Skip to main content
Top
Published in: Journal of Cancer Survivorship 3/2016

01-06-2016

Prevalence and predictors of human papillomavirus (HPV) vaccination among young women surviving childhood cancer

Authors: James L. Klosky, Brianne Favaro, Kelly R. Peck, Jessica L. Simmons, Kathryn M. Russell, Daniel M. Green, Melissa M. Hudson

Published in: Journal of Cancer Survivorship | Issue 3/2016

Login to get access

Abstract

Purpose

Human papillomavirus (HPV) is a sexually transmitted infection and the cause of cervical and other cancers. Vaccination is available to protect against genital HPV and is recommended for individuals aged 9–26 years. This study aimed to estimate the prevalence of HPV vaccination among childhood cancer survivors and to identify factors associated with vaccine outcomes.

Methods

Young adult females with (n = 114; M age = 21.18 years, SD = 2.48) and without (n = 98; M age = 20.65 years, SD = 2.29) a childhood cancer history completed surveys querying HPV vaccination initiation/completion, as well as sociodemographic, medical, and health belief factors. Multivariable logistic regression was used to calculate odds ratios (ORs) and 95 % confidence intervals (CIs) for vaccine outcomes.

Results

Among survivors, 38.6 % (44/114) and 26.3 % (30/114) initiated or completed vaccination compared to 44.9 % (44/98) and 28.6 % (28/98) among controls, respectively. In the combined survivor/control group, physician recommendation (OR = 11.24, 95 % CI 3.15–40.14) and familial HPV communication (OR = 7.28, 95 % CI 1.89–28.05) associated with vaccine initiation. Perceptions of vaccine benefit associated with vaccine completion (OR = 10.55, 95 % CI 1.59–69.92), whereas perceptions of HPV-related severity associated with non-completion (OR = 0.14, 95 % CI 0.03–0.71).

Conclusion

Despite their increased risk for HPV-related complication, a minority of childhood cancer survivors have initiated or completed HPV vaccination. Modifiable factors associated with vaccine outcomes were identified.

