This Vaccine Can Prevent Cancer, But Many Teenagers Still Don't Get It

Feb 19, 2018
Originally published on February 19, 2018 9:33 am

Each year, about 31,000 men and women in the U.S. are diagnosed with a cancer caused by an infection from the human papillomavirus, or HPV. It's the most common sexually transmitted virus and infection in the U.S.

In women, HPV infection can lead to cervical cancer, which leads to about 4,000 deaths per year. In men, it can cause penile cancer. HPV also causes some cases of oral cancer, cancer of the anus and genital warts.

The CDC says HPV vaccination can prevent many of these cancers, and urges pediatricians to recommend HPV vaccination for all their patients, beginning at age 11.

But a new analysis from the Blue Cross Blue Shield Association finds only 29 percent of the teens its members insure receive a first dose of the HPV vaccine by their 13th birthday. And the CDC finds, nationally, only 43 percent of teens are up-to-date on all the recommended doses of the vaccine.

"It's important for 12 and 13-year-olds to get the HPV vaccine to provide immunity so that when they may be exposed to HPV later in life, typically through sexual activity, they have protection, says Dr. Margaret Stager, of the Metro Health Medical Center in Cleveland. She's a pediatrician and spokesperson for the American Academy of Pediatrics.

The CDC summarizes the transmission of the virus bluntly: "People get HPV from another person during intimate sexual contact. Most of the time, people get HPV from having vaginal or anal sex. Men and women can also get HPV from having oral sex or other sex play."

HPV immunization rates have been rising in the decade or so since the first vaccine became available, but pediatricians still hear pushback from some parents. Stager says she's heard questions such as: "Why are we giving this vaccine to my [11-year-old] girl? She's not going to be having sex — so why are we doing this now?"

There are two reasons to vaccinate at this age. First, there's a more effective immune response if it is given in early adolescence. And second: "It works best if given before any sexual exposure."

Though gender differences in vaccine rates have narrowed, more girls than boys get the HPV vaccine. This may be because the recommendation to vaccinate boys began in 2011, years after it was first recommended for girls.

Meanwhile, it's clear that males are getting HPV-related cancers. "We're seeing a trend in adult men with oral cancers related to HPV," says Stager. These oropharyngeal cancers occur in the back of the throat, including the base of the tongue and tonsils. Oral HPV cancer is much more common in men than women.

"This is the [age] group of men that did not have the opportunity to get the HPV vaccine," she says.

So what's the connection between HPV and oral cancer? "It's related to oral sex," Stager explains.

The CDC has documented an increase in the cases of HPV-related cancers in men in recent years, with a significant increase in oropharyngeal cancer.

"The fastest growing segment of the oral and oropharyngeal cancer population are otherwise healthy, nonsmokers in the 25-50 age range," according to the Oral Cancer Foundation.

For young men and women, it may not be too late to get the vaccine.

The CDC says those who missed being vaccinated as teenagers, can still benefit from getting the HPV vaccine through their early and mid-20s.

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STEVE INSKEEP, HOST:

Health experts would really like to vaccinate more young people against the virus called HPV, which can cause certain cancers. The vaccine was first introduced many years ago, but a new analysis from the Blue Cross Blue Shield Association finds only about one-third of adolescents get vaccinated by their teen years. NPR's Allison Aubrey reports.

ALLISON AUBREY, BYLINE: In the U.S., about 12,000 women are diagnosed with cervical cancer each year, and about 4,000 women die from it. An HPV vaccine can prevent most of these cervical cancers. It can also prevent cancer of the penis in men. Pediatricians recommend getting it early in adolescence, says Margaret Stager of MetroHealth Medical Center in Cleveland. She's a spokesperson for the American Academy of Pediatrics.

MARGARET STAGER: It's important for 12- and 13-year-olds to get the HPV vaccine to provide immunity so that when they may be exposed to HPV later in life, typically through sexual activity, they have protection.

AUBREY: Stager says vaccination rates are rising, but she still hears pushback from parents, comments like this.

STAGER: Why are we giving a vaccine to my little girl? She's only 11, and she's not going to be having sex, so why are we doing this now?

AUBREY: Stager says there are two reasons. There's a more effective immune response when the vaccine is given earlier in adolescence. Also...

STAGER: It works best if given before any sexual exposure, and that includes oral sex, as well, and touching.

AUBREY: Now, fewer boys than girls get vaccinated, and that may be because the recommendation to give boys the vaccine came years after it was first recommended for girls. But Stager says what's become clear is that men are getting HPV-related cancers.

STAGER: We're seeing a new trend in adult men with oral cancers related to HPV. And this is alarming because this is the group that did not have the opportunity to get the HPV vaccine.

AUBREY: She says the connection between HPV and oral cancer in men is clear.

STAGER: It's related to oral sex. And it's a trend that we're seeing that's increasing in great numbers.

AUBREY: In fact, the Centers for Disease Control and Prevention has documented a significant increase in the cases of HPV-related oral cancers in men in recent years. But Stager says it may not be too late to get vaccinated. According to CDC recommendations, young men and women who missed the vaccine as teenagers can get it through their early 20s. Allison Aubrey, NPR News. Transcript provided by NPR, Copyright NPR.