RESUMO
Awareness of risk for oropharyngeal cancer from oral human papillomavirus (HPV) infection is low among men in the United States. This pilot study tested messages communicating oral HPV and oropharyngeal cancer risk among a sample of U.S. young adult men (aged 18-26). Six oral HPV and cancer risk messages were tested in an online survey. Participants (N = 68) were randomly assigned to one of two message sets, each containing three unique text-based messages. Participants evaluated messages separately based on various measures (e.g., perceived message effectiveness [PME], novelty). One-way repeated measures ANOVAs were used to assess evaluation differences within message sets. Participants provided open-ended feedback about each message, which were synthesized into overarching themes. Participants were receptive to the risk messages, rating them high on PME (mean range = 3.72-4.25 out of 5) and other measures. Analyses identified three high-performing messages. For example, participants rated a message about HPV-linked oropharyngeal cancer risk rates in men versus women higher on attention and novelty than two other messages in the same set (both ps < .05). Participants were shown three messages (instead of all six) in each message set to minimize survey fatigue. Common themes from open-ended feedback were that participants liked the short-form structure of the messages and that the messages used gender-tailored language. In conclusion, oral HPV and oropharyngeal cancer risk messages may be useful for increasing risk awareness among men in the U.S. Further work should test such messages in rigorous experimental contexts to assess their efficacy in modifying other health outcomes, such as HPV vaccination behaviors.
Assuntos
Neoplasias Orofaríngeas , Infecções por Papillomavirus , Humanos , Masculino , Neoplasias Orofaríngeas/prevenção & controle , Neoplasias Orofaríngeas/virologia , Projetos Piloto , Infecções por Papillomavirus/prevenção & controle , Adulto , Estados Unidos , Adulto Jovem , Adolescente , Conhecimentos, Atitudes e Prática em Saúde , Medição de RiscoRESUMO
The human papillomavirus is the most common sexually transmitted infection in the world. Most HPV infections clear spontaneously within 2 years of infection; however, persistent infection can result in a wide array of diseases, ranging from genital warts to cancer. Most cases of cervical, anal, and oropharyngeal cancers are due to HPV infection, with cervical cancer being one of the leading causes of cancer death in women worldwide. Screening is available for HPV and cervical cancer, but is not available everywhere, particularly in lower-resource settings. HPV infection disproportionally affects individuals living with HIV, resulting in decreased clearance, increased development of cancer, and increased mortality. The development of the HPV vaccine has shown a drastic decrease in HPV-related diseases. The vaccine prevents cervical cancer with near 100% efficacy, if given prior to first sexual activity. Vaccination uptake remains low worldwide due to a lack of access and limited knowledge of HPV. Increasing awareness of HPV and access to vaccination are necessary to decrease cancer and HPV-related morbidity and mortality worldwide.
Assuntos
Papillomaviridae , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Neoplasias do Colo do Útero , Humanos , Infecções por Papillomavirus/prevenção & controle , Infecções por Papillomavirus/virologia , Infecções por Papillomavirus/complicações , Vacinas contra Papillomavirus/administração & dosagem , Feminino , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/virologia , Papillomaviridae/patogenicidade , Neoplasias/virologia , Vacinação , Neoplasias do Ânus/prevenção & controle , Neoplasias do Ânus/virologia , Neoplasias do Ânus/epidemiologia , Infecções por HIV/complicações , Infecções por HIV/virologia , Infecções por HIV/prevenção & controle , Neoplasias Orofaríngeas/virologia , Neoplasias Orofaríngeas/prevenção & controle , Masculino , Papillomavirus HumanoRESUMO
Objective: Studies have demonstrated that tonsillectomy may alter the risk of oropharyngeal cancer (OPC). We systematically reviewed the evidence and pooled data to examine such an association. Methods: PubMed, Embase, and Scopus were searched up to 25th April 2023. Studies reporting an association between tonsillectomy and oropharyngeal cancer risk at any site were included. Results: Five studies were eligible. All examined the risk of tonsillar and base of the tongue (BOT) cancer with prior history of tonsillectomy. On meta-analysis of the data, prior history of tonsillectomy was associated with a significantly decreased risk of tonsillar cancer. The second meta-analysis showed that history of tonsillectomy did not significantly alter the risk of BOT cancer. However, after exclusion of one study, the results showed an increased risk of BOT cancer with a history of tonsillectomy. Conclusions: The scarce data available in the literature suggests that tonsillectomy may reduce the risk of tonsillar cancer but does not alter the risk of BOT cancer. Further studies are needed to explore the association between tonsillectomy and the risk of OPC.