Implications for Cancer Survivors

HPV vaccination is a useful tool for cancer prevention in survivorship, and interventions to increase vaccine uptake are warranted.
Literature
1.
go back to reference Satterwhite CL, Torrone E, Meites E, Dunne EF, Majahan R, Ocfemia MC, et al. Sexually transmitted infections among U.S. women and men: prevalence and incidence estimates, 2008. Sex Transm Dis. 2013;40:187–93.CrossRefPubMed Satterwhite CL, Torrone E, Meites E, Dunne EF, Majahan R, Ocfemia MC, et al. Sexually transmitted infections among U.S. women and men: prevalence and incidence estimates, 2008. Sex Transm Dis. 2013;40:187–93.CrossRefPubMed
2.
go back to reference American Cancer Society. Supplement: assessing the burden of HPV-associated cancers in the United States. Cancer. 2008;113(S10):2837–3057.CrossRef American Cancer Society. Supplement: assessing the burden of HPV-associated cancers in the United States. Cancer. 2008;113(S10):2837–3057.CrossRef
3.
go back to reference Steinau M, Unger ER, Hernandez BY, Goodman MT, Copeland G, Hopenhayn C, et al. Human papillomavirus prevalence in invasive anal cancers in the United States before vaccine introduction. J Low Genit Tract Dis. 2013;17:397–403.CrossRefPubMedPubMedCentral Steinau M, Unger ER, Hernandez BY, Goodman MT, Copeland G, Hopenhayn C, et al. Human papillomavirus prevalence in invasive anal cancers in the United States before vaccine introduction. J Low Genit Tract Dis. 2013;17:397–403.CrossRefPubMedPubMedCentral
4.
go back to reference Gargano JW, Wilkinson EJ, Unger ER, Steinau M, Watson M, Huang Y, et al. Prevalence of human papillomavirus types in invasive vulvar cancers and vulvar intraepithelial neoplasia 3 in the United States before vaccine introduction. J Low Genit Tract Dis. 2012;16:471–9.CrossRefPubMed Gargano JW, Wilkinson EJ, Unger ER, Steinau M, Watson M, Huang Y, et al. Prevalence of human papillomavirus types in invasive vulvar cancers and vulvar intraepithelial neoplasia 3 in the United States before vaccine introduction. J Low Genit Tract Dis. 2012;16:471–9.CrossRefPubMed
5.
go back to reference Schiller JT, Frazer IH, Lowry DR. Human papillomavirus vaccines. In: Plotkin SA, Orenstein WA, Offit PA, editors. Vaccines. 5th ed. China: Saunders; 2008. p. 243–57. Schiller JT, Frazer IH, Lowry DR. Human papillomavirus vaccines. In: Plotkin SA, Orenstein WA, Offit PA, editors. Vaccines. 5th ed. China: Saunders; 2008. p. 243–57.
6.
go back to reference Hopfer S, Clippard JR. College women’s HPV vaccine decision narratives. Qual Health Res. 2010;10:1–16. Hopfer S, Clippard JR. College women’s HPV vaccine decision narratives. Qual Health Res. 2010;10:1–16.
7.
go back to reference Myers ER, McCrory DC, Nanda K, Bastian L, Matchar DB. Mathematical model for the natural history of human papillomavirus infection and cervical carcinogenesis. Am J Epidemiol. 2000;151:1158–71.CrossRefPubMed Myers ER, McCrory DC, Nanda K, Bastian L, Matchar DB. Mathematical model for the natural history of human papillomavirus infection and cervical carcinogenesis. Am J Epidemiol. 2000;151:1158–71.CrossRefPubMed
8.
go back to reference Haydon AA, Herring AH, Prinstein MJ, Helpern CT. Beyond age at first sex: patterns of emerging sexual behavior in adolescence and young adulthood. J Adolesc Health. 2013;50:456–63.CrossRef Haydon AA, Herring AH, Prinstein MJ, Helpern CT. Beyond age at first sex: patterns of emerging sexual behavior in adolescence and young adulthood. J Adolesc Health. 2013;50:456–63.CrossRef
10.
