Study Endorses HPV Testing for All Women Over 30

Source: Medscape.com LONDON (Reuters) Dec 15 - New DNA tests looking for the virus responsible for most cases of cervical cancer make sense for all women aged 30 or over, since they can prevent more cases of cancer than Pap smears alone, Dutch researchers say. Results of a five-year study involving 45,000 women provided the strongest evidence yet in favor of using human papillomavirus (HPV) testing, Dr. Chris Meijer and colleagues from the VU University Medical Centre in Amsterdam reported in The Lancet Oncology on December 15. In recent years, tests for high-risk HPV strains have been developed by companies including Roche and Qiagen. The new tests are known to work well in detecting HPV, but the Dutch study is the first to show they are better than Pap smears alone over two screening rounds set five years apart. The researchers, who looked at women aged 29 to 56, said use of HPV tests led to earlier detection of pre-cancerous lesions, allowing for treatment that improved protection against cancer. Dr. Hormuzd Katki and Dr. Nicolas Wentzensen from the U.S. National Cancer Institute said the results reinforced earlier findings, and provided "overwhelming evidence" of the benefits of including HPV testing in cervical screening programs. The government-backed U.S. Preventive Services Task Force currently urges women who have been sexually active and have a cervix to get Pap smears at least every three years. However, the group recommends against routinely screening women over 65 if they had normal results on a recent Pap [...]

2011-12-27T11:06:49-07:00December, 2011|Oral Cancer News|

UI professors: HPV editorial misses the mark

Source: The Daily Iowan The Nov. 29 editorial "Recommend Pap smears, not vaccines, to prevent cervical cancer" completely missed the mark with regard to HPV vaccines. We are researchers and clinicians at the University of Iowa who study and treat HPV and other infectious diseases. It is disturbing to think that the article might dissuade individuals from getting a safe and effective vaccine that can prevent cancer. First of all, it has been conclusively demonstrated that the vaccines are effective at preventing HPV infection. Cervical cancer is caused by HPV. Additionally, cancers of the head and neck are linked to HPV, including cancers in males. It has been clearly shown that the vaccines prevent the development of precursors to cervical cancer. In the editorial, Dr. Diane Harper was quoted as saying, "If doctors tell patients that this vaccination will prevent cancer, they're telling them a lie." This statement from Dr. Harper is simply misleading. In the vaccine studies, non-treatment of precursor lesions in the placebo group in the context of a clinical trial was considered unethical, and therefore, any precursor lesions were treated. Subsequent development of cancer in the placebo group was prevented by the required ethical treatment. Thus, the trials could not evaluate prevention of advanced cancer, per se. Because it takes cervical cancer a long time to develop, it will take about 15 more years to have data on incidence rates of cervical cancer from a large vaccinated general population. Because the vaccines prevent HPV infection and HPV-associated [...]

2011-12-08T10:31:17-07:00December, 2011|Oral Cancer News|

HPV vaccine myths put health, lives at risk, say health leaders: Airing the facts

Source: TheNationsHealth.org Vaccination rates for human papillomavirus are lagging for teens, and a complicated web of confusion and misinformation may be to blame, according to public health leaders. Several strains of HPV can cause cervical cancer, and two vaccines, Gardasil and Cervarix, have been shown conclusively to defend against those strains. The Food and Drug Administration recommended in 2006 that girls receive the vaccine before they become sexually active so that they are protected at the outset. In 2009, FDA approved the use of the vaccine for boys as well. According to the Centers for Disease Control and Prevention, about 6 million people in the U.S. become infected with HPV each year and each year about 12,000 women are diagnosed with cervical cancer, leading to about 4,000 deaths. Studies have shown the vaccine to be overwhelmingly safe, CDC said. As of June 2011, about 35 million doses of Gardasil had been distributed in the United States. CDC’s adverse event tracking mechanisms reported about 18,000 adverse events, 92 percent of which were nonserious events, such as fainting, swelling at the injection site and headache. Sixty-eight deaths were reported, but there is “no unusual pattern or clustering to the deaths that would suggest that they were caused by the vaccine, and some reports indicated a cause of death unrelated to vaccination,” CDC said. And yet, fed perhaps by misinformation or squeamishness about the idea of their children becoming sexually active, some parents are opting not to vaccinate, and the vaccination rates are [...]

