Nearly 80 million Americans – one out of every four people – are infected with human papillomavirus (HPV). And of those millions, more than 31,000 will be diagnosed with an HPV-related cancer this year. Despite those staggering figures and the availability of a vaccine to prevent the infections that cause these cancers, HPV vaccination remains low in the United States.
UC Davis Comprehensive Cancer Center has partnered with 69 other National Cancer Institute (NCI)-designated cancer centers to issue a statement urging increased HPV vaccination and screening to eliminate HPV-related cancers, starting with cervical cancer. These institutions collectively recognize insufficient vaccination as a public health threat and call upon the nations’ physicians, parents and young adults to take advantage of this rare opportunity to eliminate several different types of cancer in men and women.
“We know that vaccination against HPV saves lives by preventing many kinds of cancers, including cervical cancer,” said Primo Lara, Jr., a medical oncologist and director of the UC Davis Comprehensive Cancer Center. “Health care providers are essential in recommending immunization, and parents can help us, too, by asking their doctors about vaccination.”
Vaccination rates remain significantly lower than other recommended adolescent vaccines in the U.S. According 2016 data from the Centers for Disease Control (CDC), less than 50 percent of girls and 38 percent of boys completed the recommended vaccine series. Research shows there are a number of barriers to overcome to improve vaccination rates, including a lack of strong recommendations from physicians and parents not understanding that this vaccine protects against several types of cancer in men and women. HPV causes multiple cancers including cervical, anal, oropharyngeal (middle throat) and other genital cancers.
Increasing vaccination rates is a priority at UC Davis Health, with several initiatives under way. With an NCI grant in 2017, the UC Davis Comprehensive Cancer Center surveyed parents, healthcare professionals and organizations and county health departments in 13 counties to better understand vaccination attitudes and beliefs, clinical practices and strategies. They found multiple barriers to vaccination including anti-vaccine sentiment and vaccine availability and clinic capacity problems.
The team also has reviewed state legislative efforts around HPV vaccination and found large data gaps in HPV reporting. And they surveyed providers and reviewed electronic medical records of more than 4,000 11- and 12-year-old patients in the UC Davis Health Primary Care Network. The findings led to a pilot intervention used to improve vaccination rates which includes provider and staff training and visual reminders for staff and patients, as well as educational materials.
In addition, a new collaboration between the Cancer Center and HALO, a group of community health clinics, will target Asian Americans at risk of vaccine-preventable cancers including HPV-caused cervical cancer, which disproportionately affects Southeast Asian women. The effort will involve specialized training of primary care providers, use of bilingual and bicultural health educators and patient navigators and enhancement of the electronic health record to alert providers to the need for screening.
HPV experts from the nation’s top cancer centers, along with partners from the NCI, CDC, and the American Cancer Society, are meeting June 7-8 in Salt Lake City to discuss a path forward to eliminating cancers caused by HPV, including ways to reduce barriers to vaccination, as well as share education, training and intervention strategies to improve vaccination rates.
“The United States has an unprecedented opportunity to not just prevent cancers caused by HPV but to eliminate them. This means getting to a point in time when cancers such as cervical cancer are no longer diagnosed in our country,” said Anna R. Giuliano, director of the Center for Infection Research in Cancer at Moffitt Cancer Center, and renowned HPV expert who is co-leading the initiative.
This is the third year that all NCI-designated cancer centers have come together to issue a national call to action. All 70 cancer centers unanimously share the goal of sending a powerful message to parents, adolescents and health care providers about the importance of HPV vaccination for the elimination of HPV-related cancers.
NCI-Designated Cancer Centers Endorse Goal of Eliminating HPV-Related Cancers
Cancers caused by the human papillomavirus (HPV) are a significant public health problem. The National Cancer Institute (NCI)-designated cancer centers fully endorse the goal of eliminating cancers caused by HPV through gender neutral HPV vaccination and evidence-based cancer screening. These practices offer a rare opportunity to prevent 12,000 cervical cancers and nearly 40,000 other HPV-related cancers (oropharyngeal, anal, penile, vulvar, and vaginal cancers) among men and women annually in the United States.
An effective and safe vaccine is available that prevents the large majority of cancer-causing HPV infections. In addition, healthcare providers can use proven methods to screen for and treat cervical pre-cancers.
Unfortunately, HPV vaccination completion rates across the U.S. remain low. According to the Centers for Disease Control and Prevention (CDC), 49.5 percent of girls and only 37.5 percent of boys, ages 13-17 years, in the U.S. completed the vaccine series in 2016. These rates are significantly lower than those for other recommended adolescent vaccinations and fall well below the nation’s goal of 80 percent coverage by the end of this decade (U.S. Department of Health and Human Service’s Healthy People 2020 objective).
Increased HPV vaccination rates combined with appropriate cervical cancer screening measures could soon eliminate cervical cancer, with other HPV-related cancers in males and females to follow. Therefore, as national leaders in cancer research and cancer care, we issue the following Call to Action in alignment with the nation’s Healthy People 2020 goals:
• Vaccination of more than 80 percent of males and females ages 13-15 by 2020;
• Screen 93 percent of age-eligible females for cervical cancer by 2020; and
• Provide prompt follow up and proper treatment of females who screen positive for high grade cervical pre-cancerous lesions.
In addition, we strongly encourage:
• Young men and women up to age 26, who were not previously vaccinated, to complete the recommended HPV vaccine series;
• Health care providers to make clear and strong recommendations for HPV vaccination and cervical cancer screening; and
• The health care community to educate parents, guardians, community members, and colleagues about the goal of eliminating cancers caused by HPV in the US.
High HPV vaccination rates combined with cervical cancer screening and treatment will result in the elimination of cervical cancer in the near future and elimination of other HPV-related cancers thereafter.
The HPV vaccine PREVENTS CANCER. Make sure your loved ones are vaccinated and protected. More information is available from the CDC.
This statement is supported by the American Cancer Society (ACS), American Association for Cancer Research (AACR), American Society for Clinical Oncology (ASCO), Prevent Cancer Foundation, American Society for Preventive Oncology (ASPO) and Association of American Cancer Institutes (AACI).