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Old 07-04-2013, 06:50 PM
gdpawel gdpawel is offline
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Default Oral HPV in Men

Smokers and single men are more likely to acquire cancer-causing oral human papillomavirus (HPV), according to new results from the HPV Infection in Men (HIM) Study. Researchers from Moffitt Cancer Center, the National Cancer Institute, Mexico and Brazil also report that newly acquired oral HPV infections in healthy men are rare and when present, usually resolve within one year.

The study results appeared in the July 2013 issue of The Lancet.

HPV infection is known to cause virtually all cervical cancers, most anal cancers and some genital cancers. It has recently been established as a cause of the majority of oropharyngeal cancers, a malignancy of the tonsils and base of tongue.

HPV-related oropharyngeal cancer is rare, but rates have been increasing rapidly, especially among men. To determine the pattern of HPV acquisition and persistence in the oral region, researchers evaluated the HPV infection status in oral mouthwash samples collected as part of the HIM Study, which was originally designed to evaluate the natural history of genital HPV infections in healthy men.

Some types of HPV, such as HPV16, are known to cause cancer at multiple places in the body, including the oral cavity, said study lead author Christine M. Pierce Campbell, Ph.D., M.P.H., a postdoctoral fellow in Moffitt' Center for Infection Research in Cancer. 'We know that HPV infection is associated with oropharyngeal cancer, but we don't know how the virus progresses from initial infection to cancer in the oral cavity. One aspect of the HIM Study is to gather data to help us understand the natural history of these infections.'

During the first 12 months, nearly 4.5 percent of men in the study acquired an oral HPV infection. Less than 1 percent of men in the study had an HPV16 infection, the most commonly acquired type, and less than 2 percent had a cancer-causing type of oral HPV.

Their findings are consistent with previous studies showing a low prevalence of oral HPV cancers. However, this study shows the acquisition of cancer-causing oral HPV appeared greater among smokers and unmarried men.

'Additional HPV natural history studies are needed to better inform the development of infection-related prevention efforts,' said Anna R. Giuliano, Ph.D., director of Moffitt's Center for Infection Research in Cancer.'HPV16 is associated with the rapid increase in incidence of oropharyngeal cancer, most noticeably in the United States, Sweden and Australia, where it is responsible for more than 50 percent of cases. Unfortunately, there are no proven methods to prevent or detect these cancers at an early stage.'

The researchers note that persistent oral HPV16 infection may be a precursor to oropharyngeal cancer, similar to how persistent cervical HPV infection leads to cervical pre-cancer.
Gregory D. Pawelski
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Old 07-30-2013, 12:29 PM
gdpawel gdpawel is offline
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Default Throat cancer from oral sex. Really?

Herman Kattlove, M.D.

It turns out that about one-third or perhaps more of throat cancers (specifically called oropharyngeal – referring to the back of the mouth and the throat) are associated with an infection called human papilloma virus or HPV. HPV is a common sexually transmitted (by the standard way) infection that affects most women at some time in their lives and is the major, maybe only, cause of cervical cancer. That is why we have developed vaccines for this virus to give to girls before they become sexually active. If every young woman were vaccinated before becoming sexually active, there would be almost no more cervical cancer. This virus is likely the main cause of cancer of the vulva and vagina as well as the anus.

So who would have thought that is would affect the oral cavity? One major proof of this is a recent article in the Journal of Clinical Oncology (July 20). Here is how the study went. Many years ago, European researchers collected blood from over 300,000 people to test in the future when these people developed a disease such as cancer to see if there was something already abnormal in these people. When they looked at people who developed throat cancer years later, it turns out that in one-third, their blood had antibodies to HPV, evidence that they had been infected with HPV. In people who didn’t have the cancer, less than one in one-hundred showed evidence of the infection. So it is clear that there is a link between this cancer and infection with HPV.

Is this the only cause? No! Smoking and alcohol abuse are other causes. But it seems that if you get the oral cancer because of HPV infection you have a much higher chance of being cured than if you got the cancer because you smoked and drank. Another bit of good news is that if boys get vaccinated against HPV (something now being recommended even though the vaccine was developed for women to prevent cervical cancer) they will likely not get oral cancer. The National Cancer Institute estimates that about 10,000 of these HPV oral cancers are diagnosed each year. So we can add this to the list of cancers that can be prevented by vaccination.
Gregory D. Pawelski
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Old 05-25-2017, 12:50 PM
gdpawel gdpawel is offline
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Default Vaccination Tied to Substantial Reduction in Oral HPV

Larry M. Weisenthal, M.D., PhD.

A press release from the MD Anderson Cancer Institute published a very important paper. It shows that HPV vaccination works in boys -- possibly even better than in girls. Vaccinated individuals have an 88% reduction in the overall prevalence of oral HPV infection. There was a ZERO percent infection rate in vaccinated boys.

The fly in the ointment is how comparatively few individuals in the study had been vaccinated.

There is currently an explosion of oral cancers (tonsil, base of tongue, soft palate, larynx, etc), attributable to oral HPV infection (thought to be the result of changing sexual activities). This is a really horrible problem with which to deal -- best case scenario is typically radiation and chemotherapy, leaving the individual with the permanent inability to salivate and worst case scenario is loss of about 1/4 of the face and neck and subsequent death.

Risk can be greatly reduced with vaccination. Abstinence? Sure, but abstinence education has been documented to be markedly ineffective. HPV vaccination is a gift to the child; one of the best insurance policies available.


