Human Papilloma Virus Vaccination and Oropharyngeal Cancer: Knowledge, Perception and Attitude among Italian Pediatric Dentists
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Knowledge on HPV-Related OP-Cancer (Statements 1–18)
3.2. Knowledge on HPV Infection (Statements 19–33)
3.3. Knowledge on HPV Vaccine (Statements 34–48)
3.4. Perception
3.5. Attitude
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Knowledge on HPV-Related OP-Cancer | |||
---|---|---|---|
Statements | Correct N (%) | Incorrect N (%) | |
1. | HPV can lead to cervical cancer. True/False | 269 (99.3) | 2 (0.7) |
2. | HPV can lead to OP-cancer. True/False | 268 (98.9) | 3 (1.1) |
3. | HPV can lead to anal cancer. True/False | 158 (58.3) | 113 (41.7) |
4. | HPV can lead to testicular cancer. True/False | 204 (75.3) | 67 (24.7) |
5. | HPV can lead to vaginal cancer. True/False | 158 (58.3) | 113 (41.7) |
6. | HPV can lead to penile cancer. True/False | 137 (50.6) | 134 (49.4) |
7. | All HPV subtypes can cause OP-cancer. True/False | 197 (72.7) | 74 (27.3) |
8. | A growing number of patients diagnosed with OP-cancer lack risk factors as tobacco and alcohol use. True/False | 239 (88.2) | 32 (11.8) |
9. | The average age of patients diagnosed with OP-cancer is decreasing. True/False | 217 (80.1) | 54 (19.9) |
10. | OP-cancer is frequently preceded by clinically identifiable premalignant lesions. True/False | 237 (87.5) | 34 (12.5) |
11. | OP-cancer caused by HPV is frequently preceded by identifiable premalignant lesions. True/False | 60 (22.1) | 211 (77.9) |
12. | OP-cancer caused by HPV carries a less favorable prognosis. True/False | 155 (57.2) | 116 (42.8) |
13. | Girls have an increased risk of developing HPV-related OP-cancer. True/False | 135 (49.8) | 136 (50.2) |
14. | HPV-related malignant lesions in the oral cavity are often diagnosed in an advanced stage of progression. True/False | 220 (81.2) | 51 (18.8) |
15. | Papilloma and verruca vulgaris are HPV-related premalignant lesions. True/False | 66 (24.4) | 205 (75.6) |
16. | The tongue is the principal head and neck cancer site associated with HPV. True/False | 131 (48.3) | 140 (51.7) |
17. | Individuals with frequent oral sex encounters, a greater number of different sexual partners and earlier sexual experiences seem to be at a higher risk for OP-cancer development. True/False | 259 (95.6) | 12 (4.4) |
18. | HPV can produce the abnormal cervical cells found on Pap test. True/False. | 264 (97.4) | 7 (2.6) |
Knowledge on HPV Infection | |||
---|---|---|---|
Statements | Correct N (%) | Incorrect N (%) | |
19. | HPV infections can be transmitted by any skin-to-skin contact. True/False | 67 (24.7) | 204 (75.3) |
20. | HPV infection is a relatively uncommon sexually transmitted infection. True/False | 173 (63.8) | 98 (36.2) |
21. | Approximately 30% of sexually active individuals are infected by HPV during their lifetime. True/False | 46 (17.0) | 225 (83.0) |
22. | There are more than 100 types of HPV. True/False | 217 (80.1) | 54 (19.9) |
23. | HPV can lead to AIDS. True/False | 261 (96.3) | 10 (3.7) |
24. | Antibiotics are effective for HPV infection. True/False | 262 (96.7) | 9 (3.3) |
25. | Most patients with HPV experience symptoms of the infection. True/False | 235 (86.7) | 36 (13.3) |
26. | HPV infection occurs in both sexes. True/False | 253 (93.4) | 18 (6.6) |
27. | 10% of HPV infections can become persistent. True/False | 251 (92.6) | 20 (7.4) |