Assuntos
Neoplasias Orofaríngeas , Tonsilectomia , Humanos , Neoplasias Orofaríngeas/epidemiologia , Neoplasias Orofaríngeas/etiologia , Neoplasias Orofaríngeas/prevenção & controle , Neoplasias Orofaríngeas/cirurgia , Medição de Risco , Fatores de Risco , Neoplasias Tonsilares/epidemiologia , Neoplasias Tonsilares/cirurgiaRESUMO
Human papillomavirus (HPV) is associated with both benign and malignant disorders, such as genital warts and a variety of cancers, including oropharyngeal squamous cell carcinomas (OPSCCs). The current 9-valent HPV vaccine (Gardasil 9) protects against high-risk strains that have been shown to cause OPSCC, and widespread vaccination should reduce the rate of all HPV-associated cancers. HPV-related OPSCCs differ from non-HPV-related OPSCCs in their clinical presentations and responsiveness to treatment. To provide oral healthcare providers with a basis for effective com-munication with patients, this article will examine the evolution of the HPV vaccination schedule and the role of the HPV vaccine in the prevention of OPSCCs.
Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Orofaríngeas , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Humanos , Papillomavirus Humano , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/prevenção & controle , Carcinoma de Células Escamosas/prevenção & controle , Carcinoma de Células Escamosas/patologia , Neoplasias Orofaríngeas/prevenção & controle , Neoplasias Orofaríngeas/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/complicações , Vacinas contra Papillomavirus/uso terapêuticoRESUMO
Due to the association with the causal HPV-16 infection, the oropharyngeal carcinoma spreads into two separate entities depending on HPV-16 positivity. More recent data show a diversified picture of the importance and prevalence of the surrogate parameter p16 (discordance) for a definitive HPV-16 association, which varies worldwide. In the context of prevention options, vaccination is of major and HPV screening of healthy people only of little importance.
Assuntos
Neoplasias Orofaríngeas , Infecções por Papillomavirus , Humanos , Inibidor p16 de Quinase Dependente de Ciclina , Neoplasias Orofaríngeas/epidemiologia , Neoplasias Orofaríngeas/prevenção & controle , Papillomavirus Humano 16 , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/prevenção & controle , PrevalênciaRESUMO
Oral squamous cell carcinomas (OSCC) signs and symptoms may be first identified by dental hygienists during routine extra and intra-oral examinations. A comprehensive extra-oral and intra-oral examination during regular dental hygiene assessment is paramount to identifying oral potentially malignant disorders (OPMD) and cancerous lesions for timely referral and treatment. Integrating a systematic list of questions during the medical and dental assessment along with careful visual and tactile examinations is critical to identifying OPMDs and cancerous lesions. Understanding the relationship between oropharyngeal squamous cell carcinomas (OPSCC) and Human Papilloma Virus (HPV) and how vaccination can prevent HPV-related OPSCC is critical to providing evidence-based recommendations and care. The purpose of this report is to provide an update on current epidemiological trends of OSCC and OPSCC rates in the United States (US) and provide the latest evidence on what dental hygienists must know to improve health outcomes and mitigate the consequences of undiagnosed cancer. This report considers enduring challenges with the annual rise in OPSCC rates and the public health burden of HPV-related cancers in the US. Emphasis on regular, quality continuing education about OSCC and OPSCC is emphasized along with recommendations for evidence-based training.