ASCO: Vaccination Tied to Substantial Reduction in Oral HPV
May 19, 2017

"Data from 2,627 Americans, aged 18 to 33, were analyzed to assess the effect of self-reported receipt of at least one dose of an HPV vaccine on oral HPV infection (vaccine types 16/18/6/11) prevalence."

"The researchers found that the population-weighted prevalence of oral HPV16/18/6/11 infections was significantly lower in vaccinated versus unvaccinated individuals (0.11 versus 1.61 percent; P = 0.008), which corresponded to an estimated 88.2 percent reduction in prevalence. For 33 non-vaccine HPV types, prevalence rates were similar (3.98 versus 4.74 percent; P = 0.24)."

“When we compared the prevalence in vaccinated men to non-vaccinated men, we didn’t detect any infections in vaccinated men. The data suggest that the vaccine may be reducing the prevalence of those infections by as high as 100 percent,” study author Maura Gillison, M.D., Ph.D., a professor of thoracic/head and neck medical oncology at the University of Texas MD Anderson Cancer Center in Houston, said in a center news release. “But, unfortunately, because of low uptake of the vaccine, the burden of infection had only been reduced by 17 percent overall, and only 7 percent in men.”

ASCO Perspective

“The HPV vaccine has the potential to be one of the most significant cancer prevention tools ever developed, and it’s already reducing the world’s burden of cervical cancers,” said ASCO President-Elect Bruce E. Johnson, MD, FASCO. “The hope is that vaccination will also curb rising rates of HPV-related oral and genital cancers, which are hard to treat. This study confirms that the HPV vaccine can prevent oral HPV infections, but we know it only works if it’s used.”

ALEXANDRIA, Va. – In one of the first large studies to explore the possible impact of HPV vaccination on oral HPV infections, researchers found it may confer a high degree of protection. The study of young adults in the United States showed that the prevalence of high-risk HPV infection was 88% lower among those who reported getting at least one vaccine dose than among those who were not vaccinated.

Researchers reported that HPV vaccination rates remain low, especially among males, which limits population-level benefits of the vaccine in the U.S. The study will be presented at the upcoming 2017 ASCO Annual Meeting in Chicago.

“Rates of HPV-caused oral cancers continue to rise every year in the U.S., particularly among men. And yet, no clinical trial has evaluated the potential use of the HPV vaccine for the prevention of oral HPV infections that could lead to cancer,” said senior study author Maura L. Gillison, MD, PhD, who conducted the research at Ohio State University but is now a professor of medicine at the University of Texas MD Anderson Cancer Center. “Given the absence of gold-standard, clinical trial data, we investigated whether HPV vaccine has had an impact on oral HPV infections among young adults in America,” said Dr. Gillison.

About the Study

The authors based their study of oral HPV infections by assessing data from part of the National Health and Nutrition Examination Survey (NHANES) of Americans from 2009 through 2016. The NHANES is designed to assess the health and wellness of the U.S. population.

In this analysis, the researchers focused on 2,627 young adults ages 18 through 33 during the period 2011-2014, comparing those who had received one or more doses of an HPV vaccine to those who had not. For the purposes of this study, the researchers evaluated the prevalence of the four HPV types (16, 18, 6 and 11) included in HPV vaccines prior to 2016 (the time at which a newer vaccine that protects against five additional HPV strains was introduced). HPV infection was detected from oral rinse samples that were collected by mobile health facilities supported by NHANES. The laboratory tests for HPV infection were developed and performed in Dr. Gillison’s lab.

Key Findings

Vaccination Rates: The researchers found that from 2011 through 2014 fewer than 1 in 5 (18.3%) young adults in the U.S. reported receiving at least one dose of the HPV vaccine before age 26. The vaccination rate was much lower among men than women (6.9% vs. 29.2%) at this time.

HPV Prevalence:

Prevalence of oral HPV infections covered by the vaccine was lower among vaccinated vs. unvaccinated young adults, 0.11% vs. 1.61% – corresponding to an 88% reduction in prevalence for vaccinated youth.

In contrast, the prevalence of oral infection with 33 HPV types not covered by the vaccine was about the same between vaccinated and non-vaccinated groups (4% for those vaccinated vs. 4.7% for the unvaccinated; difference not statistically significant).

U.S. Population-Level Impact of HPV Vaccination: Due to low uptake of the HPV vaccine in the U.S. thus far as reported by NHANES, the researchers estimate that the impact of HPV vaccination on the prevalence of vaccine-covered, oral HPV infections in the general population was modest, reducing prevalence by 17% overall; and by 25% in women and by about 7% in men between 2011 and 2014.

“While we were encouraged that there was a notable impact of the vaccine on oral HPV infections among vaccinated individuals, that benefit was modest overall and lower than we would hope in men due to low vaccine uptake,” stated Dr. Gillison.

Next Steps

Dr. Gillison emphasized that HPV vaccination is currently indicated for the prevention of cervical, vulvar, vaginal, and anal cancers in women and anal cancers in men. Whether the vaccines could eventually reduce the rising incidence of oral cancers related to oral HPV infection is thus far unknown.

“The HPV vaccine is one of the most important advances in cancer prevention in the last several decades. Parents who choose to have their children vaccinated against HPV should realize that the vaccine may provide additional benefits, such as prevention of oral HPV infections linked to oral cancers,” she concluded.

This study received funding from The National Institute of Dental and Craniofacial Research, of the National Institutes of Health.

Full Abstract: [url]
Gregory D. Pawelski
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