Despite rise of HPV-caused cancers, many still not vaccinating

Lee Haugen, a 65-year-old Olympia resident, was startled last March when he discovered a lump on his neck. He soon learned that he had tongue cancer which had spread to his lymph nodes.

"I had no idea I had cancer," Haugen says. "I felt fine."

But what surprised Haugen the most was that his cancer was caused by human papillomavirus (HPV), the most common sexually transmitted infection in the United States. Before he was diagnosed, Haugen had believed HPV could only lead to cancer in women.

"I had only heard of it causing cervical cancer," Haugen says.

Haugen's is just one of a growing number of cancer cases believed to be caused by HPV. The Centers for Disease Control and Prevention (CDC) has recommended the HPV vaccine for all children starting at age 11 to prevent them from developing cancers like Haugen's later in life. But the majority of parents in this country are not getting their children vaccinated while HPV-related cancers continue to rise, the CDC reports.

Dr. Denise Galloway, interim director of the Human Biology Division at Fred Hutchinson Cancer Research Center, has been studying HPV for 35 years. She believes many parents aren't vaccinating their kids for HPV during early adolescence because they don't know that the vaccine is most effective when given before a patient has had sex.

"Parents say 'My child is not sexually active,' or believe they are a long way away from that," Galloway says.

Other parents are concerned about the cost of the vaccine, Galloway says. While it is covered by many insurance plans, the CDC reported in July 2012 that the retail price of the vaccine is about $130 per dose, or $390 for the full series. The CDC reports that vaccination rates tend to be lower among those living in poverty.

Galloway has also spoken to parents who believe vaccinations are not safe, despite the fact that the HPV vaccine has been proven not to be harmful.

The HPV vaccine has received criticism from parents who believe it will encourage sexual behavior, though Galloway says there is no research to back up this claim.

"If you have a cholera vaccine it doesn't make you more likely to drink from the sewer," Dr. Galloway says.

The CDC reports only 40 percent of girls in Washington State, ages 13 to 17, received all three recommended doses of the vaccine in 2011. While Washington is one of the most vaccinated states in the country, it falls short of the U.S. Government's Healthy People 2020 target of 80 percent for complete vaccination among girls ages 13 through 15.

National vaccination rates are also much lower than those reported in Canada (50-85 percent) and the United Kingdom and Australia combined (greater than 70 percent), according to ACS.

Some adolescents (26 percent of girls, ages 13 to 17, in Washington in 2011) receive at least one injection of the HPV vaccine but do not get all three of the recommended does.

"You need multiple doses so that your immune system can better recognize and respond to the virus," Galloway says.

Vaccination rates are especially low among boys. The CDC initially recommended the HPV vaccine only to girls in 2006, but included boys in 2009. Still, only 8.9 percent of males in Washington, ages 13 to 17, received the HPV vaccine in 2011, according to the CDC.

"The uptake of the vaccine in this country is very disappointing, especially among boys," Galloway says. "What parent wouldn't want to protect their child against a cancer?"

Marianne Wood, a Seattle mother of five, had her four daughters vaccinated for HPV when they were in their teens and early 20s.

"It was a pretty easy decision," Wood said. "I was going to do anything that I could to protect them."

But when a doctor recommended Wood vaccinate her teenage son she decide against it.

"I just didn't feel it was necessary," she said.

Galloway says boys should get vaccinated to decrease the spread of HPV to others and to protect themselves. Of the nearly 35,000 cases of HPV-related cancer reported in the United States in 2009, 39 percent were men. While it is most commonly associated with cervical cancer, HPV can also lead to cancers of the throat, tongue, tonsils, anus, penis, vagina and vulva.

After six weeks of radiation therapy and seven weeks of chemotherapy, Haugen is now cancer free. Though he never thought about getting an HPV vaccine before, he urges young people to do so.

"I would say get it, because you don't know what kind of cancer you can end up with."

The CDC recommends the HPV vaccine for women through age 26 and men through age 21 who did not get all three doses of the vaccine when they were younger. The vaccine is also recommended for gay and bisexual men and men with compromised immune systems through age 26.

While Dr. Galloway says it is not likely be cost-effective to vaccinate all ages, all patients should talk to their doctor about getting vaccinated and be judged on a case by case basis. Even for patients who have been sexually active, the virus can still offer some protection, Galloway says.

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