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Solis-Torres N, Braverman-Diaz I, Rivera-Morales LA, Perez-Sanchez JJ, Perez-Bravo VS, Neris-Sanchez AJ, Vera A, Diaz-Algorri Y. Medical students' knowledge about human papillomavirus (HPV), HPV vaccine and head and neck cancer. Hum Vaccin Immunother 2024; 20:2344248. [PMID: 38659106 PMCID: PMC11057669 DOI: 10.1080/21645515.2024.2344248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 04/13/2024] [Indexed: 04/26/2024] Open
Abstract
The Human Papillomavirus (HPV) is a sexually transmitted infection that significantly affects the population worldwide. HPV preventive methods include vaccination, prophylactics, and education. Different types of cancers associated with HPV usually take years or decades to develop after infections, such as Head and Neck Cancer(HNC). Therefore, HPV prevention can be considered cancer prevention. A sample of medical students in Puerto Rico was evaluated to assess their knowledge about HPV, HPV vaccine, and HNC through two previously validated online questionnaires composed of 38 dichotomized questions, we measured HPV, HPV vaccination(HPVK), and HNC knowledge (HNCK). Out of 104 students surveyed, the mean HPVK score obtained was 20.07/26, SD = 3.86, while the mean score for HNCK was 6.37/12, SD = 1.78. Bidirectional stepwise regression showed study year and HPV Vaccine name had been the most influential variables on HPVK and HNCK. MS1 participants scored lower than MS2-MS4 participants, with no significant difference between MS2-MS4 scores. The results reveal knowledge gaps in HPV/HPV Vaccine and HNC among surveyed medical students. Our findings also suggest an association between knowledge of personal vaccination status, self-perceived risk, and how uncertainty in these factors may affect the medical students' understanding of HPV, HPV vaccination, and associated cancers.
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Affiliation(s)
| | - Isardo Braverman-Diaz
- Master of Public Health Program, San Juan Bautista School of Medicine, Caguas, Puerto Rico
| | - Luis A. Rivera-Morales
- Master of Public Health Program, San Juan Bautista School of Medicine, Caguas, Puerto Rico
| | - Jose J. Perez-Sanchez
- Master of Public Health Program, San Juan Bautista School of Medicine, Caguas, Puerto Rico
| | - Valeria S. Perez-Bravo
- Master of Public Health Program, San Juan Bautista School of Medicine, Caguas, Puerto Rico
| | - Angel J. Neris-Sanchez
- Master of Public Health Program, San Juan Bautista School of Medicine, Caguas, Puerto Rico
| | - Alexis Vera
- Master of Public Health Program, San Juan Bautista School of Medicine, Caguas, Puerto Rico
| | - Yaritza Diaz-Algorri
- Master of Public Health Program, San Juan Bautista School of Medicine, Caguas, Puerto Rico
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Trakimas DR, Mydlarz W, Mady LJ, Koch W, Quon H, London NR, Fakhry C. Increasing radiation therapy and lower survival for human papillomavirus-related oropharynx cancer associated with a shift to community cancer center care. J Natl Cancer Inst 2024; 116:1051-1062. [PMID: 38167712 PMCID: PMC11223870 DOI: 10.1093/jnci/djad238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/20/2023] [Accepted: 11/10/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Studies have shown lower overall survival for patients with head and neck cancer treated at low-volume or community cancer centers. As the incidence of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma steadily rises in the United States, we hypothesized that a greater proportion of patients with HPV-related oropharyngeal squamous cell carcinoma is being treated at community cancer centers, with a shift toward primary nonsurgical treatment. METHODS This cohort study included patients from the US National Cancer Database who received a diagnosis of HPV-related oropharyngeal squamous cell carcinoma from 2010 to 2019 and underwent treatment at a community cancer center or academic cancer center. The proportion of patients with HPV-related oropharyngeal squamous cell carcinoma treated at community cancer centers and receiving primary nonsurgical treatment was analyzed over time. Four-year overall survival was compared between community cancer centers and academic cancer centers. RESULTS The majority (67.4%) of 20 298 patients were treated at an academic cancer center, yet the proportion of patients treated at community cancer centers increased by 10% from 2010 to 2019 (P < .01 for trend). The proportion of patients undergoing primary nonsurgical treatment increased from 62.1% to 73.7% from 2010 to 2019 (P < .01 for trend), and patients were statistically significantly more likely to undergo nonsurgical treatment at community cancer centers than at academic cancer centers (adjusted odds ratio = 1.20, 95% confidence interval = 1.18 to 1.22). Treatment at community cancer centers was associated with worse survival overall (adjusted hazard ratio = 1.19, 95% confidence interval = 1.09 to 1.31), specifically for patients receiving primary nonsurgical treatment (adjusted hazard ratio = 1.22, 95% confidence interval = 1.11 to 1.34). CONCLUSIONS Treatment of HPV-related oropharyngeal squamous cell carcinoma has recently shifted to community cancer centers, with an increase in the proportion of nonsurgical treatment and worse overall survival at these centers compared with academic cancer centers. Concentration of care for HPV-related oropharyngeal squamous cell carcinoma at academic cancer centers and dedicated head and neck cancer centers may increase access to all available treatment modalities and improve survival.
