Straight Talk About HPV

by Jane Ashley

What is HPV? What is the HPV vaccine? Why should we give it to our pre-teen children? Does HPV cause cancer later in life? 

Protects Against6 Kinds Of Cancer

Let’s sit down and have a straight talk about HPV and the cancers that it causes. Perhaps, then we’ll understand why it’s so important that all of our young adolescent children get their HPV vaccines. These adolescents are our children and our grandchildren, our nieces and nephews – protect them against certain kinds of cancer that occur in adulthood.

What is HPC? HPV is the acronym for human papilloma virus. HPV is a very common virus, with about 100 strains. About 30 of these strains can affect the genitals of both men and women. Fourteen of these strains are classified as “high-risk.” 

HPV is very common throughout the world. Over 79 million people in the U.S. are currently infected with the HPV virus — about 14 million become newly infected every year. HPV doesn’t stay active; about 70 percent of new HPV infections go away within the first year … ninety percent are gone within two years.

How is HPV related to cancer?

Some HPV viruses cause changes in cells when our immune system doesn’t kill an HPV infection. These changes continue to occur in the cells until they begin to grow out of control and become cancer.

It is estimated that 80 percent of all sexually-active adults in the U.S. are infected with the HPV virus at some time in their life. Most never even knew that they had the virus. Both men and women may contract HPV. HPV in men is linked to penile and anal cancer as well as oropharyngeal cancers (head and neck cancer). In women, the HPV virus is the cause of almost all cervical cancer as well as anal, vaginal, vulva and oropharyngeal cancers.

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HPV is transmitted through sexual activity, including intimate skin-to-skin contact. HPV infections seldom cause symptoms so most people don’t know that they had the virus. Genital warts are usually the only visible symptom. The HPV virus is responsible for 3 percent of cancers in women and 2 percent of cancers in men. The Centers for Disease Control estimates that between 35,000 and 41,000 cases of cancer annually in the U.S. are caused by the HPV virus (based on 2010-2014 data, most recent available).

Can HPV-caused cancers be prevented?

Most of the high-risk HPV virus infections can be prevented by a vaccine. The vaccine must be given before a person is infected to be most effective, meaning that adolescents, before they become sexually active, should be vaccinated to prevent these cancers.

Merck introduced the first HPV vaccine, Gardasil®, in 2006. It was effective against four types of HPV virus (6, 11, 16, and 18). In 2014, Gardasil®9 received approval from the FDA — it adds protection against five additional strains of HPV (31, 33, 45, 52, and 58). These nine strains account for most of the HPV-caused cancers. This newer vaccine protects against genital warts too.

Based on the most recent (2010 to 2014) statistics, HPV-caused cancers results in over 16,000 deaths in the U.S. annually.

Oropharyngeal = 7,600
Cervical = 4,250
Vaginal = 1,430
Anal = 1,280
Vulvar = 1,280
Penile = 410

2019 Vaccination Guidelines

The ideal age to achieve the maximum benefits is 11-12 years old. However, recommendations are changing due to a new study. Since 2006, when adolescents first began getting the original Gardasil® vaccinations, HPV infection rates for strains 16 and 18 dropped 83 percent in girls 13 to 18 and 66 percent in women ages 20-24.

Hpv Vaccination Rate Us Map

HPV strains 16 and 18 cause about 70 percent of all cervical, vaginal, vulvar and anal cancers. The newer Gardasil®9 prevents virtually all genital warts and is effective against 90 percent of HPV-related cancers.

The Lancet study also showed a dramatic drop (54%) in HPV infections caused by the 21, 33 and 45 strains in girls 15-19 years old. Genital warts diagnoses fell by 67 percent in girls and 48% in boys the same age. The rate of grade 2 cervical neoplasia (a precancerous condition seen before cervical cancer) dropped 51 percent in younger girls 15-19 and by 31 percent in women 20-24. Because cervical cancer can take up to 20 years to develop, the full impact of the Gardasil®9 vaccine has not been seen.

The HPV vaccine is one of the safest vaccines on the market. Only two shots are required. The CDC current recommendations are:

Both girls and boys, aged 11-12

Women up to 26 years old, who didn’t receive the vaccine as a child
Men up to 21 years old, who didn’t receive the vaccine as a child
Men up to 26 years old, who have a compromised immune system
Adults over 26 – 45 years old, individual shared decision between each patient and their physician, based on which patients would benefit the most.
Over 45 – the current vaccine is not approved for people over 45

HPV Vaccination Rates in the U.S.

Sadly, only about half of the children who are eligible to receive the vaccine are vaccinated in the U.S. Vaccination rates vary by state and between rural and urban areas.

Hpv   The Global Burden

Private insurance and Medicaid cover FDA-recommended vaccinations for patients up to age 26. Yet, why is the vaccination rate only half?
Most parents depend on their child’s doctor to make vaccination recommendations. As children transition to becoming a teenager, there seems to be a “gap” by pediatricians in talking to the parent about HPV vaccinations for their pre-teen. Primary care physicians may be reluctant to talk about “sex” and a vaccine that prevents a sexually-transmitted disease.

Some parents are reluctant to have their children vaccinated for fear that it will promote them to become sexually active sooner. There isn’t any evidence to confirm that fear. It is far safer to be proactive and have our children vaccinated before they turn 13 to ensure that the vaccine is the most effective. The risk of HPV-caused cancers is far too great to risk our child’s life and future by not vaccinating them with the HPV vaccine.

The Bottom Line …

We’ve always wanted a vaccine against cancer. Now we have one – it prevents six kinds of cancer. We, as WhatNexters, know that cancer turns our life upside down and impacts our future. What can we do?

Have the conversation with people who have adolescent children — open the dialogue to help parents understand that the risk of developing cancer from the HPV virus is real. Not vaccinating puts their children at risk for a lifetime. Cervical cancer may cause infertility and prevent a daughter from having children. Some HPV cancers like anal and oropharyngeal don’t occur until later in life — 40 or more years after a parent would have decided not to vaccinate their child.

Over 16,000 people in the U.S. die annually of HPV-caused cancer. We need to start the conversation today and prevent the suffering of tomorrow.

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