Pre-Teens need just two doses of HPV vaccine, not three: Feds

Author: Maggie Fox

There’s good news for kids who haven’t received all their HPV vaccines yet – they only need two doses of the vaccine instead of three, federal government advisers said Wednesday. The new recommendations should make it easier to get more children vaccinated against the human papillomavirus (HPV), which causes a range of cancers including cervical cancer, throat cancer and mouth cancer, officials said.

“It’s not often you get a recommendation simplifying vaccine schedules,” said Dr. Nancy Messonnier, Director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention.

The CDC immediately accepted the recommendations from its Advisory Committee on Immunization Practices.

“Safe, effective, and long-lasting protection against HPV cancers with two visits instead of three means more Americans will be protected from cancer,” said CDC Director Dr. Tom Frieden. “This recommendation will make it simpler for parents to get their children protected in time.”

The CDC says every pre-teen boy and girl should get the vaccine, but fewer than a third have received all three doses.

Messonnier says the three-dose schedule was based on the earliest studies of the vaccine. New studies show that two doses protect people for decades from the cancer-causing virus. And studies also suggest that spacing the two doses a year apart is at least as effective, if not more effective than giving them more closely together – something that could also make it easier to get kids fully vaccinated.

Older teens who have not been vaccinated at all before age 15 should still get three doses, because there’s not enough evidence to show whether two doses fully protect them, ACIP said.

Adults can also get the HPV vaccine. “Young women can get HPV vaccine through age 26, and young men can get vaccinated through age 21,” the CDC says.

“The vaccine is also recommended for any man who has sex with men through age 26, and for men with compromised immune systems (including HIV) through age 26, if they did not get HPV vaccine when they were younger.”

HPV is extremely common, but rates of HPV-related disease have fallen among vaccinated people.

“About 14 million people, including teens, become infected with HPV each year. HPV infection can cause cervical,vaginal, and vulvar cancers in women; penile cancer in men; and anal cancer, cancer of the back of the throat (oropharynx), and genital warts in both men and women,” the CDC says.

The original two vaccines on the market protected against either two or four of the strains of HPV known to cause cancer. Now the only vaccine available in the U.S. is Merck’s Gardasil 9, which protect against 9 strains of HPV.

Messonnier says it’s too soon to say whether teens vaccinated with the older vaccines should get a top-up dose with the new formulation.

October, 2016|Oral Cancer News|

e-Cigarette Use Tied to Tobacco Use in Teenagers

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.

February, 2016|Oral Cancer News|

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

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.


February, 2016|Oral Cancer News|

A cancer on the rise, and the vaccine too late for Gen X

Author: Martha Shade

(CNN)The vaccine given to prevent cervical cancer in women could end up saving men’s lives, too.

Evidence is mounting that the HPV vaccine is also effective in preventing other HPV-related cancers, including those of the head and neck. Although most people who get HPV do not develop cancer, rates of HPV-related head and neck cancers are dramatically rising for men aged 40 to 50, according to Dr. Maura L. Gillison, the Jeg Coughlin Chair of Cancer Research at the Ohio State University Comprehensive Cancer Center.

When Gillison recently gave a presentation showing the increasing rate of HPV-related head and neck cancer among men, her audience was shocked. “I’ve never shown a slide where the audience gasps,” she said.

Related: Yes, oral sex can lead to cancer

“The risk of getting this cancer is strongly related to when you were born. If you are currently a 40- to 45-year-old man, your risk of getting this cancer is dramatically higher than a 40- to 45-year-old man three or four decades ago,” Gillison said.

Today’s 40- to 50-year-old men have had more sexual partners and have engaged in more oral sex than previous generations, according to experts, significantly raising their risk of an HPV-related head and neck cancer.

Actor Michael Douglas made headlines in 2013 when he announced he was battling an HPV-related cancer and that he got it from performing oral sex. Douglas was 68 when he was diagnosed, but many of the men being diagnosed with these HPV-related cancers are much younger.

