ArticleCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology2012
HPV vaccination among adolescent females from Appalachia: implications for cervical cancer disparities.
Article in Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Area-Level Variation and Human Papillomavirus Vaccination among Adolescents and Young Adults in the United States: A Systematic Review.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2021Pooled it
- Human Papillomavirus Vaccine Uptake, Knowledge, and Acceptance for Youth: A Systematic Review of Appalachia.Journal of community health · 2018Pooled it
- Geographic clusters of human papillomavirus-associated cancer incidence in the US, 2008-2022.Preventive medicine · 2026Article
- Disparities in Human Papillomavirus-Associated Cancer Incidence by Appalachian Residence.JAMA network open · 2025Article
- Examining Geographic Disparity: Variation in Cancer Outcomes Within Appalachia.Journal of the American College of Surgeons · 2025Article
- Cancer disparities in Appalachian Kentucky.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2024Article
- Contraceptive Behavior in Appalachia: Exploring Use, Nonuse, and Contraceptive Attitudes.International journal of environmental research and public health · 2023Article
- A cluster randomized controlled trial for a multi-level, clinic-based smoking cessation program with women in Appalachian communities: study protocol for the "Break Free" program.Addiction science & clinical practice · 2022Article
- Human Papillomavirus Vaccination After COVID-19.JNCI cancer spectrum · 2021Article
- HPV Vaccine Coverage among Adolescent Males in Ohio: Results of a Longitudinal Study.Ohio journal of public health · 2019Article
- Cancer-Related Beliefs and Perceptions in Appalachia: Findings from 3 States.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2019Article
- Impact of Pharmacists on Access to Vaccine Providers: A Geospatial Analysis.The Milbank quarterly · 2018Article
- A Social-Ecological Review of Cancer Disparities in Kentucky.Southern medical journal · 2018Review
- Disparity in rates of HPV infection and cervical cancer in underserved US populations.Frontiers in bioscience (Scholar edition) · 2017Review
- Multilevel Interventions To Address Health Disparities Show Promise In Improving Population Health.Health affairs (Project Hope) · 2016Review
- The process of engaging members from two underserved populations in the development of interventions to promote the uptake of the HPV vaccine.Health promotion practice · 2015Article
- Fatalistic beliefs and completion of the HPV vaccination series among a sample of young Appalachian Kentucky women.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2015Article
- Early adoption of the human papillomavirus vaccine among Hispanic adolescent males in the United States.Cancer · 2014Article
- Acceptability of HPV vaccine for males and preferences for future education programs among Appalachian residents.American journal of men's health · 2014Article
- Urban and rural safety net health care system clinics: no disparity in HPV4 vaccine completion rates.PloS one · 2014Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
backgroundAppalachia is a geographic region with high cervical cancer incidence and mortality rates, yet little is known about human papillomavirus (HPV) vaccination in this region. We determined HPV vaccine coverage among adolescent females from Appalachia, made comparisons to non-Appalachian females, and examined how coverage differs across subregions within Appalachia.
methodsWe analyzed data from the National Immunization Survey-Teen 2008-2010 for adolescent females ages 13-17 (n = 1,951, Appalachian females and n = 25,468, non-Appalachian females). We examined HPV vaccine initiation (receipt of at least one dose), completion (receipt of at least three doses), and follow-through (completion among initiators). Analyses used weighted logistic regression.
resultsHPV vaccine initiation [Appalachian = 40.8% vs. non-Appalachian = 43.6%; OR, 0.92; 95% confidence interval (CI), 0.79-1.07] and completion (Appalachian = 27.7% vs. non-Appalachian = 25.3%; OR, 1.12; 95% CI, 0.95-1.32) were similar between Appalachian and non-Appalachian females. HPV vaccine follow-through was higher among Appalachian females than non-Appalachian females (67.8% vs. 58.1%; OR, 1.36; 95% CI, 1.07-1.72). Vaccination outcomes tended to be higher in the Northern (completion and follow-through) and South Central (follow-through) subregions of Appalachia compared with non-Appalachian United States. Conversely, vaccination outcomes tended to be lower in the Central (initiation and completion) and Southern (initiation and completion) subregions.
conclusionsIn general, HPV vaccination in Appalachia is mostly similar to the rest of the United States. However, vaccination is lagging in regions of Appalachia where cervical cancer incidence and mortality rates are highest. IMPACT: Current cervical cancer disparities could potentially worsen if HPV vaccine coverage is not improved in regions of Appalachia with low HPV vaccine coverage.
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