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Changes in Immunization Practices May Reduce Oral Cancer

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Until now, the ACIP (Advisory Committee for Immunization Practices) has only approved the HPV vaccine for girls and young women through age 26, despite the fact that the FDA (Food and Drug Administration) approved a vaccine for boys and young men almost two years ago, in 2009.

Since its approval in 2006, the Gardasil vaccine, originally approved only to prevent certain strains of HPV known to cause cervical cancer and their precancerous lesions, has been expanded to include vaginal and vulvar cancers and their precancerous lesions as well. Last year, they extended this to include anal cancer.

Until now, including boys and young men would not be cost effective given the low percentage of women who actually go on to complete the three shot series.

Now, however, there has been an explosion with respect to the number of oral cancers which are predominantly affecting males and has overall exceeded the number of cervical cancers annually. Previously, smoking and alcohol were considered to be the major causes of oral cancers.

From 1984 to 1989, 16 percent of oral cancers were attributed to HPV. In comparison, from 2000 to 2004 the percentage of oral cancers related to HPV had increased to 75 percent and, it is known that the risk of oral cancer increases is related to an increase in oral sex and kissing.

During the ACIP meeting of June 22, 2011, testimony was heard from Aimee Kreimer, Ph.D., of the National Cancer Institute. She stated, "At some point ... it is projected that there will be the same incidence of [oropharyngeal] cancer in men as cervical cancer in women, If current trends continue, [oropharyngeal] cancer in men will pass cervical cancer in 2025."

Many abstinence groups are opposed to the vaccine claiming, like the distribution of condoms in the past, it was the equivalent of approval to engage in sexual activities. That argument is becoming weaker when the simple act of kissing is considered a risk factor for oral HPV-related cancers.

Dr. Dong Moon Shin of Emory University’s Winship Cancer Center stated, “The time is now. For the HPV vaccine, cost is the only issue as side effects are minimal. Routine HPV vaccination has to be implemented very soon, for both boys and girls."

Given the information to date, the sooner the ACIP includes in their recommendations that boys as well as girls receive the vaccine, the greater the impact on all HPV-related cancers will be.

http://cancer.about.com/od/hpvvaccine/a/hpv_vaccine_boys.htm http://www.time.com/time/health/article/0,8599,1619814,00.html

Reviewed July 20, 2011
by Michele Blacksberg R.N.
Edited by Shannon Koehle

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