Cervical Cancer

WHO: One-dose HPV vaccine offers protection against cervical cancer

Holly Lutmer PharmD

While several sexually transmitted diseases (STDs) lack preventive vaccines, such as herpes, HIV, and chlamydia, cervical cancer is a disease that can be prevented with an effective vaccine.

Furthermore, real-world data indicates only one dose is needed to protect certain women from this cancer.

Announced on April 20, 2023, a new study funded by the Bill and Melinda Gates Foundation and in collaboration with the Massachusetts General Hospital (MGH) and the Republic of Kenyan Ministry of Health confirmed a single dose of a Human Papillomavirus (HPV) vaccine was highly efficacious in preventing persistent infections of the virus over three years.

This randomized, multicenter, double-blind, controlled clinical trial included 2,275 women between the ages of 15-20, who were randomly assigned to receive either a single dose of the bivalent or nonavalent HPV vaccine or the control vaccine.

Over the 36-month study period, participants were regularly tested for HPV DNA, with cervical and vaginal swabs routinely collected. The results showed that the single dose of both the bivalent and nonavalent HPV vaccines was highly efficacious, with a vaccine efficacy of 98%.

Additionally, the nonavalent vaccine had a vaccine efficacy of 96% for the nine types of HPV it targets.

"This study provides important evidence that a single dose of HPV vaccine can be highly effective in preventing persistent infections and, ultimately, cervical cancer," commented Lead Investigator Dr. Ruanne Barnabas of the MGH in a press release on April 20, 2023.

"A single-dose vaccination schedule could go a long way in addressing this deadly inequity."

Since December 2022, eight countries have announced switching to a one-dose HPV schedule following updated guidance from the World Health Organization (WHO).

The WHO's Strategic Advisory Group of Experts on Immunization evaluated the evidence and supported a single-dose schedule for certain women.

In 2023, SAGE recommends updating dose schedules for HPV as follows:

One or two-dose schedule for the primary target of girls aged 9-14,
One or two-dose schedule for young women aged 15-20,
Two doses with a 6-month interval for women older than 21.

In the U.S., the recommended HPV vaccination schedule differs from the WHO.

Furthermore, these STDs lack U.S. FDA-approved vaccines as of April 21, 2023: Chlamydia, Epstein-Barr Virus, Gonorrhea, Herpes, HIV, and Syphilis.

However, there are approved vaccines targeting Mpox and Hepatitis diseases.

Sub Title:

Herpes, HIV, syphilis vaccine candidates are conducting clinical trials in 2023

References:

Kenya: Single-Dose HPV Vaccine Highly Efficacious over three years

U.S. CDC HPV vaccination scheduled 2023

STD vaccines April 2023

Image:

Age Groups:

Young Adults

Google News Keywords:

HPV, vaccinations

Featured:

Fact checked:

Sunday, April 23, 2023 - 20:45

Image Caption:

by Çiğdem Onur

Sooner the Better With HPV Vaccination

Karen McClorey Hackett — Tue, 08 Nov 2022 17:20:56 +0000

Reviewer:

HPV vaccination initiation after the routine-recommended ages of 11–12 in the U.S.

Holly Lutmer PharmD

Although the importance of cervical cancer prevention is well known, many human papillomavirus (HPV) vaccinations actually occur later than recommended.

Further, as young women continue to age, the forecastable health benefits of HPV vaccines diminish quickly.

Using data from the National Health and Nutrition Examination Survey to estimate the proportion of females who were vaccinated against HPV-16/18 prevalence before their sexual debut, researchers found vaccination by age 12 is estimated to prevent most lifetime cervical cancers caused by HPV-16/18.

But this significant benefit decreases by about 25% as the vaccination age increases to 16 years.

To ensure maximum effectiveness from vaccination, pediatricians may stress the importance of timely HPV vaccination, wrote these researchers.

This Research Letter was published by The JAMA Network on October 21, 2022, among the 4,727 female individuals (mean 17.9 yrs) ever eligible for vaccination, cervical HPV-16/18 prevalence decreased from 6% (95% CI, 4%-7%) in the unvaccinated group to 3% (95% CI, 1%-6%) in the post-sexual activity debut group and less than 1% (95% CI, <1%-1%) in the pre-debut group.

HPV-16/18 prevalence was 89% (P < .001) lower in the pre-debut group but only 41% (P = .29) lower in the post-debut group compared with the unvaccinated group.

Compared with post-debut vaccination, pre-debut vaccination was associated with an 82% (P = .08) reduction in HPV-16/18 prevalence.

Differences by race and ethnicity were negligible, as the proportions of vaccinated Asian and White participants were slightly higher than those of Black and Hispanic participants (57% and 58% vs. 54% and 52%; P = .22).

Similar proportions of participants were vaccinated before their sexual debut (32%-35%).

A study limitation is that NHANES 2011 to 2018 data may be subject to recall bias. And further studies are needed to check whether these vaccination patterns persist in the 2020s.

The Study's Corresponding Author: Didem Egemen, Ph.D., Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (didem.egemen2@gmail.com). No industry conflicts of interest were disclosed.

There are effective HPV vaccines endorsed by the U.S. CDC, World Health Organization, and European Medicines Agency that protect males and females against cancers caused by HPV.

In the U.S., HPV vaccination is recommended beginning at age 11; however, vaccination can be started at age 9, says the CDC.

HPV vaccines, such as Gardasil 9®, are generally offered by most clinics and pharmacies in the U.S.

As with any vaccination, having an informed discussion with a healthcare provider is very beneficial.

Additional HPV vaccine research is posted at PrecisionVaccinations.com/HPV.

PrecisionVaccinations publishes fact-checked, research-based vaccine news manually curated for mobile readers.

