Barriers, Attitudes and Clinical Approach of Lebanese Physicians Towards HPV Vaccination; A Cross- Sectional Study

Abstract

Objectives: HPV infection is associated with the development of cervical and oropharyngeal cancer. HPV vaccination prevents cervical cancer, but is still not part of Lebanon's routine vaccination schedule. As such, understanding physicians' practice towards HPV vaccination is essential. Material and Methods: We conducted a cross-sectional study in Greater Beirut, Lebanon to assess the barriers, attitudes and clinical approach of Lebanese physicians towards HPV vaccination. We also aimed to analyze the factors associated with physicians' barriers to HPV vaccination. Results: In total, 228 physicians completed the survey. Our results show that physicians and parents consider the cost of HPV vaccination to be a main barrier (58.9% and 80.7% respectively). Also, parents tend to have concerns about vaccine safety (78.1%), efficacy (68.6%), and lack education concerning HPV infection (81.8%). Furthermore, female physicians tend to have fewer barriers when compared to male physicians (aOR = 0.39; p-value = 0.007). Additionally, physicians who completed residency programs in the USA also showed fewer barriers when compared to physicians who completed Lebanese residency programs (aOR = 0.24; p-value = 0.040). Finally, physicians with higher knowledge score have fewer barriers when compared to those with lower knowledge scores (aOR = 0.42; p-value = 0.018). Conclusions: Physician gender, residency program and level of knowledge play a role in HPV vaccine barriers and recommendation in Lebanon. Future improvements in cost and awareness about HPV might improve vaccination rates. Creating uniform practices towards HPV vaccine is warranted to improve patient care.

Assessment of Awareness and Attitude on Cervical Cancer Prevention among Female Preparatory Students in Ziway town, Oromia Regional State, Ethiopia

“…The knowledge regarding risk factor is very low when compared with similar study done at Hawassa University which showed 49.7% and 47.4% respectively on the two risk factors mentioned above and most of the students did not know the major risk factor which is HPV (3.9%). This may be due to lack of detailed health education on the subject matter [22][23][24][25][26].…”

Awareness of Family Physicians about HPV and Prevention Methods

“…In a population-based study carried out by Adjei There are differences in information level and opinions of doctors regarding infections associated with HPV and HPV vaccination issues (13)(14)(15)(16)(17). For instance, in our study, a higher percentage of male resident physicians thought that HPV infection may be transmitted only by…”

“…Opposition of doctors to HPV vaccination or their nonrecommendation of the vaccine routinely stems from different reasons. These include (i) incorrect or incomplete information about HPV or the HPV vaccine, (ii) non-inclusion of the HPV vaccine in the routine vaccination schedule of the health ministry, (iii) high cost of the vaccine, (iv) absence of widespread acceptance for the vaccine, (v) the opinion that vaccination may increase the prevalence of risky sexual behavior, and (vi) lack of confidence in the efficacy of the vaccine(13)(14)(15)(16)(17). Abi Jaoude et al(17) have shown that opposition to HPV vaccination is significantly lower among doctors with a high level of knowledge.…”

“…These data reveal that inadequate knowledge and inexperience about the HPV vaccine on the side of doctors results in a lower rate of vaccine recommendation. Abi Jaoude et al(17) have reported that 38% of doctors explained the reason for not recommending the HPV vaccine as non-inclusion of the vaccine in the routine national vaccination schedule. In our study, besides non-inclusion of the vaccine in the health ministry vaccination schedule, the high cost of the HPV vaccine was also declared as a reason for not recommending it.…”

Cancer Awareness Among Lebanese Adults, A Cross Sectional Study 

“…This con rms ndings of previous studies, that found that 34% of adults were aware of the cancer risks of HPV, and 18.2% of adults were su ciently educated concerning HPV infection. [20][21][22] Sedentary lifestyle Prevalence sedentary lifestyle among Lebanese adults is high: 60.7% of men and 61.3% of women do not meet WHO recommendations on physical activity. [13] Physical inactivity is responsible for 0.6% of cancers in men and 3.2% in women.…”