Rural HPV Cancer Prevention

In this quarterly communication about our efforts to improve HPV vaccination with rural communities in the United States, we highlight the following:

Upcoming virtual Rural Quarterly Updates and Opportunities Meeting on August 20, featuring Dandy A. Garcia, Associate Director for Community Partnerships, American Cancer Society. Register here.
New national survey, open through September 12, to gather input on rural HPV vaccination opportunities. Take the survey here.
New study by program experts offers valuable insights as we continue to address geographic differences in HPV vaccination and cancer outcomes. Read the study here.
Upcoming seminar on October 16 exploring differences in HPV vaccination and HPV cancers within and across sub-groups present in rural communities and actionable strategies to address the unique barriers faced by rural communities. Register here.
This month’s Wide Open Spaces article, The Power of Prevention: "HPV Doesn’t Wait – Why Should You?

Plus, new trainings and resources, recent publications, and upcoming events

Tell us what you are working on related to rural HPV cancer prevention.

If you are interested in presenting as part of an upcoming quarterly updates meeting, sharing information in the quarterly communication (sent one week prior to each quarterly meeting), and/or contributing to our monthly Wide Open Spaces article series, we would love to showcase your work with rural communities to increase HPV vaccination and prevent HPV cancers. We are all learning from each other to improve protection among people living in rural communities.

Join our efforts to improve rural HPV vaccination coverage.

Visit the Preventing HPV Cancers in Rural Communities website at stjude.org/hpvrural or sign up here to receive the latest information on our rural HPV coverage efforts. Email PreventHPV@stjude.org with any questions.

Rural Resources and Reach: From Our Program to You

Rural Quarterly Updates and Opportunities Meetings

Join us on August 20 from noon-1 p.m. Central Time for the next Preventing HPV Cancers with Rural Communities Updates and Opportunities meeting featuring Dandy Garcia, Associate Director for Community Partnerships at the American Cancer Society. He will present insights from his impactful work to bring HPV cancer prevention efforts to agricultural and farm workers in the Midwest region. His presentation will offer valuable insights into how we can adapt our strategies to meet the evolving landscape and strengthen community-centered approaches.

In addition to this featured presentation, we will also share highlights from the newly compiled Preventing HPV Cancers with Rural Communities Summary Report, which captures progress made since January 2023 across the six rural HPV vaccination priority actions. This report serves as a foundation for our ongoing process to revisit and refine the rural priorities in light of today’s changing rural health and policy landscape, and it will help frame discussion of our new survey designed to gather nationwide perspectives on these priorities. Your engagement and input continue to be critical in ensuring these priorities remain responsive, effective, and grounded in the realities of rural communities.

We will wrap up the meeting by sharing plans for the release of new resources, seminars, and priority actions later this fall. You won’t want to miss it!

Register here. Registration information also is available at stjude.org/hpvrural.

As part of the St. Jude HPV Cancer Prevention Program’s ongoing efforts to improve HPV vaccination coverage with rural communities in the United States, we have been undergoing a process to revisit and strengthen six rural HPV vaccination priorities that have guided our work over the last two years. We would greatly value your input and invite you to complete a short survey to help ensure the revised priorities reflect on-the-ground realities and today’s rural health context. Far too many children in rural communities are missing out on HPV vaccination. Far too many people living in rural areas are being diagnosed with HPV cancer as adults. We want to change this. Your perspective is essential as we work to maintain momentum and an actionable path forward. Thank you in advance for your time and insights. The survey will be open until Friday, September 12.

Take the survey here and reach out to us with any questions at PreventHPV@stjude.org.

Scan to take the survey!

Past and Upcoming St. Jude Preventing HPV Cancers with Rural Communities Updates and Opportunities meetings

The Rural HPV Vaccination Quarterly Updates Meeting, held on May 14, 2025, convened rural health professionals, researchers, and public health advocates to reflect on shared progress and emerging challenges and served as an opportunity to identify next steps for advancing HPV vaccination in rural communities. This Updates meeting followed the distribution of the May rural HPV cancer prevention quarterly communication.