Sub Title:

HPV vaccines can prevent cervical cancer

References:

JAMA - HPV Vaccination Effectiveness by Age

CDC - HPV Vaccination Recommendations

Image:

Age Groups:

11 12 years

Google News Keywords:

HPV, vaccinations, cervical cancer

Featured:

Fact checked:

Thursday, November 10, 2022 - 23:15

Image Caption:

by Abhishek Kandel

Cervical Cancer Becoming Rare in the UK

Don Hackett — Thu, 04 Nov 2021 17:59:39 +0000

Reviewer:

The effects of the national HPV vaccination programme in England, UK, on cervical cancer and grade 3 cervical intraepithelial

After decades of research, the United Kingdom (UK) launched a human papillomavirus (HPV) vaccine program for teenage girls in 2008.

A new study published by The Lancet on November 3, 2021, shows the HPV vaccine dramatically reduces cervical cancer rates by almost 90% in women in their 20s who were offered the vaccine beginning at age 12.

These researchers estimated that the HPV vaccination program prevented around 450 cervical cancers and about 17,200 cases of precancerous conditions over an 11 year period. The research team looked at all cervical cancers diagnosed in England in women aged 20 to 64 between January 2006 and June 2019.

The HPV vaccine is most effective when given between the ages of 11 and 13 when someone is less likely to have been exposed to HPV.

“It’s a historic moment to see the first study showing that the HPV vaccine has and will continue to protect thousands of women from developing cervical cancer,” stated Michelle Mitchell, Cancer Research UK’s chief executive, in a related press statement.

“Cancer Research UK has been funding research in this area for many years, and we’ve been eagerly awaiting these results since the introduction of the vaccination program.”

“Around 850 women die from cervical cancer each year in the UK, so we have the chance to save many lives.”

Almost all cervical cancers are caused by HPV – a link proved more than 20 years ago by Cancer Research UK scientists, overturning previous studies that had underestimated the link.

The HPV vaccine protects against the main cancer-causing strains of the virus: HPV 16 and 18. Protecting people against the infection helps to prevent abnormal changes in cervical cells, leading to fewer cases of cervical cancer.

But as the vaccine was only introduced in the 2000s, it hasn’t been possible until recently to say the vaccine reduces cases of cervical cancer itself – the ultimate goal of the vaccination program.

This study, based at King’s College London and the UK Health Security Agency (UKHSA), and the National Cancer Registration and Analysis Service (NCRAS), is the first of its kind to focus on the UK vaccination program.

And the first-ever to analyze the effectiveness of the bivalent cervical cancer vaccine (Ceravix).

The vaccine reduced cervical cancer incidence by 34% in those who received it aged 16 to 18, by 62% if aged 14 to 16, and by 90% in those who were vaccinated aged 12 to 13.

Professor Peter Sasieni, the lead author from King’s College London, says: “It’s been incredible to see the impact of HPV vaccination, and now we can prove it prevented hundreds of women from developing cancer in England.”

“We’ve known for many years that HPV vaccination is very effective in preventing particular strains of the virus, but to see the real-life impact of the vaccine has been truly rewarding.”

“Assuming most people continue to get the HPV vaccine and go for screening, cervical cancer will become a rare disease.”

“These data show that vaccination works in preventing some cancers.”

The HPV virus is also linked to vaginal, vulval, anal, penile, and some head and neck cancers.

Dr. Vanessa Saliba, a Consultant Epidemiologist for UKHSA, said: “These remarkable findings confirm that the HPV vaccine saves lives by dramatically reducing cervical cancer rates among women.”

“This reminds us that vaccines are one of the most important tools we have to help us live longer, healthier lives.”

There are different types of HPV vaccines authorized globally.

PrecisionVaccinations publishes fact-check-research-based vaccine news.

Sub Title:

HPV vaccination reduced cervical cancer rates in the UK

References:

“The power of science”: HPV vaccine proven to dramatically reduce cervical cancer

HPV Vaccines

Image:

Age Groups:

Google News Keywords:

health, vaccines, vaccinations, hpv vaccines, hpv, hpv cancers, cervical cancer, uk women, uk and cancer

Featured:

Fact checked:

Friday, November 5, 2021 - 05:45

HPV Vaccination After 26 Years of Age Found Less Cost-Effective

Don Hackett — Tue, 23 Mar 2021 14:59:30 +0000

Reviewer:

Human papillomavirus vaccination for adults aged 30 to 45 years in the United States: A cost-effectiveness analysis

The journal PLOS published a cost-effectiveness analysis that evaluated extending human papillomavirus (HPV) vaccinations to ages 30, 35, 40, or 45.

This peer-reviewed study found HPV vaccination of women and men aged 30 to 45 years provides limited health benefits at the population level, at a substantial cost.

The HPV vaccine price was the primary cost.

This study found that HPV vaccination to older ages was inefficient or associated with unfavorable Incremental Cost-Effectiveness Ratio (CER) in the USA.

Furthermore, the sensitivity analysis revealed that assumptions about cervical screening compliance, vaccine costs, and the natural history of noncervical HPV-related cancers could significantly impact the vaccination strategies’ estimated cost-effectiveness.

However, even with the most extreme assumptions, both models almost universally found that the cost-effectiveness of HPV vaccination for adults aged 30 to 45 years was more significant than $200,000 per quality-adjusted life-year (QALY).

The only exception was in the scenario assuming imperfect screening compliance. One model found that vaccinating up to ages 40 and possibly 45 years could be cost-effective if assuming an upper-bound willingness-to-pay threshold of $200,000 per QALY.

These international researchers stated, ‘cervical screening is a very effective mechanism for secondary prevention, with the absolute effectiveness increasing, particularly in women over the age of 25 to 30 years.’

‘In general terms, the impact of secondary prevention of cervical cancer is critical to incorporate, and the CISNET models were able to achieve this in great detail.’

