Dr. Ted Teknos has become familiar with the sad scenario. A young and otherwise healthy nonsmoker comes to his office with cancer in the tonsils or at the base of the tongue. This used to be fairly rare. But as human papillomavirus infections have increased, so have cancers linked to them.
Dr. Ted Teknos has become familiar with the sad scenario. A young and otherwise healthy nonsmoker comes to his office with cancer in the tonsils or at the base of the tongue.
This used to be fairly rare. But as human papillomavirus infections have increased, so have cancers linked to them.
“Between the late ’80s and 2008, the incidence ... jumped 225 percent,” said Teknos, who is director of head and neck surgery at Ohio State University’s Arthur G. James Cancer Hospital.
A national report released yesterday showed that cancer deaths in the United States continue to drop, but it also highlighted growing concern about an increase in cancers linked to the HPV, which is sexually transmitted (including through oral sex) and in many cases now can be prevented through vaccination.
HPV is so common that at least half of sexually active men and women get it at some point in their lives. In nine out of 10 people, the immune system clears the infection within two years. In other cases, the virus remains and can lead to cancer, including cervical and oral.
In their annual cancer report, federal experts focused on HPV-linked cancers, particularly of the throat. A vaccine recommended for adolescent girls and boys is underused, according to the report, which is co-authored by researchers from the American Cancer Society, the Centers for Disease Control and Prevention, the National Cancer Institute and the North American Association of Central Cancer Registries.
Cancer deaths overall began to decline in the early 1990s. Death rates dropped by 1.8 percent per year in men and 1.4 percent per year in women from 2000 to 2009. But death rates for melanoma, pancreatic cancer, liver cancer and uterine cancer increased during that time.
The American Cancer Society estimated that 577,190 Americans would die of cancer last year.
National experts said the news in reduced deaths overall is good, but the numbers highlight the need to make progress, particularly in cases of preventable cancers.
Dr. Peter Shields, deputy director of the OSU Comprehensive Cancer Center, said that better treatment and less smoking are the primary drivers of overall lower rates of cancer death in the United States.
Much focus is currently on trying to drive down the number of people who get cancer in the first place, while continuing to lower the mortality rate, he said.
HPV infections and their connection to an increase in throat cancer and anal cancer are considered an area for improvement. No specific data are available to show how well the HPV vaccine works to prevent throat cancers — most research has focused on cervical cancer.
But the number of HPV-linked cancers of the tonsils and the back of the tongue have increased tremendously, and it stands to reason that higher vaccination rates would help, Teknos said.
In 2010, about 49 percent of girls 13 through 17 had received at least one dose of the vaccine against HPV. One-third had received the complete three-shot vaccine. Coverage rates were lower among girls living in poverty, Latinos and those living in the South. The three-shot series costs almost $400.
Federal health officials currently recommend the vaccine for girls and boys 11 or 12 years old. Girls and women not vaccinated earlier benefit through age 26, according to the CDC. And boys and young men should be vaccinated through age 21 if they weren’t vaccinated earlier.
Cervical cancer (which also is caused by HPV infection) decreased from 2000 to 2009.
The decrease is attributed to early detection of precancerous cells through Pap tests, said Dr. Carl Krantz, an obstetrician-gynecologist who practices in Dublin and Westerville and is affiliated with OhioHealth.
Krantz is a strong proponent of vaccinating boys and girls against HPV and talks regularly with his patients about getting the vaccine for their children, he said.
More parents are going ahead with vaccination, and insurance companies increasingly are covering it, he said.
Parents and educators also should be aware of and share with young people the risks associated with oral sex, Krantz said.
“It totally amazes me that these young kids who are having oral sex don’t think that it’s sex."