Oncologists Are Leading the Effort for Universal HPV Vaccination

By John Henry Dreyfuss, MDalert.com staff.

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  • HPV is thought to be responsible for more than 90% of anal and cervical cancers, 70% of vaginal, vulvar, and oropharyngeal cancers, and 60% of penile cancers.
  • The vaccine against human papillomavirus (HPV) is considered to be nearly universally effective when properly administered.
  • Pediatricians and primary care physicians have been unable to succeed in providing widespread vaccination in preteens and adolescents.
  • Studies show that physician assertion of efficacy is the most effective means of convincing parents to inoculate young patients.

Primary care physicians and pediatricians getting a push from prominent oncologists. There is concern among cancer specialists that physicians are failing to vaccinate enough children and adolescents against the human papilloma virus (HPV; Figure 1), according to an article published recently in The Washington Post .

Figure 1. Electron micrograph of a negatively stained human papilloma virus.
(Source: Laboratory of Tumor Virus Biology - NIH-Visuals Online# AV-8610-3067.)

Despite the fact that there is near universal acceptance of the efficacy of the available HPV vaccines, just 33.6% of girls and 41.7% of boys had received ≥1 HPV vaccine dose as of 2014, according to the most recently available data from the Centers for Disease Control and Prevention (CDC) (Figure 2). The single biggest barrier to wider inoculation appears to be the fact that pediatricians and family doctors are not recommending the vaccine strongly enough, The Post reports.

HPV infections have been found to cause >90% of anal and cervical cancers, 70% of vaginal, vulvar, and oropharyngeal cancers, and 60% of penile cancers. Vaccination against HPV has been shown to be nearly 100% highly protective against HPV infection in both boys and girls at the target ages of 11 and 12 years.

 

Figure 2. Estimated vaccination coverage in the U.S. with ≥1 dose of human papillomavirus vaccine among females aged 13-17 years during 2014.
* HPV vaccine, either quadrivalent or bivalent.
† Includes females (N = 10,084) born during the period January 1996–February 2002.

(Source: CDC.)

 

“The oncologists’ goal is to rebrand the vaccine to focus on cancer prevention. They are determined to dismantle what researchers say is the No. 1 obstacle to wider inoculation: pediatricians and family doctors who aren’t strongly recommending the vaccine,” . Laurie McGinley wrote in The Post.

“Studies show that a forceful endorsement from a physician is the most important factor in whether children get the vaccine, which is recommended for ages 11 and 12. Yet a frustrating level of ‘provider hesitancy’ persists,” Ms. McGinley added.

Oncologists from The University of Texas MD Anderson Cancer Center in Houston appear to be leading the effort convince pediatricians and family physicians to urge parents have their inoculated children. One physician in particular, Lois Ramondetta, MD, Associate Professor and Director of Gynecologic Oncology at MD Anderson, in particular is reaching out to front-line physicians, The Post reports.

“If you are not recommending the vaccine, you are not doing your job,” Dr. Ramondetta told physicians. “It’s the equivalent of having patients in their 50s and not recommending a colonoscopy—and then having them come back with cancer.”

“If they didn’t increase HPV vaccination of their young patients, those youths would face a greater risk of developing deadly cancers as adults. Boys would be especially vulnerable to throat cancers, a growing scourge of middle-aged men,” according to The Post.

A study published in Sexually Transmitted Diseases  in 2014 estimated that 28,000 cases of cervical cancer could be prevented in the U.S. if HPV vaccination rates were improved from 50% to 80%. (Figure 3.)

Figure: The figure above consists of two U.S. maps showing incidence and death rates for cervical cancer by state in 2011.* The overall U.S. incidence in 2011 was 7.5 per 100,000 women (12,109 new cases), ranging from 4.5 in New Hampshire to 13.7 in the District of Columbia.

(Sources: Cancer incidence combines cancer registry data from the National Program of Cancer Registries and the Surveillance, Epidemiology, and End Results Program that met USCS publication criteria for 2011, covering 99.1% of the U.S. population. Additional information available at: http://www.cdc.gov/uscs. Mortality data are provided by the National Vital Statistics System, covering 100% of the U.S. population.)
*Per 100,000 population, age-adjusted to the 2000 US standard population (19 age groups).

 

 


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