Public Awareness of HPV and HPV Vaccine Remains Low, Especially in Midwest and South, Study Finds

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Awareness of human papillomavirus (HPV), the HPV vaccine, and the link between HPV and cancer remains low across the United States, particularly in Midwestern and Southern states where HPV-associated cancers are most prevalent, according to a new cross-sectional study published in JAMA Oncology.

Researchers analyzed data from the Health Information National Trends Survey (HINTS) collected between 2017 and 2022, including 22 344 adults (mean age, 49 years; 51.1% women). Nationally, 34.3% of adults were unaware of HPV, and 37.6% were unaware of the HPV vaccine. Lack of awareness exceeded 40% in 7 states, primarily in the Midwest (Kansas, Nebraska, Illinois) and South (Mississippi, Arkansas, Alabama). More than 40% of respondents in 13 states were unaware of the HPV vaccine.

Among respondents who had heard of HPV, 70.8% were unaware that HPV causes oral cancers and 28.3% were unaware that HPV causes cervical cancer. In 45 states and Washington, DC, more than 60% of adults did not know about the link between HPV and oral cancer. In contrast, lack of awareness of the HPV–cervical cancer link was less common, ranging from 6.9% to 57.4% across states.

Authors noted that the results highlight an urgent gap in public knowledge given that HPV is associated with an estimated 48 000 cancer cases annually in the US, with nearly two-thirds occurring in the Midwest and South. Limited awareness in these regions coincides with lower HPV vaccination rates and rising incidence of HPV-related cancers, including oropharyngeal cancers.

The study’s limitations include its cross-sectional design, the ecological nature of state-level analyses, and small sample sizes for certain states. "Despite these limitations, this study offers valuable insights into public understanding of HPV and related topics across US states," investigators concluded.

"Given the importance of timely HPV vaccination and the risk of early-life exposure, there is a critical need to enhance HPV awareness among adolescents, young adults, parents or caregivers, and pediatric and adult health care professionals," they added.

Source: Garg A, Damgacioglu H, Graboyes EM, et al. State-Level Public Awareness of HPV, HPV Vaccine, and Association With Cancer. JAMA Oncol. Published online August 14, 2025. doi:10.1001/jamaoncol.2025.2638