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Affiliation(s)
- Danielle R Trakimas
- Department of Otolaryngology—Head and Neck Surgery, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Wojtek Mydlarz
- Department of Otolaryngology—Head and Neck Surgery, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Leila J Mady
- Department of Otolaryngology—Head and Neck Surgery, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Wayne Koch
- Department of Otolaryngology—Head and Neck Surgery, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Harry Quon
- Department of Otolaryngology—Head and Neck Surgery, Johns Hopkins Hospital, Baltimore, MD, USA
- Department of Radiation Oncology, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Nyall R London
- Department of Otolaryngology—Head and Neck Surgery, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Carole Fakhry
- Department of Otolaryngology—Head and Neck Surgery, Johns Hopkins Hospital, Baltimore, MD, USA
- Department of Oncology, Johns Hopkins Hospital, Baltimore, MD, USA
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Thanasuwat B, Leung SOA, Welch K, Duffey-Lind E, Pena N, Feldman S, Villa A. Human Papillomavirus (HPV) Education and Knowledge Among Medical and Dental Trainees. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:971-976. [PMID: 36002641 PMCID: PMC9402407 DOI: 10.1007/s13187-022-02215-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/17/2022] [Indexed: 06/02/2023]
Abstract
Persistent human papillomavirus (HPV) infection is responsible for the majority of oropharyngeal and cervical cancers in the USA. Currently, HPV curricula within medical and dental schools are not standardized. As such, we implemented a brief online educational intervention to increase medical and dental trainees' knowledge of the HPV vaccine and the association between HPV and cancer. The objectives of this study were to (1) assess medical and dental trainees' baseline knowledge regarding HPV and HPV vaccine, (2) determine the willingness to recommend the HPV vaccine to patients, and (3) evaluate the impact of an online intervention on HPV-related knowledge. Medical and dental trainees from two large academic centers in the USA were asked to fill out an online pre-intervention questionnaire, followed by a 10-min HPV educational intervention based on the Center of Disease Control and Prevention (CDC) resources, and then a post-intervention questionnaire. There were 75 participants (67.4% females; median age 18-30 years). When asked about HPV-related cancer types, the correct response increased from 28.4% (pre-intervention) to 51.9% (post-intervention; p < 0.01). When asked about the prevalence of HPV infections, the correct response improved from 36 to 72% (p < 0.01). There was also a 25.2% improvement in identifying the correct HPV vaccination dosing schedule (p < 0.01). Eighty-seven percent of the participants mentioned that the online education improved their HPV knowledge, and 68.5% reported that they were more likely to recommend HPV vaccine after the online intervention. The proposed online educational intervention was effective at improving HPV-related cancer and HPV vaccine knowledge as well as attitudes towards vaccine recommendation among dental and medical trainees and could be implemented in medical and dental school curricula in the future.
