Abstract 753: HPV vaccine uptake in survivors of childhood and adolescent and young adult (AYA) cancer
Authors: Nair Mrudula , Dagli Chaitali S. , Tobo Betelihem B. , Tam Samantha H. , Al-Antary Nada , Osazuwa-Peters Nosayaba , Boakye Eric Adjei 
Published: June 2023

Abstract
Introduction: There will be an estimated 110,000 children and adolescents’ cancer survivors in the United States (US) in 2022. Previous studies have argued for the establishment of a specialized adolescent and young adult (AYA) oncology service to better serve their needs. Studies have demonstrated that survivors of childhood and AYA cancers remain at higher risk of developing second primary cancers over their lifetime. AYA cancer survivors are a growing part of the population and will benefit from HPV vaccination. Documenting HPV vaccine uptake among cancer survivors will facilitate interventions to improve vaccination rates in this population. Despite evidence supporting the efficacy of HPV vaccination, AYA vaccination rates are low. Furthermore, studies assessing HPV vaccination coverage in survivors of AYA cancer are lacking. Therefore, we assessed HPV vaccine initiation and completion between survivors of AYA cancer and respondents without a cancer diagnosis among 18-35-year-old in the US.
Methods: We analyzed data from the 2017-2018 National Health Interview Survey, an annual cross-sectional national survey that provides information on the health of the noninstitutionalized US population. The outcome variables were HPV vaccine initiation (receipt of ≥1 dose) and completion (receipt of ≥3 doses). Exposure was cancer survivorship (AYA cancer survivors [respondents who were diagnosed with cancer as a child, adolescent, or young adult] vs. respondents without a cancer diagnosis). Weighted multivariable logistic regression models were used to examine the association between cancer survivorship and HPV vaccine initiation and completion, controlling for socioeconomic and healthcare access related factors.
Results: A total of 2,942 respondents were included in the study, of which 242 (7.1%) were AYA cancer survivors. HPV vaccine initiation (22.5%) and completion (16.3%) among AYA cancer survivors were comparable to respondents without cancer diagnosis (initiation: 25.5%, completion: 15.3%). In the adjusted analyses, there were no significant differences in HPV vaccine initiation (P=0.6770) or completion (P=0.2001) between AYA cancer survivors and respondents without cancer diagnosis.
Conclusions: HPV vaccine series initiation and completion were comparably low among AYA cancer survivors and respondents without a cancer diagnosis in our study. Low uptake of HPV vaccine among AYA cancer survivors is a more notable public health concern given their heightened immunocompromised status and elevated risk for second primary cancers. There is a need for primary care and oncology providers to encourage HPV vaccination and raise awareness of its crucial role among families of AYA cancer survivors.
Citation Format: Mrudula Nair, Chaitali S. Dagli, Betelihem B. Tobo, Samantha H. Tam, Nada Al-Antary, Nosayaba Osazuwa-Peters, Eric Adjei Boakye. HPV vaccine uptake in survivors of childhood and adolescent and young adult (AYA) cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 753.