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By Babita Jyoti, M.D.


HPV Vaccines: Lifesaving Cancer Prevention

February is National Cancer Prevention Month – a great time to take a look at ways to lower your cancer risk. Of course, eating a well-balanced diet, reducing consumption of red meat, exercising regularly, not smoking and making time for routine check-ups and cancer screenings are all healthy lifestyle choices that aid in cancer prevention and overall health maintenance. But vaccines also play an important role in cancer prevention.

Cancer-preventive vaccines protect the body against infectious agents that can lead to cancer. Cervical cancer was once a leading cause of cancer death for U.S. women. While introduction of the PAP test in 1950 significantly reduced cervical cancer death rates, the test only allowed for early identification of the disease – not prevention.

We now know virtually all cervical cancers are caused by chronic infections linked to certain strains of HPV (human papillomavirus). Most HPV infections clear up on their own within two years, but those that persist can lead to cancer. HPV types 16 and 18 cause 70 percent of cervical cancers and nearly half of all vaginal, vulvar and penile cancers. HPV infections can also lead to head and neck cancer. HPV is responsible for more than half of all oropharyngeal cancers, such as cancers in the back of the throat, base of the tongue and the tonsils.

In 2006, Gardasil® became the first HPV vaccine to receive approval from the Food and Drug Administration (FDA). Now three vaccines are approved for the prevention of cervical cancer.

Gardasil protects against HPV16 and 18, the two strains responsible for most cervical cancers. Cervarix®, a similar vaccine, targets the same two cancer-causing strains. A third vaccine, known as Gardasil 9®, offers protection against seven HPV strains including: HPV16, 18, 31, 33, 45, 52, and 58. 

Do the vaccines offer similar protection against oropharyngeal cancer? A large study of cervical cancer in Costa Rican women showed that Cervarix, the only vaccine tested, reduced oral HPV infections by more than 90 percent. However, these women were not tested for throat infections beforehand.

Like Cervarix, Gardasil and Gardasil 9 protect against cervical cancers and pre-cancers. Gardasil and Gardasil 9 are also effective in preventing anal, vaginal, and vulvar cancers as well as genital warts.

While studies have shown the vaccines to be well tolerated and extremely effective, the challenge lies in convincing parents to use them. Approximately half of U.S. males ages 18 to 59 have genital infections caused by HPV, but a decade since the first vaccine was approved, only about 42 percent of girls and 28 percent of boys ages 13 to 17 are estimated to have completed the vaccination series. By comparison, vaccination compliance for varicella and hepatitis B is nearly 97 percent.

Although HPV is a sexually transmitted infection, pre-teen vaccinations aren’t about sex, but rather cancer prevention. Numerous studies have shown that sexual activity does not increase with vaccination, and, by taking the vaccine, the majority of the nearly 31,000 cases of HPV-related cancers diagnosed annually could be prevented. 

Currently the Centers for Disease Control and Prevention (CDC) recommend Gardasil for both males and females between the ages of 9-26. Gardasil 9 may be administered to males ages 9-15, and females ages 9-26. Cervarix is approved for females from 9 to 25 years old. 
All three HPV vaccines require two doses given at least six months apart if administered before age 15. Those starting the vaccination series at age 15 or older should receive three doses.

Prevention of HPV-related cancers is something every child deserves. I strongly urge parents to speak with their child’s pediatrician about these lifesaving vaccines. For questions about HPV or HPV vaccines, please contact me at jyotimd@ackermancancer.com.

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