Abstract C58: Effect of physicians' recommendation on the perceived effectiveness of the HPV vaccine in preventing cervical cancer
Authors: Boakye Eric Adjei , Osazuwa-Peters Nosayaba , Pham Vy , Tobo Betelihem B. , Simpson Matthew C. , Burroughs Thomas , Buchanan Paula 
Published: February 2019

Background: The human papillomavirus (HPV) is the most common sexually transmitted infection in the United States, with nearly 80 million people currently infected. It causes virtually all cervical cancers in the United States. There are three prophylactic HPV vaccines approved and recommended in the United States, and they protect against 70-90% of the HPV types that cause cervical cancer. Although the HPV vaccine is safe and effective, vaccination rates remain suboptimal. Physicians' recommendation of the HPV vaccine is known to be the most important predictor of vaccine uptake, and prior research suggests that promoting the HPV vaccine as an anticancer vaccine increases vaccination rates. However, no previous national study has evaluated how physicians' recommendation of the HPV vaccine might influence patients' or parental views of the vaccines' effectiveness. We sought to assess how physicians' recommendation of the HPV vaccine influenced patients' view of the effectiveness of the vaccine in preventing cervical cancer.

Methods: Nationally representative data (n=1171) on respondents who were or had immediate family between the ages of 9 and 27 years old were obtained from the 2014 Health Information National Trends Survey 4, Cycle 4. Outcome of interest was an “effective” response to the question: “In your opinion, how successful is the HPV vaccine at preventing cervical cancer?” Main independent variable was physician HPV vaccine recommendation in the last 12 months (yes, no, don't know). Weighted, multivariable logistic regression was used to evaluate the effect of physicians' recommendation of the HPV vaccine on patients' perception on the effectiveness of the vaccine in preventing cervical cancer.

Results: Approximately 26% of respondents reported receiving a physician recommendation for the HPV vaccine and 28% perceived the vaccine as effective in preventing cervical cancer. Respondents who did not have a physician's HPV recommendation, or did not know they had one in the last 12 months were 55% (aOR = 0.45, 95% CI, 0.27 - 0.73) and 76% (aOR = 0.24, 95% CI, 0.12 - 0.48) less likely to perceive the HPV vaccine as effective against cervical cancer, respectively. Respondents were less likely to perceive the HPV vaccine as effective in preventing cervical cancer if they were aged 35-49 (aOR = 0.46, 95% CI, 0.25 - 0.82) vs. 18-34 and had a high school diploma (aOR = 0.44, 95% CI, 0.24 - 0.81) or some college education (aOR = 0.39, 95% CI, 0.23 - 0.66) compared with college degree.

Conclusions: Only one in four respondents with an immediate family member eligible for the HPV vaccine received a physician recommendation in our study. However, those who received a recommendation were significantly more likely to perceive the HPV vaccine as effective in preventing cervical cancer. Our finding provides added impetus for more physicians to utilize every clinical encounter as an opportunity to recommend the HPV vaccine to age-eligible parents and patients.

Citation Format: Eric Adjei Boakye, Nosayaba Osazuwa-Peters, Vy Pham, Betelihem B. Tobo, Matthew C. Simpson, Thomas Burroughs, Paula Buchanan. Effect of physicians' recommendation on the perceived effectiveness of the HPV vaccine in preventing cervical cancer [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C58.