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Affiliation(s)
- Burinrutt Thanasuwat
- Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA USA
| | - Shuk On Annie Leung
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, McGill University Health Center, Montreal, QC Canada
| | | | - Eileen Duffey-Lind
- Team Maureen, North Falmouth, MA USA
- Division of Pediatric Oncology, Dana Farber Cancer Center, Boston, MA USA
| | - Nancy Pena
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA USA
| | - Sarah Feldman
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA USA
| | - Alessandro Villa
- Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA USA
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Bunting SR, Morris S, Chael J, Feinstein BA, Hazra A, Garber SS. Knowledge of human papillomavirus vaccination: A multi-institution, cross-sectional study of allopathic and osteopathic medical students. PLoS One 2023; 18:e0280287. [PMID: 36630459 PMCID: PMC9833510 DOI: 10.1371/journal.pone.0280287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 12/23/2022] [Indexed: 01/12/2023] Open
Abstract
Human papillomavirus (HPV) vaccination is a well-established and successful tool for preventing HPV-related cancers. However, vaccine uptake remains low, influenced by patient hesitancy around safety concerns and little opportunity to discuss the vaccine with trusted healthcare providers. We conducted a national, cross-sectional study of allopathic and osteopathic medical students regarding knowledge of HPV vaccination guidelines March-April 2021. Analysis sought to identify gaps in knowledge as well as demographic and academic correlates of knowledge. A total of 718 students participated (response rate = 50.8%). While 92.8% of participants identified the connection between HPV and cervical cancer, lower percentages associated HPV with vaginal/vulvar (67.7%), anal (63.3%), and penile (53.9%) cancers. Low percentages of participants correctly identified age of HPV vaccine eligibility (33.3%) and how many doses are needed for full protection (48.1%). This study identifies specific knowledge gaps in medical students' training on HPV-related cancers and HPV vaccination guidelines. Through addressing these gaps, we may improve HPV vaccine uptake and decrease the incidence of HPV-related cancers.
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Affiliation(s)
- Samuel R. Bunting
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago Medicine, Chicago, Illinois, United States of America
| | - Samantha Morris
- Pritzker School of Medicine, The University of Chicago Medicine, Chicago, Illinois, United States of America
| | - Julia Chael
- Pritzker School of Medicine, The University of Chicago Medicine, Chicago, Illinois, United States of America
| | - Brian A. Feinstein
- Department of Psychology, College of Health Professions, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, United States of America
| | - Aniruddha Hazra
- Department of Medicine, Section of Infectious Diseases and Global Health, The University of Chicago Medicine, Chicago, Illinois, United States of America
| | - Sarah S. Garber
- Department of Pharmaceutical Sciences, College of Pharmacy, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, United States of America
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Du EY, Adjei Boakye E, Taylor DB, Kuziez D, Rohde RL, Pannu JS, Simpson MC, Patterson RH, Varvares MA, Osazuwa-Peters N. Medical students' knowledge of HPV, HPV vaccine, and HPV-associated head and neck cancer. Hum Vaccin Immunother 2022; 18:2109892. [PMID: 36070503 DOI: 10.1080/21645515.2022.2109892] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
On the basis of their training, medical students are considered "the best case scenario" among university students in knowledge of the human papillomavirus (HPV). We evaluated differences in knowledge of HPV, HPV vaccine, and head and neck cancer (HNC) among medical students. A previously validated questionnaire was completed by 247 medical students at a Midwestern university. Outcomes of interest were knowledge score for HPV and HPV vaccine, and HNC, derived from combining questionnaire items to form HPV knowledge and HNC scores, and analyzed using multivariate linear regression. Mean scores for HPV knowledge were 19.4 out of 26, and 7.2 out of 12 for HNC knowledge. In the final multivariate linear regression model, sex, race, and year of study were independently associated with HPV and HPV vaccine knowledge. Males had significantly lower HPV vaccine knowledge than females (β = -1.53; 95% CI: -2.53, -0.52), as did nonwhite students (β = -1.05; 95% CI: -2.07, -0.03). There was a gradient in HPV vaccine knowledge based on the year of study, highest among fourth year students (β = 6.75; 95% CI: 5.17, 8.33). Results were similar for factors associated with HNC knowledge, except for sex. HNC knowledge similarly increased based on year of study, highest for fourth year students (β = 2.50; 95% CI: 1.72, 3.29). Among medical students, gaps remain in knowledge of HPV, HPV vaccine, and HPV-linked HNC. Male medical students have significantly lower knowledge of HPV. This highlights the need to increase medical student knowledge of HPV and HPV-linked HNC.
