Elsevier

Journal of Cancer Policy

Volume 5, September 2015, Pages 18-22
Journal of Cancer Policy

No change in physician discussions with patients about the human papillomavirus vaccine between 2007 and 2013

https://doi.org/10.1016/j.jcpo.2015.06.001Get rights and content

Highlights

  • Examines increase in the physician–patient HPV discussion since vaccine licensure.

  • Examines racial disparities in physician–patient HPV vaccine discussion.

  • Only 3% increase in physician–patient HPV vaccine discussion between 2007 and 2013.

  • No statistically significant increase in physician–patient HPV discussion.

  • No significant difference in race of patients having HPV discussion with physicians.

Abstract

Background

The human papillomavirus (HPV) vaccine was approved for preventing some oncogenic strains of the HPV in 2006. Predictors of HPV vaccine uptake include physicians’ conversations with patients and the patients’ race; particularly among racial minorities, African-Americans are less likely to complete required doses.

Purpose

To analyze whether there were differences in the percentage of participants who reported they ever had a discussion with a provider about the HPV vaccine in 2007 and 2013; and to analyze physicians’ discussions based on patients’ race.

Methods

Adults within the vaccination age of 18–26 years were identified from the Health Information National Trends Survey (HINTS) 2007 (n = 687) and 2013 (n = 496) databases. A logistic regression generated odds ratios between races for each of the two years and a z-test compared the two odds ratios on the natural log scale.

Results

There was only a 3% increase in conversations about the HPV vaccine between 2007 and 2013, but no significant differences based on race in 2007 (p = 0.16) or 2013 (p = 0.64). In 2007, physicians had more than 2.5 greater odds of having discussed the HPV vaccine with their African-American patients than Caucasian patients while being 1.24 times more likely to do so in 2013. These ratios were not significantly different from each other (z = 0.97; p = 0.17).

Conclusions

After almost a decade since the HPV vaccine was approved, there have been no significant changes in the amount of conversations physicians have with patients about the vaccine. It is important that physicians’ encounter with patients be seen as an opportunity to encourage HPV vaccine uptake, particularly among racial minorities.

Section snippets

Background

The human papillomavirus (HPV) is currently the most common sexually transmitted viral infection globally, affecting at least 630 million people, and is causally linked to several anogenital cancers, including cervical, vaginal, vulvar, anal and penile, as well as oropharyngeal cancer, a specific sub-site of cancers of the head and neck region [1]. In the United States, HPV is the most common sexually transmitted infection (STI) [2], more common than the human immunodeficiency virus (HIV), and

Methods

Using the Health Information National Trends Survey (HINTS) data from 2007 and 2013, authors compared the two years to find if there had been differences in physicians’ discussion of the HPV vaccine with patients, and if there were any racial disparities associated with these discussions by physicians. The HINTS is a publicly available dataset that is housed by the National Cancer Institute. It reports health information trends among adults in the United States, and has been fielded every 2 or

Results

When comparing the proportions of conversations between physicians and patients in 2007, there were no significant differences based on race (p = 0.16) or 2013 (p = 0.64). Using logistic regression, in 2007, physicians were 2.5 times more likely to have discussed the HPV vaccine with their African-American patients than Caucasian patients (aOR = 2.71; 95% CI: 0.55, 13.38/cOR = 2.77; 95% CI: 0.63, 12.10); however, these results were statistically insignificant (p = 0.16). In 2013, after adjusting for

Discussion

The present study examined the amount of HPV-vaccine-related conversations between physicians and patients by reviewing the change from 2007 to 2013 as reported by patients aged 18–26 years old. Our results show that there has not been a statistically significant increase in the percentage of participants aged 18–26 years who reported that their healthcare provider ever talked with them about the HPV vaccine. This result corroborates a previous study of physicians that also found no statistical

Limitations

It is important to note that gender disparities were not explored in this research given that the HPV vaccine recommendation was extended to males only later in 2011. For that reason, the data were not stratified by sex. This could have contributed to the missing data in 2007 given that males would not have perceived the HPV vaccine applicable to their personal healthcare. Additionally, findings may be limited due to the large number of missing cases and limited age range in 2007 and 2013. The

Conclusion

Despite the fact that it has been almost a decade since the HPV vaccine was first approved, this study detected no statistically significant change in the amount of conversations physicians have with their patients about the vaccine for patients aged 18 to 26 years. To increase vaccination rates against the most common STI in the world, public health messages should consider targeting physicians and equipping them with the necessary materials needed to educate patients about the vaccine.

Conflict of interest statement

We have no conflict of interest to declare, and there was no funding for this research.

References (48)

  • S.L. Pruitt et al.

    Geographic disparity, area poverty, and human papillomavirus vaccination

    Am. J. Prev. Med.

    (2010)
  • A. Dempsey et al.

    Worsening disparities in HPV vaccine utilization among 19–26 year old women

    Vaccine

    (2011)
  • S.T. Vadaparampil et al.

    Missed clinical opportunities: provider recommendations for HPV vaccination for 11–12 year old girls are limited

    Vaccine

    (2011)
  • N. Osazuwa-Peters et al.

    Sexual behavior, HPV knowledge, and association with head and neck cancer among a high-risk group

    Oral Oncol.

    (2015)
  • A.Y. Akers et al.

    Factors underlying disparities in cervical cancer incidence, screening, and treatment in the United States

    Curr. Probl. Cancer

    (2007)
  • B. Donovan et al.

    Quadrivalent human papillomavirus vaccination and trends in genital warts in Australia: analysis of national sentinel surveillance data

    Lancet Infect. Dis.

    (2011)
  • J.M.L. Brotherton et al.

    Early effect of the HPV vaccination programme on cervical abnormalities in Victoria, Australia: an ecological study

    Lancet

    (2011)
  • D.E. Morse et al.

    Disparities in oral and pharyngeal cancer incidence, mortality and survival among black and white Americans

    J. Am. Dent. Assoc.

    (2006)
  • P. Jeudin et al.

    Race, ethnicity, and income factors impacting human papillomavirus vaccination rates

    Clin. Ther.

    (2014)
  • E. Daley et al.

    Prevention of HPV-related oral cancer: assessing dentists’ readiness

    Public Health

    (2014)
  • Centers for Disease Prevention and Control. Human Papillomavirus (HPV)....
  • G. D'Souza et al.

    Oral sexual behaviors associated with prevalent oral human papillomavirus infection

    J. Infect. Dis.

    (2009)
  • National Council of State Legislatures. HPV vaccines policies....
  • V.A. Moyer

    Screening for cervical cancer: US Preventive Services Task Force recommendation statement

    Ann. Intern. Med.

    (2012)
  • Cited by (2)

    View full text