What’s a Gen X’er to do?

HPV is usually acquired when young. It can lay dormant, and most oropharyngeal cancer (a type of head and neck cancer) is diagnosed decades later, beginning around age 40 to 50. And the more partners you have, the greater your risk.

HPV vaccines weren’t recommended and approved in the United States until 2006. And the vaccine was not even recommended for boys until 2011.

So what’s an aging Gen X’er to do?

“You’re starting to get colonoscopies; you’re starting to get checked for prostate cancer. This is one more thing to add to that list that you really have to watch for,” said Brian Hill, founder of the Oral Cancer Foundation.

Warning signs of HPV-related head and neck cancer

• Persistent lump on neck

• Persistent earache on one side

• Swelling or lump in the mouth

• Chronic sore throat

• Difficult or painful swallowing

• Change in voice

Source: Oral Cancer Foundation, Dr. Carole Fakhry

Symptoms of HPV-related head and neck cancer include a change in voice, a sore throat that doesn’t go away, an earache on one side and difficult or painful swallowing.

Hill’s story is typical: His doctors initially assumed he had an enlarged lymph node due to an infection. Two doctors gave him antibiotics before he was diagnosed with late-stage oropharyngeal cancer. His experience led him to form the Oral Cancer Foundation.

Finding the disease at an early stage is lifesaving. When it’s diagnosed early, these HPV-related cancers are survivable, according to Dr. Carole Fakhry of the Johns Hopkins Head & Neck Cancer Center. “If you have a lump in your neck, make sure to get checked.

“A very common story is: ‘I was shaving and I noticed this lump in my neck,” she said. “And he goes through two or three rounds of antibiotics and then someone finally thinks about cancer.”

‘Dental hygienists are becoming the best screeners’

Traditionally, cancers of the head and neck were often linked to alcohol or smoking, and these non-HPV cancers tend to be located at the front of the mouth and the voice box. Incidence of these cancers are dropping.

“The truth of the matter is that smoking-related cancers are declining,” Fakhry said. “On the other hand, cancers related to HPV are increasing.”

HPV-related cancers usually originate in the back of the mouth. “Most of these cancers are tonsils and back-of-tongue cancers,” she said. “Tonsils are basically these crypts, and tumors grow deep within these crypts, so these tumors can be hard to find.”

Since tumors are often hidden, dentists and dental hygienists are becoming the first line of attack. Men may also be more likely to visit a dentist regularly than a doctor, according to Hill.

“Dental hygienists are becoming the best screeners for this. They’re becoming the point at the end of the spear when it comes to screening and finding abnormalities,” he said.

Dentists and hygienists are encouraged to look for telltale signs of HPV-related cancer: asymmetrical or swollen tonsils, or a lesion in the back of the throat. But these cancers are notoriously tough to spot and tend to be diagnosed after patients develop a lump in the neck.

So what can you do?

“Make sure you get your kids vaccinated (for HPV),” Fakhry said.

Dr. Dan Beachler, lead author of a new study that found further evidence the HPV vaccine protects against multiple types of HPV-related cancers, agrees: “We still don’t know that much about oral HPV. Primary prevention through vaccination might have the most potential.”

Besides the cervix and the head and neck, some strains of HPV can also lead to cancer of the anus, penis and vulva.

A preventive HPV vaccine is most effective when given to children before they become exposed to HPV. The three dose series is recommended at age 11 or 12.

Initially recommended just for girls, the Centers for Disease Control and Prevention now recommends that boys be vaccinated, too. In addition, vaccination is recommended through the age of 26 in women and through age 21 in men who were not vaccinated previously.

“Young people do not avoid oral sex. That being a given, the best thing we can do is increase the vaccination rate. The second thing we can do is be highly aware of signs and symptoms,” Hill said.

And don’t panic. Although HPV-related cancers are on the rise, they’re still uncommon.

