Association of Receipt of Human Papillomavirus Vaccination and Personal History of Cancer Diagnosis in the United States: A Cross-Sectional Study Using NHIS Data.

Background

Cancer survivors are at increased risk for developing subsequent cancers, including HPV-associated cancers, compared to the general population. However, evidence regarding the receipt of HPV vaccination and cancer diagnosis status is limited.

Methods

We analyzed 2019 and 2022 National Health Interview Survey data, focusing on adults aged 18-45 years who were eligible for HPV vaccination. We performed descriptive statistics and evaluated associations using survey-weighted bivariable and multivariable logistic regression to assess the association between a personal history of any cancer diagnosis and receipt of HPV vaccination, adjusting for sociodemographic and behavioral factors.

Results

Among 20,917 participants (mean [SD] age (years): 31.41 [13.58]), 489 (2.0%) were cancer survivors; 99 (19.3%) received HPV vaccination. Among 20,423 adults without a cancer diagnosis, 5317 (27.8%) had received HPV vaccination. Five participants had missing data on cancer history. Cancer survivors had significantly lower odds of HPV vaccination compared to adults without a personal cancer history (Adjusted Odds Ratio [aOR]: 0.67, 95% CI: 0.52-0.87, p = 0.003). Living in non-metro areas (aOR: 0.77, 95% CI: 0.66-0.89, p < 0.001), smokers [current (aOR: 0.82, 95% CI: 0.71-0.94, p = 0.005), and former (aOR: 0.75, 95% CI: 0.67-0.84, p < 0.001)], non-US-born (aOR: 0.54, 95% CI: 0.47-0.61, p < 0.001), uninsured (aOR: 0.60, 95% CI: 0.52-0.69, p < 0.001) had significantly lower odds of receiving HPV vaccination. Those who were 18-26 years (aOR: 5.49, 95% CI: 4.73-6.37, p < 0.001), non-Hispanic others (aOR: 1.40, 95% CI: 1.11-1.75, p = 0.004), females (aOR: 3.18, 95% CI: 2.84-3.56, p < 0.001), higher education [some college/bachelor's education (aOR: 1.57, 95% CI: 1.41-1.74, p < 0.001), and graduate degree/professional scholar (aOR: 1.91, 95% CI: 1.65-2.22, p < 0.001)], living in rented housing (aOR: 1.18, 95% CI: 1.08-1.29, p < 0.001) had significantly higher odds of receiving HPV vaccination.

Conclusions

HPV vaccination uptake is low among cancer survivors. Targeted interventions such as strong oncologists' recommendations, patient reminders, and care coordination between oncology and primary care professionals are needed to increase HPV vaccination uptake in this population.