Prevention of mouth cancer and throat cancer. Prevention of HPV-related penile cancer and anal cancer. 13
Oropharyngeal cancers, cancer of the tongue, cancer of the mouth, cancer of larynx and pharynx have increased over the last 20 to 30 years. Dr. Anton Titov, MD. Oral cancers are caused also by HPV, human papilloma virus. It is the same virus that causes cervical cancer. Dr. Anton Titov, MD. There is a recent progress in HPV vaccinations. There is a progress in testing for cervical cancer. There is a better availability of HPV vaccine in women. Dr. Anton Titov, MD. What can be done to prevent oropharyngeal cancers? How can we prevent cancer of the tongue and cancer of larynx and pharynx, especially in men? Dr. Jack Cuzick, PhD. It is absolutely true that a large proportion of the oropharyngeal cancers and base of the tongue cancers are HPV-related. HPV vaccine should prevent those cancers. There are several reasons why we cannot be absolutely certain about that. For cervix cancer we have a method of detecting the precursor cancer lesions. We can see that you can eradicate the precursor lesions in cervical cancer. Then you are pretty certain that we are going to be eradicating cervical cancer. Although at this stage we do not have direct proof, even in the cervix, that we are preventing cancer. Although it’s almost certain. Because we are preventing a precursor lesion to cervical cancer. We understand it very well. Dr. Jack Cuzick, PhD. For head and neck cancers, we don’t have a precursor lesion. These cancers are not going to show up until age 50 or 60. Therefore, it’s going to take a long time to assess HPV vaccine results in cancer of larynx or cancer of pharynx. But it does raise important questions about vaccinating against HPV not only girls but boys. Certainly the genital warts problem is more common in boys than in girls. There is a major benefit of HPV vaccination at a young age. But there are other cancers, head and neck cancers, oropharynx cancer are the most common. There are also penile cancers. There some anal cancers that are also HPV-related. Those cancers should also benefit from eradication of HPV by vaccination. In fact, the cancer protection effect should be even larger. Dr. Jack Cuzick, PhD. Because the majority of those cancers are related to HPV type 16. But cervix cancer is more related to a range of different HPV types. So vaccination could be more targeted with type 16 HPV vaccine. Yes. Although the sensible thing would be to use the broad-spectrum HPV vaccine. Sometimes you want to prevent genital warts. You need to vaccinate against HPV type 6 and HPV type 11. You want to prevent other cancers. They are mostly HPV type 16, and a little bit HPV type 18. But you should just use one HPV vaccine for everybody. Dr. Anton Titov, MD. That would work for prevention of oropharyngeal cancers. Yes.
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