We have the tool at hand to potentially prevent 600,000 cases of cancer a year, says the head of the University of Wisconsin Carbone Cancer Center, in a policy statement published today urging a renewed effort to increase rates of vaccination against the human papillomavirus (HPV).
Dr. Howard Bailey recently chaired the American Society of Clinical Oncology’s (ASCO) cancer prevention committee, and is the lead author of a policy statement published this week in the Journal of Clinical Oncology.
“We are obligated to promote underused interventions that have the potential to save millions of lives through cancer prevention,” Bailey writes, in today’s statement. “Vaccinations against cancer-causing infections are such an intervention.”
Viruses cause about 1 million cases per year of cancer worldwide, and the HPV virus is responsible for about 600,000 of those cases. HPV causes cervical cancer, which kills about 266,000 women each year, most of them in the developing world. In the United States, HPV is also responsible for 60 percent of oral and neck cancers, 91 percent of anal cancers, 69 percent of vulvar cancers and 63 percent of penile cancers.
Despite the cancer-fighting power of the HPV vaccine, the United States has very low rates of vaccination. Only 36 percent of girls and 14 percent of boys ages 11 to 13 have had all three doses of the vaccine.
“The narrative regarding the HPV vaccine has been different from those for most adolescent vaccines. Rather than focusing on the life-threatening illness prevented, the focus has been on the behavior associated with infection (sexual activity),” Bailey writes. “This has led to misplaced parental attitudes toward, and understanding of, the vaccine. Studies have shown that parents do not understand the importance of the HPV vaccine or its impact on cancer prevention.”
The ASCO group chaired by Bailey hopes to increase HPV vaccination rates to the goal of 80 percent set by the Centers for Disease Control and Prevention. To do this, they propose:
– Better education of health care providers and the public about the cancer-prevention goals of the vaccine.
– Better clinical management, including using electronic medical records for reminders and followups; culturally relevant outreach to under-vaccinated groups; and bundling HPV with other vaccinations recommended for adolescents.
– Better access to low-cost vaccines, including lower out-of-pocket costs and delivery systems that could include school-based vaccinations.
– More research on HPV vaccine effectiveness and safety, including research on best practices to increase vaccination rates.
– More advocacy from oncologists in explaining the importance of HPV vaccination to their patients and the public.
“Although most oncologists will not be direct providers of these preventive measures, this does not abrogate us from contributing to this process. Our unassailable role in the mission to lessen the burden of cancer for our patients, their families, and our communities places us in a position of influence,” Bailey writes.
“We should use interactions with our patients, primary care colleagues, and health care systems to raise awareness of HPV-related cancers and the role of vaccination in preventing them.”