e-Cigarette Use Tied to Tobacco Use in Teenagers

Wed, Feb 10, 2016

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Source: www.Medscape.com
Author: Diana Swift
 

e-Cigarette smoking appears to promote progression to traditional cigarette smoking and may be helping form a new population of smokers, according to a prospective study published online September 8 in JAMA Pediatrics.

Brian A. Primack, MD, PhD, from the Division of General Internal Medicine, University of Pittsburgh School of Medicine in Pennsylvania, and colleagues analyzed data on 694 young nonsmokers who were attitudinally nonsusceptible to smoking at baseline. The very small proportion (2.3%) who already used e-cigarettes at baseline proved more likely to progress to smoking or to being open to it.

The cohort, which was more than 75% non-Hispanic white, consisted of 374 females. The mean age of the 16 baseline e-cigarette users was 19.5 years compared with 20 years for nonusers.

Study data came from waves 2 and 3 of the US-based Dartmouth Media, Advertising, and Health Study, a national survey of adolescents and young adults aged 16 to 26 years who were recruited via random digit dialing using landline (66.7%) and cellular (33.3%) telephone numbers.

The survey, conducted from October 1, 2012, to May 1, 2014, started tracking e-cigarette use at wave 2 (2012 – 2013), which served as the baseline, whereas wave 3 (2013 – 2014) served as follow-up for the current study.

Eligible participants had to be never-smokers and attitudinally nonsusceptible to smoking at baseline. This was assessed with these questions: “If one of your friends offered you a cigarette, would you try it?” and “Do you think you will smoke a cigarette sometime in the next year?” Response options included “definitely yes,” “probably yes,” “probably no,” and “definitely no.” Those who responded “definitely no” to both measures were considered nonsusceptible nonsmokers.

After a year, 11 of 16 baseline e-cigarette users (68.8%) and 128 of 678 participants nonusers (18.9%) progressed to traditional combustible cigarette smoking. After controlling for demographic covariates such as age, sex, and maternal education level, baseline e-cigarette use was independently associated with both progression to smoking (adjusted odds ratio [AOR], 8.3; 95% confidence interval, 1.2 – 58.6) and progression to susceptibility (AOR, 8.5; 95% CI, 1.3 – 57.2) among initially nonsusceptible nonsmokers.

“These findings support regulations that decrease the accessibility and appeal of e-cigarettes to nonsmoking adolescents and young adults,” Dr Primack and associates write.

Conceding that some might see the small percentage of baseline e-smokers as not translating into a substantial public health risk, the researchers caution that e-cigarette use is on the rise. “[D]ata published in 2015 suggest that large numbers of youth are initiating e-cigarette use and that as many as half of these individuals do not smoke traditional combustible cigarettes. Therefore, it will be important to continue surveillance among youth of both e-cigarette use and overlap with use of other tobacco products.”

Noting that many youth may be dual users of cigarettes and e-cigarettes, the authors say nicotine exposure may drive initial e-cigarette users to use cigarettes as a more efficient nicotine delivery device. In addition, nicotine content aside, “e-cigarettes may behaviorally accustom individuals to powerful cigarette smoking cues such as inhalation, exhalation, and holding the cigarette.”

Furthermore, e-cigarettes, which expose users to potentially harmful aerosolized substances other than nicotine, are not subject to regulations limiting cigarette smoking, such as age limits for sale, flavoring and marketing restrictions, clean air laws, taxes, and labeling requirements, which may increase their accessibility to youth. “For example, e-cigarettes are marketed on television, representing the first time in more than 40 years that a smoking-related device is advertised on this medium,” the investigators write.

In an accompanying editorial, Jonathan D. Klein, MD, MPH, an adolescent medicine specialist and an associate executive director of the American Academy of Pediatrics in Elk Grove Village, Illinois, noted that a recent Centers for Disease Control and Prevention report found that e-cigarette use in the National Youth Tobacco Survey increased from 4.5% in 2011 to 13.4% in 2014, affecting more than 2.2 million students. “The article by Primack et al is one more piece of evidence that the effect of e-cigarettes on youth is happening now in real time,” he writes, adding that “these data provide strong longitudinal evidence that e-cigarette use leads to smoking, most likely owing to nicotine addiction.”

Dr Klein also points to mounting concerns among health experts that e-cigarettes will also renormalize smoking, delay or prevent cessation, and cause former smokers to become re-addicted. He says the evidence suggests that e-cigarette users are less likely to quit smoking traditional cigarettes than nonusers In spite of such data and evidence of harm from e-smoking devices. He states that the US Food and Drug Administration has failed to assert authority and oversight over these alternative products.

“We do not need more research on this question; we have the evidence base, and we have strategies that work to protect nonsmokers from e-cigarettes and other forms of tobacco,” Dr Klein writes. “What we still need is the political will to act on the evidence and protect our youth.”

This study was supported by grants from the National Cancer Institute and the National Center for Advancing Translational Sciences. The authors and Dr Klein have disclosed no relevant financial relationships.

JAMA Pediatr. Published online September 8, 2015. Article full text, Editorial full text

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

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Possible marker for recurring HPV-linked oropharyngeal cancers

Mon, Feb 8, 2016

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Source: www.eureka.org
Author: John Hopkins Media Contact: Vanessa Wasta
 

A look-back analysis of HPV infection antibodies in patients treated for oropharyngeal (mouth and throat) cancers linked to HPV infection suggests at least one of the antibodies could be useful in identifying those at risk for a recurrence of the cancer, say scientists at The Johns Hopkins University. A report on the study is published in the February issue of Cancer Prevention Research.

HPV infections, which are virtually all sexually transmitted, are responsible for the recent rise in the incidence of oropharyngeal cancers in the United States, according to the National Cancer Institute, and now account for about 80 percent of these cancers.

