Alessandro Villa

Evaluation of Human Papillomavirus Vaccination and Cancer Prevention Behaviors among LGBTQI + Individuals: A Cross-Sectional Study

Human Papillomavirus (HPV) vaccination and cervical cancer screening rates are suboptimal in the US, particularly among historically underserved groups like Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex (LGBTQI+)-identifying women and transgender men. Therefore, our cross-sectional study assessed factors associated with these rates among LGBTQI+-identifying women and transgender men.HPV-related cancer knowledge, HPV vaccination and cervical cancer screening status, and the acceptability of self-collection for screening of 1983 LGBTQI+-identifying women and transgender men was assessed via an online survey available to members of the HER mobile app from March to May 2022. Associations between sociodemographic factors, vaccination, and screening were assessed using multivariable logistic regressions from November 2022 to December 2023.Most participants aged 18-26 (77.0%) and 6.3% of participants aged ≥46 (P < 0.001) had received at least one dose of the HPV vaccine. Cervical cancer screening rates were positively associated with age: 70.5% of those aged 21-26 and 96.1% aged ≥46 (P < 0.001). Screening was negatively associated with male gender identity (OR, 0.13; 95% CI, 0.04-0.42; P < 0.001), being uninsured (OR, 0.40; 95% CI, 0.24-0.67; P < 0.001), and being unvaccinated against HPV (OR, 0.28; 95% CI, 0.18-0.43; P < 0.001). 29.6% of those unscreened believed screening was not needed, and 22.1% were uncomfortable with pelvic exams. 40.4% of all participants would prefer self-collection for screening. Our findings indicate opportunities to increase screening and vaccination. Among under-screened individuals, lack of knowledge about screening necessity and discomfort with pelvic exams were important barriers. Targeted interventions addressing patient knowledge, practitioner communication, and exploring self-screening strategies are warranted.

Surgical protocols for oral leukoplakia and precancerous lesions across three different anatomic sites

Abstract Objective This systematic review and meta‐analysis aimed to compare the risk of recurrence and cancer progression after surgical treatment for oral potentially malignant disorders (OPMD) and precancerous lesions in different anatomical sites. Materials and Methods A comprehensive search was conducted in nine databases and grey literature. We included randomized controlled trials assessing surgical treatment efficacy for OPMD and precancerous lesions of cervical, vaginal, anal, and penile sites. Excision or ablation surgical treatments were considered. Results Overall, 12 studies met the eligibility criteria for oral leukoplakia (OL), proliferative verrucous leukoplakia, cervical intraepithelial neoplasia (CIN), vaginal intraepithelial neoplasia, and anal intraepithelial neoplasia (AIN). In qualitative analysis of surgical protocols, the lack of margin description impacts the clinical outcomes of OL and AIN, and the ablative protocols were heterogeneous in both OPMD and precancerous lesions. No significant difference in OL (risk ratio 0.82 [95% CI: 0.59–1.15]) and CIN (risk ratio 0.31 [95% CI: 0.09–1.09]) for recurrence was observed when cold‐knife was compared with ablative protocols. OL exhibited higher recurrence and cancer progression rates compared to CIN and AIN. Conclusion There is no difference in recurrence risk post‐surgical treatment for OL and CIN. Surgical protocols for oral leukoplakia and CIN/AIN lack standardized approaches.

An educational intervention on HPV knowledge and comfortability discussing vaccination among oral health care professionals of the American Indian and Alaskan Native population

This study aimed to evaluate the effectiveness of an educational intervention at improving Oral Health Professionals (OHP's) knowledge of HPV and comfortability to discuss vaccination with their American Indian and Alaskan Native patients. OHP's attended an educational lecture covering HPV vaccination. Participants completed four validated questionnaires that encompassed a sociodemographic survey, a pre-lecture questionnaire (pre-Q), a post-lecture questionnaire (post-Q), and a follow-up questionnaire (follow-Q). The McNemar test was used to assess the significance of marginal probabilities in the responses between the pre-Q and post-Q and the Chi-square test to assess responses between the post-Q and follow-Q. A total of 122 OHP's completed the sociodemographic survey, pre-Q, and post-Q. Among these, 29 OHP's completed the eight-week follow-Q. The majority of all the participants were White/Caucasian (41%), 31 to 60 years of age (72%), females (64%), and held a graduate/professional degree (52%). Analysis of the pre-Q responses showed that only 6.8% of OHP's discuss the connection between HPV and oropharyngeal cancer with patients and a lack of information on the topic was the major barrier reported. After the educational intervention (post-Q), 86.5% of OHP's reported they were more likely to recommend the HPV vaccine and 69.8% felt more comfortable administering it. Comparison between the pre-Q and the post-Q showed a significant improvement in overall HPV knowledge. Similarly, a comparison between the post-Q and the follow-Q showed retained knowledge overtime. Our study suggests that the educational intervention was effective at improving OHP's knowledge of HPV and enhancing their comfortability and preparedness to discuss the vaccination with their patients.

Knowledge that HPV can cause oropharyngeal cancer and cervical cancer among adults in the United States: A comparison of prevalence and predictors

To compare prevalence and predictors of knowledge that human papillomavirus (HPV) can cause oropharyngeal cancer (OPC) and cervical cancer among U.S. adults. Cross-sectional. Using Health Information National Trends Survey-5 cycles 1-4 (2017-2020), we estimated weighted prevalence of knowledge that HPV can cause OPC and cervical cancer, overall and by sex. Predictors were identified using logistic regression adjusting for age, sex, race and ethnicity, and education. Females vs. males had greater OPC knowledge (22.3 % vs. 17.1 %) [adjusted odds ratio (aOR) = 1.4; 95 % confidence interval (95 % CI) = 1.2-1.6] and cervical cancer knowledge (59.4 % vs. 40.0 %) (aOR = 2.6; 95 % CI = 2.2-3.0). Females with notably greater OPC knowledge were White vs. Black (aOR = 2.0; 95 % CI = 1.5-2.7), and had a college degree or higher vs. high school or less (aOR = 2.8; 95 % CI = 2.1-3.7). Males with greater OPC knowledge had a college degree or higher vs. high school or less (aOR = 3.1; 95 % CI = 2.2-4.4) and visited a provider 1-2 times within the past year (aOR = 1.7; 95 % CI = 1.1-2.6). Females with greater cervical cancer knowledge were White vs. Black (aOR = 2.1; 95 % CI = 1.6-2.6), had a college degree or higher vs. high school or less (aOR = 5.6; 95 % CI = 4.5-6.9), and visited a provider within the past year (aOR = 2.2; 95 % CI = 1.7-2.9). Males with greater cervical cancer knowledge were White vs. Black (aOR = 1.6; 95 % CI = 1.1-2.4), had at least $75,000 vs. $34,999 or less annual income (aOR = 1.8; 95 % CI = 1.3-2.4), had a college degree or higher vs. high school or less (aOR = 4.7; 95 % CI = 3.5-6.2), and visited a provider within the past year (aOR = 1.5; 95 % CI = 1.1-2.2). HPV-related cancer knowledge is limited, especially for OPC. Knowledge disparities exist across many social and healthcare engagement factors, emphasizing need for broader dissemination of HPV education.