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)

Facebook app personalizes message to women about getting cervical cancer screening and HPV vaccine

To raise awareness about cervical cancer and ways to avoid getting it, the Cervical Cancer-Free Kentucky Initiative has created a Facebook application that "incorporates pictures of users' Facebook pals into an educational video on cervical cancer," reports Darla Carter of The Courier-Journal.

"We want to get the message [to] where we know people are getting their information, and Facebook, Twitter and websites are 'the things'," said Dr. Baretta R. Casey, director of the University of Kentucky initiative.

The application can be found at www.causethemovement.org. "Their friends' and family's faces will actually come up into the video," Casey said, to make the subject resonate more with the viewer.

The goal is to educate women about cervical cancer, which can be prevented through screening and the HPV vaccine. The disease is more likely to occur in women over the age of 30, according to the Centers for Disease Control and Prevention. There are 12,170 new cases of cervical cancer each year and 4,220 deaths, according to the National Cancer Institute. The American Cancer Society states there will be 180 new cases in Kentucky this year.

The most common cause of the cancer is the human papilloma virus, which is transmitted sexually. Two HPV vaccines, Gardasil and Cervarix, have been approved by the U.S. Food and Drug Administration.

"Right now, this is the only vaccine on the market that can prevent a cancer," Casey said. "I have a daughter and I have a granddaughter, and they have both received the HPV immunization because I don't ever want them to come and look at me and say, 'Mom, why didn't you give me this shot? I wouldn't be going through treatment for cervical cancer now.'"

Women can be screened for the disease with a Pap test, which detects abnormal cells that could lead to cancer. (Read more)

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)

Most women over 65 don't need annual Pap smears anymore

Many women over the age of 65 no longer need to get an annual Pap smear in order to detect cervical cancer, the American Cancer Society, the American College of Obstetricians and Gynecologists and the U.S. Preventive Services Task Force agree. For low-risk women in that age bracket, there is no additional benefit to routine yearly screening, reports Paula Span for The New York Times.

"In women who have had normal annual Pap tests for many years and are in monogamous relationships, the risk of cervical cancer is very low," said Dr. Sarah Feldman, a gynecologist oncologist at Brigham and Women's Hospital in Boston.

However, there are some exceptions. If a woman received a Pap for reasons other than a routine screening, she should continue to be tested. She should have received three normal tests in the past decade; if not, she should get a Pap whether she's over 65 or not. And a woman should still have discussions with her doctor about any problems she might be having.

Though studies show the Pap test is not necessary for women over 65, it may be difficult for women, and their doctors, to agree to stop getting it. "People have gotten comfortable with that annual Pap smear," Feldman said. "They don't want it to stop." "It's a habit that might prove difficult to break," Span reports. (Read more)

Boys should get HPV vaccine to keep from spreading virus

A federal committee has recommended that boys receive the human papilloma virus vaccine, already recommended for girls, to fight the sexually transmitted virus that is known to cause cervical cancer. The vaccine could also protect boys against genital warts and anal cancer.

The Advisory Committee on Immunization Practices released its recommendation Wednesday. It is the first time there has been a public push for boys to receive the vaccine, though it has been licensed for male use for the past two years.

Dr. Baretta Casey, director of Cervical Cancer-Free Kentucky, applauded the move. "To stem the spread of the HPV virus and the many problems it causes is the best thing," she said.

The vaccine is usually given at the age of 11 or 12 and is only effective if it is given before a person becomes sexually active. As many as 80 percent of men and women are infected with HPV during the course of their lives, but most do not develop symptoms or illness, the Centers for Disease Control and Prevention reports.

The vaccine has been met with reluctance by parents, some of whom fear it would encourage sexual activity. Last year, just 49 percent of adolescent girls nationwide had received at least the first of its three doses, and only a third had gotten all three. In Kentucky, only 25 percent of adolescent females had received the first dose, and fewer than 11 percent had received all three doses.

Casey attributed parents' hesitation to a fear that the vaccine is harmful, though research shows otherwise. "It's our hope that people understand that this is a vaccine that has been around for quite a while now," she said. "The effects of the immunization are similar to other vaccines that we currently give our children. And if I can give my child a vaccine that would prevent them from ever developing cancer, I'm for it." On average, 391 Kentucky women develop cervical cancer and 66 die.

The cost of the vaccine — about $110 for each of the three doses — is also believed to be a factor in the low vaccination numbers, though Casey said Medicaid covers it, as do major health insurance providers such as Blue Cross Blue Shield and Anthem. Though the numbers are low, Casey said she is seeing some boys being vaccinated in Kentucky "but it's not a widely done practice." (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)

Funding available to help communities fight cervical cancer

For the second year, agencies, coalitions and community groups are invited to apply for funding to improve cervical cancer screening rates and human papillomavirus (HPV) vaccinations in their areas. Cervical Cancer-Free Kentucky, housed in the University of Kentucky College of Public Health, has funding available and will be awarding mini-grants in the coming year, Ann Blackford of the UK news service reports.

In August, 13 agencies received CCFKy funding ranging from $7,000 to 20,000 for projects that will help residents in 19 Kentucky counties.

"CCFKy saw great results from the first year of funded projects," said Dr. Baretta R. Casey, director of CCFKy. "The projects' outcomes convinced our team that increasing the number of funded agencies in the second year will move our mission of a cervical cancer-free Kentucky forward. Let's stop the deaths of women in Kentucky from this preventable and curable disease."

About 391 women are diagnosed with cervical cancer every year in Kentucky and 66 Kentucky women die. (Read more)