Fewer teens having oral sex

Source: CNN.com

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.

2012-08-20T10:51:44-07:00August, 2012|Oral Cancer News|

Gardasil vaccine to be free for boys for protection against human papilloma virus

Source: Herald Sun

IN a world first, Australian schoolboys will receive the Gardasil vaccine free from next year.

Federal Health Minister Tanya Plibersek’s announcement yesterday comes five years after it was first funded for girls.

She said about 870,000 boys would receive Gardasil over the next four years under the national immunisation program, costing about $21 million.

The vaccine, which protects against four strains of the human papilloma virus, will be funded for 12 and 13-year-old boys, but Year 9 students will also be included in a two-year catch-up program.

HPV causes cervical cancer in women, as well as a range of other cancers affecting both sexes, including tumours of the head and neck.

Ms Plibersek made the announcement at Brisbane’s Diamantina Institute, where the vaccine was developed.

She said the decision continued Australia’s reputation as being a world pioneer in immunisation.

“We were one of the first countries to introduce polio and measles vaccinations,” the Minister said. “We’re the first country to provide free HPV vaccinations for girls, and from next year we will be the first country to provide free HPV vaccinations for boys.”

Scientist Ian Frazer, who developed Gardasil, hailed the “important public health measure”.

“The papillomavirus is responsible for some of the cancers inside the mouth and throat along with cancers of the genital tract,” Prof Frazer said from overseas.

“This is a very safe and effective vaccine.”

Cancer Council Australia CEO Ian Olver said funding Gardasil for girls was already having positive impacts, decreasing the number of pre-cancerous cervical lesions.

“There’s already a 0.38 per cent decrease in high-grade lesions in girls in the 18 age group,” he said. “To have a measurable difference in such a short time has been quite remarkable.

“That difference over a population is quite remarkable.

“We hope this is the first in a series of anti-cancer vaccines.”

Scientist Fiona Simpson paid for her six-year-old son, Euan, to be vaccinated with Gardasil six months ago.

“Given that I know the background of HPV and cancer, I thought I’d … protect my son,” she said.

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

HPV vaccine reduces infection, even in unvaccinated

Source: Therapeutics Daily

The HPV vaccine not only has resulted in a decrease in human papillomavirus infection in immunized teens but also in teens who were not immunized.

The study is believed to be the first to show a substantial decrease in HPV infection in a community setting as well as herd protection – a decrease in infection rates among unimmunized individuals that occurs when a critical mass of people in a community is immunized against a contagious disease.

The Cincinnati Children’s Hospital Medical Center study will be published online July 9 in the eFirst pages of Pediatrics.

“Infection with the types of HPV targeted by the vaccine decreased in vaccinated young women by 69 percent,” says Jessica Kahn, MD, MPH, a physician in the division of Adolescent Medicine at Cincinnati Children’s and lead author of the study. “Two of these HPV types, HPV-16 and HPV-18, cause about 70 percent of cervical cancer. Thus, the results are promising in that they suggest that vaccine introduction could substantially reduce rates of cervical cancer in this community in the future.”

The first HPV vaccine was licensed for use in the United States in June 2006. The U.S. Advisory Committee on Immunization Practices has recommended vaccination of girls and women between the ages of 11 and 26 to reduce rates of HPV infection, which ultimately can lead to cervical cancer.

In 2006 and 2007, Dr. Kahn and colleagues at Cincinnati Children’s recruited 368 young women between the ages of 13 and 16 from two primary care clinics in the city of Cincinnati. The young women had sexual contact but none were vaccinated. In 2009 and 2010, they recruited a different group of 409 young women in the same age range, more than half of whom had received at least one dose of the vaccine. The researchers compared pre- and post-vaccination HPV prevalence rates.

The prevalence of vaccine-type HPV decreased 58 percent overall, from 31.7 percent to 13.4 percent. The decrease was high among vaccinated participants (69 percent), but also was substantial for those who were unvaccinated (49 percent).

Dr. Kahn says the decrease in vaccine-type HPV among vaccinated participants was “especially remarkable,” given that participants were sexually experienced, many were exposed to vaccination-type HPV before vaccination, and only one dose of the vaccine was required to be considered vaccinated.

