促进27-45岁成人接种HPV疫苗以预防口咽癌的医务人员沟通策略：行动号召

Background: At least 21,000 oropharyngeal cancer (OPC) cases are diagnosed annually, with an estimated 70% attributable to Human papillomavirus (HPV) infection. Unlike cervical cancer, there are no established screening tools for early OPC detection, making vaccination the only proven method of prevention. In 2018, the FDA expanded HPV vaccine eligibility to adults up to age 45. This expansion heightens the need for effective shared decision-making between providers and patients. We conducted a scoping review to examine the landscape of provider communication strategies aimed at promoting HPV vaccine uptake in adults aged 27-45, with a focus on OPC prevention. Methods: A medical librarian with expertise in systematic searching developed a comprehensive strategy using keywords to capture the concepts of HPV vaccination, patient-provider communication, vaccine uptake, and OPC. The databases MEDLINE, Embase, and the Web of Science were searched from inception to September 4, 2025. All results were compiled in EndNote and imported into Covidence for deduplication and screening. Results: Of the 325 studies reviewed, 43 met the criteria for full-text screening and 9 were included in the analysis. Concerningly, only one study included otolaryngologists, who are critical in managing OPC. Eight studies consisted primarily of cross-sectional studies, surveys, and interviews with dental providers. Few evidence-based communication strategies specific to head and neck cancer prevention were identified. One promising approach was a dialogue tool that facilitated conversations about the HPV vaccine between dental providers and patients. However, significant barriers to uptake were identified: only half of dental providers believed it was their role to recommend the HPV vaccine, and only 18% of providers actually made recommendations. Only 16% of referred patients received their first dose within 6 weeks. Additional barriers included limited time, hesitancy, inadequate training, and cost. Limitations: Many dental providers indicated that they lacked sufficient training to counsel patients about HPV vaccination and oropharyngeal cancer prevention. Conclusions: Across the literature, one study evaluated communication strategies among otolaryngologists-despite their direct involvement in the management of HPV-related OPC. This near-total absence of ENT-focused communication research signals a missed opportunity for specialty engagement. Given the expanded adult HPV vaccine indication and the rising incidence of HPV-related OPC, the field urgently needs targeted provider-facing communication tools to promote vaccination in adults aged 27-45. This review serves as a call to action for otolaryngology, dentistry, and primary care alike to fill this gap develop evidence-based communication strategies that support mid-adult HPV vaccine promotion.