People with HPV-positive tumors of the throat, base of the tongue and tonsils have higher overall survival rates compared to people with similar tumors not caused by HPV, but studies show that more than 25 percent of HPV-positive cancers recur–usually within the first two years after treatment.

“There are currently no reliable tests available to detect early recurrence, so we hope to find a biological marker that could help identify those most at risk,” says Carole Fakhry, M.D., M.P.H., associate professor of otolaryngology-head and neck surgery at the Johns Hopkins University School of Medicine and member of the Johns Hopkins Kimmel Cancer Center.

For the new study, Fakhry and her colleagues focused their attention on the antibodies, or immune system protein the body produces to fight HPV-related cancer proteins. One such antibody, called E6, is strongly linked to the diagnosis of HPV-positive oropharyngeal cancer.

Levels of the E6 antibody should fall when a patient is treated and cured of their cancer, Fakhry and her colleagues reasoned, so an increase in a patient’s E6 levels after treatment might indicate a higher risk of the cancer returning.

To find out, the researchers looked back at the health records and blood serum samples of 60 patients with HPV-positive oropharyngeal cancer and a median age of 56, mostly Caucasian men, who were treated at The Johns Hopkins Hospital. Some 43 of the patients had samples taken before their treatment, 34 had samples taken up to six months after therapy, and 52 had samples taken six months or later after therapy. Among the 60 patients, Fakhry and colleagues identified six cases of recurring cancer within an average of 4.4 years of follow-up after treatment.

The scientists looked at a variety of HPV cancer cell antibodies in these patients and discovered that the average level of most of these antibodies was lower after treatment. Patients who had high levels of E6 antibody before their treatment were seven times more likely than those with lower levels to have their cancer return, they also found.

Fakhry says the study is a promising start toward finding a way to identify patients most at risk for a cancer recurrence through the use of a blood test, but much more data are needed to confirm E6’s usefulness as a biomarker. One of the best ways to proceed, she says, would be to conduct a study of the antibody on a large group of patients at the start of their treatment, drawing blood at a series of predetermined points during their therapy to examine E6 levels.

At the moment, these HPV antibodies are not measured routinely in patients, so it is difficult to estimate the costs and time needed to conduct such a “gold-standard” trial, she notes.

More research is also needed to know whether such tests would be useful in determining the path of a patient’s follow-up care, such as whether and how often a patient might need imaging or clinical exams to watch for a cancer’s possible return.

“Potentially, a low-risk patient may need less stringent surveillance while a high-risk patient may require more intense imaging,” Fakhry explains. “But this is far away from clinical practice, as we would really need to understand whether this hypothetical approach [with E6] would improve lead time to diagnosis of recurrence and survival outcomes.”

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Other Johns Hopkins scientists who contributed to the research include Jesse Qualliotine, Zhe Zhang, Nishant Agrawal, Daria Gaykalova, Justin Bishop, Rathan M. Subramaniam, Wayne Koch, Christine Chung, David W. Eisele, Joseph Califano and Raphael P. Viscidi.

Funding for the study was provided by the Oral Cancer Foundation and the National Institute of Dental and Craniofacial Research (P50DE019032-13).

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

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NCI-designated Cancer Centers Urge HPV Vaccination for the Prevention of Cancer

Thu, Feb 4, 2016

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Source: www.medicine.wustl.edu
Author: Washington University School of Medicine in St. Louis Staff
 

Approximately 79 million people in the United States are currently infected with a human papillomavirus (HPV) according to the Centers for Disease Control and Prevention (CDC), and 14 million new infections occur each year. Several types of high-risk HPV are responsible for the vast majority of
cervical, anal, oropharyngeal (middle throat) and other genital cancers. The CDC also reports that each year in the U.S., 27,000 men and women are diagnosed with an HPV-related cancer, which amounts to a new case every 20 minutes. Even though many of these HPV-related cancers are preventable with a safe and effective vaccine, HPV vaccination rates across the U.S. remain low.

Together we, a group of the National Cancer Institute (NCI)- designated Cancer Centers, recognize these low rates of HPV vaccination as a serious public health threat. HPV vaccination represents a rare opportunity to prevent many cases of cancer that is tragically underused. As national leaders in cancer research and clinical care, we are compelled to jointly issue this call to action.

According to a 2015 CDC report, only 40 percent of girls and 21 percent of boys in the U.S. are receiving the recommended three doses of the HPV vaccine. This falls far short of the goal of 80 percent by the end of this decade, set forth by the U.S. Department of Health and Human Service’s Healthy People 2020 mission. Furthermore, U.S. rates are significantly lower than those of countries such as Australia (75 percent), the United Kingdom (84-92 percent) and Rwanda (93 percent), which have shown that high vaccination rates are currently achievable. The HPV vaccines, like all vaccines used in the U.S., passed extensive safety testing before and after being approved by the U.S. Food and Drug Administration (FDA). The vaccines
have a safety profile similar to that of other vaccines approved for adolescents in the U.S. Internationally, the safety of HPV vaccines has been tested and approved by the World Health Organization’s Global Advisory Committee on Vaccine Safety. CDC recommends that boys and girls receive three doses of HPV vaccine at ages 11 or 12 years. The HPV vaccine series can be started in preteens as early as age 9 and should be completed before the 13th birthday. The HPV vaccine is more effective the earlier it is given; however, it is also recommended for young women until age 26 and young men until age 21.The low vaccination rates are alarming given our current ability to safely and effectively save lives by preventing HPV infection
and its associated cancers. Therefore, we urge parents and health care providers to protect the health of our children through a number of actions:

  • We encourage all parents and guardians to have their sons and daughters complete the 3-dose HPV vaccine series before the 13th birthday, and complete the series as soon as possible in children aged 13 to 17. Parents and guardians should talk to their health care provider to learn more about HPV vaccines and their benefits.
  • We encourage young men (up to age 21) and young women (up to age 26), who were not vaccinated as preteens or teens, to complete the 3-dose HPV vaccine series to protect themselves against HPV.
  • We encourage all health care providers to be advocates for cancer prevention by making strong recommendations for childhood HPV vaccination. We ask providers to join forces to educate parents/guardians and colleagues about the importance and benefits of HPV vaccination. HPV vaccination is our best defense in stopping HPV infection  in our youth and preventing HPV-related cancers in our communities. The HPV vaccine is CANCER PREVENTION. More information is available from the CDC.

