Health care providers play a key role in recommending the human papillomavirus vaccination for survivors of childhood cancer, according to a study from the University of Alabama at Birmingham and St. Jude Children’s Research Hospital.
“Survivors of childhood cancer are at increased risk for developing HPV-related second cancers,” said Wendy Landier, Ph.D., co-principal investigator of the National Institutes of Health-funded study and associate professor in the UAB Division of Pediatric Hematology and Oncology. “The HPV vaccine is effective in preventing infection with the oncogenic HPV types responsible for the large majority of HPV-related cancers in this high-risk population.”
The study, published in the Journal of Clinical Oncology, highlights the low rate of vaccine initiation among 13- to 26-year-old cancer survivors at 23.8 percent, compared with age-matched peers in the U.S. population, who have a vaccination rate of 40.5 percent.
Over half of the survivors or parents who reported receiving a recommendation for the HPV vaccine from a health care provider had received the vaccine. Among survivors who did not receive a provider recommendation, only one in 20 initiated the vaccine.
“The HPV vaccine is an important tool to help us keep young cancer survivors safe because it significantly lowers the risk of developing HPV-associated cancers in the future,” said first author and co-principal investigator James Klosky, Ph.D., an associate member of the St. Jude Department of Psychology. “So, we were concerned to find vaccination rates were significantly lower for survivors of childhood cancer compared to their peers.”
Childhood cancer survivors who are younger or male had an increased likelihood of non-initiation of the HPV vaccine, similar to what is seen in the general population. The study showed that lack of provider recommendation, perceived lack of insurance coverage and endorsement of vaccine barriers were all associated with an increased likelihood of vaccine non-initiation, which is similar to findings reported among healthy U.S. youth.
The Affordable Care Act mandates that insurance plans cover preventive services including vaccines without a co-payment or deductible, and the federally funded Vaccines for Children Program provides free vaccine coverage to medically uninsured and Medicaid-eligible children in the United States. Additionally, the vaccine is available in community health departments and college health services, typically for a nominal charge, for vaccine-naïve young adults who are uninsured.“Survivors of childhood cancer,” Landier said, “stand to gain particular benefit from initiating and completing the vaccine series to reduce the risk of developing an HPV-related malignancy . We plan to use the findings from this study as a springboard for developing interventions to increase HPV vaccination rates among survivors of childhood cancers. The HPV vaccine is an important cancer-prevention tool that is readily available.”
The HPV vaccine is recommended by the Children’s Oncology Group as part of its Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers, and has been endorsed by many leading health organizations, including the American Society of Clinical Oncology, the American Academy of Pediatrics, the U.S. Centers for Disease Control and Prevention, and all 69 of the National Cancer Institute-Designated Cancer Centers, including UAB.
“If survivors of childhood cancer or their parents have any concerns about getting the HPV vaccine, they should talk with a trusted health care professional,” Landier said.