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Entries in HPV (23)

Monday
Jan072013

HPV-Related Cancers on Rise as Vaccination Rates Stay Low

iStockphoto/Thinkstock(NEW YORK) -- As cancer rates overall continue to decline, HPV-related cancers of the esophagus and anus are on the rise, according to the Annual Report to the Nation on the Status of Cancer.

At the same time, vaccination rates, which could stem the number of cancer deaths, still remain low.

The report, published Monday in the Journal of the National Cancer Institute, concludes that the spike in cancers thought to be caused by the human papilloma virus, or HPV, underscores the need for additional prevention efforts, including immunization.

Since the 1990s, deaths for cancer of the lung, colon, breast and prostate have been declining, according to the report. However, death rates from melanoma and cancers of the pancreas, liver and uterus all appear to be on the rise.

For years now, doctors have urged young women to be vaccinated against the human papilloma virus (HPV), which is believed to cause cervical cancer.

But in 2010, fewer than half of girls aged 13-17 had received even just one dose of the vaccine against HPV, while only 32 percent had received the recommended three doses, according to the report.

And now, growing research in Europe and the United States is implicating HPV in a rising number of cases of head and neck cancers in men, and many doctors are recommending that all boys be vaccinated as well.

Doctors say that changing sexual behaviors -- earlier sex, more partners and especially oral sex -- are contributing to a new epidemic of orpharyngeal squamous cell cancers, those of the throat, tonsils and base of the tongue.

These cancers can be deadly, and are striking men at a younger age and in increasing numbers.

"There's a lag in information," Dr. John Deeken, a medical oncologist at Georgetown University, told ABC News in a report on HPV-related cancers in 2010. "We physicians have done a poor job of advertising the fact that boys and girls should have the vaccine."

"This kind of cancer traditionally affects males who have been smoking and drinking all their life, and now in their mid-60s they are getting head and neck cancer," he said. "However, HPV cancer we are seeing in younger patients who have never smoked."

Two decades ago, about 20 percent of all oral cancers were HPV-related, but today that number is more than 50 percent, according to studies published by the American Association for Cancer Research.

Similarly high rates have also been seen in Europe, where a 2010 Swedish study showed a strong correlation between oral cancers and oral sex.

The Food and Drug Administration (FDA) approved the use of Gardasil for girls in 2006 and for boys for treatment of genital and anal warts in 2009. The vaccine can be given at any age, though it is most effective when given to young people before any sexual exposure.

Doctors say it could prevent 10,000 more cases of oral cancer a year.

Each year, more than 30,000 new cases of cancer of the oral cavity and pharynx are diagnosed, and more than 8,000 people die from oral cancer, according to the Centers for Disease Control and Prevention (CDC).

Cure rates are higher than for smoking-related throat cancers, but still only 50 percent.

Today, men are more likely to get oral cancer than are women, but as the epidemic grows, that could soon change.

HPV is the most common sexually transmitted infection. Those who are infected often have no symptoms and pass it on to their partners through genital contact during vaginal and anal sex. It can also be transmitted during oral sex and, more rarely, during deep kissing through saliva.

There are more than 100 strains of the virus. Some cause genital warts, but others can result in cell changes that decades later can become cancerous. Each strain is identified by a number; oral and cervical cancers are caused by HPV sub-types 16 and 18.

HPV can also cause cancers of the vulva, vagina and penis, and there is some evidence it is associated with lung cancers.

Copyright 2013 ABC News Radio

Monday
Oct152012

HPV Vaccine Does Not Raise Sexual Activity, Study Finds

Joe Raedle/Getty Images(NEW YORK) -- Adolescent girls who get the human papillomavirus (HPV) vaccine are no more likely to engage in sexual activity than girls who do not get the vaccine, according to a new study that challenges a widely held belief.

HPV is the most common sexually transmitted virus, and some strains of the virus can lead to oral and genital cancers.  The U.S. Centers for Disease Control and Prevention as well as the American Academy of Pediatrics recommend the HPV vaccine for girls and boys as young as age 11.

Previous surveys have found that some parents are concerned their daughter may be more likely to engage in sexual activity if they receive the vaccine.

"Some parents are concerned that saying 'yes' to the HPV vaccine is also encouraging teenagers to say 'yes' to sex," said Dr. Carol Ford, chief of the Craig Dalsimer division of adolescent medicine at the Children's Hospital of Philadelphia.