Assuntos
Carcinoma de Células Escamosas , Higienistas Dentários , Neoplasias Bucais , Neoplasias Orofaríngeas , Infecções por Papillomavirus , Humanos , Neoplasias Orofaríngeas/virologia , Neoplasias Orofaríngeas/diagnóstico , Neoplasias Orofaríngeas/prevenção & controle , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/prevenção & controle , Neoplasias Bucais/virologia , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/prevenção & controle , Estados Unidos/epidemiologia , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/virologia , Carcinoma de Células Escamosas/prevenção & controle , Carcinoma de Células Escamosas/epidemiologia , Higienistas Dentários/educaçãoRESUMO
OBJECTIVE: To validate the efficacy of a virtual, interdisciplinary workshop in improving HPV knowledge, and vaccination practices among primary care and dental trainees. METHODS: A virtual platform was utilized to hold HPV educational workshops with primary care and dental trainees. Online surveys were distributed before and after the 1-h interactive workshop, led by otolaryngology residents. Surveys included the workshop's impact on (a) improving knowledge of HPV-associated oropharyngeal squamous cell carcinoma (OPSCC) and (b) affecting change in HPV vaccination practices. The vaccination rates of trainees were recorded prior to and after workshop attendance. RESULTS: After the workshop, participants demonstrated significantly improved scores related to knowledge of HPV in the head and neck (p = 0.003) and showed an increased comfort level with counseling on HPV vaccination (p = 0.002). Respondents were also more aware that the HPV vaccine is approved to prevent OPSCC (61% vs. 95%, p < 0.05). Ninety-seven percent of respondents stated that the workshop changed their HPV vaccination practices, and 95% of those not fully vaccinated stated they would now be more likely to receive the vaccine themselves. There was a significant increase in the average number of HPV vaccines administered at the studied trainee clinic, from 16.83 vaccines/month to 37.6 vaccines/month (percent increase = 123%) in 5 months following the workshop (p = 0.002). CONCLUSION: The present interactive virtual workshop demonstrates efficacy in improving HPV-related knowledge and vaccination practices among trainees. The virtual nature of the course facilitates knowledge transfer and can be used to foster multi-institutional partnerships regarding medical education and vaccination efforts. LEVEL OF EVIDENCE: 4 Laryngoscope, 134:3096-3101, 2024.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Neoplasias Orofaríngeas , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Vacinação , Humanos , Neoplasias Orofaríngeas/virologia , Neoplasias Orofaríngeas/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Infecções por Papillomavirus/prevenção & controle , Feminino , Vacinação/estatística & dados numéricos , Masculino , Internato e Residência , Inquéritos e Questionários , Otolaringologia/educação , AdultoRESUMO
INTRODUCTION: The incidence of human papillomavirus (HPV)-related oropharyngeal cancer is rising, thus the understanding of HPV infection and vaccination among oral healthcare professionals is becoming increasingly important. This study aimed to investigate the knowledge of Dutch dental hygiene students on HPV infection and vaccination and assessed various aspects of HPV-related oropharyngeal cancer. METHODS: This descriptive cross-sectional study invited the entire Dutch dental hygiene student population registered in September 2016 to complete an online questionnaire concerning the knowledge of HPV infection and vaccination, including the aspects of HPV-related Oro-Pharyngeal Squamous Cell Carcinoma (OPSCC). Data were analysed using t-tests, Mann-Whitney U tests and Chi-square tests. RESULTS: Invited were all 1248 Dutch dental hygiene students and 232 (18.6%) students completed the questionnaire. More than 95% of the students indicated HPV infection as a risk factor for OPSCC and 48.7% was aware of the availability of HPV vaccination. Additionally, students considered it important to discuss HPV as a risk factor for oropharyngeal cancer with their patients. In general, the students scored highest on the questions about risk factors for OPSCC and poorest on the questions about general HPV knowledge and HPV vaccination. Although the mean overall knowledge score was significantly higher in senior compared with junior students, knowledge scores of senior students remained insufficient. CONCLUSION: This study identified deficits in knowledge of HPV and HPV vaccination among Dutch dental hygiene students. Future research should focus on improving the content of dental hygiene curricula and development of ongoing educational tools for dental hygienists.
