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Awareness of the causal association between human papillomavirus and anal cancer among US adults

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Abstract

Purpose

The incidence of anal cancer is on the rise in the US, especially among high-risk groups. This study examined the prevalence and determinants of awareness of the causal relationship between HPV and anal cancer among US adults.

Methods

Study data was obtained from the 2017 to 2020 iterations of the Health Information National Trends Survey. The prevalence of awareness that HPV causes anal cancer was estimated among HINTS respondents who were aware of HPV in general. Survey weights were used to provide estimates representative of the adult US population. Multivariable logistic regressions were used to examine the associations between awareness that HPV causes anal cancer and cancer-related behaviors/perceptions and sociodemographic characteristics of respondents.

Results

Two thousand six hundred and eighty four (27.2%) of the study population were aware that HPV caused anal cancer. Those of gay sexual orientation were more aware than heterosexuals [OR 2.27; 95% CI (1.24, 4.14)]. Compared to respondents with a high school diploma or less, individuals with some college education [OR 1.38; 95% CI (1.03, 1.85)] and those with at least a college degree [OR 1.52; 95% CI (1.17, 1.98)] were more likely to be aware. Participants who had positive cancer information seeking behavior were more aware of the HPV-anal cancer link compared to those who did not [OR 1.57; 95% CI (1.30, 1.89)].

Conclusion

Population-level awareness that HPV causes anal cancer remains critically low in the US. Sexual orientation, level of education and cancer information seeking behavior are associated with increased awareness of the causal relationship between HPV and anal cancer. Efforts should be directed toward addressing the awareness gap among individuals with lower education levels and promoting curiosity-driven information seeking behaviors.

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Data availability

The data underlying this article are publicly available from the National Cancer Institute’s Health information National Trends Survey at https://hints.cancer.gov/data/survey-instruments.aspx.

References

  1. Viens LJ, Henley SJ, Watson M, Markowitz LE, Thomas CC, Thompson TD, Razzaghi H, Saraiya M (2016) Human papillomavirus-associated cancers—United States, 2008–2012. Morbidity Mortality Wkly Rep 65(26):661–666. https://doi.org/10.15585/mmwr.mm6526a1

    Article  Google Scholar 

  2. Bansal A, Singh M, Rai B (2016) Human papillomavirus-associated cancers: a growing global problem. Int J Appl Basic Med Res 6(2):84. https://doi.org/10.4103/2229-516X.179027

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Melkonian SC, Henley SJ, Senkomago V, Thomas CC, Jim MA, Apostolou A, Saraiya M (2020) Cancers associated with human papillomavirus in American Indian and Alaska Native populations—United States, 2013–2017. Morbidity Mortality Wkly Rep 69(37):1283–1287. https://doi.org/10.15585/mmwr.mm6937a2

    Article  Google Scholar 

  4. Frisch M, Glimelius B, van den Brule AJC, Wohlfahrt J, Meijer CJLM, Walboomers JMM, Goldman S, Svensson C, Adami H-O, Melbye M (1997) Sexually transmitted infection as a cause of anal cancer. N Engl J Med 337(19):1350–1358. https://doi.org/10.1056/NEJM199711063371904

    Article  CAS  PubMed  Google Scholar 

  5. Deshmukh AA, Suk R, Shiels MS, Sonawane K, Nyitray AG, Liu Y, Gaisa MM, Palefsky JM, Sigel K (2020) Recent trends in squamous cell carcinoma of the anus incidence and mortality in the United States, 2001–2015. J Natl Cancer Inst 112(8):829–838. https://doi.org/10.1093/jnci/djz219

    Article  PubMed  Google Scholar 

  6. Colón-López V, Shiels MS, Machin M, Ortiz AP, Strickler H, Castle PE, Pfeiffer RM, Engels EA (2018) Anal cancer risk among people with HIV infection in the United States. J Clin Oncol 36(1):68–75. https://doi.org/10.1200/JCO.2017.74.9291

    Article  PubMed  Google Scholar 

  7. Lin D, Gold HT, Schreiber D, Leichman LP, Sherman SE, Becker DJ (2018) Impact of socioeconomic status on survival for patients with anal cancer. Cancer 124(8):1791–1797. https://doi.org/10.1002/cncr.31186

