Optimizing Cancer Prevention in Adolescents by Improving HPV Vaccine Delivery

Sep 24, 2026

Uploaded by nayy☆

Optimizing Cancer Prevention in Adolescents by Improving HPV Vaccine Delivery examines how routine HPV vaccination can prevent multiple cancers and why US adolescent coverage remains below Healthy People 2030 targets. It highlights barriers such as absent or weak provider recommendations, caregiver hesitancy, multi-dose scheduling complexity, and limited school-entry requirements. It focuses on actionable best practices including strong presumptive recommendations, standing orders, feedback on vaccination rates, incentives, school-entry strategies, and vaccine registry forecasting starting at age 9.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages4

Reading Time10 min

AccessFree to download

Introduction

Burden of HPV infection and cancer

Rationale for early vaccination

Best Practices

Provider recommendation approaches

Announcement Approach Training

Systemic reminder and recall strategies

INVITED COMMENTARY Optimizing Cancer Prevention in Adolescents by Improving HPV Vaccine Delivery Nadja A. Vielot, Noel T. Brewer Routine HPV vaccination can prevent six cancers. Best practices for achieving high adolescent HPV vaccination coverage include automatically scheduled appointments, presumptive provider recommendations, standing orders, feedback on vaccination rates, and incentives. Promising practices include school entry requirements and starting HPV vaccine recommendations and vaccine registry forecasting at age 9. Introduction An estimated 13 million new human papillomavirus (HPV) infections occur annually in the United States [1], most commonly among young adults [2, 3] . Persistent HPV infection causes cervical, vulvar, and vaginal cancer in women, penile cancer in men, and anal and oropharyngeal cancers in both sexes [4]. The United States has over 36,000 new HPV cancers each year [5] . Cervical cancer incidence in the United States varies across states, from 3.9 to 10.3 cases per 100,000 women annually [5], with only New Hampshire meeting the World Health Organization’s Cervical Cancer Elimination Initiative goal of less than 4.0 [6] . As of 2021, oropharyngeal cancer incidence in men exceeded cervical cancer incidence in women, highlighting men as a critically important group for HPV cancer prevention [5] . Prevention of HPV infection through vaccination is the most widely accessible HPV cancer prevention method available given that routine screening is only available for cervical cancer. The immune response to HPV vaccination is strongest in the preteen years [7], and it persists for at least a decade. Thus, administration of two doses of the HPV vaccine to boys and girls before age 13 (i.e., up-to-date vaccination) is recommended by the US Centers for Disease Control and Prevention (CDC) to prevent HPV acquisition and HPV cancer development in adulthood [8] . Despite the clear need for early cancer prevention through HPV vaccination, complete and timely vaccination among US adolescents has been slow to reach the Healthy People 2030 goal of 80% coverage for up-to-date vaccination [9] . One problem is absent or low-quality HPV vaccine recommendations during, which a provider does not stress the importance of vaccination, describe the vaccine’s role in cancer prevention, or recommend same-day vaccination [10] . In addition, caregiver hesitancy toward the vaccine, complexity of the multi-dose vaccination schedule, and lack of a school-entry requirement in most states have contributed to suboptimal vaccination rates. North Carolina has a pressing need for HPV cancer prevention. The state’s HPV cancer incidence is higher than the national incidence (13.2 versus 11.8 per 100,000) [5], with oropharyngeal cancers among men accounting for much of this difference. HPV vaccine initiation among 13-yearold North Carolinians was only 69% as of 2022, well below rates for other recommended adolescent vaccines: tetanusdiphtheria-acellular pertussis (85%) and meningococcal conjugate vaccines (85%) [11] . The up-to-date HPV vaccination rate was even lower, at 50% . In addition, up-to-date vaccination rates among adolescents from rural areas of the state and from underserved racial and ethnic groups tend tobe even lower [12] . To ensure equitable and accessible HPV cancer prevention for all youth, primary care professionals, public health practitioners, and policymakers must strive to scale up effective HPV vaccination approaches and develop novel ones. Best Practices A best practice for increasing HPV vaccine uptake is a primary care professional’s recommendation of HPV vaccine [13] . Clear and strong recommendations can counteract hesitancy or indifference toward vaccination, particularly in states where HPV vaccination is not required for middle school and caregivers can choose to opt out. An evidencebased intervention that fosters strong recommendation is the Announcement Approach Training [14] . In

FAQs

Why is HPV vaccination important for cancer prevention in adolescents?

Routine HPV vaccination can prevent six cancers, and the immune response is strongest before age 13 and persists for at least a decade.

What factors contribute to low and delayed HPV vaccination among US adolescents?

Low-quality or absent provider recommendations, caregiver hesitancy, complexity of multi-dose schedules, and lack of school-entry requirements in many states contribute to suboptimal coverage.

Which best practices are recommended to improve HPV vaccine uptake?

Strong presumptive provider recommendations, standing orders and feedback mechanisms, incentives, school-entry requirements, and approaches such as announcement training and reminder/recall or automatic scheduling for second doses are highlighted.

Sep 24, 2026

Uploaded by nayy☆