“Even though the rates are dramatically increasing, it’s still a relatively rare cancer. We don’t want to create a panic. We just want to raise awareness,” Gillison said.

Athletes drive increase in high schoolers’ use of smokless tobacco, CDC study shows

Author: web staff


High-school athletes are using more smokeless tobacco, even though overall tobacco use among high-school students has declined, according to a study published by the federal Centers for Disease Control and Prevention.

We can do more to protect America’s youth from a lifetime of addiction,” Tom Frieden, CDC director, said in a press release. “The fact is, smokeless tobacco products, such as chewing tobacco, snuff or dip, can cause cancer of the mouth, esophagus and pancreas. And the nicotine in these products is harmful to the developing brain. Because we know tobacco-free policies in schools and other public recreational areas work, we must take action now so that our children are safe from these toxins.”

Student responses to the national Youth Risk Behavior Survey from 2001 through 2013 show that the share reporting any tobacco use dropped to 22.4 percent from 33.9 percent, and the rate of those smoking combustible tobacco products dropped to 19.5 percent from 31.5 percent. However, those who reported using smokeless tobacco products increased to 8.8 percent from 8.2 percent.

The increased use of smokeless tobacco was driven by athletes. The rate among non-athletes remained unchanged at 5.9 percent but has “increased significantly” to 11.1 percent from 10 percent in youth athletes.

Researchers suggest that athletes are aware of the adverse consequences of smoking on athletic performance, but may view smokeless tobacco as “less harmful, socially acceptable, or even a way to enhance athletic performance.”

The 2013 YRBS found that 26.3 percent of Kentucky’s high school youth reported any use of tobacco; 17.9 percent were smoking cigarettes, and 13.2 percent reported using smokeless tobacco.

“Tobacco use among youth athletes is of particular concern because most adult tobacco users first try tobacco before age 18,” Brian King, deputy director for research translation in the CDC Office on Smoking and Health, said in a press release. “The younger people are when they start using tobacco, the more likely they are to become addicted and the more heavily addicted they can become.”

The reports calls for increased education about the dangers of smokeless tobacco; recognition that the tobacco industry pushes smokeless tobacco as an alternative to smoking where it is prohibited; that the role of professional athletes, many who use smokeless tobacco, must be part of the discussion because they are often considered role models by youth; and that “implementing and enforcing tobacco-free policies that prohibit all tobacco use on school campuses and at all public recreational facilities, including stadiums, parks, and school gymnasiums, by players, coaches, referees, and fans might help reduce tobacco use among student athletes.”

As of September, Kentucky had 47 school districts with comprehensive tobacco free policies. These policies cover 45 percent of Kentucky’s students and represents 27 percent of the school districts in the state, according to the Kentucky 100% Tobacco Free Schools website.

“Creating 100 percent tobacco-free environments is one of the best ways we can set our kids up for a healthy future,” U.S. Surgeon General Vivek H. Murthy said in the release. “It helps them see that being tobacco-free is the way to better health and a longer life.”


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

October, 2015|Oral Cancer News|

How Anti-Vaxxers Ruined Disneyland for Themselves (and everyone else)

Author: Robbie Gonzalaz

“The Happiest Place On Earth” is ground zero for a recent measles outbreak centered in California. Now, unvaccinated people are being warned to avoid visiting Disneyland parks.

No Infants In Disneyland

There are now 67 confirmed cases of measles in an ongoing outbreak centered in California. According to the California Department of Public Health, 59 of the cases are in-state. Among the 34 California patients for whom vaccination status is known, 28 were unvaccinated and one had received partial vaccination. Only five were fully vaccinated.

Forty-two of the California cases have been linked to an initial exposure at Disneyland or Disney California Adventure Park, and while cases were originally tied to people who visited the park in mid-December, state health officials now note other cases visited Disney parks in January. According to the CDC, the majority of measles cases reported so far during 2015 have been part of the “large, ongoing outbreak” connected with these parks.

