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According to a CDC analysis, the 43,371 new cases of HPV-associated cancers reported nationally in 2015 represented a 44% increase over the 30,115 cases reported in 1999.
HPV vaccination rates have improved over the years, but not fast enough to stem the rise in cancers, according to the CDC.
Oropharyngeal cancer (throat) was the most common HPV-related cancer in 2015; 15,479 cases in men and 3,438 in women, according to data from the CDC.
iStock Photo.
In Connecticut, 58.4% of girls aged 13 to 17 and 37.8% of boys received three doses of HPV vaccine.
HPV infects approximately 14 million people each year and, between 1999 and 2015, rates of oropharyngeal (throat) and vulvar cancer have increased, vaginal and cervical cancer rates have decreased and rates of Penile cancer remained stable.
"The [overall rise] seems to be mainly caused by oropharyngeal cancers, "said Dr. Sangini Sheth, assistant professor of obstetrics, gynecology and reproductive science at the Yale School of Medicine.
"Immunization is the key to preventing these cancers," said Sheth, who is also assistant medical director and director of colposcopy and cervical dysplasia at the Yale New Haven Hospital Women's Center.
"Oropharyngeal cancer is the most common in men and HPV vaccination rates, while they increase in the United States and Connecticut, have become common for boys later. [than girls]. And the vaccination rate among boys is significantly lower than that of girls. We hope that the vaccination of our boys will have an impact on oropharyngeal cancer, but it will take time. "
The incentive to vaccinate adolescents against HPV is a relatively recent development. Vaccination was included in the routine immunization program for women in 2006 and for men in 2011, according to the CDC.
According to Dr. Richard Brauer, head of the otolaryngology section at Greenwich Hospital, the HPV vaccine was primarily aimed at preventing sexually transmitted diseases and some parents "felt" it and thought that it was not necessary for their children.
Now it is being marketed as a cancer vaccine and parents have become more receptive, said Brauer, who also has a private practice, Associates of Otolaryngology, in Greenwich.
In 2017, 65.5% of adolescents aged 13-17 across the country had received at least one dose of HPV vaccine, up 5.1 percentage points from 2016, according to CDC data released in August.
In Connecticut, 75.4% of girls aged 13 to 17 had received one dose of the vaccine, 67.1% had two doses and 58.4% had three doses. Of the men, 67.3% received one dose, 58.8% received two, and 37.8% received three.
But even in a context of global gains, the obstacles remain: the disparity between the sexes persists and many adolescents received the first dose of vaccine but did not receive the necessary doses.
According to the CDC, children aged 11 or 12 should receive two HPV vaccines six to 12 months apart. Adolescents who are vaccinated less than five months apart need a third dose of vaccine, as do all children over 14 years of age. Three doses are also recommended for people aged 9 to 26 with certain immunocompromised diseases.
"It's up to the parents" to know if the children are vaccinated, "said Dr. Bradford Whitcomb, Chief of Gynecologic Oncology at UConn Health." People associate HPV with women's things. that we do not just prevent women's cancers.
While it is heartening to see vaccination rates increase, "we may not see the benefit of this for years," said Whitcomb. "It will take longer, especially with the development of cancer, to see the effects. After HPV infection, it sometimes takes years before a cancer develops. "
Many people exposed to HPV will never develop cancer, doctors say.
The most common HPV-associated cancer in women is cervical cancer. The data shows that cancer rates are declining, but there are racial disparities.
According to an analysis of the Kaiser Family Foundation, between 2011 and 2015, Hispanic women had the highest incidence rates of cervical cancer, or 8.9%. This compares to 8.4% for black women, 7.4% for white women and 6.1% for Asian women and Pacific Islanders.
Cervical cancer mortality rates also showed racial disparities during this period. Black women have the highest mortality rate at 3.7%, compared with 2.6% among Hispanics, 2.2% among whites and 1.8% among Asians and Pacific Islanders.
It is crucial that doctors talk to young patients and their parents about the HPV vaccine, even if it encourages conversations that parents may be uncomfortable with, Sheth said.
"Clinicians need to feel comfortable to normalize the HPV vaccine and present the HPV vaccine as a cancer prevention tool," she said.
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