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Symposium explores prevention of HPV-associated cancers

Mar. 7, 2019, 12:07 PM

 

by Kelsey Herbers

Physicians and researchers from across the country came to the Vanderbilt Symposium on HPV Infections and Associated Cancers on March 1 to discuss screening and prevention strategies for the human papillomavirus (HPV).

Focused specifically on the identification and elimination of HPV-associated cervical, anal and oropharyngeal cancers, the symposium featured seven keynote speakers representing the U.S. Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI) and academic medical centers. The event was hosted by HPV Active, one of the initiatives supported by Vanderbilt University’s Trans-Institutional Programs (TIPs) funding.

Although the first HPV vaccine was approved in 2006, the United States has not met vaccination goals. Vaccine coverage for HPV still falls well below the rates of other vaccines recommended for adolescents, such as the tetanus-diphtheria-pertussis (Tdap) and meningococcal vaccines.

“The HPV vaccine is a very important prevention tool. Roughly 630,000 cancers worldwide each year could be prevented with this vaccine, with 34,000 of those cancers being within the United States,” said Jennifer Pietenpol, PhD, Executive Vice President for Research at Vanderbilt University Medical Center and director of Vanderbilt-Ingram Cancer Center (VICC). “We must reduce the missed opportunities in the community to educate about the HPV vaccine as well as the missed opportunities in clinics to recommend and administer the vaccine.”

“What you’re doing by being here today is answering the call to action that the NCI has had for the past 13 years,” said Pietenpol, Benjamin F. Byrd Jr. Professor of Oncology and holder of the Brock Family Directorship in Career Development.

Tennessee and its surrounding states have the lowest HPV vaccination rates in the country for both girls and boys, with less than 39 percent of adolescents being up-to-date on their HPV vaccines, compared with a national average of 49 percent.

“It is critical for VICC to lead the charge toward increasing the number of girls and boys and young women and men getting the HPV vaccine. We are seeing more and more evidence of the efficacy of this vaccine in reducing HPV infections and cancer precursor lesions in the cervix,” said Ronald Alvarez, MD, MBA, chair of Obstetrics and Gynecology, who leads VUMC’s HPV TIPs initiative. “Eradicating HPV cancers in Tennessee is right at our fingertips provided we effectively vaccinate and screen eligible citizens.”

The state’s low vaccination rates prove especially problematic when it comes to oropharyngeal cancer (OPC), as the Southeast region also has the highest incidence of HPV-associated OPC in the country.

“Here at Vanderbilt, we are at the epicenter of what is being called an emerging epidemic of OPC, and it will likely stay that way given our region’s low vaccination rate,” said Krystle Kuhs, PhD, MPH, assistant professor of Medicine in VUMC’s Division of Epidemiology.

A focus of research at Vanderbilt led by Kuhs is testing for the presence of antibodies against HPV to identify those most at risk for HPV-related cancers so tumors can be detected earlier. The rate of OPC has increased by roughly 225 percent since the late 1980s.

The symposium concluded with research related to best practices for managing the vaccine hesitant, presented by Amanda Dempsey, MD, PhD, MPH, associate professor of Pediatrics at the University of Colorado Denver.

Dempsey reminded the audience that “vaccine hesitancy is actually a continuum” in which most parents are neither for nor against every vaccination that’s recommended for their child — they’re somewhere in between.

Using communication techniques that are presumptive and motivational, Dempsey recommends physicians ask open-ended questions and request permission to share information with parents to help them feel more in control of the situation while still providing strong recommendations.

Other speakers for the symposium included: Warner Huh, MD, FACOG, FACS, from the University of Alabama at Birmingham; Nicolas Wentzensen, MD, PhD, from the NCI; Timothy Wilkin, MD, MPH, from Weill Cornell Medical College; Julia Gargano, PhD, MS, from the CDC; and Vivian Colón-López, PhD, MPH, from the University of Puerto Rico.

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