On the Path to Prevention from the St. Jude HPV Cancer Prevention Program January 2022

As we usher in a new year, we remain committed to achieving our program’s vision—a world free of HPV cancers. Through education, promoting best-practice models, and strategic stakeholder engagement, our mission is to increase on-time HPV vaccination for all children.

We galvanize existing efforts and introduce new ones to help increase HPV vaccination in three areas:

Clinical interventions that focus on health care systems and providers
Community interventions that engage partners and strengthen local, regional, and national partnerships
Public policy and advocacy activities that build a supportive vaccination environment

We strongly value partnerships that advocate for equitable cancer prevention practices and policies and advancing best practice models in the field.

We work to ensure that our program services and communication are delivered equitably. As we remember Dr. Martin Luther King Jr. this month, we also acknowledge the disparities that exist in HPV vaccination coverage and HPV cancers. These realities guide our work each day. Within the community, we will meaningfully and intentionally engage diverse audiences and sectors to plan, implement and evaluate initiatives. We look forward to working with you in 2022.

January is Cervical Health Awareness Month, which offers a time to reflect and act. Cervical cancer may be the most well-known cancer caused by HPV. Yet, this cancer is just the tip of the iceberg. Cervical cancer is the only type of HPV cancer with a recommended screening test to detect it at an early stage. The other types of HPV cancers may not be detected until they cause health problems.

HPV vaccination could prevent more than 90% of cancers caused by HPV from developing. It also is important to note that hundreds of thousands of women are diagnosed with pre-cancers of the cervix each year. The cancer prevention potential is awesome. We join Cervivor, the National Cervical Cancer Coalition and other organizations raising awareness this month and always.

Every month, our program will send an email like this. We hope you will share it with others who may be interested and ask them to subscribe, too. We also want to hear from you if you have opportunities and information we can share. Email PreventHPV@stjude.org with questions.

HPV vaccination is cancer prevention.

Cervical cancer can be prevented by increasing education and awareness, HPV vaccination and screening.

The new year is a great time to bring awareness to cervical cancer and better understand its connection to HPV and what can be done to prevent it. The American Cancer Society estimates that by the end of the year, about 14,000 new cases of invasive cervical cancer will be diagnosed in the United States and about 4,300 women will die from the disease. The good news is that cervical cancer is highly preventable. The National Cancer Institute has shown that HPV vaccination and cervical cancer screening (Pap test) are both proven tools for decreasing the risk of developing cervical cancer.

According to the Centers for Disease Control and Prevention, HPV vaccination could prevent more than 90% of HPV-attributable cancers, which include cervical cancer. HPV vaccination is safe, effective and provides long-lasting protection. HPV vaccination is recommended for routine vaccination at age 11 or 12 years and may be started at age 9. Adults aged 27–45 should talk to their doctors to see if HPV vaccination is right for them.

The American Cancer Society recommends cervical cancer screening should begin at age 25. The most important thing to remember is to get screened regularly, no matter which test you get. Other guidelines include:

Those aged 25–65 should have a primary HPV test every 5 years.
If a primary HPV test is not available, screening may be done with either a co-test that combines an HPV test with a Pap test every 5 years or a Pap test alone every 3 years.
Those over age 65 who have had regular screening in the past 10 years with normal results and no history of CIN2 or more serious diagnosis within the past 25 years should stop cervical cancer screening. CIN2 is a condition in which abnormal cells are on the surface of the cervix. Once cervical cancer screening is stopped, it should not be started again.

People who have been vaccinated against HPV should still follow these guidelines for their age groups.

We join Cervivor, the National Cervical Cancer Coalition and other organizations in supporting cervical cancer survivors. These groups use survivors’ stories to inspire action and prevent future cervical cancers.

St. Jude is the only National Cancer Institute–designated Cancer Center specifically focused on children. Thus, we have a responsibility to increase HPV vaccination rates to prevent cervical and other HPV cancers. Our goal is to increase HPV vaccination rates locally, regionally and nationally. Through our HPV Cancer Prevention Program, we strive to prevent future HPV cancers by increasing HPV vaccinations.

“It is important to have conversations in simple terms to explain HPV, such as what it means and what you can do. We have to listen to the concerns about HPV and then respond with the best information.” —Jennifer Erves, PhD, MPH, MAEd, MS, CHES

When her family experienced a cervical cancer diagnosis, Jennifer Erves, PhD, assistant professor of internal medicine at Meharry Medical College, became passionate about preventing HPV cancers through HPV vaccination. As a researcher, Erves develops strategies for education and community interventions that help to increase HPV vaccination. Her goal is to ensure information is accessible and meaningful.

