Importance:
As the incidence of human papillomavirus (HPV) related oropharyngeal cancer in the United States increases, vaccination is a safe option for primary prevention of HPV infection. However, less than 40% of adults aged 18-26 report receiving one or more doses of the HPV vaccine, with lower rates in men than women. Provider recommendation is consistently cited as one of the most important facilitators of vaccination, but knowledge deficits among providers regarding the link between HPV and oropharyngeal cancer (OPC) can be a barrier to this recommendation.

Objective:
: To assess Pediatrics residents’ knowledge of HPV-related cancers and vaccination practices before and after a knowledge-based lecture on HPV-OPC given during resident education. Our hypothesis was that provider-focused education can improve understanding of oropharyngeal cancer prevention and consequently alter Pediatrics residents’ attitudes toward HPV vaccination.

Design: Single group survey study administered pre- and post-HPV vaccination lecture, which was administered by a head and neck surgeon.

Setting: Two academic medical centers.

Participants: Twenty-eight Pediatrics residents.

Intervention: One-hour didactic presentation on the epidemiology, pathogenesis, and prevention of HPV-related oropharyngeal cancer delivered to Pediatrics residents during resident education by head and neck surgical oncologists.

Main Outcomes and Measures: Anonymous pre- and post-lecture surveys assessing Pediatrics residents’ attitudes towards HPV vaccination and usual prescribing practices, barriers to vaccination, and knowledge of HPV’s causative role in oropharyngeal cancer. Differences in responses between the two surveys were assessed using a Wilcoxon signed-rank test and McNemar’s test.

Results: Pre- and post-lecture surveys were completed by 28 Pediatrics residents. Survey respondents reported a significant increase in their likelihood of discussing the link between HPV and OPC when discussing vaccination with future patients, from a median of somewhat unlikely / somewhat likely on pre-survey to very likely on post-survey based on a 6-point Likert scale (p<0.05). Pediatrics residents also reported increased likelihood of continuing the conversation if patients are initially hesitant about vaccination (median increased from likely to very likely, p<0.05) and greater agreement that OPC prevention is a motivation for offering the HPV vaccine (median increased from agree to strongly agree on a 7-point Likert scale, p<0.05). There was also a significant improvement in performance on all four questions assessing knowledge of HPV-related cancers.

Conclusions and Relevance: HPV vaccination may prevent cancer-causing infections, yet many physicians do not include the connection between HPV and oropharyngeal cancer when discussing the vaccine with patients. Our results demonstrate that education from a head and neck oncologist for Pediatrics residents can increase awareness of this connection and change perspectives on vaccination. Widespread education of Pediatrics providers on this topic may increase HPV vaccination rates and prevent future cases of HPV-related oropharyngeal cancer.