Dr. Kahn emphasizes that despite the evidence of herd immunity demonstrated in her study, vaccination of all young women between the ages of 11 and 26 is important to maximize the health benefits of vaccination.

Although vaccine-type HPV decreased, the overall prevalence of HPV (including types not targeted by the vaccine) in the study was “extremely high,” says Dr. Kahn. “Nearly one in four unvaccinated study participants was already positive for at least one high-risk HPV type.”

Most participants in the study were young, black women, many with Medicaid insurance. Given this, and the fact that the study was a relatively small one conducted in a single city, larger studies with more representative samples are needed to definitively determine the public health impact of the HPV vaccine, says Dr. Kahn.

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

Viral Marketing: What’s Stopping Men From Getting the HPV Vaccine

Source: GOOD Mobile

By: Jake Blumgart on July 6, 2012 at 3:00AM PDT

In early 2011, my doctor informed me that a vaccine to protect against the human papillomavirus—HPV—was now available for men. I was relieved, then frustrated—my doctor didn’t actually offer the principal vaccine, Gardasil, to her male patients. After a couple days of hunting around town, I finally found the vaccine at the Mazzoni Center, a LGBT health clinic in downtown Philly. I received all three shots, and joined the less than 1 percent of American men who are vaccinated against the most dangerous strains of the virus.

While I was exceedingly grateful to the Mazzoni Center inoculating me, I knew of only one other male friend who’d received his shots. So since I got my shots, I’ve made a point of discussing my experience with any friend, acquaintance, or bemused bystander who will listen. And I’ve learned two things about young, straight men and HPV: We all know it exists, and not much else.

When I posted about my vaccinations on Facebook and Twitter, the response was largely positive—but the dozen or so likes and comments mainly came from my female friends. When I brought up the issue with a few straight guys, they seemed confused about my decision to air the information in public. Embarrassed, I let the conversation drop. But a couple weeks later, I received a Facebook message from an acquaintance in another city, freaking out about his own HPV scare, and asking me whether he could be vaccinated, and where. My status update provided a rare safe zone around a toxic topic.

Like local zoning policy, a death in the family, or what actually lurks within Taco Bell tacos, few people feel comfortable talking publicly about STDs. There’s no better environment for breeding misinformation than the dense cocoon of embarrassment we’ve woven around sex. The result is that most men I’ve spoken with are familiar with just one statistic that pervades the conversation around HPV: An estimated 50 to 80 percent of American adults will contract it. The universality of the threat engenders a laissez-faire attitude: Fuck it. I probably already have HPV, as do all my peers. Why worry?

The stats above are as accurate as we have. But the real story of HPV is more complicated. There are more than 130 strains of HPV, and the vast majority of them do no harm: No cancer, no warts, nothing. Most immune systems take care of the few nastiest strains just as they would any other virus. Then again, some don’t.

“[Nearly] everyone is going to be HPV positive in their lifetime, but we are only worried about the people who have an immune system who cannot clear the infection,” says Brian Hill, president of the Oral Cancer Foundation and a survivor of HPV-related oral cancer, which was located at the base of his tongue in 1997, before the virus was recognized as a cause. “Of the 99 percent of people that engage in a sexual activity that transfers the virus, orally or genitally, only 1 percent will have it cascade into a cellular event. It’s the luck of the draw in having a gene pool that does not recognize HPV 16”—the dominant cancer-causing strain—“as a threat.”

There’s no way to tell if you, or your partner, lost the genetic lottery. HPV is transmittable through skin-to-skin contact, so condoms aren’t as effective as they are at, say, preventing HIV/AIDS. There aren’t even worthwhile tests to determine if you have a dangerous HPV infection or, unnervingly, a way to test for the penile cancer HPV can cause. Anal and oral cancer screenings exist, but dental insurance often does not cover the latter, as I found to my dismay when I booked one while researching this article. (I decided that the $65 out-of-pocket fee was worth protecting against tumors on my tonsils.)

