Most American adults do not know that HPV causes oral, anal, and penile cancers

More than 70% of U.S. adults are unaware that human papillomavirus (HPV) causes anal, penile, and oral cancers, according to an analysis led by researchers at The University of Texas Health Science Center at Houston (UTHealth) School of Public Health and published in the current issue of JAMA Pediatrics.

Men are also less likely than women to know that the virus carries a risk of cancer, said Ashish A. Deshmukh, PhD, MPH, assistant professor at UTHealth School of Public Health, who led the study that included 2,564 men and 3,697 women who took part in the Health Information National Trend Survey. Two-thirds of men and one-third of women ages 18-26 did not know that HPV causes cervical cancer. More than 80% of men and 75% of women in the same age group – and 70% of all American adults of any age – did not know that HPV can cause oral, anal, and penile cancers.

Human papillomavirus is the most common sexually transmitted infection. There are many types of HPV, but some are more likely to cause cancers and genital warts. The HPV vaccine can protect against cancers caused by the virus.

The analysis by Deshmukh and colleagues also showed that, of people who were vaccine-eligible or had vaccine-eligible family members, only 19% of men and 31.5% of women received recommendations for the vaccine from a health care provider.

According to the U.S. Centers for Disease Control and Prevention (CDC), boys and girls ages 9-14 should receive the two-dose immunization. A three-dose schedule is recommended if the first dose was given on or after the 15th birthday. Recently, CDC also recommended that adults ages 27-45 may decide to get the HPV vaccine based on discussion with their clinician. A 2018 report by the CDC suggested only 51% of those in the recommended age groups were vaccinated.

“The lack of knowledge may have contributed to low HPV vaccination rates in the United States,” said Deshmukh.

“Low levels of HPV knowledge in these older age groups is particularly concerning, given that these individuals are (or will likely be) parents responsible for making HPV vaccination decisions for their children,” said Kalyani Sonawane, PhD, assistant professor at UTHealth School of Public Health, the study’s co-lead author.

“HPV vaccination campaigns have focused heavily on cervical cancer prevention in women. Our findings demonstrate a need to educate both sexes regarding HPV and HPV vaccination,” Deshmukh said. “Rates of cervical cancer have declined in the last 15 to 20 years because of screening. On the other hand, there was a greater than 200% increase in oropharyngeal cancer rates in men and a nearly 150% rise in anal cancer rates in women.”

Improving HPV vaccination rates is important to reverse rising rates of these cancers, Deshmukh added.

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Others who took part in this research include Ryan Suk of UTHealth in Houston; Jane R. Montealegre, PhD, of Baylor College of Medicine; Gizem S. Nemutlu, PhD, of Massachusetts General Hospital in Boston; Alan G. Nyitray, PhD, of Medical College of Wisconsin in Milwaukee; and Kathleen M. Schmeler, MD, of The University of Texas MD Anderson Cancer Center.

Funding for this research came from the National Cancer Institute (R01CA232888), part of the National Institutes of Health.

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