Department of Oral Health Policy & Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA.
Department of Cariology, Restorative Dentistry and Dental Public Health, Indiana University School of Dentistry, IN, USA.
J Public Health Dent. 2020 Sep;80(4):327-332. doi: 10.1111/jphd.12408. Epub 2020 Oct 10.
Human papillomavirus (HPV) infection is associated with oropharyngeal cancers. The Centers for Disease Control and Prevention (CDC) estimate that >15,000 new cases of HPV-associated oropharyngeal cancers are diagnosed in the United States annually. We evaluated an association between HPV vaccination and dental visits in the previous year.
Data were analyzed from the 2012, 2014, and 2016 Massachusetts Behavioral Risk Factor Surveillance System (MA-BRFSS) datasets. We created four categories of exposures to healthcare services in the past 12 months: a) both medical and dental visits, b) medical visit only, c) dental visit only, d) neither. Outcomes were HPV vaccination ever or influenza vaccination within the past 12 months. Logistic regression, controlled for race and education, was used to measure the association between medical/dental visits and vaccination status. Separate models were generated by sex.
Crude and adjusted odds ratio of influenza and HPV vaccination were highest among males and females with both medical and dental visits. Women with both medical and dental provider visits had 3.7 times higher odds of being vaccinated for influenza and 1.7 times higher odds of being vaccinated for HPV. There were no differences in crude or adjusted odds among both males and females if the type of healthcare visits were only medical or only dental.
No difference in association between vaccination and medical or dental healthcare exposures suggests that oral health professionals might partner in promotion of positive health behaviors, including HPV vaccination. The type of provider did not affect the outcome as per this study.
人乳头瘤病毒(HPV)感染与口咽癌有关。美国疾病控制与预防中心(CDC)估计,每年在美国诊断出超过 15000 例 HPV 相关的口咽癌病例。我们评估了 HPV 疫苗接种与前一年牙科就诊之间的关联。
对 2012 年、2014 年和 2016 年马萨诸塞州行为风险因素监测系统(MA-BRFSS)数据集进行了分析。我们创建了过去 12 个月内医疗保健服务接触的四个类别:a)医疗和牙科就诊,b)仅医疗就诊,c)仅牙科就诊,d)都没有。结果是过去 12 个月内是否接种过 HPV 疫苗或流感疫苗。采用 logistic 回归,控制种族和教育,衡量医疗/牙科就诊与接种状况之间的关联。分别按性别生成模型。
在接受过医疗和牙科治疗的男性和女性中,流感和 HPV 疫苗接种的未调整和调整后优势比最高。同时接受过医疗和牙科服务的女性接种流感疫苗的几率是仅接受过医疗服务的女性的 3.7 倍,接种 HPV 疫苗的几率是仅接受过医疗服务的女性的 1.7 倍。如果医疗保健就诊仅为医疗或仅为牙科,则男性和女性的粗和调整后比值均无差异。
接种和医疗或牙科保健接触之间的关联没有差异表明,口腔健康专业人员可能会合作促进包括 HPV 疫苗接种在内的积极健康行为。根据本研究,提供服务的类型并未影响结果。