The HPV virus, HPV vaccination, Oral cancer: What it means to oral health professionals
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How can HPV-associated cancers be prevented?
The HPV vaccine was originally developed to prevent cervical and some less-common genital cancers. Pre- and post-marketing studies indicate that the vaccine reduces HPV prevalence, genital warts and cervical lesions. While extensive research on the impact of HPV vaccination on oropharyngeal cancers has not been completed, the vaccine may prevent these cancers because it confers immunity against infection with HPV types, including 16, that can cause oropharyngeal cancers. Current research indicates that the vaccine provides at least ten years of immunity without waning. The CDC estimates that HPV vaccination can prevent approximately 28,500 new cases of cancer( 90 percent of all HPV-related cancer) each year in the United States.
HPV vaccine is recommended for routine vaccinations at age 11 or 12 years.( Vaccination can be started at age 9). Two doses are recommended for most persons starting the series before their 15th birthday, with the second dose being given 6 to 12 months after the first dose. Three doses are recommended for girls and young women who start the series at age 15 through 26, and for immunocompromised persons; three doses are recommended for boys and young men who start the series at age 15 through 21. Ideally, adolescents should be vaccinated before they are exposed to HPV. However, people who have already been infected with one or more HPV types can still get protection from other HPV types in the vaccine. HPV vaccine can be administered at the same time as other adolescent vaccinations.
Despite strong recommendations for the HPV vaccine, in 2016, the prevalence of adolescents( age 13-17 years) in Pennsylvania being up to date on HPV vaccination was 51.0 percent, with Philadelphia at 68.4 percent and the rest of state behind at 48.7 percent.
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What can you do?
Dentists, dental hygienists and other oral health professionals have an important role in both the prevention of HPV infection and early detection of HPV-associated lesions and cancers. First, oral health professional can provide education and resources related to HPV, HPV vaccination and oral cancer to their patients. The 2013- 2018 Pennsylvania Comprehensive Cancer Control Plan has already been active on several fronts related to HPV education and vaccination. Over the past few years, they have conducted HPV vaccination education with school nurses and in public schools. In addition, they have hosted webinars and community education programs using the documentary,“ Someone You Love: The HPV Epidemic.” In addition, they have produced small media and public educational resources that can be used by healthcare providers with students, parents and the public. Materials are located on the LiveHealthyPA website at http: www. livehealthypa. com / health-team / educational-toolkits / hpv-toolkit. Finally, the HPV Workgroup of the Comprehensive Cancer Control Plan of Pennsylvania will be working about HPV education and vaccination with oral health professionals during the upcoming year.
More information can be found at the PA Department of Health website. http:// www. health. pa. gov / My % 20Health / Diseases % 20 and % 20Conditions / A-D / cancer1 / Pages / Cancer % 20Prevention % 20 Resources. aspx #. WbHHQrJ96Uk
In addition, the Southwest PA Area Health Education Center( AHEC) has received a grant from the CDC through the National AHEC Organization to promote HPV vaccination by increasing provider awareness and rates of immunization. In addition to providing educational materials and online webinars, the Southwest PA AHEC is able to provide a presentation entitled“ You are the Key to Cancer Prevention” to provider groups and practices. The focus for this upcoming year will be on education and materials for oral health professionals. Learn more at www. southwestahec. org.
REFERENCES
2013-2018 Pennsylvania Comprehensive Cancer and Control Plan. http:// www. health. pa. gov / My % 20Health / Diseases % 20 and % 20Conditions / A-D / cancer1 / Documents / 2013-2018 _ Cancer _ Plan. pdf. Accessed Sept 7, 2017.
Cervical Cancer Statistics. Center for Disease Control and Prevention. https:// www. cdc. gov / cancer / cervical / statistics. Accessed Sept 8, 2017.
What is HPV? Centers for Disease Control and Prevention. www. cdc. gov / hpv. Accessed Sept 5, 2017.
Walker, TY, Elam-Evans LD, Singleton JA, et al. National, Regional, State and Selected Local Area Vaccination Coverage Among Adolescents Aged 13-17 Years – United States, 2016. MMWR Morb Mortal Wkly Rep 2017; 66:874-882.
DOI: http:// dx. doi. org / 10.15585 / mmwr. mm6633a2
44 NOVEMBER / DECEMBER 2017 | PENNSYLVANIA DENTAL JOURNAL