Cervical cancer affects more than half a million women and causes more than a quarter of a million deaths each year globally. Almost all cervical cancers result from a human papillomavirus, or HPV, infection. HPV infections cause cancers in other parts of the body, too. But the latest HPV vaccine could prevent most infections — and millions of cancers — worldwide, according to an article by Cosette Wheeler, PhD, and her collaborators.
The article describing the HPV vaccine and strategies to overcome issues with its use was published online by the American Society of Clinical Oncology. ASCO shared a print of the article with the 30,000 attendees at its Annual Meeting this year. Annual Meeting attendees included top oncologists from around the country and the world. Wheeler is an international HPV expert, a University of New Mexico Regents’ Professor and a member of The University of New Mexico Comprehensive Cancer Center. She and the other authors of the article served as expert panel members for the Primary Prevention of Cervical Cancer: ASCO Resource-Stratified Guideline.
The HPV vaccine could prevent up to 90 percent of HPV-related cancers worldwide, according to the article. The authors report that women in high-income countries or regions are far more likely to survive a cervical cancer diagnosis. But even within high-income countries, those women in lower-income regions get cervical cancer more frequently and fewer of them survive it. And, this disparity applies to other HPV-related cancers in women and men, including other genital cancers, anal cancers, and cancers of the mouth and throat.
The HPV vaccine can prevent HPV infection if the vaccine is given before exposure to any of the HPV types that the vaccine protects against. Different formulas of the HPV vaccine protect against different types of HPV. Only two types, HPV16 and HPV18, cause 70 percent or more of all invasive cervical cancers and all HPV vaccine formulas protect against these two. The nonavalent formula of the HPV vaccine is the most protective: it protects against HPV16, HPV18 and five other cancer-causing HPV types. As of June, 2017, only the nonavalent HPV vaccine is available in the United States.
Experts estimate that the nonavalent HPV vaccine could reduce HPV-related cancers worldwide by 90 percent or more if the entire global population received it. Several studies have shown the vaccine to be efficacious. Studies have also shown its benefits and its harms to be similar to many other vaccines that protect against infections.
Currently, though, global HPV vaccination rates are low. The vaccine must be given in two or three doses. This can prove difficult for teens and preteens who lack easy and affordable access to a clinic and who do not receive regular medical check-ups. The article suggests giving the HPV vaccine with other childhood vaccines as a critical strategy to lessen this burden. The article also cites studies that have shown two doses to be as protective as three doses if vaccination is started at a younger age. The United States Advisory Committee on Immunization Practices now recommends two doses of HPV vaccine for both boys and girls, but only if they receive their first HPV vaccine dose between ages 9 and 14. After a teen’s fifteenth birthday, the Committee still recommends three HPV vaccine doses.
The article strongly recommends reaching out to parents, teachers, medical providers and other community members to encourage HPV vaccination among teens and preteens. Providers’ support of using the HPV vaccine is linked to higher vaccination rates, the article states. The article goes on to say that providers’ strong recommendation for HPV vaccination is therefore key to protecting global populations against HPV-related cancers.
“Cervical and other HPV-related cancers are preventable,” says Wheeler. “We have the unprecedented opportunity to impact the global cancer burden and improve people’s lives and health everywhere.”
Cosette Wheeler, PhD is a UNM Regents Professor in the Departments of Pathology and Obstetrics and Gynecology at the University of New Mexico Health Sciences Center. She holds the Victor and Ruby Hansen Surface Endowed Chair in Translational Medicine and Public Health. Her New Mexico research group has contributed for over 25 years to understanding the molecular epidemiology of human papillomaviruses (HPV) in cervical precancer and cancer among Native American, Hispanic and non-Hispanic women of the southwest and on a global basis. She has overseen a number of large-scale multidisciplinary population-based projects that have ultimately enabled advances in primary (HPV vaccines) and secondary cervical cancer prevention (Pap and HPV tests). Dr. Wheeler has authored over 200 peer-reviewed articles in a number in top tier journals.
“Prevention of HPV-Related Cancers: A Case for Global Equity and Local Action” was published in the June 3, 2017, online edition of ASCO Daily News (am.asco.org/dn). Authors include Cosette M. Wheeler, PhD; Isabel C. Scarinci, PhD, MPH; Silvia de Sanjosé MD, PhD; and Silvina Arrossi PhD.
The Annual Meeting brings together more than 30,000 oncology professionals from around the world to discuss state-of-the-art treatment modalities, new therapies, and ongoing controversies in the field [of oncology]. The 2017 Annual Meeting took place June 2 through 6, 2017, in Chicago, Illinois. Learn more about the American Society of Clinical Oncology at www.asco.org.
The University of New Mexico Comprehensive Cancer Center is the Official Cancer Center of New Mexico and the only National Cancer Institute-designated Cancer Center in a 500-mile radius. Its 125 board-certified oncology specialty physicians include cancer surgeons in every specialty (abdominal, thoracic, bone and soft tissue, neurosurgery, genitourinary, gynecology, and head and neck cancers), adult and pediatric hematologists/medical oncologists, gynecologic oncologists, and radiation oncologists. They, along with more than 500 other cancer healthcare professionals (nurses, pharmacists, nutritionists, navigators, psychologists and social workers), provided cancer care for nearly 60 percent of the adults and children in New Mexico affected by cancer. They treated 11,249 patients in 84,875 ambulatory clinic visits in addition to in-patient hospitalizations at UNM Hospital. These patients came from every county in the State. More than 12 percent of these patients participated in cancer clinical trials testing new cancer treatments and 35 percent of patients participated in other clinical research studies, including tests of novel cancer prevention strategies and cancer genome sequencing. The 130 cancer research scientists affiliated with the UNMCCC were awarded almost $60 million in federal and private grants and contracts for cancer research projects and published 301 high quality publications. Promoting economic development, they filed more than 30 new patents in FY16, and since 2010, have launched 11 new biotechnology start-up companies. Scientists associated with the UNMCCC Cancer Control & Disparities have conducted more than 60 statewide community-based cancer education, prevention, screening, and behavioral intervention studies involving more than 10,000 New Mexicans. Finally, the physicians, scientists and staff have provided education and training experiences to more than 230 high school, undergraduate, graduate, and postdoctoral fellowship students in cancer research and cancer health care delivery. Learn more at www.cancer.unm.edu.
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