The Role of the Dental Community in Oropharyngeal Cancer Prevention Through HPV Vaccine Advocacy Thomas Luke Arnell 1 & Collin York 1 & Alexis Nadeau 1 & Maeve Lauren Donnelly 1,2 & Laura Till 1 & Pedram Zargari 1 & Wendy Davis 1 & Christine Finley 3 & Thomas Delaney 1 & Jan Carney 1 # American Association for Cancer Education 2019 Abstract As rates of human papillomavirus (HPV)–related oropharyngeal cancer (OPC) continue to rise, the dental community’ s role in primary prevention efforts related to HPV vaccination will become increasingly important. The aim of this study was to assess knowledge, beliefs, practices, and perceived barriers regarding HPV and HPV vaccine advocacy within the dental community. A sample of 266 dentists and dental hygienists completed an online survey, and responses were then analyzed using frequencies of responses, t tests, chi-square tests, and Spearman’ s correlations. Ninety percent of providers believe it is important to play an “active role” in their patients’ general medical care, yet only 50% believe it is their responsibility to recommend the HPV vaccine. Only 50% feel knowledgeable enough to recommend the vaccine. 78.6% of providers rarely discuss HPV vaccination with their age-appropriate patients, and 82% rarely recommend the vaccine. The two most strongly agreed-upon barriers were “parent concerns about the safety or efficacy of the vaccine” (71.6%) and “parent opposition to HPV vaccination for philosophical or religious reasons” (72.6%). Dentists were more knowledgeable about HPV vaccination and more likely to recommend the vaccine than hygienists. Higher levels of HPV-related knowledge correlated positively with beliefs and practices that support HPV vaccine advocacy. We have identified multiple opportunities for intervention aimed at increasing vaccine advocacy among oral health providers. These include clarification of role from dental professional organizations, alleviation of concerns related to perceived parental objection to the vaccine, and educational interventions targeting knowledge deficits among oral health providers. Keywords Human papillomavirus . Human papillomavirus vaccine . Oropharyngeal cancer . Dentists . Dental hygienists . Public health . Cancer prevention Introduction The incidence of oropharyngeal cancers (OPC) in the USA has climbed dramatically since the mid-1980s. Specifically, the incidence of human papillomavirus (HPV)–related OPC is on the rise, increasing approximately 225% from 1988 to 2004 [1, 2]. Between 1984 and 1989, the prevalence of HPV among OPC was 16.3%, increasing dramatically to 71.7% by 2000–2004. According to the CDC, from 2011 to 2015 there were an estimated 18,226 new cases of OPC diagnosed in the USA each year, of which 70–72% were related to HPV infec- tion [1, 3, 4]. Evidence suggests that approximately 62% of HPV-related OPCs are attributable to HPV types 16 and 18, with some estimates suggesting > 90% [5, 6]. The HPV vaccine, first introduced in 2006, has been re- markably effective in curbing transmission of HPV types 16 and 18, thus reducing the incidence of cervical and non- cervical HPV-related malignancies, such as anal, vulvar, and vaginal cancers [7, 8]. While there is currently no conclusive data regarding the efficacy of the HPV vaccine in preventing OPC, researchers have hypothesized that prophylactic vacci- nation is likely to reduce the incidence of HPV-related OPC [9]. The CDC’s Advisory Committee on Immunization Practices (ACIP) has recommended vaccination for both males and females at ages 11–12, though it may be given as early as age 9 and until age 26 [10]. Unfortunately, uptake of * Thomas Luke Arnell Luke.arnell@med.uvm.edu 1 Robert Larner, MD College of Medicine, University of Vermont, 89 Beaumont Ave, Burlington, VT 05405, USA 2 Tufts University School of Medicine, 145 Harrison Ave, Boston, MA 02111, USA 3 Vermont Department of Health, 108 Cherry St, Burlington, VT 05402, USA Journal of Cancer Education https://doi.org/10.1007/s13187-019-01628-w