Human papillomavirus (HPV) vaccination rates among eligible veterans and active-duty military are half that of their civilian peers, putting them at greater risk of HPV-related cancers. That’s according to a new study published today in JAMA Oncology that provides the first national estimate of HPV vaccination rates in this population.

“Our findings should serve as a call to action to the Department of Defense and the Veterans Health Administration to advocate that their service members get vaccinated,” said senior author José P. Zevallos, M.D., chair of the Department of Otolaryngology at UPMC and the University of Pittsburgh School of Medicine. “Without intervention these low HPV vaccination rates will lead to more HPV-associated cancers and deaths among future U.S. veterans.” The study included more than 128,000 veterans aged 18 to 26 and found that, just 30.2% of females and 18.7% of males had received HPV vaccination. In comparison, 62.4% of female and 37% of male civilians of the same age group had been vaccinated.

HPV vaccination, which is recommended for everyone under the age of 26, greatly reduces the risk of developing HPV-related cancers, which affect more than 45,000 people in the U.S. each year. Compared with the general U.S. population, service members and veterans are twice as likely to develop cancer-causing HPV infections and have higher rates of HPV-associated oropharyngeal cancer, but there are no vaccination requirements or campaigns targeting this population.

According to Zevallos, the findings suggest that “catchup” HPV vaccination campaigns are needed to boost vaccination rates among veterans and reduce deaths from HPV-associated cancers. Effective vaccination strategies could also save the Veterans Health Administration millions of dollars in costs associated with treating these largely preventable cancers.