HPV

Head and neck surgeons are knowledgeable about the human papillomavirus (HPV) and show generally positive attitudes and beliefs about HPV education and vaccination, according to a new study in JAMA Otolaryngology–Head & Neck Surgery. However, 68.9% reported that their daughters had received or would receive the HPV vaccine, while 55.8% reported that their sons had received or would receive the vaccination.

The relationship of HPV to oropharyngeal cancer is now well-established, with 40% to 80% of cases of oropharyngeal squamous cell carcinoma (OSCC) in the U.S. estimated to be related to HPV, noted the U.S. team of researchers. The incidence of OSCC has been increasing over the past 30 years in many parts of the world, a trend now attributed to the HPV epidemic.

In the U.S., the incidence of HPV-positive OSCC increased by 225% between 1988 and 2004, compared with a 50% decline in the incidence of HPV-negative OSCC. Recent epidemiologic evidence indicates that the prevalence of oral HPV infection is associated with an increased number of lifetime sexual partners.

Head and neck surgeons play a critical role in detecting and treating HPV-related OSCC, and they are arguably the best poised to educate patients, families, and the public regarding the prevention of the disease, the study authors noted.

In the study, a majority of the respondents (94.9%) said they routinely discuss the risk factors for head and neck cancer with their patients. Most (90.9%) also specifically mention HPV as a risk factor. However, only 160 respondents (49.1%) discuss the importance of current efforts to provide HPV vaccine to preadolescents.

When asked why they do not discuss the HPV vaccine with their patients, respondents gave various answers. The most common reason (38.7%) was because their patients are adults. The next commonly cited reasons were that the safety and effectiveness of the vaccine have not yet been proved (16.7%), and they didn’t consider it part of their healthcare role (13.5%).

A majority of respondents in the study agreed that it’s necessary to discuss sexual issues with patients before recommending HPV vaccines (56.2%), and they agreed that efficacy and safety of new vaccines can only be established after they’ve been on the market for five to ten years (59.6%). Notably, 70.1% agreed that discussing the HPV vaccine is appropriate and helps patients.

The U.S. Centers for Disease Control and Prevention currently recommends routine HPV vaccination for girls and boys ages 11 to 12 years, although the series of three shots can be started as young as age 9. Catch-up immunization is recommended to age 26 years for women and age 21 for men.

If you have children in these age groups, and this subject has not been brought up, I think it is worth a discussion with your children’s physician.