Subject matter experts discussed a central question, “What do we need to be doing to improve HPV vaccination and prevent HPV cancers within rural communities?” describing the shifting policy, funding, and public health landscapes, emphasizing the need for continued collaboration, culturally relevant and tailored interventions, and developing a proactive response to the changing environment. If you were unable to join us, you can catch up with the recording and presentation slides. We hope to see you at our next meeting.

Given the ongoing changes to the rural HPV vaccination and cancer prevention landscape, the St. Jude team along with guidance from subject matter experts has been revisiting the Rural HPV Vaccination Priority Actions to ensure our primary strategies continue to address the most pressing issues in rural communities and leverage the strengths of rural communities as part of our implementation efforts.

The May 14 discussion served as a starting point to revisit rural HPV vaccination priorities to maximize the impact of HPV cancer prevention efforts with rural communities in the face of constant change. The process of revisiting the rural HPV vaccination priorities will culminate with the release of a summary report later this fall and the release of updated priority actions on National Rural Health Day on November 20.

We are grateful to our rural HPV vaccination subject matter experts for their continued engagement and dedication to this work.

Trisha Amboree, PhD, MPH, Assistant Professor, Medical University of South Carolina, Hollings Cancer Center
Natoshia Askelson, PhD, MPH Associate Professor, Community & Behavioral Health, Director of the Research and Evaluation Core, Institute for Public Health Practice, Research, and Policy, Associate Director for Community Outreach & Engagement, Holden Comprehensive Cancer Center
Gabriel Benavidez, PhD, Assistant Professor of Epidemiology, Dept of Public Health, Baylor University
Deanna Kepka, PhD, MPH, Professor, College of Nursing & Huntsman Cancer Institute University of Utah
Ashley Lach, MHA, CPHQ, Program Manager, HPV Disparities, American Cancer Society
Jason Semprini, PhD, Assistant Professor, Department of Public Health, Des Moines University
Christina Turpin, Director, National HPV Vaccination Roundtable, American Cancer Society
Whitney Zahnd, PhD, Assistant Professor, Department of Health Management and Policy in the College of Public Health at the University of Iowa

Program Experts Publish Study on Intersectional Variation of HPV-Associated Cancers in Rural America

A new study, Evaluating intersectional variation of HPV-associated cancers in rural America, led by members of the St. Jude HPV Cancer Prevention Program and rural subject matter experts was published this month in BMC Public Health. The study examined how rural residence intersects with race, ethnicity, and gender to shape differences in HPV cancer incidence. The study finds that while rural areas overall face higher rates, important variation exists within rural populations. The research reinforces the need for more precise, community-informed HPV prevention strategies.

Close-Knit, Far-Reaching: Harnessing the Strengths of Rural Communities to Prevent HPV Cancers Through HPV Vaccination, October 16, 2025

As part of our ongoing series, Empowering and Strengthening Community, Culture, and Connection to Prevent HPV Cancers, we will hold the sixth seminar in this series on October 16 from 10-11:15 a.m. Central Time. The seminar will explore differences in HPV vaccination and HPV cancers within and across sub-groups present in rural communities and will explore actionable strategies to prevent HPV cancers by addressing the unique barriers faced by rural communities. Through the lens of rural intersectionality, participants will examine how geography, race, ethnicity, sex, and socioeconomic status intersect to influence HPV vaccination access and outcomes in rural communities. The session will highlight approaches to advance equal access to health care, strengthen culturally responsive communication, and equip public health professionals with tools to close gaps in HPV cancer prevention across rural landscapes. Stay tuned for more information and register to attend here.

National Rural Health Day is November 20

Since 2011, the National Organization of State Offices of Rural Health (NOSORH) has set aside the third Thursday of November to celebrate the "Power of Rural" on National Rural Health Day (NRHD). This day is an opportunity to bring attention to and honor the incredible efforts of rural health care providers, communities, organizations, State Offices of Rural Health, and other stakeholders dedicated to addressing the unique health care needs of rural America.

