Gardasil

HPV Vaccine Linked to Less-Risky Behavior

Source: torontosun.com
Author: Roxanne Nelson, Reuters
 

Contrary to concerns that getting vaccinated against human papilloma virus (HPV) will lead young people to have more or riskier sex, a new study in England finds less risky behaviour among young women who got the HPV vaccine.

“To my knowledge no studies have shown that HPV vaccination increases risky sexual behavior among young women and some of these studies have shown this (less risky behaviour) is also the case outside of the UK,” said Dr. Laura Sadler of the University of Manchester, who led the study.

It’s possible that getting vaccinated led to better education about sexual health, Sadler and her colleagues write in the Journal of Family Planning and Reproductive Health Care.

Sadler and other experts say it’s also possible that young women who are already less likely to take risks are the ones who are more likely to get vaccinated.

HPV is one of the most common sexually transmitted infections and causes the majority of cervical cancers. The virus has also been linked to anal and throat cancers. Two vaccines, Cervarix and Gardasil, are now available that protect against strains of HPV that cause most cervical cancers.

Even though public health officials recommend that girls and young women be vaccinated against HPV, some parents have hesitated, fearing that it could encourage sexual activity or unsafe sex.

For their study, Sadler’s team reviewed the medical records of 363 women born in 1990 or later who attended an English clinic. Almost two-thirds of the young women in the group had received at least one dose of the vaccine. Full vaccination requires three vaccine shots.

The researchers compared the womens’ histories of behaviours that are risky in themselves or tend to be linked to risky sexual behaviour, such as not using condoms, having sex for the first time when they were 15 or younger, having six or more sexual partners and drinking alcohol two or more times a week.

They found five variables related to sexual behaviour that were significantly different between women who had been vaccinated and those who hadn’t.

Women who were not vaccinated were more likely to have had three sex partners in the last six months, to have attended the clinic with symptoms of a sexually transmitted disease, to have had anal intercourse with their last sexual contact and to have tested positive for Chlamydia (a common sexually transmitted infection) at their clinic visit.

Being vaccinated, in contrast, was associated with less-risky behaviours, such as using condoms.

“In this study, the lower prevalence of some risk outcomes among vaccinated women relative to unvaccinated women may be related to underlying differences in preventive care seeking and preventive health behaviors,” said Robert A. Bednarczyk, an assistant professor at the Rollins School of Public Health at Emory University, and who was not involved in the study.

“The women in our study were mainly from the catch-up vaccine program – older teens – and as in the other studies, it shows that among this group, vaccination was taken up by those demonstrating other types of preventive or less risky behaviors,” Sadler told Reuters Health by email.

While the findings are encouraging, and consistent with other research demonstrating that HPV vaccination does not lead to riskier behaviors, the study does not demonstrate that vaccination causes less risky behaviors, said Dr. Jessica Kahn, a professor of pediatrics at Cincinnati Children’s Hospital Medical Center.

“One explanation for the findings is that girls who are vaccinated receive education about sexual health and prevention which decreases riskier behaviors,” Kahn said in an email.

Another explanation is that girls who practice healthier and less risky behaviors are more likely to receive the vaccine, she noted. “Preventive health behaviors tend to cluster, so it makes sense that girls who practice safer behaviors are more likely to be vaccinated.”

 

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
February, 2015|Oral Cancer News|

Doctors Trying To Remind Americans That The HPV Vaccine Isn’t All About Sex

Source: thinkprogress.org
Author: Tara Culp-Ressler

 

Dr. Ronald A. DePinho is on a mission.

 
DePinho, who’s been a cancer researcher for decades and currently serves as the president of the University of Texas MD Anderson Cancer Center, wants to reframe the national conversation about the HPV vaccine to drive home a fundamental point.

 
“It’s important to appreciate that this is a cancer vaccine. A cancer vaccine!” DePinho said in an interview with ThinkProgress. “It’s a dream come true that we’ve converted knowledge into something that can actually save lives and avoid getting cancer in the first place. It’s really what we have been hoping for, and now we have it.”
Since the introduction of the HPV vaccine in 2006, the rate of human papillomavirus in teenage girls has plummeted. And the research in this field continues to advance. On Thursday, the Food and Drug Administration approved an updated version of the Gardasil vaccine that protects against nine strains of the cancer-causing virus — more than twice as many as the 2006 version, which covered just four strains.

 
According to DePinho, that’s a really significant advance for cancer care. He doesn’t want it to get lost in the ongoing controversy about HPV vaccination, a round of shots that some parents still worry is unsafe or inappropriate for their kids.
There’s a persistent myth, for instance, that giving teen girls the shots will spur them to become more “promiscuous” because they know they’ll be protected from a sexually transmitted infection. Large scientific studies have debunked the notion that there’s any link between the HPV vaccine and sexual activity, but inoculation rates still lag behind in some of the Southern states that are wary to provide teens with preventative tools to protect their sexual health.
In general, HPV vaccination rates in the U.S. are still much too low, hovering around 30 percent. Public health professionals are aiming to increase those rates dramatically, to at least 80 percent — closer to the percentage of people who get vaccinated against the virus in other developed countries.

