New Insights into HPV Screenings and Vaccine Recommendations

Multiple new studies, which attempt to explore new techniques and recent trends of diagnosing and treating the human papillomavirus (HPV), were released in early 2014. The first study, published in light of new data indicating that only small percentages of young girls receive the vaccine despite support for universal vaccination in the medical community, investigates the role physicians’ recommendations play in the prevalence of vaccination, or lack thereof, in that population. Other studies released review the effectiveness of newly available at-home HPV screenings and compares those tests to clinician screening. In light of these new studies, perhaps recent calls for more widespread attempts at preventing and screening for HPV, the leading cause of cervical cancer, will be answered.

HPV Data

According to the CDC, HPV is the most common type of sexually transmitted infection and approximately 79 million Americans are infected with the virus. An additional 14 million become infected each year. In fact, the CDC estimates that “HPV is so common that nearly all sexually active men and women will get at least one type of HPV at some point in their lives.” Further, CDC reviews have found that 70 percent of cervical cancers worldwide are attributable to HPV types 16 and 18. HPV can also cause genital warts and other types of cancers such as vulvar, vaginal, penile, anal, and oropharyngeal. In 2006, an HPV vaccination was licensed for use in the United States for females ages 9 to 26 years, and in 2006 the same vaccination was approved for use on males ages 9 to 26 in the country.

AAP Recommendations

Due to its widespread rates of infection and potential for various serious health problems, the American Academy of Pediatrics (AAP), as of March 2012, began officially recommending routine HPV vaccinations for both males and females at 11 to 12 years of age. This recommendation was based on the finding that HPV vaccinations are most effective if administered before the “onset of sexual activity,” and because antibody responses to the vaccine were found to be highest for those between the ages of 9 and 15. In 2013, the AAP renewed its support of vaccinations of children in the 11th and 12th year in response to the CDC’s report of “low, stagnating vaccination rates.”

Increasing Physician Recommended Vaccinations

A Moffitt Cancer Center study in early 2014 highlighted the role that physician recommendations for vaccination can play in increasing vaccinations rates overall. The study, published by the Journal of Preventative Medicine, found that despite recommendations of universal or routine vaccinations such as the AAP’s suggestions, individual physician recommendations for vaccinations of female patients ages 11 or 12 only increased moderately in a two-year period. Further, recommendations for other age groups were described as “suboptimal”,  as those rates showed no significant increase in the reviewed period. According to infectioncontroltoday.com, the study identified a number of factors that contributed to the likelihood that a physician would recommend a vaccination for a pre-adolescent female including the age of the physician, as younger doctors were found to be more likely to make the HPV vaccination recommendation than older doctors. Additionally, pediatricians and obstetricians or gynecologists were more likely to recommend vaccination than family doctors.

HPV Self-Screening

The Lancet Oncology published another HPV-related analysis this year that compared the effectiveness of HPV self-screening with those screens performed by a clinician. While the study began with the assertion that clinical HPV screening is more effective than cervical cancer screening through pap smears, the authors conducted the investigation to explore the accuracy of screens using “self-taken” samples by patients at home. Although the study’s findings suggest samples taken by clinicians are more desirable, it also supports the increased use of at-home self-screenings as an “additional strategy to reach women not participating in” traditional clinical screenings. A similar study released last year by Queen Mary University of London identified the same types of results, that “large-scale HPV screening can be successfully implemented by home testing.” The analysis found that this type of approach to the identification and prevention of the spread of HPV to be particularly suitable for low-income populations.