    Article  PubMed  Google Scholar 

  8. Ramamoorthy S, Luo L, Luo E, Carethers JM (2008) Tobacco smoking and risk of recurrence for squamous cell cancer of the anus. Cancer Detect Prev 32(2):116–120. https://doi.org/10.1016/j.cdp.2008.04.004

    Article  PubMed  PubMed Central  Google Scholar 

  9. Brewer NT, Ng TW, McRee A-L, Reiter PL (2010) Men’s beliefs about HPV-related disease. J Behav Med 33(4):274–281. https://doi.org/10.1007/s10865-010-9251-2

    Article  PubMed  PubMed Central  Google Scholar 

  10. Wheldon CW, Maness SB, Islam JY, Deshmukh AA, Nyitray AG (2021) Gay and bisexual men in the US lack basic information about anal cancer. J Low Genit Tract Dis 25(1):48–52. https://doi.org/10.1097/LGT.0000000000000571

    Article  PubMed  PubMed Central  Google Scholar 

  11. Osazuwa-Peters N, Adjei Boakye E, Mohammed KA, Tobo BB, Geneus CJ, Schootman M (2017) Not just a woman’s business! Understanding men and women’s knowledge of HPV, the HPV vaccine, and HPV-associated cancers. Prev Med 99:299–304. https://doi.org/10.1016/j.ypmed.2017.03.014

    Article  PubMed  Google Scholar 

  12. Mohammed KA, Subramaniam DS, Geneus CJ, Henderson ER, Dean CA, Subramaniam DP, Burroughs TE (2018) Rural-urban differences in human papillomavirus knowledge and awareness among US adults. Prev Med 109:39–43. https://doi.org/10.1016/j.ypmed.2018.01.016

    Article  PubMed  Google Scholar 

  13. Wells JS, Flowers L, Paul S, Nguyen ML, Sharma A, Holstad M (2020) Knowledge of anal cancer, anal cancer screening, and HPV in HIV-positive and high-risk HIV-negative women. J Cancer Educ 35(3):606–615. https://doi.org/10.1007/s13187-019-01503-8

    Article  PubMed  Google Scholar 

  14. Franca MC, Boyer VE, Gerend MA, Lee M, Whittington KD, McKinney SL, Collins SK, McKinnies RC, Adjei Boakye E (2023) College students’ awareness of the link between human papillomavirus (HPV) and HPV-associated cancers. J Cancer Educ 38(2):669–676. https://doi.org/10.1007/s13187-022-02172-w

    Article  PubMed  Google Scholar 

  15. Blumenthal J, Frey MK, Worley MJ, Tchabo NE, Soren K, Slomovitz BM (2012) Adolescent understanding and acceptance of the HPV vaccination in an underserved population in New York City. J Oncol 2012:1–8. https://doi.org/10.1155/2012/904034

    Article  Google Scholar 

  16. FitzGerald SM, Savage EB, Hegarty JM (2014) The human papillomavirus: men’s attitudes and beliefs toward the HPV vaccination and condom use in cancer prevention. J Men’s Health 11(3):121–129. https://doi.org/10.1089/jomh.2014.0022

    Article  Google Scholar 

  17. McBride KR, Singh S (2018) Predictors of adults’ knowledge and awareness of HPV, HPV-associated cancers, and the HPV vaccine: implications for health education. Health Educ Behav 45(1):68–76. https://doi.org/10.1177/1090198117709318

    Article  PubMed  Google Scholar 

  18. Saraiya M, Rosser JI, Cooper CP (2012) Cancers that US physicians believe the HPV vaccine prevents: findings from a physician survey, 2009. J Women’s Health 21(2):111–117. https://doi.org/10.1089/jwh.2011.3313

    Article  Google Scholar 

  19. National Cancer Institute. Health information national trends survey. https://hints.cancer.gov/. Accessed 18 Jun 2023

  20. Health Information National Trends Survey 5 (HINTS 5) Cycle 3 (2020) Methodology report. https://hints.cancer.gov/docs/Instruments/HINTS5_Cycle3_MethodologyReport.pdf. Accessed 19 June 2023