Moreover, this analysis has several limitations. Where possible, the researchers erred in the direction of making assumptions that were favorable to increasing the age of vaccination, including assuming no delay between the reduction in HPV infections from vaccination and the reduction in genital warts.

There are approximately 100 types of HPV that have been identified, at least 40 of which can infect the genital area, says the U.S. CDC.

The Gardasil 9 vaccine produced by Merck consists of HPV proteins, Types 6, 11, 16, 18, 31, 33, 45, 52, and 58.

HPV infections can lead to certain cancers. Many females with cervical cancer were probably exposed to cancer-causing HPV types in their teens and early 20s. Unlike some other cancers, cervical cancer is not thought to be passed down through family genes.

Additionally, males can get HPV, causing anal and throat cancers and genital warts say the CDC. Most HPV infections are self-limited and are asymptomatic or unrecognized. Most sexually active persons become infected with HPV at least once in their lifetime.

Although the HPV vaccine holds promise to nearly eliminating cervical cancer with complete population coverage, U.S. vaccination rates remain far below those in other high-income countries.

A Research Brief published by the American Academy of Pediatrics in February 2021 reported the proportion of up-to-date adolescents has improved over time.

However, in 2017–2018, 7.3 million vaccine-eligible US adolescents were unvaccinated.

Notably, despite a provider recommendation, the parents of 60.6% of unvaccinated adolescents had no intention to initiate the HPV vaccine series.

This new study was conducted to directly inform the Advisory Committee on Immunization Practices’ deliberations to guide HPV vaccination policy for women and men in the United States.

These researchers received grant support from the U.S. National Cancer Institute at the National Institutes of Health (grant number U01CA199334). The funders had no role in study design, data collection, analysis, decision to publish, or preparation of the manuscript. All other authors declare no conflicts.

PrecisionVaccinations publishes research-based vaccine news.

Note: updated with additional citation.

Sub Title:

Gardasil 9 vaccine consists of HPV proteins 6, 11, 16, 18, 31, 33, 45, 52, and 58

References:

HPV Vaccine Recommendations and Parental Intent

Gardasil 9 HPV Vaccine

Image:

Age Groups:

22 26 years

27 49 years

Google News Keywords:

health, vaccines, vaccinations, hpv vaccine, gardasil 9 vaccine, how old to get the vaccine, hpv cancers, cervical cancer

GoodRx Vaccine:

Featured:

Fact checked:

Monday, March 29, 2021 - 13:30

Advanced Cervical Cancer Monotherapy Study Stopped Early for Positive Results

Don Hackett — Mon, 15 Mar 2021 17:42:03 +0000

Reviewer:

PHASE 3 TRIAL OF LIBTAYO® (CEMIPLIMAB) MONOTHERAPY IN ADVANCED CERVICAL CANCER STOPPED EARLY FOR POSITIVE RESULT ON OVERALL SURV

Regeneron Pharmaceuticals, Inc. and Sanofi today announced positive results demonstrating an overall survival benefit from the Phase 3 trial investigating the PD-1 inhibitor Libtayo® (cemiplimab) monotherapy compared to chemotherapy in patients previously treated with chemotherapy whose cervical cancer is recurrent or metastatic.

The trial will be stopped early based on a unanimous recommendation by the Independent Data Monitoring Committee, and the data will form the basis of regulatory submissions in 2021.

This is the largest Phase 3 randomized clinical trial in advanced cervical cancer, and included women (median age: 51 years) with either squamous cell carcinoma or adenocarcinoma. Patients were randomized to receive Libtayo monotherapy (350 mg every 3 weeks) or an investigator's choice of commonly used chemotherapy.

"Libtayo monotherapy is the first medicine to demonstrate an improvement in overall survival in women with recurrent or metastatic cervical cancer following progression on platinum-based chemotherapy in a Phase 3 trial," said Krishnansu S. Tewari, M.D., Professor and Director of the Division of Gynecologic Oncology at the University of California, Irvine and a trial investigator, in a press statement.

"This landmark clinical achievement will bring hope to women with advanced cervical cancer who are often younger than patients with other cancers. This is reflected in this trial where the average age was 51."

This announcement follows the recent U.S. approval of Libtayo monotherapy for certain patients with advanced non-small-cell lung cancer whose tumors have high PD-L1 expression.

The FDA also recently authorized the use of Libtayo as the first immunotherapy indicated for patients with basal cell carcinoma previously treated with a hedgehog pathway inhibitor (HHI) or for whom an HHI is not appropriate, whose cancer is either locally-advanced (full approval) or metastatic (accelerated approval).

In 2018, Libtayo was approved as the first systemic treatment for certain patients with advanced cutaneous squamous cell carcinoma.

"We are committed to developing therapies for cancers with high unmet needs including patients with advanced cervical cancer," added Peter C. Adamson, M.D., Global Development Head, Oncology and Pediatric Innovation at Sanofi.

"Combined with data from our non-melanoma skin cancer and lung cancer studies, these data contribute to the growing evidence demonstrating the significant potential of Libtayo to treat a spectrum of difficult-to-treat cancers."

Cervical cancer is the fourth leading cause of cancer death in women worldwide and is most frequently diagnosed in women between the ages of 35 and 44.

Almost all cases are caused by human papillomavirus infection, with approximately 80% classified as squamous cell carcinoma (arising from cells lining the bottom of the cervix) and the remainder largely adenocarcinomas (arising from glandular cells in the upper cervix).

Cervical cancer is often curable when detected early and effectively managed, but treatment options are more limited in advanced stages.

Tarrytown, NY-based Regeneron is a leading biotechnology company that invents life-transforming medicines for people with serious diseases.

With more than 100,000 people in 100 countries, Sanofi is transforming scientific innovation into healthcare solutions around the globe.

Vax-Before-Cancer publishes research-based oncology news.

