Study Finds HPV Vaccination Underutilized by Childhood Cancer Survivors

A new study in the Journal of Clinical Oncology identifies an increased role for physicians in boosting human papillomavirus (HPV) vaccination rates among childhood cancer survivors to reduce their risk of a second cancer.

The study surveyed 982 childhood cancer survivors (the majority whom were leukemia/lymphoma survivors), aged 9 to 26 years, who had completed treatment between 1 and 5 years prior to the survey. The survey touched on:

• Whether they had received an HPV vaccine
• Whether their provider had recommended the vaccine
• Their attitude toward vaccination

The results drawn on the HPV vaccination rates, based on the survey, were consequently compared with the vaccine initiation rates in the general population. More than a 1.5-fold difference was noted between the 2 populations: a 24% vaccination rate among the childhood cancer survivors, compared with 40% in the general-population peers. Males, overall, were more likely to get vaccinated.

The biggest difference, the study noted, was among teens 13 to 17 years of age: 22% for cancer survivors, compared with 42% for the general-population peers. However, the numbers were at par in the older population (18 to 26 years old): 25% for survivors and 24% for the general-population peers.

With nearly 7 million adolescents and young children infected with HPV annually, the virus has a significant bearing on the incidence of cervical cancers and many oral, anal, vaginal, vulvar, and penile cancers. Childhood cancer survivors are particularly susceptible to HPV infection due to their already weakened immune system post cancer treatment. This has led organizations like the American Society of Clinical Oncology to recommend that girls, as well as boys, should be vaccinated against HPV to reduce the incidence of cancer.

The current study identified lack of physician recommendation as being the biggest barrier to vaccination: 72% did not get a recommendation at all and only 5% of those surveyed ended up getting vaccinated. The most important finding was that, of the 28% who received a recommendation from their physicians, more than half got vaccinated.

“This study shows that an effective, affordable, and widely available tool for cancer prevention is being underutilized by survivors of childhood cancer,” said study author James Klosky, PhD, ABPP, an associate member at St. Jude Children’s Research Hospital in Memphis, Tennessee, in a statement. “As clinicians, we need to initiate more conversations about HPV vaccination, especially with childhood cancer survivors because they stand to benefit even more than their peers.”

Next steps, according to Klosky, are to develop interventions that would ensure clear communication between a patient’s survivorship and primary healthcare teams so that appropriate measures are in place for care continuity.

Reference

Klosky JL, Hudson MM, Chen Y, et al. Human papillomavirus vaccination rates in young cancer survivors [published online August 24, 2017]. J Clin Oncol. doi: 10.1200/JCO.2017.74.1843.