The new findings, published Monday in the journal Pediatrics, are the first clinical data to study the concern, and found that the HPV vaccine does not lead to increased sexual activity among adolescent girls.

Researchers from Emory University in Atlanta followed electronic data of nearly 1,400 girls aged 11 and 12 between July 2006 and December 2010 to see whether they received at least one dose of the vaccine within the first year and whether they were later counseled about contraception, acquired a sexually transmitted disease or became pregnant.

More than a quarter of girls ages 15 to 17 report being sexually active, according to the CDC.

The study followed the girls to the age range where sexual activity would have been initiated, according to the researchers.

The nearly 500 girls who received at least one dose of the vaccine were no more likely to be diagnosed with a sexually transmitted disease, discuss contraception or become pregnant than the nearly 900 girls who did not get the vaccine, the study found.

"We couldn't directly look at sexual activity, so we looked at external outcomes that would suggest sexual activity," said Dr. Robert Bednarczyk, clinical investigator with the Kaiser Permanente Center for Health Research Southeast, and lead author of the study. The study is based on the assumption that girls who engage in sexual activity would seek care for a sexually transmitted disease, ask for contraception or become pregnant.

According to some experts, the effectiveness and safety of the vaccine are more concerning to many parents than whether their child will see it as a gateway to sexual activity.  Still, the findings are reassuring to a smaller group of parents who may see this it as a reason to be apprehensive.

"Those of us who work with adolescents are happy to use this information in discussing the vaccine with parents," said Dr. Eve Shapiro, a pediatrician in Tucson, Ariz.

In previous surveys, adolescent girls reported that they would not be more likely engage in sexual activity if they got the vaccine.

"We did a clinical validation of the self reported data," said Bednarczyk.  "This is reassuring to physicians and the parents that the concern doesn't need to be there."

Copyright 2012 ABC News Radio

Tuesday
Aug072012

HPV Vaccination: Sooner Is Better, Study Says

Joe Raedle/Getty Images(CINCINNATI) -- Vaccinating teenage girls against the human papillomavirus or HPV may be too little too late, according to a new study that found more than half of girls 13 and older already have the infection.

The three-dose vaccine, proven to slash the risk of HPV infection -- the number one risk factor for cervical cancer -- is recommended for 11- and 12-year-old girls, according to the U.S. Centers for Disease Control and Prevention.  But some doctors delay the shots, thinking pre-teens have a low risk for the sexually transmitted infection.

"It really is important for physicians to offer the vaccine as recommended to girls that are 11 and 12 years old," said Dr. Lea Widdice, assistant professor of adolescent medicine at Cincinnati Children's Hospital Medical Center and lead author of the study, published Tuesday in the Archives of Pediatric and Adolescent Medicine.  "The vaccine is very safe and highly effective, but it works best if we can give it to girls and boys before they're sexually active."

Widdice and colleagues tested 259 young women aged 13 to 21 for HPV during clinic visits for their first vaccine doses.  Among 190 who were sexually active, 70 percent were already infected.

"The vaccine can only prevent the infection," said Widdice, warning that the vaccine cannot cure someone who's already HPV-positive.

Even girls who had sexual contact without intercourse were at risk, with 11 percent testing positive for the virus.

"HPV is different from other sexually transmitted infections in that it appears to be transmitted a lot more easily," said Widdice.  "Although it's most efficiently transmitted through sexual intercourse, it can definitely be transmitted through genital skin-to-skin touching."

The study adds to mounting evidence that early vaccination can curb HPV infection, which beyond cervical cancer is also linked to genital warts and cancers of the vulva, vagina, penis, anus and throat.

"It supports the recommendation that the HPV vaccine be given to girls when they're 11 and 12 years old," said Widdice.

The CDC also recommends the vaccine for boys and men aged 9 through 26.

Copyright 2012 ABC News Radio

Monday
Jul092012

HPV Vaccine Protects Even Those Who Skip It

Joe Raedle/Getty Images(CINCINNATI) -- The vaccine against the human papilloma virus (HPV) is not only effective in decreasing the rate of high risk types of HPV infections in girls and women, but it also shows evidence of bestowing what is known as "herd immunity" -- an indirect protection against the virus for those who have not been vaccinated -- in a community at large, researchers said on Monday.

Researchers at the Cincinnati Children's Hospital Medical Center compared HPV infection rates in women who received the HPV vaccine to infection rates in those who had not.