go back to reference Ojha RP, Tota JE, Offutt-Powerll TN, Klosky JL, Ashokkumar R, Gurney JG. Human papillomavirus-associated subsequent malignancies among long-term survivors of pediatric and young adult cancers. PLoS ONE. 2013;8:e70349.CrossRefPubMedPubMedCentral Ojha RP, Tota JE, Offutt-Powerll TN, Klosky JL, Ashokkumar R, Gurney JG. Human papillomavirus-associated subsequent malignancies among long-term survivors of pediatric and young adult cancers. PLoS ONE. 2013;8:e70349.CrossRefPubMedPubMedCentral
11.
go back to reference Saslow D, Castle PE, Cox JT, Davey DD, Einstein MH, Ferris DG, et al. American cancer society guideline for human papillomavirus (HPV) vaccine use to prevent cervical cancer and its precursors. CA Cancer J Clin. 2007;57:7–28.CrossRefPubMed Saslow D, Castle PE, Cox JT, Davey DD, Einstein MH, Ferris DG, et al. American cancer society guideline for human papillomavirus (HPV) vaccine use to prevent cervical cancer and its precursors. CA Cancer J Clin. 2007;57:7–28.CrossRefPubMed
12.
go back to reference Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0 through 18 years—United States, 2012. MMWR Morb Mortal Wkly Rep. 2012;61:1–4. Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0 through 18 years—United States, 2012. MMWR Morb Mortal Wkly Rep. 2012;61:1–4.
14.
go back to reference Laz TH, Rahman M, Berenson AB. Human papillomavirus vaccine uptake among 18- to 26-year-old women in the United States: National Health Interview Survey, 2010. Cancer. 2012;119:1386–92.CrossRefPubMedPubMedCentral Laz TH, Rahman M, Berenson AB. Human papillomavirus vaccine uptake among 18- to 26-year-old women in the United States: National Health Interview Survey, 2010. Cancer. 2012;119:1386–92.CrossRefPubMedPubMedCentral
15.
go back to reference Schmidt S, Parsons HM. Vaccination interest and trends in human papillomavirus vaccine uptake in young adult women aged 18 to 26 years in the United States: an analysis using the 2008–2012 National Health Interview Survey. Am J Public Health. 2014;104:946–53.CrossRefPubMedPubMedCentral Schmidt S, Parsons HM. Vaccination interest and trends in human papillomavirus vaccine uptake in young adult women aged 18 to 26 years in the United States: an analysis using the 2008–2012 National Health Interview Survey. Am J Public Health. 2014;104:946–53.CrossRefPubMedPubMedCentral
16.
go back to reference Hopfer S, Clippard JR. College women’s HPV vaccine decision narratives. Qual Health Res. 2011;21:262–77.CrossRefPubMed Hopfer S, Clippard JR. College women’s HPV vaccine decision narratives. Qual Health Res. 2011;21:262–77.CrossRefPubMed
17.
go back to reference Pierre Joseph N, Clark JA, Mercilus G, Wilbur M, Figaro J, Perkins R. Racial and ethnic differences in HPV knowledge, attitudes, and vaccination rates among low-income African-American, Haitian, Latina, and Caucasian young adult women. J Pediatr Adolesc Gynecol. 2014;27:83–92.CrossRefPubMed Pierre Joseph N, Clark JA, Mercilus G, Wilbur M, Figaro J, Perkins R. Racial and ethnic differences in HPV knowledge, attitudes, and vaccination rates among low-income African-American, Haitian, Latina, and Caucasian young adult women. J Pediatr Adolesc Gynecol. 2014;27:83–92.CrossRefPubMed
18.
go back to reference Bednarczyk RA, Birkhead GS, Morse DL, Doleyres H, McNutt LA. Human papillomavirus vaccine uptake and barriers: association with perceived risk, actual risk and race/ethnicity among female students at New York State University, 2010. Vaccine. 2011;29:3138–43.CrossRefPubMed Bednarczyk RA, Birkhead GS, Morse DL, Doleyres H, McNutt LA. Human papillomavirus vaccine uptake and barriers: association with perceived risk, actual risk and race/ethnicity among female students at New York State University, 2010. Vaccine. 2011;29:3138–43.CrossRefPubMed
19.