28. | HPV infection risk increases with the number of sex partner and starting to have sex at an early age. True/False | 258 (95.2) | 13 (4.8) |
29. | Majority of HPV infections can be cleared on their own within 1 to 2 years. True/False | 102 (37.6) | 169 (62.4) |
30. | Vertical transmission of HPV infection is not possible from mother to the embryo, fetus or baby during pregnancy or childbirth. True/False | 179 (66.1) | 92 (33.9) |
31. | Human papilloma virus may be transmitted among the family members by kissing and digital contact. True/False | 77 (28.4) | 194 (71.6) |
32. | Children cannot acquire the infection from close family members and caregivers with hand warts during cleaning of the anogenital area and diaper changing. True/False | 160 (59.0) | 111 (41.0) |
33. | Oral papilloma can develop as a result of oral sex or autoinoculation. True/False | 245 (90.4) | 26 (9.6) |
Knowledge on HPV Vaccine | |||
---|---|---|---|
Statements | Correct N (%) | Incorrect N (%) | |
34. | The HPV vaccine defends women against cervical cancer. True/False | 258 (95.2) | 13 (4.8) |
35. | Bivalent, quadrivalent, and nonavalent vaccines are available in our country. True/False | 202 (74.5) | 69 (25.5) |
36. | HPV vaccines are suggested ideally between 9 and 26 years of age. True/False | 258 (95.2) | 13 (4.8) |
37. | Women who have been vaccinated should not continue screening for HPV infection. True/False | 254 (93.7) | 17 (6.3) |
38. | HPV vaccines are more effective in women prior to exposure to the virus. True/False | 248 (91.5) | 23 (8.5) |
39. | It is important that male adolescents receive HPV vaccination. True/False | 210 (77.5) | 61 (22.5) |
40. | HPV vaccination is recommended in the first year of life. True/False | 257 (94.8) | 14 (5.2) |
41. | In the national immunization program, the HPV vaccine is only available for females. True/False | 147 (54.2) | 124 (45.8) |
42. | HPV vaccination is recommended before the beginning of sexual activity. True/False | 259 (95.6) | 12 (4.4) |
43. | HPV vaccination is recommended in sexually active people. True/False | 100 (36.9) | 171 (63.1) |
44. | The HPV vaccine is equally effective no matter what age it is given. True/False | 179 (66.1) | 92 (33.9) |
45. | HPV vaccine is able to prevent HPV infection and possibly prevent children from developing cancers associated with the infection. True/False | 241 (88.9) | 30 (11.1) |
46. | Sexually active patients should not be offered the HPV vaccine. True/False | 246 (90.8) | 25 (9.2) |
47. | Before vaccination, individuals should be screened for HPV infection. True/False | 107 (39.5) | 164 (60.5) |
48. | HPV vaccination is active only against subtypes 16 and 18. True/False | 163 (60.1) | 108 (39.9) |
Perception | ||||||
---|---|---|---|---|---|---|
Statements | Strongly Disagree N (%) | Disagree N (%) | Neither Agree Nor Disagree N (%) | Agree N (%) | Strongly Agree N (%) | |
1. | As a pediatric dentist, I have a significant role in preventing HPV infection. | 1 (0.4) | 2 (0.7) | 38 (14.0) | 127 (46.9) | 103 (38.0) |
2. | As a pediatric dentist, I should inform patients about the link between HPV and OP-cancer. | 3 (1.1) | 5 (1.8) | 30 (11.1) | 127 (46.9) | 106 (39.1) |
3. | As a pediatric dentist, I should promote HPV vaccination. | 3 (1.1) | 4 (1.5) | 41 (15.1) | 117 (43.2) | 106 (39.1) |
4. | I need more information about the HPV infection. | 4 (1.5) | 4 (1.5) | 18 (6.6) | 123 (45.4) | 122 (45.0) |
