P3.S380: HPV Vaccine Recommendations after Abnormal Pap Smear

Background: Human Papillomavirus (HPV) is the most common sexually transmitted infection globally, with millions of new cases reported each year. HPV is associated with cervical, anal, vulva, penile and esophageal cancer. Cervical cancer is a significant threat to women due to its insidious nature; thus, cervical cancer screening is crucial for early detection and intervention. The most effective method to protect against the dangers of HPV-related cancers is through vaccination with the HPV vaccine. The HPV vaccine targets the most common high-risk HPV strains. Vaccination is recommended for both males and females between the ages of 9-26. Vaccination reduces the risk of infection and contributes to the prevention of HPV-related cancers, representing a crucial public health initiative in battling HPV. A visit for a pap smear, the screening for cervical cancer is an optimal time for providers to encourage the HPV vaccine.

Methods: A retrospective medical chart review was performed at a single military treatment facility (MTF) of active-duty women between the ages of 21-26 with a recorded abnormal pap smear and no record of receiving the HPV vaccine. Visits reviewed included when the pap smear was performed as well as the visit/phone call discussing the abnormal pap smear. Chart reviews were analyzed for discussion of the HPV vaccine. It was documented if the HPV vaccine was recommended, the patient noted that they had already received it, or it was not recommended.

Results: 751 charts were reviewed from 2005 to 2021 of unvaccinated active-duty women with abnormal pap smear. 46.3% of the abnormal pap smears were low-grade squamous intraepithelial cells (LGSIL) whereas 3.3% were high grade squamous intraepithelial cells (HGSIL). Of the charts reviewed, 8.3% of the patients noted they had been vaccinated, 13.8% of the chart had documented recommendation for the HPV vaccination, and 77.9% had no documentation regarding the patient’s HPV status or recommendation for vaccination.

Conclusion: The HPV vaccine has been shown to be effective in reducing the risk of HPV related cancer. Pap smears are an opportune time for providers to engage in discussion regarding the importance of vaccination. Discussing the results of an abnormal pap smear is an added incentive for providers to encourage patients to be vaccinated. This data indicates a need for increased awareness and education amongst providers in promoting the HPV vaccine. HPV vaccination rates amongst the active-duty population is low. Pap smears are a prime opportunity for providers to engage in discussion of the importance of the HPV vaccine and encouraging adherence.