Thirteen years after the HPV vaccine was hailed as a revolution in cancer prevention, most Americans still don’t know the virus causes oral and genital cancers, and most doctors still aren’t recommending the vaccine to patients, according to a new study in JAMA Pediatrics.
Part of the problem is that the Merck vaccine, Gardasil, was initially tested, approved, and marketed to prevent cervical cancer, creating the impression that it was only for females, said study leader Ashish Deshmukh, an HPV researcher at the University of Texas School of Public Health in Houston.
Even so, Deshmukh and his team were surprised to find that more than 80% of men and 75% of women ages 18 to 26 — and 70% of all U.S. adults — are unaware that HPV causes oral, anal, and penile cancers. Genital strains of HPV, the human papillomavirus, are transmitted during sexual activity and are ubiquitous, though most people clear the virus naturally before it can evolve into cancer.
“In fact, we were shocked,” Deshmukh said. “We thought knowledge might be low, but the knowledge that HPV causes cancers other than cervical cancer basically doesn’t exist.”
For the study, the researchers analyzed a nationally representative survey conducted by the National Cancer Institute in 2017. The survey included questions about knowledge of HPV, the HPV vaccine, and the relationship between HPV and cervical, oral, anal, and penile cancers. It also asked whether a health-care provider had urged eligible patients to get the vaccine, which is recommended for boys and girls at age 11 or 12, and as “catch-up” shots up to age 26.
Although two-thirds of women ages 18 to 26 knew HPV causes cervical cancer, only one-third of men knew.
Among people who were eligible for the vaccine or had children who were eligible, only 19% of men and 32% of women said their health-care provider recommended the vaccine.
Studies have consistently shown that doctors hold great sway when they endorse the immunization. But despite educational campaigns by public health and medical groups, many doctors — especially pediatricians — hold back, uncomfortable discussing the link between HPV and sex.
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Pediatrician Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, said, “This study shows that the public health community still has a lot of work to do in educating parents and children about the devastating consequences of HPV infection."
Offit, who was not involved with the study, added: "At present, only about half of the adolescent boys and girls recommended to receive the HPV vaccine get it. That means that every year, about 2,000 children will grow up and die from a preventable cancer.”
Deshmukh noted that while cervical cancer rates have declined over the last 20 years because of routine Pap screening, rates of mouth and throat cancers in men have risen more than 200%, and anal cancers in women have risen 150%.
“Our findings demonstrate a need to educate both sexes regarding HPV and HPV vaccination,” he said.