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HPV (Human Papilloma Virus)

There is increasing evidence that the HPV virus (responsible for genital warts and cervical cancer in women) is thought to be responsible for a recent increase in head and neck cancer among men and women.  This is due to the fact that HPV can also be spread through oral sex, and recent research has strongly encouraged the use of condoms or rubber dams when performing oral sex in order to minimize risk of contraction of HPV.

It is possible to contract HPV during sexual intercourse even with the use of a condom, and there is currently no HPV test currently available for men.

There is a vaccine available for both sexes that protects against HPV strain 16, which in one NEJM study accounted for over 95% of the HPV-associated head and neck cancers. There is currently no direct evidence that the HPV vaccine will prevent HPV head and neck cancers, and using barrier methods is still advised.

Recent Journal Articles and More Information

  1. National Cancer Institute. Surveillance epidemiology and end results. [?date].
  1. Cancer Research UK. Oral cancer—UK incidence statistics. [?date].
  1. Nasman A, Attner P, Hammarstedt L, Du J, Eriksson M, Giraud G, et al. Incidence of human papillomavirus (HPV) positive tonsillar carcinoma in Stockholm, Sweden: an epidemic of viral-induced carcinoma? Int J Cancer 2009;125:362-6.[CrossRef][Web of Science][Medline]
  1. Worden FP, Hooton J, Lee J, Eisbruch A, Wolf GT, Prince M, et al. Association of tobacco (T) use with risk of distant metastases (DM), tumor recurrence, and death in patients (pts) with HPV-positive (+) squamous cell cancer of the oropharynx (SCCOP). J Clin Oncol 2009;27:15s.[CrossRef]
  1. Worden FP, Kumar B, Lee JS, Wolf GT, Cordell KG, Taylor JM, et al. Chemoselection as a strategy for organ preservation in advanced oropharynx cancer: response and survival positively associated with HPV16 copy number. J Clin Oncol 2008;26:3138-46.[Abstract/Free Full Text]
  1. Fakhry C, Westra WH, Li S, Cmelak A, Ridge JA, Pinto H, et al. Improved survival of patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial. J Natl Cancer Inst 2008;100:261-9.[Abstract/Free Full Text]
  1. Dahlstrand H, Dahlgren L, Lindquist D, Munck-Wikland E, Dalianis T. Presence of human papillomavirus in tonsillar cancer is a favourable prognostic factor for clinical outcome. Anticancer Res 2004;24:1829-35.[Abstract/Free Full Text]
  1. Lindel K, Beer KT, Laissue J, Greiner RH, Aebersold DM. Human papillomavirus positive squamous cell carcinoma of the oropharynx. A radiosensitive subgroup of head and neck carcinoma. Cancer 2001;92:805-13.[CrossRef][Web of Science][Medline]
  1. Gillison ML, Harris J, Westra W, Chung C, Jordan R, Rosenthal D, et al. Survival outcomes by tumor human papillomavirus (HPV) status in stage III-IV oropharyngeal cancer (OPC) in RTOG 0129. ASCO Meeting Abstracts. J Clin Oncol 2009;27(15S):6003.
  1. Heck JE, Berthiller J, Vaccarella S, Winn DM, Smith EM, et al. Sexual behaviours and the risk of head and neck cancers: a pooled analysis in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. Int J Epidemiol 2009; Published online 18 December.
  1. Kim JJ, Goldie SJ. Cost effectiveness analysis of including boys in a human papillomavirus vaccination programme in the United States. BMJ 2009;339:b3884.[Abstract/Free Full Text]
  1. Sturgis EM, Dahlstrom KR. Inaccurate assumptions about oropharyngeal cancer. BMJ 2009;339:b4525.[Free Full Text]


Relevant Article

Cost effectiveness analysis of including boys in a human papillomavirus vaccination programme in the United States

Jane J Kim and Sue J Goldie
BMJ 2009 339: b3884. [Abstract] [Full Text] [PDF]

Rapid Responses:

Read all Rapid Responses

Oesophageal?

Gwendoline M Harlow
bmj.com, 26 Mar 2010 [Full text]

Oropharyngeal carcinoma related to human papillomavirus

Guy L Rees
bmj.com, 28 Mar 2010 [Full text]

HPV-related Oropharyngeal Cancer

Elizabeth J Junor, et al.
bmj.com, 29 Mar 2010 [Full text]

Human papillomavirus associated with ameloblastoma in India

Shailendra K Saxena, et al.
bmj.com, 31 Mar 2010 [Full text]

Re: Mehanna et al., Australian Data

Angela Hong, et al.
bmj.com, 1 Apr 2010 [Full text]


FDA NEWS RELEASE

For Immediate Release: Oct. 16, 2009

Media Inquiries: Shelly Burgess, 301-796-4651, shelly.burgess@fda.hhs.gov
Consumer Inquiries: 888-INFO-FDA

FDA Approves New Indication for Gardasil to Prevent Genital Warts in Men and Boys

The U.S. Food and Drug Administration today approved use of the vaccine Gardasil for the prevention of genital warts (condyloma acuminata) due to human papillomavirus (HPV) types 6 and 11 in boys and men, ages 9 through 26.

Each year, about 2 out of every 1,000 men in the United States are newly diagnosed with genital warts.

Gardasil currently is approved for use in girls and women ages 9 through 26 for the prevention of cervical, vulvar and vaginal cancer caused by HPV types 16 and 18; precancerous lesions caused by types 6, 11, 16, and 18; and genital warts caused by types 6 and 11.

HPV is the most common sexually transmitted infection in the United States and most genital warts are caused by HPV infection.

“This vaccine is the first preventive therapy against genital warts in boys and men ages 9 through 26, and, as a result, fewer men will need to undergo treatment for genital warts,” said Karen Midthun, M.D., acting director of the FDA’s Center for Biologics Evaluation and Research.

Gardasil’s effectiveness was studied in a randomized trial of 4,055 males ages 16 through 26 years old. The results showed that in men who were not infected by HPV types 6 and 11 at the start of the study, Gardasil was nearly 90 percent effective in preventing genital warts caused by infection with HPV types 6 and 11.

Studies were conducted to measure the immune response to the vaccine in boys ages 9 through 15. The results showed that the immune response was as good as that found in the 16 through 26 years age group, indicating that the vaccine should have similar effectiveness.

The manufacturer will conduct postmarketing studies to obtain additional information on the safety and effectiveness of Gardasil in boys and men.

Gardasil is given as three injections over a 6-month period. Headache, fever and pain at the injection site, itching, redness, swelling and bruising, were the most common side effects observed.

Gardasil is manufactured by Merck and Company Inc. of Whitehouse Station, N.J.

Gardasil product information:
www.fda.gov/cber/products/gardasil.htm

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