title: Prevalence and predictors of human papillomavirus (HPV) vaccination among young women surviving childhood cancer.
abstract: Human papillomavirus (HPV) is a sexually transmitted infection and the cause of cervical and other cancers. Vaccination is available to protect against genital HPV and is recommended for individuals aged 9-26 years. This study aimed to estimate the prevalence of HPV vaccination among childhood cancer survivors and to identify factors associated with vaccine outcomes.
  
  
  
  Young adult females with (n = 114; M age = 21.18 years, SD = 2.48) and without (n = 98; M age = 20.65 years, SD = 2.29) a childhood cancer history completed surveys querying HPV vaccination initiation/completion, as well as sociodemographic, medical, and health belief factors. Multivariable logistic regression was used to calculate odds ratios (ORs) and 95 % confidence intervals (CIs) for vaccine outcomes.
  
  
  
  Among survivors, 38.6 % (44/114) and 26.3 % (30/114) initiated or completed vaccination compared to 44.9 % (44/98) and 28.6 % (28/98) among controls, respectively. In the combined survivor/control group, physician recommendation (OR = 11.24, 95 % CI 3.15-40.14) and familial HPV communication (OR = 7.28, 95 % CI 1.89-28.05) associated with vaccine initiation. Perceptions of vaccine benefit associated with vaccine completion (OR = 10.55, 95 % CI 1.59-69.92), whereas perceptions of HPV-related severity associated with non-completion (OR = 0.14, 95 % CI 0.03-0.71).
  
  
  
  Despite their increased risk for HPV-related complication, a minority of childhood cancer survivors have initiated or completed HPV vaccination. Modifiable factors associated with vaccine outcomes were identified.
  
  
  
  HPV vaccination is a useful tool for cancer prevention in survivorship, and interventions to increase vaccine uptake are warranted.
authors.affiliation: Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105-2794, USA. james.klosky@stjude.org.
authors.forename: James L
authors.initials: JL
authors.lastname: Klosky
authors.affiliation: Department of Psychology, Winona State University, 175 W Mark St, Winona, MN, 55987, USA.
authors.forename: Brianne
authors.initials: B
authors.lastname: Favaro
authors.affiliation: Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105-2794, USA.|Department of Psychology, University of Mississippi, 205 Peabody, University, MS, 38677, USA.
authors.forename: Kelly R
authors.initials: KR
authors.lastname: Peck
authors.affiliation: Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105-2794, USA.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Simmons
authors.affiliation: Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105-2794, USA.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Russell
authors.affiliation: Department of Oncology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105-2794, USA.|Department of Epidemiology & Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105-2794, USA.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Green
authors.affiliation: Department of Oncology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105-2794, USA.|Department of Epidemiology & Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105-2794, USA.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Hudson
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D016022:Case-Control Studies; D002648:Child; D003142:Communication; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009369:Neoplasms / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation*; D030361:Papillomavirus Infections / Q000150:complications / Q000517:prevention & control; D053918:Papillomavirus Vaccines / Q000627:therapeutic use*; D015995:Prevalence; D017741:Survivors / Q000706:statistics & numerical data*; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control / Q000821:virology; D014594:Uterine Neoplasms / Q000517:prevention & control / Q000821:virology; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: Human papillomavirus; Oncology; Vaccination; Young adults