PURPOSE: Young cancer survivors are at increased risk for morbidities related to infection with the human papillomavirus (HPV), yet their HPV vaccine initiation rates remain low. Patient-/parent-reported lack of health care provider recommendation for HPV vaccination is strongly associated with vaccine noninitiation. We aimed to identify patient-level factors associated with survivor-/parent-reported lack of provider recommendation for HPV vaccination among young cancer survivors. METHODS: Cancer survivors ages 9-26 years and 1-5 years off therapy completed a cross-sectional survey (parent-completed for survivors 9-17 years of age). Lack of health care provider HPV vaccine recommendation was the outcome of interest in a multivariable logistic regression model that included relevant patient-level sociodemographic, clinical, and vaccine-related variables. RESULTS: Of 955 survivors, 54% were male, 66% were non-Hispanic White, and 36% had leukemia. At survey participation, survivors were an average age (± standard deviation) of 16.3 ± 4.7 years and 32.8 ± 14.7 months off therapy. Lack of provider HPV vaccine recommendation was reported by 73% (95% CI, 70% to 75%) of survivors. For the entire cohort, patient-level factors associated with lack of reported provider recommendation included perceived lack of insurance coverage for the HPV vaccine (odds ratio [OR], 4.0; 95% CI, 2.7 to 5.9; P < .001), male sex (OR, 2.8; 95% CI, 1.9 to 4.0; P < .001), and decreased parent-survivor communication regarding HPV vaccination (OR, 1.7 per unit decrease in score; 95% CI, 1.3 to 2.2; P < .001). In the sex- and age-stratified models, perceived lack of insurance coverage (all models) and male sex (age-stratified models) were also significantly associated with lack of reported provider recommendation. CONCLUSION: We identified factors characterizing survivors at risk for not reporting receipt of a health care provider HPV vaccine recommendation. Future research is needed to develop interventions that facilitate effective provider recommendations for HPV vaccination among all young cancer survivors.
PURPOSE: Young cancer survivors are at increased risk for morbidities related to infection with the human papillomavirus (HPV), yet their HPV vaccine initiation rates remain low. Patient-/parent-reported lack of health care provider recommendation for HPV vaccination is strongly associated with vaccine noninitiation. We aimed to identify patient-level factors associated with survivor-/parent-reported lack of provider recommendation for HPV vaccination among young cancer survivors. METHODS:Cancer survivors ages 9-26 years and 1-5 years off therapy completed a cross-sectional survey (parent-completed for survivors 9-17 years of age). Lack of health care provider HPV vaccine recommendation was the outcome of interest in a multivariable logistic regression model that included relevant patient-level sociodemographic, clinical, and vaccine-related variables. RESULTS: Of 955 survivors, 54% were male, 66% were non-Hispanic White, and 36% had leukemia. At survey participation, survivors were an average age (± standard deviation) of 16.3 ± 4.7 years and 32.8 ± 14.7 months off therapy. Lack of provider HPV vaccine recommendation was reported by 73% (95% CI, 70% to 75%) of survivors. For the entire cohort, patient-level factors associated with lack of reported provider recommendation included perceived lack of insurance coverage for the HPV vaccine (odds ratio [OR], 4.0; 95% CI, 2.7 to 5.9; P < .001), male sex (OR, 2.8; 95% CI, 1.9 to 4.0; P < .001), and decreased parent-survivor communication regarding HPV vaccination (OR, 1.7 per unit decrease in score; 95% CI, 1.3 to 2.2; P < .001). In the sex- and age-stratified models, perceived lack of insurance coverage (all models) and male sex (age-stratified models) were also significantly associated with lack of reported provider recommendation. CONCLUSION: We identified factors characterizing survivors at risk for not reporting receipt of a health care provider HPV vaccine recommendation. Future research is needed to develop interventions that facilitate effective provider recommendations for HPV vaccination among all young cancer survivors.
Authors: Siobhan M Phillips; Lynne S Padgett; Wendy M Leisenring; Kayla K Stratton; Ken Bishop; Kevin R Krull; Catherine M Alfano; Todd M Gibson; Janet S de Moor; Danielle Blanch Hartigan; Gregory T Armstrong; Leslie L Robison; Julia H Rowland; Kevin C Oeffinger; Angela B Mariotto Journal: Cancer Epidemiol Biomarkers Prev Date: 2015-04 Impact factor: 4.254
Authors: Gwendolyn P Quinn; Devin Murphy; Teri L Malo; Juliette Christie; Susan T Vadaparampil Journal: J Pediatr Adolesc Gynecol Date: 2012-04-18 Impact factor: 1.814
Authors: Kahee A Mohammed; Christian J Geneus; Nosayaba Osazuwa-Peters; Eric Adjei Boakye; Betelihem B Tobo; Thomas E Burroughs Journal: J Adolesc Health Date: 2016-08-06 Impact factor: 5.012
Authors: Melissa B Gilkey; William A Calo; Jennifer L Moss; Parth D Shah; Macary W Marciniak; Noel T Brewer Journal: Vaccine Date: 2016-01-24 Impact factor: 3.641
Authors: Rohit P Ojha; Joseph E Tota; Tabatha N Offutt-Powell; James L Klosky; Timothy D Minniear; Bradford E Jackson; James G Gurney Journal: PLoS One Date: 2013-08-05 Impact factor: 3.240
Authors: Melany Garcia; Cailey McGillicuddy; Elisa M Rodriguez; Kristopher Attwood; Jennifer Schweitzer; Scott Coley; Denise Rokitka; Nicolas F Schlecht Journal: Pediatr Blood Cancer Date: 2022-09-12 Impact factor: 3.838