What they found was that women who received the HPV vaccine cut their likelihood of having an HPV infection by 69 percent.  The surprise was that the likelihood of HPV infection among women in the same community who had not gotten their HPV shots also dropped -- by 49 percent.

"I was surprised at the decrease in the prevalence of HPV and the effectiveness of the vaccine in a real-world setting," said Dr. Jessica Kahn, lead author of the study, which appeared Monday in the journal Pediatrics.

But Kahn said that while the finding was encouraging, it should not deter parents from getting their children vaccinated.

"Although the study shows evidence of early herd immunity, the results cannot be generalized to imply you shouldn't get vaccinated," she said.  Kahn said it is "still very important... there is no way of knowing you are one of those protected unless you actually get the vaccine."

Other experts in infectious diseases agreed that the study demonstrates how important it is to get vaccinated.

"I think it is important to point out to potential vaccine recipients that herd immunity is routinely achieved when greater than 80 percent of the population has been vaccinated," said Robert Rose, professor emeritus of infectious diseases at the University of Rochester in Rochester, N.Y.  "Thus, it is incumbent upon immune-competent individuals to participate in the vaccine effort in order to protect those who are in one way or another immune-compromised."

HPV is responsible for the most common sexually transmitted infections.  There are more than 100 types of HPV, including more than 40 high-risk types of infection that are responsible for causing approximately 70 percent of cervical cancers, genital warts, vaginal and anal cancers and a growing number of head and neck cancers, especially in men.

Since these viruses have the ability to cause such widespread disease, current recommendations from the U.S. Advisory Committee on Immunization Practices include vaccination against HPV for both males and females ages 9 to 26.

Copyright 2012 ABC News Radio

Thursday
Mar292012

HPV Vaccine May Prevent Recurrence of Precancerous Conditions

Joe Raedle/Getty Images(VIENNA, Austria) -- 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 a 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, Fla.

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."

Copyright 2012 ABC News Radio

Friday
Feb032012

CDC Urges HPV Vaccine for Boys

Hemera/Thinkstock(WASHINGTON) -- All 11- and 12-year-old boys should be vaccinated against the human papillomavirus, according to new vaccination guidelines from the U.S. Centers for Disease Control and Prevention.

The guidelines serve as the official recommendation of the conclusions of a CDC advisory panel vote in October that boys should be routinely vaccinated for HPV, which has been recommended since 2006 for girls of the same age with the aim of preventing cervical cancer.

The agency also recommends that 13- to 21-year-old males and 13- to 26-year-old females get the three-dose vaccination, if they have not already been vaccinated. Men ages 22 to 26 “may be vaccinated.”

Experts have noted that increasing evidence shows that the vaccine is highly effective in preventing HPV, leading many to support universal vaccination.

“Girls acquire the infection from boys and it seems appropriate, even fair, for boys to share responsibility for maximizing community [herd] immunity,” Dr. Lawrence Stanberry, chief pediatrician at New York Presbyterian Morgan Stanley Children’s Hospital, told ABC News in October.

Calls for boys and men to get the HPV vaccine increased last week after a report that nearly 7 percent of U.S. teens and adults have oral HPV, a virus which can lead to oral cancer. The report said men were three times more likely to have oral HPV than women.

The vaccines currently available, like Merck’s Gardasil and Glaxo SmithKline’s Cervarix, have only been tested for their effectiveness against the viruses that lead to cervical, vulvar and anal cancers.

The CDC’s latest recommendations also say all persons with Type 1 or 2 diabetes should get the vaccine for hepatitis B. Dr. Sarah Schillie, a CDC scientist, said that advice came about after several outbreaks of hepatitis B in long-term care facilities that began in the 1990s and occurred more frequently in recent years. Schillie said the outbreaks were the result of improper infection control and shared blood glucose monitoring equipment.

The guidelines were published in the Annals of Internal Medicine.

Copyright 2012 ABC News Radio

Thursday
Jan262012

Experts Call for Safer Sex, More Vaccinations to Fight Oral HPV Rates

Hemera/Thinkstock(NEW YORK) -- Oral HPV infections are much higher than expected among American adults, according to a new study of 5,500 people. Experts say the study also paints a picture of changing sexual practices in the U.S. and advances the case for expanding vaccination against the virus among children and young adults.

