A vaccine against the human papilloma virus (HPV) may help prevent mouth and throat cancers, a new study suggests. Infection with HPV infection causes most cervical cancers. The HVP vaccine is known to help prevent cervical cancer. HPV infection is also a risk factor for oral cancers. Researchers randomly divided 7,466 women ages 18 to 25 into 2 groups. One group got the HPV vaccine, Cervarix. The other group got the hepatitis A vaccine. The study lasted 4 years; 5,840 women completed the study. Researchers took samples of cells from the women's throats at the beginning and end of the study. Only one woman who was vaccinated had infected cells at the end of the study. Fifteen of the women who were not vaccinated were infected with HPV. The study was published in the journal PLOS. HealthDay wrote about it June 19.
By Lori Wiviott Tishler, M.D.
Harvard Medical School
What Is the Doctor's Reaction?
Over the past year or two, I've seen more patients with cancers of the throat and tongue. Many years ago, these patients would have been considered "atypical" for this sort of cancer – young men and women who don't smoke or drink to excess.
The actor, Michael Douglas, made headlines this year by saying that his throat cancer may have, in part, been caused by oral sex. My colleague, Howard Lewine, wrote about this in his news review in early June.
Smoking and alcohol remain important risk factors for oral cancers. But we now know that most mouth and throat (oropharyngeal) cancers contain human papilloma virus (HPV), which is the virus known to cause cervical cancer. There are many strains of HPV, but sexual contact transmits only about 30 of them. Experts expect the number of people with HPV-related head and neck cancers to increase over the next decade. At present, 70% of oral cancers are considered to be caused by HPV.
There are two HPV vaccines that protect against the strains of HPV that cause cervical cancer. This new study suggests that the vaccine may help protect against mouth and throat cancers.
The data from this study are exciting. The study, which was published in the journal PLOS, was a long-standing collaboration between the National Cancer Institute and researchers in Costa Rica. The study showed that Cervarix, one of the HPV vaccines currently on the market, provided 93% protection against oral infection with HPV among over 5,000 women who took the vaccine.
Researchers took oral samples of the women at the beginning and end of the study to look for cells infected with HPV. Of the women who were vaccinated, only 1 had infected cells at the end of the study. Of the women who were not vaccinated, 15 were infected with HPV.
The study, like all studies, had limitations. These include the fact that:
- All the participants were women.
- The investigators only used the vaccine called Cervarix and not Gardisil, which is another effective HPV vaccine.
- A longer follow up time is needed to see if the vaccine actually prevents cancer, not just infection with HPV.
- We don't yet know if the primary series of three shots is enough to protect women and men for a lifetime or if booster shots are needed.
I think this study lends more compelling evidence that the HPV vaccine – for both sexes – is a potentially life-saving, cancer-preventing opportunity.
What Changes Can I Make Now?
The HPV vaccine is currently recommended for both boys and girls between the ages of 9 and 26. If you are within this age range, get vaccinated. If you have a loved one within this age range, get them vaccinated! Topics that relate to sexual activity of young people always generate controversy. When I discuss HPV vaccine with patients, I stress that this is about preventing cancer. That is something we all want for our children.
In addition, while HPV is one contributor to head and neck cancer, smoking and drinking remain important risk factors. Avoid smoking and drinking.
Talk to your doctor if you have persistent symptoms of:
- A sore in your mouth that won't heal
- A persistent lump in your neck
- Painful swallowing
The relatively good news about HPV-related oral cancers is that they are less likely to be fatal.
What Can I Expect Looking to the Future?
This is a hopeful study about the potential for a vaccine to prevent cancers. We will be looking for other vaccine-preventable cancers in the future. We will also be waiting to see that the results for women are equivalent in men.
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