Date of Award
Medical Doctor (MD)
Benjamin L. Judson
The current state of U.S. public knowledge surrounding head and neck cancers (HNCs) and Human Papillomavirus’ (HPV) role within HNCs has not been clearly delineated. We sought to quantify the general population’s knowledge of signs/symptoms, risk factors, and subsites of HNC, including their awareness of HPV’s role in HNC’s pathogenesis in 2020; to assess the utility of Oral, Head and Neck Cancer Awareness Week (OHANCAW); to assess the general population’s knowledge of human papillomavirus (HPV) and HPV vaccinations; to evaluate factors associated with decisions not to vaccinate; and to assess whether targeted education regarding the role of HPV in the etiology of oropharyngeal cancer (OPSCC) can change decisions to vaccinate. An online, cross-sectional survey was distributed utilizing quotas built from U.S. Census data to represent the U.S. population was administered to 517 individuals in 2020 via a paid Qualtrics panel. Descriptive and multivariate analyses were performed, and, where appropriate, compared to results from a similar survey performed in 2013. Compared to the 2013 survey results, participants in the 2020 survey were more likely to be knowledgeable about each subsite, risk factor, and sign/symptom of HNC. Knowledge of HPV’s role in oropharyngeal cancer also increased, from 12.8% in 2013 to 30.6% in 2020, and this growth was independent of demographics in multivariate analyses (OR 2.20 [95% CI: 1.66-2.93]). Of these, 43.0% gained this knowledge exclusively from non-healthcare professional sources, like television. However, exposure to OHANCAW was most closely associated with this knowledge (OR: 12.41 [95% CI: 8.16-18.89]). We then analyzed factors that were associated with exposure to or knowledge of OHANCAW. Females and elderly individuals were less likely to be exposed, while Hispanics, those with higher education, those who drink heavily (>4 drinks/day), and current, but not former, tobacco users were more likely to be exposed to OHANCAW. 72.7% of participants stated that they had or would vaccinate their child against HPV and were designated as “vaccinators,” and there were disparities based on demographics. Knowledge about vaccination side-effects, eligibility, and mechanisms of HPV spread was low. When presented with four short HPV-OPSCC-centered facts (HPV’s role in OPSCC etiology, prevalence of infection, clinically-silent course, and vaccine preventative effects), 54.0% of “non-vaccinators” indicated a willingness to change their minds. Overall, our results suggest that OHANCAW is an effective public educational tool that should be utilized more often, and that certain populations, such as former smokers and older individuals, are not being effectively reached. Our results also show that general knowledge about HPV, HPV’s role in OPSCC, and the vaccine remains low in the general population, and often came from sources other than healthcare professionals. Encouragingly, we show that any disparities in knowledge and willingness to vaccinate can be overcome by effective, focused education on HPV-related OPSCC. The results herein may be used to created targeted public health efforts to increased knowledge of HNCs and HPV.
Torabi, Sina John, "A Nationwide Survey Assessing Public Awareness Of Head And Neck Cancers And The Human Papillomavirus" (2021). Yale Medicine Thesis Digital Library. 4035.