Nursing Made Incredibly Easy!:
Department: Ask an Expert
Bobby Griffin is a Clinical Nurse at Portland Veterans Medical Center in Portland, Ore. Diane Kelton is a Nurse Manager at Alvin C. York VA Medical Center in Murfreesboro, Tenn. Charlotte Davis is a CCU/CVICU Clinical Nurse at Heritage Medical Center in Shelbyville, Tenn., and a Clinical Nurse/Charge Nurse/CCRN Review Program Coordinator at Alvin C. York VA Medical Center in Murfreesboro, Tenn. She is also a Nursing made Incredibly Easy! Editorial Advisory Board Member. Lisa Lockhart is a Nurse Manager, Specialty Clinics, at Alvin C. York VA Medical Center in Murfreesboro, Tenn.
The authors have disclosed that they have no financial relationships related to this article.
A: Human papillomavirus (HPV) is the most common sexually transmitted viral pathogen, affecting both men and women. According to the CDC, 6 million new cases of HPV were reported in 2013; there are currently 20 million Americans infected with HPV.
Recent research has linked HPV exposure to an increased risk of cancer. According to the National Institutes of Health, there are more than 150 strains of HPV; however, only 30 strains place the patient at increased risk for cancer. HPV 16 DNA is the most common strain responsible for vaginal, vulvar, cervical, penile, and anal cancer biopsy results. HPV 16 and HPV 18 are currently responsible for approximately 70% of all newly diagnosed cervical cancers. Recent research has also linked the HPV 16 strain to an increased risk of oropharyngeal cancer.
An average of 33,369—or 10.8 cases per 100,000—people are diagnosed with HPV-associated cancers each year in the United States. This includes 12,080 men (8.1 per 100,000) and 21,290 women (13.2 per 100,000). The CDC estimated that approximately 26,000 new cancers attributable to HPV occurred in 2013, including 18,000 among women and 8,000 among men. Population-based cancer registries are important surveillance tools to measure the impact of public health interventions, such as vaccination and screening, on cancer rates.
Despite the growing prevalence of HPV, there are preventive measures that can reduce the risk of infection. The CDC recommends increased public health education on safe sex techniques, vaccination, cervical cancer screening, and symptom recognition. Currently, there are two HPV vaccines approved by the FDA: bivalent to treat HPV 16 and quadrivalent to treat HPV 18. Although the bivalent vaccine can provide immunity to strains 16 and 18, the quadrivalent vaccine can provide immunity against strains 6, 11, 16, and 18.
The bivalent vaccine is approved for girls and women between ages 9 and 25 to protect against cervical cancer. The quadrivalent vaccine is recommended for girls and women ages 9 to 26 to protect against the development of cervical cancer and genital warts. It's also approved for boys and men ages 9 to 26 to protect against genital warts. These vaccines don't provide immunity against the other strains of HPV.
Although there are concerns about the HPV vaccination being linked to increased cancer risk, the benefits far outweigh the risks. The CDC recommends that all boys and girls ages 11 to 12 be routinely vaccinated with a three-dose series; either bivalent or quadrivalent for girls and only quadrivalent for boys. HPV vaccination is also recommended for women up to age 26 and men up to age 21 who haven't completed or begun a three-dose series. In addition, vaccination is recommended for men ages 22 to 26 who have sex with men or are immunocompromised as a result of infection, disease, or medication. Ideally, the vaccine should be administered before potential exposure to HPV through sexual contact.
Parents should openly discuss their concerns and questions with the healthcare practitioner to ensure they make the correct decision for their child when contemplating HPV vaccination. Currently, the CDC strongly recommends that children be vaccinated to reduce their risk of vaginal, vulvar, cervical, penile, and anal cancer.
By improving patient education, we can increase the knowledge base on the benefits of HPV vaccination to reduce the risk of cancer. To read more about HPV, visit http://www.cdc.gov/hpv.
Learn more about it
Palefsky JM, Cranston RD.Virology of human papillomavirus infections and the link to cancer. UpToDate. 2014. http://www.uptodate.com
Saslow D, Solomon D, Lawson HW, et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. Am J Clin Pathol. 2012;137(4):516–542.