HPV-linked cancers on rise, more prevalent in Kentucky

The human papillomavirus, which is generally blamed for causing cervical cancer, is being linked to the formation of several other kinds of cancer, and Kentuckians are getting these diseases in unusually high numbers, reports Laura Ungar of The Courier-Journal.

HPV is being linked to cancers of the vagina, vulva, penis, anus and lung, as well as the head and neck. "It's turning out to be a pretty bad actor ... an extensive health problem," said Dr. Daniel Metzinger, a gynecological oncologist with University of Louisville Physicians.

Kentucky's rates for HPV-related cancer are among the highest in the country. Part of the reason may be that smoking is a risk factor and Kentucky has the nation's highest smoking rate, Ungar reports. "I'm seeing more of it for sure," said Metzinger. "It used to be a disease we'd see in older people. Now, we see it in younger and younger people."

One way to protect against the virus is to be immunized with the HPV vaccine. A federal committee recommends vaccinating 11- and 12-year-old girls through to women up to age 26. Boys and men should also be immunized from age 11 to age 21. The immunization must occur before the patient is sexually active, since HPV is sexually transmitted.

In 2010, just 49 percent of adolescent girls nationwide received at least the first of the vaccine's three doses, and only a third had gotten all three, which are required for full effectiveness. In Kentucky that year, only 25 percent of adolescent females had gotten the first dose, and fewer than 11 percent have received all three doses, according to Cervical Cancer-Free Kentucky.

National Cancer Institute numbers show more than half of sexually active people are infected with HPV at some point. Usually, it goes away on its own within a few years. "But it can also set the stage for cancer," Ungar reports. "Across the nation, about 26,000 new cancers attributed to HPV occur each year, with 18,000 in women and 8,000 in men." (Read more)

Beshear vetoes parts of budget, but health spending is intact

Though Gov. Steve Beshear vetoed 45 parts of the state budget yesterday evening, health-related spending was safe from the cut.

The budget will help reduce caseloads for social workers who investigate child abuse and neglect, funds colon cancer screenings for 4,000 uninsured Kentuckians, substance-abuse treatment for Medicaid recipients and includes funding for an elder abuse registry to protect senior citizens from unscrupulous caretakers.

"This is the most difficult budget I have ever drafted, and it will also be a challenge to implement and manage over the next two years," the governor said in a statement.

In the two-year, $19 billion budget, Beshear voted more than three dozen line-item appropriations, including "portions of the General Fund budget that limited his ability to manage the state's budget or spent money that doesn't exist," reports Beth Musgrave of the Lexington Herald-Leader.

He also cut some earmarks, including $100,000 for Actors Theatre of Louisville and $150,000 for the International Mystery Writers' Festival in Owensboro. "I am vetoing these parts because they identify new spending earmarks yet the General Assembly failed to appropriate additional funds to finance them," Beshear said. (Read more)

This week is National Public Health Week; this year's focus is on prevention and wellness

With a focus on prevention and wellness this year, the Kentucky Department of Public Health is promoting national Public Health Week, which kicked off yesterday and will be observed until Sunday. The prevention theme was chosen to underscore the impact of chronic disease on the American population.

Americans miss 2.5 billion days of work because of diseases like heart disease, cancer and diabetes, which costs the country $1 trillion. Unintentional injuries, such as those stemming from motor vehicle accidents, poisonings and burns, rank within the top 10 causes of death for people 44 and younger, according to a DPH press release.

"Often, these horrible diseases and injuries could have been prevented with more attention to lifestyle choices like physical activity and nutrition or preventive safety measures," said Dr. Steve Davis, acting DPH commissioner. "The health care community — as well as the individual — must work to understand the risk for developing chronic disease and avoiding injury so that we can prevent complications. This is key to improving the health of our state."

