HPV Cancers: The Most Preventable Human Cancers


HOUSTON: IACAN had a very informative educational program on HPV cancers and as speakers, we had the honor of having Dr. Kathleen M. Schmeler, and Dr. Erich M. Sturgis of the University of Texas-M.D. Anderson Cancer Center, Houston, Texas.

The human papillomavirus (HPV), is a group of more than 150 related viruses.  Some “low-risk HPV” can cause non-cancerous warts and papillomas and other “high-risk HPV” cause cervical cancers, the majority of oropharyngeal and anal cancers and linked to many penile, vaginal and vulvar cancers. The lifetime risk of acquiring an HPV infection is approximately 80%. Most never know they are infected (no symptoms). HPV is most commonly transmitted by having vaginal, anal, or oral sex with HPV+ non-symptomatic individual but intercourse is not necessary. HPV can also be transmitted by close intimate skin-to-skin contact, and from infected mother to her child during birth. Cervical cancer is number 1 cause of cancer death in women in most of Africa and second/third in most of Latin America and South Asia. In the US and other developed countries oropharyngeal cancers in men, and anal cancers in both men and women are increasing. Cervical pre-cancer is identifiable and treatable through routine Pap/HPV testing and is effective in reducing cervical cancer incidence and mortality in the developed world. However, this approach is expensive and likely not feasible in resource/infrastructure-poor regions of the developing world. Furthermore, the HPV-related oropharyngeal pre-cancer is almost never identifiable prior to the development of invasive cancer. Therefore, prevention of initial infection is most desirable option and vaccination is the most effective approach.

Fortunately, we now have very effective vaccines approved in 2007 by CDC for pre-adolescent boys and girls 11 to 12 years of age to prevent HPV infection and the resulting diseases.  Catch-up vaccination is recommended for males and females through age 26. The 3-dose vaccine is administered over six months and can be given along with other childhood vaccines. The HPV vaccines produce a higher immune response in preteens and young teens than they do in older teens and young adults, which is why it is very important for children to get vaccinated earlier than age 14. HPV vaccine protection lasts for at least 10 years, and potentially even longer. The vaccine has been extensively monitored for safety with minor and temporary side effects. Studies have shown that being vaccinated against HPV will not affect sexual behavior. For those who practice abstinence, there is no guarantee that a future partner will have made the same choice, leaving them open to future infection.

Despite this remarkable opportunity to prevent HPV-cancers through the simple and safe vaccination, only 40% girls and only 20% boys in the U.S. are completing HPV vaccination. The gravity of this missed opportunity to eradicate this disease from the next generation is that these cancers typically require aggressive multimodality cancer treatment including radiation and chemotherapy and sometimes mutilating surgeries that have life-long impact on quality of life and daily functions. If these cancers return after treatment they are typically incurable. Consequently, it is imperative that children complete the HPV vaccination series before their 13th birthday so that they are protected from being a victim of these cancers.

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