go back to reference Manhart LE, Burgess-Hull AJ, Fleming CB, Bailey JA, Haggerty KP, Catalano RF. HPV vaccination among a community sample of young adult women. Vaccine. 2011;29:5238–44.CrossRefPubMedPubMedCentral Manhart LE, Burgess-Hull AJ, Fleming CB, Bailey JA, Haggerty KP, Catalano RF. HPV vaccination among a community sample of young adult women. Vaccine. 2011;29:5238–44.CrossRefPubMedPubMedCentral
20.
go back to reference Donadiki EM, Jimenez-Garcia R, Hernandez-Barrera V, Carrasco-Garrido P, Lopez de Andres A, Velonakis EG. Human papillomavirus vaccination coverage among Greek higher education female students and predictors of vaccine uptake. Vaccine. 2012;30:6967–70.CrossRefPubMed Donadiki EM, Jimenez-Garcia R, Hernandez-Barrera V, Carrasco-Garrido P, Lopez de Andres A, Velonakis EG. Human papillomavirus vaccination coverage among Greek higher education female students and predictors of vaccine uptake. Vaccine. 2012;30:6967–70.CrossRefPubMed
21.
go back to reference Roberts ME, Gerrard M, Reimer R, Gibbons FX. Mother-daughter communication and human papillomavirus vaccine uptake by college students. Pediatrics. 2010;125:982–9.CrossRefPubMed Roberts ME, Gerrard M, Reimer R, Gibbons FX. Mother-daughter communication and human papillomavirus vaccine uptake by college students. Pediatrics. 2010;125:982–9.CrossRefPubMed
22.
go back to reference Daley MF, Crane LA, Markowitz LE, Black SR, Beaty BL, Barrow J, et al. Human papillomavirus vaccination practices: a survey of US physicians 18 months after licensure. Pediatrics. 2010;126:425–33.CrossRefPubMed Daley MF, Crane LA, Markowitz LE, Black SR, Beaty BL, Barrow J, et al. Human papillomavirus vaccination practices: a survey of US physicians 18 months after licensure. Pediatrics. 2010;126:425–33.CrossRefPubMed
23.
go back to reference Rosenthal SL, Rupp R, Zimet GD, Meza HM, Loza ML, Short MB, et al. Uptake of HPV vaccine: demographics, sexual history and values, parenting style, and vaccine attitudes. J Adolesc Health. 2008;43:239–45.CrossRefPubMed Rosenthal SL, Rupp R, Zimet GD, Meza HM, Loza ML, Short MB, et al. Uptake of HPV vaccine: demographics, sexual history and values, parenting style, and vaccine attitudes. J Adolesc Health. 2008;43:239–45.CrossRefPubMed
24.
go back to reference Ojha RP, Jackson BE, Tota JE, Offutt-Powell TN, Hudson MM, Gurney JG. Younger age distribution of cervical cancer incidence among survivors of pediatric and young adult cancers. Gynecol Oncol. 2014;134:309–13.CrossRefPubMed Ojha RP, Jackson BE, Tota JE, Offutt-Powell TN, Hudson MM, Gurney JG. Younger age distribution of cervical cancer incidence among survivors of pediatric and young adult cancers. Gynecol Oncol. 2014;134:309–13.CrossRefPubMed
25.
go back to reference Klosky JL, Russell KM, Canavera KE, Gammel HL, Hodges JR, Foster RH, et al. Risk factors for non-initiation of the human papillomavirus vaccine among adolescent survivors of childhood cancer. Cancer Prev Res. 2013;6:1101–10.CrossRef Klosky JL, Russell KM, Canavera KE, Gammel HL, Hodges JR, Foster RH, et al. Risk factors for non-initiation of the human papillomavirus vaccine among adolescent survivors of childhood cancer. Cancer Prev Res. 2013;6:1101–10.CrossRef
26.
go back to reference Brabin L, Roberts SA, Farzaneh F, Kitchener HC. Future acceptance of adolescent human papillomavirus vaccination: a survey of parental attitudes. Vaccine. 2006;24:3087–94.CrossRefPubMed Brabin L, Roberts SA, Farzaneh F, Kitchener HC. Future acceptance of adolescent human papillomavirus vaccination: a survey of parental attitudes. Vaccine. 2006;24:3087–94.CrossRefPubMed
27.
go back to reference Constantine NA, Jerman P. Acceptance of human papillomavirus vaccination among Californian parents of daughters: a representative statewide analysis. J Adolesc Health. 2007;40:108–15.CrossRefPubMed Constantine NA, Jerman P. Acceptance of human papillomavirus vaccination among Californian parents of daughters: a representative statewide analysis. J Adolesc Health. 2007;40:108–15.CrossRefPubMed
