HealthApril 23, 2024

The HPV vaccine: A powerful tool in cancer prevention

The HPV vaccine has accumulated significant wins in reducing rates of cancer mortality. Clinical leaders are perfectly positioned to keep the momentum. 

Human papillomavirus (HPV) is one of the most common viruses that can cause cancer, and has been linked to malignancy in more than six areas of the human body. Twelve HPV strains associated with cancers in both men and women include throat, anal, penile, cervical, vaginal, and vulvar cancer. HPV infection causes about 5% of cancers worldwide, according to the World Health Organization.

The HPV vaccine has been outstandingly effective in preventing cervical cancer and improving patients’ lives—and there are still significant gains on the horizon for administrative and clinical leaders who understand the dynamics of the disease and vaccine. 

Victories in cancer prevention—The benefits of HPV vaccination

Every year, over 46,000 new cases of cancer are found in body parts where HPV is known to reside—the cervix, vagina, vulva, penis, anus, rectum, and oropharynx. HPV is believed to be responsible for the following percentages of cancers in these body parts:

  • Cervix: 91% 
  • Anus: 91%
  • Vagina: 75%
  • Oropharynx: 70%
  • Vulva: 69%
  • Penis: 63%

The most common type of cancer caused by HPV, cervical cancer, was a leading cause of death among women in the US. Wider use of Pap tests and the HPV vaccine have helped decrease the rate of HPV infections and genital warts by over 80%. Among women between 20 and 24 years (the first patients to receive the vaccine after its introduction in 2006) cervical cancer rates dropped 65% between 2012 and 2019.  

With the support of administrative and clinical leaders, even more progress in prevention of HPV-related cancers is possible through education, screening, and vaccination.  

Understanding the HPV vaccine as a powerful cancer prevention tool

Genital HPV is the most common sexually transmitted infection in the US, having the ability to infect both men and women. In most cases of HPV, the immune system clears the virus within two years. But in some cases, the body isn’t able to get rid of the infection. In cancer-causing infections, it can linger and turn normal cells into abnormal ones, which can then become cancer.

Cancers caused by HPV infection have become highly preventable, largely thanks to clinical leaders' efforts in improving screening and vaccine uptake. An increase in vaccine uptake has the potential benefits of reduced cancer risk, improved sexual health and overall well-being, and better quality of life for patients and communities. 

Promoting HPV vaccination: The role of healthcare providers and administrative leaders

Administrative and clinical leaders play a critical role in reducing HPV infections and associated cancers by making HPV vaccination accessible to all. But there have been some challenges to implementing proactive and preventive healthcare with the HPV vaccine. 

Supporting access and affordability

Ideally, all patients should have access to evidence-based cancer prevention. Unfortunately, HPV is the most expensive of the routinely recommended pediatric vaccines. In the U.S. the vaccine can cost upwards of $200 before insurance. The financial returns can also be low for certain providers.

This means administrators can play a key role in addressing disparities in access to care. Clinical leaders can reduce hurdles by negotiating vaccine coverage and by ensuring adequate reimbursement for providers, who can then provide access to their communities. 

Addressing stigma and social determinants of health

When the vaccine first became available, some people had concerns that its use could encourage sexual activity, particularly in young people. This concern has resulted in social stigma around the vaccine and raised parents’ concern. However, studies support a different perspective. Parents report a lack of confidence in vaccine decision-making, a desire for more information, and a dissatisfaction with provider encounters, along with concerns around necessity and safety. Clinical leaders have a unique opportunity to promote accurate information and encourage shared decision-making.

Demographic factors like social determinants of health can also influence HPV awareness. A recent study found significant variation in understanding the connection between the virus and cancer based on educational level and race.

Regarding awareness of HPV vaccines:  

  • Less than high school 34.7% 
  • College degree or higher 74.7% 
  • Asian individuals 48.4%
  • White individuals 68.2%

Regarding knowledge that HPV causes cervical cancer (among adults aware of HPV):

  • Less than high school 51.7%
  • College degree or higher 84.7%
  • Black individuals 66.0%
  • Asian individuals 77.9%

Evidence-based care can effectively promote the screening and treatment of HPV-related cancers, but disparities exist. Black and Hispanic populations, as well as women in low-resource areas, are much less likely to have access to evidence-based care and, thus, have higher rates of mortality. This finding is significant, since access to evidence-based care contributes to differences in patient outcomes and that the outcome of cancer is preventable. 

Fostering a healthy patient-provider relationship

Progress in increasing HPV vaccination rates will rely on a healthy patient-provider relationship.

Administrators should encourage providers to listen to patient’s health goals, objections, and concerns, so that they can work together to create an acceptable vaccination plan. This effort includes facilitating clinicians’ access to the tools, content, and technology that supports personalized and effective conversations with patients.

Clinical leaders have the opportunity to reverse HPV-attributable cancer trends through the awareness of the HPV vaccine, screening, and prevention. Success will rely on advanced patient engagement and tracking outcomes in care populations to optimize results.

UpToDate® Patient Engagement
Kristen Eckler professional headshot
Director, Clinical Content – Editorial Marketing and Deputy Editor — Obstetrics, Gynecology and Women's Health, Wolters Kluwer Health
Dr. Eckler is a board-certified clinical specialist in Obstetrics and Gynecology with a focus on Female Pelvic Medicine and Reconstructive Surgery, Menopause, and Female Sexual Dysfunction.

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