The Growing Epidemic of HPV-Positive Oropharyngeal Carcinoma
The Growing Epidemic of HPV-Positive Oropharyngeal Carcinoma
The sharply increasing prevalence of HPV+ OPSCC further establishes the importance of vaccination against HPV in all eligible patients, both male and female. Two vaccines against HPV are currently available: one that targets HPV-16 and -18 (Cervarix; GlaxoSmithKline) and one that targets HPV-6, -11, -16, and -18 (Gardasil; Merck Sharp & Dohme Corp.). HPV+ OPSCC is most often caused by HPV-16 and infrequently by HPV-18; thus both vaccines are effective in preventing oral transmission of the cancer-causing virus. HPV-6 and -11 are most often implicated in benign warts in the anogenital area. While the specific effect of HPV vaccination on HPV+ OPSCC itself has not been evaluated yet, the currently available HPV-16/-18 vaccine has recently been found to be even more efficacious against oral HPV infection (vaccine efficacy, 93.3%; 95% CI, 62.5–99.7%) than against cervical HPV infection (vaccine efficacy, 72.0%; 95% CI, 63.0–79.1%) in a randomized trial of young women in Costa Rica. This efficacy is likely to also be observed in men. In a 2008 analysis of the cost-effectiveness of routine HPV vaccination of 12-year-old girls, the cost per quality-adjusted life-year was $3,906 when cervical, anal, vaginal, vulvar, and oropharyngeal cancers, as well as herd immunity effects, were considered. As a comparison, in a 2006 study the cost per quality-adjusted life-year for vaccinating adults aged 50 to 64 years against influenza was $28,044. Vaccination against high-risk HPV types is crucial in preventing these devastating cancers in the future. The HPV vaccine is recommended for children and adolescents aged 9 to 26 years, and parents should be counseled with regard to its cancer-preventing potential. The current cost is approximately $360, which is covered through most public and private insurances.
Vaccination
The sharply increasing prevalence of HPV+ OPSCC further establishes the importance of vaccination against HPV in all eligible patients, both male and female. Two vaccines against HPV are currently available: one that targets HPV-16 and -18 (Cervarix; GlaxoSmithKline) and one that targets HPV-6, -11, -16, and -18 (Gardasil; Merck Sharp & Dohme Corp.). HPV+ OPSCC is most often caused by HPV-16 and infrequently by HPV-18; thus both vaccines are effective in preventing oral transmission of the cancer-causing virus. HPV-6 and -11 are most often implicated in benign warts in the anogenital area. While the specific effect of HPV vaccination on HPV+ OPSCC itself has not been evaluated yet, the currently available HPV-16/-18 vaccine has recently been found to be even more efficacious against oral HPV infection (vaccine efficacy, 93.3%; 95% CI, 62.5–99.7%) than against cervical HPV infection (vaccine efficacy, 72.0%; 95% CI, 63.0–79.1%) in a randomized trial of young women in Costa Rica. This efficacy is likely to also be observed in men. In a 2008 analysis of the cost-effectiveness of routine HPV vaccination of 12-year-old girls, the cost per quality-adjusted life-year was $3,906 when cervical, anal, vaginal, vulvar, and oropharyngeal cancers, as well as herd immunity effects, were considered. As a comparison, in a 2006 study the cost per quality-adjusted life-year for vaccinating adults aged 50 to 64 years against influenza was $28,044. Vaccination against high-risk HPV types is crucial in preventing these devastating cancers in the future. The HPV vaccine is recommended for children and adolescents aged 9 to 26 years, and parents should be counseled with regard to its cancer-preventing potential. The current cost is approximately $360, which is covered through most public and private insurances.
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