Sub Title:

Regeneron Libtayo is the first immunotherapy to demonstrate improved overall survival in patients with cervical cancer

Reference:

Image:

Google News Keywords:

health, vaccines, vaccinations, cervical cancer, cancer vaccine, cancer treatments, hpv vaccines,

GoodRx Vaccine:

Featured:

Cervical Cancer Prevention Investments Produce Significant ROI

Don Hackett — Tue, 17 Nov 2020 14:18:16 +0000

Reviewer:

WHO: A cervical cancer-free future: First-ever global commitment to eliminate a cancer

The World Health Organization (WHO) Global Strategy to Accelerate the Elimination of Cervical Cancer announced today marks the first time that 194 countries commit to eliminating cancer - following the adoption of a resolution at the World Health Assembly in 2020.

Cervical cancer is a preventable disease that is also curable if detected early and adequately treated. Yet it is the 4th most common cancer among women globally.

This WHO cervical cancer strategy outlines three key steps: vaccination, screening, and treatment.

Vaccination against human papillomavirus (HPV) is recommended to prevent new HPV infections and HPV-associated diseases, including cervical cancer.

On November 17, 2020, the WHO stated the ‘successful implementation of these actions could reduce more than 40 percent of new cases of cervical cancer and 5 million related fatalities over the next three decades.

The WHO strategy also stresses that investing in the interventions to meet these targets can generate substantial economic and societal returns.

An estimated US $ 3.20 will be returned to the economy for every dollar invested through 2050 and beyond, owing to increases in women’s workforce participation. The figure rises to US $ 26.00 when the benefits of women’s improved health on families, communities, and societies are considered.

The WHO says meeting the following targets by 2030 will place all countries on the path toward elimination:

90% of girls fully vaccinated with the HPV vaccine by 15 years of age
70% of women screened using a high-performance test by age 35 and again by 45
90% of women identified with cervical disease receive treatment (90% of women with pre-cancer treated and 90% of women with invasive cancer managed).

“Eliminating any cancer would have once seemed an impossible dream, but we now have the cost-effective, evidence-based tools to make that dream a reality,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus, in a press release.

“But we can only eliminate cervical cancer as a public health problem if we match the power of the tools we have with unrelenting determination to scale up their use globally.”

Without taking additional action, the annual number of new cases of cervical cancer is expected to increase from 570,000 to 700,000 between 2018 and 2030, while the annual number of fatalities is projected to rise from 311,000 to 400,000.

In low- and middle-income countries, its incidence is nearly twice as high and its death rates three times as high as those in high-income countries.

“The huge burden of mortality related to cervical cancer is a consequence of decades of neglect by the global health community. However, the script can be rewritten,” added WHO Assistant Director-General Dr. Princess Nothemba (Nono) Simelela.

Many females with cervical cancer were probably exposed to cancer-causing HPV types in their teens and early 20s. Additionally, males can get HPV, causing anal and throat cancers, and genital warts say the WHO.

“Critical developments include the availability of prophylactic vaccines; low-cost approaches to screening and treating cervical cancer precursors; and novel approaches to surgical training. Through a shared global commitment to the Sustainable Development Goals and leaving no-one behind, the countries of the world are forging a new path to ending cervical cancer. “

“The fight against cervical cancer is also a fight for women’s rights: the unnecessary suffering caused by this preventable disease reflects the injustices that uniquely affect women’s health around the world,” says Dr. Princess Simelela.

“Together, we can make history to ensure a cervical cancer-free future.”

There are safe and effective HPV vaccines that can protect males and females against cancers caused by HPV. These vaccines include 9vHPV, 4vHPV, and/or 2vHPV, says the US Centers for Disease Control and Prevention (CDC).

In the USA, the Gardasil 9 vaccine consists of HPV proteins, Types 6, 11, 16, 18, 31, 33, 45, 52, and 58.

PrecisionVaccinations publishes research-based news.

Sub Title:

WHO Global Strategy to Accelerate the Elimination of Cervical Cancer focuses on vaccination, screening, and treatment

References:

Image:

Age Groups:

Google News Keywords:

health, vaccines, vaccinations, cancer vaccines, gardasil, cervical cancer, cancer prevention

GoodRx Vaccine:

Featured:

Immune Therapy Shows Promise in Advanced Cervical Cancer Studies

Don Hackett — Mon, 12 Oct 2020 19:11:34 +0000

Reviewer:

Preliminary Results of Two Large Immune Therapy Studies Show Promise in Advanced Cervical Cancer

Preliminary results from phase II clinical trials investigating a new programmed cell death protein 1 (PD-1) based immune therapy for metastatic cervical cancer suggest potential new treatment options for a disease that currently has limited effective options and disproportionately impacts younger women.

These studies announced on October 5, 2020, tested an immune-based agent called balstilimab given alone or in combination, with a second monoclonal antibody drug called zalifrelimab.

Each study involved more than 150 patients with recurrent or metastatic cervical cancer from cancer treatment centers across the USA and Europe. All patients were previously treated with platinum-based chemotherapy as a first-line therapy.

Balstilimab is part of a class of drugs called checkpoint inhibitors. These drugs target the PD-1 protein within cancer cells and act as an “on” switch to help the immune system recognize and destroy cancer cells that would otherwise go undetected.

Zalifrelimab is a drug that delivers engineered molecules (monoclonal antibodies) that allow for an improved immune response to attack cancer cells.

For the first study, 160 patients were treated with single-agent balstilimab, resulting in a 14 percent response rate in all treated patients and a 19 percent response rate in PD-L1 positive patients.

For the second study, 155 patients were treated with balstilimab given in combination with zalifrelimab, resulting in a 22 percent response rate in all patients and a 27 percent response rate in PD-L1 positive patients.