 
To accomplish that, the health professionals who have dedicated their lives to treating HPV-related cancers want to move the conversation away from sexuality altogether. Instead of framing Gardasil as vaccine that protects against an STD — which might give some Americans the impression that they don’t need to worry about it — they want to present it as a vaccine that protects against cancer.

 
“It doesn’t seem like it makes sense to see it in terms of a vaccine for a sexually transmitted disease necessarily,” Dr. Erich Sturgis, an expert in head and throat cancer who works as the program director for the MD Anderson Oropharynx Program, said in an interview with ThinkProgress. “Most of us will have an HPV infection at some point in our lifetime and we’ll never know it.”
Nearly all sexually active Americans get HPV at some point in their lives, according to the Centers for Disease Control and Prevention. An estimated 80 percent of people are infected at some point, and most never realize it because the infection resolves itself on its own. But certain strains of the virus go on to cause cervical, vulvar, anal, penile, and oropharyngeal cancers.

 
Without the HPV vaccine, men in particular are put at risk of developing neck and throat cancers. Unlike cervical cancers, which can be detected with regular Pap smears, there’s no way to screen men.

 

Sturgis treats mostly middle aged male patients, and he estimated that about 60 percent of the cancers he deals with are caused by HPV. He said it’s important to increase the rates of vaccination among both girls and boys because it will be another 30 to 40 years before today’s kids hit the point when these type of throat cancers may start displaying themselves.
“To let your kids potentially suffer later in life is just a tragedy. That’s really the message here,” he said.

 
Both cancer doctors are optimistic that once more parents are educated about what’s at stake, they’ll start vaccinating their kids at higher rates. There’s a big information gap — one recent study found that 70 percent of U.S. adults didn’t realize the HPV vaccine has any connection to cancer whatsoever — that they believe can be corrected with more investment from primary care doctors who are on the front lines of recommending the shots.

 
“It’s really about empowering parents and health care professionals, and making them recognize that this is a childcare responsibility and a priority for all of us,” DePinho said. “It begins with interviews like this and just having the media getting this information out there.”

 
“Doctors are probably not as good at messaging to the public as we could be. We need some help,” Sturgis agreed.

 

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

Federal goal is set to increase the amount of boys and girls vaccinated against HPV by 2020

Source: www. wsj.com (Wall Street Journal.com)
Author: Caitlin McCabe
 

Public-health officials are pushing for higher HPV vaccination rates amid growing evidence that cancers linked to the virus are afflicting more men.

The National Cancer Institute announced recently it is pouring nearly $2.7 million into 18 U.S. cancer centers to boost HPV vaccinations among boys and girls. The cancer centers will work with local health clinics to set recommendations for vaccinating against the sexually transmitted infection, which in some cases can cause cancers in men and women later in life.

HPV, or human papillomavirus, was considered a women’s-only issue, after researchers discovered a link between it and cervical cancer in the 1980s. 

Now, as cervical-cancer rates are falling and oral-cancer rates in men steadily rise, “the burden of HPV cancer is shifting to men,” said Maura Gillison, a professor in the College of Medicine at Ohio State University Comprehensive Cancer Center.

Vaccination rates remain stifled, despite the availability of two vaccines that experts say provide effective coverage against cancer. 

The Department of Health and Human Services’ goal is to boost HPV-vaccination rates to 80% by 2020—which is far higher than the 38% of girls and 14% of boys who completed the three-dose HPV vaccine last year, according to data from the National Immunization Survey of teenagers.

Pediatricians say boosting those rates can be difficult. Pediatricians may feel uneasy talking to parents of young children about sexually transmitted infections, health experts say, while parents may resist the vaccine because they believe their child isn’t at risk.

“Discussing this vaccination is difficult because there’s an implication of sexual activity,” said Carrie Byington, a practicing pediatrician in Salt Lake City and chairwoman of the Committee on Infectious Diseases for the American Academy of Pediatrics. “It can make some pediatricians uncomfortable with the topic.”

A study conducted in 2011 by the Moffitt Cancer Center in Tampa, Fla., found fewer than 15% of physicians always recommended the vaccine to boys, and no more than 55% always recommended it to girls. Susan Vadaparampil, a professor in the department of oncologic services at Moffitt who helped lead the study, said she thinks recommendation rates have risen today but there’s a long way to go.

To ease difficult conversations, Dr. Vadaparampil said resources on the Centers for Disease Control and Prevention website suggests that pediatricians should emphasize the vaccine is ultimately a protection against cancer and explain why children should receive the shots at such a young age. 

Experts recommend the vaccine at age 11 or 12, but it can be given to girls up to age 26 and boys up to age 21. It is important for children to receive all three doses of the vaccine before they become sexually active.