When people understand HPV, it builds trust and creates a level of comfort with health care providers. By normalizing the information, individuals gain confidence in the message they receive. Erves has studied HPV vaccination hesitancy and has identified messages to overcome hesitancy and promote vaccination.

There are lessons to be learned from HPV vaccination and from COVID-19 vaccination. She says researchers should explain how COVID-19 vaccines were developed to alleviate hesitancy toward the vaccine and other vaccines. Another one of the main lessons is related to the messenger: The person who delivers the message is as important as the message itself.

Health care providers are often thought to be natural, trusted messengers, but not everyone has regular interactions with their health care provider. This means looking outside of the clinical setting for trusted messengers and information sources. Parents and other advocates who are trained with accurate information can be valuable messengers among those who might be hesitant.

After parents share stories about how they protected their children against HPV cancers through vaccination, it is important to follow up with what happened afterwards. They may explain that their children have gone on to start families or that nothing negative happened after getting the HPV vaccine. Above all, making sure the message is clear also includes who delivers the message.

Learn more about Erves and her research program.

Join us January 27 for the first of four sessions focused on HPV vaccination and implementation science research.

The HPV Research Group of the St. Jude–Washington University Implementation Sciences Collaborative invites you to explore opportunities for collaborations on implementation science research in the setting of HPV vaccination.

The collaborative brings expertise in implementation sciences from Washington University and Siteman Cancer Center together with childhood cancer care and survivorship resources from St. Jude. The goals are to:

Maximize dissemination and implementation of evidence-based programs
Increase implementation sciences training for St. Jude faculty and fellows
Build collaborative research projects across survivorship, global children’s cancer care and HPV vaccination

The collaborative will host a short conference in 2022 that aims to:

Increase awareness of key HPV vaccination implementation science issues
Identify opportunities for new collaborations on HPV vaccination projects
Share opportunities for involvement in the collaborative

The first session will feature Prajakta Adsul, MBBS, PhD, of the University of New Mexico as the moderator and discussant. Presenters include Lisa Klesges, PhD; Kia Davis, ScD; and Michelle Silver, PhD, of Washington University in St. Louis and Heather Brandt, PhD, of St. Jude.

Register today to attend any or all of the following sessions:

HPV Vaccination in Community Contexts on Thursday, January 27 from Noon–1:30 p.m. CST
HPV Vaccination in Clinical Contexts on Thursday, February 24 from Noon–1:15 p.m. CST
HPV Vaccination in Policy Contexts on Thursday, March 31 from Noon–1:15 p.m. CST

HPV Vaccination: Opportunities and Next Steps on Thursday, April 28 from Noon–1:30 p.m. CST

Brandt and Klesges lead the HPV Vaccination Research Group. For more information, email Carrie Stoll.

Addressing Disparities in HPV Cancer Prevention

The late Dr. Martin Luther King Jr. once said, “Of all the forms of inequality, injustice in health is the most shocking and the most inhumane.” As we celebrate King’s legacy, we also celebrate how his contributions led to advancements in achieving health equity. Yet, we are also reminded of the work that remains.

Healthy People 2030 aims to “eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all.” There are also goals related to improving social determinants of health by creating social, physical and economic environments that promote attaining the full potential for health and well-being for all.

In the St. Jude HPV Cancer Prevention Program, we acknowledge that disparities exist related to HPV vaccination and cancer disparities. For example, adolescents in rural areas are less likely to be vaccinated against HPV. According to the National Cancer Institute, cervical cancer disparities exist between rural and urban areas. Hispanic and Latino and Black or African-American women are also diagnosed with cervical cancer more often than women of other racial and ethnic groups. Black or African-American women die more often from the disease.

We aim to take an equitable approach to HPV vaccination as a strategy to prevent HPV cancers and reduce cancer disparities.

HPV Best Practices Learning Collaborative:
Putting Lessons Learned into Practice

The HPV Vaccination Best Practices Learning Collaborative began in 2019 as a national partnership between the American Medical Group Association and the National HPV Vaccination Roundtable. Between November 2019 and May 2021, the collaborative aimed to improve HPV vaccination rates among adolescents.

A national advisory committee selected 8 health care systems to take part in the collaborative. Through multidisciplinary teams led by a provider or clinical champion, the organizations took the following actions:

Developed and implemented evidence-based strategies
Developed action plans
Monitored progress
Reported quarterly on HPV vaccination rates

Interventions implemented by the organizations were tailored to local communities. Types of interventions included:

Provider education and incentives
Patient education and outreach
Patient scheduling
EHR features

Overall, vaccination rates and rates between boys and girls varied significantly across the organizations. To address these gaps, each organization aimed to reduce its rate of unvaccinated adolescents at baseline by 20%.