David O’Malley, MD, of The Ohio State University Comprehensive Cancer Center (OSUCCC) and Richard J. Solove Research Institute presented the preliminary study results at the European Society for Medical Oncology Virtual Congress 2020.

“These two studies represent the largest trials of immuno-oncology therapies in relapsed cervical cancer to date and show that balstilimab and zalifrelimab may present meaningful new therapies for patients with cervical cancer,” Dr. O’Malley stated in a press release.

“Advances in these agents offer renewed hope for patients who have limited treatment options. This is especially important because this disease disproportionately affects younger women.”

O’Malley is a gynecologic oncologist at the OSUCCC – James, and professor at The Ohio State University College of Medicine. O’Malley is a compensated consultant for Agenus, sponsor of the studies.

To learn more about gynecologic research and patient care visit OSUCCC.

The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute strives to create a cancer-free world by integrating scientific research with excellence in education and patient-centered care, a strategy that leads to better methods of prevention, detection, and treatment.

Vax-Before-Cancer publishes research-based oncology news.

Sub Title:

Balstilimab and zalifrelimab may present meaningful new therapies for patients with cervical cancer

References:

ESMO Congress 2020

Vax Before Cancer

Image:

Google News Keywords:

health, vaccines, vaccinations, cancer, cervical cancer, new treatment for cervical cancer

GoodRx Vaccine:

Featured:

HPV Vaccination Substantially Protects Women From Cancer

Don Hackett — Thu, 01 Oct 2020 18:21:07 +0000

Reviewer:

HPV Vaccination and the Risk of Invasive Cervical Cancer

According to a new study from Sweden, women between the ages of 10 to 30 years old, substantially reduced their risk of invasive cervical cancer following quadrivalent human papillomavirus (HPV) vaccination.

The efficacy and effectiveness of the quadrivalent HPV vaccine in preventing high-grade cervical lesions reached 88 percent for the younger women who participated in this extensive study.

Published in the NEJM on October 1, 2020, this study evaluated 1,672,983 women for cervical cancer until their 31st birthday. Cervical cancer was diagnosed in 19 women who had received the quadrivalent HPV vaccine and in 538 women who had not received the vaccine.

The cumulative incidence of cervical cancer was 47 cases per 100,000 persons among women who had been vaccinated and 94 cases per 100,000 persons among those who had not been vaccinated.

After adjustment for age at follow-up, the incidence rate ratio for the comparison of the vaccinated population with the unvaccinated population was 0.51 (95% confidence interval [CI], 0.32 to 0.82).

And after additional adjustment for other covariates, the incidence rate ratio was 0.37 (95% CI, 0.21 to 0.57).

Furthermore, after adjustment for all covariates, the incidence rate ratio was 0.12 (95% CI, 0.00 to 0.34) among women who had been vaccinated before the age of 17 years and 0.47 (95% CI, 0.27 to 0.75) among women who had been vaccinated at the age of 17 to 30 years.

"Our results also support the recommendation to administer quadrivalent HPV vaccine before exposure to HPV infection to achieve the most substantial benefit, since vaccination has no therapeutic effect against preexisting HPV infection,” stated the study authors.

"Unvaccinated persons would indirectly benefit from HPV vaccination if vaccination coverage of girls and women in a population exceeds 50%," they added. "A herd effect of HPV vaccination against genital warts has been observed previously in the Swedish population."

Recently, the American Cancer Society (ACS) updated its guideline for HPV vaccination on July 8, 2020. The ACS’s new recommendations are for healthcare providers to routinely offer the HPV vaccine series to boys and girls between ages 9 and 12.

Vax-Before-Cancer publishes research-based cancer news.

Sub Title:

Young women benefit from HPV vaccination

References:

Substantially reduced incidence of genital warts in women and men six years after HPV vaccine availability in Sweden

Image:

Age Groups:

Google News Keywords:

health, vaccines, vaccinations, hpv vaccine, cancer vaccines, hpv cancers, swedish girls and cancer

GoodRx Vaccine:

Featured:

New Cancer Screening Guideline Calls For Less and More Simplification

Don Hackett — Fri, 31 Jul 2020 13:52:22 +0000

Reviewer:

American Cancer Society Updates Guideline for Cervical Cancer Screening

An updated cervical cancer screening guideline from the American Cancer Society reflects the rapidly changing landscape of cervical cancer prevention in the USA.

Published on July 30, 2020, the new guideline calls for less and more simplified screening.

And, recommends that women initiate cervical cancer screening at age 25 and that primary human papillomavirus (HPV) testing (HPV testing without the Pap test) every 5 years be the preferred method of testing through age 65.

The guideline says using HPV testing in combination with a Pap test (called co-testing) every 5 years or Pap tests alone every 3 years are acceptable options for now, as not all labs have transitioned to primary HPV testing.

The previous ACS guideline, released in 2012, called for screening starting at age 21. Since then, HPV vaccination rates have improved in the USA.

“These streamlined recommendations can improve compliance and reduce potential harms,” said Debbie Saslow Ph.D., managing director, HPV & GYN Cancers for the American Cancer Society, in a press statement.

“They are made possible by some important developments that have allowed us to transform our approach to cervical cancer screening, primarily a new understanding of the role of HPV and the development of tools to address it.”

HPV is the cause of nearly all cervical cancers.

Evidence shows the HPV test is more accurate than the Pap test and can be done less often; one HPV test every five years is more effective than a Pap test every three years, and even every year as was recommended in the 1980s and 1990s, in reducing the risk of cervical cancer.

A negative HPV test is linked to a very low cervical cancer risk. In addition, a vaccine for HPV has been in use for nearly 15 years, and more women of screening age are now vaccinated and protected from the majority of cervical cancers.

Data suggest HPV vaccination has led to a drop in rates of precancerous cervical changes, the precursors to cancer. In addition, cervical cancer incidence is low in this age group.