“There’s science behind giving it at age 11—it’s not just about moral or family choices, or a child’s choice for sexual debut,” said Wendy Sue Swanson, a pediatrician and executive director of digital health at Seattle Children’s Hospital. “The immune response is better if you give it to an 11-year-old.”

Administering the vaccine at a young age doesn’t encourage sexual activity, Dr. Swanson said, citing a concern some parents have. A 2012 study comparing girls who had been vaccinated at ages 11 and 12 to nonvaccinated girls showed the vaccine made no difference in sexual behavior for at least three years after receiving the doses.

Not all cases of HPV are cancerous. Experts estimate nearly 79 million Americans are currently infected with one of the 100 different strains of HPV, which is passed via sex. 

Typically, a body’s immune system fights off HPV naturally within two years of exposure. Complications, such as genital warts or cancer, arise when the virus lingers. 

About 26,800 Americans are diagnosed with HPV-related cancers each year, about two-thirds of whom are women, according to 2010 data, the latest available, from the CDC.

The largest HPV-related threat to men is throat cancer, which has grown sharply in the past decade, Dr. Gillison said. 

Today, more than 90% of all oral cancers are HPV-related, according to trends Dr. Gillison has observed in clinical settings in developed countries. That is up from about 72% between 2000 and 2004 and 16% between 1984 and 1989, she said, referencing a study she conducted that analyzed throat tumors in the U.S.

Most of that growth has been in men: Each year, about 7,200 American men are diagnosed with HPV-related oral cancer, versus 1,800 cases in women, according to 2010 CDC data. 

Dr. Gillison said researchers estimate that around 2020, HPV-related oral cancers in men will eclipse cervical cancer, which afflicts some 12,000 new women each year, according to 2014 data from the American Cancer Society.

It’s unclear why men are more at risk for oral cancer than women, though some researchers suggest a person’s number of sexual partners may be related. The rise is problematic, Dr. Gillison said, because no preventive screening against throat cancer exists. 

“The problem with HPV-positive oral cancer is that premalignant lesions are not clinically detectable. They’re deep within the tonsils that are in the base of the tongue,” Dr. Gillison said. “By the time HPV-infection is detected, they usually already have Stage 3 or 4 cancer.”

That is why doctors and experts are relying so heavily on vaccination as prevention.

Two vaccines—Cervarix, manufactured by GlaxoSmithKline Inc., and Gardasil, manufactured by Merck & Co.—are currently available, though only Gardasil is usually recommended for boys.

Cervarix offers protection against two strains of HPV; Gardasil against four. A third vaccination from Merck currently awaiting approval from the Food and Drug Administration would offer protection against an additional five strains of HPV—nine in total. Doctors expect approval within in the next several months.

 

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

November, 2014|Oral Cancer News|

Update on head and neck cancers, HPV: creating public awareness

Source: www.dentistryiq.com
Author: Maria Perno Goldie, RDH, MS

Public awareness of head and neck cancer (HNC) is limited, with the lack of awareness including the term head and neck cancer and common symptoms and risk factors, such as tobacco use and human papillomavirus (HPV).1 The online survey of 2,126 randomly selected adults in the United States. Most respondents lacked understanding of the organs or tissues affected by head and neck cancer, with 21% incorrectly identifying brain cancer as head and neck cancer. Only 0.8% of respondents identified HPV infection as a risk factor for mouth and throat cancer, but more were aware of the vaccine.

The investigators projected that extensive HPV vaccination could prevent almost 9,000 cases of oropharyngeal cancer yearly. The conclusion was that self-reported and objective measures indicate that few American adults know much about HNC including risk factors such as tobacco use and HPV infection and common symptoms. Strategies to improve public awareness and knowledge of signs, symptoms, and risk factors may decrease the disease burden of HNC and are important topics for future research. The American Dental Association has a pamphlet titled “Get the Facts About Mouth and Throat Cancer.”2

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Human papillomavirus type 16 (HPV-16) is a major contributory factor in oropharyngeal squamous cell carcinoma (OPSCC). The detection of primary OPSCC is often delayed due to the complicated anatomy of the oropharynx. One study examined the possibility of HPV-16 DNA detection in pretreatment and posttreatment plasma and saliva and its possible role as a marker of prognosis.3 A retrospective analysis of a prospectively collected cohort of patients with oropharyngeal and unknown primary squamous cell carcinoma with known HPV-16 tumor status was conducted. Real-time quantitative polymerase chain reaction was used to identify HPV-16 E6 and E7 DNA in saliva and plasma samples.

