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HOT TOPIC: Why vaccinate for hpv today along with other adolescent recommended vaccines?

Immunization Graphic Every year in the U.S., 31,000 women and men are diagnosed with a cancer caused by HPV infection. While HPV is most associated with cervical cancer prevention, this type of cancer only accounts for 33% of the cancers caused by HPV, and most of these cancers can also be prevented by HPV vaccination. HPV vaccination prevents not only cervical cancer, but also cancers of the back of the throat (oropharynx) and cancer of the anus/rectum. These types of cancers are typically not detected until at later stages, when they are more difficult to target. 

HPV vaccination can prevent uncomfortable testing and treatment in the event of cervical pre-cancers (each year in the U.S. more than 300,000 women endure invasive testing and treatment for cervical cells that can develop into cancers), and can prevent other cancers that are not tested for in the U.S.

Human papillomavirus (HPV) is transmitted through intimate skin-to-skin contact. Someone can get HPV by having vaginal, anal, or oral sex with someone who has the virus. HPV is so common that nearly all men and women get it at some point in their lives. HPV can be passed even when an infected person has no signs or symptoms. You can develop symptoms years after being infected, making it hard to know when you first became infected.

In most cases, HPV goes away on its own and does not cause any health problems. But when HPV does not go away, it can cause health problems like genital warts and cancer.

The CDC recommends that 11- to 12-year-olds receive two doses of HPV vaccine at least six months apart rather than the previously recommended three doses to protect against cancers caused by human papillomavirus (HPV) infections. Teens and young adults who start the series later, at ages 15 through 26 years, will continue to need three doses of HPV vaccine to protect against cancer-causing HPV infection.

Use every opportunity to effectively recommend and administer all of the adolescent vaccines to parents of your preteen and teen patients. A clinician recommendation is the number one reason parents decide to vaccinate.

Resource Alert
The Top 10 List for HPV #VaxSucces is a great resource that offers tips and strategies for attaining and maintaining higher HPV vaccine rates in your practice. Quality Insights encourages you to download this tip sheet and review it with your clinician team at your practice's next staff meeting. The Delaware Division of Public Health maintains an Information System for all immunizations reported, and would be a good resource to assist in determining your vaccine rates.  If you wish to see a report of your immunizations rates, email the Immunization Program for a report.
Science corner: let's take a look at the Number of HPV-Attributable Cancer Cases per Year

The graph below from the Centers for Disease Control and Prevention (CDC) shows the number of HPV-associated cancer cases that were diagnosed and reported each year in United States from 2010 to 2014 (the most recent 5-year period with available data) by sex, cancer type, and HPV-type.

In order to estimate the number of HPV-associated cancers, researchers look at cancer in parts of the body and cancer cell types that are likely to be caused by HPV. These include all carcinomas of the cervix and squamous cell carcinomas of the vagina, vulva, penis, anus (including rectal squamous cell carcinomas), and oropharynx, including the base of the tongue and the tonsils.

A CDC study published in 2016 used population-based data to genotype HPV types from cancer tissue. These data are used to estimate the percentage of these cancers that are probably caused by HPV, what we call HPV-attributable cancers.

This graph shows the total number of HPV-associated cancers and uses the attributable fractions from the genotyping study to estimate the number probably caused by HPV types. HPV types were grouped as 16/18 (the dark blue bar), other high risk types 31/33/45/52/58 (the medium blue bar), and other HPV types (light blue bar). The white bar means that HPV DNA was not detected.

CDC Cancer graph
patient perspective: 
videos shine a light on cancer from the human point of view

provider and patient The American Cancer Society (ACS) supports a series of articles and videos featuring cancer survivors and providers who treat cancer patients. Some stories share the patient's perspective on what it was like to be diagnosed with cancer, their treatment journeys, and how they have emerged stronger on the other side. Other stories feature physician perspectives on cancer treatment, including why they have taken on the challenge of treating cancer, the symptoms and risk factors they see for different types of cancer, and some physicians also discuss the importance of promoting prevention strategies, such as the HVP vaccine, as a viable solution for significantly reducing the incidence of cancer. These stories are now available on the ACS website.
Additionally, the ACS has posted cancer patient video stories on its YouTube channel. Below please find links to two HPV-related stories:
Quality Insights plans to feature more cancer patient and provider videos in future editions of this e-newsletter.
backyard news: tap into the education and resources available from the immunization coalition of delaware

provider group Did you know that there are Immunizations Coalitions in states across the United States? Immunization coalitions are comprised of a variety of community partners, including healthcare and public health professionals, community leaders, parents, businesses, and anyone else who is interested in improving vaccination rates in that region. 

Most importantly, did you know that there is an Immunization Coalition right here in in Delaware? Its called the Immunization Coalition of Delaware (ICD) and is a program of the  Delaware Academy of Medicine /  Delaware Public Health Association in partnership with the  Delaware Division of Public Health. The ICD hosts quarterly meetings and has a great website that is full of educational information on all vaccination type, including HPV. Please visit the ICD website to learn more.
"I'd much rather prevent a cancer than have to diagnose and treat and cure it because then we save the patient all of the problems of tr eatment."

- Otis Brawley, MD, FACP
Chief Medical and Scientific Officer, American Cancer Society
contact information

For more details about the HPV Vaccine Improvement Project , please contact Lisa Gruss.

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This project is in collaboration with the Division of Public Health (DPH) - Comprehensive Cancer Control Program, Immunization and Vaccines 
for Children, and the Centers for Disease Control and Prevention (CDC). Publication number DEDPH-HPV-040318