Assuntos
Neoplasias de Cabeça e Pescoço , Neoplasias Orofaríngeas , Infecções por Papillomavirus , Humanos , Carcinoma de Células Escamosas de Cabeça e Pescoço/complicações , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/prevenção & controle , Papillomavirus Humano , Higiene Bucal , Estudos Transversais , Papillomaviridae , Neoplasias Orofaríngeas/prevenção & controle , Neoplasias Orofaríngeas/etiologia , Estudantes , Vacinação/efeitos adversos , Neoplasias de Cabeça e Pescoço/complicações , Conhecimentos, Atitudes e Prática em SaúdeRESUMO
BACKGROUND: Gay and bisexual men (GBM) are at increased risk of developing human papillomavirus (HPV)-associated oropharyngeal cancer (OPC). Vaccination may prevent OPC in GBM; however, vaccination rates are low. The authors explored the correlates associated with HPV vaccination intent for OPC prevention among GBM. METHODS: The authors conducted a cross-sectional study in which they surveyed 1,700 adult GBM with a profile on 2 online dating sites. Eligibility criteria included self-identified GBM living in the United States, aged 18 through 45 years who had sex with a man in the past 5 years. Factors associated with participants' HPV vaccination status and intent to vaccinate were assessed via the online questionnaire using the Health Belief Model. RESULTS: Most of the 1,108 eligible GBM had not received 1 dose or more of the HPV vaccine (54.2%), were aged 27 through 37 years (52.3%), were White (58.3%), identified as cisgender men (93.4%), were gay (79.3%), were in a monogamous relationship (99.4%), and had a bachelor's degree (29.4%) or higher college education (26.1%). Among unvaccinated GBM, 25.3% reported intent to receive the vaccine. In the multivariable model, independent associations (P < .05) were found for the Health Belief Model constructs (perceived benefits and perceived barriers) with HPV vaccine intent, after adjusting for all other predictor variables in the model. CONCLUSIONS: The benefits of HPV vaccination for the prevention of OPC is associated with intent to vaccinate among GBM. Dental care providers can use this information to educate patients in this high-risk population on prevention of HPV-associated OPC. PRACTICAL IMPLICATIONS: Dentists can advocate for HPV vaccination uptake among GBM patients by means of discussing the benefits of vaccination in the prevention of HPV-associated OPC.
Assuntos
Neoplasias Orofaríngeas , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Minorias Sexuais e de Gênero , Masculino , Adulto , Humanos , Estados Unidos , Homossexualidade Masculina , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/prevenção & controle , Infecções por Papillomavirus/epidemiologia , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Vacinas contra Papillomavirus/uso terapêutico , Vacinação , Neoplasias Orofaríngeas/prevenção & controle , Papillomavirus HumanoAssuntos
Neoplasias Orofaríngeas , Infecções por Papillomavirus , Humanos , Incidência , Otorrinolaringologistas , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/prevenção & controle , Faringe , Neoplasias Orofaríngeas/epidemiologia , Neoplasias Orofaríngeas/prevenção & controleRESUMO
INTRODUCTION: Human papillomavirus (HPV), as the most common form of sexually transmitted infection, has been implicated in almost one-third of oropharyngeal cancers. One way to prevent HPV infections is through vaccination. This study aimed to investigate whether dentists in British Columbia (BC) were willing to discuss, refer and administer the vaccine in a dental practice setting. METHODS: Our cross-sectional study used a survey consisting of 14 questions pertaining to demographics, scope of practice, barriers to discussing the HPV vaccine and willingness to engage in HPV vaccination. On 1 April 2021, the survey was distributed to all practising dentists in BC via a URL link; the link remained active for 30 days. Descriptive and inferential statistics were used to analyze results, and statistical significance was set at p < 0.05. RESULTS: Of the 201 respondent who completed a survey, 168 (84%) agreed that discussing the link between HPV and oropharyngeal cancer falls within their scope of practice. Fewer agreed that recommending (74%) and administering (39%) the HPV vaccine were within their scope of practice. Barriers that may contribute to this unwillingness included lack of professional policies and guidelines. Although a significant proportion of respondents were willing to educate patients on HPV, they were unwilling to discuss sexual history in a dental setting (p = 0.02). CONCLUSIONS: Despite a willingness to discuss and refer patients for HPV vaccination, most respondents were unwilling to administer the vaccine in a dental setting, as they perceived the act to fall outside their scope of practice. There remains a reluctance to engage in vaccination activities in dental settings in BC.
