Most Americans are unaware that the human papillomavirus, or HPV, can increase the risk of throat cancer, according to a recent study.
While public health campaigns have successfully spread the word about HPV’s ability to cause cervical cancer, there has been less focus on other malignancies the virus can cause, study author Daniel Kwon, MDsaid a head and neck surgeon at the University of Southern California Keck Medicine Health.
In addition to cervical and throat cancer, which is now the most common type of cancer attributed to HPV, the sexually transmitted infection can also lead to vaginal, vulva, anal, and penile cancer.
Lack of awareness of HPV-related cancers may be why most eligible U.S. adults forgo HPV vaccination, another recent study out of USC found. In 2018, adults aged 27 to 45 became eligible for the vaccination, which was previously only available to those aged 9 and 26.
Experts said two studies were published in the journal Otorhinolaryngology – head and neck surgeryshow that the public has little knowledge about an extremely common disease.
HPV, which is spread through intimate skin-to-skin contact and vaginal, anal, or oral sex, affects 13 million Americans annually. More than 42 million Americans have types of viruses that cause cancer. Because high-risk HPV is usually asymptomatic, most people who have it don’t realize it.
“Many HPV-related diseases carry a bit of shame, and they shouldn’t,” Geoffrey Young, MDhead and neck surgical oncologist at Baptist Health Cancer Institute in Miami, said Health. “There’s not this loud voice behind (widespread vaccination efforts) because there’s still this unfortunate embarrassment associated with discussing that virus.”
The researchers wanted to assess Americans’ knowledge about HPV after the vaccine was rolled out in 2018. To do this, they relied on the National Health Information Survey (HINTS), which collects data on awareness of cancer-related health information over time.
Researchers analyzed data from 3,504 HINTS participants in 2018 and 3,865 participants in 2020. At each time point, participants answered questions about their awareness of the link between HPV and certain cancers and the existence of an HPV vaccine.
Although the vast majority of people knew about the HPV vaccination, this was not the case for awareness of the link between HPV and a throat cancer called oropharyngeal squamous cell carcinoma. In 2018, 27% of participants reported awareness of this connection, but that number was only 29.5% two years later.
The number of people who knew that HPV can cause cervical cancer also decreased. In 2018, 75% of people reported awareness of this relationship; in 2020, that number dropped to 70.2%.
The team concluded that despite expanding vaccine eligibility, the public is still largely unaware of the risks of HPV and the benefits of the HPV vaccine.
The second paper, published in August, relied on data from the Behavioral Risk Factor Surveillance System, which collects health data on Americans in all 50 states through telephone surveys.
Researchers analyzed data from a cohort of 26,470 adults ages 30 to 44 who participated in the BRFSS program between 2018 and 2022.
The CDC does not officially recommend vaccination for people 27 to 45 years of age, but advises that the population make individual decisions about whether or not to get vaccinated in cooperation with their health care providers.
The scientists found that 15.8% of participants reported any HPV vaccination status, while only 6.5% reported being fully vaccinated. (Three doses are recommended for adults in the US.)
The following factors were associated with a higher likelihood of vaccination:
- Younger years
- Female sex
- You live in the western or northeastern regions of the US
- Higher education
- Being single
- Have a personal health care provider
- Gay or lesbian sexual orientation
There are several reasons why U.S. adults don’t have a good understanding of the dangers of HPV, experts say.
HPV awareness had more momentum in the late 2010s, Young said, but the pandemic has halted some of that. After COVID emerged, “the focus of the vaccine shifted to COVID, and we reached stagnation” with HPV vaccination rates, he explained. “The conversation about the vaccine took a different course and became politicized.”
Vaccination hesitancy also plays a role, as does confusion about HPV in general. At first, the vaccine was only recommended for girls, leaving people unaware that boys and men were also eligible, experts said.
It also doesn’t help, Kwon added, that the type of cancer caused by HPV doesn’t get as much attention as buzzier types like breast cancer.
“Head and neck cancer is a bit of an ugly stepchild of cancer,” he said. “A lot of cancers get press and funding, but we don’t really see that for head and neck cancer because, traditionally, those are cancers of the poor and the underprivileged.”
The more lifetime and recent sexual partners you have, the higher your risk of HPV infection. If you or your child is eligible for the vaccine, experts recommend that you consult with your health care provider to discuss vaccination.
While women can turn to HPV tests and Pap smears to determine if they have HPV, neither test can detect the virus in men – making vaccination even more important.
Education is essential, Kwon said, “and that’s where advocacy for public health (workers) and clinicians is important.