Weekly Wednesday 19 October 2016

Many head and neck cancers are caused by the  human papillomavirus  and rates are increasing.  A vaccine against HPV was developed several years ago  and, as it is responsible for cervical cancer in women, it has been widely available free to girls for some time.   More countries, including NZ from January next year, are also making it free to boys.

However it’s not all plain sailing as some of the following stories indicate.

Ireland asked to attend WHO meeting over low uptake of HPV vaccine
Uptake in vaccine to prevent cervical cancer low ‘due to huge impact of lobby groups’

Ireland has been asked by the World Health Organisation (WHO) to participate in a meeting over concerns regarding the State’s low uptake of the HPV vaccine.

The meeting  will also discuss the even lower uptake of the vaccine in Denmark, along with ways of increasing public acceptance of it.

The HSE’s (Health Service Executive-Ireland) National Immunisation Office launched a HPV vaccination campaign in 2010, with the initial target group being young girls aged 12 to 13 years. Since then about 220,000 girls have been vaccinated. An initial shot is given followed by a second about six months later.

Vaccination rates peaked at 87 per cent in 2014-15, but rates have fallen since due to negative campaigning by lobby groups who claim the vaccine causes significant side effects, says the head of the immunisation office, Dr Brenda Corcoran.

“It is a really big issue,” she said. “We have preliminary figures that suggest the uptake is low due to the huge impact of lobby groups.”

There was a fall in vaccine numbers of about 5,000 last year compared to the previous year.

“The rates of head and neck cancers in men is expected to overtake cervical cancer by 2020,” Dr Corcoran said.

Full Story:
http://www.irishtimes.com/news/health/ireland-asked-to-attend-who-meeting-over-low-uptake-of-hpv-vaccine-1.2820866

Boys should also get the HPV vaccine to protect themselves from oral and genital cancers

The human papillomavirus (HPV), which causes cervical cancer in women, is also responsible for many cancers in men. It causes most cancers of the tonsils (known as oropharyngeal cancers), which are more common in men than women. HPV is also to blame for cancers of the anus, vulva, vagina and penis.

Oral cancers – which include those of the tonsils, mouth and tongue – affect more than 300,000 people globally each year. A person living in Australia has a one in 49 estimated risk of being diagnosed with head and neck cancer by their 85th birthday, which includes oral cancers.

The chance is higher in males (one in 32) than females (one in 98)..

The best way to prevent these cancers is to get the HPV vaccine, which is available for free under Australia’s National HPV Vaccination Program to boys and girls aged 12 and 13. Those over 14 can obtain the vaccine from their GP or local immunisation provider, but they will need to pay for it.

Most of us (around 80%) will acquire an infection from a virus in the human papillomavirus family at some point in our lives – usually without knowing it, as there are often no symptoms. HPV infections are transmitted through vaginal and oral sex, and even kissing.

HPV is a group of viruses first identified in the mid-1970s. There are now more than 170 known types, which can infect the skin and live in the genital tract and on the lining inside our mouth.

The HPV vaccine was developed by Australian scientists in 2006 to protect women from cervical cancer. In 2007, Australia was one of the first countries to implement a secondary high school HPV vaccination program for girls, which was then extended to include boys in 2013.

Full story:

http://theconversation.com/boys-should-also-get-the-hpv-vaccine-to-protect-themselves-from-oral-and-genital-cancers-58772

Study questions rise of head and neck cancers in the UK

In the first study of its kind researchers from the University of Liverpool's Institute of Translational Medicine have examined the possible reasons for the rapid increase in incidence of particular head and neck cancers in the UK.

A rising incidence of Oropharyngeal squamous cell carcinoma (OPSCC), a type Head and Neck cancer arising in the tonsils, base of tongue and soft palate, has occurred throughout the developed world, and has frequently been attributed to an increasing impact of Human Papillomavirus (HPV).

The researchers found that the doubling in incidence of oropharyngeal squamous cell carcinoma in the United Kingdom from 2002 to 2011 was not solely attributable to a rise in incidence of Human Papillomavirus (HPV)-positive disease.

The study clearly demonstrated that the incidence of HPV-negative OPSCC was climbing as quickly as that of HPV-positive disease.
Andrew Schache, Clinical Senior Lecturer in Head & Neck Surgery and first author of the study, said: "The results of this study are in stark contrast to the previously held understanding, that rapid and dramatic changes in Oropharyngeal cancer incidence, witnessed in the UK (and other developed nations) over the last three decades, have been exclusively an HPV-driven phenomenon.

"Indeed, it appears that whilst HPV positive Oropharyngeal cancer is rising in incidence, so too is HPV-negative disease.

"This study draws attention to the need for further research capable of guiding the implementation of appropriate prevention strategies for both types of disease. Whilst the results lend further weight to calls for the UK to adopt a gender-neutral HPV vaccination policy, critically, we also need to better understand the reasons or risk behaviours lying behind rising HPV-negative oropharyngeal cancer."

Full story:
http://medicalxpress.com/news/2016-10-neck-cancers-uk.html

Voice box prostheses may only last three months

(Reuters Health) - Tracheoesophageal voice prosthetic devices often last less than three months before they need to be replaced, which is a shorter lifespan than previously reported, according to a new study.

“In an ideal setting, voice prostheses should last at least six months and even more ideally, up to one year,” says lead author Jan S. Lewin of The University of Texas MD Anderson Cancer Center in Houston. “In reality, they generally last somewhere about three months before they have to be replaced.”

The silicone devices are placed in the shared wall between the trachea and the esophagus after a laryngectomy, the removal of the voice box due to cancer, injury or radiation damage.

That the voice prostheses don’t last as long as they once did is “unfortunate, but not surprising when one considers the significant effects from the intensification of our cancer treatment regimens on our patients’ bodies,” Lewin said

These devices are not common, as the number of head and neck cancer patients who are treated with a total laryngectomy is very small.  

“The benefit is that they help restore speech production very quickly and almost as normally as speech was produced when the patient had his/her larynx,” she said. “The drawbacks are that they need to be replaced as they wear out and sometimes if not managed properly, they allow saliva and food to get into the trachea (windpipe) that causes aspiration and coughing.”

Full story:

http://www.channelnewsasia.com/news/health/voice-box-prostheses-may-only-last-three-months/3183452.html