Last year, there were 644 measles cases documented in 27 states – the biggest annual numberin close to a quarter century. For those hoping to avoid seeing similar infection rates in 2015, the year is off to an inauspicious start.

Unvaccinated people are now being warned to avoid visiting Disneyland parks. The reasoning is simple: Most people who get measles are unvaccinated, and the disease spreads easiest when when it reaches a community where large groups of people are unvaccinated. Limiting the number of unvaccinated people in the park therefore not only protects them from themselves, it protects the immunized visitors, as well.

It also protects those too young to be immunized. Of the measles patients who have been hospitalized in this recent outbreak, six cases have been in infants too young to be vaccinated, whether their parents want them immunized or not.

“I would recommend that infants are not taken to places like Disneyland today,” said Gil Chavez, deputy director of the California Department of Public Health’s Center for Infectious Diseases, in an interview with the LA Times. Yesterday, Chavez implored parents to take action to protect not only their own children, but other children who might be affected by their decisions.

“I am asking unvaccinated Californians to consider getting immunized,” Chavez said. “We have a particular responsibility to protect all of our infants in the state until they are old enough to be vaccinated.”

This is how the anti-vaccination movement ruined Disneyland, not just for those who would actively refuse vaccines, but for everyone else. The cause for measles’s resurgence is as unambiguous today as it has been in recent months. Last May, Dr. Anne Schuchat, assistant surgeon general and director of the CDC’s National Center for Immunization and Respiratory Diseases stated unambiguously that “the current increase in measles cases is being driven by unvaccinated people.” Yesterday, pediatric infectious disease specialist James Cherry told the New York Times that the Disneyland outbreak was “100 percent connected” to the anti-vaccine movement. “It wouldn’t have happened otherwise — it wouldn’t have gone anywhere,” he said.

When Anti-Vaxxers Cluster

Of course, the ill-effects of the anti-vaccination movement are not limited to Disneyland. The consequences of refused vaccinations are felt anywhere that people gather, allowing diseases like measles to spread vast distances very quickly. Venues like theme parks and airports are considered potential flashpoints, because they see a lot of international travelers, who may originate from countries where diseases like measles have yet to be eliminated.

Schools also pose a serious challenge. While state officials have not gone so far as to ban unvaccinated people from visiting Disneyland altogether, such measures have recently been taken at California schools. Health officials in Orange County this week issued more than 20 letters to parents stating that students who could not prove they had received a measles vaccine could be barred from class. (The Journal of the American Medical Association has published research this week on legal strategies for combating the growing danger of nonmedical vaccine refusal.)

The major concern of California health officials is that school vaccination rates remain above 95% – a threshold critical to maintaining herd immunity. Statewide, the vaccination exemption rate among California kindergartners was 3.1% for the 2013–2014 school year, but there are pockets across the state where exemption rates have crept into the double digits.

A newly published study on anti-vaccination patterns is the latest to highlight some of these pockets. The study, which was led by Kaiser Permanente Division of Research Director Tracy Lieu and appears in this week’s issue of the journal Pediatrics, finds that parents who opt out of vaccinating their children tend to cluster, creating geographic hot-spots where large percentages of children receive no vaccines or are under-immunized. The findings could explain how a disease like measles – which was officially “eliminated” from the U.S. in 2000 – has managed to acquire so firm a foothold within the American population.

NPR’s Liza Gross reports on the study, and an ironic consequence of this clustering effect:

“If these parents were distributed randomly, their decisions would be less likely to harm others, especially babies too young for vaccination. But parents who use personal belief exemptions to avoid school vaccination requirements often live in the same communities, studies have found.

And parents of children too young to go to school do, too… These younger children face the highest risk of dying from whooping cough and other vaccine-preventable diseases.