Cancer registry data from 2011 to 2015 indicates an estimated 108 cases of invasive cervical cancer in women 20 to 24 years in the U.S. each year. There are also potential harms related to the treatment of precancerous cells identified by screening including preterm birth; and screening has not been shown to lower the rate of cancer in women in this age group.

Also, most HPV infections in women in this age group become undetectable in 1-2 years. Those factors led the ACS to move the recommended age to initiate cervical cancer screening to 25.

“We estimate that compared with the currently recommended strategy of cytology (Pap testing) alone beginning at age 21 and switching to co-testing at age 30 years, starting with primary HPV testing at age 25 prevented 13% more cervical cancers and 7% more cervical cancer deaths,” said Dr. Saslow.

“Our model showed we could do that with a 9% increase in follow-up procedures, but with 45% fewer tests required overall.”

American Cancer Society screening guidelines are created by the Guideline Development Group (GDG), with 11 clinicians and population health care professionals, and a patient advocate appointed by the ACS Board of Directors to create all of its cancer screening guidelines.

To avoid professional conflicts of interest, the GDG considers content specific input and the opinions of expert clinical specialists but is responsible for supervising the review of the evidence and transforming the evidence into writing the guidelines.

Vax-Before-Cancer publishes HPV testing news.

Sub Title:

HPV vaccination has led to a drop in rates of precancerous cervical changes

References:

Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society

Image:

Google News Keywords:

health, vaccines, vaccinations, cervical screeening, cancer, cervical cancer, hpv cancers, gardasil 9, cancer vaccines, hpv vaccines

GoodRx Vaccine:

Featured:

Prostate Cancer’s Casual Relationship With HPV

Don Hackett — Sat, 18 Jul 2020 15:05:46 +0000

Reviewer:

Evidence for a causal role by human papillomaviruses in prostate cancer – a systematic review

A group of sexually transmitted viruses known to cause cervical cancers in women may also have a causal role in prostate cancer, according to a literature review.

This study found ‘it is “highly likely” that high-risk Human papillomaviruses (HPVs) have causal roles in prostate cancer.

Therefore, these authors suggest that the evidence for a causal role of HPVs in prostate cancer is sufficiently sound to encourage universal vaccination against HPV infections.

Published on July 14, 2020, by James Lawson and Wendy Glenn, at the University of New South Wales, Australia, this review of 26 previous studies on HPVs and their links to prostate cancer, reported the high-risk (hr) HPV types 16 and 18, which cause the majority of cervical cancers, have been identified in normal, benign and malignant prostate tissues.

In several case-control studies, the prevalence of hr-HPV DNA, which indicates the presence of cancer-causing types, was significantly higher in prostate cancers compared to normal and benign prostate controls.

More specifically, recent studies found that 231 of 1071 prostate cancers (21.6%) were HPV positive, whereas only 74 of 1103 benign prostate controls (6.7%) were HPV positive.

James Lawson stated in a press statement, "Although HPVs are only one of many pathogens that have been identified in prostate cancer, they are the only infectious pathogen we can vaccinate against, which makes it important to assess the evidence of a possible causal role of HPVs in prostate cancer.”

Additionally, Wendy Glenn said: "Across several studies conducted in a wide range of countries and using different methods to identify HPVs, we found reasonably consistent evidence that high-risk HPVs are significantly more prevalent in prostate cancers than in normal prostate tissues and benign prostate tissues.”

“Previous studies have also shown that high-risk HPVs were present in benign prostate tissues that up to ten years later developed HPV positive prostate cancer of the same HPV type."

The authors also found that in countries where mortality from cervical cancer was high, mortality from prostate cancer was also high.

Whereas in countries where mortality from cervical cancer was low, mortality from prostate cancer was also low.

Lawson added: "As high-risk HPV infections are associated with the majority of cervical cancers and the most frequent means of HPV transmission is probably by sexual activity, the data may indicate that HPV infection may be transmitted during sexual activity and play a causal role in prostate cancer, as well as cervical cancer."

James Lawson said: "Many people assume that HPV infections mainly lead to cancers in women. This is not the case. HPVs are a common cause of cancers in men. These are mainly genital cancers of the anus and penis but also include cancers of the mouth, tongue, and throat.”

“It is therefore plausible that HPVs may also play a role in prostate cancer and that HPV vaccination may help prevent prostate cancer development."

The authors caution that the exact mechanisms for how HPV infection may lead to prostate cancer formation are not clear and studies exposing normal prostate cells to HPVs are needed to investigate these mechanisms.

The evidence reviewed by the authors suggests that possible mechanisms may include an indirect role of HPVs in cancer formation by inhibiting the protective function of specific enzymes against virus infections.

HPVs may also collaborate with other pathogens in prostate oncogenesis or play a role in inflammation of the prostate, which may lead to benign prostate enlargement and later prostate cancer.

There are effective HPV vaccines approved around the world that can protect males and females against diseases, including cancers caused by HPV.

These vaccines include 9vHPV, 4vHPV, and/or 2vHPV, says the US Centers for Disease Control and Prevention.

Prostate cancer news published by Vax-Before-Cancer.

Sub Title:

HPV vaccination may reduce prostate cancer rates

References:

Potential causal role of human papilloma viruses (HPVs) in prostate cancers

Image:

Google News Keywords:

health, vaccines, vaccinations, hpv cancers, gardasil 9, prostate cancers, cervical cancer, cancer vaccine

GoodRx Vaccine:

Featured:

Facebook’s Vaccine Fake-News Focuses on HPV

Don Hackett — Thu, 16 Jul 2020 00:09:02 +0000

Reviewer:

From bad to worse: The representation of the HPV vaccine Facebook

A new survey focused on Facebook posts about human papillomavirus (HPV) vaccines were mostly negative with a frequent focus on barriers to vaccination.