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Affiliation(s)
- Eric Y Du
- School of Medicine, Saint Louis University, Saint Louis, MO, USA
| | - Eric Adjei Boakye
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA.,Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health System, Detroit, MI, USA
| | - Derian B Taylor
- School of Medicine, Saint Louis University, Saint Louis, MO, USA
| | - Duaa Kuziez
- Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Rebecca L Rohde
- Department of Otolaryngology & Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jaibir S Pannu
- Department of Otolaryngology-Head and Neck Surgery, Loma Linda University, Loma Linda, CA, USA
| | - Matthew C Simpson
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St Louis, MO, USA.,Advanced Health Data Research Institute, Saint Louis University, St Louis, MO, USA
| | - Rolvix H Patterson
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Mark A Varvares
- Department of Otolaryngology, Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA, USA
| | - Nosayaba Osazuwa-Peters
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, USA.,Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.,Duke Cancer Institute, Durham, NC, USA
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Levy MS, Finch L, Lindsay KA, Jeudin P, Huang M. Leveraging teachable moments in cancer prevention by improving HPV vaccination in health professional students (HPS): A systematic review. Front Oncol 2022; 12:978843. [PMID: 36106117 PMCID: PMC9467466 DOI: 10.3389/fonc.2022.978843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionVaccination against HPV is safe and effective in cancer prevention, yet vaccination uptake remains low. Strong recommendation of HPV vaccination by healthcare providers increases immunization rates, but gaps in knowledge persist surrounding HPV and HPV vaccination amongst health professional students (HPS). It is critical to educate HPS in all professions to maximize vaccination opportunities and increase vaccine uptake. The objective of this study is to evaluate evidence on HPV knowledge, vaccine uptake, and educational interventions in HPS to identify specific deficits to improve education.MethodsA systematic literature search for articles on HPV vaccine uptake, knowledge, and educational interventions in HPS was performed in PubMed, Embase, Web of Science, CINAHL, and Scopus from January 1, 2006 – July 21, 2021. Included studies assessed HPS for HPV vaccine uptake, knowledge, counseling comfort, or educational interventions to increase HPV vaccine knowledge. Studies were screened for inclusion by 2 independent reviewers and evaluated for risk of bias. PRISMA guidelines for reporting were followed.ResultsTwenty-one unique articles met inclusion criteria and were included in the analysis. Of the studies included, 20 included knowledge, 11 included vaccine uptake, 8 included interventions, and 12 included counseling comfort. The students in the studies included medical (n=14), dental (n=7), dental hygiene (n=6), nursing (n=3), physician assistant (n=2), public health (n=1), and pharmacy (n=1). Across studies, HPV vaccine series initiation ranged from 34.6-70.3%, with 28.3-58.3% up to date on vaccination. Most students knew that HPV causes cervical cancer (99%), but fewer knew that HPV causes head and neck cancer (40-47%) and oropharyngeal cancer (45%). Educational interventions included team-based approaches and lectures, and improved outcomes including vaccine knowledge, vaccination schedule, and cancer knowledge. Medical students with lower knowledge of HPV were more hesitant to recommend vaccination at baseline but were more likely to recommend vaccination after an education session.DiscussionAcross HPS, inadequacies persist in HPV vaccine uptake, knowledge, and counseling comfort. It is critical to target vaccine uptake in this population and improve existing educational efforts to reduce preventable cancers. Institutions must prioritize HPV vaccine education to impact HPV related death.
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Affiliation(s)
- Morgan S. Levy
- Department of Medical Education, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Lindsey Finch
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Jackson Memorial Hospital, Miami, FL, United States
| | - Kara A. Lindsay
- Department of Medical Education, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Patricia Jeudin
- Division of Gynecologic Oncology, Sylvester Comprehensive Cancer Center/University of Miami Miller School of Medicine, Miami, FL, United States
| | - Marilyn Huang
- Division of Gynecologic Oncology, Sylvester Comprehensive Cancer Center/University of Miami Miller School of Medicine, Miami, FL, United States
- *Correspondence: Marilyn Huang,
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Alzabibi MA, Alolabi H, Ali DA, Shibani M, Ismail H, Mohsen F, Armashi H, Sawaf B, Swed S, Bakr A, Nahas LD, Ghaith HS, Motawea KR. Oral cancer knowledge and practice among medical students: A cross-sectional study during the Syrian crisis. Ann Med Surg (Lond) 2022; 77:103504. [PMID: 35638081 PMCID: PMC9142404 DOI: 10.1016/j.amsu.2022.103504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 03/16/2022] [Accepted: 03/26/2022] [Indexed: 12/24/2022] Open
Abstract
Background lack of medical practitioners' knowledge about oral cancer has contributed to delays in referral and treatment. Oral cancer is amenable to treatment when detected early, which leads to better prognosis and survival rates. In this study, we aimed to assess the knowledge of the Syrian medical students about the risk factors of oral cancer, oral cavity changes associated with oral cancer, and the relation between the relation with Human Papilloma Virus (HPV) and oral cancer. Methods This is a cross-sectional study conducted at the Syrian Private University. Data were collected through self-administered questionnaires, which targeted social demographic information, general knowledge, risk factors, oral changes and HPV knowledge associated with oral cancer. Data was categorized and analyzed to assess and compare the levels of knowledge between clinical and preclinical students. Results 301 out of 401 medical students responded to the questionnaires bringing the response rate to 75.25%. The study revealed adequate knowledge about oral cancer, general information, clinical features, risk factors and relation to HPV. Clinical students showed higher levels of awareness compared to pre-clinical students. No significance in knowledge was found between the genders. Conclusion The findings of the present study suggest that there is a need to reinforce the medical curriculum concerning oral cancer education, particularly in prevention and early detection to improve practices.