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

 

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Japanese team invents movable tongue prosthesis to enable speech for cancer victims

Mon, Feb 1, 2016

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Source: www.japantimes.co.jp
Author: Tomoko Otake

Dentistry researchers at Okayama University have come up with what could be the world’s first movable tongue prosthesis to help oral cancer patients who have partially lost the ability to speak.

The invention, the product of a team led by Shogo Minagi, a professor of dentistry at the university, is good news for scores of oral cancer victims in Japan with speech problems.

The number of oral cancer patients in the nation has surged to 7,800 in 2015, up from around 2,100 in 1975, according to estimates by the Japan Society of Oral Oncology. The figure does not include those with damaged tongues from traffic accidents and other physical injuries.

Minagi’s work was inspired by Kenichi Kozaki, also a dentistry professor at Okayama University and an expert on dental pharmacology. Kozaki was diagnosed with tongue cancer in May 2014 and has had most of his tongue surgically removed. Kozaki asked Minagi to create a tongue prosthesis that he could use to speak. Minagi said he looked into tongue prostheses developed in the past but found just one paper in Japan, in which the artificial tongue was part of a denture and could not be moved.

“Developing an oral prosthesis is a painstaking process for patients,” Minagi said by phone Monday. “This time, we could create a really good prosthesis quickly thanks to Kozaki, who is a dentist himself. He tried many different versions of the prosthesis and offered us detailed feedback.”

When a person speaks, the tongue needs to touch the palate, but people whose tongues have been removed are unable to do this and thus have difficulty speaking.

The tongue prosthesis developed by Minagi’s team and made from resin can move up and down in the mouth as it is connected to the back teeth by a wire. Users can control the device by pushing it with the remaining base of their tongue, Minagi said, noting that many users also wear a resin filling over their palate to make it easier for the device to make contact.

tongue

He said he hopes the device will become widely available.

“We have used materials that are already widely used, so any dental technician can make this type of prosthesis,” Minagi said. “We would like to share our know-how widely with clinics nationwide, to help as many people as possible.”

According to Minagi, Kozaki, who is still battling cancer after having most of his tongue, jaw bones and pharynx removed, has also expressed hope that more people will learn about the device and find their voice again.

In September, Okayama University opened an outpatient clinic called Yume no Kaiwa Purojekuto Gairai (Outpatient Clinic to Achieve the Dream of Speaking Project).

At least four people are currently having artificial tongues made through the clinic, Minagi said, adding that it takes several months for technicians to adjust the prosthesis to fit users, and for the users to train their muscles to speak through the device.

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HPV debate reframed to focus on cancer

Thu, Jan 28, 2016

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January 27, 2016

By Dr. Rachel Tompa / Fred Hutch News Science

 

U.S. cancer centers unanimously call for increase in vaccine use for cancer prevention.

Gardasil Vaccine

Amid recent talk of “moonshot” cancer cures and new treatments in development, it can be easy to forget that we already have an effective, simple way to prevent at least six types of cancer.

It’s called the HPV vaccine and it protects people from infection with the strains of human papillomavirus responsible for causing nearly all cervical and anal cancers, as well as many other genital cancers and certain head and neck cancers. And it’s not getting used.

The Centers for Disease Control and Prevention recommends that all adolescent boys and girls receive the three-dose vaccine series at age 11 or 12. But in 2014, only about 40 percent of eligible teenage girls and just over 21 percent of boys had received the full course, according to the CDC’s latest data.

Now, all 69 National Cancer Institute-designated cancer centers are joining together to voice their frustration at the low uptake of the HPV vaccine — with the hope of refocusing the lens of the vaccination discussion on cancer prevention.

Public debate about the vaccine — and, possibly, the low levels of vaccine use among adolescents — likely stems from the virus’ sexual transmission, said Fred Hutchinson Cancer Research Center virologist Dr. Denise Galloway. Galloway made critical discoveries linking HPV to cervical and other cancers and her laboratory helped lay the groundwork that made the vaccine’s development possible.

“[The low uptake] has to do with it being considered a vaccine to protect against a sexually transmitted infection, that’s likely the case,” said Galloway in a previous interview. “Even though hepatitis B should fall in that same category, it’s been portrayed more as protecting against a liver disease.”

Galloway and her colleagues at Fred Hutch, which is among the NCI-designated cancer centers issuing the statement in support of HPV vaccination, want parents and adolescents to think about the HPV vaccine in the light of cancer, not sex.

“I think people in the United States are leery of vaccines or they don’t trust pharma or they don’t want to talk about sex,” Galloway said. “So something that could prevent cancer is not having the impact that it should.”

Proactive steps to combat a public health threat

Even though so few U.S. families are following recommendations for this particular vaccine, it is still having a positive effect: HPV infection rates among adolescent girls dropped from nearly 12 percent in the years before the vaccine was routinely available to about 5 percent after the vaccine was introduced in 2006.

The CDC also estimates that every year, 27,000 men and women are diagnosed with HPV-driven cancers. The majority of these diseases can be prevented with currently available HPV vaccines.