…The main problem with this clustering behavior, says [Saad Omer, a researcher at Emory University who found that clusters of personal belief exemptions contributed to the 2010 California whooping cough epidemic that killed 10 babies], is that every child’s risk for disease depends on what others do. That’s because no vaccine is 100 percent effective, so even a vaccinated child could get sick if exposed.”

Lieu’s team also identified five clusters where all vaccines were refused for close to 9,000 babies and toddlers in the study:

– 10.2 percent of children in an area from El Cerrito to Alameda

– 7.4 percent in northeastern San Francisco

– 6.6 percent in Marin and southwest Sonoma counties

– 5.5 percent in northeastern Sacramento County and Roseville

– 13.5 percent of kids in a small area south of Sacramento

“These are early signals,” says Lieu. “These kinds of clusters can be associated with later epidemics.”

In an interview with the NYT, Jane Seward, deputy director of the viral diseases division at the CDC, echoes Lieu’s sentiment:

“The problem is that there are these pockets with low vaccination rates… if a case comes into a population where a lot of people are unvaccinated, that’s where you get the outbreak and where you get the spread.”


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


January, 2015|Oral Cancer News|

The Cancer Cure Parents Aren’t Using

Author: Meredith Wadman


Not so long ago, when my sons still had smooth cheeks and children’s voices, I had them vaccinated against human papillomavirus, the most common sexually transmitted disease. It was late 2011, and the Centers for Disease Control and Prevention had just recommended that boys join girls in being vaccinated at age 11 or 12. I was certainly receptive: HPV, as it’s commonly called, causes cervical cancer, cancer of the tonsils, cancer of the back of the tongue and, less often, cancers of the vulva, vagina, anus and penis. It seemed important to ensure that my kids were protected.

Yet numbers released last month by the CDC show that my sons, now 14 and 15, are among a small minority of adolescent males who have been vaccinated. In 2013, just 14 percent of American boys ages 13 to 17 had received all three recommended doses of the HPV vaccine. (The CDC also recommends “catch-up” vaccination for males up to age 21.)

Not that parents are rushing to have their girls vaccinated either, even though the CDC first recommended the vaccine for prepubescent girls in 2007 and virtually all insurers pay for it. In 2013, fewer than 38 percent of American girls between 13 and 17 had received the full three-dose course.

It is heartbreaking to watch a safe, effective vaccine go unused. Consider this: The CDC estimates that increasing the vaccination rate of American girls to 80 percent would prevent 53,000 cervical cancers during the lifetimes of girls who are now 12 and younger.

When I had my sons vaccinated, it was partly with girls in mind. After all, if fewer young men are infected, fewer young women will be exposed to the virus that causes cervical cancer — currently the most common cancer prevented by the vaccine. But now I am realizing that HPV poses a growing risk to boys.

A new breed of cancer of the back of the tongue and tonsils, caused by HPV, is rising in incidence — likely caused, researchers suspect, by increases in premarital sex and oral sex over the past several decades. These cancers afflict men far more often than women, and at relatively younger ages than do other head and neck cancers, which typically appear in men older than 60. Middle-aged men who don’t die from their HPV-linked cancer often must live for years with the side effects of intensive chemotherapy and radiation delivered to the back of the throat. These can include the permanent inability to swallow and the appearance later ofnew, aggressive, radiation-induced cancers.

If this trend continues, we are going to see more cancer of the back of the tongue and the tonsils caused by HPV. One recent analysis of 30 studies, conducted by University of Wisconsin researchers, found that the proportion of such cancers caused by HPV rose from 21 percent before 1990 to 65 percent after 2000. Anil Chaturvedi of the National Cancer Institute and his colleagues have estimated, based on recent trends, that by 2020 there will be more new cases of these HPV-induced throat cancers in the United States each year than new cervical cancer cases.

So the actor Michael Douglas did us all a service when he was so frank with Britain’s Guardian newspaper last year. When asked if his throat cancer had been caused by heavy drinking and smoking, which are also risk factors for the disease, the actor replied: “No. I mean, without getting too specific, this particular cancer in tests is caused by something called HPV, which actually comes about from cunnilingus.”

