Introduction: Human Papilloma Virus (HPV) infections are mostly self-limited, however in certain cases the virus replication can become carcinogenic. To prevent cancerous lesions, the HPV vaccine can prevent over 90% of cancers caused by HPV and is recommended by the CDC to be administered by the age of 26 years. Between ages 27 and 45 years patients are still eligible to receive the vaccine with balanced discussion of risks and benefits.
According to the current American College of Gastroenterology guidelines, it is recommended that all adult patients with Inflammatory Bowel Disease (IBD), regardless of their immunosuppression status, receive non-living vaccinations which are in-line with national guidelines, including the HPV vaccine.
Methods: A survey was performed assessing knowledge and practices of preventative health in primary care providers, including residents and attending physicians, in the management of patients with IBD. Providers were asked about vaccination practices for their IBD patients.
A sample of patients was selected from the medical health record database within a tertiary care center. Inclusion criteria included a confirmed diagnosis of Ulcerative Colitis (UC) or Crohn’s Disease (CD) and an established primary care clinic relationship with the internal medicine residents or non-teaching internists of the same medical center. Excluded were patients over the age of 60, due to first approval of HPV vaccine in 2006. General Demographics, HPV vaccination status, and clinical information relating to IBD was collected.
Results: 70% of physicians (38 physicians surveyed) had responded in the survey that female IBD patients should be routinely vaccinated for HPV.
A total of 48 patients were included in the study, all of these patients being of female gender. The age of patients ranged from 22 years old to 60 years old. Only 9 out of 48 patients were vaccinated against HPV. 22 patients were on biologic therapy. Of the 22 patients on biologic therapy, 6 patients had completed their HPV vaccination series.
Discussion: Our survey revealed that more than two-thirds of physicians understood that HPV Vaccination should be a routine vaccination for female patients with IBD. Although 70% of these physicians acknowledged that this population should be vaccinated for HPV, only 18.8% of patients received the vaccine. It would be necessary moving forward to determine the barriers of care, including gaps in physician knowledge, lack of access to the vaccine, patient preference and patient adherence.