Mark your calendars for National Rural Health Day on November 20, which will be the fourth and final Rural Quarterly Updates Meeting of 2025. Register here.

We look forward to celebrating the strengths of rural communities during this meeting, and through our quarterly newsletter in November, dedicated to National Rural Health Day.

St. Jude HPV Cancer Prevention Program Launches New National Campaign

Updates with Rural-focused Resources and Content

St. Jude HPV Cancer Prevention Program’s national public awareness campaign "Their Future is in Your Hands" has re-launched to include a focus on rural communities. The online resource now features rural-specific HPV vaccination resources, messages, and materials tailored for health professionals, partners, and communities working to prevent HPV cancers in rural America. These tools aim to address the unique challenges and strengths in rural settings while equipping users with evidence-based strategies and sharable content. Access the campaign at stjude.org/PreventHPV and rural content directly here.

Announcement Approach Training Available

The Announcement Approach Training is a proven, evidence-based intervention that helps health care providers make effective, confident HPV vaccination recommendations. This training boosts HPV vaccination rates by teaching clinicians to deliver strong, presumptive messages that resonate with parents and respond to questions using research-tested messages and can be tailored for rural providers.

The St. Jude HPV Cancer Prevention Program team is available to help coordinate this impactful training for groups of health care providers. If your team is ready to improve communication and protect more patients from HPV cancers, email us at PreventHPV@stjude.org to get started.

Wide Open Spaces

Wide Open Spaces is a series of articles included in the St. Jude HPV Cancer Prevention Program’s monthly Path to Prevention newsletter. These articles address ways to improve HPV vaccination with rural communities. Articles are written by guest contributors, who share information on their efforts and success in improving HPV vaccination with rural communities. We invite guest contributors to share information on how they are working to improve HPV vaccination in rural areas.

This month, we feature work from the Nebraska Cancer Coalition (NC2), who recently released a new HPV vaccination campaign, HPV Doesn't Wait - Why Should You? You can request campaign materials here.

Nebraska is a predominantly rural state, with 27% of its population living in rural areas, well above the national average. Of the state's 93 counties, 61 are entirely rural, and many more are mostly rural. Compounding this, 69 counties are designated as primary care health professional shortage areas, creating significant barriers to health care access, including vaccinations. Although HPV vaccination is a proven, life-saving tool, increasing awareness and addressing rural-specific challenges are essential to improving vaccination rates and protecting Nebraska communities. Every Nebraskan deserves a shot at prevention.

As part of their ongoing efforts to increase HPV vaccination awareness, NC2’s July monthly meeting featured the webinar Don’t Wait: The Power of HPV Vaccination in Cancer Prevention. Presented by the St. Jude Rural HPV Cancer Prevention Lead, Nicole Williams, MPH, the webinar highlighted the critical role of health care providers in recommending HPV vaccination and highlighted data on differences in HPV cancer types and vaccination rates geographically, with a particular focus on rural communities. The presentation reflects our continued efforts to collaborate with partners like NC2, who are working to reduce HPV cancers in their predominately rural state and beyond.

To learn more about the work of NC2, read this month’s Wide Open Spaces article describing their new HPV vaccination campaign, HPV Doesn't Wait - Why Should You?

Recent Wide Open Spaces articles include:

The Power of Prevention: "HPV Doesn’t Wait – Why Should You? (August 2025)
Patriotism and Public Health: We the People Vax (July 2025)
A Preventable Cancer Crisis We Can't Ignore (June 2025)
Addressing Cervical Cancer Disparities in the Mississippi Delta through Community-Based Participatory Research (May 2025)

Access all Wide Open Spaces articles at stjude.org/hpvrural.

We are looking for authors for Wide Open Spaces articles. If you are interested in contributing, please email us at PreventHPV@stjude.org.

