Q&A: Lack of knowledge about HPV and its vaccine ‘not surprising’

Key takeaways:

• Nearly half of people think HPV causes only cervical cancer when it is actually tied to six types of cancer.
• People also showed gaps in knowledge about HPV frequency in men and presentation of symptoms.

HPV is the most common sexually transmitted infection, yet many people lack knowledge of the infection or hold several misconceptions about it.

Healio previously reported on the infection’s frequency, with one analysis indicating a global prevalence of 31% for HPV overall and 21% for high-risk HPV.

A recent survey conducted by The Ohio State University Comprehensive Cancer Center assessed the knowledge of 1,005 U.S. adults regarding the HPV vaccine, HPV’s frequency in women vs. men, its ties to cancer and the presentation of symptoms.

The findings revealed that 45% of respondents did not know whether HPV causes only cervical cancer, whereas 15% said it does.

In actuality, the infection can cause six types of cancers, including penile, cervical, anal, oropharyngeal, vaginal and vulvar, according to the National Cancer Institute.

Meanwhile, 23% of respondents said that a person will show symptoms if they are infected with HPV, whereas 40% did not know if symptoms are present.

Overall, 38% of respondents said that HPV is more common in women, whereas 42% did not know.

The survey also showed that 33% of respondents did not know if those who receive pap smears do not need the HPV vaccine, whereas 10% said they do not. Electra D. Paskett, PhD, the Marion N. Rowley Professor of Cancer Research at The Ohio State University, spoke with Healio to discuss her thoughts on the findings, how primary care providers can bring awareness to HPV and more.

Healio: What is your reaction to the results?

Paskett: [The findings were] not surprising because most people have misunderstandings about HPV, about the vaccine and about who's at risk. What was concerning was that most people thought it was only a woman's problem and that men shouldn't be concerned and shouldn't probably get vaccinated is what it inferred. But we know that men are the reservoir for the HPV infection. So, men have an equal part in this, and they also have the responsibility and the need to get vaccinated.

Healio: Why do you think there is a significant lack of knowledge about HPV?

Paskett: Historically, sex has been negatively thought about, and HPV is a sexually transmitted disease. And so, the thought has been that only certain women would get cervical cancer [and] thus, HPV. Those are women who are very sexually active with multiple partners and prostitutes. Therefore, HPV has been put in the gutter, along with cervical cancer, and that's the wrong place for it to be.

When the [first] HPV vaccine was approved and released, the general thought about it wasn't, “Oh, we have a vaccine against potentially multiple cancers.” No, that wasn't the mindset. Instead, it was, “Why do you want to give my daughter this vaccine so that she can have sex and be promiscuous?” That's sort of where people's thoughts were instead of acknowledging that we have a cancer vaccine that everybody should be lining up down the street to get.

Healio: What should PCPs know about HPV vaccination?

Paskett: PCPs can vaccinate children starting at age 9 years and going up to age 45 years. I'm going to explain the difference in the vaccination schedule for both boys and girls, men and women.

[PCPs can] approach the patient’s family with, “We have this vaccine. It has shown that it can prevent cancer. It is safe and it is effective. It has been given in tens of thousands of doses around the world, and I think that your child should get this now.”

Now, why do we give it young? Because then the immune system is good and the immunity can build up. Under age 15 years, you need only two doses. Starting at age 15 years and up to age 45 years, it is three doses.

[For ages] 27 to 45 years, [it] is required that there is a shared decision-making conversation between the physician and the patient, explaining the risks and the benefits of getting the vaccine. Then the person can get the vaccine and insurance will cover it.

I have always, in my research, recommended ages 9 to 45 years for the vaccination.

Healio: Should PCPs adjust how they inform patients of HPV vaccines as new top health officials have questioned their safety and effectiveness?

Paskett: First of all, I don't think politicians should have any business recommending vaccination or any type of health care treatment. They're not educated on that. They're not trained on that. They don't know the data. We need to rely on people who have researched and have done studies and carefully looked at the correct data to make recommendations. We have a lot of vaccines now, right? That's why we see children surviving childhood. Now we see people living up to age 100 years. It's because of vaccines that have really eliminated, eradicated or significantly reduced infectious diseases.

These vaccines are safe, effective and have been tested rigorously before being approved by the FDA. The HPV vaccine, specifically, is as safe and effective as the other childhood vaccinations that are given. There are years of data now that say they do not cause all these anomalies that [some] are attributing to it. In fact, the Autism Society itself says that vaccines do not cause autism. I think people need to rely on those who are trained to understand the data and not rely on their own personal bias or opinion.

Healio: Do you have anything else to add?

Paskett: I've been doing studies for many years on trying to help increase vaccination rates in children and adults, and what we found is that PCPs really want to do what's best for their patients, whether it's colon cancer screening, HPV vaccination, recommending breast screening, whatever. The problem is that we don't give them the tools that they need to effectively and succinctly communicate to their patients what they need to know to make an informed decision.

In a lot of our research studies, that's what we do. We go in the clinic, and we say, “All right. You want to talk to your patients about HPV vaccination. Here's the facts about the HPV vaccination. This is what HPV is. This is what the vaccine does, and this is the schedule. Here is a sheet that gives you the questions parents usually ask. Here's some quick to-the-point answers, you can use this in your 10- to 20-minute visit with your patients.” We educate the entire clinic staff so that they can also help patients make those decisions. I think we don't take into account enough the burdens that are placed upon our PCPs and their staff.

We need to start thinking about giving them help by providing them with messages to make their job easier, so that they can provide the best care for their patients.

References:

• HPV and cancer. Available at: https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-and-cancer. Accessed March 3, 2025.
• Hidden Dangers and Myths What you need to know about HPV and cancer. Available at: https://cancer.osu.edu/news/hidden-dangers-and-myths-what-you-need-to-know-about-hpv-and-cancer. Published March 4, 2025. Accessed March 5, 2025.