The truth is that most young men don’t know about the risks of HPV—and their options for preventing it—because our culture’s sexual awkwardness distorts corporate, government, and even scientific decision-making. In the mid-2000s, before the vaccination was marketed to the public, the CDC conducted extensive focus group research to ascertain the American public knowledge of, and attitude toward, HPV. “Current focus-group findings revealed that STD-associated stigma served as a barrier to HPV-vaccine acceptability,” the researchers found. “[E]xperts…cautioned strongly against focusing primarily on the sexually transmitted nature of HPV…which can be stigmatizing and detract from the more important public health concern of cervical cancer.”

Merck took note. The results can be seen in the company’s initial “One Less” advertising campaign, which used images of jump-roping school girls to advocate the vaccination use for girls ages 9 to 26. Any mention of sexual transmission, genital warts, male victims, and non-cervical HPV-linked cancers are noticeably absent. I don’t remember seeing those ads, which were rolled out in late 2006, in the midst of my higher education. But my college girlfriend knew about HPV and Gardasil, and I’m sure her awareness was directly affected by Merck’s framing. I remember her frustration at learning of another negative consequence of sex—and that women, as usual, were expected to bear its financial and health costs. Neither of us knew that men could be anything more than passive carriers, or that the vaccine might eventually be available to both genders. “When we talk to guys, often young men especially will say, oh, but that’s the girl vaccine,” says Dr. Robert Winn, Medical Director of the Mazzoni Center. The culture of silence around men and HPV means that the burden is on women to protect themselves and their partners—and that the virus can be doubly dangerous for men. Of the HPV-associated cancers, cervical cancer (11,967 cases annually) is only slightly more prevalent than oral cancer (11,726). The death rates are three times higher for the latter, and men are far more likely to contract it. In a population of 100,00, 6.2 men and 1.4 women are diagnosed with HPV-related oral cancer. Of the 2,500 cases of HPV-related anal cancer reported annually, 900 are in men and 1,600 in women. According to the CDC, men who have sex with men are 17 times more likely to contract anal cancer. Prevalence rates are also higher among those with HIV/AIDS. Some of the statistics on male HPV rates are still emerging, but the idea that HPV affects men, too, has long been obvious. “When vaccines were being developed, HPV had the clearest causal link to cervical cancer,” says Adina Nack, Associate Professor of Sociology at California Lutheran University and author of Damaged Goods: Women Living With Incurable Sexually Transmitted Diseases. “[But] they knew boys contract it. Boys transmit it. There was already a growing body of clinical research that some cancers men suffer from are caused by the same strains of HPV.” Three years after the 2006 release for women, the vaccines were quietly approved for men. Neither Merck nor the U.S. government widely advertises its universal availability. I consider myself relatively plugged-in when it comes to sexual health, and I didn’t learn I could use the vaccine until 2011—two years of exposure while protection was there, unknown and unasked for. But in men, the HPV vaccine is still only approved as a defense against genital warts and anal cancer. Oral cancer is not officially one of the cancers Gardasil protects against, although the CDC notes that it’s “likely that this vaccine also protects men from other HPV-related cancers,” like cancers of the penis and the back of the throat. The Oral Cancer Foundation has been pushing for studies on the issue, but Merck announced in 2010 that it had no “plans to study the potential of Gardasil to prevent HPV-related [oral] cancers.” These false assumptions can be easily reversed. But men and women are still paying for Merck’s crappy reasoning. It would be great if the CDC conducted a sweeping public health campaign to alert Americans to the full facts about HPV and its vaccines. Merck should advertise its services to both men and women. But with the institutional players showing little inclination to try another big push for HPV vaccination, word of mouth  remains our principal sources of information about HPV protection. So start calling your local clinics—LGBT and otherwise—to see if they offer free shots. And when you get your vaccine, tell everyone who will listen.

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

1 of 6 cancer deaths worldwide caused by preventable infections

Source: Los Angeles Times

HPV

One in every six cancer deaths worldwide is caused by preventable infections, a total of 1.5 million deaths yearly that could be halted by widespread vaccination programs, researchers reported Wednesday. Since 1990, that number has grown by about half a million, suggesting that vaccination programs are losing ground in the battle rather than gaining it.  The vast majority of the cases are caused by three viruses and a bacterium, which are the leading causes of gastric, liver and cervical cancers. Cervical cancers account for about half of the infection-related cancers in women, while liver and gastric cancers account for about 80% of those in men.