Trainings and Resources

Librarians as Catalysts for Head and Neck Cancer Prevention

Researchers, Joni Nelson, PhD, MS, and Rena Lubker PhD, MLS, MPH, RD, AHIP of the Medical University of South Carolina, are exploring an innovative model to improve head and neck cancer literacy in rural communities—by partnering with public libraries. Supported by funding from the National Institutes for Health and the National Library of Medicine, their project, PULL A-HEAD, engages librarians as trusted messengers to deliver education, screening resources, and health care navigation tools to underserved populations. With libraries already serving as community information hubs, this approach holds promise to reduce racial and geographic differences in cancer outcomes. While the work is preliminary, it lays the groundwork for broader adoption of community-centered health literacy strategies nationwide. Learn more here and explore the PULL A-HEAD guide, a navigation resource for head and neck cancer literacy.

Still Time to Join the 2025 Rural HPV Vaccination Learning Community Summer HPV Vaccine Communication Series

It's not too late to join the Rural HPV Vaccination Learning Community, a national effort supporting rural health care professionals and public health leaders in increasing rural HPV vaccination rates. Participants gain access to expert-led sessions, peer networking, and tailored resources—all designed to advance health equity and cancer prevention in rural communities. Continuing education credits (CEs) are available.

Be sure to check out the Learning Community’s Summer HPV Vaccine Communication Series, a three-part series designed to equip participants with effective communication strategies to boost HPV vaccination rates in rural settings.

Register now to be part of this impactful initiative from our partners at the American Cancer Society and the National HPV Vaccination Roundtable. And you can catch up anytime on previous sessions you might have missed here.

St. Jude Rural HPV Vaccination Resources

Website: stjude.org/hpvrural

Preventing HPV Cancers in Rural Communities fact sheet

Wide Open Spaces articles are available at stjude.org/hpvrural – read the August 2025 article here

International HPV Awareness Day 2025: Harvesting Best Practices to Prevent Rural HPV Cancers

Preventing HPV Cancers with Rural Communities: Quarterly Updates and Opportunities

May 2025 quarterly updates recording and newsletter

February 2025 quarterly updates recording and newsletter

November 2024 quarterly updates recording (unedited) and newsletter

Recent Publications

A Promising Drop: HPV Vaccination Linked to Major Decline in Cervical Cancer

A new study, Quantifying the impact of introducing HPV vaccines in 2006 on 25-29-year-old cervical cancer incidence in 2022 by Semprini, et al. published in JNCI Cancer Spectrum delivers long-awaited evidence of HPV vaccination’s impact: cervical cancer incidence among 25-29-year-old U.S. females dropped by 48% from 2019 to 2022, linking this decline directly to the 2006 HPV vaccination recommendation for adolescent girls. This promising data arrives as momentum builds for using HPV vaccination not only as a pathway for prevention—but as a pathway to elimination.

CDC and Rural Researchers Agree: HPV Vaccination is Working

A CDC Morbidity and Mortality Weekly Report (MMWR) from earlier this year highlighted a 79% decrease in cervical precancer (cervical intraepithelial neoplasia [CIN] grades 2–3 and adenocarcinoma in situ [AIS], collectively CIN2+) incidence and an 80% decline in higher-grade precancer (CIN3+) incidence among women aged 20-24 from 2008 to 2022, reinforcing the power of HPV vaccination to prevent cervical disease. These national trends were echoed in findings from Semprini, et al., who similarly observed declining cervical cancer incidence rates among young women—a shift attributed to vaccine uptake. Together, these studies provide compelling, real-world evidence of the success of HPV vaccination. Yet differences in outcomes persist, particularly in rural areas. Continued efforts are needed to ensure all communities benefit equally from HPV prevention tools that are already changing the trajectory of cervical cancer in the U.S. and across the globe.