HPV Virus

HPV Virus

The conclusion of the authors is that use of a combination of pretreatment plasma and saliva can increase the sensitivity of pretreatment HPV-16 status as a tool for screening patients with HPV-16–positive OPSCC. Also, analysis of HPV-16 DNA in saliva and plasma after primary treatment may make it easier to detect recurrence in patients with HPV-16–positive OPSCC at an earlier stage.

cervarix

HPV is the leading cause of oropharyngeal cancers, and a very small number of front of the mouth, oral cavity cancers. HPV16 is the version most responsible, and affects both males and females. It is a sexually transmitted disease, and while there is no cure, it can be prevented. Practicing safe sex is one way, and vaccination is another way. Two vaccines, Gardasil and Cervarix, protect against the strains of HPV that cause cervical cancers (HPV16 and 18). Garadsil also protects against two versions that cause genital warts (HPV6 and 11). Millions of young girls in the United States and in developed countries around the world have been safely vaccinated with an HPV vaccine.4

For more information, visit the Oral Cancer Foundation, or the Oral Cancer Cause (OCC).4,5 “OCC’s purpose is to improve the quality of life for oral cancer patients through financial support so that they may face the world with peace and dignity during and after medical treatment.”5

Oral mucositis is a common complication of cancer chemotherapy, whether for head and neck or other cancers, and is often present after radiation for head and neck cancer. The purpose of one study was to compare the beneficial effects of treatment modalities, including topical steroid, honey, and honey plus coffee, in patients suffering from oral mucositis.6 The results showed that all three treatment regimens reduce the severity of lesions. The best reduction in severity was achieved in the honey plus coffee group. The honey group and topical steroid group took the second and third places. While further study is encouraged, the honey plus coffee regimen was the most effective modality for the treatment of oral mucositis in this study.

Another study found that treating cancer with bacteria shows real promise.7 They directly injected Clostridium novyi, a common bacteria species that does not need oxygen to survive, into tumors in a small study. It shrunk or eliminated tumors and possibly bolstered the immune system to continue targeting tumor cells for up to two years.

Maybe one day we will be able to cure cancer!!


References

  1. Luryi AL, Yarbrough WG, Niccolai LM, Roser S, Reed SG, Nathan CA, Moore MG, Day T, and Judson BL. Public awareness of head and neck cancers: a cross-sectional survey. JAMA Otolaryngol Head Neck Surg. 2014 Jul 1;140 (7):639-46. doi: 10.1001/jamaoto.2014.867.
  2. http://www.ada.org/en/publications/ada-news/2014-archive/june/raise-awareness-of-mouth-and-throat-cancer-among-patients-with-ada-brochure.
  3. Ahn SM, Chan JK, Zhang Z, et al. Saliva and Plasma Quantitative Polymerase Chain Reaction–Based Detection and Surveillance of Human Papillomavirus–Related Head and Neck Cancer. JAMA Otolaryngol Head Neck Surg. Published online July 31, 2014. doi:10.1001/jamaoto.2014.1338.
  4. http://www.oralcancerfoundation.org/hpv/hpv-oral-cancer-facts.php.
  5. http://oralcancercause.org/.
  6. Raeessi MA, Raeessi N, Panahi Y, et al. “Coffee plus Honey” versus “topical steroid” in the treatment of Chemotherapy-induced Oral Mucositis: a randomised controlled trial BMC Complementary and Alternative Medicine 2014, 14:293. http://www.biomedcentral.com/1472-6882/14/293.
  7. Roberts NJ, Zhang L, Janku F, et al. Intratumoral injection of Clostridium novyi-NT spores induces antitumor responses. Sci. Transl. Med. 6, 249ra111 (2014).

 

September, 2014|Oral Cancer News|

Finding better ways to treat, prevent HPV

Source: www.fhcrc.or
Author: Diane Mapes – Fred Hutch News Service

Twenty-nine years ago, scientists didn’t know what caused many of the genital-tract cancers they studied, much less how to stop them.

Today, not only has human papillomavirus been pinpointed as the viral perpetrator behind nearly all genital-tract and some head and neck cancers, there’s now an incredibly effective vaccine that can prevent high-risk HPV infections from ever developing into cancer.

“You can almost say on the street, ‘I’m doing HPV research’ and ordinary people will know what that is,” said Aaro Turunen, an HPV researcher from the University of Turku in Finland. “It’s a sexy subject, especially for the media.”

While scientific advancements, public awareness and yes, media coverage, have grown exponentially in the last three decades, there is still much to learn and do – particularly with regard to getting the vaccine to the people who most need it, both here in the U.S. and around the world.

That’s where the International Papillomavirus Conference, currently in its twenty-ninth year, comes in. The HPV2014 conference, now underway at the Washington State Convention Center in Seattle, has drawn the brightest minds in HPV research, including nearly 1,300 basic scientists, public health researchers, physicians, providers and others dedicated to eliminating the suffering caused by the human papillomavirus. The goal of the conference is to share cutting-edge scientific advances in the field of HPV infection and disease and come up with new ways to collaborate to advance science and public health.

The conference officially began today but kicked off early Wednesday with two days of clinical and public health pre-conference workshops covering everything from HPV infection and disease in HIV-infected men to implementing and evaluating two-dose vaccine schedules to a peek at the next generation of HPV vaccines coming down the pike.