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Affiliation(s)
- Mhd Amin Alzabibi
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
| | - Homam Alolabi
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
| | - Dania Alsayed Ali
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
| | - Mosa Shibani
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
| | - Hlma Ismail
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
| | - Fatema Mohsen
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
| | - Humam Armashi
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
| | - Bisher Sawaf
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
| | - Sarya Swed
- Faculty of Medicine, Aleppo University, Aleppo, Syria
| | - Aliaa Bakr
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
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Tucker J, Sarsfield E, Choi KY, Goyal N. Educating School Nurses about Human Papillomavirus (HPV) Associated Cancers and the Importance of HPV Vaccination. J Community Health Nurs 2021; 38:201-208. [PMID: 34787044 DOI: 10.1080/07370016.2021.1972244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE To assess and improve school nurse knowledge of HPV-associated cancers. DESIGN An experimental quality improvement study. METHODS At a continuing education regional conference, an interactive HPV education session was provided. Pre- and post-education surveys were completed by attendees. FINDINGS After the educational intervention, 89.9% of nurses indicated a change in knowledge and 83.2% indicated a planned change in practice. CONCLUSIONS An education intervention aimed at school nurses can be impactful in broadening the understanding of HPV oncogenesis. CLINICAL EVIDENCE Educational interventions can be a strategy to increase school nurse knowledge and subsequently patient knowledge about HPV associated cancers.
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Affiliation(s)
- Jacqueline Tucker
- College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA
| | - Erin Sarsfield
- Department of Otolaryngology, Head and Neck Surgery, College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA.,Penn State Health, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Karen Y Choi
- College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA.,Department of Otolaryngology, Head and Neck Surgery, College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA.,Penn State Health, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Neerav Goyal
- College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA.,Department of Otolaryngology, Head and Neck Surgery, College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA.,Penn State Health, Penn State Cancer Institute, Hershey, Pennsylvania, USA
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Sallam M, Dababseh D, Yaseen A, Al-Haidar A, Ettarras H, Jaafreh D, Hasan H, Al-Salahat K, Al-Fraihat E, Hassona Y, Şahin GÖ, Mahafzah A. Lack of knowledge regarding HPV and its relation to oropharyngeal cancer among medical students. Cancer Rep (Hoboken) 2021; 5:e1517. [PMID: 34291614 PMCID: PMC9327668 DOI: 10.1002/cnr2.1517] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 07/07/2021] [Accepted: 07/09/2021] [Indexed: 11/19/2022] Open
Abstract
Background Oropharyngeal cancer (OPC) is an important cause of cancer‐related mortality. Early detection of OPC results in a favorable prognosis and higher survival rates. Infection by high‐risk types of human papillomavirus (HPV) is a risk factor for OPC with an upward trend globally. Medical students' knowledge and awareness of HPV‐related OPC can be crucial in the preventive efforts. Aim To assess HPV knowledge among medical students at the University of Jordan, with particular focus on its relation to different cancers. Methods This paper‐based survey study was conducted in November 2019. The survey items were based on previously validated surveys used to evaluate HPV‐related OPC knowledge among dental students and professionals. To assess HPV knowledge and students' confidence in personal history taking and physical examination, we developed a knowledge and confidence scores that showed acceptable reliability. Results The total number of participants was 1198 students, with a median age of 21 and female predominance (n = 697, 58.2%). Among the participants, 93.3% heard of HPV prior to this survey (n = 1118). Higher levels of knowledge regarding cervical cancer, OPC and HPV vaccination was seen among clinical students compared to their preclinical counterparts, but their overall HPV knowledge was low. Only 18.4% and 21.0% of the clinical students correctly identified the association of HPV with penile and oropharyngeal cancers, respectively. Additionally, 34.5% of the clinical students were not aware of the availability of HPV vaccines. The majority of students (92.0%) reported that the university courses were their major source of knowledge about HPV. Conclusion A profound lack of knowledge regarding HPV role in OPC was found among medical students. This insufficiency included several aspects of the virus and its associated diseases. Such gaps in knowledge could have negative consequences in early detection and prevention of OPC and should be addressed by evaluation of the current curriculum.