“The HPV vaccine is an amazing public health advance, but it doesn’t guarantee eradication of HPV. It’s important to remember that the vaccine works best in those who haven’t been infected with the virus, which means, essentially, people who are not yet sexually active,” said Dr. Gary Gilliland, president and director of Fred Hutch.

The cancer centers’ consensus statement arose from a summit held at MD Anderson Cancer Center in Houston last November to discuss concerns about low HPV vaccination rates in the U.S. and ways to improve uptake. Experts from more than half of NCI-designated cancer centers, the NCI, CDC and American Cancer Society met at the event, starting conversations to develop the shared endorsement for HPV vaccination.

The statement also echoes the spirit of President Barack Obama’s recent call for a “moonshot” to cure cancer. In 2013, the President’s Cancer Panel, comprised of expert advisers to the president on cancer-related topics, chose to focus its yearly report and recommendations on improving HPV vaccine uptake.

“The President’s Cancer Panel applauds the NCI-designated cancer centers for issuing this consensus statement urging HPV vaccination for the prevention of cancer in support of the Panel’s recommendations,” Dr. Barbara Rimer, chair of the panel, said in an email.  “We are confident that if HPV vaccination for girls and boys is made a public health priority, hundreds of thousands will be protected from these HPV-associated diseases and cancers over their lifetimes.”

Cancer center representatives hope that by joining together, they will send a stronger message to the U.S. public that the vaccine is a safe and important means to prevent potentially deadly cancers.

“Every day we delay, that means more people are going to get infections that in the future could end up causing cancers that could have been prevented,” said Dr. Melinda Wharton, director of the CDC’s National Center for Immunization and Respiratory Diseases, at the summit. “There really is great urgency to stop this from happening.”

Addressing concerns

Many parents have real concerns that may put up barriers to agreeing to the vaccine, Galloway said. These barriers range from worries about the vaccine’s possible side effects to fear that vaccinating against an STD could increase teen sex to a lack of awareness of the benefits of the vaccine.

Many care providers aren’t following the CDC’s guidelines to improve HPV vaccine uptake among their patients. A 2015 survey led by researchers at Harvard Medical School found that more than a quarter of physicians don’t strongly endorse the vaccine or bring it up to families at the recommended time. And nearly 60 percent said they recommend the vaccine more strongly to adolescents they felt are at high risk of HPV infection, even though public health officials say everyone should receive the vaccine to increase herd immunity.

“There’s some reluctance and ambivalence among a lot of primary care providers in terms of just building HPV vaccination into the normal course of care,” said the NCI’s Dr. Robert Croyle at the MD Anderson summit.

Here’s a quick roundup of expert responses to some of the most common barriers to HPV vaccination:

Does it work? The HPV vaccine works incredibly well to protect against several strains of HPV. Although it’s too soon to say whether the vaccine is going to reduce rates of HPV-related cancers on a population level, there have been studies done on reduction of precancerous lesions and genital warts, which are earlier indications that the vaccine is working to reduce HPV in the population. “If you look at places like Australia or parts of the U.K. where the uptake of the vaccine is 80 percent, and you look at the earliest manifestation of HPV-associated disease, which is genital warts, there’s virtually none in Australia. And not only was there none in the girls, who they started vaccinating in 2006, but there’s none in boys, who weren’t vaccinated until 2012. Herd immunity really works if you can get high uptake of the vaccine,” Galloway said.

Will it increase teen sex? No — a large 2015 study found that girls aged 12 to 18 who’d received the HPV vaccine did not have increased sexual activity as compared to teens who hadn’t been vaccinated.

Is it affordable? Yes — The Affordable Care Act mandates coverage of the vaccine by private insurance plans. In Washington state, the HPV vaccine — like all childhood vaccines — is free to children aged 18 and under. Nationwide, the CDC provides free vaccines for children who can’t afford to pay for them through the Vaccines For Children program.

Is it safe?Yes — like every other CDC-recommended vaccine, the three HPV vaccines on the market have been through rigorous safety testing before their release to the public. Since the vaccines’ release, there have been numerous studies in the U.S. and Europe of hundreds of thousands of adolescents who received the vaccine — and again, no adverse safety effects have been found to be linked to the vaccine.

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

 

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Cancer Centers urge increase in HPV vaccinations

Wed, Jan 27, 2016

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Source: www.wsj.com
Author: Ron Winslow

The top cancer centers in the U.S. jointly called for an increase in vaccination against the human papilloma virus, or HPV, saying low uptake of the three-shot regimens amounts to a “public health threat” and a major missed opportunity to prevent a variety of potentially lethal malignancies.

In a statement issued Wednesday, all 69 of the nation’s National Cancer Institute-designated centers urged parents and health-care providers to “protect the health of our children” by taking steps to have all boys and girls complete the three-dose vaccination by their 13th birthdays, as recommended by federal guidelines, or as soon as possible in children between 13 and 17 years old.

Currently, just 40% of girls and 21% of boys in the U.S. have received the vaccine, according to a report last year by the U.S. Centers for Disease Control and Prevention. The U.S. Department of Health and Human Services Healthy People 2020 initiative has set the goal for HPV vaccination for both boys and girls at 80%.

The first HPV vaccine, Merck & Co.’s Gardasil, was approved by the U.S. Food and Drug Administration in 2006. A second version of Gardasil and GlaxoSmithKline PLC’s Cervarix are now on the market. Neither company was involved in development of the cancer centers’ statement, those involved in the effort said.

The CDC estimates that 79 million Americans are infected with HPV, a sexually transmitted virus that causes 14 million new infections each year. While the body’s immune system fights off the virus in most cases, certain high-risk strains are responsible for cancers of the cervix, anus, and various genital sites as well as a growing rate of oropharyngeal or throat cancers, all told affecting about 27,000 patients a year in the U.S.