Nearly seven percent of 14- to 69-year-olds in the U.S. have oral HPV, according to the report published Thurday in the Journal of the American Medical Association. Men were at three times greater risk than women for infection with the virus, particularly from age 30 to 34 and 60 to 64.

About one percent of the population -- nearly two million people -- has HPV-16, a particular strain of the virus that has been linked to oral cancers. The study said that this strain of the virus puts a person at a 50-fold increased risk of developing oral cancer.

The study is the first to give an idea of just how common oral HPV is among Americans. Much more is known about the version of the virus that leads to cervical cancer, which has recently been publicized by the creation of a vaccine against it. But experts say oral HPV is still something of a mystery. Unlike for genital HPV, oral HPV has no approved screening test.

"We know almost nothing about oral HPV infections," said Dr. Maura Gillison, the study's lead author.

But the study gives new insight into the factors that make oral HPV infection more likely. Perhaps not surprisingly, one of those factors is sex. Less than one percent of people who had never had sex had oral HPV in the study, but the risk of infection for those with sexual experience was nearly eight times greater. The risk also edged higher as people reported greater numbers of sexual partners.

Dr. Peter Leone, medical director of the North Carolina HIV/STD Prevention and Control Branch, said these data point to shifts in patterns of sexual practices in the U.S.

"With the era of HIV, we've seen a movement of heterosexuals engaging in more oral sex with the idea that it's safer than vaginal sex. That's probably also why we're seeing increases in these infections," Leone said. "A lot of people don't think of their head and neck as a sex organ, which fuels the idea that we don't have to worry about acquiring an infection there."

Experts say studies show that more people are having oral sex at younger ages than in decades past. The Centers for Disease Control and Prevention reported that 48 percent of heterosexual males and 44 percent of heterosexual females ages 15 to 19 reported having oral sex in a 2008 survey.

Oral sex often does not get the same attention when it comes to protection as other intercourse. Condom sales in the U.S. have increased, but Leone said people most likely use them exclusively for vaginal or anal sex.

Smoking was also an important risk factor for oral HPV in the study, possibly indicating that it leaves the body more vulnerable to infection, particularly in the mouth and throat.

More oral sex with less protection may be one reason why the risk of oral HPV was so heavy for men, though the study didn't provide any official reason for the gender difference in infection. The authors speculated that the virus may have an easier time transmitting orally in men than in women, or that other factors like smoking that are more common among men could facilitate transmission.

Experts say the study provides another strong argument for vaccinating both boys and girls against HPV, a move recommended by the CDC in 2011. By 2008, only about 30 percent of women and even fewer men had gotten the vaccine, which has been approved for both men and women ages 9 to 26.

HPV vaccines like Merck's Gardasil and Glaxo SmithKline's Cervarix have so far only been tested for their effectiveness against the virus that causes cervical, vulvar and anal cancer. The vaccines work against several strains of the virus, including HPV-16, which Gillison noted is responsible for about 90 percent of oral HPV cases, as opposed to about 57 percent of cervical HPV infections.

"We have every reason to be optimistic that it will work against oral HPV, but we don't know directly because it's never been studied," she said.

Dr. Hans Schlecht, an assistant professor of infectious diseases at Drexel University College of Medicine in Philadelphia, said it will probably take at least a decade to know whether the vaccines are effective against oral HPV.

Experts say protection against oral HPV begins by practicing safe oral sex and quitting smoking.

Copyright 2012 ABC News Radio

Tuesday
Oct252011

CDC Panel: All Young Boys Should Get HPV Vaccine

Joe Raedle/Getty Images(WASHINGTON) -- All males starting at age 11 should receive the HPV vaccine Gardasil to protect themselves against sexually transmitted forms of human papillomavirus, the cause of most cervical and anal cancers as well as most mouth and throat cancers, a Center for Disease Control and Prevention (CDC) advisory committee voted Tuesday.

Thirteen members of the committee voted in favor of extending the HPV vaccine to young boys, and one member abstained. The recommendation now goes to the director of the CDC and the secretary of the U.S. Department of Health and Human Services for final approval.

The CDC already recommends routinely immunizing girls with a three-dose vaccine beginning at age 11 or 12, before they become sexually active, although they can be vaccinated as young as age 9. The agency has previously issued a so-called permissive recommendation giving males from ages 9 through 26 the option of receiving the vaccine.

The prospect of requiring that preteen boys and girls get vaccinated against a sexually transmitted infection has drawn the sharpest outcry from some parents, who fear that vaccinating preteens might encourage promiscuous behavior. Vaccination policies also have become an issue in the 2012 presidential campaign, with several GOP candidates objecting to mandates for HPV vaccination.

