April 19th, 2017

We’ve spent a lot of time in this space over the last few years discussing human papillomavirus and its predilection for causing despair, disease, and death. Today, we’ll let Jia Naqvi describe the facts on the ground:

HPV is the most common sexually transmitted disease in the United States. The CDC estimates that nearly 80 million people are infected and that about 14 million new infections occur annually among teenagers and adults. Most of these go away on their own, typically without even causing symptoms, but some HPV strains can lead to genital warts and cancer. Each year, 31,000 men and women are diagnosed with cancers caused by HPV — which, in most cases, would have been preventable with the HPV vaccine, according to the CDC.

 

We also know that the rates of HPV-related cancers — cervical, oral (throat, tonsils, tongue), anal, vaginal, penile — are increasing. In February, we looked at research showing that American men had a high rate of HPV infection:

The study, published last month in JAMA Oncology, estimates that nearly half of American men (45.2%) ages 18-59 have genital infections due to HPV. Moreover, half of this group of infected men (or 25.1% of men in the U.S.) are infected with one of the high-risk strains associated with causing cancer.

 

Last week, the CDC took this data, derived from the National Health and Nutrition Examination Survey (NHANES, the largest and longest-running (1956) source of objective health and nutrition data in the United States), and added that women also have high rates of infection, though somewhat lower than men. Still, about 23% of American adults carry evidence of a virus that can cause cancer. This is a “serious concern,” and Naqvi points out that the HPV vaccine is an effective tool to prevent these sexually transmitted cancers:

The CDC recommends HPV vaccinations for youths ages 11 to 12 so that they are protected before potential exposure to the virus through sexual contact. Vaccination rates have been increasing, but they still lag for boys and girls.

Lingering misconceptions and fears are among the reasons for the lower use of HPV vaccination, said Electra Paskett, a cancer control researcher at Ohio State University’s Comprehensive Cancer Center. Some people still think vaccination encourages youth to become promiscuous. “The way [the vaccine] was introduced in Australia and the United Kingdom was as a cancer vaccine, which is truly what it is. It is a cancer vaccine,” Paskett said.

 

The “some people [who] think vaccination encourages youth to become promiscuous” do not include pediatricians. Christopher Wanjek thinks it’s a silly notion:

Vaccines simply aren’t known to encourage risky behavior. Why should the HPV vaccine be different?

That is, people who get the flu shot are no more inclined to rub their eyeballs into a doorknob than people who don’t get the flu shot. People who get a tetanus shot are no more inclined to purposely puncture themselves with a rusty nail from the boardwalk of Coney Island than those who don’t get a tetanus shot. And so on with every vaccine and every route of exposure.

 

Sociologist Sinikka Elliott also addresses parental reluctance to protect their children with a demonstrably safe and effective vaccine in spite of the dangers of HPV, encouraging parents to talk to their kids about sex:

Parents’ reluctance to vaccinate against HPV mirrors their fears of talking with their children about sex. The most frequent question I hear from parents is: Won’t talking about sex encourage teens to have sex? The simple answer is no. There is absolutely no evidence that talking about sex—including discussing contraception—leads youth to have sex. This is a myth much like the notion that vaccinating youth against a sexually transmitted infection will lead to promiscuity.

… Talking about sex doesn’t lead to sex anymore than vaccinating a child against HPV leads to promiscuity. In fact, teens who have plenty of information about sexuality and have supportive parents tend to make more informed decisions about sex—including deciding to wait. And a number of studies show that youth want to learn about sexuality from their parents—even if they don’t always act like it. So parents start your engines—it’s time to talk!

 

Parents should also be able to explain to their children how human papillomavirus infection is acquired, what the consequences are of those infections on their future health, and how a 2-shot series of vaccines (3-shots after 15 years old) can prevent those consequences. This discussion should occur before the 11-year well-child checkup when the first HPV vaccine will be given along with other vaccines (Tdap and meningitis B). There is no need to delay the start of the HPV vaccine series. Parents who remain hesitant should not hesitate to discuss this honestly with the pediatrician they trust.

 

(Google Images)

 

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  • MEET THE EDITOR

    Ned Ketyer, M.D.

    Ned Ketyer, M.D.

    Dr. Ketyer has special interests in developmental pediatrics and preventative medicine, specifically how nutrition and the environment affect health. He earned his bachelor’s degree from the University of Vermont and his medical degree from Northwestern University Medical School. He completed his residency at Children’s Hospital of Pittsburgh.

    As one of the founding physicians of Pediatric Alliance, PC, Dr. Ketyer served as its president from 1997-2004. He has been practicing general pediatrics at Pediatric Alliance since 1990. Dr. Ketyer and his wife have three boys and live in Pittsburgh's South Hills. 



  • Note: The information included in these posts is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice.

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