TIP Talk!

Thursday April 19, 2018

Oropharyngeal Cancer is a Growing HPV Concern


Most of what people read about the human papillomavirus concerns how it can cause cervical cancer. And no wonder. The American Cancer Society reports that U.S. doctors will diagnose about 13,200 new cases of invasive cervical cancer in 2018, and more than 4,000 women will die of the disease. Most future cases of cervical cancer could be prevented with the HPV vaccine. Yet fewer than half of teenagers in the nation are up to date on HPV immunization and Texas HPV vaccination rates lag behind the rest of the nation.

It’s just as important to be aware that HPV can cause other types of cancer, including cancer of the mouth and throat. April is Oral Cancer Awareness Month, a vital opportunity to stop thinking of HPV as a “women’s disease.” It’s an “everybody disease” and yet HPV vaccination rates for boys are significantly lower than those for girls, though the gap has been narrowing.

In fact, a recent study found that even doctors were much less likely to offer the HPV vaccine to their male preteen and teenage patients than to female patients. That’s a mistake that could have serious repercussions for future generations of men and women. People who don’t get HPV can’t pass it to others.

Note these facts about oropharyngeal cancer from the U.S. Centers for Disease Control and Prevention and recent medical journals articles:

• Recent studies indicate that 70 percent of oropharyngeal cancer cases are caused by HPV.

• Some 13,200 new cases of HPV-associated oropharyngeal cancers are diagnosed in men each year, and 3,200 new cases in women.

• About one in nine men  have oral HPV.

• The prevalence of oropharynx cancer has increased dramatically in recent years because of HPV infections.

• By 2020, new cases of HPV-related pharyngeal cancer are expected to outnumber those of HPV-related cervical cancer. 

The Association of Pediatric Dentistry is well aware of the value of the vaccine in preventing cancer. In 2017, it called on dentists to play an active role in educating their young patients and patients’ families about the importance of the HPV vaccine.

The policy that it adopted on oral and oropharyngeal cancers (OOPC) states:

The AAPD supports measures that prevent OOPC, including the prevention of HPV infection, a critical factor in the development of oral squamous cell carcinoma. The AAPD encourages oral health care providers to:

• Educate patients, parents, and guardians on the serious health consequences of OOPC and the relationship of HPV to OOPC.

 • Counsel patients, parents, and guardians regarding the HPV vaccination, in accordance with CDC recommendations, as part of anticipatory guidance for adolescent patients.

The question is how often these recommendations are followed. A recent article published by the organization Shot of Prevention questions whether dentists are regularly delivering the message about he HPV vaccine and oropharyngeal cancer to families. Author and mom Christine Vara described her own dentist’s failure to reach out with important information:

While oral health professionals should be recommending HPV vaccination to all age-eligible patients, it would be prudent to also provide that information to patients who are parents. Although my dentist is not a pediatric dentist, my five children are also patients and we all get our regularly scheduled dental cleanings twice each year. 

 At no point has anyone at this particular dental practice ever discussed oral cancer or HPV with me or any of my children, despite the fact that all five of my children are considered “age-eligible”. (I know this because after my appointment yesterday, I asked my kids.)

Yesterday, my dentist failed to discuss HPV vaccination as a potential way to prevent oral and oropharyngeal cancers, which I consider to be a missed opportunity. However, during our collective twelve appointments each year for the past five years, it’s actually more like 60 enormous missed opportunities!

What can be done to make dentists more aware of their obligations to safeguard future generations from these cancers? Have you mentioned it to your dentist recently and asked whether they regularly educate the parents of children who are reaching the recommended ages for HPV vaccination, which start as early as 9 years old?



The Ultimate Vaccine Quiz 

Meningococcal Vaccine, the Teen Vaccine Too Easily Forgotten 

HPV Awareness Day, the Perfect Time for Some Serious Questions and Answers 


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