Parental and Patients' Awareness, Knowledge, and Willingness for Human Papillomavirus Vaccination Among Survivors of Childhood Hematologic Malignancies.
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In childhood, cancer survivors are at a higher risk of developing secondary cancers, including human papillomavirus (HPV)-related malignancies, compared with the general population. In Turkey, HPV vaccines are not included in the National Immunization Program (NIP). This study assessed the knowledge, awareness of HPV, and the willingness for HPV vaccines among survivors of childhood hematologic malignancies and their parents. This cross-sectional study was conducted with 156 parents and their children (age 9-18 years), in accordance with the sample size calculation. A structured questionnaire prepared for both parents (19 questions) and children (15 questions) was employed for data collection, and the data were gathered through face-to-face interviews or by phone. Regarding the questions evaluating knowledge of HPV, 34% of the parents and 29.5% of the children participating in the study had heard of HPV and the HPV vaccine. The most important sources of information for parents were physicians (43.4%) and television (26.4%), while for children it was social media (52.7%) and physicians (21.7%). HPV vaccination rates were very low in both parents and children (3.2% and 2.6%, respectively). The most common reasons for not receiving the vaccine were the lack of a physician's recommendation and insufficient information in both groups. Logistic regression analysis evaluating factors associated with HPV awareness revealed that high educational level (OR: 2.85 [95% CI: 1.22-6.61]; p = 0.011), receipt of privately administered vaccines (not including in NIP) (OR: 2.45 [95% CI: 1.35-4.45]; p = 0.004, and female sex (OR: 1.97 [95% CI: 1.19-3.26], p = 0.007) were significant predictors. Raising awareness about HPV vaccines is essential to improve immunization coverage especially in survivors of hematologic cancers. Efforts are required to strengthen the training of different departments and encourage their collaboration and increase vaccination rates.