Racial and Economic Gap in Awareness of Lifesaving HPV Vaccine
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The study is being presented at the 2013 annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago.
HPV is a primarily sexually transmitted virus most widely known for causing cervical cancer, but it can also cause anal cancer, certain oral cancers, and cancers of the sexual organs of both women and men.
Two vaccines currently exist to prevent HPV infection, and national guidelines exist for their use in men and women up to the age of 26.
Until now, however, data were lacking about awareness of the vaccines. The Yale researchers gathered data from the National Health Interview Survey, which is conducted annually by the Centers for Disease Control (CDC). The 2010 survey of more than 20,000 people between the ages of 18 and 64 provided a great deal of data about HPV awareness.
The researchers found many gaps in awareness about the lifesaving potential of HPV vaccines.
Among the findings:
• 68.1% of women had heard about the vaccine, but just 34% of men;
• 57.8% of whites surveyed were aware of the vaccine, but only 46.1% of blacks, 36% of Asians, and 32.5% of Hispanics;
• 57.8% of those with private insurance were aware, but only 36.2% of those covered by Medicare, and 37.6% of those with no health insurance;
• 72.2% of those with doctorate degrees and 61% of those with bachelors degrees were aware, but only 28.2% of those who did not complete high school;
• 62.7% of families with an income above $100,000 were aware of the vaccines, but only 41.9% of those with an income under $35,000
Even among girls aged 18-26 for whom the CDC recommends vaccination, race, ethnicity, education, and insurance remained independent predictors of awareness. All else being equal:
• Hispanics were less than a third as aware of the vaccines as non-Hispanic whites;
• Those with private insurance were nearly twice as aware of the vaccine as those who were uninsured;
• Those with an associate’s or bachelor’s degree were 2.5 times more aware of the vaccine than those with less than a high school education.
Yale investigators hope that these data will inform public health strategies to improve awareness of HPV vaccination that could lower cervical cancer rates.
“In an era when such tremendous advances have been made, and we can prevent cancer with vaccines, it is unfathomable that such differences exist in the simple awareness of these vaccines based on racial, ethnic, and socioeconomic disparities. We have got to do better,” said senior author Anees Chagpar, M.D., associate professor of surgery at Yale School of Medicine and the assistant director for diversity and health equity at Yale Cancer Center.
"Awareness is the first step to prevention,” said first author and lead presenter Abigail Shrader. “With such a disastrous infection as HPV, the lack of knowledge among different subsets of the population is astonishing. The effective vaccines that our heroic doctors create are worth nothing if someone infected is unaware of the existence or effectiveness of these drugs. Increasing awareness is the first and simplest step in the right direction, and by analyzing the data from past surveys, we can now target our efforts to those who lack the most information."