“We have everything we need to eliminate at least cervix cancer and many other HPV-related cancers and we haven’t taken advantage in this country,” said Lois Ramondetta, professor of gynecologic oncology at University of Texas MD Anderson Cancer Center, Houston. She said she is already seeing patients in their 20s and 30s who have developed precursors to cancer that she says could have been prevented had they been vaccinated.

The U.S. rates stand in contrast to those in some other countries, including Australia, where 75% of boys and girls are fully vaccinated; the U.K., with a rate between 84% and 92%;, and Rwanda, where 93% of children are in compliance with World Health Organization recommendations for HPV shots.

When the first vaccine hit the market a decade ago, it was targeted at girls in hopes of preventing cervix cancer. But the rising incidence of HPV-related head and neck cancers, especially among men, in recent years, led to including boys in the prevention effort as well.

Factors responsible for the low U.S. rates include resistance among antivaccination groups, a “misunderstanding” that vaccination might promote sexual activity and a reluctance of pediatricians to discuss prevention of a sexually transmitted virus for children, said Sarah Krobin, acting chief of health systems and interventions research at the NCI. Research shows no link between the vaccine and sexual activity, she said. Early administration is required because “for the vaccine to work, the child shouldn’t have yet had sex,” she said.

The three-dose vaccine can cost around $500, including doctor fees, according to the American Cancer Society, though it is often covered by insurance. It is available free to beneficiaries of the Medicaid program, a key reason why children in low-income families are more likely to have been fully vaccinated than those from wealthier families, Dr. Krobin said.

The statement emerged from a meeting of HPV experts from many of the cancer centers at MD Anderson in November, which in turn resulted from a special NCI initiative among 18 designated centers to study factors affecting HPV vaccination rates in their local markets. NCI designation recognizes centers for excellence in cancer research and care. The NCI wasn’t involved in drafting the document.

The statement urges physicians and other providers “to be advocates for cancer prevention by strongly recommending the vaccine for children. It encourages men up to age 21 and women up to 26 to get vaccinated if they missed the younger age targets.

“This is really a sentinel event to have all the centers get together and say we’re really not doing the best for our kids,” said Dr. Ramondetta, who is also co-director of MD Anderson’s HPV-related Moon Shot initiative. “We feel this is an effective, safe and long-lasting vaccine that we’re not taking advantage of.”

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Rodeo Insider: Cowboy takes it on himself to ride home a message

Tue, Jan 26, 2016

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Source: www.star-telegram.com
Author: Brett Hoffman
 
0125 rodeoBronc rider Cody Kiser is trying to encourage cowboys to abstain from tobacco. Richard W. Rodriguez Star-Telegram

 

In a day when rodeo riders are approaching the sport from an athletic standpoint more than ever, there’s a heavier emphasis on physical fitness and many competitors are taking a closer look at abstaining from substances such as alcohol and tobacco.

One cowboy attempting to send a message about abstaining from frequent tobacco consumption is bareback bronc rider Cody Kiser.

“A lot of these cowboys don’t smoke or chew, and if they do, it’s really rare,” Kiser said. “A lot of the guys consider themselves as athletes. So they want to keep their bodies at an optimum performance and they don’t want to do anything that would break them down.”

When the Fort Worth Stock Show conducted the opening performance of its 16-day Professional Rodeo Cowboys Association show on Friday, Kiser turned in a bareback score of 80, the highest marking of the night.

As he competed in the renowned rodeo, Kiser wore a patch on his shirt that said: “Oral Cancer Foundation.”

The foundation’s website lists Kiser and a spokesman and states: “The western/rodeo environment has had a long-term relationship with tobacco, and until 2009 the PRCA had a lengthy history of tobacco sponsorship money. While that has ended, tobacco use, and smokeless/spit tobaccos still thrive in the sport. While adults have the right to make any lifestyle choice, they inadvertently expose impressionable young people to what are sometimes harmful habits though poor examples like the use of tobacco products. This is particularly harmful as kids look up to athletes.”

Kiser, 25, who is from Carson City, Nev., aspires to set a great example.

“My message is for the younger generation, to expand the sport of rodeo and help it become more mainstream,” he said. “Rodeo can be like NASCAR. When NASCAR started getting rid of most of their alcohol and tobacco sponsors and then started bringing in sponsors such as Tide and Kellogg, which are more family oriented, then the sport exploded. Today, there’s so much more money in NASCAR and it can become the same for rodeo.”

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
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HPV vaccines: Research on safety, racial disparities in vaccination rates and male participation

Tue, Jan 26, 2016

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Source: journalistsresource.us1.list-manage.com
Author: staff

Since it became available in the United States in 2006, the Human Papillomavirus (HPV) vaccine has been a source of debate, with proponents lauding it as a substantial gain in the fight against cancer, and opponents concerned with its implications for sexual activity among youth. With the U.S. Food and Drug Administration’s recent approval of Gardasil-9 — a vaccine that protects against nine of the most common strains of HPV that account for approximately 90 percent of cervical, vulvar, vaginal and anal cancers — there is both a renewed interest and concern that calls for a nuanced and comprehensive review of the science.

HPV is the most common sexually transmitted infection in the United States, with nearly all sexually active men and women believed to contract at least one form of it during their lifetime. According to the U.S. Centers for Disease Control and Prevention (CDC), an estimated 79 million Americans have HPV, and about 14 million become newly infected annually. While most infections clear the body within two years, some can persist and result in genital warts, cervical cancer or other types of cancers in men and women. Of the many HPV strains that exist, HPV types 16 and 18 have been identified as high risk, accounting for about 70 percent of all cervical cancer, as well as a large proportion of other HPV-related cancers.

