Awareness of human papillomavirus and its vaccine are low among American adults—especially men. That’s the conclusion of a new study in the journal JAMA Pediatrics, which points to a need for more education about HPV and the vaccine that can prevent it.

The study analyzed data from the last two years of the Health Information National Trends Survey (conducted annually by the National Institutes of Health). It found that more than 70 percent of US adults were unaware that HPV can cause oral, penile, and anal cancers as well as cervical cancer, which has been the focus of most public health campaigns to date. Even cervical cancer awareness is low: two-thirds of men and one-third of women don’t know HPV can cause it.

HPV is the most common sexually transmitted infection, and an estimated 75-80 percent of sexually active adults will get some type of genital HPV in their lifetimes. It can be transmitted by vaginal, anal or oral sex. Often, it’s completely harmless and goes away on its own, but some types of the infection can lead to cancer of the cervix, mouth and tongue, throat, anus, vulva, penis, and vagina. The HPV vaccine, which the CDC recommends for preteens of all genders aged 11 or 12, provides protection against all of these. According to the CDC, young adults up to age 27 can drastically lower their risk by getting the vaccine even after the recommended age. However, the new study found that only around 51 percent of eligible people are vaccinated.

Although the World Health Organization recommends HPV vaccination as part of the regular course given to all schoolchildren, parents in the US have to seek it out. “Vaccination decisions are generally based on knowledge,” says study author Ashish Deshmukh, assistant professor of public health at the University of Texas Health Science Center at Houston. Given the general lack of awareness about HPV among most parent-age Americans, he says, it’s no wonder that vaccination rates are hovering around 50 percent.

Education is even more important now that the CDC has approved an HPV vaccine for people aged 27-45, he says, because more of the population could be protected. The CDC states that people in this age group should talk to their doctor about whether getting the vaccine is a good idea for them, unlike younger people, where the vaccination recommendation is across the board.

The data also confirms that fewer boys are getting the HPV vaccine than girls, which experts think is related to the fact that prevention education has historically focused on cervical cancer. “Men generally know less about HPV vaccination and the causative association between HPV and cancers,” says Deshmukh.

The work “reveals an important public health concern,” writes University of South Florida women’s health professor Ellen Daley in an email to Popular Science. “Public health programs directed toward increasing HPV knowledge and vaccine implementation are critical.”

Although the incidence of cervical cancer has dropped dramatically in the last two decades thanks to screening and vaccination programs, other cancers you can get from HPV have gone up even more so. Oropharyngeal cancer (a type of throat cancer), has gone up in men by more than 200 percent, while in women, anal cancer has seen a nearly 150-percent increase.

“The great news here is that things can be done,” says University of California San Francisco HPV specialist Joel Palefsky. Palefsky is involved with the International Papillomavirus Society, which runs a website offering public information about HPV. Besides getting vaccinated, getting screened for cervical cancer can help reduce danger. There is currently no blood test for HPV, and no reliable way of screening for it in people with penises.

The lack of public understanding this study reveals is Americans is “scary”, Palefsky says, but based on his international work, “I’m guessing that if you did similar surveys elsewhere, you would find similar results, perhaps even worse.”

HPV is common, and it’s preventable: this new study identifies some obvious next steps. “This vaccine prevents cancers,” Daley says. “This is a gift we can pass on to our children.“