As summer ends and a new school year approaches, parents are busy scheduling back-to-school physicals and ensuring their children are up-to-date on all necessary immunizations. Among these, the Human Papillomavirus (HPV) vaccine stands out as particularly crucial for tweens and teens.
HPV is a sexually transmitted infection that can lead to serious health issues, including various types of cancer such as cervical, penile, anal, vaginal, and throat cancer. For parents in Athens and elsewhere, understanding the importance of this vaccine is paramount in safeguarding their children’s future health.
As an expert in otolaryngology-head and neck surgery, I frequently encounter patients battling throat cancer. Over recent decades, there has been a significant rise in HPV-positive oropharyngeal squamous cell carcinoma (HPV+ OPSCCA), a specific type of throat cancer. Studies have shown alarming increases, with one indicating a surge of over 225 percent between 1998 and 2004. This form of cancer has now surpassed cervical cancer as the leading HPV-related cancer, and alarmingly, men face a higher risk compared to women.
Historically, head and neck cancers, including oropharyngeal cancer, were primarily linked to smoking and alcohol consumption. However, with declining smoking rates, cancers associated with smoking have decreased. Today, HPV-associated head and neck cancers account for approximately 75 percent of all head and neck cancers and about 90 percent of oropharyngeal cancers.
A concerning aspect of HPV-positive cancers is that they often affect younger, healthier individuals, with a median age of diagnosis around 54. Many of these patients have no history of smoking or heavy drinking. While risk factors like genetic predisposition, early sexual activity, multiple partners, and prior anogenital warts exist, many cases occur without any identifiable risk factors.
Oropharyngeal cancers, located in the throat, often remain asymptomatic until they become quite large. Unlike cervical cancer, there is no routine screening test like the PAP smear available for early detection. Consequently, patients frequently present with a neck mass, indicating that the cancer has already spread to the neck. Large primary tumors may necessitate aggressive treatments like chemotherapy and radiation therapy. Fortunately, despite its aggressiveness, HPV+ OPSCCA often responds well to treatment and carries a more favorable prognosis compared to HPV-negative cancers.
HPV is now the most prevalent sexually transmitted infection globally. The Centers for Disease Control and Prevention (CDC) estimates that up to 75 percent of the reproductive-age population in the United States has been exposed to HPV. Transmission occurs through sexual contact, including orogenital contact, which can lead to oropharyngeal HPV infection. Most HPV infections are asymptomatic and resolve on their own within a couple of years. However, testing can detect oropharyngeal HPV infection in approximately seven percent of people.
Predicting whether an HPV infection will lead to cancer, and if so, where in the oropharynx it might occur, is currently impossible. Therefore, preventive treatment after exposure is not an option. Among the approximately 100 HPV strains, about 35 are considered to have cancer-causing potential. HPV 16 is the most common culprit, particularly in oropharyngeal cancers.
Given the lack of post-infection prevention and the potentially severe nature of treatment, vaccinating both boys and girls against HPV is crucial. The American Academy of Pediatrics (AAP) recommends two doses of the HPV vaccine for children aged 11 to 12, or three doses for teenagers who did not receive it earlier. Vaccination at younger ages is more effective in preventing infection and future cancers. It is estimated that widespread HPV vaccination could prevent thousands of cases of HPV+ OPSCCA.
For Athens parents seeking more information about HPV vaccination for their children, consulting with a pediatrician or another healthcare provider is the best step. An ear, nose, and throat doctor in Athens can also provide specialized information and address concerns related to HPV and throat cancer.
For further details on vaccination, speak with your child’s pediatrician or another healthcare professional.
Information provided by Robert Strominger, MD, a board-certified otolaryngologist-head and neck surgeon.