The causes of many cancers are largely unknown, but genetics and poor luck play big roles. The World Health Organization estimated in 2004 that nine lifestyle and environmental factors — smoking being a particularly large one — account for as many as 35% of the 12.7 million cancers that occur each year, about twice the proportion now linked to infections.

Cervical cancers are caused primarily by the human papilloma virus (HPV), as are anal and penile tumors. Stomach cancers are caused by the bacterium Helicobacter pylori. The hepatitis B and hepatitis C viruses cause liver cancer.  All such infections are readily preventable by vaccination. Other less common agents include the Epstein-Barr virus, which causes nasopharynx tumors and Hodgkin’s lymphoma; human herpes virus type 8, which causes Kaposi’s sarcoma, usually in conjunction with HIV; and the parasite Schistosoma haematobium, which causes bladder cancer.

A team headed by Dr. Catherine de Martel and Dr. Martyn Plummer of the International Agency for Cancer Research in Lyon, France, used data compiled by the agency’s GLOBOCAN program to estimate the cancer incidence in various regions of the world, then used actual data of various cancers as well as estimates to predict the total attributable to infectious agents. They reported in the journal Lancet that the worldwide average of cancers caused by infectious agents was 16.5%, with about three times more (22.9%) occurring in developing countries than in developed countries (7.4%). Rates varied widely between regions, ranging from a low of 3.3% in Australia and New Zealand to a high of 32.7% in sub-Saharan Africa. About 4% of cancers were caused by infectious agents in North America and 7% in Europe.

In an editorial accompanying the report, Dr. Goodarz Danaei of the Harvard School of Public Health in Boston noted that vaccines for HPV and hepatitis B are available at a “relatively low cost” and “increasing coverage [with them] should be a priority for health systems in high-burden countries.”

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

Alberta committee suggests free HPV vaccine for boys

Source: CBC News

Cost to the province estimated between $5 million and $8 million

The province is considering offering boys free immunizations against the human papillomavirus.

The HPV vaccination is currently offered on a voluntary basis to all girls in Alberta entering Grade 5. The vaccine is said to prevent 70 per cent of cervical cancers, according to Alberta Health and Wellness.

Two strains of HPV are also thought to be a cause of anal, penile and oral cancers.

Susan Morgan’s husband was diagnosed with Stage 4 oral cancer, which they later found out was caused by the HPV virus.

She has been lobbying to have the vaccine for boys covered by the province and was astounded the HPV vaccination was only free for girls.

Morgan says the effects of the radiation and chemotherapy treatment for the cancer were horrific.

“You have open sores in your mouth,” she said. “You start to lose your ability to swallow; you end up on a feeding tube.”

Free vaccine for boys recommended

A report by an advisory committee in Alberta recommends extending HPV coverage to boys.

Chief medical officer Dr. Andre Corriveau says that would cost between $5 million and $8 million.

Now he’ll review the report and advise the province by the end of the month.

“I have a responsibility right now to make sure our system has the capacity to deliver,” he said.

But, for the Morgans, waiting is not an option and they have decided to pay hundreds of dollars to vaccinate both of their sons.

A HPV vaccination for boys has been endorsed by the federal government.

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

Ongoing surveillance needed to monitor trends in HPV rates after vaccination

Source: HemOnc Today

The ongoing monitoring of HPV-associated cancers via the National Program of Cancer Registries and the Surveillance, Epidemiology and End Results program indicate a decrease in the US rates for cervical cancer, yet disparities remain, according to data published in a recent Morbidity and Mortality Weekly Report.

Data pooled from the high-quality population-based cancer registry programs indicated that between 2004 and 2008, there were 12,080 HPV-associated cancers diagnosed annually among males and 21,290 among females.

Of the overall cases, cervical cancer was the most common diagnosis (11,967 annually), followed by oropharyngeal cancer (11,726 annually). Compared with whites and non-Hispanics, blacks and Hispanics had the highest rates for cervical and penile cancer. Conversely, vulvar cancer rates were highest among whites and non-Hispanics.

Anal cancer rates were highest among females (1.8 per 100,000) vs. males (1.2 per 100,000). Specifically, the rates were highest among white females and among black males.

