Most Americans unaware that HPV causes multiple types of cancer

The human papillomavirus (HPV) can cause six types of cancer. 

It’s responsible for almost all cervical cancer cases. HPV now causes the majority of oropharyngeal (throat) cancers. It can also cause anal, vaginal, vulvar and penile cancers. 

Yet new analysis from researchers at MUSC Hollings Cancer Center shows that most people are unaware of the connection between HPV and all of these cancers. 

That awareness is critical, said lead researcher Kalyani Sonawane, Ph.D., because it informs people’s decisions about whether to have their children vaccinated against HPV. 

When people make decisions about whether they want to get vaccinated or whether they want to get their child vaccinated, they are doing a risk-versus-benefit assessment. So it’s important for them to understand what can happen when someone gets HPV infection.” 

Kalyani Sonawane, Ph.D., lead researcher

Sonawane and colleagues used data from the Health Information National Trends Survey (HINTS), a survey conducted by the National Cancer Institute. They published their findings this week in JAMA Oncology. 

They found that about a third of people, nationally, aren’t aware of either HPV or the HPV vaccine. The lack of awareness tended to be clustered in states in the Midwest and South. 

For example, more than 40% of people in 13 states – including South Carolina – are unaware that there is a vaccine against HPV. 

The vaccine is the first and best defense against HPV-caused cancers. Research from Europe and the U.S., including research at Hollings, is showing a significant reduction in cervical cancer cases in young women.

The young women of today were children when the vaccine was first introduced and, therefore, the first group to be vaccinated. As they get older and enter the decades of life when cancer is most common, scientists expect to see even greater reductions in HPV cancers.

Cervical cancer is the bellwether because that type of cancer most commonly shows up when people are in their 30s or 40s. Oropharyngeal cancers, on the other hand, most often are diagnosed when people are in their 50s or 60s, so it will be some time before the first group that was vaccinated reaches this age. 

Sonawane noted that the biggest knowledge gap is in relation to oropharyngeal cancer. Across the nation, 70% of those who have heard about HPV didn’t know it causes oropharyngeal cancer. 

“HPV is linked with six different types of cancers, but cervical cancer seems to be the one that people are most aware of,” she said. That probably goes back to the original introduction of the vaccine in 2006. “It was first approved for girls and heavily marketed toward girls. Even the packaging was pink.” 

The vaccine has since been approved for boys, but rates of vaccination for boys remain lower than for girls.

“People think, ‘Oh, cervical cancer. I don’t need to get my boys vaccinated,'” Sonawane said. “Anecdotally, when we speak with pediatricians, they always tell us that when they ask a parent of a male child about HPV vaccination, the parents always say, ‘Oh, but he’s a boy.'” 

The pandemic interrupted many measures of preventive care, including HPV vaccination and screening for cervical, breast and colon cancers. A recent report from the American Cancer Society showed that screening for breast and colon cancers has since rebounded. Cervical cancer screening and HPV vaccination, however, have not.

“It just worries me how this is going to translate five years, 10 years down the line,” Sonawane said. “We are losing that critical opportunity of being able to vaccinate kids, being able to screen women at the right time and being able to catch these cancers early. Both primary and secondary prevention are suffering.”