Many parents don’t like to think of their 11- and 12-year-olds as sexual creatures. Ironically, the CDC recommendation assumes not that kids are sexually active at this tender age but rather that they are not: The point of vaccination is to close the door before the horse is out of the barn.

It’s no use telling yourself that your child isn’t “that kind” of kid. The fact is, HPV is so common that almost all sexually active adults are infected at some point. Last year, the CDC estimated that about 79 million Americans were infected, most of them in their late teens and early 20s.

Most people who get HPV have a transient infection that their immune system clears with no lasting damage. But in some people, the virus takes up residence and goes on to cause cancer. I am grateful that, thanks to the HPV vaccine, I will never have to find out if my sons fell into that second, unlucky group.

 *This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
August, 2014|Oral Cancer News|

CDC finds coverage for HPV vaccination among teens is still low

Author: staff

Although there has been a slight increase in human papillomavirus vaccination coverage among adolescents since 2012, a new report from the Centers for Disease Control and Prevention states that vaccine coverage in this population remains “unacceptably low”.

Human papillomavirus (HPV) is the most common sexually transmitted infection in the US. There are more than 150 types of HPV, 40 of which can be contracted through skin-to-skin contact during vaginal, anal or oral sex.

Low-risk HPV types, such as HPV-6 and HPV-11, can cause warts around the genitals or anus. But high-risk types, including HPV-16 and HPV-18, account for approximately 5% of all cancers worldwide.

Specifically, HPV-16 and HPV-18 account for around 70% of all cervical cancers and almost 50% of all vaginal, vulvar and penile cancers. HPV-16 is also accountable for more than 50% of throat cancers.

There are currently two vaccines available for HPV, which are administered in three shots over 6 months. Cervarix and Gardasil are used for the prevention of cervical cancer, while Gardasil can also protect against anal, vulvar andvaginal cancers and genital warts.

The Advisory Committee on Immunization Practices (ACIP) recommends that preteen girls and boys aged 11 or 12 are vaccinated against HPV. The vaccination is also recommended for teenage girls and young women up to the age of 26 who did not receive it when they were younger, and teenage boys and young men up to the age of 21.

HPV vaccination coverage increased in 2012-13, but remains too low

But despite these recommendations, a new report from the Centers for Disease Control and Prevention (CDC) – published in this week’s Morbidity and Mortality Weekly Report – estimates that in 2013, only 57% of girls and 35% of boys ages 13-17 years received one or more doses of the HPV vaccine.

The figures came from results of the CDC’s National Immunization Survey-Teen (NIS-Teen), which includes vaccine information via telephone surveys for adolescents aged 13-17 years from across the US.

The CDC investigators did, however, find that HPV vaccination coverage increased slightly among girls between 2012-13, from 53.8% to 57.3%, although only a third received the complete three doses. Teenage boys saw a greater increase in vaccination coverage, from 20.8% to 34.6%.

But still, the CDC say HPV vaccination coverage among adolescents is too low, particularly when compared with coverage to other vaccination types. For example, another report from the CDC found that almost 86% of adolescents received one dose of the Tdap vaccine last year, which protects against tetanus, diphtheria and whooping cough.

A 10-year national objective in the US – set in 2010 by Healthy People 2020 – is to reach 80% HPV vaccination coverage among adolescents. These latest statistics suggest there is a lot of work to be done. But lead author of the report, Shannon Stokley, assistant director for science at the CDC’s Immunization Services Division, says they also show the 80% vaccination coverage target is realistic:

“The data on missed vaccination opportunities tells us that it is possible. When we look at the most recent cohort of girls that turned 13, 91% of them had a health care encounter where they could have started the HPV vaccine series before their 13th birthday.

