Dagli Chaitali S, Tobo Betelihem B, Nair Mrudula, Al-Antary Nada, Tam Samantha H, Osazuwa-Peters Nosayaba, Adjei Boakye Eric
Epidemiology, Birmingham School of Medicine, University of Alabama, Birmingham, USA.
Community and Family Medicine, Howard University College of Medicine, Washington, USA.
Cureus. 2024 Dec 22;16(12):e76177. doi: 10.7759/cureus.76177. eCollection 2024 Dec.
Introduction Studies assessing human papillomavirus (HPV) vaccination uptake in survivors of childhood, adolescent, and young adult (CAYA) cancers are sparse. We examined HPV vaccine uptake between survivors of CAYA cancer aged 18-35 and 18-35-year-old respondents without a cancer diagnosis in the United States. Methods We used the 2017-2018 National Health Interview Survey, a national, annual cross-sectional national dataset that monitors health-related information on the non-institutionalized civilian population in the United States. Outcome variables included: 1) self-reported initiation of the HPV vaccine, defined as having received ≥1 dose, and 2) self-reported completion of the HPV vaccine, defined as having received ≥3 doses. The exposure variable was cancer survivorship, dichotomized as CAYA cancer survivors (those diagnosed with cancer during childhood, adolescence, or young adulthood) versus non-cancer survivors (no cancer diagnosis). -Weighted multivariable logistic regression models estimated the association between cancer survivorship and HPV vaccine initiation and completion, adjusting for socioeconomic covariates and factors related to healthcare access. Results A total of 2677 respondents were included in the study, of which 177 (5.3%) were CAYA cancer survivors. Overall, 28.0% of the study cohort initiated and 17.1% completed the HPV vaccine series. When stratified by cancer survivorship, initiation of the HPV vaccine (27.1%) and completion of the vaccine series (20.3%) among CAYA cancer survivors were comparable to respondents without cancer diagnosis (initiation: 28.1%, completion: 16.9%). After we controlled for covariates, cancer survivorship had neither a significant association with initiation of HPV vaccine (aOR=1.12; 95% CI, 0.71-1.79; P=0.6242) nor completion of HPV vaccine (aOR=1.37; 95% CI, 0.84-2.22; P=0.2055). Conclusions There was low HPV vaccination initiation and completion among both cohorts. CAYA may benefit the most from HPV vaccination, given that they are at a higher risk of developing secondary HPV-related cancer.
评估儿童、青少年和青年期（CAYA）癌症幸存者人乳头瘤病毒（HPV）疫苗接种情况的研究较为稀少。我们调查了美国18至35岁的CAYA癌症幸存者与未患癌症的18至35岁受访者之间HPV疫苗的接种情况。
我们使用了2017 - 2018年美国国家健康访谈调查，这是一个全国性的年度横断面数据集，用于监测美国非机构化平民人口的健康相关信息。结果变量包括：1）自我报告的HPV疫苗起始接种，定义为已接种≥1剂；2）自我报告的HPV疫苗全程接种，定义为已接种≥3剂。暴露变量为癌症幸存者状态，分为CAYA癌症幸存者（在儿童期、青少年期或青年期被诊断为癌症者）与非癌症幸存者（未患癌症）。加权多变量逻辑回归模型估计了癌症幸存者状态与HPV疫苗起始接种和全程接种之间的关联，并对社会经济协变量和与医疗保健可及性相关的因素进行了调整。
共有2677名受访者纳入研究，其中177名（5.3%）为CAYA癌症幸存者。总体而言，研究队列中28.0%的人起始接种了HPV疫苗，17.1%的人完成了HPV疫苗全程接种。按癌症幸存者状态分层时，CAYA癌症幸存者中HPV疫苗的起始接种率（27.1%）和全程接种率（20.3%）与未患癌症的受访者相当（起始接种率：28.1%，全程接种率：16.9%）。在我们对协变量进行控制后，癌症幸存者状态与HPV疫苗起始接种（调整后比值比[aOR]=1.12；95%置信区间[CI]，0.71 - 1.79；P = 0.6242）和HPV疫苗全程接种（aOR = 1.37；95% CI，0.84 - 2.22；P = 0.2055）均无显著关联。
两个队列中的HPV疫苗起始接种率和全程接种率都较低。鉴于CAYA患继发性HPV相关癌症的风险较高，他们可能从HPV疫苗接种中获益最大。
