Data from a study published online today in the Journal of Clinical Oncology suggest that survivors of childhood cancer are not vaccinated for the human papillomavirus (HPV) as regularly as those without cancer. The U.S. Centers for Disease Control and Prevention has recommended vaccination for HPV since 2006 for girls and 2011 for boys. Yet, vaccination rates continue to be low. Adolescents and young adults are at the highest risk of getting a sexually transmitted infection like HPV. Furthermore, young people who have survived cancer treatment have an even higher risk of health complications after exposure to HPV, so the importance of protecting themselves against HPV is greater.
HPV is usually passed from person to person during direct skin-to-skin contact. It is the most common sexually transmitted infection in the United States. There are more than 150 different types of HPV, called strains. There are vaccines available to protect people from some HPV strains. HPV causes most cervical cancers and many oral, anal, vaginal, vulvar, and penile cancers.
In this study, researchers gave surveys to 982 survivors of childhood cancer, or their parents. They ranged in age from 9 to 26 years and had finished cancer treatment between 1 and 5 years before taking the survey. More than half of them were survivors of leukemia or lymphoma. The survivors in this study were asked whether they had received the HPV vaccine, whether their health care provider had recommended the vaccine, and what their attitudes were toward vaccination. The researchers then compared the survey responses with data for people who did not have cancer from 2 national health surveys.
Researchers found that 24% of survivors started the HPV vaccine compared with 40% of peers in the general population. The HPV vaccine is given as 2 or 3 doses, depending on certain factors, and this study found that just under 14% of survivors completed the whole series of doses. Both male and female respondents had lower vaccination rates, with males less likely to be vaccinated than females.
The researchers suggest that there are several explanations for low HPV vaccination rates, but none is more important than the doctor’s recommendation. Among the survivors in this study, 72% reported that their doctor did not recommend the HPV vaccine, and only 5% of them received the vaccine. In contrast, among the 28% whose doctor did recommend the vaccine, more than half were vaccinated.
What does this mean for patients? Adolescents and young adults, especially cancer survivors, should ask for the HPV vaccine, regardless of whether a member of their health care team recommends it.
“This study shows that an effective, affordable, and widely available tool for cancer prevention is being underutilized by survivors of childhood cancer. As health care providers, we need to initiate more conversations about HPV vaccination, especially with childhood cancer survivors because they stand to benefit even more than their peers.”
—study author James Klosky, PhD, ABPP
St. Jude Children’s Research Hospital