Assuntos
Neoplasias Orofaríngeas , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Humanos , Estudos Transversais , Infecções por Papillomavirus/prevenção & controle , Colúmbia Britânica , Neoplasias Orofaríngeas/prevenção & controle , Inquéritos e Questionários , Vacinação , Papillomavirus Humano , OdontólogosRESUMO
Classical oropharyngeal squamous cell carcinoma (OPSCC) caused by alcohol consumption and smoking and HPV-associated OPSCC caused by human papillomavirus (HPV) infection have different etiologies, incidences, and prognoses. Therefore, the 8th American Joint committee on Cancer (AJCC) and Union for International Cancer Control (UICC) TNM classifications propose distinguishing HPV-associated OPSCC from classical OPSCC and classifying it as an independent disease. Therefore, this review provides an overview of HPV-associated OPSCC from the perspectives of epidemiology, carcinogenesis, development, diagnosis, treatment, and prevention. The incidence of HPV-associated OPSCC is increasing. Although HPV vaccination has been shown to be effective at reducing the incidence of cervical cancer, it is still unclear how it affects the incidence of HPV-associated OPSCC. Additionally, the prognosis of patients with HPV-associated OPSCC is extremely favorable compared to that of patients with classical OPSCC. Therefore, patients with HPV-associated OPSCC may undergo reduced-dose therapy, although attempts to reduce treatment intensity should be carefully planned to ensure they do not compromise oncological outcomes, and large-scale trials aimed at reducing treatment intensity are ongoing.
Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Orofaríngeas , Infecções por Papillomavirus , Humanos , Carcinoma de Células Escamosas de Cabeça e Pescoço/diagnóstico , Carcinoma de Células Escamosas de Cabeça e Pescoço/terapia , Papillomavirus Humano , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/etiologia , Carcinoma de Células Escamosas/prevenção & controle , Neoplasias Orofaríngeas/diagnóstico , Neoplasias Orofaríngeas/prevenção & controle , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/diagnóstico , Papillomaviridae , PrognósticoRESUMO
Vaccination for Human Papillomavirus (HPV) is important to reduce rates of cervical and oropharyngeal cancer. We aimed to evaluate if a program to initiate HPV vaccination at 9 years improved initiation and completion rates by 13 years of age. Data on empaneled patients aged 9-13 years from January 1, 2021 to August 30, 2022 were abstracted from the electronic health record. Primary outcome measures included HPV vaccination initiation and series completion by 13 years of age. The secondary outcome measure was missed opportunities for HPV vaccination. In total, 25,888 patients were included (12,433 pre-intervention, and 13,455 post-intervention). The percentage of patients aged 9-13 with an in-person visit who received at least 1 dose of HPV vaccine increased from 30% pre-intervention to 43% post-intervention. The percentage of patients who received 2 doses of vaccine increased from 19.3% pre-intervention to 42.7% post-intervention. For the overall population seen in-person, initiation of HPV vaccination by age 13 years increased from 42% to 54%. HPV completion increased as well (13% to 18%). HPV vaccination initiation at 9 years of age may be an acceptable and effective approach to improving vaccination rates.
Assuntos
Neoplasias Orofaríngeas , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Humanos , Criança , Adolescente , Papillomavirus Humano , Infecções por Papillomavirus/prevenção & controle , Infecções por Papillomavirus/complicações , Vacinação , Neoplasias Orofaríngeas/prevenção & controleRESUMO
PURPOSE OF REVIEW: Human papillomavirus (HPV) is responsible of the increasing incidence rates of oropharyngeal squamous cell carcinoma (OPSCC) in high-income countries. This significant epidemiological change requires several and diverse prevention strategies. RECENT FINDINGS: The cervical cancer prevention model is the paradigm of HPV-related cancer, and its success provides encouragement for the development of similar methods to prevent HPV-related OPSCC. However, there are some limitations that hinder its application in this disease. Here, we review the primary, secondary and tertiary prevention of HPV-related OPSCC and discuss some directions for future research. SUMMARY: The development of new and targeted strategies to prevent HPV-related OPSCC is needed since they could definitely have a direct impact on the reduction of morbidity and mortality of this disease.
Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Orofaríngeas , Infecções por Papillomavirus , Humanos , Papillomavirus Humano , Carcinoma de Células Escamosas/prevenção & controle , Carcinoma de Células Escamosas/patologia , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/prevenção & controle , Papillomaviridae , Neoplasias Orofaríngeas/prevenção & controle , Carcinoma de Células Escamosas de Cabeça e Pescoço/prevenção & controle , Neoplasias de Cabeça e Pescoço/complicaçõesAssuntos
Neoplasias Orofaríngeas , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Masculino , Humanos , Idoso , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/prevenção & controle , Papillomavirus Humano , Neoplasias Orofaríngeas/prevenção & controle , Vacinação , PapillomaviridaeRESUMO
OBJECTIVE: As the incidence of human papillomavirus related oropharyngeal cancer continues to rise, it is increasingly important for public understanding to keep pace. This study aimed to identify areas of patient interest and concern regarding human papillomavirus and oropharyngeal cancer. METHOD: This study was a retrospective survey of search queries containing the keywords 'HPV cancer' between September 2015 and March 2021. RESULTS: There was 3.5-fold more interest in human papillomavirus related oropharyngeal cancer (15 800 searches per month) compared with human papillomavirus related cervical cancer (4500 searches per month). Among searches referencing cancer appearance, 96.8 per cent pertained to the head and neck region (3050 searches per month). Among vaccination searches, 16 of 47 (34.0 per cent; 600 searches per month) referenced human papillomavirus vaccines as being a cause of cancer rather than preventing cancer. CONCLUSION: The vast majority of online searches into human papillomavirus cancer pertain to the oropharynx. There are relatively few search queries on the topic of vaccination preventing human papillomavirus associated oropharyngeal cancer, which highlights the continued importance of patient education and awareness campaigns.
Assuntos
Neoplasias Orofaríngeas , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Humanos , Papillomavirus Humano , Estudos Retrospectivos , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/prevenção & controle , Neoplasias Orofaríngeas/epidemiologia , Neoplasias Orofaríngeas/prevenção & controle , Vacinas contra Papillomavirus/uso terapêutico , PapillomaviridaeRESUMO
BACKGROUND: The authors examined adults' perceptions about the importance of the human papillomavirus (HPV) vaccine in preventing oropharyngeal cancers and dental care providers' role in HPV prevention and identified associated factors. METHODS: Adults (≥ 18 years) completed a national survey of consumer and patient attitudes, experiences, and behaviors on oral health. Descriptive and multivariable logistic regression models determined associations between perceptions regarding HPV and attitudes toward dental care providers' role and HPV knowledge, HPV vaccine recommendation, and sociodemographic characteristics. RESULTS: One in 3 adults (32.8%; n = 5,320) said the HPV vaccine was very important, 1 in 2 said it was somewhat important (48.1%), and 1 in 5 said it was not important (19.1%) in preventing mouth and throat cancers. More than one-half (56.7%) of adults had positive perceptions about dental care providers' role in HPV education and were comfortable discussing the HPV vaccine with a dental care provider (59.4%). Adults with knowledge about HPV and oral health linkage and those who received HPV vaccine recommendation from a dental care provider had 2.0 to 2.5 times higher odds of reporting positively for all 3 outcomes (P < .001). CONCLUSIONS: Most adults are comfortable discussing HPV and the HPV vaccine with their oral health care provider. Perceptions about the HPV vaccine's importance in preventing oropharyngeal cancers and the role of dental care providers in HPV prevention can be improved by means of increasing adults' knowledge about the relationship between HPV and oral health. PRACTICAL IMPLICATIONS: Dental care providers' engagement in HPV conversations with patients may increase their knowledge about the HPV and oral health linkage and their understanding of the role of the HPV vaccine in preventing oropharyngeal cancers.