2011-12-01T12:41:51-07:00December, 2011|Oral Cancer News|

Use and Acceptance of HPV Vaccine Still a Work in Progress

Source: National Cancer Institute A bellwether moment in the history of cancer prevention came in 2006 when the Food and Drug Administration (FDA) approved the first vaccine to prevent cervical cancer. The vaccine, Gardasil, protects against the two primary cancer-causing, or oncogenic, types of the human papillomavirus (HPV)—HPV-16 and HPV-18. These types are responsible for more than 70 percent of cervical cancer cases worldwide. In 2009, the FDA approved a second HPV vaccine, Cervarix, which also targets HPV-16 and HPV-18. Gardasil and Cervarix, vaccines that protect against the two primary cancer-causing types of the human papillomavirus (HPV), entail a three-shot regimen, with each dose delivered several months apart. But what has transpired since these two vaccines received regulatory blessing in the United States has reaffirmed something that cancer and public health researchers have appreciated for some time: The translation of basic research to the clinic doesn’t end with FDA approval of a new drug or treatment. In many respects, FDA approval is just a beginning. In March 2007, the CDC’s Advisory Committee on Immunization Practices (ACIP) gave its strongest recommendation for HPV vaccination for females ages 9 to 26, which is the FDA-approved indication for Gardasil. Cervarix is approved for females ages 10 to 25. Both vaccines entail a three-shot regimen, with the doses delivered several months apart. According to the most recent data, only 44 percent of adolescent girls 13 to 17 years of age have received at least one dose of the vaccine. Completion rates for the three-shot [...]

2011-11-30T10:47:00-07:00November, 2011|Oral Cancer News|

Trial Confirms Efficacy of HPV Vaccine, Shows Cross-Protection

Source: National Cancer Institute End-of-trial results from a trial testing Cervarix, a vaccine against human papillomavirus (HPV) types 16 and 18, showed that the vaccine continued to provide substantial protection against cervical precancers 4 years after vaccination. Cervarix provided almost complete protection in young women who had no evidence of exposure to HPV at the time of vaccination. The vaccine provided less protection for the total vaccinated cohort and was less effective with increasing age at vaccination. These findings reflect the vaccine’s lack of effectiveness against infections acquired before vaccination. The vaccine also partially protected women against four types of HPV that are not targeted by the vaccine. (Although HPV-16 and -18 cause about 70 percent of cervical cancers worldwide, as many as 15 HPV types can cause cancer.) These results from the PATRICIA trial (Papilloma Trial against Cancer in Young Adults) were published online November 9 in Lancet Oncology in two separate papers, available here and here. The PATRICIA trial enrolled 18,644 young women between the ages of 15 and 25 from 14 countries. The participants were randomly assigned to receive either three doses of Cervarix or three doses of a hepatitis A vaccine as a control. Results from the interim analysis, published in July 2009, showed that the vaccine greatly reduced the risk of grade 2 cervical intraepithelial neoplasias and higher (CIN2+). The new analysis shows that, 4 years after vaccination, Cervarix provided complete protection against grade 3 cervical intraepithelial neoplasias or higher (CIN3+) associated with HPV-16 and [...]

2011-11-29T18:55:35-07:00November, 2011|Oral Cancer News|

Data Published in the Lancet Oncology Support High Efficacy Previously Demonstrated By Cervarix

Source: Therapeutics Daily Author: Staff LONDON, Nov. 9, 2011-An analysis published today in The Lancet Oncology reinforces previous findings showing that GlaxoSmithKline’s Cervarix®, provided protection against advanced precancerous lesions (CIN3+), above that expected from a vaccine that protects against human papillomavirus (HPV) types 16 and 18. CIN3+ is the immediate step before invasive cervical cancer and data showing protection against this type of lesion are considered the most stringent evidence of potential cervical cancer prevention.1 Results from the largest efficacy trial of a cervical cancer vaccine to date (PATRICIA), show that Cervarix provided 93%† efficacy against CIN3+ irrespective of the HPV type associated with the CIN3+ lesion.1This pre-defined, exploratory analysis was conducted in women with no evidence of past or current HPV infection.‡ These women are thought to be representative of young girls prior to the onset of sexual activity – the primary target population for organised vaccination programmes. These findings have been incorporated into the European label for Cervarix, updated by the European Commission in September 2011. Additional data from the same end-of-study analysis have been published in a separate article in TheLancet Oncology. These data demonstrate that Cervarix provided 82%* efficacy against CIN3+, associated with a composite of 12 cancer-causing HPV types not included in the vaccine, in the same population as the analysis discussed above.2 This analysis excluded cases co-infected with HPV 16 and/or 18 and is therefore a conservative estimate of cross-protective efficacy. Non-vaccine HPV types, including the 12 studied in this analysis, together account for approximately 30% of cervical cancers globally.3 The authors [...]

