A Growing Epidemic of HPV-Related Cancers

Last week the Centers for Disease Control and Prevention (CDC) reported a frightening rise between 2008 and 2012 in cancers triggered by the human papillomavirus (HPV)--a sexually transmitted virus. During this time period, an average of 23,000 women and 15,800 men received a diagnosis each year of a cancer associated with HPV. These cancers include cancer of the cervix, vulva, vagina, penis, anus, rectum, and oro-pharyngeal areas (tongue, palate, tonsils). This represents an increase of 17% in HPV-associated cancers during this 4-year time period. Cervical cancer rates actually decreased slightly, but oropharyngeal and anal cancers are becoming more and more common.

Sadly, at least 73% of these cancers could have been prevented if boys and girls had been vaccinated against HPV. The best age for vaccination is 11-12, before most children have any kind of sexual contact, but the vaccine can help young people up to age 26. The vaccine may also help prevent HPV-associated cancers even in men or women who are infected with HIV.

It has not been easy to get the American public to accept HPV vaccination. There have been the usual false claims that it causes horrible medical problems, but even more than that, parents see it as a vaccine to prevent a sexually-transmitted infection. THEIR precious darling is going to save her- or himself for marriage, so no need to "encourage promiscuity" by vaccinating a child. The success of giving teens information and responsibility rather than encouraging sexual abstinence can easily be seen if you compare unintended teen pregnancy rates in Norway or the Netherlands, where sex education is routinely performed, and our own United States. The HPV vaccines are given in 3 doses over several months. Even having 1 or 2 doses gives some protection, though 3 is best. Currently about 60% of girls in the United States have had at least 1 dose, along with 42% of boys. Only 40% of girls and 22% of boys have had all 3 doses.

HPV is everywhere. One study estimated that 80% of female college students have an HPV infection within the first year after becoming sexually active. Even condoms are not 100% protection against infection with HPV. Luckily, most infections clear up quickly as the immune system fights them. It is the persistent HPV infections, with one of 7 subtypes of the virus that are known as "high risk" that leads gradually to cancer, over a period of years. The vaccines now cover 9 HPV types, including a couple that cause genital warts rather than cancer. 

Experts recommend explaining to parents that HPV vaccination prevents cancer, rather than "selling" it as preventing a sexually-transmitted virus. When my own son was about to go away to college, I easily persuaded him to get the three doses, explaining it could save him from genital warts and several types of cancer. At that time, each dose had over a $100 co-pay, another barrier for most families. In fact, the person who objected to the vaccination was our internist, who believed that the cost of the vaccine was not justified in terms of lives saved. However, he was focusing only on cancer of the cervix. HPV vaccination is a pretty good value, as preventive medical treatments go. I encourage every parent to consider HPV vaccination for your kids. What an easy way to prevent the misery of cancer diagnosis and treatment (including sexual dysfunction and infertility)!

This educational material is intended for informational purposes only and is not intended to replace, or substitute for, professional advice, counseling, diagnosis, or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a condition. Never disregard professional advice or delay in seeking treatment because of something you have read in this educational material.

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