Human Papilloma Virus Vaccines May Decrease Chances of Oral Cancer
The Centers for Disease Control report that nearly 25 million women are infected with some form of the Human Papilloma Virus (HPV). Of those, more than three million are thought to have one of the four strains known to cause cases of cervical cancer and genital warts.
HPV is linked to oropharyngeal cancer and may be linked to oral cancers as well, and vaccines that have been developed to treat HPV might decrease the risk of these cancers, according to a study in the May/June issue of General Dentistry, the clinical, peer-reviewed journal of the Academy of General Dentistry (AGD).
James J. Closmann, BS, DDS, the lead author of the study, found that oral and oropharyngeal squamous cell carcinoma (OOSCC) have been linked to high-risk HPV strains, the same strains that cause cervical cancer.
Recently, a vaccine was developed to treat patients with HPV against cervical cancer, and this could have an effect on women’s oral health.
“More than 100 strains of HPV have been identified,” says Dr. Closmann. “They have been shown to cause other benign and malignant disorders, which now include those in the mouth. Nearly 30,000 new cases of oral and oropharyngeal cancer are reported each year. It’s possible that oral and oropharyngeal cancers could be reduced if vaccination were more widespread; however, additional research is needed.”
Additional research could result in a comprehensive test for dentists at patients’ semiannual visits. However, a dentist can perform a head and neck exam to detect early signs, despite the lack of a specific test.
A possible connection between HPV and oral cancers, and the stronger link to oropharyngeal cancers, is even more of an indicator that patients should visit the dentist twice a year to identify irregularities early.
“Visiting the dentist on a regular basis is an important factor in the detection of any oral health complication,” says Laura Murcko, DMD, spokesperson for the AGD. “Taking preventive measures is especially important, and your dentist can check for early signs of oral cancer.”
Oral Health Tips for Women:
- Keep your dentist informed about changes in oral health.
- Visit the dentist regularly, which will help them to detect changes in the mouth.
- Ask your dentist to take a full medical history to determine if you are at risk for certain problems.
- Ask your dentist to perform a complete head and neck exam to detect early signs of certain conditions.
Can a vaccine treat my existing HPV infection?
By Dr. Judith Reichman
Q: I tested positive for high-risk HPV on my recent Pap smear. I’m freaked! If I get the HPV vaccine will it help cure me?
A: First, the good news. It’s most likely that your body will clear the virus by itself through your own immune reactions. But the bad news is that we don’t know how to help that process along and the vaccine won’t do it.
A recent article in the Journal of the American Medical Association (JAMA) detailed a study in which more than 2,000 women between the ages of 18 to 25 were followed for over a year. These women lived in Costa Rica and were found, on initial testing, to be positive for human papilloma virus (HPV). They were divided into two groups: Half the women got a vaccine that immunizes against HPV 16 and 18, the other half did not. There are over 30 types of HPV, but only some are high risk. Type 16 and 18 are found in (and felt to be the cause of) 70 percent of cervical cancers. (The vaccine currently available in the U.S. is called Gardasil. It’s a quadrivalent vaccine because it protects against four types of HPV: 16, 18, 6 and 11. These last two types of HPV are not involved in cervical cancer development but do cause genital warts.)
The women were then followed and tested for viral shedding at 6 and 12 months. The study found that there was no significant difference in viral clearance (i.e., the virus disappeared) between those who received immunization after becoming infected with HPV and those who didn’t. The clearance rate of HPV in the women who took the vaccine at six months was 33.4 percent vs. 31.6 percent in the control group. At 12 months, the rate of continued shedding of the virus was 48.8 percent in the vaccinated group and 49.8 percent in the control group.
The study didn’t evaluate the long-term progression of HPV infections, the extent of future abnormalities in cervical cells, or the development of cervical cancer in these women. There’s still a possibility that the vaccine may diminish the progression to cancer, but it seems unlikely since it didn’t cause the virus to disappear.
We do know that within two years of HPV exposure (and infection), most women clear these viruses on their own. Thank goodness for our cervical “powers of viral destruction.” HPV prevalence is frighteningly ubiquitous — 50 to 70 percent of sexually active young adults test positive for one of the HPVs within two years of initiating sexual activity, especially if they are not consistent in using condoms. (And even then there can be “oops” occurrences). Because of its overwhelming prevalence, the current recommendation is not to test for HPV infection in young adults (under the age of 30).
Those who have persistent viral infections are a small minority of women who are then at risk for cervical cancer. Finding a persistent HPV infection in women after the age of 30 should be a signal for careful follow-up.
Despite this study’s results, there are those who feel that it is worthwhile to give the quadrivalent vaccine (Gardasil) to young women aged 11 to 26 who have tested positive for one of the high-risk HPVs. This is because, in theory, the vaccine may provide immunity against HPV types that these young women were not exposed to and/or infected with. Whether it is cost-effective to do this, especially in a large population, is still under discussion.
Bottom Line: If you are infected with HPV, getting the HPV vaccine will not help you clear the virus; the vaccine should not be used to treat current infections.
Dr. Judith Reichman, the TODAY show’s medical contributor on women’s health, has practiced obstetrics and gynecology for more than 20 years. You will find many answers to your questions in her latest book, “Slow Your Clock Down: The Complete Guide to a Healthy, Younger You,” which is now available in paperback.
Should My Daughter Get The HPV Vaccine?
Physicals and immunizations are all part of the back-to-school ritual. After a summer of information overload about the new HPV vaccine, many parents are wondering if it’s necessary for their daughters. According to the doctors at the University of Southern California, you may want to consider adding the HPV vaccine to your daughter’s to-do list.
‘The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices and the American College of Obstetricians and Gynecologists, which advises the Centers for Disease Control and Prevention, haves recommended that all girls from 11-12 years old routinely receive the HPV vaccine,’ says Nandini Datta, M.D., assistant professor of obstetrics and gynecology at the Keck School of Medicine of USC. ‘This vaccine is meant to prevent cervical cancer by preventing infection with cancer-causing HPV. The vaccine has been shown to be safe in women aged 9-26 and the ideal candidate is a girl prior to sexual activity. If the patient is older than 12, I think it¹s reasonable to discuss with your physician if this is something right for her.’
Human papilloma virus (HPV) is one of the most common sexually-transmitted infections in the U.S. While most HPV types cause no symptoms, according to the CDC there are a few types that can cause cervical cancer in women. In the U.S., about 6.2 million people become infected with HPV each year and more than half of all sexually active men and women become infected at some time in their lives.
Earlier this year, the Food and Drug Administration (FDA) approved the first HPV vaccine, Gardasil, which is indicated for girls from nine to 26 years old. Gardasil protects women from the HPV strains that are responsible for 70% of all cervical cancers and 90% of all genital warts. Although it does not protect women from all variations of HPV, studies have shown that the vaccine is effective in preventing disease caused by four HPV strains.
‘Since the vaccine does not protect against all HPV strains, it is still important for women to continue to receive yearly screenings,’ continues Datta. ‘Women should have regular Pap tests beginning at the age of 21 or three years after the onset of sexual activity.’
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