Conference chair Dr. Denise Galloway, who holds a joint appointment with Fred Hutch’s Human Biology and Public Health Sciences divisions, said she was thrilled the conference was taking place in the Hutch’s back yard.

“I’m excited that the HPV meeting will be here as it recognizes the strength and breadth we have in HPV research in Seattle,” she said. “Our main goal was to provide a setting where people from all over the world who study various aspects of papillomavirus biology, disease and prevention could come together to share their data and ideas.”

Galloway, who has been investigating the link between cancer and viruses since 1978, was instrumental in both discovering HPV’s association with many cancers and paving the way for a vaccine able to check cervical cancer before it starts in hundreds of thousands of women worldwide.

These days, she’s researching B cell memory in order to determine how effective the HPV vaccine is over a person’s lifetime.

“If a vaccine is going to work, it’s not just important how well this will stimulate the immune system, which you can measure within a couple of months after you get the vaccine,” she said. “You also want to know, is it going to be durable? Are you going to have a response 10 years, 20 years or 30 years from now? We’re trying to figure that out by looking at the cells that are there and available to make the responses in 10 and 15 years.”

Long-term efficacy is just one of many topics covered at the conference, which boasts an ambitious lineup of over 700 abstract presentations, nine satellite sessions, four symposia and four plenary sessions, all highlighting basic, clinical and public health science topics ranging from molecular virology to novel cancer screening and treatment strategies to global public health.

Also represented at the conference are pharmaceutical companies such as Merck, producer of the HPV vaccine Gardasil, and Roche, developer of the cobas HPV test. Also present are medical device manufacturers such as QIAGEN, which along with support from Seattle’s PATH, developed the careHPV test, a field-friendly and inexpensive test that allows women, particularly in developing countries, to gather screening samples themselves.

On Friday morning, Dr. Freddie Bray of the International Agency for Research on Cancer talked about the need for quality data and cancer registries, especially in developing countries and and Dr. Scott Ramsey of Fred Hutch’s HICOR division spoke about the value of prevention-based studies and interventions.

“There was a nice study done by the CDC a few years ago that looked at the cost effectiveness of HPV vaccination of young girls in the U.S.,” he said. “This is a slide I wish I could produce as a health economist more often. HPV vaccines in this population are among the most cost effective interventions we have in the U.S.“

Despite the efficacy and overall cost effectiveness of the vaccine, however, delivery and implementation of the vaccine remain a problem, said Galloway.

“We need to find better strategies to get girls and boys to take the vaccine,” she said. “In other countries, where they have school-based programs, they’re doing much better than in the U.S.”

Saturday’s plenary will feature talks on the natural history of HPV infection and cervical cancer, the natural history of oral HPV and its progression of oropharyngeal cancer and the “genetic arms race” between host and viral genomes, presented by Fred Hutch’s Dr. Harmit Malik. Vaccines will be covered in the Sunday plenary session with talks on Merkel cell carcinoma by Fred Hutch’s Dr. Paul Nghiem, an update on Australia’s HPV vaccination program and a presentation on vaccine dosage.

“There is a growing consensus of switching from three doses to two and it will be exciting to hear more about that,” said Galloway.

Finnish researcher Turunen, whose research focuses on the relationship between HPV and the Epstein-Barr virus, said he was amazed at how much the field – and the International Papillomavirus Conference — had grown, adding that a much smaller HPV conference took place in Seattle 20 years ago.

“Both HPV researchers were there,” he quipped.

August, 2014|Oral Cancer News|

CDC finds coverage for HPV vaccination among teens is still low

Source: medicalnewstoday.com
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|

Anti-seizure medications prevent cancer

Source: guardianlv.com
Author: Lindsey Alexander

A recent report came out from the journal Cancer indicating a new finding that anti-seizure medications might prevent some forms of cancer. Drugs like valporic acid (Depakote), are one form of prescription in this classification. Though also used as a mood-stabilizer, Depakote can prevent seizures from occurring, and has been investigated for cancer prevention.

These particular anti-seizure medications have been found to inhibit genetic changes that lead to cancer of the head and neck. The study included nearly 440,000 veterans, including 27,000 who were taking valporic acid for various disorders including post-traumatic stress disorder, bipolar disorder, seizures, and migraines. The overall findings suggested that veterans who were on the prescription were 34 percent less likely to develop cancers of the head and neck, than those who were not taking the drug.

The risk decreased in those subjects who took higher doses or for longer periods of time.

Dr. Johann Brandes with Atlanta Veterans Affairs Medical Center was the team leader of this study. He claims that this 34 percent statistic means 16,000 new cases, and between 3,000 and 4,000 cancer deaths can be prevented every year. Though there is a strong association, the study did not form a direct cause-and-effect relationship between cancer prevention and anti-seizure medications.

The National Cancer Institute describes cancers of the neck and head as usually squamous cell cancers that line mucosal surfaces inside the head and neck. This can affect the mouth, the throat, and the nose. This is a carcinoma that can begin in the salivary glands, and can contain many different types of cells that can in turn also become cancerous.

Valporic acid was found not to have any impact on lung, bladder, prostate, or colon cancers.

The Mayo Clinic currently says there is no proven way to prevent throat cancer. A person can restrict the amount of alcohol consumed, avoid smoking, chose a healthy diet to stick to (which includes plentiful amounts of fruits and vegetables), and protect against the human papilloma virus (HPV). Even though the HPV vaccine is recommended by the Mayo Clinic, other sources warn against the shot.

Christina England from Vactruth claims 140 people as of 2013 were lost due to the HPV vaccine, commonly referred to as Gardasil. Statistics from the Vaccine Adverse Event Reporting System (VAERS) listed many more side-effects than deaths, however. In 2013, the VAERS recorded nearly 1,000 people physically disabled, 10,000 people made a visit to the ER, and 3,000 were hospitalized among many others severe, and sometimes life-threatening side-effects.

The American Academy of Otolaryngology mentions three people in history who suffered from either oral, head, or neck cancer.

Babe Ruth, born in 1895, played for the National Baseball League and held a record of 60 home runs in one season. He was diagnosed just before retirement with nasopharyngeal carcinoma, which metastasized and later killed him.

Ulysses S. Grant was a Civil War leader and the 18th President of the United States. He came down with a cancer of the right tonsillar pillar, which was at the base of the tongue. This was referred to as a malignant squamous epithelioma. His death was referred to a slow and painful illness.

Today, however, he could have been treated and perhaps saved with inventions such as the aspiration pump, radiotherapy, surgery, and even a tracheotomy.

Sigmund Freud was also a victim of cancer. Freud was an Austrian psychoanalytic psychologist. He suffered from multiple health disorders and smoked heavily. He had cancer in the jaw, and was diagnosed at the age of 67. Treatment continued for 16 years, and he underwent many surgeries–one of which included the merging of the nasal cavity and the mouth. He died in 1939 from heart failure, cancer, and morphine overdose.

Researchers in medicine are discovering new ways of preventing cancer, and treating cancer, ranging many disciplines. Recent findings suggest future studies are necessary to determine a more substantial link between cancer prevention and anti-seizure medications. However, people are now able to consider yet another preventative measure that might prove helpful.

March, 2014|Oral Cancer News|

President’s panel calls for more girls, boys to get HPV vaccine

Author: Government news release
Source: consumer.healthday.com

Too few American girls and boys are getting vaccinated against the cancer-causing human papillomavirus (HPV), the President’s Cancer Panel reported Monday.

HPV is linked to cervical cancer as well as penis, rectal and oral cancers. One in four adults in the United States is infected with at least one type of HPV. Increasing HPV vaccination rates could prevent a large number of cancer cases and save many lives, the panel said.

“Today, there are two safe, effective, approved vaccines that prevent infection by the two most prevalent cancer-causing types, yet vaccination rates are far too low,” Barbara Rimer, chair of the President’s Cancer Panel, said in a panel news release.

“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,” she added.

Currently, the U.S. Centers for Disease Control and Prevention is recommending that girls aged 11 and 12 receive either the Cervarix or Gardasil vaccines, and Gardasil is recommended for boys of similar age.

In 2012, only a third of girls aged 13 to 17 got all three recommended doses of HPV vaccine, CDC data shows. That’s much lower than the federal government’s goal of having 80 percent of girls aged 13 to 15 fully vaccinated against HPV by 2020, the report said.

The picture is even more disappointing for boys. Less than 7 percent of males aged 13 to 17 completed the recommended HPV vaccination series in 2012. The vaccine was recommended for boys more recently.

Boosting HPV vaccination rates to 80 percent would prevent 53,000 future cervical cancer cases among girls who are currently aged 12 or younger, according to the CDC.

The agency also estimates that increased vaccination would prevent thousands of cases of other HPV-associated cancers in both females and males, the report added.

A number of things need to be done to increase HPV vaccination rates, the panel said. These include public education and other efforts to increase teens’ and parents’ acceptance of the vaccines; encouraging doctors and other health care providers to recommend and give vaccinations; and making sure that the vaccines are available where teens receive health care.

Source: President’s Cancer Panel, news release, Feb. 10, 2014

February, 2014|Oral Cancer News|

Four Ways Katie Couric Stacked The Deck Against Gardasil

Source: Forbes
Published: Wednesday, December 4, 2013
 
 

This afternoon, Katie Couric ran a long segment on her daytime talk show, Katie, about what she called the “controversy” over the vaccines against human papilloma virus, or HPV, an infection that causes cervical, throat, penile, and anal cancers. She featured one mother who says that Gardasil, the HPV vaccine made by Merck , killed her daughter, and a young woman, seated with her mother, who said that Gardasil had caused years of illness that made her think she might die. (GlaxoSmithKline GSK +0.15% makes another HPV vaccine, Cervarix, that is less commonly used in the U.S.)

