcare providers

nurse puts bandaid on teen girl's arm after vaccination

The human papilloma virus (HPV) causes most cervical cancers and many oral, anal, vaginal, vulvar, and penile cancers. According to the CDC, about 75 to 89% of all males and females will contract some form of HPV at some point during their lifetime. Survivors of childhood cancers are especially vulnerable to HPV infection, because cancer treatment often suppresses their immune systems. The American Cancer Society recommends that both boys and girls get vaccinated against HPV at age 11 or 12.

Despite the fact that the HPV vaccine is widely available and can help prevent forms of cancer caused by the virus, most young cancer survivors don’t get vaccinated. But a conversation between survivors of childhood cancer and their healthcare providers could help to change that, suggests a study published August 24, 2017 in the Journal of Clinical Oncology.

Researchers surveyed 982 cancer survivors from ages 9 to 26 who had completed cancer therapy within the past 1 to 5 years and were in remission. Parents answered the surveys for survivors younger than 18.

The survey asked whether survivors had received the HPV vaccine, whether their health care provider had recommended the vaccine, and what their (or their parents) attitudes were toward vaccination. The team then compared the number of participants who had received the HPV vaccine to data from a general population taken from the National Immunization Survey-Teen and the National Health Interview Survey.

What they found was that for the most part, childhood cancer survivors received the HPV vaccine at an even lower rate (24%) than their peers without cancer (40%). This was true for both male and female participants, although males were less likely to have been vaccinated than females.

The largest discrepancy in vaccination rates was among teens aged 13-17. Just 22% of teen cancer survivors had received the vaccine, vs. 42% of their peers who had never had the disease. Among youths aged 18-26, vaccination rates were about the same – 25% for cancer survivors, vs. 24% for those who had never had cancer.

According to the study’s authors, when asked their reasons for not being vaccinated, nearly three-quarters (72%) of study participants said it was because their healthcare provider did not proactively recommend vaccination – healthcare professionals simply never brought up or encouraged the conversation. Of the 28% who did receive a provider recommendation, more than half received the vaccination.

Other barriers to vaccination included the survivors’ assumption that their insurance wouldn’t cover the vaccine, one that could be overcome with a conversation with their healthcare provider.

The study’s authors note that more research is needed to fully identify all the barriers that prevent childhood cancer survivors from getting the HPV vaccine. But initial indications are that not talking about it is perhaps the first major hurdle healthcare providers for these young people must cross.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Human Papillomavirus Vaccination Rates in Young Cancer Survivors. Published August 24, 2017 in the Journal of Clinical Oncology. First author James L. Klosky, PhD, St. Jude Children’s Research Hospital, Memphis, Tenn.

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