Harnessing AI to Tackle HPV Vaccination Hesitancy in Rural America

A recent study, HPV Vaccine Hesitancy in Rural America and Exploring Artificial Intelligence Interventions by Argyris, et al. presented earlier this year at the 58th Hawaii International Conference on System Sciences explores the potential for artificial intelligence (AI) to combat HPV vaccination hesitancy in rural America. The researchers highlight persistent barriers to vaccination in rural communities, including access issues, misinformation, and cultural stigma. By proposing a framework for AI-informed educational interventions—such as intelligent chatbots—the study outlines how technology can help personalize communication and improve trust. As rural health systems seek innovative solutions, this timely research offers a compelling direction for using AI to increase HPV vaccination coverage and reduce preventable cancers in rural communities.

Study Investigates Differences in Survival and Cause-Specific Mortality between Rural and Urban Populations with HPV-associated Oropharyngeal Cancer

A new study, Disparities in rural and urban outcomes in populations with human papillomavirus–associated oropharyngeal cancers by Mills, et al. published in the Journal of Rural Health explores differences in outcomes for rural vs. urban patients with HPV-associated oropharyngeal cancers. Analyzing national data, researchers found that rural patients had significantly higher odds of dying from HPV-associated oropharyngeal cancers, despite lower comorbidity rates, emphasizing that more research is needed to determine the best way to mitigate this difference and examine interventions to improve overall survival and cause-specific mortality in rural patients. The article adds to the growing body of literature indicating significant differences in rural and urban outcomes in HPV cancers.

Community-Level Factors Found to Contribute to Outcomes in Cervical Cancer

A new study, Community-level Social Vulnerability and Cervical Cancer Mortality Among Young and Old Adults in the State of Alabama by Patel, et al. published in the Journal of Community Health highlights the impact of community-level social vulnerability on survival outcomes for women diagnosed with cervical cancer and sheds light on how factors like neighborhood socioeconomic status, housing conditions, and household composition are linked to worse cancer outcomes, particularly for older women. This timely research aligns with other studies linking community vulnerability with poorer cancer outcomes and underlines the need for a more comprehensive understanding of the role of community environments on cervical cancer outcomes.

The Future of Rural Health Summit Report

The Future of Rural Health Summit report offers timely insights for rural health leaders, advocates, and decision-makers highlighting emerging trends, persistent barriers, and innovative strategies that align closely with today’s evolving rural health landscape. As we revisit our rural HPV vaccination priorities, this report provides valuable context to help ground our efforts in the realities rural communities face.

Other Happenings in Rural Health

Focusing on Rural Strengths – From What’s Missing to What’s Possible
National Rural Health Association Conference, May 20-23, 2025

An important theme emerged from the 48th Annual National Rural Health Association (NRHA) Conference: rural health conversations must shift away from focusing on what rural communities lack, and instead emphasize the strengths, assets, and resilience they already possess. The conference underscored the rural health motto: Nothing about us, without us, calling for solutions that build on the capacities within rural communities rather than framing them solely by deficits. Read a recap of the conference in our July Path to Prevention newsletter here.

National Rural Health Association Meets with RFK Jr. at Health and Human Services to Outline Rural Health Needs

According to Becker’s, nearly 800 rural hospitals are at risk of closure. National Rural Health Association (NRHA) leaders recently met with Health and Human Services Secretary Robert F. Kennedy, Jr. to explain how rural hospitals help communities flourish. The One Big Beautiful Bill Act calls for nearly $1 trillion in cuts to Medicaid, which NRHA CEO Alan Morgan warns will cause rural hospitals to close, as roughly 1 in 4 rural Americans are on Medicaid. NRHA Chief Policy Officer Carrie Cochran-McClain also discussed how cuts could impact rural cancer patients, and a rural Missouri family explains why Medicaid access is a matter of life and death. Additionally, experts warn tariffs will hurt rural health care centers and medical suppliers and NRHA supports a bill to aid rural emergency hospitals (REHs). Learn how to navigate how the legislation impacts rural communities at NRHA’s 23rd Rural Health Clinic and 24th Critical Access Hospital Conferences September 23-26 in Kansas City. More information about the conferences can be found below in Upcoming Events.