Also, 86% of 13-17 year-olds have received the Tdap vaccine. What these numbers tell us is that preteens and teens are getting to the doctor and they are getting vaccinated, but they aren’t always receiving the HPV vaccine.” 

Why is HPV vaccination coverage still low?

From NIS-Teen, the CDC investigators were also able to establish some reasons as to why HPV vaccination coverage remains low among adolescents.

They found that clinicians’ recommendations significantly influenced a parent’s decision of whether to have their children vaccinated against HPV.

Of parents whose daughters were vaccinated, 74% said they received a recommendation from their doctor, while 52% of parents who did not have their daughters vaccinated received a doctor’s recommendation. Among parents whose sons were vaccinated, 72% received a recommendation, while only 26% of parents whose sons were not vaccinated received a recommendation.

Based on these findings, Dr. Anne Schuchat, assistant surgeon general and director of CDC’s National Center for Immunization and Respiratory Diseases, believes health care professionals are key in boosting HPV vaccination coverage among adolescents in the US.

“Pediatricians and family physicians are uniquely situated to prevent missed opportunities by giving HPV vaccine during the same visit they give Tdap and meningococcal vaccines,” she adds.

Parents also revealed that concerns over the safety of the HPV vaccine deterred them from vaccinating their children. However, the CDC stress that – after analyzing national postlicensure vaccine safety data – no serious safety concerns have been linked to the HPV vaccine in the 8 years it has been available.

The investigators point out that the most commonly reported side effects of the vaccine include dizziness, fainting, nausea and headache, and injection-site reactions – including pain, redness and swelling.

When we asked Stokely what needs to be done to alleviate parents’ concerns about vaccinating their children against HPV, she replied:

“Parents need to see information in mainstream media that HPV vaccination is very effective at preventing infection with the types of HPV that cause the most cancers. Parents also need to hear that the HPV vaccine is safe and that it is recommended to be given when their children are 11 or 12 years old, before their risk of acquiring an HPV infection increases.”

In conclusion to the report, the CDC say they will continue efforts to team up with state and local immunization programs, cancer organizations, professional organizations and other stakeholders in an attempt to educate parents and health care professionals about the importance of the HPV vaccine, adding:

“Collaborative efforts remain critical to promoting HPV vaccination so that the nation’s adolescents are protected against vaccine-preventable, HPV-associated cancers.”

Earlier this year, Medical News Today reported on a study claiming that two thirds of healthy American adults areinfected with one or more of 109 strains of HPV.

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
July, 2014|Oral Cancer News|

High-Risk HPV Prevalent in Oropharyngeal Cancers

Author: Roxanne Nelson

A larger percentage of oropharyngeal cancers might be related to human papillomavirus (HPV) than previously thought. The Centers for Disease Control and Prevention (CDC) reports that in a large sample of invasive oropharyngeal squamous cell carcinomas, 72% were positive for HPV and 62% were positive for high-risk HPV types 16 and 18, which are covered by the 2 commercially available vaccines (Gardasil, Merck & Co.;Cervarix, GlaxoSmithKline).

On the basis of these data, the CDC researchers suggest that vaccines could prevent most oropharyngeal cancers in the United States.

The vaccines are marketed mainly for the prevention of cervical cancer, but there is hope, and some evidence, that the vaccines might also protect against oropharyngeal cancer. For example, last year, the Costa Rica HPV Vaccine Trial found that the Cervarix vaccine reduced oral HPV infections in women by more than 90%.

However, the effect of the vaccines could vary by demographic factors; HPV prevalence differed by sex and race/ethnicity, the researchers note.

In their study, Martin Steinau, PhD, senior scientist at the CDC, and colleagues report that the current global incidence of oropharyngeal cancers is estimated to be 85,000 annually, although there is considerable geographic variation. In the United States, there are about 12,000 new cases diagnosed every year, and most are classified histologically as squamous cell carcinoma (OPSCC).

The retrospective analysis was published in the May issue of Emerging Infectious Diseases.

