title: HPV knowledge gaps and information seeking by oral cancer patients.
abstract: The incidence of human papillomavirus (HPV) positive oral squamous cell carcinoma (OSCC) continues to increase over time, challenging healthcare providers to address their patients' HPV-related concerns.
  
  
  
  This prospective study assessed health literacy, HPV knowledge, utilization and trust in information sources among patients with incident HPV-positive or HPV-negative OSCC diagnosed at the Ohio State University from 2011 to 2015. Health literacy was assessed with a standardized scale. Additional questions evaluated HPV knowledge (including transmission, prevalence, health consequences and treatment), the frequency and type of information sources sought, and trust in those sources.
  
  
  
  Surveys were collected from 372 OSCC cases (HPV-positive, n=188; HPV-negative, n=184). Despite high mean health literacy scores, only 45.2% of HPV-related knowledge questions were answered correctly. HPV was known to be a sexually transmitted infection and a cause of cervical and anal cancer by 66.0%, 56.5% and 15.2%, respectively. In all domains, cases with HPV-positive OSCC were significantly more informed than HPV-negative cases (for all, p<0.01). Only 52.7% and 56.2% of patients with HPV-positive OSCC felt they knew enough to be comfortable discussing HPV with their doctor or sexual partner, respectively. The most frequently used information source was the internet (80.9%), which ranked 8th in trust of 15 possible sources. Although most (95.5%) patients trusted information from their doctors, only 37.9% used doctors as an information source.
  
  
  
  Doctors are a highly trusted, but infrequent utilized, information source and should facilitate patient access to high-quality HPV information sources.
authors.affiliation: MSTP Program, The Ohio State University College of Medicine, Columbus, OH, United States.
authors.forename: R C
authors.initials: RC
authors.lastname: Inglehart
authors.affiliation: Department of Medical Oncology, Catalan Institute of Oncology (ICO), IDIBELL. L'Hospitalet de Llobregar, Barcelona, Spain; Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), IDIBELL. L'Hospitalet de Llobregat, Barcelona, Spain; University of Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Taberna
authors.affiliation: Department of Medicine, The Ohio State University, Columbus, OH, United States.
authors.forename: R K L
authors.initials: RK
authors.lastname: Pickard
authors.affiliation: Department of Medicine, The Ohio State University, Columbus, OH, United States.
authors.forename: M
authors.initials: M
authors.lastname: Hoff
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Johns Hopkins School of Medicine, Johns Hopkins Outpatient Center, Baltimore, MD, United States.
authors.forename: C
authors.initials: C
authors.lastname: Fakhry
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, The Ohio State University, Columbus, OH, United States.
authors.forename: E
authors.initials: E
authors.lastname: Ozer
authors.affiliation: Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, United States; Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, United States.
authors.forename: M
authors.initials: M
authors.lastname: Katz
authors.affiliation: Department of Medicine, The Ohio State University, Columbus, OH, United States. Electronic address: maura.gillison@osumc.edu.
authors.forename: M L
authors.initials: ML
authors.lastname: Gillison
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D052685:Alphapapillomavirus / Q000302:isolation & purification*; D002294:Carcinoma, Squamous Cell / Q000821:virology*; D005260:Female; D006801:Humans; D019359:Knowledge; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000821:virology*; D010817:Physician-Patient Relations; D055815:Young Adult
keywords: Health literacy; Human papillomavirus (HPV); Information seeking behavior; Knowledge; Mouth neoplasms