title: Providers' beliefs about the effectiveness of the HPV vaccine in preventing cancer and their recommended age groups for vaccination: Findings from a provider survey, 2012.
abstract: BACKGROUND
  The human papillomavirus (HPV) vaccine was recommended in 2007 by the Advisory Committee on Immunization Practices (ACIP) to preadolescent and adolescent girls. Vaccination initiation was recommended at age 11-12 years with the option to start at age 9. Catchup vaccination was recommended to females aged 13-26 previously not vaccinated. However, vaccination coverage remains low. Studies show that the HPV vaccine can prevent cervical, vulvar, vaginal, anal and some oropharyngeal cancers and that provider recommendation of vaccines can improve low vaccination rates.
  
  
  METHODS
  Using data from 2012 DocStyles, an annual, web-based survey of U.S. healthcare professionals including physicians and nurse practitioners (n=1753), we examined providers' knowledge about the effectiveness of the HPV vaccine in preventing cancer and their vaccine recommendation to all age-eligible females (9-26 years). Descriptive statistics and Chi-square tests were used to assess differences across specialties.
  
  
  RESULTS
  Knowledge about HPV vaccine effectiveness in preventing cervical cancer was highly prevalent (96.9%), but less so for anal, vaginal, vulvar and oropharyngeal cancers. Only 14.5% of providers recommended the vaccine to all age-eligible females and 20.2% recommended it to females aged 11-26 years. Knowledge assessment of cancers associated with HPV and vaccination recommendations varied significantly among providers (p<0.01). Providers more frequently recommended the vaccine to girls older than 11-12 years.
  
  
  CONCLUSIONS
  Improving providers' knowledge about HPV-associated cancers and the age for vaccination initiation, communicating messages focusing on the vaccine safety and benefits in cancer prevention and on the importance of its delivery prior to sexual onset, may improve HPV vaccine coverage.
authors.affiliation: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS F76, Atlanta, GA 30341, USA. Electronic address: zab3@cdc.gov.
authors.forename: Z
authors.initials: Z
authors.lastname: Berkowitz
authors.affiliation: Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, USA. Electronic address: mmalone829@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Malone
authors.affiliation: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS F76, Atlanta, GA 30341, USA.
authors.forename: J
authors.initials: J
authors.lastname: Rodriguez
authors.affiliation: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS F76, Atlanta, GA 30341, USA.
authors.forename: M
authors.initials: M
authors.lastname: Saraiya
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines; D010818:Practice Patterns, Physicians'; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D014611:Vaccination / Q000706:statistics & numerical data
chemical_list: D053918:Papillomavirus Vaccines
keywords: Cervical, anal, vaginal, vulvar and cancers; HPV vaccine knowledge; HPV vaccine recommendations; Vaccine initiation