5. | I need more information about the HPV vaccine. | 2 (0.7) | 2 (0.7) | 14 (5.2) | 136 (50.2) | 117 (43.2) |
6. | I need more information about HPV’s connection to cancer. | 2 (0.7) | 15 (5.5) | 27 (10.0) | 137 (50.6) | 90 (33.2) |
7. | I think safety and effectiveness of the HPV vaccine are not yet demonstrated. | 73 (26.9) | 116 (42.8) | 58 (21.4) | 18 (6.6) | 6 (2.2) |
8. | I am afraid to offend patients and their parents discussing oral sex practices. | 24 (8.9) | 73 (26.9) | 89 (32.8) | 71 (26.2) | 14 (5.2) |
9. | I think patients’ parents are interested in HPV prevention. | 1 (0.4) | 13 (4.8) | 45 (16.6) | 166 (61.3) | 46 (17.0) |
10. | I think patients’ parents would accept HPV vaccination to prevent a sexually transmitted infection. | 4 (1.5) | 10 (3.7) | 52 (19.2) | 164 (60.5) | 41 (15.1) |
11. | I think patients’ parents would accept HPV vaccination to avoid a potentially carcinogenic infection. | 0 | 3 (1.1) | 29 (10.7) | 162 (59.8) | 77 (28.4) |
12. | I think patients’ parents would decline HPV vaccination for fear of adverse events. | 7 (2.6) | 80 (29.5) | 103 (38.0) | 70 (25.8) | 11 (4.1) |
13. | I think patients’ parents would decline HPV vaccination for lack of adequate knowledge on sexually transmitted infection. | 5 (1.8) | 18 (6.6) | 44 (16.2) | 140 (51.7) | 64 (23.6) |
14. | I think patients’ parents would decline HPV vaccination for fear of increasing sons’ sexual activity. | 22 (8.1) | 98 (36.2) | 95 (35.1) | 43 (15.9) | 13 (4.8) |
15. | I think pediatric dentists should acquire additional knowledge on HPV-related diseases during their post-graduated training (school of specialization, masters, post-graduated advanced courses). | 3 (1.1) | 6 (2.2) | 21 (7.7) | 133 (49.1) | 108 (39.9) |
16. | I think I have acquired extensive knowledge on HPV-related oral diseases during my post-graduated training (school of specialization, masters, post-graduated advanced courses) on pediatric dentistry. | 20 (7.4) | 121 (44.6) | 72 (26.6) | 52 (19.2) | 6 (2.2) |
17. | In discussing HPV vaccination with patients and their parents, it would be helpful to have standard talking points. | 2 (0.7) | 3 (1.1) | 45 (16.6) | 175 (64.6) | 46 (17.0) |
18. | I think I have to acquire skills on how communicate with parents on HPV infection and oral cancer. | 4 (1.5) | 21 (7.7) | 40 (14.8) | 154 (56.8) | 52 (19.2) |
19. | I consider inclusion of the HPV vaccine in the national vaccine schedule as necessary. | 1 (0.4) | 2 (0.7) | 20 (7.4) | 155 (57.2) | 93 (34.3) |
20. | HPV vaccine may encourage starting to have sex at an early age. | 85 (31.4) | 129 (47.6) | 42 (15.5) | 12 (4.4) | 3 (1.1) |
Attitude | ||||||
---|---|---|---|---|---|---|
Statements | Strongly Disagree N (%) | Disagree N (%) | Neither Agree Nor Disagree N (%) | Agree N (%) | Strongly Agree N (%) | |
1. | I feel comfortable talking about HPV-related cancer with patients and their parents. | 8 (3.0) | 39 (14.4) | 92 (33.9) | 107 (39.5) | 25 (9.2) |
2. | I feel comfortable talking about HPV vaccination with patients and their parents. | 8 (3.0) | 25 (9.2) | 70 (25.8) | 138 (50.9) | 30 (11.1) |
3. | I feel comfortable talking about HPV infection with patients and their parents. | 7 (2.6) | 28 (10.3) | 77 (28.4) | 130 (48.0) | 29 (10.7) |
4. | I would obtain the HPV vaccine for me/my child if eligible. | 3 (1.1) | 3 (1.1) | 22 (8.1) | 143 (52.8) | 100 (36.9) |