South Carolina Expands Access with New Mobile Health Units

The South Carolina Department of Public Health (DPH) has launched three new mobile health units (MHUs) to deliver preventive care and public health services directly to underserved communities. These fully equipped “health departments on wheels” offer services like vaccinations, family planning, and STD testing—removing barriers to care for rural and remote populations. Staffed by clinical and community health professionals, the MHUs will improve access, promote health equity, and meet communities where they are. This timely initiative reflects a growing emphasis on community-based, flexible models of care delivery. Learn more or request a visit at DPH’s MHU webpage. For additional information or questions, contact MobileHealthUnits@dph.sc.gov.

The Medical University of South Carolina (MUSC) Hollings Cancer Center has also launched a mobile HPV Vaccination Van that travels the state with an HPV health educator and nurse on board to make it easier for children and young adults in underserved, often rural areas, to take advantage of this important cancer prevention resource. Click here to learn more.

Upcoming Events

Registration Now Open for National Rural Health Association’s Clinic and Hospital Events

Learn how colleagues are raising the standards for rural health at NRHA’s 23rd Rural Health Clinic and 24th Critical Access Hospital Conferences September 23-26 in Kansas City. This is your chance to take advantage of more than 40 educational and networking opportunities for clinic and hospital professionals and board members serving rural America. Register for both events and save $100 on your total registration cost to join in NRHA’s hometown to share with colleagues, network with partners, and learn from experts from across the country.

17th National Conference for Immunization Coalitions and Partners Conference, October 15-17, 2025

The Indiana Immunization Coalition will host the 17th National Conference for Immunization Coalitions and Partners (NCICP) conference on October 15-17, 2025, in Indianapolis, Indiana. NCICP is the only conference solely dedicated to collaboration and partnership to improve immunization uptake, educate our communities, and prevent the spread of disease. The conference is an engine to address immunizations and public health challenges by sharing successful strategies that strengthen the work our coalitions and partnerships do. This year’s conference is built around three tracks: (1) Growing & Sustaining Coalitions, (2) Advocacy for All, and (3) Innovation: New Partnerships & Strategies. Here are links to conference registration and Sheraton Keystone hotel reservation information. Visit ncicp.org for more information, join the network for conference reminders via the Network News, or reach out here with questions.

National Rural Health Association Annual Conference Call for Presentations

NRHA's Annual Rural Health Conference and Rural Hospital Innovation Summit are the nation's premier events celebrating rural health. They are curated for anyone with an interest in rural health care, including rural health practitioners, hospital administrators, clinic directors and lay health workers, social workers, state and federal health employees, academics, community members, and more. Each year, more than 200 individuals present over 85 concurrent educational sessions, 20 research papers and up to 100 research and educational posters at NRHA's annual events, constituting the nation's largest, most inclusive rural health conference.

Any person with an interest in rural health is invited to submit a concurrent session by August 14, 2025, or an original research by January 15, 2026, for presentation during the 2026 conferences.

2025 New England Rural Health Association Conference, November 4-5, 2025, in Groton, Connecticut

The annual conference is the flagship event of the year for the New England Rural Health Association (NERHA), attracting 400 attendees from across New England. This is a unique opportunity for rural health care professionals from hospitals, clinics, oral health, behavioral health, human services, higher education, advocates, community leaders and stakeholders to come together for two days of rural health immersion. More conference information and registration details here.

About the St. Jude HPV Cancer Prevention Program

The vision of the HPV Cancer Prevention Program at St. Jude Children’s Research Hospital is a world free of HPV cancers. The program aims to reduce HPV cancer deaths locally and nationally by increasing on-time HPV vaccination coverage through education, promoting best practice models, and strategic partner engagement locally, regionally, and nationally. The program is committed to ensuring equitable access to HPV cancer prevention, which includes a specific focus on geographic disparities in the southeastern United States and in rural communities. Learn more about the St. Jude HPV Cancer Prevention Program at stjude.org/hpv. Contact the program at PreventHPV@stjude.org for more information.