HPV-associated cancer rates were highest among females in West Virginia (16.3 per 100,000) and among males in Washington, D.C. (11.6 per 100,000). Rates in the lowest tertile for HPV-associated cancers were most common in Maryland, Colorado and Utah, whereas rates in the highest tertile were found in Kentucky, Louisiana and Tennessee.

“The HPV vaccine will likely help decrease cervical cancer rates further and reduce the disparities,” the researchers wrote in the report. “Other HPV-associated cancers do not have approved screening programs; therefore, HPV vaccines are important prevention tools to reduce the incidence of non-cervical cancers.”

In an accompanying editorial, CDC officials wrote, “Reasons for variations in rates of noncervical HPV-associated cancers by race/ethnicity and state are not clear but might be attributable, in part, to demographics, screening practices, tobacco use or other factors related to HPV infection of persistence.”

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

HPV Vaccine Recommendation for Boys Viewed as Necessary

Source: OncLive.com

 As the incidence of head and neck cancers linked to the human papillomavirus (HPV) continues to rise, a federal advisory panel has recommended that all 11- and 12-year-old boys be vaccinated against the virus, igniting further controversy in an area where acceptance of a public health policy has been slow.

The recommendation from the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention (CDC) would expand the use of the vaccine beyond the original target population of 11- and 12-year-old girls for whom it is recommended as protection against cervical cancer.

Ezra E. W. Cohen, MD, firmly supports the latest recommendation. “It’s the right move by the CDC,” he said in an interview. “I think it’s a long time coming.”

Cohen said that the fact that the original recommendations targeted cervical cancer created a cultural perception that the vaccine was only intended for girls.

Yet the HPV virus affects men as well. According to the CDC, HPV is associated with about 18,000 cancers in women and 7000 cancers in men each year.

Overall, the incidence of HPV-positive oropharynx cancers increased by 225% between 1988 and 2004, according to National Cancer Institute research. There were an estimated 6700 cases of HPV-positive oropharynx cancers in 2010, up from 4000 to 4500 in 2004.

vaccination

Cohen said he believes such numbers are going to continue to rise. Even by taking proactive steps in 2011, the vaccine is only intended for children and young adults. HPV that is already circulating will continue to be spread and lead to the development of cancer in certain people who contract it.

“Even if vaccinations were made mandatory, we will not see the effects on cancer for decades,” Cohen said. “Just simply recommending it is probably not going to be enough.”

Indeed, the CDC has found that public acceptance of the HPV vaccine for girls has lagged behind adoption rates for other vaccines. The recommendation has been controversial because HPV is spread through sexual activity, leading many parents to protest over the notion that their children could be engaging in sexual activities at a young age.

Key HPV Vaccination Statistics

  • Coverage for 1 dose of HPV vaccine for girls increased by only 4.4 percentage points to 48.7% in 2010 versus 44.3% in 2009.
  • For girls who received the recommended 3 doses of HPV vaccine, coverage increased 5 points to just 32% in 2010 versus 26.7% in 2009.
  • Of the girls who began the HPV vaccine series, 30% did not receive all 3 doses.
  • Completion of the 3-dose HPV series was lower among blacks and Hispanics than whites.
  • Coverage for 3 doses of HPV vaccine was lower for those living below poverty levels.
  • Poor and minority teens are less likely to receive all 3 recommended doses of the HPV vaccine.

Source: Centers for Disease Control and Prevention. Teen vaccination coverage. 2010 National Immunization Survey (NIS)—Teen. www.cdc.gov/vaccines/who/teens/vaccination-coverage.html#nis-tables. Published August 25, 2011. Accessed November 7, 2011.

The HPV vaccine was first recommended for 11- to 12-year-old girls as well as for teenage girls and women through age 26 in 2006, yet less than one-third of those who started the vaccine series received all 3 doses (Key Statistics, Left).

The FDA has approved 2 products, the quadrivalent Gardasil (Merck) and the bivalent Cervarix (GlaxoSmithKline), as vaccinations against HPV. For girls and young women, both vaccines are recommended as protection against cervical cancer, while Gardasil also protects against anal, vaginal, and vulvar cancers.

The only HPV vaccine recommended for males is Gardasil, a CDC official said in discussing the new recommendations in October.