While cervical cancer was previously a leading cause of death among women in the U.S., death rates declined substantially after the introduction of the Pap test in the 1950s. Nevertheless, according to the CDC, more than 12,000 women in the U.S. are diagnosed with cervical cancer each year, and more than 4,000 die from it. Public discourse around HPV tends to focus on the health of women because they disproportionately bear the burden of its health consequences. However, men also face substantial risk, particularly as it relates to oral and anal cancers.

Although screening procedures are in place for early detection of cervical cancer, there are no comparable strategies to identify HPV-related cancer in its early stages for men. Consequently, the administration of a vaccine to prevent infection and transmission presents an important line of protection. Currently, the HPV vaccine is administered over a course of three injections, which must be completed within six months to confer full protection. A 2012 review of clinical trials of HPV vaccines shows that vaccines designed to protect against two or four of the most common strains have very high efficacy rates, ranging between 90 percent and 100 percent. For that reason, large public health efforts have focused on improving vaccination rates before boys and girls become sexually active.

Today, both the CDC and American Academy of Pediatrics recommend routine vaccination against HPV for all 11-year-olds and 12-year-olds in the U.S. Although the early age of vaccination has been a source of public debate, medical recommendations are based partly on evidence that shows that antibody responses are highest during this age period. Also, it is a good idea to vaccinate adolescents before they come into contact with the virus as the vaccine is not effective against HPV types that already have been acquired. Despite such recommendations from medical professionals, vaccination completion rates remain low — 40 percent for girls and 20 percent for boys in 2014. That is substantially lower than the vaccination rate for tetanus, diphtheria, and pertussis and the vaccination rate for meningitis among members of the same age group.

Below are a series of studies that will help journalists understand and explain this important health topic from a variety of angles, including vaccine safety and racial and gender disparities in vaccination rates. Beat reporters can find related reports and statistics from organizations such as the CDC, National Cancer Institute and World Health Organization.

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Barriers to vaccination

“Reasons for Not Vaccinating Adolescents: National Immunization Survey of Teens, 2008-2010”
Darden, P.M.; et al. Pediatrics, April 2013, Vol. 131. doi: 10.1542/peds.2012-2384.

Summary: Using data from the National Immunization Survey of Teens, researchers found that parental intentions to not vaccinate for HPV increased from 39.8 percent in 2008 to 43.9 percent in 2010. The most commonly cited reasons for not vaccinating were “not recommended/needed,” “not sexually active,” and “safety concerns/side effects.” Vaccine safety concerns increased from 4.5 percent in 2008 to 16.4 percent in 2010.

“Barriers to Human Papillomavirus Vaccination Among US Adolescents: A Systematic Review of the Literature”
Holman, D.M.; et al. JAMA Pediatrics, January 2014, Vol. 168. doi: 10.1001/jamapediatrics.2013.2752.

Summary: “Health care professionals cited financial concerns and parental attitudes and concerns as barriers to providing the HPV vaccine to patients. Parents often reported needing more information before vaccinating their children. Concerns about the vaccine’s effect on sexual behavior, low perceived risk of HPV infection, social influences, irregular preventive care, and vaccine cost were also identified as potential barriers among parents.”

Vaccine safety

“Adverse Events Following Immunization in Ontario’s Female School-Based HPV Program”
Harris, T.; Williams, D.M.; Feiurek, J.; Scott, T.; Deeks, S.L. Vaccine, January 2014, Vol. 32. doi: 10.1016/j.vaccine.2014.01.004.

Summary: After a school-based HPV vaccination program was implemented among eighth grade girls in Ontario, Canada, researchers analyzed reports of adverse events following immunization over the following four years. From 2007 to 2011, nearly 700,000 HPV vaccine doses were administered and 133 confirmed cases of adverse events were reported. The most commonly reported side effects included allergic reactions (25 percent), rashes (22 percent), reactions at the injection site (20 percent), and non-specific “other events” (26 percent). Ten serious cases were identified, which included two cases of anaphylaxis, two seizures, one thrombocytopenia, and one death, which was concluded by the coroner to be due to a previously undiagnosed cardiac condition. Ultimately, the researchers conclude that the findings are in line with existing evidence on the safety profile of the HPV vaccine, and no new safety concerns were identified.

“Safety of Human Papillomavirus Vaccines: A Review”
Macartney, K.K.; Chiu, C.; Georgousakis, M.; Brotherton, J.M.L. Drug Safety, June 2013, Vol. 36. doi: 10.1007/s40264-013-0039-5.

Abstract: “Both vaccines are associated with relatively high rates of injection site reactions, particularly pain, but this is usually of short duration and resolves spontaneously. Systemic reactions have generally been mild and self-limited. Post vaccination syncope has occurred, but can be avoided with appropriate care. Serious vaccine-attributable adverse events, such as anaphylaxis, are rare, and although not recommended for use in pregnancy, abnormal pregnancy outcomes following inadvertent administration do not appear to be associated with vaccination. HPV vaccines are used in a three-dose schedule predominantly in adolescent females: as such, case reports linking vaccination with a range of new onset chronic conditions, including autoimmune diseases, have been made. However, well-conducted population-based studies show no association between HPV vaccine and a range of such conditions.”

Disparities in vaccination rates

“Racial/Ethnic and Poverty Disparities in Human Papillomavirus Vaccination Completion”
Niccolai, L.M.; Mehta, N.R.; Hadler, J.L. American Journal of Preventive Medicine, October 2011, Vol. 41. doi: 10.1016/j.amepre.2011.06.032.

