Stout Capt Eleanor, Poiani L T Hannah, Mcglynn Andrea, Enujioke C D R Sharon C
Department of Pediatrics, Naval Medical Center Portsmouth, Portsmouth, VA 23708, United States.
Clinical Investigation Department, Naval Medical Center Portsmouth, Portsmouth, VA 23708, United States.
Mil Med. 2025 Aug 13. doi: 10.1093/milmed/usaf404.
Human Papillomavirus (HPV) is the most common sexually transmitted infection globally, with millions of new cases reported each year. Human Papillomavirus is associated with cervical, anal, vulva, penile, and esophageal cancer. Cervical cancer is a significant threat to women because of its insidious nature; thus, cervical cancer screening remains crucial for early detection and intervention.The most effective method to protect against HPV-related cancers is through vaccination with the HPV vaccine. The Human Papillomavirus vaccine targets the most common high-risk HPV strains. Vaccination is recommended for both males and females between the ages of 9-26. Vaccination reduces the risk of infection and contributes to the prevention of HPV-related cancers, representing a crucial public health initiative in battling HPV. The active duty military population has low HPV vaccination rates. A visit for a pap smear, the screening for cervical cancer, is an optimal time for providers to discuss the HPV vaccine. This research aims to understand the low HPV vaccination rate among active duty women and whether providers are maximizing opportunities to promote vaccination against HPV.
A retrospective medical chart review was performed at a single military treatment facility (MTF) of active duty women between the ages of 21-26, who had an abnormal pap smear, and no record of receiving the HPV vaccine. A chart review was conducted for the visit in which the pap smear was performed, as well as the follow-up visit/phone call to discuss the abnormal pap smear results.
Seven hundred fifty-one charts were reviewed from 2005 to 2021 of unvaccinated active duty women with an abnormal pap smear. 46.3% of the abnormal pap smears were low-grade squamous intraepithelial cells (LGSIL), whereas 3.3% were high-grade squamous intraepithelial cells (HGSIL). Of the charts reviewed, 8.3% of the patients noted they had been vaccinated; 13.8% of the charts had documented recommendations for the HPV vaccination; and 77.9% had no documentation regarding the patient's HPV status or recommendation for vaccination.
Although the HPV vaccine is effective in reducing the risk of HPV-related cancers, our results indicate the need for increased awareness and education practices amongst providers in promoting the HPV vaccine.A limitation of the study was that it was conducted at a single MTF. The study was not able to distinguish between provider types or clinic settings. Possible proposals for future studies include evaluating why the HPV vaccination rates amongst the active duty population are low. Pap smears are a prime opportunity for providers to engage in discussion of the importance of the HPV vaccine and encourage adherence.
人乳头瘤病毒（HPV）是全球最常见的性传播感染，每年报告数百万新病例。人乳头瘤病毒与宫颈癌、肛门癌、外阴癌、阴茎癌和食管癌有关。宫颈癌因其隐匿性对女性构成重大威胁；因此，宫颈癌筛查对于早期发现和干预仍然至关重要。预防HPV相关癌症的最有效方法是接种HPV疫苗。HPV疫苗针对最常见的高危HPV毒株。建议9至26岁的男性和女性接种疫苗。接种疫苗可降低感染风险，有助于预防HPV相关癌症，是抗击HPV的一项关键公共卫生举措。现役军人人群的HPV疫苗接种率较低。进行巴氏涂片检查（宫颈癌筛查）时，是医护人员讨论HPV疫苗的最佳时机。本研究旨在了解现役女性中HPV疫苗接种率低的情况，以及医护人员是否充分利用机会推广HPV疫苗接种。
在一家军事治疗机构（MTF）对年龄在21至26岁之间、巴氏涂片异常且无HPV疫苗接种记录的现役女性进行回顾性病历审查。对进行巴氏涂片检查的就诊记录以及讨论巴氏涂片异常结果的随访就诊/电话记录进行审查。
对2005年至2021年期间751份未接种疫苗、巴氏涂片异常的现役女性病历进行了审查。46.3%的巴氏涂片异常为低级别鳞状上皮内病变（LGSIL），而3.3%为高级别鳞状上皮内病变（HGSIL）。在审查的病历中，8.3%的患者表示已接种疫苗；13.8%的病历有HPV疫苗接种的记录建议；77.9%没有关于患者HPV状况或疫苗接种建议的记录。
尽管HPV疫苗在降低HPV相关癌症风险方面有效，但我们的结果表明，医护人员在推广HPV疫苗方面需要提高认识并加强教育实践。该研究的一个局限性是在单一军事治疗机构进行。该研究无法区分医护人员类型或诊所环境。未来研究的可能建议包括评估现役人群中HPV疫苗接种率低的原因。巴氏涂片检查是医护人员讨论HPV疫苗重要性并鼓励接种的绝佳机会。
