HPV Vaccination: An Underused Strategy for the Prevention of Cancer

Abstract

Human papillomavirus (HPV) vaccination prevents cervical, head and neck, and anogenital cancers. However, global HPV vaccine coverage falls short of global targets and has seen unexpected and dramatic declines in some countries. This paper synthesizes the impact of HPV on the global burden of cancer and the potential benefit of HPV vaccination. Approximately 5% of the world's cancers are specifically attributed to HPV. While the greatest global burden of HPV is cervical cancers in low- and middle-income countries, HPV-associated head and neck cancers are increasing in high-income countries and have surpassed cervical cancer as the primary HPV-associated cancer in some countries. Therefore, it is also critical to improve gender-neutral HPV vaccination. Understanding the modifiable drivers of vaccine acceptance and uptake is important for increasing HPV vaccination. The Behavioural and Social Drivers of Vaccination framework is broadly applied to identify key factors associated with HPV vaccination including domains concerning practical issues, motivation, social processes, and thinking and feeling. Among the behavioural strategies available to reduce the incidence and mortality of cancer, increasing HPV vaccination stands out as having unrealized potential to prevent disease, financial cost, and psychological distress. An understanding of the shifting burden of HPV and the factors associated with vaccination can be leveraged to regularly measure these factors, develop interventions to promote vaccine uptake, and improve global HPV vaccine coverage. Future research in diverse contexts is necessary to investigate the barriers and facilitators of global HPV vaccination.

Keywords: behavioural and social drivers of vaccination framework; cancer prevention; human papillomavirus; vaccine hesitancy; vaccine uptake.

Figure 1

Number of vaccine hesitancy publications by year, and percent concerning HPV. Note. This figure was modified from previous work by the author [98]. Pubmed was searched for articles published between 2010 and 2021 using the term “vaccine hesitancy”, and the number of papers is plotted against the year (in blue, see left y-axis). A separate search in Pubmed over the same time was conducted using the terms “vaccine hesitancy” AND “HPV”; the percent of “vaccine hesitancy” papers concerning “HPV” was calculated (in orange, see right y-axis).