2011-11-16T12:04:02-07:00November, 2011|Oral Cancer News|

Implications of the Oropharyngeal Cancer Epidemic

Source: Journal of Clinical Oncology Chaturvedi et al,1 analyzing specimens back to 1984, validate the long-held hypothesis that infection with human papillomavirus (HPV) has increased oropharyngeal squamous cell carcinoma (OPSCC) incidence in the US. They find the incidence of OPSCC in men—who have higher risks of both HPV-positive and HPV-negative OPSCC than women—similar to that of cervical cancer in women. From 1988 to 2004, incidence of HPV-negative OPSCC decreased in parallel with smoking whereas incidence of HPV-positive OPSCC increased at about 7.5% per year, so the percentage of OPSCC that was HPV-positive went from less than 20% to more than 70%. HPV-positive and HPV-negative OPSCC are etiologically and clinically distinct,2,3 with HPV-positive disease having better outcome.4–6 In the current study,1 the hazard ratio of 0.3 for HPV-positive/HPV-negative in survival analysis essentially balances the difference in prevalence so each form of OPSCC now accounts for a similar number of deaths. Notably, the authors found that outcomes for HPV-positive OPSCC have improved over time, whereas outcomes for HPV-negative OPSCC are as dismal as they were 25 years ago. The authors argue convincingly that vaccination to prevent oral HPV infections should be evaluated and that better treatments for both types of OPSCC should be developed. We are unlikely to get a better picture of the recent history of OPSCC in the United States. This study used all available OPSCC specimens from the three Surveillance, Epidemiology, and End Results (SEER) registries that participate in the Residual Tissue Repositories Program, analyzed them in several ways, [...]

2011-11-09T15:24:59-07:00November, 2011|Oral Cancer News|

HPV Vaccination Could Reduce the Number of Screening Procedures

The National Journal By Sophie Quinton Widespread vaccination against cervical cancer could reduce the need for burdensome screenings, U.S. and Finnish researchers said on Tuesday. A study published in the journal Lancet Oncology show that GlaxoSmithKline’s Cervarix vaccine, which protects against two strains of human papillomavirus, or HPV, was more than 93 percent effective in preventing precancerous lesions in women who had never been infected and completely protected young women from the strains of virus targeted by the vaccine. The vaccine also reduced cancer risk for women who had already been infected by HPV, but was far less effective. A second study found that Cervarix can protect against rarer strains of HPV that also cause cancer. Neither study looked at Gardisil, the other licensed HPV vaccine, which protects against four strains of HPV—including the two targeted by Cervarix. The efficacy of vaccination adds fuel to two debates: how often women need to undergo cervical cancer screenings, and how important it is to reach girls—and boys—with HPV vaccinations before they become sexually active. The U.S. Preventive Services Task Force, American Cancer Society, and other clinical groups have agreed that the pap smear—the screening for cervical cancer—does not need to be done every year for most women, and suggest that screenings begin at age 21. For vaccinated women, the need for screening might be further reduced. “Provided that organised vaccination programs achieve high coverage in early adolescents before sexual debut, HPV vaccination has the potential to substantially reduce the incidence of cervical [...]

2011-11-08T20:47:32-07:00November, 2011|Oral Cancer News|

Possible Link Between HPV and Heart Disease

Source: CVTNews.ca We already know HPV, or human papillomavirus, can cause cervical cancer. It's also known to cause some kinds of oral cancer. But could HPV also cause heart disease? An intriguing new study is drawing a link. The study found that women who are known to be infected with cancer-causing strains of the virus may be at increased risk for cardiovascular disease and stroke -- even when they have none of the usual heart disease risk factors. The study authors say their research is one of the first to investigate a potential link between heart disease and HPV, which is one of the most common sexually transmitted infections. The Public Health Agency of Canada estimates that more than 70 per cent of sexually-active Canadian men and women will have a sexually transmitted HPV infection at some point in their lives. They say they began the study because they wanted to know why some people have heart attacks even though they have none of the usual risk factors, like high cholesterol or high blood pressure. About 20 per cent of patients with heart disease lack risk factors, which has left open the possibility that underlying "nontraditional" causes might be involved in the disease. If there is indeed a link between the virus and heart disease, it could have a number of implications. It would mean that doctors would have to monitor patients with HPV to help prevent heart attack and stroke. As well, there is the possibility that the HPV vaccine [...]

HPV Vaccine Recommended for Boys aged 11 to 12 Years

Source: HemOncToday.com The CDC's Advisory Committee on Immunization Practices today approved routine recommendation in favor of administering the quadrivalent HPV vaccine for boys aged 11 to 12 years. Committee members decided that the vaccine (Gardasil, Merck) was safe, efficacious and cost-effective enough to warrant routine usage in this population. The recommendation issued in 2009 was permissive, meaning providers could give the vaccine to boys, but it was not routinely administered. This change would put the HPV vaccine into the regular vaccination schedule. The three-vaccination series can start as early as age 9 years. "The committee recommended that routine vaccination of males aged 11 or 12 years with three doses of quadrivalent vaccine be given to prevent HPV infection and HPV-related disease," Anne Schuchat, MD, director of the CDC's National Center for Immunization and Respiratory Diseases, said in a phone call with reporters. "Boys and young men 13 to 21 years of age who have not already received the vaccine should be vaccinated." Anne Schuchat, MD Insurance companies typically cover HPV vaccine in boys, but that is not necessarily the case for a permissive recommendation, according to Schuchat, who said a routine recommendation for a vaccine usually translates into coverage without co-pays. The committee voted 8-5 with one abstention in favor of recommending vaccination for young men up to age 21 years with permissive recommendation for men aged 22 to 26 years. The committee considered recommending vaccination up to age 26 years, which would have harmonized recommendations for men and women, [...]

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