Public health is also crucial in emergency response, as witnessed with recent tornadoes that struck the state. "The contribution of public health is tremendous — both on a day-to-day basis and in times of crisis," Davis said. "I encourage everyone to go online to read more about our public health programs; talk to your health care provider about chronic disease and injury prevention; or, better yet, visit your local health department to learn more about how public health can — and does — improve your life." (Read more)

Norton and UK HealthCare formalize the collaboration they announced almost a year and a half ago

UK HealthCare and Norton Healthcare have formalized the collaboration they announced almost a year and a half ago and will "focus on creating collaborations with hospitals across the state in stroke, cardiovascular and cancer care," Dr. Michael Karpf, executive vice president for health affairs at the University of Kentucky, announced today.

Said Steve Williams, president and CEO of Norton: "Our intent is to bring our combined health care expertise and resources into communities across the commonwealth to improve health-care outcomes."

The partnership will be in the form of a non-profit organization. The board of the Norton-UK HealthCare Partnership for Quality has already approved a budget of $595,000 to grow stroke outreach and education and launch programs to fight heart attacks and cancer, a press release says.

In late 2010, the two systems joined forces to create a statewide collaboration that addresses Kentucky's major health issues, including cancer, stroke and heart disease that stem from high obesity and smoking rates. Some of the accomplishments since the agreement include a transplant program, an effort to increase the number of obstetricians statewide; pharmacy education; and cancer care.

A competing collaboration, between the University of Louisville, Jewish Hospital and the Lexington-based St. Joseph Health System, is again trying to formalize its arrangement following rejection of a merger by state officials on grounds that University Hospital was a public institution that could not be bound by the Catholic system's restrictions on reproductive care.

Replacing cigarettes with smokeless tobacco reduces disease risk, says U of L prof who's received tobacco-industry funding

Smokers can greatly reduce their risk of disease if they replace their cigarettes with spit-free smokeless tobacco or electronic cigarettes, University of Louisville professor Brad Rodu, right, said in a presentation at the annual meeting of the American Association for the Advancement of Science last week. It's the same message residents of Owensboro heard in an advertising campaign with which Rodu was involved late last year, one partly funded with grants from the tobacco industry.

"Quit or die: That's been the brutal message delivered to 45 million American smokers, and it has helped contribute to 443,000 deaths per year," Rodu said in a U of L press release. "The truth, however, is that total nicotine and tobacco abstinence is unattainable and unnecessary for many smokers."

Rodu's 20 years of research has reportedly shown that e-cigs and smokeless tobacco are relatively safe alternatives for smokers who can't or are unwilling to quit nicotine. "Nicotine is addictive, but it is not the cause of any smoking-related disease," he said. "Like caffeine, nicotine can be used safely by consumers."

Research has shown smokeless products are 98 percent safer than cigarettes, the press release states. A 2002 study in the United Kingdom found smokeless tobacco to be up to 1,000 times less hazardous than smoking.

As for whether smokeless tobacco can contribute to mouth cancer, Rodu said the risk "is extremely low." "The annual mortality rate among long-term dry snuff users is 12 deaths per 100,000 and the rate among users of more popular snus, moist snuff and chewing tobacco is much lower. For perspective, the death rate among automobile users is 11 per 100,000 according to the 2009 report from the National Highway Traffic Safety Administration. Compare those to the rate among smokers: more than 600 deaths per 100,000 per year." (Read more)

The Oral Cancer Foundation's website says about 37,000 Americans will be diagnosed with oral or pharyngeal cancer this year and cause about 8,000 deaths. The foundation does not support the contention that smokeless tobacco is "safe." "Promoted by some as a safer alternative to smoking, it has in actuality not proven to be any safer to those who use it when referring to oral cancers," the website reads. "Campaigns to promote the safety of smokeless are being initiated, but it is clear that while it may reduce lung cancers, it has a negative effect on the rates of oral cancers."

Rural women are less likely to complete vaccinations for cervical-cancer virus; study finds vaccine does not increase sexual activity

Women living in rural areas of the U.S. were far less likely to return for their follow-up doses after they get the initial injection of the human papillomavirus vaccine, a study in the Journal of Rural Health has found. (Photo by Pete Rodman, Bowling Green Daily News)

The study contrasted the rates of vaccination follow-up by young women recruited from two rural locations and one urban location. "Despite being free, the researchers concluded that uptake of booster doses by rural women was problematic," states an article in the Rural Center for AIDS/STD Prevention's "RAP Time" publication. "This barrier might be resolved by providing the HPV doses at easy-to-access locations in rural communities, such as large grocery stores and area events."

