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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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Review

Area-Level Variation and Human Papillomavirus Vaccination among Adolescents and Young Adults in the United States: A Systematic Review

Elizabeth K. Do, Brianna Rossi, Carrie A. Miller, Albert J. Ksinan, David C. Wheeler, Askar Chukmaitov, John W. Cyrus and Bernard F. Fuemmeler
Elizabeth K. Do
1Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia.
2Virginia Commonwealth University Massey Cancer Center, Richmond, Virginia.
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  • ORCID record for Elizabeth K. Do
Brianna Rossi
3Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia.
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Carrie A. Miller
1Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia.
2Virginia Commonwealth University Massey Cancer Center, Richmond, Virginia.
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Albert J. Ksinan
1Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia.
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David C. Wheeler
2Virginia Commonwealth University Massey Cancer Center, Richmond, Virginia.
4Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia.
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Askar Chukmaitov
1Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia.
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John W. Cyrus
5Tompkins-McCaw Library, Research and Education, Virginia Commonwealth University, Richmond, Virginia.
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Bernard F. Fuemmeler
1Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia.
2Virginia Commonwealth University Massey Cancer Center, Richmond, Virginia.
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  • For correspondence: Bernard.Fuemmeler@vcuhealth.org
DOI: 10.1158/1055-9965.EPI-20-0617 Published January 2021
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Abstract

Understanding how human papillomavirus (HPV) vaccination coverage varies by geography can help to identify areas of need for prevention and control efforts. A systematic review of the literature was conducted using a combination of keywords (HPV vaccination, geography, neighborhoods, and sociodemographic factors) on Medline and Embase databases. Studies had to provide information on HPV vaccination by area-level variables, be conducted in the United States, and be published in English (analyzing data from January 2006 to February 2020). Conference abstracts and opinion pieces were excluded. Of 733 records identified, 25 were included for systematic review. Across studies, the average initiation rate was 40.5% (range, 6.3%–78.0%). The average rate of completion was 23.4% (range, 1.7%–55.2%). Geographic regions and area-level factors were associated with HPV vaccination, including zip code tabulation area-level poverty, urbanicity/rurality, racial/ethnic composition, and health service region characteristics. Only three studies utilized geospatial approaches. None accounted for geospatial–temporal associations. Individual-level and area-level factors and their interactions are important for characterizing HPV vaccination. Results demonstrate the need to move beyond existing multilevel methods and toward the adoption of geospatial approaches that allow for the mapping and detection of geographic areas with low HPV vaccination coverage.

Footnotes

  • Note: Supplementary data for this article are available at Cancer Epidemiology, Biomarkers & Prevention Online (http://cebp.aacrjournals.org/).

  • Cancer Epidemiol Biomarkers Prev 2021;30:13–21

  • Received April 24, 2020.
  • Revision received July 31, 2020.
  • Accepted September 25, 2020.
  • Published first October 2, 2020.
  • ©2020 American Association for Cancer Research.
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Cancer Epidemiology Biomarkers & Prevention: 30 (1)
January 2021
Volume 30, Issue 1
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Area-Level Variation and Human Papillomavirus Vaccination among Adolescents and Young Adults in the United States: A Systematic Review
Elizabeth K. Do, Brianna Rossi, Carrie A. Miller, Albert J. Ksinan, David C. Wheeler, Askar Chukmaitov, John W. Cyrus and Bernard F. Fuemmeler
Cancer Epidemiol Biomarkers Prev January 1 2021 (30) (1) 13-21; DOI: 10.1158/1055-9965.EPI-20-0617

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Area-Level Variation and Human Papillomavirus Vaccination among Adolescents and Young Adults in the United States: A Systematic Review
Elizabeth K. Do, Brianna Rossi, Carrie A. Miller, Albert J. Ksinan, David C. Wheeler, Askar Chukmaitov, John W. Cyrus and Bernard F. Fuemmeler
Cancer Epidemiol Biomarkers Prev January 1 2021 (30) (1) 13-21; DOI: 10.1158/1055-9965.EPI-20-0617
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