Advancing Education, Research, and Quality of Care for the Head and Neck oncology patient.
Background: Despite rising rates of Human Papillomavirus (HPV) associated oropharyngeal squamous cell carcinoma (OPSCC), the administration of the HPV vaccine in the United States has been inadequate. Primary care and other providers who administer HPV vaccinations are reported to have low rates of counseling on OPSCC with low knowledge of HPV manifestations in the head & neck. Otolaryngologists are uniquely positioned to provide multidisciplinary education on HPV diseases given their expertise in OPSCC.
Methods: A cross-sectional study was conducted to assess the baseline knowledge of HPV and its role in head and neck cancers among trainees and providers in Southern California. Participants included family medicine, internal medicine, OB/GYN, ENT, and dental trainees and providers. Participants completed a 20-question survey designed to evaluate their understanding of key topics related to HPV as well as attitudes regarding vaccination. The survey included questions that specifically addressed general HPV knowledge, information about the vaccine, association between HPV and OPSCC, and general attitudes towards HPV counseling and recommendations for patients.
Results: 165 participants responded to the survey. More than half of the participants were resident physicians, with only 23% attendings. Of those that participated 32% were not fully or partially vaccinated with the HPV vaccine. In ranking the most common sites affected by HPV-related malignancy in the U.S., 69.30% of providers incorrectly marked cervical cancer as #1, while only 19.30% correctly identified head and neck cancer as the most common. Regarding the HPV vaccine, 62.80% correctly recognized that the vaccine was FDA-approved to protect against head and neck cancer. Knowledge of vaccine coverage varied by specialty: 86% of dental providers and 84% of ENT providers correctly identified that the current HPV vaccine protects against 9 strains, compared to 91% of internal medicine, family medicine, and OB/GYN providers combined. When assessing counseling practices, 44% of providers currently counsel patients on HPV's role in the development of OPSCC. Regarding comfort levels in counseling patients on HPV, including head and neck manifestations, 45% of providers agreed or strongly agreed that they felt comfortable doing so.
Conclusion: These survey results revealed varying levels of knowledge and attitudes among healthcare providers regarding HPV and its related malignancies, particularly in relation to head and neck cancers. While participants demonstrated a strong understanding of HPV's role in OPSCC, misconceptions persisted regarding its frequency compared to other HPV-related cancers. These findings highlight the need for targeted educational interventions across medical specialties to improve understanding of HPV-related head and neck cancers, enhance provider confidence in patient counseling, and ultimately strengthen prevention and early detection efforts. Future initiatives should focus on addressing these knowledge gaps and improving provider comfort with HPV-related cancer discussions to ensure comprehensive patient care and education.