In a study published in The New England Journal of Medicine in October, a phase III trial demonstrated that Gardasil was 77.5% effective in reducing the rates of anal intraepithelial neoplasia associated with 4 HPV types among 602 healthy men ages 16 to 26 years who have sex with men.

Despite the vaccine’s ability to protect patients from HPV, the vaccine does not protect against a wide variety of other sexually transmitted diseases, including the human immunodeficiency virus.

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

HPV Vaccine May Prevent Recurrence of Precancerous Conditions

Source: abcnews.com

The human papillomavirus (HPV) vaccine has been touted as a way to prevent cervical cancer and genital warts, but a new study suggests the vaccine may also prevent women diagnosed with precancers from developing recurrences.

Researchers randomly assigned more than 1,350 women diagnosed with genital warts or certain precancerous conditions to receive either three injections of the HPV vaccine or a placebo. The women were followed for about four years.

Women who received the vaccine had 46.2 percent lower risk of developing another HPV-related disease after treatment for their genital warts or their precancerous condition.

Typically, women treated for these types of conditions are at risk for subsequent disease later, but the study offers evidence that “vaccination offered substantial benefit” in terms of lowering that risk, wrote the international team of authors, led by Elmar Joura, an associate professor at the University of Vienna in Austria.

Experts not involved with the research told ABC News that the research is significant because it suggests for the first time that the HPV vaccine may offer benefits beyond prevention.

“We always thought about the vaccine from the prevention, and this suggests it can lower the risk of developing a second episode of disease,” said Dr. Anna Giuliano, director of the Center for Infection Research in Cancer at the Moffitt Cancer Center in Tampa.

Giuliano cited another study published online in January that found the HPV vaccine reduces the recurrence of abnormal anal cell growths in men.

“We’re now seeing a pattern with cervical, vulvar, vaginal and anal dysplasias,” she said. “There are prevention effects beyond the first case of disease.”

While the findings seem to offer more promise for the HPV vaccine, it’s too soon to say whether clinicians will be able to use it for something other than primary prevention of cervical cancer and genital warts in girls and women who have not yet been exposed to the virus through sexual contact.

“It sometimes takes decades to go from HPV infection to pre-invasive disease to cancer, so we’re going to need a long period of time before we’re going to see cervical cancer prevention or reduction in women who are vaccinated,” said Dr. Ursula Matulonis, medical director of medical oncology at the Dana-Farber Cancer Institute in Boston.

Currently, vaccination is recommended for 11 and 12-year-old girls, as well as for girls and women ages 13 through 26, who have not been vaccinated or have not completed the series of vaccines. The Centers for Disease Control and Prevention also recently expanded the recommendations to include 11 and 12-year-old boys. They also recommend that men and boys ages 13 through 21 should also get caught up with their HPV vaccinations.

Pre-cancerous gynecologic conditions are a major headache for the many women who live with them because of the risk of developing HPV-related diseases. There currently is no way to prevent the recurrence of these conditions, meaning clinicians must regularly monitor them.

“Most women that become carriers of HPV will clear the infection on their own, but more high-risk type of the virus will stay in the system, and as long as they carry it, dysplasias can occur,” said Dr. Ginger Gardner, a gynecologic oncologist at Memorial Sloan-Kettering Cancer Center in New York. “Once there’s a dysplasia, it requires continued surveillance. There are a lot of health care dollars given to screening diagnosis and management of dysplasias.”

In an editorial accompanying the study, Jane Kim, assistant professor of health decision science at the Harvard School of Public Health, wrote that learning more about the vaccine’s ability to prevent these gynecologic conditions and its other potential benefits is crucial.

“Worldwide, decision makers who are increasingly considering adopting HPV vaccination programs need information on the total potential health gains and the priority target groups for vaccination,” she wrote. “The current study moves us closer to understanding the full scope of benefits from HPV vaccination by showing for the first time that vaccine protection against disease can endure beyond the management of HPV-related disease in women already vaccinated.”

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

Young Girls More Likely to Report Side Effects after HPV Vaccine

Source: Therapeutics Daily

PORTLAND, Ore., April 3, 2012 /PRNewswire/ — Younger girls are more likely than adult women to report side effects after receiving Gardasil, the human papillomavirus vaccine. The side effects are non-serious and similar to those associated with other vaccines, according to a new study funded by the Centers for Disease Control and Prevention and published in the Journal of Women’s Health.

