The University of Texas MD Anderson Cancer Center and Baylor College of Medicine have once again joined forces with the other 67 National Cancer Institute-designated cancer centers to issue a joint statement to endorse the Centers for Disease Control and Prevention’s updated vaccination guideline for the human papillomavirus (HPV).
The CDC is now recommending two doses of the 9-valent HPV vaccine, at least six months apart, for girls and boys between the ages of 11 and 12 years old. Originally, the CDC recommended three doses of the vaccine for that age group, but studies showed that people developed the same antibody levels necessary for protecting the body against HPV regardless of whether they were administered two doses or three. Because the vaccine is most effective when given to children earlier, people between 15 and 26 years old should still receive three doses.
The revised guideline is a welcomed change among many health care providers who have seen vaccination rates decline when more doses are required and believe the two-dose recommendation will motivate more people to get vaccinated.
“Switching to two doses made a lot of sense from just the practicality of getting the kids vaccinated,” said Erich Sturgis, M.D., head and neck surgeon at MD Anderson. “We’re excited about that. We think that it’s going to make it easier for parents, and it’s going to make it easier for pediatricians and providers who are giving the vaccinations.”
According to the CDC, approximately 79 million people in the country are infected with HPV, with 14 million new infections occurring each year. There are more than 200 different strains of HPV that are classified as either low-risk HPVs or high-risk HPVs. The low-risk HPVs are non-cancerous but can cause warts on the genitals, anus, mouth or throat. The high-risk HPVs can cause several types of cancer, including cervical cancer, anal cancer and oropharyngeal (throat) cancers. There is currently no way to identify the specific types of HPV in individuals or to screen for HPV in men. The most effective form of prevention is to be vaccinated.
While vaccination rates have increased over the years, the U.S. has yet to reach numbers close to accomplishing the Healthy People 2020 goal of 80 percent coverage. A 2016 study by the CDC showed that 41.9 percent of girls and 28.1 percent of boys have completed the series of vaccines. The vaccination rates in Texas are even more disappointing, with 40.9 percent of girls and 24 percent of boys receiving the full vaccination series.
But doctors, including Matthew Anderson, M.D., Ph.D., assistant professor of of obstetrics and gynecology at Baylor, hope the joint statement will encourage the public to take preventative action and, ultimately, improve vaccination rates.
“[The statement] reinforces the need to get vaccinated and that people from many different walks of life believe this is an important goal. I think that it may help motivate people who have experienced HPV-related cancer to communicate that message to their partners, to their children, perhaps even motivate them to take their children to get vaccinated and to encourage family members to go and get vaccinated,” Anderson said. “That’s the kind of thing that’s going to really help change the tide.”
Low vaccination rates have been attributed to the lack of parent education on HPV vaccines and an insufficient number of health care providers recommending the vaccine. However, Sturgis said there are still some parents who are not vaccinating their children out of fear of vaccinations—a fear he calls “irrational.”
“If parents are open to receiving the information, they can hear about how these vaccines—just like other vaccines—are extremely safe,” Sturgis said. “In fact, they’re putting their kids at much, much higher risk by not vaccinating their children.”
Vaccines have yet to fully shed the false rumors of causing birth defects or autism, and public perception of HPV has wrongfully tied the vaccine to sexual promiscuity.
“This vaccine really got a bad messaging at first when all the talk was about HPV as an infection. The vaccination is not about the infection. It’s about preventing cancer. It’s a cancer prevention vaccine,” he said. “For the public, seeing this message from all the cancer centers I hope really drives home that that’s the issue. This is not an issue of sexual behavior in people. It’s something virtually all of us are exposed to and we want to prevent cancer.”
As a head and neck surgeon, Sturgis said tobacco-related cancers used to be the most common type of cancer he treated. Thanks to federal health initiatives and warnings issued by the Surgeon General, cancers of the mouth and voice box have been greatly reduced. Unfortunately, oropharyngeal cancer, which can be caused by HPV, has replaced tobacco-related cancers and is now the most common type Sturgis treats.
“Oropharynx cancer is an extremely difficult cancer to treat. We do have good success with it, but it’s difficult in the sense that the side effects of the treatment are horrible,” he said. “Most patients receive a combination of radiation and chemotherapy. Occasionally, they need surgery and … the one-year cost for treating an oropharynx cancer is well over $110,000 just for the medical cost. So it’s an expensive and morbid treatment.”
In an effort to develop a screening test for oropharyngeal cancer, Sturgis and his team recently created a clinical trial, called the HPV-related Oropharyngeal and Uncommon Cancers Screening Trial of Men (HOUSTON). The trial will open in the next few weeks and will be recruiting men between the ages of 55 and 59 who may be at high risk for developing oropharyngeal cancers. Patients will undergo blood testing, ultrasound testing to look for any early spread to the lymph nodes and a consultation with a colorectal surgeon and urologist.
For more information about participating in the trial, call 713-745-3511.
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