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Original Investigation
February 2017

Sociodemographic Factors Associated With Knowledge and Risk Perception of Human Papillomavirus and Human Papillomavirus–Associated Oropharyngeal Squamous Cell Carcinoma Among a Predominantly Black Population

Author Affiliations
  • 1St Louis University Cancer Center, St Louis, Missouri
  • 2Department of Otolaryngology–Head and Neck Surgery, School of Medicine, St Louis University, St Louis, Missouri
  • 3Department of Epidemiology, College for Public Health and Social Justice, St Louis University, St Louis, Missouri
  • 4St Louis University Center for Outcomes Research (SLUCOR), St Louis, Missouri
  • 5currently medical students at St Louis University, School of Medicine, St Louis, Missouri
  • 6Department of Otolaryngology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston
JAMA Otolaryngol Head Neck Surg. 2017;143(2):117-124. doi:10.1001/jamaoto.2016.2784
Key Points

Question  Are sociodemographic factors associated with knowledge and risk perception of human papillomavirus (HPV)–associated oropharyngeal cancer in the community?

Findings  In this survey of 301 adults, 30% scored 0 on 15 knowledge questions; approximately 80% of these individuals were male, and approximately 70% were of black race. Men, black individuals, and those with a high school diploma or less were statistically more likely to have low knowledge of HPV-associated oropharyngeal cancer.

Meaning  Black individuals are an important target for future interventions aimed at increasing knowledge of oropharyngeal cancer risk factors.


Importance  The incidence of human papillomavirus (HPV)–associated oropharyngeal squamous cell carcinoma (OPSCC) is increasing in the United States and may be underestimated among black individuals. Characterizing the current knowledge level among black individuals is critical to developing interventions to increase awareness.

Objective  To describe the sociodemographic correlates of knowledge and risk perception of HPV and HPV-associated OPSCC among a predominantly black population.

Design, Setting, and Participants  A cross-sectional survey was conducted at a drag racing event on September 12 and 13, 2015, in Madison, Illinois. The setting was a community-based oral head and neck cancer screening and education initiative. Participants were 301 drag race attendees 18 years or older who were conveniently sampled from attendees at an annual drag racing event predominantly patronized by black individuals.

Main Outcomes and Measures  The primary outcome was knowledge and risk perception of HPV and HPV-associated OPSCC. An electronic-based questionnaire elicited sociodemographic information and contained oral cancer knowledge and risk perception items, which were combined to form knowledge and risk perception scores. Multivariable linear regression analysis assessed estimates of knowledge and risk perception of HPV and HPV-associated OPSCC.

Results  Of the 301 participants (111 female and 190 male) completing the questionnaire, 194 (64.5%) were black. Overall, respondents ranged in age from 18 to 78 years, with a mean (SD) age of 48.0 (13.0) years. The mean (SD) knowledge score was 5.7 (4.6) of 15, and the mean (SD) risk perception score was 2.2 (1.4) of 6. Using multivariable linear regression, we found that, for every 1-year increase in age, knowledge of HPV-associated OPSCC decreased by 5.0% and was worse in men (β = −1.26; 95% CI, −2.33 to −0.18), black vs white individuals (β = −1.29; 95% CI, −2.35 to −0.23), and those with a high school diploma or less vs college graduates (β = −3.23; 95% CI, −4.67 to −1.80). Black individuals also had lower perceived risk of developing HPV-associated OPSCC (β = −0.36; 95% CI, −0.69 to −0.02) compared with white individuals, and participants with a high school diploma or less had lower perceived risk of developing HPV-associated OPSCC compared with those with a college degree or higher (β = −0.59; 95% CI, −1.04 to −0.14).

Conclusions and Relevance  Age and sex were independent correlates of knowledge of HPV-associated OPSCC, while race and education level were correlates of both knowledge and risk perception of HPV-associated OPSCC. These findings should inform future interventions targeted at increasing knowledge of HPV-associated OPSCC in black communities.