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Affiliation(s)
- Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan.,Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman, Jordan.,Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Deema Dababseh
- School of Dentistry, the University of Jordan, Amman, Jordan
| | - Alaa Yaseen
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan
| | - Ayat Al-Haidar
- School of Dentistry, the University of Jordan, Amman, Jordan
| | - Hajar Ettarras
- School of Dentistry, the University of Jordan, Amman, Jordan
| | - Dania Jaafreh
- School of Dentistry, the University of Jordan, Amman, Jordan
| | - Hanan Hasan
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan
| | - Khaled Al-Salahat
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan
| | - Esraa Al-Fraihat
- Department of Basic Medical Sciences, Faculty of Medicine, Al-Balqa Applied University, Salt, Jordan
| | - Yazan Hassona
- School of Dentistry, the University of Jordan, Amman, Jordan.,Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, Jordan University Hospital, Amman, Jordan
| | - Gülşen Özkaya Şahin
- Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden.,Department of Clinical Microbiology, Laboratory Medicine, Skåne University Hospital, Lund, Sweden
| | - Azmi Mahafzah
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan.,Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman, Jordan
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11
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Parsel SM, Barton BM, Beatty S, Friedlander PL. Knowledge Gaps among Patients and Providers in HPV-Related Oropharyngeal Cancer: A Systematic Review. Otolaryngol Head Neck Surg 2020; 162:612-621. [DOI: 10.1177/0194599820908596] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
ObjectiveTo describe the level of knowledge of human papillomavirus (HPV) and HPV-associated oropharyngeal squamous cell carcinoma (OPSCC) among the general population and health care providers.Data SourcesSystematic search was performed on December 20, 2018, using MEDLINE (1966 to December 2018), EMBASE (1975 to December 2018), Web of Science (1900 to December 2018), and CENTRAL (1996 to December 2018) databases. English-language literature involving human subjects was used, and studies were limited to case series, case-control, cohort, and randomized controlled trial designs.Review MethodsStudies were included if they assessed knowledge of HPV and HPV-associated OPSCC. The primary outcome measure was the knowledge of HPV-associated OPSCC among the general population and with health care providers. Meta-analysis of proportions was attempted using random-effects model. The PRISMA guidelines were used for accuracy of reporting.ResultsThirty-two studies were included with 17,288 participants. There was a high degree of heterogeneity preventing completion of a meta-analysis. Knowledge of HPV and HPV-associated OPSCC varied between the general population and health care providers. The proportion of the general population and health care providers with knowledge of HPV ranged from 16% to 75% and 21% to 84%, respectively. Knowledge of HPV-associated OPSCC was greater in health care providers and ranged from 22% to 100% compared with the general population, which ranged from 7% to 57%.ConclusionThere is a knowledge gap of HPV-associated OPSCC for both the general population and health care providers. Additional education may not only increase awareness but may also result in prevention and earlier detection.