Assuntos
Neoplasias Orofaríngeas , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Humanos , Adulto , Papillomavirus Humano , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/uso terapêutico , Conhecimentos, Atitudes e Prática em Saúde , Neoplasias Orofaríngeas/prevenção & controle , Vacinação , Assistência OdontológicaRESUMO
BACKGROUND: Human papillomavirus (HVP)-positive oropharyngeal cancer is the most common HPV-associated cancer in the United States. The age at acquisition of oral HPV infections that cause oropharyngeal cancer (causal infections) is unknown; consequently, the benefit of vaccination of US men aged 27-45 years remains uncertain. METHODS: We developed a microsimulation-based, individual-level, state-transition model of oral HPV16 and HPV16-positive oropharyngeal cancer among heterosexual US men aged 15-84 years, calibrated to population-level data. We estimated the benefit of vaccination of men aged 27-45 years for prevention of oropharyngeal cancer, accounting for direct- and indirect effects (ie, herd effects) of male and female vaccination. RESULTS: In the absence of vaccination, most (70%) causal oral HPV16 infections are acquired by age 26 years, and 29% are acquired between ages 27 and 45 years. Among men aged 15-45 years in 2021 (1976-2006 birth cohorts), status quo vaccination of men through age 26 years is estimated to prevent 95% of 153â450 vaccine-preventable cancers. Assuming 100% vaccination in 2021, extending the upper age limit to 30, 35, 40, or 45 years for men aged 27-45 years (1976-1994 cohorts) is estimated to yield small benefits (3.0%, 4.2%, 5.1%, and 5.6% additional cancers prevented, respectively). Importantly, status quo vaccination of men through age 26 years is predicted to result in notable declines in HPV16-positive oropharyngeal cancer incidence in young men by 2035 (51% and 24% declines at ages 40-44 years and 45-49 years, respectively) and noticeable declines (12%) overall by 2045. CONCLUSION: Most causal oral HPV16 infections in US men are acquired by age 26 years, underscoring limited benefit from vaccination of men aged 27-45 years for prevention of HPV16-positive oropharyngeal cancers.
Assuntos
Vacinas Anticâncer , Neoplasias Orofaríngeas , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Humanos , Masculino , Feminino , Estados Unidos/epidemiologia , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/prevenção & controle , Papillomavirus Humano , Vacinação , Neoplasias Orofaríngeas/epidemiologia , Neoplasias Orofaríngeas/prevenção & controle , Papillomavirus Humano 16RESUMO
Novel preventive interventions are needed to address the rising incidence of human papillomavirus (HPV)-mediated oropharyngeal cancer (HPV+ OPC). This pilot study evaluated the feasibility of a stepped, behavioral and biological screening program for oral oncogenic HPV infection, an intermediate HPV+ OPC outcome.This was a cross-sectional, feasibility study. Eligible 45-74 years old adults identified from three clinical research registries were administered a behavioral risk survey (step 1). Participant tobacco use and sexual behavior history were translated into a quantifiable risk of oral oncogenic HPV DNA, according to prior National Health and Nutrition Examination Survey analyses. Females with >2% risk and males with >7% risk were offered biological screening for oral oncogenic HPV DNA (step 2) via an oral rinse and gargle specimen.A total of 292 individuals were contacted, but only 144 (49%) were reached. Among these, 56 individuals (19%) were uninterested and 18 (13%) were ineligible. Seventy individuals began the survey and 66 completed it (step 1), among whom 46 were classified as low-risk. Among the remaining 20 participants classified as high-risk for an oral oncogenic HPV infection, 5% were current smokers and the median participant had performed oral sex on 10 unique partners. During step 2 (biological screening), 45% (9/20) completed testing, all of whom tested negative for oral oncogenic HPV DNA.In this pilot of a stepped, oral oncogenic HPV screening program, enrollment and study completion were suboptimal. These barriers to screening should be characterized and addressed before reevaluating the feasibility of this program. PREVENTION RELEVANCE: Novel preventive interventions are needed to address the rising incidence of HPV+ OPC. In this feasibility study, we characterized barriers to a two-step, behavioral and biological screening program for oral oncogenic HPV infection, an intermediate outcome for HPV+ OPC.