Primary care providers' use of risk factors and test results to determine human papillomavirus vaccine receipt

Background: Since 2006, the Centers for Disease Control and Prevention recommends that girls aged 11 and 12 receive the HPV vaccine and that females aged 13 to 26 receive “catch up” HPV vaccinations. Prior to vaccination, Pap and HPV testing and patient report of number of sexual partners are not needed to determine who should receive the vaccine. Few national studies have investigated factors related to physician recommendations for the HPV vaccine.

Methods: Data from a nationally representative sample of Pap test providers were analyzed from the 2007 Cervical Cancer Screening Supplement administered in conjunction with the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey.

Results: Among 422 participants, preliminary findings demonstrate that, of physicians who recommend the vaccine, 20% reported that their practice performs a Pap test to determine who should receive the HPV vaccine sometimes to always, 21% reported that their practice uses an HPV test to determine who should receive the vaccine sometimes to always, and 28% reported that their practice uses number of sexual partners to determine who should receive the vaccine sometimes to always.

Conclusions: Some providers reported inappropriate use of patient factors to determine who should receive the HPV vaccine. As a result, vaccine eligible females may be denied the HPV vaccine. Furthermore, reported use of additional screening tests to determine vaccine receipt may increase health care costs.