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Affiliation(s)
- Sean M. Parsel
- Department of Otolaryngology–Head and Neck Surgery, Tulane University, New Orleans, Louisiana, USA
| | - Blair M. Barton
- Department of Otolaryngology–Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Sydney Beatty
- Department of Otolaryngology–Head and Neck Surgery, Tulane University, New Orleans, Louisiana, USA
| | - Paul L. Friedlander
- Department of Otolaryngology–Head and Neck Surgery, Tulane University, New Orleans, Louisiana, USA
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Laitman BM, Ronner L, Oliver K, Genden E. US Medical Trainees' Knowledge of Human Papilloma Virus and Head and Neck Cancer. Otolaryngol Head Neck Surg 2019; 162:56-59. [PMID: 31661360 DOI: 10.1177/0194599819886117] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Given the increasing incidence of human papilloma virus (HPV)-positive head and neck cancers (HNCs), discussion of this oncologic outcome should be incorporated into HPV vaccine counseling practices. Yet, preliminary evidence shows that knowledge of the association between HPV and HNC is lacking among most medical trainees. To better characterize this deficit, we nationally assessed knowledge of HPV's association with HNC among medical students and residents across 4 specialties (pediatrics, obstetrics and gynecology, family medicine, and otolaryngology). A total of 3141 responses from 46 states were obtained (n = 402 pediatric residents, n = 346 obstetrics/gynecology residents, n = 260 family medicine residents, n = 87 otolaryngology residents, and n = 2045 medical students). Only 40.3% of surveyed medical students and 56.1% of surveyed obstetrics/gynecology, pediatrics, and family medicine residents identified associations between persistent HPV infection and HNC. When counseling on the vaccine, nonotolaryngology residents more often discussed cervical cancer (99.8%) as compared with HNC (39.7%), commonly because of less HNC knowledge (61.5%). These results suggest that it is imperative to develop educational interventions targeted at medical students and resident trainees on the front line of HPV vaccine counseling and administration.
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Affiliation(s)
- Benjamin M Laitman
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Lukas Ronner
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Kristin Oliver
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Eric Genden
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Berger MH, Haidar YM, Bitner B, Trent M, Tjoa T. Practice patterns and knowledge among California pediatricians regarding human papillomavirus and its relation to head and neck cancer. Am J Otolaryngol 2019; 40:525-529. [PMID: 31064672 DOI: 10.1016/j.amjoto.2019.04.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 04/16/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To identify practice patterns regarding human papillomavirus (HPV) vaccination efforts and vaccination rates in context of head and neck cancer prevention, identify barriers to vaccination, and identify gaps in knowledge regarding the link between HPV and head and neck cancer in the pediatrician population. STUDY DESIGN/METHODS A 27-question cross-sectional survey was distributed to members of the four California chapters of the American Academy of Pediatrics. RESULTS Of the completed responses, 89.4% identified as "always" recommending the HPV vaccine to patients, but only 19.5% of pediatricians estimated that >75% of their eligible patients had completed the HPV vaccination series. 71.5% of respondents felt that further education about HPV's link to head and neck cancer them more comfortable discussing vaccination. Physicians who were in practice longer were less likely to respond that additional education about HPV and its link to head and neck cancer would make them more comfortable discussing vaccination with patients (p = 0.043). Physicians who were in practice longer were more likely to correctly respond that HPV type 16 is the most common strain linked to head and neck cancer (p = 0.021). CONCLUSION There is need to improve both the knowledge base and comfort level of pediatricians in counseling their patients during vaccine recommendations. Otolaryngologists have a critical role in providing education to physicians, trainees, and the general public in the effort to combat the epidemic of HPV-associated head and neck cancer.
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Todd C, Brody-Camp S, Friedlander P. The Role of Otolaryngologists in Eradicating Human Papillomavirus-Reply. JAMA Otolaryngol Head Neck Surg 2018; 144:1186-1187. [PMID: 30286221 DOI: 10.1001/jamaoto.2018.2450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Cameron Todd
- Department of Otolaryngology-Head and Neck Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Sabrina Brody-Camp
- Department of Otolaryngology-Head and Neck Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Paul Friedlander
- Department of Otolaryngology-Head and Neck Surgery, Tulane University School of Medicine, New Orleans, Louisiana
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Laitman BM, Ronner L, Genden E. The Role of Otolaryngologists in Eradicating Human Papillomavirus. JAMA Otolaryngol Head Neck Surg 2018; 144:1186. [PMID: 30286240 DOI: 10.1001/jamaoto.2018.2444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Benjamin M Laitman
- Department of Otolaryngology, The Mount Sinai Hospital, New York, New York
| | - Lukas Ronner
- The Icahn School of Medicine at Mount Sinai, New York, New York
| | - Eric Genden
- Department of Otolaryngology, The Mount Sinai Hospital, New York, New York
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