Editor’s Note: Dr. Mary T. Bassett is the commissioner of health for New York City. Previously, she was the program director for the African Health Initiative and the child well-being program at the Doris Duke Charitable Foundation. The views expressed in this commentary are solely hers.
Mary T. Bassett: A study showing a high rate of oral HPV among American men is disheartening, but could be an opportunity
Society must recommit -- parents, health care providers, public health authorities -- to protect our young people from HPV
For over a decade now, our country’s health leadership has raised awareness about the human papillomavirus vaccine and urged young people to be immunized. Sadly, HPV vaccine rates in America have remained inadmissibly low.
That fact, well-known in the medical and public health communities, feels particularly poignant today, after a study published this week by the Annals of Internal Medicine exposed the stunning statistic that an estimated 11 million men in America have oral HPV infections and 7 million men have the high-risk type of HPV that can cause cancers of the mouth and throat.
The reasons why our young people are not receiving this important vaccine vary and are complex, but the responsibility falls mostly on two parties: the health care provider who must recommend it, and the parent who must accept it. Health care providers must shift the conversation from the way in which HPV is transmitted and focus on the disease it prevents. Let’s call the vaccine what it is: a vaccine against cancer.
Through immunization, we can protect future generations from HPV. But there’s more to be done for those who have oral HPV infection and are past vaccination age. For this group, early diagnosis and behavioral changes are critical. At this time, there are no FDA-approved oral HPV tests, but possible signs of throat and mouth cancer should prompt doctors and dentists to do thorough head and neck examinations.
Thankfully, this new study grabbed many headlines. Its eye-popping research reminded us of how dangerous certain HPV viruses can be for men and women, despite being extremely common and often asymptomatic.
There is evidence the HPV vaccine, recommended for young people between 9 and 26 years old, can prevent most cervical cancers and protect against vaginal, vulvar and anal cancers associated with certain high-risk HPV strains. Researchers are now also looking to see if it is effective in preventing high-risk oral HPV infections.
But despite the availability of a vaccine – our best tool to fight the virus – according to the Centers for Disease Control and Prevention, in 2016 only 56% of boys ages 13 to 17 received one or more doses of the vaccine, compared with 65% of girls nationally. And only 37.5% of boys in this age group completed the HPV vaccine series, compared with 49.5% of girls.
Some parents fear that authorizing their teenagers to get the vaccine somehow gives them permission to have sex before they may be ready. As a parent and as a doctor, I understand this as a real concern, but it is unfounded. Very much like the hepatitis B vaccine, the HPV vaccine can protect people from developing cancer later in life.
There is also a persistent belief that vaccines in general – and the HPV vaccine in particular – are unsafe and not effective. This is also untrue, and it is a myth regrettably being perpetuated by some leaders in Washington. The fact is, those who complete the HPV vaccine series will be protected from the virus for at least 10 years.
Many studies have also proven that tobacco smoking is associated with a worse prognosis in HPV-associated oral cancers. As a former smoker, I remind myself that while quitting smoking is extremely hard, continuing smoking can be deadly.
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And of course, engaging in safe sex practices is key to prevent HPV. According to the study, the risk for infection was higher for people who have had multiple sex partners and who have frequent oral sex. Condoms and dental dams, when used consistently and correctly, may lower the chances of giving or getting oral HPV because they can stop the transmission of HPV from person to person.
This week’s news is an opportunity to recommit as a society – parents, health care providers, public health authorities – to our collective responsibility to protect our young people from HPV and reduce their risk of developing related cancers.