In a background memo leading up to the vote, the CDC estimated that routinely vaccinating 11 and 12-year-old boys would likely be cost-effective. If 1 million 12-year-old boys were vaccinated, over the course of a lifetime, they would prevent 2,381 cases of mouth and throat cancer; 633 cases of anal cancer and 169 cases of penile cancer, assuming the vaccine was 75 percent effective against those conditions.

Copyright 2011 ABC News Radio

Tuesday
Oct252011

CDC Committee to Vote on HPV Vaccine Recommendation for Boys

iStockphoto/ThinkstockUPDATE: The Advisory Committee on Immunization Practices voted 13-0 on Tuesday to recommend that all boys get the HPV vaccine at ages 11 and 12.

(WASHINGTON) -- The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices’ (ACIP) planned meeting Tuesday morning to decide whether the HPV vaccine should be recommended for all males ages 9 to 26 has created a firestorm among medical experts, most of whom seem to be rooting for the committee to recommend that all boys within the age group get the vaccine.

Still, some are shaking their heads at the lack of evidence to suggest that the vaccine even works for boys.

The HPV vaccines -- commonly known as Cervarix and Gardasil -- are currently recommended for girls ages 9 to 26.  Both vaccines have been shown to prevent cervical cancers, with Gardisil also preventing vaginal, vulva and anal cancers.  Some studies also suggest that the vaccine could protect against penis, head, neck and throat cancers.  Gardasil, shown to also protect against genital warts, is the only vaccine of the two that is approved by the Food and Drug Administration for boys.
 
The strongest data of male HPV prevention is limited to men with compromised immunity and men who have sex with other men.  Some parents may argue that the vaccinating their sons would encourage promiscuous behavior.  But medical experts say that isolating the vaccine to just some segments of the population will only exacerbate that way of thinking.

“Research has shown that parents are more enthusiastic regarding universal recommendations rather than targeting "at risk" groups,” said Dr. Lawrence Stanberry, pediatrician-in-chief at New York Presbyterian Morgan Stanley Children's Hospital.  “Recommending universal immunization for girls and making the recommendation for boys permissive sends parents mixed messages.”

According to William Muraskin, professor in the department of urban studies at Queens College, one of the challenges is identifying who may benefit from the vaccine. 

“The HPV vaccine if given before males become sexually active will also protect those who will become homosexual or bisexual,” said Muraskin.  "Routinely vaccinating the entire cohort of young males protects an important sub-group that otherwise will be at significant risk but cannot be identified until it is too late.”

But some experts say the data showing long-term benefit to both homosexual and heterosexual males is slim.

“It is misguided to think that all boys will gain any health benefit from HPV vaccination,” said Diane Harper, Director, Gynecologic Cancer Prevention Research Group at the University of Missouri.

Harper said the vaccine only provides absolute protection against cervical cancer and, “mass vaccination for the prevention of the other HPV associated cancers puts large numbers of people at risk for harms from vaccination compared to both the personal and public health risk of anal, penile, and oropharyngeal cancers.”

Studies have also only shown a nearly 3-year window of protection, Harper said.

“The benefit of HPV vaccination in preventing these cancers which develop much later in life and require vaccination efficacy to last much longer is not proven,” she said. 

Copyright 2011 ABC News Radio

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Monday
Oct242011

HPV Linked to Heart Disease in Women

Medioimages/Photodisc/Thinkstock(GALVESTON, Texas) -- Women with cancer-causing strains of the human papillomavirus (HPV) may be at increased risk for heart disease, even if they have no risk factors for the disease.

Researchers at the University of Texas Medical Branch at Galveston looked at survey data for nearly 2,500 women, 23 percent of whom had cancer-causing strains of HPV. They found that women with the cancer-causing HPV were more likely to have heart disease than those with non-cancer-related strains or those without HPV.

The researchers say more attention should be paid to identifying potential heart problems in women with HPV. These findings could also suggest that the HPV vaccine could potentially prevent heart disease.

The study, which only looks at these women’s information at one point in time, doesn’t show a cause-and-effect relationship. Researchers also depended on women’s report of their own health, and trusted the women to collect their own HPV samples.

The research was published in the Journal of the American College of Cardiology.

Copyright 2011 ABC News Radio







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