Counseling helps patients start and complete HPV shot regimen

Educating female patients age 9 to 26 about the human papillomavirus vaccine could help bolster their protection against cervical cancer, the author of a new report says.

Only about a third of young women who begin the three-dose HPV immunization series recommended by the Centers for Disease Control and Prevention actually complete it, according to a study presented Nov. 9 at a meeting of the American Assn. for Cancer Research in Philadelphia.

Women 18 and older, black women and black teenagers were among the least likely to receive all the suggested doses.

The findings indicate that large numbers of teenagers are unprotected or underprotected from strains of HPV that can lead to cervical cancer, said lead study author J. Kathleen Tracy, PhD.

Infection from the human papillomavirus is the most common sexually transmitted disease in the U.S., affecting at least 50% of sexually active men and women at some point in their lives, the CDC said. Cervical cancer is usually caused by the virus, according to the National Cancer Institute. This year, an estimated 12,200 women will be diagnosed with cervical cancer, and 4,210 will die from it, the NCI said.

"If we really want people to initiate getting the vaccine, health care providers have to create systematic strategies for how to discuss the HPV vaccine with women" who are eligible for it, said Tracy, assistant professor of epidemiology and public health at the University of Maryland School of Medicine in Baltimore. "When a woman decides to get the vaccine, doctors need to communicate the importance of getting all the doses and continuing Pap smear" screening.

Researchers examined data on 9,658 females 9 to 26 who received care at the University of Maryland Medical Center's outpatient practices between August 2006 and August 2010. They found that 27.3% received at least one dose of the HPV vaccine. Of those individuals, 39.1% got only a single dose and 30.1% received two doses. The remaining 30.8% completed the three-dose series.

The CDC recommends immunization of females 11 or 12 years old against HPV with either GlaxoSmithKline's bivalent vaccine Cervarix or Merck's quadrivalent vaccine Gardasil. The three-dose series can be started on patients as young as 9. Physicians should administer the immunization to females 13 to 26 who have not yet started or completed the series.

"It's in all of our best interest to reach out to any group of young women at risk of not getting all three doses and making extra efforts to encourage them" to do so, Tracy said.