Study Details

Dr. Steinau and colleagues sought to determine prevalence of HPV types detected in oropharyngeal cancers in the American population, and to establish a prevaccine baseline for monitoring the impact of vaccination.

They examined oropharyngeal tumors from 588 patients.

HPV was detected in 403 of the 557 patients with OPSCC (72.4%), and 396 (71.1%) were positive for only 1 or no high-risk types. A single HPV type was detected in 68.4% of cases, and 3.9% of samples contained 2 types. In 7 cases, only low-risk HPV types were detected. High-risk HPV16 was present in 337 (60.5%) cases, HPV18 was present in 14 (2.5%) cases, and 331 (59.4%) cases were exclusively positive for these 2 types.

Other high-risk types, including HPV31, 33, 35, 39, 45, and 52, were found at low frequency, the researchers point out.

There were differences in prevalence based on sex and race/ethnicity. The prevalence of the high-risk HPV16 and HPV18 was lower in women than in men (53%vs 66%), and in non-Hispanic black than other racial/ethnic groups (31% vs 68% to 80%).

When the researchers conducted a multivariate analysis for high-risk HPV, only race/ethnicity emerged as a significant independent factor (P = .003). The odds for high-risk HPV infections were significantly higher for all other race groups than for non-Hispanic black patients (P < .001).

When only HPV16/18 detection was considered, there were significant differences between those infected and those not infected for sex (P = .009) and race/ethnicity (P < .001), but not for age (P = .063).

“Future assessments are needed to monitor general prevalence and possible type-specific shifts,” the researchers conclude. “Data from the present and future studies will provide a baseline for early assessment of vaccine effects.”

This project was supported in part by CDC grants and federal funds for Residual Tissue Repositories from the National Cancer Institute SEER Population-based Registry Program, National Institutes of Health, Department of Health and Human Services. Coauthor Brenda Y. Hernandez reports receiving consultation and speaker fees from Merck and Co.


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

May, 2014|Oral Cancer News|

Fewer teens having oral sex


Fewer teens aged 15 to 17 are having oral sex now than in 2002, according to a new report from the U.S. Centers for Disease Control, but the number remains high.

The report, based on data from The National Survey of Family Growth, found that more than a third of teens had engaged in oral sex by the time they turned 17. That number climbed to almost 50% by age 19, and more than 80% for 24-year-olds.

The study – based on computer surveys given to over 6,000 teens – also looked at the timing of first oral sex in relation to the timing of first vaginal intercourse. It found that the prevalence of having oral sex before vaginal intercourse was about the same as those having vaginal intercourse before oral sex.

“This new CDC analysis debunks many myths about when young people are initiating oral sex,” wrote Leslie Kantor, vice president for education at Planned Parenthood, a family planning advocacy group. “Although there has never been data to support it, there has been the perception that many teens engage in oral sex as a ‘risk-free’ alternative to intercourse. But the CDC analysis shows that sexually active young people are likely to engage in both activities,” she wrote.

How Americans view teen sex

But oral sex, like vaginal intercourse, is not risk-free. According to the CDC’s website, “numerous studies have demonstrated that oral sex can result in the transmission of HIV and other sexually transmitted disease,” not the least of which is Human Papillomavirus (HPV), the disease known to cause both cervical and some throat cancers.

“It’s widely accepted that there is an increased number of head and neck cancers today due to changes in sexual practices in the ’60s, ’70s and ’80s,” – specifically, an increase in oral sex, said Dr. Otis Brawley, the chief medical officer of the American Cancer Society.

Regardless of whether teens have oral or vaginal sex first, Kantor says, it’s imperative they have the knowledge to make an educated decision about their sexual health.

“We need to make sure that young people have the skills to negotiate what they do and don’t want to do in sexual relationships, as well as education about and access to condoms and birth control so that they can protect themselves from STDs and pregnancy and remain healthy,” she wrote.

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

August, 2012|Oral Cancer News|