Abstract B121: Factors associated with HPV vaccination among childhood cancer survivors: Differences by Hispanic ethnicity and parental health literacy
Authors: Miguel Yazmin San , Aristizabal Paula , Avitia Yesenia , Perdomo Bianca P. , Martinez Maria E. , Nodoro Jesse N. 
Published: August 2020

Introduction: Pediatric cancer survivors are at high risk of secondary malignancies, which include those related to human papillomavirus (HPV) infection. HPV vaccination has been shown to be safe and effective at preventing HPV-related cancers. Up-to-date vaccination completion rates in healthy children are low, estimated to be 50% for girls and 38% for boys ages 13 to 17. Data on vaccination prevalence for pediatric cancer survivors are scarce. The objective of our study was to determine the association of Hispanic ethnicity and parental health literacy on HPV vaccination among childhood cancer survivors.

Methods: A cross-sectional study was conducted at Radys Children's Hospital in San Diego, California. Parents/guardians of childhood cancer survivors (N=168) completed a questionnaire including their and their child's sociodemographic characteristics and their child's HPV vaccination behavior. Clinical information for pediatric cancer survivors was obtained from their medical record. Participants were excluded if self-reported HPV vaccination was unknown (n=18) or they refused to answer (n=2), resulting in 148 total participants. Health literacy was assessed using the Newest Vital Sign questionnaire. The study outcome was self-reported HPV vaccination (yes/no). Logistic regression was used to assess if Hispanic ethnicity and level of parental health literacy were associated with HPV vaccination. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated to assess associations. Multivariable models were adjusted for age at diagnosis.

Results: The study population consisted of 148 parents/guardians of childhood cancer survivors. The pediatric survivors were mostly Hispanic (56%), female (55%), and with hematologic malignancies (63%). The parents /guardians were primarily female (89%) and had more than a high school education (75%). Of the 148 parents/guardians, 28% reported their child having had one or more doses of the HPV vaccine. After adjusting for age at cancer diagnosis of the child, Hispanic children were less likely to have been vaccinated compared to non-Hispanics (OR= 0.88; 95%CI: 0.41-1.89). Results for parental health literacy showed that children of parents with low health literacy were less likely to have been vaccinated compare to those with adequate health literacy (OR=0.51; 95% CI: 0.13-1.97).

Conclusion: Results of this hospital-based study show that HPV vaccination rates among pediatric cancer survivors are low. Hispanic children and those whose parents have low health literacy appear to be a priority for intervention. Health care providers, including pediatric oncologists who see these patients multiple times a year, appear to be missing the opportunity to vaccinate these children with elevated risk for HPV exposure and persistence.

Citation Format: Yazmin San Miguel, Paula Aristizabal, Yesenia Avitia, Bianca P. Perdomo, Maria E. Martinez, Jesse N. Nodoro. Factors associated with HPV vaccination among childhood cancer survivors: Differences by Hispanic ethnicity and parental health literacy [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B121.