A scoping review of uptake and interventions in specialty and non-primary care clinical settings

Document Type

Conference Proceeding

Publication Date

5-28-2025

Publication Title

J Clin Oncol

Abstract

Background: Persistent human papillomavirus (HPV) infection significantly increases the risk of developing several cancers, including cervical, anal, and oropharyngeal cancers. According to CDC guidelines, vaccinations are recommended for individuals ages 9-26 and have been expanded to include some adults aged 27-45 based on a shared decision-making process with their clinician. It is estimated that over 90% of the HPV-associated cancers could be prevented with the HPV vaccine. Despite substantial evidence regarding the safety and effectiveness of the HPV vaccine, vaccination rates remain below the Healthy People 2030 goal of 80%, with vaccines primarily administered in primary care settings. Specialty clinics and non-primary care clinics that do not traditionally offer HPV vaccination, present an opportunity to improve vaccine uptake. This scoping review evaluates the potential impact of HPV vaccination in non-primary care settings. Methods: Our approach to data collection and analysis was guided by Arksey and O'Malley's scoping review framework, and the Preferred Reporting Items for Systematic reviews and meta-analyses extension for Scoping Reviews (PRISMA-ScR). Ovid MEDLINE, Embase, and Web of Science were queried to include articles published in the US from 2006 to 2024 using search terms such as human papillomavirus vaccination and specialty clinics by an academic librarian. Original empirical studies were included, there were no restrictions on study design. Results: Out of the 1752 studies identified, 10 studies met the inclusion criteria, including 5 retrospective observational studies, 2 cross sectional studies, 1 randomized control trial, 1 pre-post study, and 1 survey study. Sample size for studies included ranged from 50 to 3709 participants, age range 18-45 years. Settings included otolaryngology, OBGYN, family planning, and substance health services. Baseline vaccination rate ranged from 5.2% to 47%. Five studies were interventional, and evaluated the effects of patient counseling, pharmacistphysician education, free vaccination or mailed reminders on HPV vaccination rates. The interventions resulted in increases in vaccination from 5.6% to 16%. Conclusions: Practice settings for interventions included in this scoping review focused on specialties that treat the downstream effects of HPV vaccination or high-risk populations. For adults eligible for HPV vaccination, specialty outpatient clinics may present a unique additional opportunity to discuss and deliver HPV vaccination, especially since providers in these settings also treat HPV-related diseases and are well equipped to engage in shared decision making with patients. Future research should focus on the acceptability, feasibility, and effectiveness of implementation of an HPV vaccination program in these settings.

Volume

43

Issue

16 Suppl

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