The HPV vaccine requires three doses. The women who went to the rural clinic were seven times less likely to return for at least one follow-up dose.

The vaccine, which has proven to prevent most cervical cancers, has been approved for use in women ages 9 to 26 years, as well as boys. The vaccine is generally given at the age of 11 or 12 and is effective only if administered before a person becomes sexually active. As many as 80 percent of men and women become infected with HPV during their lives, but most do not develop symptoms or illness.

The vaccine has been met with reluctance by parents, some of whom fear it encourages sexual activity, but a study published in the American Journal of Preventive Medicine found girls or women who received the vaccine "were no more likely to be sexually active or have more partners than those not vaccinated."

Last year, just 49 percent of adolescent girls nationwide had received at least the first dose of the vaccine, and only a third had gotten all three. In Kentucky, just 25 percent of adolescent females had gotten the first dose and fewer than 11 percent had received all three doses.

In Kentucky, the annual death rate caused by cervical cancer is 2.9 deaths per 100,000. In the United States, it's 2.4 per 100,000. "The U.S. is remaining stable. Kentucky's is actually falling," gynecologist Dr. Mark Yurchisin told Alyssa Harvey of the Bowling Green Daily News.

The decrease is being attributed to an increase in screenings. "In certain counties in Kentucky there is a high incidence, they implemented outreach clinics because they didn't have clinics where they could get Pap screenings done," Yurchisin said. "They can diagnose it at an earlier and treatable stage." (Read more)

State health department starts new ad campaign against secondhand smoke, including three 15-second TV commercials

The Kentucky Department for Public Health is launching a new campaign to educate Kentuckians about the dangers of secondhand tobacco smoke and its potential effect. The campaign is funded by $281,000 from the economic stimulus package of 2009 and about $90,000 from the federal Centers for Disease Control and Prevention. This week the department will start running television, billboard and radio advertisements to show the dangers of smoke that comes from the burning end of cigarette, cigar or pipe or the exhaled smoke from a smoker. The ads, which will run statewide, highlight the link between secondhand smoke and dangerous illnesses in both adults and children.



The ads, produced by Louisville-based Doe-Anderson, feature people being unwillingly exposed to secondhand smoke in places such as residences and cars. Each ad carries the tag line, “Secondhand smoke is 100 percent unsafe, 100 percent of the time.”

Kentucky’s smoking rate remains the second highest in the country, with 24.8 percent of the adult population identified as current smokers, and secondhand smoke exposure is equally high. The health department says 39.5 percent of Kentucky children live with someone who smokes – the highest percentage in the country. Secondhand smoke has become a major public health concern because it contains approximately 4,000 chemicals, many of which are known carcinogens, and is responsible for approximately 3,000 cases of lung cancer deaths among nonsmokers each year.



The campaign is another project of the Kentucky Tobacco Prevention and Cessation program. Community interventions for tobacco cessation are available through local health departments staffed with tobacco control specialists, and the program operates a toll-free telephone line, 1-800-QUIT NOW. It also provides technical assistance, with the Kentucky Center for Smoke Free Policy at the University of Kentucky, to assist communities in seeking smoke-free ordinances.

Smokeless tobacco can help you quit cigarettes, Owensboro-area residents are told (partly with tobacco money)

"Switch and quit" is the theme of an advertising campaign being promoted by a prominent cancer center in Kentucky, in which smokers are advised to lay off the cigarettes in favor of smokeless tobacco such as chew or snuff. "Supporters say smokers who switch are more likely to give up cigarettes than those who use other methods such as nicotine patches, and that smokeless tobacco carries less risk of disease than cigarettes do," The Associated Press reports.

AP reports the program is partly funded with grants from the tobacco industry, though program director Brad Rodu, a University of Louisville professor of medicine, said the industry has "absolutely no influence whatsoever." Smokeless tobacco has been linked to oral cancer.

"We need something that works better than what we have," said Dr. Donald Miller, an oncologist and director of the James Graham Brown Cancer Center, which is co-sponsoring the campaign with the university. "This is as reasonable a scientific hypothesis as anybody has come up with and it needs to be tried."