  21. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP (2008) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 61(4):344–349. https://doi.org/10.1016/j.jclinepi.2007.11.008

    Article  Google Scholar 

  22. Thompson EL, Wheldon CW, Rosen BL, Maness SB, Kasting ML, Massey PM (2020) Awareness and knowledge of HPV and HPV vaccination among adults ages 27–45 years. Vaccine 38(15):3143–3148. https://doi.org/10.1016/j.vaccine.2020.01.053

    Article  PubMed  Google Scholar 

  23. Glenn BA, Tsui J, Singhal R, Sanchez L, Nonzee NJ, Chang LC, Taylor VM, Bastani R (2015) Factors associated with HPV awareness among mothers of low-income ethnic minority adolescent girls in Los Angeles. Vaccine 33(2):289–293. https://doi.org/10.1016/j.vaccine.2014.11.032

    Article  PubMed  Google Scholar 

  24. Sarfati D, Koczwara B, Jackson C (2016) The impact of comorbidity on cancer and its treatment. Cancer J Clin 66(4):337–350. https://doi.org/10.3322/caac.21342

    Article  Google Scholar 

  25. Langston ME, Fuzzell L, Lewis-Thames MW, Khan S, Moore JX (2019) Disparities in health information-seeking behaviors and fatalistic views of cancer by sexual orientation identity: a nationally representative study of adults in the United States. LGBT Health 6(4):192–201. https://doi.org/10.1089/lgbt.2018.0112

    Article  PubMed  PubMed Central  Google Scholar 

  26. Jabson JM, Patterson JG, Kamen C (2017) Understanding health information seeking on the internet among sexual minority people: cross-sectional analysis from the health information national trends survey. JMIR Public Health Surveill 3(2):e39. https://doi.org/10.2196/publichealth.7526

    Article  PubMed  PubMed Central  Google Scholar 

  27. D’Souza G, Rajan SD, Bhatia R, Cranston RD, Plankey MW, Silvestre A, Ostrow DG, Wiley D, Shah N, Brewer NT (2013) Uptake and predictors of anal cancer screening in men who have sex with men. Am J Public Health 103(9):e88–e95. https://doi.org/10.2105/AJPH.2013.301237

    Article  PubMed  PubMed Central  Google Scholar 

  28. Quinn GP, Sanchez JA, Sutton SK, Vadaparampil ST, Nguyen GT, Green BL, Kanetsky PA, Schabath MB (2015) Cancer and lesbian, gay, bisexual, transgender/transsexual, and queer/questioning (LGBTQ) populations. Cancer J Clin 65(5):384–400. https://doi.org/10.3322/caac.21288

    Article  Google Scholar 

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Medicine, MedStar Health, Baltimore, MD, USA

    Joseph Atarere

  2. Department of Internal Medicine, Texas A&M School of Medicine, Longview, TX, USA

    Onyema Chido-Amajuoyi

  3. Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

    Henry Onyeaka

  4. Department of Medicine, Geisinger Wyoming Valley, Luzerne County, PA, USA

    Ogheneyoma Akpoviroro

  5. Division of Geriatrics and Gerontology, Emory University School of Medicine, Atlanta, GA, USA

    Comfort Adewunmi

  6. Department of Medicine, Northeast Georgia Medical Center, Gainesville, GA, USA

    Ange Ahoussougbemey Mele

  7. Department of Medical and Laboratory Sciences, Madonna University, Okija, Anambra State, Nigeria

    Chilota O. Faith

  8. Department of Pharmaceutical Sciences, University of Nigeria, Enugu, Nigeria

    Somtochi Nwani

  9. Division of Gastroenterology, Georgetown University, District of Columbia, Washington, DC, USA

    Priyanka Kanth

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  1. Joseph Atarere
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All authors made substantial contributions to the design, analysis and drafting of the manuscript. All authors gave final approval of the version to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy and integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Joseph Atarere.

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Atarere, J., Chido-Amajuoyi, O., Onyeaka, H. et al. Awareness of the causal association between human papillomavirus and anal cancer among US adults. Cancer Causes Control 35, 719–725 (2024). https://doi.org/10.1007/s10552-023-01830-8

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  • DOI: https://doi.org/10.1007/s10552-023-01830-8

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