A Survey of Primary Care Providers’ Knowledge of HPV-associated Head and Neck Cancers: A focus on clinical characteristics, presentation and outcomes

Importance: The epidemiology of head and neck cancer has changed in recent years, particularly as related to those associated with human papillomavirus (HPV). Understanding primary care physicians’ (PCPs) current knowledge about HPV-associated head and neck cancers (HNC) will help inform educational efforts on this important topic. Objective: To assess the knowledge and understanding of PCPs towards the rapidly changing clinical characteristics, presentation and outcomes associated with HPV-positive HNCs Design, Setting and Participants: Online survey of primary care physicians (pediatricians, general internists and family medicine physicians) at two tertiary academic medical centers in North Carolina between May and July of 2016. Results: 275 PCPs at two tertiary academic medical centers were invited to participate via email, 95 PCPs completed the survey for a response rate of 34.5%. The majority of respondents were female (67.0%), attending physicians (61.5%), had less than 10 years of practice experience (46.0%), and practiced in an academic setting (85.3%). PCPs correctly answered 56% of knowledge based questions about HPVs causative role in HNC. 79% of PCPs failed to correctly identify the most common clinical presentation of the HPV-positive patient. Further, only 23% of PCPs correctly identified that HPV is associated with a much improved prognosis in HNC. Survey data indicate that PCPs most commonly consider the HPV-positive patient to be an African American male presenting with a persistent sore throat or non-healing ulcer and to have prior tobacco and alcohol consumption. However, PCPs demonstrated a high degree of knowledge on HPV infection correctly answering 91% of questions regarding HPV infection. Conclusions and Relevance: Although knowledgeable about HPV infection, PCPs are less knowledgeable about HPV’s role in head and neck cancer. We demonstrate the need for additional education among PCP physician groups with a focus on the clinical characteristics, presentations, and outcomes of the HPV-positive HNC patient.Master of Public Healt