HPV vaccination beyond primary prevention: survey of practices and attitudes of Polish obstetrician-gynecologists.

BACKGROUND: Evidence indicates benefits of HPV vaccination beyond primary prevention, including for women treated for high-grade lesions (HSIL/CIN2+), immunocompromised individuals, and healthcare personnel. Despite comprehensive guidelines, clinical implementation remains inconsistent. This study evaluated the knowledge, attitudes, and practices of Polish obstetrician-gynecologists (OBGYNs) regarding HPV vaccination, with emphasis on recommendations extending beyond primary prevention. METHODS: A cross-sectional online survey was conducted among Polish OBGYNs between October 2024 and June 2025 as part of a European Federation for Colposcopy initiative. The anonymous questionnaire assessed attitudes, guideline awareness, clinical practice patterns, and demographics. Descriptive statistics were applied. RESULTS: Respondents demonstrated broadly positive attitudes toward HPV vaccination, with nearly all reporting that they inform patients about adult vaccination options. Adherence to national regulations was high (> 97%), and most participants were familiar with recommendations from professional societies. Younger physicians, vaccinated respondents, and OBGYNs with completed specialty training reported the highest awareness of guidelines and were most supportive of vaccination beyond primary prevention. A significant proportion endorsed vaccination for women treated for HSIL/CIN2+, individuals with HIV, and immunosuppressed patients after organ transplantation. Strong support was also expressed for expanding reimbursement to improve adult access. Furthermore, respondents emphasized the importance of randomized controlled trials to validate extended indications and guide evidence-based policy. CONCLUSION: Polish OBGYNs show strong support for HPV vaccination, including extended use in high-risk groups. Ongoing education and further clinical research are needed to guide consistent implementation and inform evidence-based policy.