28.
go back to reference Dempsey AF, Zimet GD, Davis RL, Koutsky L. Factors that are associated with parental acceptance of human papillomavirus vaccines: a randomized intervention study of written information about HPV. Pediatrics. 2006;117:1486–93.CrossRefPubMed Dempsey AF, Zimet GD, Davis RL, Koutsky L. Factors that are associated with parental acceptance of human papillomavirus vaccines: a randomized intervention study of written information about HPV. Pediatrics. 2006;117:1486–93.CrossRefPubMed
29.
go back to reference Kelly JA, McAuliffe TL, Sikkema KJ, Murphy DA, Somlai AM, Mulry GW, et al. Reduction in risk behavior among adults with severe mental illness who learned to advocate for HIV prevention. Psychiatr Serv. 1997;48:1283–8.CrossRefPubMed Kelly JA, McAuliffe TL, Sikkema KJ, Murphy DA, Somlai AM, Mulry GW, et al. Reduction in risk behavior among adults with severe mental illness who learned to advocate for HIV prevention. Psychiatr Serv. 1997;48:1283–8.CrossRefPubMed
30.
go back to reference Kelly JA, Murphy DA, Bahr GR, Brasfield TL, Davis DR, Hauth AC, et al. AIDS/HIV risk behavior among the chronic mentally ill. Am J Psychiatry. 1992;149:886–9.CrossRefPubMed Kelly JA, Murphy DA, Bahr GR, Brasfield TL, Davis DR, Hauth AC, et al. AIDS/HIV risk behavior among the chronic mentally ill. Am J Psychiatry. 1992;149:886–9.CrossRefPubMed
31.
go back to reference Gomez CA, Marin BV. Gender, culture, and power: barriers to HIV-prevention strategies for women. J Sex Res. 1996;33:355–62.CrossRef Gomez CA, Marin BV. Gender, culture, and power: barriers to HIV-prevention strategies for women. J Sex Res. 1996;33:355–62.CrossRef
32.
go back to reference Cox DS, Cox AD, Sturm L, Zimet G. Behavioral interventions to increase HPV vaccination acceptability among mothers of young girls. Health Psychol. 2010;29:29–39.CrossRefPubMed Cox DS, Cox AD, Sturm L, Zimet G. Behavioral interventions to increase HPV vaccination acceptability among mothers of young girls. Health Psychol. 2010;29:29–39.CrossRefPubMed
33.
go back to reference Gerend MA, Lee SC, Shepherd JE. Predictors of human papillomavirus vaccination acceptability among underserved women. Sex Transm Dis. 2007;34:468–71.PubMed Gerend MA, Lee SC, Shepherd JE. Predictors of human papillomavirus vaccination acceptability among underserved women. Sex Transm Dis. 2007;34:468–71.PubMed
34.
go back to reference Mariotto AB, Rowland JH, Yarbroff KR, Scoppa S, Hachey M, Ries L, et al. Long-term survivors of childhood cancers in the United States. Cancer Epidemiol Biomarkers Prev. 2009;18:1033–40.CrossRefPubMed Mariotto AB, Rowland JH, Yarbroff KR, Scoppa S, Hachey M, Ries L, et al. Long-term survivors of childhood cancers in the United States. Cancer Epidemiol Biomarkers Prev. 2009;18:1033–40.CrossRefPubMed
35.
go back to reference Krull KR, Huang S, Gurney JG, Klosky JL, Leisenring W, Termuhlen A, et al. Adolescent behavior and adult health status in childhood cancer survivors. J Cancer Surviv. 2010;4:210–7.CrossRefPubMedPubMedCentral Krull KR, Huang S, Gurney JG, Klosky JL, Leisenring W, Termuhlen A, et al. Adolescent behavior and adult health status in childhood cancer survivors. J Cancer Surviv. 2010;4:210–7.CrossRefPubMedPubMedCentral
36.
go back to reference Rahman M, Laz TH, Berenson AB. Geographic variation in human papillomavirus vaccination uptake among young adult women in the United States during 2008–2010. Vaccine. 2013;31:5495–9.CrossRefPubMedPubMedCentral Rahman M, Laz TH, Berenson AB. Geographic variation in human papillomavirus vaccination uptake among young adult women in the United States during 2008–2010. Vaccine. 2013;31:5495–9.CrossRefPubMedPubMedCentral
