Experts at congressional briefing on HPV: It's 'time to end cervical cancer'

Experts at a congressional briefing today addressed the need for the U.S. to actively pursue the goal of eradicating HPV and its associated cancers.

"Every 2 minutes, a woman dies of cervical cancer,” keynote speaker Anna R. Giuliano, PhD, founding director of the Center for Immunization and Infection Research in Cancer at Moffitt Cancer Center, said during the briefing. “This is a completely preventable cancer. That means that every 2 minutes, a woman dies of something she doesn’t need to die of.”

A panel of experts at the briefing — sponsored by American Association for Cancer Research, Moffitt Cancer Center and Biden Cancer Initiative — discussed the types of cancers that stem from HPV; the available, but underused, HPV vaccine; and the impact of the ACA’s Medicaid expansion on HPV vaccination uptake.

In 2017, only 53.1% of girls and 44.3% of boys in the U.S. completed the vaccine series.

Every year, more than 33,000 HPV-related cancers are diagnosed among men and women in the U.S, including 12,000 diagnoses of cervical cancer.

By 2040, approximately 500,000 women are predicted to die of cervical cancer each year due to the growing global burden of the disease.

“HPV is an equal-opportunity virus; all of us sitting in this room have been exposed to HPV, and at some point, we will be infected with it,” Guiliano said. “What we don’t know is who among us will develop these cancers, but this is the first cancer we can actually cure.”

‘We can do something about it’

U.S. Rep. Kathy Castor, of the 14th District of Florida, also stressed the importance of HPV vaccination. As a resident of the state with the lowest HPV vaccine uptake in the country, Castor has taken up cervical cancer elimination as a personal and political cause.

“One of the reasons we began having an HPV awareness campaign in the Tampa Bay area a few years back is because, yes, I did see that the uptake in Florida was very low, but also because I was a young mom with two daughters. Back then, the HPV vaccine was three doses, and I dropped the ball and missed one of the doses they were supposed to have,” Castor said. “I work on health policy; I should make sure my daughters are getting the HPV vaccine.”

Castor realized that compared with many parents in the U.S., she was lucky to be able to afford and obtain basic medical care for her children.

“I couldn’t believe I missed that dose, with every blessing I have in my life and all the knowledge I have,” she said. “It’s not easy, and for a lot of working families who don’t have access to routine health care, there are barriers. It’s a terrible thing, that if you don’t get a vaccine, you could be diagnosed one day with cervical cancer.”

Castor said this realization motivated her to use her influence as a congresswoman to bring HPV into the spotlight. Additionally, bills have been introduced in the Florida Senate (SB 357) and House (HB 245) that would make HPV vaccinations part of school immunization requirements. Currently, only Washington, D.C., Rhode Island and Virginia have such laws in place.

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“The nice thing about being a member of Congress is that we can do something about it, and we did,” she said. “We’re not going to stop there. We’re going to marshal all of the resources, all of the tools we have at our disposal to eliminate these cancers and save lives.”

Getting to ‘near zero’

During her talk, Giuliano noted that although cervical cancer is the most well-known HPV-related cancer, there are six of these cancers, affecting both women and men.

“One I’d like to highlight is a subset of head and neck cancers that affect the base of the tongue and tonsils, or throat cancers, 80% of which are caused by HPV,” she said. “This is a cancer that mainly affects men.”

In terms of U.S. data on the effectiveness of screening and treatment in HPV-related cancers, she said although the country has been very effective in controlling cervical cancer, the incidence is not yet near zero.

“However, what we’ve seen is a significant increase in oropharyngeal cancers in men in this country,” she said. “In fact, that increase has been so dramatic that in the last 15 years, there has been a doubling of men diagnosed with HPV-related oropharyngeal cancer in the U.S. alone.”

Although the control of cervical cancer in the United States has been encouraging, the true goal is to eliminate these diseases altogether, she said.

“When we use the words ‘control’ and ‘eliminate,’ I want to make sure we’re all on the same page,” she said. “Control is reducing cancer incidence to an acceptable level. Elimination means getting to near zero of that disease, and that’s what we are trying to achieve."

Given the fact that curing cancer has long been a major goal for all of medicine, Giuliano said now is the time to focus on cancers that can be eradicated.

“This is the one opportunity we have to actually see a cancer disappear; what will that take?” she said. “It will take adding the vaccine to U.S. programs of screening and treatment that we currently have. By adding the vaccination, we can ... really get to that word we really care about, which is ‘eliminate.’”

Giuliano said the scientific community believes so strongly that this goal is in sight that the new WHO director-general, Tedros Adhanom Ghebreyesus, PhD, last year stated that it is “time to end cervical cancer.”

“He made a call to all communities in the world to join forces and make it a reality. Here in the U.S., all NCI-designated cancer centers have said, ‘we agree,’” she said. “The call to action is for the United States to get on board. We have the tools and the knowledge to achieve this. There are several countries who have already decided that they are going to be the first to end cervical cancer. Should we be the first?” – by Jennifer Byrne

Disclosures: HemOnc Today could not confirm the panelists’ relevant financial disclosures at the time of reporting.