Preventable HPV-Related Cancers Rising in the U.S.

Preventable HPV-Related Cancers Rising in the U.S.
By getting this HPV vaccine, this young woman in Brazil will be protected from six different cancers. Photo courtesy American Health Organization.

With all the advances in medical care, too many people are still dying of preventable causes. It seems that cancers related to HPV are rising in the United States, even though many of these cancers would be preventable with vaccination.

The report comes from Laura J. Viens, MD and other researchers at the United States Centers for Disease Control and Prevention (CDC). The organization published their findings in the Morbidity and Mortality Weekly Report on July 7th.

For their report, the authors looked at the total number of cancers that can be caused by the human papillomavirus (HPV), such as cervical, vaginal, vulvar, penile, anal, rectal, and oropharyngeal, which is throat, tongue, and tonsil. Although these types of cancer can have other causes besides HPV, the researchers calculated the percentage of these cancers that are usually caused by HPV, which other researchers have determined is 79 percent. This gave the scientists an estimate of the number of cancers caused by HPV in the U.S.

When they crunched the numbers, the researchers saw that between the years 2008 and 2012, 11.7 of every 100,000 people had a cancer that was likely caused by HPV. This was up from the years 2004 to 2008, when 10.8 of every 100,000 people in the U.S. had an HPV-related cancer. In 2004 to 2008, an average of 33,369 HPV-related cancers were diagnosed each year, but from 2008 to 2012, this rose to 38,793 cases a year.

For 2008 to 2012, the most common HPV-related cancers were cervical carcinoma, with an average of 11,771 cases per year, and oropharyngeal squamous cell carcinoma, with an average of 15,738 cases per year. These throat cancers were more common in men than women, with an average of 12,638 cases each year.

The researchers also discovered disparities in cervical cancer diagnosis geographically, with Vermont having the lowest rates and West Virginia the highest. Those who are hispanic or black were also more likely to have cervical cancer than those who are white. These statistics are likely caused by the higher prevalence of HPV vaccination in certain populations versus others.

When researchers collect information on cancer diagnoses and deaths, they usually specify the type of cancer. However, they do not usually include information such as the presence of HPV in the cancer cells. By gathering data related specifically to HPV-associated cancers, the researchers are helping to show how many of these deaths may be preventable.

HPV comes in different types, some of which are covered by vaccines that can help prevent infection. Types 16 and 18, for example, cause about 63 percent of the HPV-related cancers in the U.S., and a vaccine is available to help prevent these infections. HPV types 31, 33, 45, 52, and 58 cause an additional 10 percent of the HPV-related cancers, and a vaccine is available to help prevent infection by these HPV types as well. Of 30,700 new cancers related to HPV in 2008-2012, about 92 percent were related to HPV types that have a vaccine available. This means that 28,244 cancer cases could have been prevented with a simple preventative vaccination.

The study authors point out that so far vaccination programs in high-income countries seem to be effective, reducing the percentage of certain HPV types in the population and reducing cases of genital warts. Some regions have mandated HPV vaccination for preteen girls, and many have also added boys. Sometimes this is covered by government programs, making the vaccinations free for parents.

The idea is that if doctors can vaccinate young girls and boys for HPV before they become sexually active, the young people will make antibodies now and be protected from infection once they do have sex. This can reduce their chances of the infection causing genital, anal, and throat cancers. However, the vaccination programs are controversial because of their association with sexual activity. Some parents do not like the idea of their child becoming sexually active, and may not want to acknowledge this by allowing them to get a vaccine related to sexually-transmitted disease. However, the authors point out that with one simple vaccine, parents can help prevent their children from getting six different types of cancer. There are few types of cancer that are this preventable this easily. The authors suggest that by talking about the HPV vaccine as more of a cancer prevention vaccine than an STD prevention vaccine, they could possibly get more parents and community members on board with promoting the HPV vaccine.

The HPV virus has more than a hundred different types. About half of all people who have ever had sex will get an HPV infection, usually not causing any symptoms, but some will get genital warts or cancer. Because HPV can affect mucous membranes but also other areas of skin, using a condom may not protect against the spread of the virus, and it can spread through genital, anal, or oral sex. People can help protect themselves from an HPV infection by reducing their number of sexual partners and choosing partners who have had fewer sexual partners themselves. Girls and boys as young as 9 and women up to the age of 26 can get the Gardasil, Gardasil-9, or Cervarix vaccine to help protect them against an HPV infection.

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