Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta, 1E4.34, Walter Mackenzie Center 8440 - 112 Street, Edmonton, AB, T6G 2B7, Canada.
Department of Pediatrics, The Stollery Children's Hospital, Edmonton, AB, Canada.
J Otolaryngol Head Neck Surg. 2017 Oct 26;46(1):61. doi: 10.1186/s40463-017-0237-8.
Human papillomavirus (HPV) has recently been implicated as a causative agent in a rapidly growing number of oropharyngeal cancers. Emerging literature supports the hypothesis that HPV vaccination may protect against HPV-related head and neck cancer (HNC) in addition to HPV-related cervical and anogenital disease. While the association between HPV infection and cervical cancer is widely understood, its relation to HNC is less well known. The purpose of this study was to better understand HPV counseling practices for infection and vaccination in relation to HNC of primary care physicians (PCPs), Obstetricians/Gynecologists (OBGYNs), and Otolaryngology - Head and Neck Surgeons (OHNSs) in Canada.
A Canada-wide electronic questionnaire regarding counseling practices on HPV infection, transmission, and vaccination was designed and distributed to PCPs, OBGYNs, and OHNSs across Canada through electronic and paper-based methods. Basic Descriptive statistics were used to analyze responses.
In total, 337 physicians responded (239 family physicians, 51 OHNSs, 30 OBGYNs, and 17 pediatricians). Three out of four PCPs reported routine counseling of their patients regarding HPV infection, transmission, and vaccination. Among this group, 68% reported "never" or "rarely" counseling patients that HPV can cause HNC. The most commonly reported reason that PCPs cited for not counseling was a lack of knowledge. The majority of OHNSs (81%) and OBGYNs (97%) counseled patients regarding HPV infection, transmission, and vaccination. However, very few OHNSs (10%) regularly counseled patients with HPV-related HNC about HPV-related anogenital cancer. Similarly, very few OBGYNs (18%) regularly counseled patients with HPV related cervical/anogenital cancer about HPV related HNC.
The rate of counseling on HPV infection, transmission, and vaccination in relation to HNC among PCPs is low. The most common reason is a lack of knowledge. Specialists rarely counsel patients with confirmed HPV-related cancer about other HPV-related malignancies. More research is needed on the relationship between different HPV-related cancers in order to better inform counseling practices.
人乳头瘤病毒（HPV）最近被认为是越来越多的口咽癌的致病因素。新出现的文献支持这样一种假设，即 HPV 疫苗接种除了可以预防 HPV 相关的宫颈癌和肛门生殖器疾病外，还可能预防 HPV 相关的头颈部癌症（HNC）。虽然 HPV 感染与宫颈癌之间的关系广为人知，但它与 HNC 的关系却知之甚少。本研究旨在更好地了解加拿大初级保健医生（PCP）、妇产科医生（OBGYN）和耳鼻喉科-头颈外科医生（OHNS）在与 HNC 相关的 HPV 感染和疫苗接种方面的咨询实践。
设计了一份关于 HPV 感染、传播和疫苗接种咨询实践的加拿大范围的电子问卷，并通过电子和纸质方法分发给加拿大各地的 PCP、OBGYN 和 OHNS。使用基本描述性统计来分析应答。
共有 337 名医生（239 名家庭医生、51 名 OHNS、30 名 OBGYN 和 17 名儿科医生）做出了回应。四分之三的 PCP 报告说他们经常对患者进行 HPV 感染、传播和疫苗接种的咨询。在这一组中，68%的人报告说“从未”或“很少”告知患者 HPV 会导致 HNC。PCP 未进行咨询的最常见原因是缺乏知识。大多数 OHNS（81%）和 OBGYN（97%）都对患者进行了 HPV 感染、传播和疫苗接种的咨询。然而，很少有 OHNS（10%）经常对 HPV 相关 HNC 患者进行 HPV 相关肛门生殖器癌症的咨询。同样，很少有 OBGYN（18%）经常对 HPV 相关宫颈/肛门生殖器癌症患者进行 HPV 相关 HNC 的咨询。
PCP 中与 HNC 相关的 HPV 感染、传播和疫苗接种咨询率较低。最常见的原因是缺乏知识。专家很少向确诊的 HPV 相关癌症患者告知其他 HPV 相关恶性肿瘤的信息。为了更好地为咨询实践提供信息，需要对不同 HPV 相关癌症之间的关系进行更多的研究。
