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Pieces of the Continent #13: Dr Ashish Deshmukh

Our latest interview in our Pieces of the Contienent series is with Dr Deshmukh

Q: Please introduce yourself and tell us a bit about your work.

I am an Assistant Professor at UTHealth School of Public Health. I am a clinical decision scientist with an interest in HPV and HPV-associated cancer epidemiology and prevention. In particular, the emphasis of my research is around the study of HPV natural history and HPV-associated associated cancer epidemiology using registries and large databases as well as identifying optimal ways to prevent HPV-associated cancers using disease simulation models.

Q: How have you seen your work impact global healthcare over the few years?

Some of the very recent work of my team showed that the genital and oral HPV infection is more common in men and that men and women with genital HPV are also at increased risk for oral HPV, men and women with first HPV associated cancers are at increased risk for subsequent HPV-associated cancers, public knowledge of HPV and associated cancers is extremely poor in the US (with over 75% individuals don’t know that HPV causes oropharyngeal, anal, and penile cancers), and the rates of HPV-associate cancers and related mortality (particularly anal cancer) is increasing very rapidly in the US. Collectively, our work highlights the need for increased HPV and associated cancer prevention efforts. Our work also helped raised public awareness regarding the issue through various platforms.

Q: What are the main responses have you seen to the HPV vaccine?

Although HPV vaccination rates are increasing in the US, there are still substantial disparities in vaccine uptake. For instance, only a handful of states are able to achieve coverage over 70%; in many states, vaccination rates are still less than 40%. There is still a substantial hesitancy and selectivity about the HPV vaccine. To overcome this, it is very important that provider-parent communication needs to improve.

Globally, more than 70% of HPV-associated cancer cases occur in countries where there are no HPV vaccination programs. In many low-income and middle-income countries, less than 5% of adolescents are vaccinated. There is a need to find ways to rapidly scale-up vaccination rates through public health campaigns that are often effective in low and middle-income countries.

Q: How have your simulations made an impact on policy-making?

Our prior simulation work has shown that similar to cervical cancer screening, screening and treatment for anal cancer prevention can be effective in reducing cancer risk (in that such a program has the potential to cut cancer risk by over 75%). Our current work will further optimize anal and other HPV-related cancer screening algorithms and will lead to algorithms with the potential to inform cancer screening policies.

Q: How might gender-neutral vaccination affect the HPV infection rate of high-risk groups?

Gender-neutral HPV vaccination programs can lead to prompt prevention of HPV-associated cancers. For effective implementation gender-neutral there is a need to improve awareness of HPV and its association with oropharyngeal, penile, and anal cancers that are rising in men.

Q: What do you see as the greatest obstacle to take up of the HPV vaccine? How can we overcome this?

As I mentioned before, parents hesitancy/selectivity is a major obstacle to the HPV vaccine uptake. Understanding and overcoming any concerns parents may have about the vaccine can lead to an improvement in vaccination rates. It is also essential to prevent any misinformation, which is becoming more prevalent in the era of social media.

Q: Do you have any final thoughts or anything you would like to add?

Rates of anal and throat cancers caused by HPV are increasing rapidly. Persons at increased risk (e.g., those with HIV, women with a history of abnormal cervical cancer screening, and individuals with Inflammatory bowel disorders) should speak with their health care professionals if they are eligible and can undergo screening (e.g., anal examination) as early detection from screening can also decrease deaths from cancers caused by HPV.


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