National Survey Study on the Approaches of Pediatricians, Family Physicians, Medical Oncologists and Gynecologists to the HPV Vaccine

"...clear and strong communication of physicians about the importance of the vaccine is extremely important for protecting today's young people from HPV-related cancers..."

Despite the high efficacy and safety profile of human papillomavirus (HPV) vaccination, the number of vaccinated individuals is well below the target rate in many countries, including Turkey. This study aims to emphasise the critical role of physician recommendations in increasing HPV vaccination rates, and to create awareness in this regard, by revealing the approach of Turkish oncologists, gynaecologists, paediatricians, and family physicians, who are the primary interlocutors in the matter of HPV vaccination.

Interviews were conducted, and a questionnaire administered, among 425 physicians at 4 separate national oncology, pediatrics, gynaecology, and family medicine congresses in Turkey, between March 10 and March 19 2016. Selected findings:

• Only 21% of the respondents reported promoting the vaccine in their routine practice.
• Thirty-three percent of the respondents stated that HPV vaccination was not important, and the ones who considered it to be unnecessary (31%) pointed out its non-cost effectiveness to justify their opinion.
• Although current guidelines state that the vaccine should be administered to boys as well, only 51% of the respondents believe the vaccine should be administered to both girls and boys.
• The rate of the respondents who stated that it should be administered to those with a risk factor was only 19%, yet current guidelines state that the vaccine should be routinely administered to everyone of the appropriate age.
• Respondents who answered correctly the question intended for assessing their knowledge about HPV's share in all types of cancer considered the vaccine to be more important and recommended it more in their routine practices.
• When the HPV status was evaluated based on branch, the proportion of those who considered the vaccination important was found to be significantly lower in gynaecologists (p < 0.001).
• Physicians with a lower number of patients per week and those who did not serve in public institutions encouraged the use of vaccine more in their routine practices. Therefore, work intensity is an obstacle to the promotion of the vaccine.
• The fact that those who have HPV vaccine in the stocks of their workplaces promote the vaccine more often shows that the ability to easily obtain the vaccine is one of the factors affecting the recommendation of the vaccine by physicians.

Among those who did not recommend the vaccination in their daily practices, the rate of correct answer to the question intended for questioning the respondents' knowledge of HPV was found to be significantly lower (p = 0.011). "In other words, physicians recommend the vaccine more often when they are more aware of the importance of HPV. This indicates that training intended for physicians will be a key strategy in increasing HPV vaccination rates....However, there is a need for comprehensive and well-designed studies intended for evaluating the attitudes of nurses, pharmacists and parents of children in the target age group - who are the other interlocutors in the matter of vaccination - towards the HPV vaccine, for determining the strategies that will ensure the vaccination rates to reach the desired levels."