A Cancer Vaccine Exists – Why Aren't More Americans Getting It?

It would have seemed impossible two decades ago to think you could go to the doctor, get a shot, and be protected against a multitude of cancers. And yet, for more than half a dozen types of cancer, a vaccine now exists.

Most cancers of the cervix and a rising number of oropharynx, penile, vulvar, vaginal, anal and rectal cancers are linked to the human papilloma virus (HPV), and a widely available vaccine is incredibly effective at preventing that virus from living in our bodies. Also, almost all people who are sexually active will contract the virus in their lifetime, which means more than 80 percent of adults are at risk for developing an HPV-related cancer.  

However, not everyone who needs the vaccine is getting it, and data published this week by the U.S. Centers for Disease Control and Prevention (CDC) reveals those cancers are now affecting more Americans than ever before.

According to the study published July 7 in the CDC's Morbidity and Mortality Report, an average of 33,000 HPV-associated cancers were diagnosed in Americans each year from 2004 through 2008, but the yearly average rose to almost 39,000 cases from 2008 through 2012 (the latest year with data available).  That's an increase of 16 percent.

"HPV-associated" means these cancers are caused by an HPV infection that has not cleared and previous research has linked HPV to an increased risk for certain cancers.  The researchers estimate that 79 percent of these cancers were HPV-positive, meaning a vaccine could have prevented nearly 31,000 people from developing cancer every year.

Countries with higher rates of HPV vaccination have seen drastic drops in pre-cancerous changes of the cervix, changes that, if untreated, can become cancer. As more people get protected, the virus has fewer chances to reach both protected and unprotected people, and the disease begins to be eliminated.  Think of other diseases that vaccines now prevent - measles, mumps, polio, TB - in vaccinated communities.

But the opposite is happening with HPV: Vaccination rates for young people age 13 to 17 are extremely low: only 40 percent of girls and 20 percent of boys are fully vaccinated. As a result, in Americans these cancers are increasing. It's a national trend in the wrong direction. The vaccine is recommended for girls aged 9 to 26 and boys aged 9  to 21 - why so young? Like for other diseases, people need to be vaccinated before exposure, so before sexual activity and kissing begins, which is how the virus is spread.

Despite the trends, there are no requirements for students to receive HPV vaccines to attend school as there are for the measles, mumps and rubella viruses. HPV represents a public health threat - why is this vaccine not on the list?

When the HPV vaccine was first approved 10 years ago, it's introduction was linked to sexual promiscuity and permissiveness.  This is not about sex - it's about preventing cancer. Two other diseases children are vaccinated for - Hepatitis B and Meningococcal viruses - are also contracted through risky behaviors like sexual activity, but there has not been such a concerted effort to tarnish or shame these vaccines. Moreover, the HPV vaccine is as safe as these other childhood vaccines and the TDAP vaccine. Too many children are now at risk for cancer in adulthood because of smear campaigns and false information. It's time to change the conversation about the HPV vaccine from one that starts with how you are exposed to the virus to its ability to prevent cancer - with its pain and suffering. Tens of thousands of families are losing a parent from cervical cancer or oral cancer, caused by HPV, now a preventable cancer - think of all those children left without a parent!  This is a crime.

Education is the first step - people must know these vaccines are available (in many cases, for free). We must also expand the national conversation about HPV, and encourage an informed dialogue, with questions asked and correct facts being provided.  The vaccine should be bundled with the recommendation of the TDAP and Meningococcal vaccine at the 11- to 12-year-old well child visit. Children older than 12 can still get the vaccine until they are 26 for girls or 21 for boys. If your child has not had the vaccine ask your doctor for it.  

Every parent should ask the question: if there was a vaccine I could give my child that would prevent them from developing six different cancers, would I give it to them? The answer would be a resounding yes - and we would have dramatic decrease in HPV-related cancers across the globe." A "cancer vaccine" exists, now people have to use it.