The campaign is being pushed in Owensboro using print, radio, billboard and other advertising. Residents of Owensboro and the surrounding area reportedly consume about 3 million cigarettes a week. "That amounts to well over a pack for every man, woman and child in the community of about 115,000 people," AP reports.

"The worst that you can say about smokeless tobacco is that it's the lesser of two evils," said Dr. Randall Thomas, an oncologist at the Owensboro Medical Health System. "I don't think we have any problem in telling a person that drinks a six-pack a day that if they could cut it back to two beers a day or two drinks a day that their health risks are greatly reduced ... Finding a way to let people have their nicotine that carries less risk, it's the realistic solution."

But there are opponents to the program, including Matthew Myers, president of the Campaign for Tobacco-Free Kids, who called it "a giant experiment with the people of Owensboro without rules or guidance designed to protect individuals from experimental medicine." The theme of the program does seem to run counter to warnings by the Centers for Disease Control and the National Cancer Institute at the National Institutes of Health, whose websites say the use of all varieties of tobacco products "should be strongly discouraged" and that there is "no scientific evidence that using smokeless tobacco can help a person quit."

Owensboro is an old tobacco town, and in the face of falling cigarette sales, tobacco companies are marketing more smokeless tobacco and other cigarette alternatives. (Read more)

Clinic in Greenup will offer free ovarian cancer screenings for Northeast Ky. women

Women in Northeastern Kentucky will be able to receive free ovarian cancer screenings thanks to funding that will set up a clinic in Greenup County.

The clinic is intended for women in Lewis, Carter, Elliott, Greenup and Boyd counties, as well as two counties in Ohio, but "certainly anyone who arrives at the clinic who meets the requirements will be eligible for screening," said Parry Barrows, spokeswoman for Gov. Steve Beshear's office. Eligible women must be age 50 and older or over the age of 25 who have a family history of ovarian cancer.

The clinic will be an expansion of a program that has been in place in Lexington since 1987. As of September, more than 200,000 screenings have been performed on more than 37,000 Kentucky women as part of the program.

To build the clinic, which will be located in the Greenup County Health Department, a $200,000 Appalachian Regional Commission grant will be combined with $45,000 from UK. The health department will contribute $66,600.

"Funding will go toward purchasing required equipment and furnishings, as well as provide program operations for up to 3 years," saysa press release from Beshear's office. "UK will train local ultrasound technicians to facilitate the scans and the UK Markey Cancer Center will read the scans and deliver patient reports."

"Establishing this satellite clinic ... will help save lives by giving women in northeast Kentucky and southern Ohio better access to free ovarian cancer screenings," said Chris Crum, director of the Greenup County Health Department. (Read more)

Parents, children should discuss HPV vaccine, study indicates

A study at Ohio State University found that college-aged women who have talked to their mothers about the human papillomavirus are more likely to get the vaccine that prevents it, Brandy Reeves, right, a certified sexuality educator and health education coordinator at the University of Kentucky, writes in the Lexington Herald-Leader.

HPV is known to cause cancer, including cervical cancer, oral cancer, vulvar cancer, anal cancer and penile cancer.

There are two vaccines for HPV approved by the Food and Drug Administration: Gardasil and Cervarix. "Because men can carry HPV and transmit it sexually to their partners, the FDA has approved the use of Gardasil in both genders, from ages 9 to 26," Reeves writes. "Parents who are nervous about bringing up the topic can focus on how the vaccine is safe and effective, and that it prevents cancer." (Read more)

Markey Cancer Center at UK says its patients have higher survival rates than those treated elsewhere in Ky. and the nation

"Patients at the University of Kentucky's Markey Cancer Center who have certain types of cancer have higher rates of survival than patients with the same cancers treated elsewhere in the state or even the nation according to new data released today," Business Lexington reports.

"Markey officials said the data shows that the center's patients have significantly better five-year survival rates than those Kentucky cancer patients who were treated elsewhere for brain, breast, liver, lung, ovarian, pancreatic and prostate cancer, as well as for stage IV colorectal cancer." (Read more)