Last week the U.S. Food and Drug Administration (FDA) expanded the indication for Gardasil 9, one of the HPV vaccines, to include head and neck cancer. With this change, yet another compelling reason (on top of the large body of evidence in support of the HPV vaccine) has been given as to why we should vaccinate our sons and daughters against the human papillomavirus.
What are Head and Neck Cancers?
credit: Terese Winslow
Head and Neck Cancers are a group of cancers which affect areas including the mouth, voice box, throat, and sinuses. Specifically, oropharyngeal cancers are a type of head and neck cancer which affect the part of the throat called the oropharynx; an area of body which incorporates the tonsils, throat, base of the tongue and roof of the mouth (soft palate). The incidence rates of these HPV-related head and neck cancers is increasing, whilst rates associated with other causes such as tobacco and alcohol is falling.
According to CRUK the incidence rate of head and neck cancers has increased some 33% since the early 1990s. The CDC report that 13,500 cases of these cancers are diagnosed each year in the United States. Around 70% of these are caused by HPV in particular, HPV 16, one of the strains of the virus. Whilst these are cancers can affect both sexes, these cancers affect men 5 times more than they do women. Equally, the rates of HPV-related head and neck cancers, have now overtaken those of cervical cancer.
Data from CDC
What does this news mean?
80% of us will have an HPV infection at some stage in our lives and in the United States, around 14 million people are newly infected with the virus each year. As we know, in the vast majority of cases our bodies clear the virus and we never develop any symptoms or issues. But for those unfortunate, the virus can manifest into some nasty diseases including cancer.
The extension of the licence to include head and neck cancer helps us in quest to educate the public that this is not a female-only issue, and that both boys and girls should receive the vaccine. Men are also at risk of developing HPV-related cancers, and head and neck cancers are now the most common type of cancer caused by this virus. Data from a recently published study in Eastern Denmark showed that rates of HPV-related oropharyngeal cancer had tripled over the past 18 years.
Knowledge around HPV and its disease burden are poor. A study in 2019 discovered that 70% of US adults were unaware that HPV caused head and neck, penile and anal cancers. Likewise only a third of respondents in a European study were aware that HPV caused cancer in men.
With this change, medical professionals can add preventing head and neck cancers to the list of benefits when communicating about the vaccine to parents and young people, in particular around the importance of protecting both boys and girls. These vaccines are a safe and effective means of preventing 5% of cancer, and present the greatest opportunity to prevent cancer in decades.
This new recommendation can hopefully ensure that more people are taking the steps to protect their loved ones. Prevention is better than cure.