37.
go back to reference Klosky JL, Gamble HL, Spunt SL, Randolph ME, Green DM, Hudson MM. Human papillomavirus (HPV) vaccine in survivors of childhood cancer. Cancer. 2009;115:5627–36.CrossRefPubMedPubMedCentral Klosky JL, Gamble HL, Spunt SL, Randolph ME, Green DM, Hudson MM. Human papillomavirus (HPV) vaccine in survivors of childhood cancer. Cancer. 2009;115:5627–36.CrossRefPubMedPubMedCentral
38.
go back to reference Ojha RP, Tota JE, Offutt-Powell TN, Klosky JL, Ashokkumar R, Gurney JG. The accuracy of human papillomavirus vaccination status based on adult proxy recall or household immunization records for adolescent females in the United States: results from the National Immunization Survey-Teen. Ann Epidemiol. 2013;23:281–5.CrossRefPubMed Ojha RP, Tota JE, Offutt-Powell TN, Klosky JL, Ashokkumar R, Gurney JG. The accuracy of human papillomavirus vaccination status based on adult proxy recall or household immunization records for adolescent females in the United States: results from the National Immunization Survey-Teen. Ann Epidemiol. 2013;23:281–5.CrossRefPubMed
39.
go back to reference Rolnick SJ, Parker ED, Nordin JD, Hedblom BD, Wei F, Kerby T, et al. Self-report compared to electronic medical record across eight adult vaccines: do results vary by demographic factors? Vaccine. 2013;31:3928–35.CrossRefPubMedPubMedCentral Rolnick SJ, Parker ED, Nordin JD, Hedblom BD, Wei F, Kerby T, et al. Self-report compared to electronic medical record across eight adult vaccines: do results vary by demographic factors? Vaccine. 2013;31:3928–35.CrossRefPubMedPubMedCentral
40.
go back to reference Arora NK, Jensen RE, Sulayman N, Hamilton AS, Potosky AL. Patient-physician communication about health-related quality-of-life problems: are non-Hodgkin lymphoma survivors willing to talk? J Clin Oncol. 2013;31:3964–70.CrossRefPubMedPubMedCentral Arora NK, Jensen RE, Sulayman N, Hamilton AS, Potosky AL. Patient-physician communication about health-related quality-of-life problems: are non-Hodgkin lymphoma survivors willing to talk? J Clin Oncol. 2013;31:3964–70.CrossRefPubMedPubMedCentral
41.
go back to reference Askelson NM, Campo S, Smith S, Lowe JB, Dennis L, Andsager J. Assessing physicians’ intention to talk about sex when they vaccinate nine-year-old to 15-year-old girls against HPV. Sex Educ. 2011;11:431–41.CrossRef Askelson NM, Campo S, Smith S, Lowe JB, Dennis L, Andsager J. Assessing physicians’ intention to talk about sex when they vaccinate nine-year-old to 15-year-old girls against HPV. Sex Educ. 2011;11:431–41.CrossRef
43.
go back to reference Murphy D, Klosky JL, Reed D, Termuhlen A, Shannon SV, Quinn GP. The importance of assessing priorities of reproductive health concerns among adolescent and young adult (AYA) patients with cancer. Cancer. 2015;121:2529–36.CrossRefPubMed Murphy D, Klosky JL, Reed D, Termuhlen A, Shannon SV, Quinn GP. The importance of assessing priorities of reproductive health concerns among adolescent and young adult (AYA) patients with cancer. Cancer. 2015;121:2529–36.CrossRefPubMed
Metadata
Title
Prevalence and predictors of human papillomavirus (HPV) vaccination among young women surviving childhood cancer
Authors
James L. Klosky
Brianne Favaro
Kelly R. Peck
Jessica L. Simmons
Kathryn M. Russell
Daniel M. Green
Melissa M. Hudson
Publication date
01-06-2016
Publisher
Springer US
Published in
Journal of Cancer Survivorship / Issue 3/2016
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI
https://doi.org/10.1007/s11764-015-0495-2

Other articles of this Issue 3/2016

Journal of Cancer Survivorship 3/2016 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine