Oral cancer sneaks up

Source: well.blogs.nytimes.com Author: Donald G. McNeail Jr. and Anahad O'Connor The actor Michael Douglas has done for throat cancer what Rock Hudson did for AIDS and Angelina Jolie did for prophylactic mastectomy. By asserting last week that his cancer was caused by a virus transmitted during oral sex, Mr. Douglas pushed the disease onto the front pages and made millions of Americans worry about it for the first time. In this case, it was a subset of Americans who normally worry more about being killed by cholesterol than by an S.T.D. The typical victim is a middle-aged, middle-class, married heterosexual white man who has had about six oral sex partners in his lifetime. The virus, human papillomavirus Type 16, also causes cervical cancer. So is there any early oral screening that a man can have — an equivalent to the Pap smear, which has nearly eliminated cervical cancer as a death threat in this country? The answer, according to cancer experts and a recent opinion from the United States Preventive Services Task Force, is no. And for surprising reasons. The Pap test — invented in 1928 by Dr. George N. Papanicolaou — involves scraping a few cells from the cervix and checking them under a microscope for precancerous changes. Precancerous cells have a “halo” around the nucleus, while cancerous ones have larger, more colorful nuclei, said Dr. Paul D. Blumenthal, a professor of gynecology at Stanford University Medical School. In theory, it should be similarly easy to scrape and examine [...]

Fact check: Michael Douglas on HPV and throat cancer

Source: www.huffingtonpost.com Author: Meredith Melnick A Michael Douglas interview in The Guardian caused waves when the publication reported that the "Behind the Candelabra" star revealed HPV, the human papilloma virus, to be the cause of his stage-4 throat cancer diagnosis in 2010. "Without wanting to get too specific, this particular cancer is caused by HPV, which actually comes about from cunnilingus," Douglas allegedly told The Guardian. Douglas, through his publicist, has said that the statement was misinterpreted: He wasn't saying that his cancer was caused by the sexually transmitted disease -- merely that many cancers like his are HPV-positive. As The Daily Beast points out, there is scant research evidence to directly link the act of cunnilingus with HPV infection. But regardless of the details of his own cancer, the actor is right about one thing: A growing majority of oral cancer cases are caused by HPV. While most strains of HPV clear up on their own, the sexually transmitted disease is responsible for an array of cancers. As Douglas describes, it's true that oral sex is an avenue through which a person can contract HPV and especially the strains, HPV-18 and HPV-16, the latter of which is responsible for half of oral cancer cases, according to the National Cancer Institute. HPV-16, HPV-18 and some less-common strains can also cause cancers of the cervix, vagina, vulva, anus and penis. Douglas' experience follows trends in cancer diagnosis, according to a January report from the American Cancer Society, which found a rise [...]

Dose of reality: HPV is epidemic, which is odd since it is largely preventable

Source: www.sciencenews.org Author: Nathan Seppa There are two vaccines that guard against human papilloma­virus, and they are in rare company among medical inventions — the vaccines prevent cancer. Only the hepatitis B vaccine can make the same claim. Cancer-causing HPV can trigger abnormal cell growth on the cervix, and cervical cancer still kills up to 4,000 U.S. women each year. The virus is also implicated in cancers occurring in the anus and the throat. All told, according to a 2011 study, 29 percent of sexually active U.S. girls and women carry a potentially cancer-causing HPV infection. Preteen and adolescent girls and boys are priority groups for vaccines that prevent human papillomavirus infection.© Jessica Rinaldi/Reuters/Corbis Back in 2006 and 2009, when the HPV vaccines Gardasil and Cervarix came onto the market, health officials dreamed of halting the spread of HPV, which is sexually transmitted, in a single generation. Scientists call such blanket coverage herd immunity — in which a pathogen gets vaccinated into oblivion, becoming so rare that even unvaccinated people are protected. With such heady potential, Gardasil, developed by Merck, and Cervarix, created by GlaxoSmithKline, should be an easy sell. They rev up a potent immunity against HPV 16 and 18, the two types of the virus that account for most cases of cervical cancer. Gardasil also prevents most genital warts. The immunity the vaccines provide is many-fold better than the weak protection engendered by a run-in with the virus itself, and since approval, both vaccines have proven [...]

Should You Get the HPV Vaccine?

You don’t have to be a virgin to be protected against cancer. By Jake Blumgart|Posted Friday, Jan. 25, 2013, at 1:22 PM ET Source: Slate A doctor gives a 13-year-old girl an HPV vaccination Photo by Joe Raedle/Getty Images. The human papillomavirus has the dubious distinction of being the sexually transmitted disease you are most likely to get. It’s also the leading cause of cervical cancer. January has, somewhat arbitrarily, been dubbed Cervical Health Awareness Month (also National Hobby Month and Hot Tea Month, the last at least for good reason). While cervical cancer is the disease most commonly associated with HPV, a recent report from the American Cancer Society emphasizes that HPV’s threat is not gender-specific or organ-specific. While cervical cancer cases are in decline (as are general cancer rates), cancers linked to HPV are on the rise. The increasing prevalence of HPV-linked cancers should permanently alter our limited conception of the disease as chiefly a women’s issue. Oropharyngeal (which I’ll be vulgarizing as “oral”) and anal HPV-related cancers (which particularly afflict men who have sex with men) are becoming more common. Oral malignancies account for 37.3 percent of HPV-related cancers, edging out cervical cancer, which makes up 32.7 percent. For men, oral cancers make up 78.2 percent of total HPV-related cancer incidences, and they account for 11.6 percent of cases among women. The death rate for oral cancer is three times higher than that for cervical cancer. (About 40 percent of penile cancer cases are HPV-related, but rates [...]

2013-01-28T14:28:34-07:00January, 2013|OCF In The News, Oral Cancer News|

High HPV Immunization Rates Achieved With PATH Initiative

Source: Medscape.com August 30, 2012 (Montreal, Quebec) — Exceptionally high immunization rates against human papillomavirus (HPV) have been achieved in target-aged girls in India, Peru, Uganda, and Vietnam as a result of a PATH initiative, researchers told delegates here at the Union for International Cancer Control World Cancer Congress 2012. Vivien Tsu, PhD, MPH, director of the HPV vaccines project at PATH, reported that a minimum of 80% — and in some countries well over 90% — of school-aged girls received at least 1 dose of the HPV vaccine in the 4 countries to which the initiative has been directed over the past several years. "The reason the program was successful in these countries, and likely many others, is that there is visible government endorsement and involvement in the program," Dr. Tsu explained. "For the most part, people trust that the government is trying to help them, so if the government is saying 'this is worth doing,' the community participates." As Dr. Tsu noted, cervical cancer — at least 70% of which is caused by HPV types 16 and 18 — is a major health issue for women in low- and middle-income countries, with a projected incidence in 2030 of more than 750,000 women. In North America and Europe, cytology has been extremely effective in detecting cervical cancer and, more important, precursor lesions. However, in low- and middle-income countries, "cytology has failed to have much of an impact," Dr. Tsu explained, because these countries lack the necessary resources to offer widespread [...]

2012-08-31T11:09:43-07:00August, 2012|Oral Cancer News|

Oral sex may cause more oral cancer than smoking in men, researchers say

Source: www.bloomberg.com Author: Robert Langreth A virus spread by oral sex may cause more cases of throat cancer in men than smoking, a finding that spurred calls for a new large-scale test of a drug used against the infection. Researchers examined 271 throat-tumor samples collected over 20 years ending in 2004 and found that the percentage of oral cancer linked to the human papillomavirus, or HPV, surged to 72 percent from about 16 percent, according to a report released yesterday in the Journal of Clinical Oncology. By 2020, the virus-linked throat tumors -- which mostly affected men -- will become more common than HPV-caused cervical cancer, the report found. HPV is known for infecting genitals. The finding that it can spread to the throat and cause cancer may increase pressure on Merck & Co., the second-largest U.S. drugmaker, to conduct large-scale trials to see if its vaccine Gardasil, which wards off cervical cancer in women, also prevents HPV throat infections. “The burden of cancer caused by HPV is going to shift from women to men in this decade,” Maura Gillison, an oncologist at Ohio State University and study senior author, said in a telephone interview. “What we believe is happening is that the number of sexual partners and exposure to HPV has risen over that same time period.” Gillison said she worked with researchers at Whitehouse Station, New Jersey-based Merck several years ago to design a study in men. After Merck acquired Schering-Plough Corp. in 2009, though, the trial “was canceled,” [...]

HPV Cancer Hits 8,000 Men, 18,000 Women a Year

Source: WebMD.com HPV cancer isn't just a female problem, new CDC figures show. Although HPV causes 18,000 cancers in women each year, it also causes 8,000 cancers in men, the CDC calculates. To get the figures, CDC researchers analyzed data collected from 2004 to 2008 in two large cancer registries. HPV, human papillomavirus, is the cause of nearly all cervical cancers. But that's obviously not the only cancer caused by this sexually transmitted virus. HPV also causes about two-thirds of mouth/throat (oropharyngeal) cancers, 93% of anal cancers, and more than a third of penile cancers. Men are four times more likely than women to get HPV mouth/throat cancer, while women are more likely than men to get HPV anal cancer. Clearly, HPV is not just a female problem. Yet it was only last year that one of the two FDA-approved HPV vaccines was recommended for teen boys. Gardasil was recommended for girls in 2006; Cervarix was recommended for girls in 2009. "HPV vaccines are important prevention tools to reduce the incidence of non-cervical cancers," the CDC notes in a report in the April 20 issue of Morbidity and Mortality Weekly Report. "Transmission of HPV also can be reduced through condom use and limiting the number of sexual partners." HPV vaccines are most effective when given before people become sexually active. Yet in 2010, less than a third of teen girls had received all three doses of HPV vaccines. Numbers aren't yet available for boys. The slow uptake of the vaccine [...]

2012-04-25T11:21:53-07:00April, 2012|Oral Cancer News|

AAP Now Recommends HPV Vaccine for Boys and Girls

Source: HemOnc Today The American Academy of Pediatrics Committee on Infectious Diseases issued an updated policy statement on human papillomavirus vaccination that recommends both boys and girls be immunized. The policy statement notes vaccination reduces the incidence of sexually transmitted infections and reduces cancer risk. “Persistent infection with high-risk HPV types is responsible for most cervical and anal cancers in females,” the statement reads. “In males, high-risk HPV types are responsible for a large proportion of cancers of the mouth and pharynx, which are increasing in recent years, and of anal and penile cancers.” There currently is one approved HPV vaccine (HPV4; Gardasil, Merck) for boys and two vaccines — HPV4 and HPV2 (Cervarix, GlaxoSmithKline) — approved for girls. The committee recommended that: Girls aged 11 to 12 years should receive three doses of HPV2 or HPV4 — administered intramuscularly at 0, 1 to 2, and 6 months — even if they already are sexually active. Boys aged 11 to 12 years should receive three doses of HPV4 using the same schedule. Females aged 13 to 26 years and males aged 13 to 21 years who were not previously immunized or who are missing a vaccination should complete the full series. Men aged 22 to 26 years who were not immunized previously or who are missing a vaccination may receive the HPV4 series, but “cost-efficacy models do not justify a stronger recommendation in this age group.” The policy statement recommended that women who receive the vaccine continue to undergo cervical [...]

2012-03-21T10:35:17-07:00March, 2012|Oral Cancer News|

Canadian provinces weighing HPV vaccination of boys

Source: www.cmaj.ca/ Author: Laura Eggertson Provinces weighing the merits of implementing the National Advisory Committee on Immunization's recommendation to offer human papillomavirus (HPV) vaccine to boys and men aged 9–26 are facing a tricky trade-off between benefits and costs. “I think the benefits are there, but the costs are high,” which is a crucial issue for publicly funded programs, says Dr. Monika Naus, medical director of immunization programs and vaccine-preventable diseases for the British Columbia Centre for Disease Control. The National Advisory Committee on Immunization last month recommended extending the human papillomavirus vaccine to boys and men aged 9 to 26 “for the prevention of anal intraepithelial neoplasia (AIN) grades 1, 2, and 3, anal cancer, and anogenital warts”. The move followed on the heels of an October 2011 recommendation from United States Centers for Disease Control and Prevention advisory panel recommendation that HPV vaccine be given to boys aged 11–12 to ward off genital warts, anal cancer and “possibly” head and neck cancer. In deciding whether to proceed, the provinces should note that “the public health and economic burden of AGWs [anogenital warts] in Canada is considerable, particularly among men whose incidence rates and incidence rate ratios compared to females have been increasing in recent years,” the committee stated. The committee’s report also noted that the number of annual cases (and average annual incidence per 100 000) of penile cancer among men in Canada is 127.4 (1.0 per 100 000), while the number for cancer of the anus is [...]

2012-02-26T10:01:29-07:00February, 2012|Oral Cancer News|

Success of HPV vaccination is now a matter of coverage

Source: The Lancet Oncology, Volume 13, Issue 1, Pages 10-12, January 2012 In a pair of articles in The Lancet Oncology, Lehtinen and colleagues and Wheeler and colleagues present 4-year end of study data from a trial of a prophylactic human papillomavirus (HPV)-16/-18 vaccine (Cervarix, GlaxoSmithKline) in young women aged 15-25 years. From a public-health perspective, these studies have several important contributions. The results assure us that among HPV-naive women in the 15—25 year age range, Cervarix has extremely high efficacy against HPV-16/-18-associated persistent infection, CIN2, and CIN3 or worse, the best ethical surrogate endpoint for prospective studies of invasive cervical cancer risk. Combined with other trials of Cervarix and Merck's quadrivalent Gardasil vaccine against HPV-16/-18/-6/-11,3 the evidence is strong for near 100% prophylactic vaccine efficacy in HPV-naive women at any age. Nonetheless, even with vaccine efficacy near 100% in HPV-naive women, the efficacy in the total vaccinated cohort decreased steeply with increasing age, showing an absence of therapeutic effect against already-acquired infections and associated lesions. We know from natural history studies that new HPV transmission (incidence, not prevalence) decreases with age in most cultures.4 Together, natural history data and results of trials for both vaccines suggest that vaccination before sexual debut, or around the time of menarche, will achieve the greatest reduction in cervical cancer rates. The 4-year trial data shows no decline in vaccine efficacy in HPV-naive women with time since vaccination.1 We know from other trials of the two vaccines that the duration of protection is several [...]

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