Over the course of the learning collaborative, the organizations reached 132,500 adolescents, ages 9–17. Every organization saw improvement in one or more measures. Every measure saw improvement within at least one organization.

The collaborative achieved relative improvement in HPV vaccination initiation rates of 9% for patients aged 11–12 and 8% for patients aged 13–17. Series completion rates for these adolescents also improved by 5% and 11%, respectively, relative to baseline measures.

Over the course of the learning collaborative, about 5,700 additional adolescents aged 11–17 initiated HPV vaccination as compared to baseline and an additional 6,100 completed the series.

Key lessons learned included:

Measurement is critical because you cannot improve what is not measured.
Benchmarking trusted data is essential for comparison.
Health care providers may be motivated by competitive benchmarking of trusted data.
Facilitated shared learning generated the improvements.
Organizational change is a slow process, so begin as soon as possible.

Read the full summary report.

The National HPV Vaccination Roundtable offers clinician and health systems action guides to help you start increasing HPV vaccination coverage today. In addition, the American Cancer Society’s Steps for Increasing HPV Vaccination in Practice offers an action guide for improving HPV vaccination coverage in clinical settings.

HPV Prevention Week Is January 23-29

Members of American Medical Women’s Association, Global Initiative Against HPV and Cervical Cancer, and Indiana University are once again collaborating to present the Us vs. HPV Prevention Week January 23–29. The initiative’s goal is to increase public and practitioner awareness of HPV, HPV-related diseases, and the importance of HPV vaccination. Each day of the week focuses on a different HPV-related topic, with daily free webinars.

Building on the foundation laid over the past three years, the 2022 Us vs. HPV will highlight strategies to tackle the various types of vaccine hesitancy, discuss the updated World Health Organization guidelines on cervical cancer elimination strategy, and provide new information on HPV-related head and neck cancers. All webinars and panel discussions are open to a broad audience—from stakeholders to the general public who are interested in preventive health and in making cervical cancer the first cancer to be wiped out.

Monday, January 24: HPV Vaccination: Roaring Back to Prevent Cancer
Tuesday, January 25: Conquering Cancer - Documentary
Wednesday, January 26: Cervical Cancer Action for Elimination: Marching Towards a Sustainable and Resilient Recovery
Thursday, January 27: HPV Head and Neck Cancers: What You Don't Know CAN Hurt You
Friday, January 28: Champions of HPV and Cervical Cancer Awareness: You, the Media, Educational Campaigns and Young Leaders

All webinars are from 11 a.m. to noon CST, except the January 25 documentary, which extends from 11 a.m. to 1 p.m. CST.

Download the full webinar schedule.
Register for the webinar series.

What do you hope to accomplish in 2022?

New Year’s resolutions are commonplace, and some serve as a focus for the year while some are quickly forgotten. The St. Jude HPV Team takes a different but related approach by framing what they hope to accomplish this year.

“I would like to fit more relaxation techniques into my busy schedule.” – Andrea Stubbs, administrative director

“I want to reach more providers and parents in rural areas with HPV education and resources.” – Carol Minor, program coordinator

“In the new year, I want to be more organized and impactful. I also want to continue my education.” – Julia Neely, program coordinator

“I would like to do better in my daily meditation.” – Contrina Huffman, graduate student assistant

“I hope to complete my Master of Public Health degree and graduate this year!” - Duha Magzoub, graduate student assistant

“I would like gain new skills and increase my professional knowledge and training.” – Ursula LeFlore, administrative specialist

“I always have resolutions that serve as my goals for the year. Some of these are related to health and well-being, some are related to work, and some are aspirational. One of my goals for this year is to read more books. I hope to read at least 50 books this year.” – Heather Brandt, director

Get Free St. Jude HPV Education Materials Today

The St. Jude HPV Cancer Prevention Program has created a series of HPV cancer prevention educational materials. These colorful fact sheets contain essential information about the importance of HPV vaccination as cancer prevention.

There are four versions of the fact sheets to target various audiences: general public, parents, health care providers, and cancer patients and families. The materials emphasize basic information about HPV vaccination and include action steps to prevent HPV cancers.

You can select the versions most appropriate for those you serve. Download the fact sheets online or email PreventHPV@stjude.org to have copies mailed to you.