Published on July 8, 2020, these researchers announced they studied more than 6,500 public HPV vaccine-related posts on Facebook over the first 10 years.

Despite the HPV vaccine's reported benefits of preventing multiple cancers and genital warts, Monique Luisi Ph.D., an assistant professor in the Missouri School of Journalism, said in a related press statement, ‘45 percent of the (Facebook) posts she identified displayed a negative tone toward people getting the vaccine.’

The study found barriers to HPV vaccination appeared more often (47.1%) than benefits (19.8%).

As an example, the post with the most engagement (11,000 reactions, 6,100 comments, and 329,000 shares displayed) was anti-HPV vaccine.

In addition, over the course of a decade, Luisi identified a negative trend occurring on Facebook toward how people perceive the vaccine -- including its safety, and whether its use leads to the encouragement of sexual behavior.

The data published on June 15, 2020, showed evidence for forward momentum (Durbin-Watson values) of HPV infection susceptibility (0.004), HPV infection severity (0.426), HPV vaccine benefits (0.297), and barriers to HPV vaccination (0.226) messages, tone (0.690), and the number of reactions (1.589), comments (1.389), and shares (1.340).

"The representation of the HPV vaccine has not only worsened, but negative posts toward the HPV vaccine have received more public engagement, and evidence shows that these negative posts have generated momentum for other related negative posts," Luisi said.

"It would be one thing if we only saw just the negative information out there.”

“But there's also negative momentum carried by these posts, and if negative posts are encouraging more people to post other negative content, then we can predict how the conversation is going to go and that people are also being influenced by the messages they see."

Luisi said her next step for this research will be to study the implications this content has on parents and guardians as decision-makers. She said it's important for people to recognize the power of sharing content on social media.

"People talk about a lot of things on social media," she said.

"While someone might not be directly involved in a conversation on a particular topic, they still might see that conversation while scrolling through their social media.”

“Therefore, I think it's important to think about intent when sharing content. Even the simple act of sharing -- intentional or unintentional -- can influence others."

The study, "From bad to worse: The representation of the HPV vaccine Facebook," was published in Vaccine, a journal that publishes content related to the field of vaccinology from various disciplines. Dr. Luisi did not disclose any industry conflicts of interest.

In the USA, there are safe and effective HPV vaccines that can protect males and females against diseases, including cancers, caused by HPV, says the Centers for Disease Control and Prevention (CDC).

HPV is transmitted through intimate skin-to-skin contact. People get HPV by having sex with someone who has the virus.

The HPV vaccine often prescribed is Gardasil 9 consists of HPV proteins, Types 6, 11, 16, 18, 31, 33, 45, 52, and 58.

Vax-Before-Cancer publishes HPV vaccination news.

Sub Title:

HPV vaccine posts on Facebook often display a negative tone towards people getting the HPV vaccine

References:

Monique Luisi Ph.D.

Study: 'Anti-vaxxers' gain traction against HPV vaccine on Facebook

Image:

Google News Keywords:

health, vaccines, vaccinations, hpv vaccine, hpv cancer, cancer vaccine, gardasil 9, facebook and hpv vaccine

GoodRx Vaccine:

Featured:

Cervical Cancer Co-Testing is Best

Don Hackett — Wed, 08 Jul 2020 15:52:38 +0000

Reviewer:

HPV Test Misses Twice as Many Women Who Develop Cervical Cancer as Cotesting, Quest Diagnostics Health Trends™ Study Finds

A study from researchers provides new evidence that Human Papillomavirus (HPV) screening test is significantly less likely to detect cervical cancer and precancer than co-testing, a method that combines HPV and the Papanicolaou test (Pap) by liquid-based cytology testing using the same specimen.

The Health Trends™ study published on July 8, 2020, is significant because it is the largest to date to assess the performance of guideline-recommended cervical cancer screening methods in a diverse population of American women in real-world care settings.

Produced by Quest Diagnostics and the University of Pittsburgh Medical Center (UPMC), the study reveals stark differences in the performance of the various recommended methods in detecting cancer and precancers in women, who are 30 years of age and older.

HPV testing identifies the genetic material of the HPV, which can cause cervical cancer, while Pap identifies cellular changes on the cervix that may be or become cancer.

Published online today in the American Journal of Clinical Pathology, the peer-reviewed study assesses sensitivity rates of HPV alone, Pap alone, and co-testing (HPV and Pap testing together) in detecting cancer and precancer of the cervix in nearly 19 million de-identified co-test results performed by Quest Diagnostics on behalf of 13.6 million women in the United States from 2010 to 2018.

Of these cases, 1,259 were diagnosed with cervical cancer, which is 2x the number of diagnosed cancer cases as the next largest study.

"This Health Trends analysis should put to rest any notion that HPV alone achieves the same bar for quality cancer screening," said R. Marshall Austin, M.D., Ph.D., Emeritus Professor of Pathology, UPMC, in an edited press statement.

The United States Preventive Services Task Force (USPSTF) recommends screening in women 30-65 years of age every three years with Pap, every 5-years with co-testing or every five years with primary HPV testing.

Among this study’s key findings:

HPV and Pap testing alone fails to detect twice as many women who develop cervical cancer as co-testing.
Of 1,615 co-tests taken at any time prior to a cancer diagnosis, 86.9 percent were positive by co-testing, a non-detection rate (also known as false negative) of about 13.1 percent.
By comparison, Pap and HPV testing alone had non-detection rates nearly twice as high: Pap at 26.4 percent and HPV at 28.4 percent.
Co-testing detected significantly more women who developed biopsy-confirmed adenocarcinomas, a typically aggressive form of cervical cancer, identifying 82.3 percent of this cancer compared to only 61.2 percent by HPV and 59.7 percent by Pap.