Katie Couric

Alongside those stories, Couric also featured two medical experts: Dr. Diane Harper, the chair of family and geriatric medicine at the University of Louisville, who helped test Gardasil but has since argued that the vaccine has been over-marketed and its benefits oversold; and Mallika Marshall, a Harvard Medical School doctor who is Couric’s in-house medical correspondent. Marshall defended the vaccine; strangely, only her arguments appear on the show’s Web site.

Despite the attempt at balance, I think most viewers will be left with the impression that the vaccine is dangerous and that its benefits don’t outweigh its risks – a conclusion that is not shared by the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, or the Centers for Disease Control & Prevention.

Here’s how Couric stacked the deck against the HPV vaccine:

1. By downplaying the effectiveness of the vaccine: Harper argued that HPV vaccines offer only short-term protection, lasting just five years. This elicited a shocked reaction from Couric – understandably. Why would national guidelines recommend that 11-year-old girls and boys get a vaccine that wears off by the time they are sixteen?

But the statement isn’t true. It’s more true to say that the vaccine’s effectiveness can only be measured using the data we have so far, which at one point was only five years. A recent analysis of 4,900 women in Nordic countries, which use more robust medical records systems than the United States, found Gardasil “is effective up to 6 years following vaccination with a trend of continuing protection up to 8 years following vaccination.” A second analysis, conducted by Merck, also indicates that people still have immune responses 8 years after getting the shot.

“The antibody levels would indicate that immunity is going to be for many, many years beyond five years,” says William Schaffner, a professor of preventative medicine at Vanderbilt Medical School. “We don’t know for how long.”

It’s possible that Gardasil could offer lifetime protection; or patients may need a booster shot. HPV is also different than many other infections, because it takes decades to cause cancer, so protection over the short term may actually be enough.

2. By overplaying the power of Pap smears: Harper also argued that the combination of Pap smears and HPV DNA testing could catch all cervical cancer cases – she said they were 100% accurate. The tests are really incredibly accurate, and women should get them regardless of whether or not they have had the HPV vaccine. But nothing is perfectly effective, and some women will fail to get regular screening, so a vaccine may still help. “That’s a remarkable statement because that is incorrect,” says Schaffner. “She overstated the case enormously.”

3. By underplaying the risk of cancer: Harper dismissed other cancers caused by HPV as extremely rare, implying that they shouldn’t be part of a risk-benefit calculus about the vaccine. But that’s not fair. Between 2004 and 2008, the CDC estimates that there were 11,967 cases of cervical cancer caused by HPV each year and 11,726 cases of head and neck cancer, meaning they could be seen as equally big problems. Work by authors including Maura Gillison of Ohio State University, a pioneer in studying the HPV/throat cancer link, indicates that by 2025 HPV throat cancer will be more common than cervical cancer, thanks largely to pap smears and HPV DNA tests. The CDC estimates that HPV causes 26,000 cases of different cancers each year.

A caveat: use of HPV vaccines to prevent head and neck cancer has not been approved by the Food and Drug Administration, and it probably never will be, because the studies would be too difficult to conduct. In cervical cancer, researchers could look for precancerous lesions; these are harder to detect in the tonsils, where throat cancer starts.

4. By pulling viewers’ heartstrings: Couric told moving stories about vaccine risks using live interviews with people who said they had been harmed. Defenses of Gardasil were offered in dry platitudes. There were no interviews with people who suffered from cancer that might have been prevented by the vaccine.

I started writing about the link between HPV and throat cancer in 2009. Generally speaking, head-and-neck cancer caused by HPV is less deadly than other types of head-and-neck cancer. But the patient I spoke to for that story – an economist named Martin Duffy who had run 40 consecutive Boston marathons – was killed by his disease. “I made my living as a public speaker,” he told me before he died. “Now I sound like Daffy Duck.” Without his voice, he asked, “How do you tell the people that you love you love them?”

We can’t ignore the stories of the girls Couric reported on, either. She said that eleven cases allege that HPV vaccines have caused death, according to the National Vaccine Information Center, an anti-vaccine group. (For comparison, Merck has shipped 62 million doses of Gardasil.) Vaccine makers and the CDC should redouble their efforts to make sure that if there is a risk of death from the vaccine, we know that. I think Merck in particular should be making an effort to approach these families and find out if there is anything it can learn about its vaccine. Is there any biologically plausible way that Gardasil could be having these effects? It seems unlikely, but we can’t be careful enough.

But deaths – including deaths by seizures or unexplained causes – do occur for all sorts of reasons, without explanation, and just because a death happened 18 days after a vaccine was given, as in the example on Katie’s show, does not mean the vaccine caused it. So far, investigations trying to link Gardasil and Cervarix to serious side effects have come up empty.

A study of 997,000 girls in Nordic countries found no link to autoimmune, neurological, and venous thromboembolic adverse events from the vaccine. A CDC analysis published in the Journal of the American Medical Association in 2009 also found no link between HPV vaccines and serious side effects. Schaffner says the main side effects he sees are sore arms and fever.