As part of an ongoing study and evaluation of this relatively new vaccine, researchers surveyed 899 girls and young women (ages 11-26) within two weeks after they received the Gardasil vaccine injection in the upper arm. The survey, which took place in 2008, also found that while most girls and young women did know that the vaccine can prevent cervical cancer, and that three doses are recommended, many didn’t know that the vaccine can also prevent genital warts and abnormal pap smears.

“Gardasil is an important cancer-prevention vaccine, but too few girls are getting it. Our study found that young girls do have some knowledge about the vaccine, but they need to know more. If these girls and their parents know what to expect, they will likely be less afraid of getting the vaccine,” said study lead author Allison Naleway, PhD, a senior investigator with the Kaiser Permanente Center for Health Research in Portland, Ore.

Since 2006, the CDC has recommended Gardasil for girls ages 11-12, and for older girls and women (ages 13-26) who did not receive the vaccine when they were younger. The CDC also recently recommended Gardasil for boys ages 11-12, and for older boys and men (ages 13-21) who did not receive the vaccine when they were younger.

Information about side effects has been reported by the manufacturer, the CDC, and by the federal government’s Vaccine Adverse Event Reporting System, but this study is one of the first to survey girls themselves shortly after they received the vaccine. Many other studies have relied on information reported by health care providers and parents.

For this study, researchers used electronic health records to identify 3,490 Oregon and Washington girls and young women (ages 11-26) who received their first dose of HPV vaccine between February and September of 2008.  Within a week of vaccination, researchers sent out surveys to young women ages 18-26. For girls under 18, researchers notified parents that their daughters would be receiving the surveys the following week, and gave the parents a choice to opt out. The survey included 50 questions about vaccine side effects, about girls’ knowledge of the vaccine and the HPV virus, and about what kind of information their doctors shared with them before vaccine administration.

Of the 899 girls and women who responded to the survey, 78 percent reported pain when receiving the vaccine. Seventeen percent reported bruising or discoloration, 14 percent said they had swelling at the injection site, 15 percent reported dizziness, and 1 percent of the girls reported fainting.

Younger girls were more likely to have received other vaccines such as tetanus, meningitis and hepatitis A at the same time they received the HPV vaccine, and they were also more likely to report side effects. For example, 84 percent of girls aged 11-12 reported pain with the injection vs. 74 percent of women aged 18-26. Nineteen percent of girls aged 11-12 reported feeling dizzy after receiving the vaccine, but fewer than half that many (8 percent) of women aged 18-26 reported dizziness.

“These side effects are non-serious and very manageable,” said Mike Wilmington, MD, a Kaiser Permanente pediatrician in Vancouver, Wash., who was not involved in the study. “The main complaint I hear about is pain with the injection, but there are ways to lessen the pain. Some girls will feel dizzy after this and other vaccines, so I follow CDC guidelines and have them sit or lie down for a few minutes after receiving the vaccine.”

Eighty-four percent of girls and young women said they knew that the HPV virus can cause cervical cancer, but only half reported knowing that it can also cause genital warts and abnormal pap smears. Most respondents said their providers told them they needed three doses of the vaccine, and most also said their providers talked with them about the vaccine’s benefits, possible side effects, and about HPV infection. Most girls, however, said their providers did not discuss genital warts or abnormal pap smears, and only one-fifth of girls said their provider asked them to sit and rest after receiving the vaccination.

Study authors include Allison Naleway, PhD, Rachel Gold, PhD, MPH, Lois Drew, Karen Riedlinger, MPH and Michelle Henninger, PhD — all from the Kaiser Permanente Center for Health Research in Portland, Ore., and Julianne Gee, MPH, from the Centers for Disease Control and Prevention in Atlanta.

This study is part of Kaiser Permanente’s ongoing research to understand the safety and efficacy of Gardasil. A study of 189,629 girls, teenage girls and young women, published earlier this year in the Journal of Internal Medicine, found that Gardasil does not trigger autoimmune conditions such as lupus, rheumatoid arthritis, type 1 diabetes or multiple sclerosis after vaccination in young women.

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

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