Background: In persons with cystic fibrosis (pwCF), little is known about the prevalence or impact of HPV on quality of life and attitudes towards vaccination.
Methods: We conducted a national online survey of adult pwCF. We sought to determine the prevalence of self-reported HPV infection, disease-associated complications and effects on quality of life. Additionally, we investigated factors associated with vaccination status.
Results: A total of 235 adult pwCF across Canada (≥18 years, 68% female) completed the survey. Forty-eight percent of female pwCF had a history of abnormal Pap smear, with 62% self-reporting a 'no' or 'low' chance of risk of HPV-associated disease. Across participants, 12% reported at least one HPV-associated complication including anogenital warts (58%), HPV-associated malignancies (34%) and cervical dysplasia requiring colposcopy (69%). Only 19% reported discussions with their CF care provider around HPV complications. Across both sexes, pwCF experienced high psychosocial burden in the domains of 'worries and concerns', 'sexual impact' and 'self-image'. Sixty percent of adult pwCF were unvaccinated for HPV. Eighty-one percent reported never having discussed HPV vaccination with their CF care provider, with similar rates in vaccinated and unvaccinated groups. Barriers to vaccination included: lack of discussions with healthcare providers (31%), insured coverage (based on age) (19%) and perceived side effects/risk (10%).
Conclusions: Across adult pwCF, we found high prevalence of HPV disease and associated HPV-psychosocial burden and low vaccination uptake. Given the limited medical discussions reported, incorporation of HPV prevention and management should be prioritized by CF care providers as part of comprehensive multimodal care.
Keywords: Cystic fibrosis; Human papillomavirus; Quality of life; Vaccination.
Copyright © 2023 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.