So far, despite the fact that many families do opt not to get the vaccine, Gardasil is performing better than expected. In the seven year period ending in 2010, the prevalence of HPV infection in girls and women fell 56% to 5.1% of the population. Thomas Frieden, the director of the CDC, told NBC the reduction was “better than we hoped for.” Let’s hope that can continue.

 

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

 

December, 2013|Oral Cancer News|

Merck’s Experimental HPV Vaccine Shows Promise in Late Stage Trial

Source: Nasdaq
By: Peter Loftus
Published: November 3, 2013

 

An experimental Merck & Co. vaccine appeared to provide broader protection against a cancer-causing virus than the company’s Gardasil shot in clinical trials.

Merck said the study results support its plan to submit the new vaccine, code-named V503, for U.S. regulatory approval by year’s end, which could lead to market launch next year at the soonest. Merck expects health-care providers to eventually switch to V503 if the product receives marketing approval. Some analysts expect its annual sales could exceed $1 billion.

“The case for using V503 is even stronger than the case for using Gardasil, which was already strong,” said Roger Perlmutter, head of Merck’s research and development unit. Dr. Perlmutter has singled out V503 as one of the programs Merck will focus on as it overhauls its R&D unit in a bid to recover from a series of setbacks.

Gardasil, launched in 2006, was the first vaccine to protect against human papillomavirus, or HPV, a sexually transmitted virus that can cause cervical cancer in women and other less-common types of cancer in males and females. The U.S. Centers for Disease Control and Prevention recommends HPV vaccination of boys and girls ages 11 and 12, though it is approved to be given to people ages 9 to 26. GlaxoSmithKline also sells an HPV vaccine called Cervarix.

Gardasil is designed to protect against four strains of HPV, two of which are believed to be responsible for about 70% of all cervical cancer cases. The other two strains are the primary culprits in causing genital warts. But Gardasil doesn’t protect against many other strains of HPV, some of which can also cause cervical and other cancers.

To close the gap, Merck designed V503 to protect against nine HPV strains, adding five cancer-causing HPV types to the four included in Gardasil. This wider set is believed to account for nearly 90% of all cases of cervical cancer globally, said Alain Luxembourg, director of clinical research for adult vaccines in Merck’s R&D unit.

Merck ran clinical trials to test the new vaccine’s safety and efficacy, and results are being presented at an HPV- focused medical meeting in Florence, Italy, this week. One study enrolled more than 14,000 women ages 16 to 26, who received either Gardasil or V503 in three doses over six months. The goal was to demonstrate V503 was comparable to Gardasil in protecting women against the four HPV strains common to both vaccines, and superior to Gardasil in protecting against the five additional strains in V503.

For the four HPV strains common to both vaccines, the study compared immune responses as measured in blood tests, and found V503 to be comparable to Gardasil. The researchers used immune response as the key measure because the rates of disease caused by these four HPV strains were too low in both groups to provide a meaningful comparison.

For the five HPV strains not covered by Gardasil, researchers compared the rates of precancerous lesions caused by those five strains. The study found that V503 reduced the incidence of these lesions by about 97% compared with Gardasil.

Merck said it couldn’t test the efficacy of V503 in virginal adolescents because they generally haven’t yet been exposed to HPV. So researchers measured immune responses in boys and girls ages 9 to 15 and compared them to the immune responses seen in women ages 16 to 26. The study concluded the responses were comparable across the nine HPV types targeted by V503, which Merck hopes will demonstrate to health authorities that the vaccine is effective in adolescents.

The rates of adverse events among V503 recipients were generally similar to those for Gardasil, though V503 subjects had a higher incidence of injection-site problems such as pain and redness than Gardasil subjects, 90.8% versus 85.1%. Safety concerns have occasionally dogged Gardasil, particularly reports of fainting after receiving the shot. But the CDC has concluded the vaccine is safe and effective.

Analysts from Leerink Swann estimate V503 sales could reach $1.9 billion by 2018, though it would cannibalize sales of Gardasil. Merck reported $1.6 billion in Gardasil sales last year, but Leerink predicts that would fall to $525 million by 2018.

Some health experts say an HPV vaccine with broader coverage would be an important advance. “We should be able to prevent more cervical cancer if that vaccine is given,” said Jessica Kahn, professor of pediatrics in the division of adolescent medicine at Cincinnati Children’s Hospital Medical Center. She wasn’t involved in the studies of V503.

It’s unclear, however, whether an HPV vaccine with broader protection would help improve vaccination rates, which have flattened out in the U.S. Public health experts say family physicians and pediatricians aren’t recommending HPV vaccination as strongly as other vaccines given to adolescents, such as the shot for tetanus, diphtheria and pertussis.

There is little research to suggest that a vaccine protecting against additional HPV strains would significantly improve vaccination rates, said Anne Schuchat, head of immunization programs at the CDC. Still, she said she welcomed industry research on improving HPV vaccines.

 

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

 

 

November, 2013|Oral Cancer News|