Practices regarding human Papillomavirus counseling and vaccination in head and neck cancer: A Canadian physician questionnaire

Abstract

BackgroundHuman papillomavirus (HPV) has recently been implicated as a causative agent in a rapidly growing number of oropharyngeal cancers. Emerging literature supports the hypothesis that HPV vaccination may protect against HPV-related head and neck cancer (HNC) in addition to HPV-related cervical and anogenital disease. While the association between HPV infection and cervical cancer is widely understood, its relation to HNC is less well known. The purpose of this study was to better understand HPV counseling practices for infection and vaccination in relation to HNC of primary care physicians (PCPs), Obstetricians/Gynecologists (OBGYNs), and Otolaryngology - Head and Neck Surgeons (OHNSs) in Canada.MethodsA Canada-wide electronic questionnaire regarding counseling practices on HPV infection, transmission, and vaccination was designed and distributed to PCPs, OBGYNs, and OHNSs across Canada through electronic and paper-based methods. Basic Descriptive statistics were used to analyze responses.ResultsIn total, 337 physicians responded (239 family physicians, 51 OHNSs, 30 OBGYNs, and 17 pediatricians). Three out of four PCPs reported routine counseling of their patients regarding HPV infection, transmission, and vaccination. Among this group, 68% reported “never” or “rarely” counseling patients that HPV can cause HNC. The most commonly reported reason that PCPs cited for not counseling was a lack of knowledge. The majority of OHNSs (81%) and OBGYNs (97%) counseled patients regarding HPV infection, transmission, and vaccination. However, very few OHNSs (10%) regularly counseled patients with HPV-related HNC about HPV-related anogenital cancer. Similarly, very few OBGYNs (18%) regularly counseled patients with HPV related cervical/anogenital cancer about HPV related HNC.ConclusionsThe rate of counseling on HPV infection, transmission, and vaccination in relation to HNC among PCPs is low. The most common reason is a lack of knowledge. Specialists rarely counsel patients with confirmed HPV-related cancer about other HPV-related malignancies. More research is needed on the relationship between different HPV-related cancers in order to better inform counseling practices.

Knowledge about human papillomavirus transmission and prevention among physicians in Rio de Janeiro state, Brazil

“…We also observed a lack of knowledge about the Brazilian cervical cancer screening protocol. Among ObGyn physicians, we found a better understanding of Pap test and HPV diagnosis, in agreement with Canadian studies 18,19 . As to the HPV vaccine, 94.4% of RJ physicians were aware of the recommended age, while other studies showed lower scores: in Polonia, only 24.9% 13 ; in Liguria, Italy, 73.7% 7 ; in Italy, among general practitioners, 87.0% 12 ; in Lebanon, 81.5% 20 ; and in the USA, 56.0% (family physicians) and 85.0% (pediatricians) 21 .…”

HPV-associated oropharyngeal cancer

“…When surveyed, pediatricians, primary care physicians, otolaryngologists, and obstetricians/gynecologists lacked awareness of the primary tumor site (palatine and lingual tonsils), the higher prevalence in men, the sexual transmission, and the availability of a vaccine that targets HPV types associated with oropharynx cancer. 24,25 Due to this selfreported lack of knowledge, these topics often are not part of physicians' routine patient counseling about HPV vaccination. 25 Further study by the scientifi c community is ongoing in an attempt to fully understand HPV-associated oropharyngeal SCC.…”

“…24,25 Due to this selfreported lack of knowledge, these topics often are not part of physicians' routine patient counseling about HPV vaccination. 25 Further study by the scientifi c community is ongoing in an attempt to fully understand HPV-associated oropharyngeal SCC. Clinicians should tell patients that: • HPV infection is common and does not indicate promiscuity.…”

Oral and oropharyngeal cancer: Knowledge, attitude and practices among medical and dental practitioners

“…On the other hand, according to a study conducted on Canadian physicians, only 5% of primary care physicians revealed any doubt regarding the evidence supporting HPV associated head and neck cancer. 36 Although a significant difference was not found, more DP identified HPV as a risk factor for OPC, when compared to MP. Similarly, dentists showed higher overall HPV related knowledge than dental hygienists in a study examining knowledge of HPV among dentists and dental hygienists attending a regional dental conference in Florida, United States.…”