5. | I agree with the current effort to provide HPV vaccination to preadolescents. | 1 (0.4) | 1 (0.4) | 21 (7.7) | 139 (51.3) | 109 (40.2) |
6. | For religious reasons, I am against recommending HPV vaccinations to my patients. | 180 (66.4) | 74 (27.3) | 8 (3.0) | 9 (3.3) | 0 |
7. | I am more inclined to recommend HPV vaccination to girls rather than boys. | 55 (20.3) | 89 (32.8) | 60 (22.1) | 61 (22.5) | 6 (2.2) |
8. | I am inclined to routinely carry out oral cancer screening on my patients. | 4 (1.5) | 13 (4.8) | 48 (17.7) | 134 (49.4) | 72 (26.6) |
9. | I am inclined to periodically update my knowledge on HPV-related diseases reading scientific papers. | 2 (0.7) | 12 (4.4) | 32 (11.8) | 147 (54.2) | 78 (28.8) |
10. | I am inclined to attend lectures/seminars/conferences on HPV-related diseases. | 1 (0.4) | 4 (1.5) | 33 (12.2) | 137 (50.6) | 96 (35.4) |
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Characteristics | N (%) |
---|---|
Gender Male | 64 (23.6) |
Female | 207 (76.4) |
Age range 25–35 years | 116 (42.8) |
35–45 years | 85 (31.4) |
45–55 years | 44 (16.2) |
55–65 years | 26 (9.6) |
Graduation year 1970s | 2 (0.7) |
1980s | 20 (7.4) |
1990s | 41 (15.1) |
2000s | 86 (31.7) |
2010s | 122 (45.0) |
Type of practice Paediatric dentistry exclusively | 37 (13.7) |
Paediatric dentistry not exclusively | 234 (86.3) |
Practice setting Academic setting | 33 (12.2) |
Public health setting | 10 (3.7) |
Private setting | 228 (84.1) |
Characteristics | Knowledge on HPV-Related OP-Cancer (Correct Responses) | Knowledge on HPV Infection (Correct Responses) | Knowledge on HPV Vaccine (Correct Responses) |
---|---|---|---|
Gender | |||
Male | 68% | 68.4% | 74.0% |
Female | 69.5% | 68.5% | 77.9% |
Age range | |||
25–35 years | 69.9% | 69.1% | 73.9% |
35–45 years | 68.8% | 67.3% | 77.9% |
45–55 years | 69.5% | 70.9% | 81.5% |
55–65 years | 68.4% | 65.3% | 79.7% |
Graduation year | |||
1970s | 72.2% | 63.3% | 70.0% |
1980s | 66.6% | 66.3% | 79.6% |
1990s | 69.2% | 70.5% | 81.6% |
2000s | 67.2% | 67.0% | 77.9% |
2010s | 70.4% | 69.3% | 74.4% |
Type of practice | |||
Paediatric dentistry exclusively | 72.2% | 72.1% | 77.6% |
Paediatric dentistry not exclusively | 68.7% | 68.0% | 76.8% |
Practice setting | |||
Academic setting | 70.9% | 73.5% | 75.1% |
Public health setting | 70.0% | 78.6% | 81.3% |
Private setting | 68.9% | 56.6% | 77.0% |
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Cantile, T.; Leuci, S.; Blasi, A.; Coppola, N.; Sorrentino, R.; Ferrazzano, G.F.; Mignogna, M.D. Human Papilloma Virus Vaccination and Oropharyngeal Cancer: Knowledge, Perception and Attitude among Italian Pediatric Dentists. Int. J. Environ. Res. Public Health 2022, 19, 790. https://doi.org/10.3390/ijerph19020790
Cantile T, Leuci S, Blasi A, Coppola N, Sorrentino R, Ferrazzano GF, Mignogna MD. Human Papilloma Virus Vaccination and Oropharyngeal Cancer: Knowledge, Perception and Attitude among Italian Pediatric Dentists. International Journal of Environmental Research and Public Health. 2022; 19(2):790. https://doi.org/10.3390/ijerph19020790
Chicago/Turabian StyleCantile, Tiziana, Stefania Leuci, Andrea Blasi, Noemi Coppola, Roberto Sorrentino, Gianmaria Fabrizio Ferrazzano, and Michele Davide Mignogna. 2022. "Human Papilloma Virus Vaccination and Oropharyngeal Cancer: Knowledge, Perception and Attitude among Italian Pediatric Dentists" International Journal of Environmental Research and Public Health 19, no. 2: 790. https://doi.org/10.3390/ijerph19020790