ENTtoday

Slowing the Rise of Oropharyngeal Cancers

by Mary Beth Nierengarten •

HPV Vaccination Rates

  • 32% of girls between the ages of 13 and 17 have completed the recommended three-dose HPV vaccine.
  • 49% of girls received at least one dose of the vaccine.
  • 8.3% of boys received at least one dose of the vaccine.

Recommendations for the HPV Vaccine

    Who should receive the vaccine?

    Girls:

    • Routine vaccination of girls aged 11 to 12 years
    • Vaccination for unvaccinated girls and women aged 13-26 years

    Boys:

    • Routine vaccination of boys aged 11 to 12 years
    • Vaccination for unvaccinated boys and men aged 13-21

    What vaccines are available?

    • Cervarix: Licensed for girls
    • Gardasil: Licensed for girls and boys

With the availability of a simple and safe vaccine with proven efficacy to prevent cervical and, it is widely thought, human papillomavirus-related oropharyngeal cancers, why aren’t more people demanding it and more providers recommending it? This question takes on new importance in light of the results of a recent national survey that concluded that the rates of adolescents receiving the HPV vaccine remain low since its initial approval for girls in 2006 and for boys in 2011 for prevention of HPV-related cancers.

Data from the National Immunization Survey-Teen (NIS-Teen) found that only 32 percent of girls between the ages of 13 and 17 have completed the recommended three-dose HPV vaccine, and only 49 percent of girls received at least one dose of the vaccine. For boys, the uptake was substantially lower, with only 8.3 percent of boys receiving at least one dose and no available data on those receiving the full three doses (MMWR Morb Mortal Wkly Rep. 2012;61:671-677). For older girls and women the uptake is also low, with data from a 2010 National Health Interview Survey showing that only one in eight women aged 18 to 26 years completed the three-dose regimen (Cancer. 2013;119:1386-1392).

The importance of increasing the uptake of HPV vaccination is highlighted by recent data that show its robust efficacy. Data published this spring showed that the vaccine decreased the rates of infection with HPV strains covered by the vaccine by 56 percent in 14- to 19-year old girls in the first four years following the vaccine’s availability, when compared with the four years prior to the vaccine’s availability (J Infect Dis. 2013; doi: 10.1093/infdis/jit192). Decreasing HPV infection through vaccination is considered critical to the reduction and prevention of specific cancers, with HPV infection considered the cause of most, if not all, cervical cancers, 90 percent of anal cancers, and 40 percent of vaginal, vulvar and penile cancers. In addition, HPV infection is reported to be linked to more than 50 percent of oropharyngeal cancers (J Natl Cancer Inst. 2013;105:175-201).