Abstract: “Data from the 2008-2009 National Immunization Survey-Teen for girls aged 13-17 years who received at least one dose of HPV vaccine (n=7606) were analyzed in 2010-2011. During this 2-year period, 55 percent of adolescent girls who initiated vaccination completed the three-dose series. Completion was significantly higher in 2009 (60 percent) compared to 2008 (48 percent; p<0.001). After controlling for covariates, adolescents who were black or Hispanic were significantly less likely to complete vaccination than whites. Adolescents living below the federal poverty level were significantly less likely to complete vaccination than adolescents with household incomes >$75,000.”

“Social Inequalities in Adolescent Human Papillomavirus (HPV) Vaccination: A Test of Fundamental Cause Theory”
Polonijo, A.N.; Carpiano, R.M. Social Science & Medicine, April 2013, Vol. 82. doi: 10.1016/j.socscimed.2012.12.020.

Abstract: “Analyses of 2008, 2009, and 2010 United States National Immunization Survey-Teen data (n = 41,358) reveal disparities particularly for vaccine knowledge and receipt of a health professional recommendation. While parental knowledge is a prerequisite to adolescent vaccine uptake, low socioeconomic status (SES) and racial/ethnic minority parents have significantly lower odds of knowing about the vaccine. Receipt of a health professional’s recommendation to vaccinate is strongly associated with vaccine uptake, however the odds of receiving a recommendation are negatively associated with low SES and black racial/ethnic status.”

“Sociodemographic Differences in Human Papillomavirus Vaccine Initiation by Adolescent Males”
Agawu, A.; et al. Journal of Adolescent Health, November 2015, Vol. 57. doi: 10.1016/j.jadohealth.2015.07.002.

Summary: Researchers studied patterns of HPV vaccination among a sample of 58,757 adolescent males between the ages of 11 and 18 in a large primary care network. Results showed that African American males with private health insurance were twice as likely to initiate vaccination than White males with private insurance, while African American males on Medicaid were nearly three times more likely. Similar trends were observed among Hispanic males. The authors conclude that, “although the true mechanism underlying these differences remains unknown, potential candidates include provider recommendation patterns and differential vaccine acceptance within these groups.”

HPV vaccine and young males

“HPV Vaccination Coverage of Male Adolescents in the United States”
Lu, P.J.; et al. Pediatrics, October 2015, Vol. 136. doi: 10.1542/peds.2015-1631.

Summary: Researchers used data from the 2013 National Immunization Survey-Teen to investigate trends in HPV vaccination of adolescent boys. Findings revealed low rates of both vaccine uptake (34.6 percent) and completion (13.9 percent), however African American and Hispanic males were more likely to receive the vaccine than their White peers. In order to improve vaccination coverage, the authors conclude that a comprehensive approach is needed which includes physicians regularly assessing their patient’s vaccination status, educating doctors about current HPV vaccine recommendations as well as information on vaccine efficacy and safety, reducing costs, and improving health communication strategies to dispel misinformation about the vaccine.

“Longitudinal Predictors of Human Papillomavirus Vaccination Among a National Sample of Adolescent Males”
Reiter, P.L.; et al. American Journal of Public Health, August 2013, Vol. 103. doi: 10.2105/AJPH.2012.301189.

Abstract: “In fall 2010 and 2011, a national sample of parents with sons aged 11 to 17 years (n = 327) and their sons (n = 228) completed online surveys to identify predictors of HPV vaccination. Only 2 percent of sons had received any doses of HPV vaccine at baseline, with an increase to 8 percent by follow-up. About 55 percent of parents who had ever received a doctor’s recommendation to get their sons HPV vaccine did vaccinate between baseline and follow-up, compared with only 1 percent of parents without a recommendation. Willingness to get sons the HPV vaccine decreased from baseline to follow-up among both parents and sons.”

“Acceptability of Human Papillomavirus Vaccine for Males: A Review of the Literature”
Liddon, N.; Hood, J.; Wynn, B.A.; Markowitz, L.E. Journal of Adolescent Health, February 2010, Vol. 46. doi:10.1016/j.jadohealth.2009.11.199.

Abstract: “Among mothers of sons, support of HPV vaccination varied widely from 12 percent to 100 percent, depending on the mother’s ethnicity and type of vaccine, but was generally high for a vaccine that would protect against both genital warts and cervical cancer. Health providers’ intention to recommend HPV vaccine to male patients varied by patient age but was high (82 percent-92 percent) for older adolescent patients. A preference to vaccinate females over males was reported in a majority of studies among parents and health care providers. Messages about cervical cancer prevention for female partners did not resonate among adult males or parents. Future acceptability studies might incorporate more recent data on HPV-related disease, HPV vaccines, and cost-effectiveness data to provide more current information on vaccine acceptability.”

“Parents’ Decisions About HPV Vaccine for Sons: The Importance of Protecting Sons’ Future Female Partners”
Schuler, C.L.; DeSousa, N.S.; Coyne-Beasley, T. Journal of Community Health, October 2014, Vol. 39. doi: 10.1007/s10900-014-9859-1.

Abstract: “76 percent of parents reported vaccine decisions for sons were likely to be influenced by preventing HPV transmission from sons to their female partners. Parents likely to be influenced by female partner protection in vaccine decisions had greater intention to vaccinate sons than their counterparts (adjusted odds ratio 2.54). Because parents likely to consider female partners had increased intention to vaccinate sons, future efforts to improve vaccine uptake in boys should explore the benefits of highlighting potential female partner protection, as this concept may resonate with many parents.”

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New pen-sized microscope could ID cancer cells in doctor’s offices and operating rooms

Tue, Jan 26, 2016

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Source: www.sciencecodex.com
Author: staff

Surgeons removing a malignant brain tumor don’t want to leave cancerous material behind. But they’re also trying to protect healthy brain matter and minimize neurological harm.

Once they open up a patient’s skull, there’s no time to send tissue samples to a pathology lab — where they are typically frozen, sliced, stained, mounted on slides and investigated under a bulky microscope — to definitively distinguish between cancerous and normal brain cells.

But a handheld, miniature microscope being developed by University of Washington mechanical engineers could allow surgeons to “see” at a cellular level in the operating room and determine where to stop cutting.

The new technology, developed in collaboration with Memorial Sloan Kettering Cancer Center, Stanford University and the Barrow Neurological Institute, is outlined in a paper published in January in the journal Biomedical Optics Express.

“Surgeons don’t have a very good way of knowing when they’re done cutting out a tumor,” said senior author Jonathan Liu, UW assistant professor of mechanical engineering. “They’re using their sense of sight, their sense of touch, pre-operative images of the brain — and oftentimes it’s pretty subjective.”

“Being able to zoom and see at the cellular level during the surgery would really help them to accurately differentiate between tumor and normal tissues and improve patient outcomes,” said Liu.

The handheld microscope, roughly the size of a pen, combines technologies in a novel way to deliver high-quality images at faster speeds than existing devices. Researchers expect to begin testing it as a cancer-screening tool in clinical settings next year.

For instance, dentists who find a suspicious-looking lesion in a patient’s mouth often wind up cutting it out and sending it to a lab to be biopsied for oral cancer. Most come back benign.

That process subjects patients to an invasive procedure and overburdens pathology labs. A miniature microscope with high enough resolution to detect changes at a cellular level could be used in dental or dermatological clinics to better assess which lesions or moles are normal and which ones need to be biopsied.

“The microscope technologies that have been developed over the last couple of decades are expensive and still pretty large, about the size of a hair dryer or a small dental x-ray machine,” said co-author Milind Rajadhyaksha, associate faculty member in the dermatology service at the Memorial Sloan Kettering Cancer Center in New York City. “So there’s a need for creating much more miniaturized microscopes.”

Making microscopes smaller, however, usually requires sacrificing some aspect of image quality or performance such as resolution, field of view, depth, imaging contrast or processing speed.

“We feel like this device does one of the best jobs ever — compared to existing commercial devices and previous research devices — of balancing all those tradeoffs,” said Liu.

The miniature microscope uses an innovative approach called “dual-axis confocal microscopy” to illuminate and more clearly see through opaque tissue. It can capture details up to a half millimeter beneath the tissue surface, where some types of cancerous cells originate.

“Trying to see beneath the surface of tissue is like trying to drive in a thick fog with your high beams on – you really can’t see much in front of you,” Liu said. “But there are tricks we can play to see more deeply into the fog, like a fog light that illuminates from a different angle and reduces the glare.”

The microscope also employs a technique called line scanning to speed up the image-collection process. It uses micro-electrical-mechanical — also known as MEMS — mirrors to direct an optical beam which scans the tissue, line by line, and quickly builds an image.

Imaging speed is particularly important for a handheld device, which has to contend with motion jitter from the human using it. If the imaging rate is too slow, the images will be blurry.

In the paper, the researchers demonstrate that the miniature microscope has sufficient resolution to see subcellular details. Images taken of mouse tissues compare well with those produced from a multi-day process at a clinical pathology lab — the gold standard for identifying cancerous cells in tissues.

The researchers hope that after testing the microscope’s performance as a cancer- screening tool, it can be introduced into surgeries or other clinical procedures within the next 2 to 4 years.

“For brain tumor surgery, there are often cells left behind that are invisible to the neurosurgeon. This device will really be the first to let you identify these cells during the operation and determine exactly how much further you can reduce this residual,” said project collaborator Nader Sanai, professor of neurosurgery at the Barrow Neurological Institute in Phoenix. “That’s not possible to do today.”

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Celine Dion’s husband René Angélil dies following long battle with throat cancer

Fri, Jan 15, 2016

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Source: www.mirror.co.uk
Author: Zoe Shenton

Celine Dion’s husband René Angélil has died at the age of 73. René, who acted as a mentor and manager to Celine, had been battling throat cancer since 2013 but lost the fight on Thursday morning.

“Rene Angelil, 73, passed away this morning as his home in Las Vegas after a long and courageous battle against cancer. The family requests that their privacy be respected at the moment; more details will be provided at a later time,” his representative told People in a statement.

René had been undergoing treatment for the disease, but his struggle was very difficult on Celine as well as the pair’s three children – 14-year-old son, Rene, and five-year-old fraternal twins Eddy and Nelson.

Celine-Dion-Rene-Angelil

RIP: René Angélil had been battling cancer since 2013

He also has three grown up children from a previous relationship – Anne-Marie, Patrick and Jean-Pierre.

Celine took a break from her residency at The Colosseum at Caesars Palace Las Vegas Hotel and Casino last year when René’s illness worsened, but returned to the stage in August.

She previously revealed it was her spirituality that has helped her to cope during her spouse’s health struggles.

Speaking to Taste of Life magazine, Celine – who was raised a Roman Catholic – revealed: “Life is not always perfect. You have to deal with it. Whatever life imposes – sickness, or whatever, you don’t have a choice. This is life, this is nature.

“But you do have the choice on how you’re going to go through this. And if you don’t have spirituality you’re going to fall apart before things happen. I am very spiritual.

“I believe in myself, I believe in my family, and I’m positive. Through this, you show your children how to deal with things, and how to be strong.”

René was first diagnosed with throat cancer in April 1998 but made a full recovery from the illness before contracting it again in December 2013.

The pair first met when Celine was just 12-years-old and began dating when she was 19 and he was 45.

They tied the knot at the Basilica Notre-Dame in Montreal, Quebec, on 17 December 1994 before renewing their wedding vows in Las Vegas in 2000.

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