According to a report published in January 2020 by the American Cancer Society, cervical cancer is the second leading cause of cancer death nationally in women 20-39 years of age, causing 10 premature deaths per week in this age group.

"While widespread screening has helped cut cervical cancer mortality by three fourths in the past 80 years, this disease is still far too common," said co-author Harvey W. Kaufman, M.D., Senior Medical Director and Director, Health Trends Research Program, Quest Diagnostics.

"Because most cervical cancers develop in the absence of regular screening, ensuring women have access to the most reliable screening method, co-testing, when they are screened is an essential step in lowering mortality from this disease."

The new findings confirm previous Quest Diagnostics research published in Cancer Cytopathology in 2015, a journal of the American Cancer Society, which found HPV-only cervical screening would not have detected approximately 19 percent of 526 women who developed confirmed cervical cancer.

An analysis of data from Magee-Women's Hospital (MWH) of the University of Pittsburgh Medical Center (UPMC) reported a higher percentage of positive Pap than HPV tests among 109 co-testing results within 12 months from cancer diagnosis, similar to the present Quest Diagnostics Health Trends study.

By comparison, analysis of a regional dataset from Kaiser Permanente Northern California (KPNC) also found that co-testing outperformed other methods, but the authors of that study concluded that "the contribution of cytology to screening is shown to be very small."

The KPNC data were also limited in its ability to identify cytological abnormalities associated with confirmed adenocarcinomas, aggressive cancer, as compared to the Quest and MWH data.

"It is important to reconcile the similar conclusions of Quest Diagnostics and Magee-Women's Hospital with the different findings of Kaiser Permanente in Northern California," said Lee H. Hilborne, MD, Professor of Pathology and Laboratory Medicine at UCLA, Senior Medical Director, Quest Diagnostics.

"KPNC has an exemplary care model, but this very strength may limit the usefulness of KPNC data for drawing conclusions about the real-world care experience of most American women who receive care in less integrated practice settings."

"For women who may otherwise not be screened at all, there is no question that cytology or HPV primary are useful screening technologies," said Damian P. Alagia, III, MD, Senior Medical Director of Woman's Health for Quest Diagnostics.

"Yet, that should not obscure the fact that co-testing is fundamentally the better screening option for women and is widely available in the U.S."

Quest Diagnostics Health Trends™ is a series of scientific reports that provide insights into health topics.

Vax-Before-Cancer publishes HPV testing news.

Sub Title:

University of Pittsburgh Medical Center and Quest study reveals differences detecting cancer and precancers in women

Reference:

Image:

Google News Keywords:

health, vaccines, vaccinations, cancer tests, hpv and cervical cancer, pap tests,

GoodRx Vaccine:

Featured:

El Paso Shares Strategies to Increase HPV Vaccinations

Don Hackett — Wed, 01 Jul 2020 12:29:50 +0000

Reviewer:

City Increases HPV Vaccination Rates in El Paso

As the world anxiously awaits the development of a vaccine against COVID-19, the City of El Paso Department of Public Health (DPH) is helping to make sure area teens are vaccinated against a virus for which a vaccine does exist.

El Paso, Texas leaders presented the use of community-based strategies on June 18, 2020, to reduce the risk of human papillomavirus (HPV) infections and prevent cervical cancer through vaccination.

Additionally, Hispanics have higher rates of HPV cancers, and meeting the needs of residents in El Paso has been a top priority.

HPV is the highest sexually transmitted infection with about 25 percent of teenagers affected and approximately 80 million cases diagnosed each year.

“In 2018 we began a partnership with organizations and agencies in El Paso to determine who had not been vaccinated and then went further to provide easy access, on-site vaccination to area youth,” said Claudia Lozano, Medicaid Waiver Program Manager, in a press statement.

“This included local middle and high schools, college campuses, recreation centers, and faith-based organizations.”

As a result of the community-based efforts, the City of El Paso has experienced a 55 percent increase in HPV vaccination rates.

Lozano shared best practices such as using a voucher system to track referrals from schools and community organizations; providing mobile, on-site vaccination events; and the importance of tailoring health messaging to teenagers.

More than 1,100 participants have been screened and assessed as a part of the project and so far, nearly half of the patients have returned to complete their HPV vaccination in a 3-dose series.

Using the “Theory of Planned Behavior,” Claudia Lozano, MPH, from the El Paso Department of Public Health, and colleagues created the three approaches to improve the HPV vaccination rate in the city.

The Theory of Planned Behavior (TPB) started as the Theory of Reasoned Action in 1980 to predict an individual's intention to engage in a behavior at a specific time and place.

The theory was intended to explain all behaviors over which people have the ability to exert self-control.

The key component to this model is behavioral intent; behavioral intentions are influenced by the attitude about the likelihood that the behavior will have the expected outcome and the subjective evaluation of the risks and benefits of that outcome.

The TPB is comprised of 6 constructs that collectively represent a person's actual control over the behavior.

The TPB has been used successfully to predict and explain a wide range of health behaviors and intentions including smoking, drinking, health services utilization, breastfeeding, and substance use, among others.

For more information on the El Paso Texas Public Health Department Medicaid Waiver and Immunization program, call 2-1-1 or visit El Paso Public Health.

HPV vaccine development news is available here.

HPV vaccine news published by Vax-Before-Cancer

Sub Title:

City of El Paso Texas increased HPV vaccination rates by 55 percent

References:

The Theory of Planned Behavior

Image:

Age Groups:

Google News Keywords:

health, vaccines, vaccinations, hpv, hpv cancer, cancer vaccines, hpv vaccines, cervical cancer

GoodRx Vaccine:

Featured:

How To Improve HPV Vaccination Rates For Everyone

Don Hackett — Wed, 17 Jun 2020 17:11:38 +0000

Reviewer: