Risk Factors for Non-Initiation of the Human Papillomavirus (HPV) Vaccine among Adolescent Survivors of Childhood Cancer

Authors

James L. Klosky, St. Jude Children’s Research HospitalFollow
Kathryn M. Russell, St. Jude Children’s Research Hospital
Kristin E. Canavera, St. Jude Children’s Research Hospital
Heather L. Gammel, St. Jude Children’s Research Hospital
Jason R. Hodges, St. Jude Children’s Research Hospital
Rebecca H. Foster, Winona State University
Gilbert R. Parra, University of Nebraska-LincolnFollow
Jessica L. Simmons, St. Jude Children’s Research Hospital
Daniel M. Green, St. Jude Children’s Research Hospital
Melissa M. Hudson, St. Jude Children’s Research Hospital

Document Type

Article

Date of this Version

10-2013

Citation

Cancer Prev Res (Phila). 2013 October ; 6(10): 1101–1110. doi:10.1158/1940-6207.CAPR-13-0127.

Comments

Published by American Association for Cancer Research. Used by permission.

Abstract

Effective vaccination is now available to prevent human papillomavirus (HPV), the most common sexually transmitted infection and cause of cervical cancer. This study aimed to estimate the prevalence of HPV vaccination among childhood cancer survivors and identify factors associated with HPV vaccine initiation and completion. Mothers of daughters aged 9–17 years with/without a history of childhood cancer (n = 235, M_age= 13.2 years, SD= 2.69; n = 70, M_age= 13.3 years, SD=2.47, respectively) completed surveys querying HPV vaccination initiation and completion along with socio-demographic, medical, HPV knowledge and communication, and health belief factors, which may relate to vaccination outcomes. Multivariate logistic regression was utilized to identify factors which associate with HPV vaccination initiation and completion. Among cancer survivors, 32.6% initiated and 17.9% completed the 3-dose vaccine series, whereas 34.3% and 20.0% of controls initiated and completed, respectively. Univariate analyses indicated no differences between cancer/no cancer groups on considered risk factors. Among all participants, multivariate logistic regression analyses found vaccine initiation associated with older age of daughter and physician recommendation, while increased perceived barriers associated with a decreased likelihood of initiation (all Ps < .05). Among those having initiated, risk factors for non-completion included being non-white, increased perceived severity of HPV, and increased perceived barriers to vaccination (all Ps < .05). A minority of adolescents surviving childhood cancer have completed vaccination despite their increased risk for HPV-related complication. These results inform the prioritization of strategies to be included in vaccine promotion efforts.